Kroni̇k Böbrek Hastalığı Olan Yaşlılarda Demans, Deli̇ryum Ve Depresyon
Esra Ateş Bulut, Ahmet Turan IşıkKronik böbrek hastalığı (KBH), bilişsel yetmezlik ve duygusal değişikliklere sıklıkla yol açmaktadır. Ancak; KBH ile sinir sistemi arasındaki etkileşimin altında yatan mekanizmalar tam olarak anlaşılamamıştır. KBH bilişsel bozukluk için ileri yaş ile birlikte en güçlü risk faktörlerinden biridir. Bilişsel bozukluğun gelişiminde vasküler faktörler, üremik toksinler, inflamasyon, oksidatif stres gibi faktörler suçlanmaktadır. Bununla birlikte; depresyon erken dönemde demans özellikleriyle ortaya çikabilir, demans deliryuma zemin hazirlayabilir ve deliryum yaklaşmakta olan demansin habercisi olabilir. Her üç durum, KBH hastalarında yeterince tanınıp tedavi edilmemektedir. Bu nedenle, ileri yaştaki hastalara en uygun yaklaşım ayrıntılı geriatrik değerlendirme uygulamaktır. KBH’lı hastalarda gerek santral sinir sistemindeki değişiklikleri önlemek gerekse tedavi hedeflerinin belirlenmesi için daha ileri çalışmalara ihtiyaç vardır.
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