Geriatrik Nefroloji

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DOI :10.26650/B/CH12CH47.2023.014.24   IUP :10.26650/B/CH12CH47.2023.014.24    Full Text (PDF)

Kroni̇k Böbrek Hastalığı Olan Yaşlılarda Anemi̇ Ve Yöneti̇mi̇

Zeynep Ural, Ülver Derici

Yaşlı toplumda anemi görülme sıklığı oldukça yüksek olup bunun büyük kısmının kronik böbrek hastalığı ile ilişkili olduğu bulunmuştur. Anemi kronik böbrek hastalığının en önemli komplikasyonlarından biridir ve prevalansı glomerüler filtrasyon değeri azaldıkça artmaktadır. Kronik böbrek hastalığı (KBH) olan yaşlılarda aneminin en sık nedenleri eritropoetin eksikliği ve demir eksikliğidir. Yorgunluk, depresyon, egzersiz intoleransı ve nefes darlığı gibi böbrek hastalığı ile ilişkili birçok semptomun asıl nedenini oluşturmaktadır ve tedavi edilmediği durumlarda mortalite artışına neden olmaktadır. Bu nedenle tedavisi hayati önem taşımaktadır. Kronik böbrek hastalığı olan yaşlı hastalarda eritropoetin tedavisine başlamadan önce demir eksikliği ve inflamatuar durumlar dahil olmak üzere tüm düzeltilebilir nedenler araştırılmalı ve tedavi edilmelidir. Diğer nedenler tedavi edildikten sonra Kronik böbrek hastalığı ilişkili anemide idame demir tedavisi ile birlikte hemoglobin değeri <10 g/dl olduğunda eritropoezi stimüle eden ajanlar (ESA) ile tedaviye başlanmalı ve hedef hemoglobin değeri 11.5 g/dl’yi geçmemelidir. 



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