Follow-Up and Community Care of the Child With a Chronic Disease

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DOI :10.26650/B/CH32.2024.010.029   IUP :10.26650/B/CH32.2024.010.029    Full Text (PDF)

Follow-up and Community Care of the Child with Chronic Kidney Disease

Bağdagül Aksu, Ahmet Nevzat Nayır

Chronic kidney disease (CKD) is defined as a glomerular filtration rate (GFR) below 60 mL/min/1.73 m² for three months or longer or the presence of kidney damage that persists for three months or longer, even if GFR is  above 60 mL/min/1.73 m². Children with end-stage CKD are treated with renal replacement therapies (RRT) such as kidney transplantation, hemodialysis, or peritoneal dialysis. As the stage of CKD rises in children, complications such as fluid-electrolyte disorders, growth retardation, anemia, mineral and bone disorders, or increased cardiovascular risk may develop, therefore requiring close monitoring. To reduce or stop the progression of CKD, these patients should undergo routine follow-up and receive immunizations. In children undergoing dialysis, hepatitis serology should be checked every six months, and hepatitis B vaccine should be administered according to their antibody level. The vaccination must be completed at least 4 weeks before kidney transplantation. Children with CKD should be evaluated in terms of their relationship with the school, family, and peers. Children should also undergo medical follow-up and treatment to obtain the necessary support in order to adapt to social life. In this section, the principles and justifications for the follow-up of children with CKD in the community are discussed.


Keywords: Hypertension, chronic kidney disease, dialysis, transplantation, follow-up
DOI :10.26650/B/CH32.2024.010.029   IUP :10.26650/B/CH32.2024.010.029    Full Text (PDF)

Kroni̇k Böbrek Hastalığı Olan Çocuğun İzlemi̇ ve Toplumda Bakımı

Bağdagül Aksu, Ahmet Nevzat Nayır

Kronik böbrek hastalığı (KBH), glomerüler filtrasyon hızının (GFH) üç ay veya daha uzun süre 60 mL/dk/1,73 m²’nin altında seyretmesi veya GFH 60 mL/dk/1,73 m²’nin üstünde olsa bile üç ay veya daha uzun süre devam eden böbrek hasarının varlığı olarak tanımlanır. KBH olan çocuklar için, KBH son evreye ilerlediğinde böbrek nakli, hemodiyaliz veya periton diyalizi gibi renal replasman tedavilerinden (RRT) birisi tercih edilir. KBH’nın evresi ilerledikçe çocuklarda sıvı-elektrolit bozuklukları, büyümede gerileme, anemi, mineral ve kemik bozuklukları veya artmış kardiyovasküler risk gibi komplikasyonlar gelişebilir. Hastalığın evresi ilerledikçe gelişebilecek bu komplikasyonlar açısından KBH olan çocuklar, yakın izlenmeli ve hastalığın ilerlemesini azaltmaya veya durdurmaya yönelik tüm önlemler alınmalıdır. Bununla beraber bu çocukların rutin çocuk sağlığı izlemleri mutlaka devam etmelidir. Tüm KBH olan çocuklara çocukluk çağı aşıları eksiksiz olarak uygulanmalıdır. Diyalize giren tüm çocukların altı ayda bir hepatit serolojilerine bakılmalı ve antikor düzeyine göre gerekiyorsa Hepatit B aşısı yapılmalıdır. Böbrek nakli yapılması planlanıyorsa nakilden en az 4 hafta önce aşılamanın tamamlanmış olması gereklidir. Bu çocuklar, medikal takip ve tedavilerin yanında okul, aile ve arkadaşlık ilişkileri açısından da değerlendirilmeli ve sosyal hayata adapte olabilmeleri için gerekli destek sağlanmalıdır. Bu bölümde KBH olan çocukların toplumda izlemi prensiplerinin ve gerekçelerinin anlatılması amaçlanmıştır.


Keywords: Hipertansiyon, kronik böbrek hastalığı, diyaliz, nakil, takip

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