Geriatrik Nefroloji

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DOI :10.26650/B/CH12CH47.2023.014.06   IUP :10.26650/B/CH12CH47.2023.014.06    Full Text (PDF)

Geri̇atri̇k Vakalarda Noktüri̇ Ve Noktürnal Poli̇üri̇

Sümeyra Koyuncu, Bülent Tokgöz

Yaşlanmayla birlikte üriner sistem anatomi ve işlevlerinde meydana gelen değişiklikler poliüri, noktüri ve noktürnal poliüri gibi işeme bozukluklarına yol açabilir. Poliüri, noktüri ve noktürnal poliüri iç-içe geçen kavramlardır. Tanım olarak poliüri, günlük idrar hacminin günde 40 ml/kg vücut ağırlığı veya 2800 ml’yi aşmasıdır. Normal fizyolojik koşullarda gece idrar miktarı azalması gerekirken, toplam idrar çıkışının %33’ünden fazlasının gece saatlerine denk gelmesine noktürnal poliüri denir. Gece uykusunun idrara çıkmak için birden çok kez bölünmesi noktüri olarak isimlendirilir.1 Yaşlılarda noktüri, mortalite ve morbiditede artışla ilişkili bulunmuştur.2,3 Yaşlılarda noktüriye ve noktürnal poliüriye yol açan sebepler, sırasıyla, Tablo 1 ve Tablo 2’de belirtilmiştir. Poliüri ve noktürnal poliürinin kesişim noktasında yer alan noktüri, halen en sık rastlanan alt üriner sistem semptomu olma özelliğini korumaktadır.4,5 Noktüri uyku kalitesinin bozulmasıyla birlikte depresyon oranlarında artış, fiziksel ve zihinsel sağlıkta bozulma ve yaş ilerledikçe düşme oranlarının artmasıyla birlikte kırık riskinin de artmasına neden olmaktadır.2,3 Genel olarak 60 yaş üstü kişilerde, 40-50 yaşlara göre 4 kat daha sık görülür. Erken yaşlarda kadınlarla daha sık görülürken, ilerleyen yaşlarda her iki cinste de sıklığı yükselir.6 Genç̧ kadınlarda noktüri sıklığı %4.4 -18 aralığındayken yaşlı kadınlarda bu oran %28.3-61.5 aralığındadır. Erkeklerdeyse, genç yaşlarda %2-16.6 ve yaş- lılarda %29-59.3 aralığında tespit edilmektedir.7



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