Transplantacija bubrega u osoba starije životne dobi

master's thesis

• Title (english): Kidney transplantation in the eldery
• Author: Krunoslav Leskovar
• Mentor: Nikolina Bašić Jukić (mentor)
• Committee member: Marko Jakopović (predsjednik povjerenstva)
• Committee member: Tvrtko Hudolin (član povjerenstva)
• Committee member: Nikolina Bašić Jukić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2017-09-28, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Kronična bubrežna bolest (KBB) u svom terminalnom stadiju zahtjeva jedno od modaliteta nadomještanja bubrežne funkcije. Postoje tri osnovne opcije nadomještanja bubrežne funkcije (NBF): hemodijaliza, peritonealna dijaliza i transplantacija bubrega. Iako povijesno najmlađa, transplantacija bubrega se nametnula kao opcija kojom se bolesnik s KBB na najbolji mogući način vraća u svoju obiteljsku i društvenu zajednicu. Osobe starije životne dobi zauzimaju sve veći udio u ukupnoj populaciji pa stoga i KBB kao velik javnozdravstveni problem najvećim dijelom pogađa upravo stariju životnu dob. Bolesnicima starije životne dobi s KBB kao potencijalnim kandidatima za transplantaciju bubrega potrebno je pristupiti s određenim oprezom i proširenjem same prijetransplantacijske obrade zbog česte prisutnosti komorbiditeta kao i skraćenog očekivanog trajanja života.
Glavni cilj istraživanja je utvrditi kvalitetu transplantacijskog programa Centra za dijalizu Opće bolnice Varaždin kao i udio bolesnika starije životne dobi u ukupnom broju transplantiranih. Nadalje utvrđivanje preživljavanja transplantiranih starije životne dobi kao i dobrobiti transplantacije kao opcije nadomještanja bubrežne funkcije.
Istraživanje je provedeno retrospektivnom analizom desetogodišnjeg perioda (2007.-2016.) u kojem je obuhvaćeno 69 transplantiranih bolesnika od kojih je 9 bolesnika starije životne dobi. Istraživanje je pokazalo veću zastupljenost (83%) bolesnika muškog spola. Povećanje udjela transplantiranih bolesnika (45%) u 2017. godini, u ukupnom broju bolesnika s kroničnom bubrežnom bolesti kojima je potrebno NBF govori u prilog kvalitetnom transplantacijskom programu i sve većem zbrinjavanju kroničnih bubrežnih bolesnika upravo transplantacijom. Bolesnici s transplantiranim bubregom starije životne dobi imaju 100% jednogodišnje preživljavanje i dobro su prihvatili transplantaciju kao izbor nadomještanja bubrežne funkcije. Najstariji bolesnik je transplantiran u dobi od 77 godina starosti i ima funkcionalan presadak pune četiri godine do zaključenja ovog istraživanja što nam daje najbolji primjer kako transplantacija bubrega u osoba starije životne dobi ne smije biti opterećena predrasudama o starijima kao potencijalnim kandidatima za transplantaciju bubrega.

Abstract (english)

Chronic kidney disease (CKD) in a terminal stage requires one of the modalities of renal replacement therapy (RRT). There are three basic options of RRT: hemodialysis, peritoneal dialysis and kidney transplantation. Although historically the youngest, kidney transplantation has become a feature in which a patient with CKD in the best possible way back to his family and the community. Elderly people occupy an increasing share in the total population, so CKD as a major public health problem mostly affects the older age. Elderly patients with CKD as potential candidates for kidney transplantation need to be accessed with particular caution and by extending pre-transplantation treatment because of the frequent presence of comorbidities and shortened life expectancy.
The main objective of the study was to determine the quality of the Transplantation Program of the General Hospital Varaždin Dialysis Center as well as the proportion of elderly patients in the total number of transplanted patients. Furthermore, survival of transplanted elderly as well as the benefits of transplantation as well as the option of RRT. The research was conducted a retrospective analysis of ten years (2007th-2016th), which included 69 transplant patients, of which 9 elderly. The study showed a higher share (83%) patients were male. Increasing the share of transplant patients (45%) of the total number of patients with chronic kidney disease who require RRT speaks in favor of quality transplantation program and increasing care of chronic renal disease by transplantation. Patients with kidney transplant elderly have a 100% one-year survival and well accepted as a transplant choice of RRT. The oldest patient was transplanted at the age of 77 years old and has a functional graft for four years until the conclusion of the study which gives us the best example of how kidney transplantation in the elderly should not be burdened with prejudices about older people as potential candidates for a kidney transplant.

• Keywords: transplantacija; starija životna dob; kronična bubrežna bolest
• Keywords (english): transplantation; older age; chronic kidney disease
• Language: croatian
• URN:NBN: urn:nbn:hr:105:108189
• Study programme: Title: Studies in Nursing; Study programme type: university; Study level: graduate; Academic / professional title: magistar/magistra sestrinstva (magistar/magistra sestrinstva)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2018-03-19 12:32:16