სისხლდენის გამოვლენის ტენდენციები ჰემოდიალიზზე მყოფ პაციენტებში -რეტროსპექტული კვლევა

ანოტაცია

Background: Patients who regularly perform hemodialysis are constantly at high risk of manifesting hemorrhages around the body, especially on the lower limbs (Purpura). In cases of serious conditions, it can be manifested as bleeding from the GI tract, respiratory ways, etc. Bleeding from the GI tract is considered one of the serious complications. We decided to do a small research with the questionnaire, the primary objective of our research was to make statistical data about patients with renal failure in chronic hemodialysis in Georgia, to find out the most vulnerable location of the human body for bleeding, to bring out the average age that is considered as a risk factor in hemodialysis patients, to identify some other chronic diseases except chronic renal failure that are connected to that problem and to give recommendations for the ER surgeons, and physicians to take this problem into account while having a practice with renal failure and hemodialysis patients.

Methods: We created the questionnaire for retrospective research. Totally 300 hemodialysis patients were interviewed. 165 out of them where from the "High technology medical center" which is the biggest dialysis center in Tbilisi and 135 of them were from "Via-Vita Center of Dialysis, Nephrology and Efferent Treatment" The questionnaire included 12 questions, that helped us to analyze data.

Results: Retrospective research clearly showed that the risk of bleeding in patients with hemodialysis is pretty high, about 26%. One of the biggest risk factor is age, hemodialysis patients over 65 years old are more likely to have bleeding from the different parts of organ systems with 25%, especially if the hemodialysis is a new procedure for them and need adaptation or over the 5 years of experience at hemodialysis. Most of the patients who had bleeding in their anamnesis, it was from gastrointestinal tract. It is important to emphasize that most of the interviewed patients who had bleeding in their anamnesis had Diabetes Type 2, gastric ulcer, and heart failure as a chronic disease, so there is a correlation between those diseases and renal failure. It is important to say that there is a high risk of recurrent bleeding. That is why patients and medical professionals must be informed to act carefully E.g., while doing some procedures that can mechanically damage the mucosal tissue etc.

Conclusion: The research showed that hemodialysis patients have a high risk of demonstrating gastrointestinal bleeding, because of the tendency of recurrent manifestation it is necessary to give some recommendations. Patients should have a consultation with a gastroenterologist once a year to have instructions about taking gastroprotectants. It is important to control blood analysis to detect any kind of problem and then have a consultation with a hematologist. Departments like Emergency, and ICU medical professionals must be informed about the supposed risks of performing procedures in those patients that can damage mucosal tissue and cause bleeding. The research showed some really interesting questions that need deep study, which confirms the importance of this kind of research about bleeding in renal failure patients to avoid mortality.