Geriatrik Nefroloji

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DOI :10.26650/B/CH12CH47.2023.014.28   IUP :10.26650/B/CH12CH47.2023.014.28    Full Text (PDF)

Kroni̇k Böbrek Yetmezli̇ği̇ Olan Yaşlı Hastalarda Metaboli̇k Asi̇doz Ve Tedavi̇si̇

Gülay Ulusal Okyay, Mehmet Deniz Aylı

Metabolik asidoz, kronik böbrek hastalığı (KBH)’nın yaygın bir komplikasyonudur ve tüm evrelerinde ortaya çıkabilir. Böbrek hastalığının ilerlemesinin yanısıra kardiyovasküler bozukluklar, kemik ve mineral dengesizlikleri, bilişsel ve fiziksel fonksiyonlarda kayıp gibi yaşlı insanların sağlık öncelikleriyle oldukça bağlantılı bir dizi patofizyolojik düzensizliğe yol açabilir. Yaşlı böbrek hastalarında KBH’nın ilerleme hızı gençlere kıyasla daha düşüktür, ve populasyonun önemli bir kısmı, son dönem böbrek hastalığına ulaşamadan kaybedilmektedir. Bu nedenle ileri yaş grubunda tedavi hedeflerinin öncelikleri farklıdır. Çok sayıda komorbiditenin varlığı ve birçok ilacın halihazırda birlikte kullanılıyor olması, belirlenmiş hedeflere göre düzenlenmiş yönetimi bazı noktalarda komplike hale getirebilir. Kitabın bu bölümünde aşağıdaki alt başlıklar uyarınca KBH hastalarında ortaya çıkan metabolik asidoz ve tedavisi, geriatrik populasyondaki farklılıkları vurgulanarak detaylandırılacaktır;

• Asid - baz homeostazı - böbrek ilişkisine genel bakış ve metabolik asidozun tanısı

• KBH vakalarında ortaya çıkan metabolik asidozun olumsuz sonuçları

• KBH vakalarında ortaya çıkan metabolik asidozun tedavisi



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