Poremećaji koagulacije u bolesnika s kroničnom bubrežnom bolesti

master's thesis

• Title (english): Coagulation disorders in patients with chronic kidney disease
• Author: Antonio Skalnik
• Mentor: Eleonora Goluža (mentor)
• Committee member: Nikolina Bašić Jukić (predsjednik povjerenstva)
• Committee member: Dinko Tonković (član povjerenstva)
• Committee member: Eleonora Goluža (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities); Zagreb
• Defense date and country: 2023-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Anesthesiology and Reanimatology

Abstract

Kronična bubrežna bolest jedan je od najčešćih uzroka mortaliteta i morbiditeta u današnjem svijetu. Zbog porasta prevalencije rizičnih čimbenika poput dijabetesa, arterijske hipertenzije, pretilosti procjenjuje se da danas preko 800 milijuna ljudi boluje od kronične bubrežne bolesti. To je progresivno stanje u kojem bubrezi postepeno gube svoju funkciju. Osim slabljenjem bubrežne funkcije, kronična bubrežna bolest može se očitovati brojnim sistemskim učincima poput anemije, koštano-mineralne bolesti bubrega, kardiovaskularnim poremećajima i poremećajima koagulacije. Pacijenti s kroničnom bubrežnom bolesti pokazuju kompleksne promjene u faktorima koagulacije i fibrinolize, što može dovesti do komplikacija poput tromboze, embolije ili pak pojačane sklonosti krvarenju. Povećana aktivacija trombocita, visoke razine fibrinogena i promjene u koagulacijskim faktorima neki su od mehanizama koji pridonose povećanoj koagulabilnosti kod pacijenata s kroničnom bubrežnom bolesti. S druge strane, poremećaji u broju i funkciji trombocita te smanjenje koagulacijskih faktora mogu rezultirati povećanom sklonosti krvarenju. Pacijenti često zahtijevaju antikoagulacijsku terapiju, posebno ako imaju atrijsku fibrilaciju ili duboku vensku trombozu. Međutim, primjena antikoagulacijskih lijekova može dodatno povećati rizik od krvarenja kod ovih pacijenata. Stoga je važno pažljivo procijeniti korist i rizik antikoagulacijske terapije kod svakog pacijenta.

Abstract (english)

Chronic kidney disease is one of the leading causes of mortality and morbidity worldwide. Due to the increasing prevalence of risk factors such as diabetes, arterial hypertension, and obesity, it is estimated that over 800 million people are affected by it today. Chronic kidney disease is a progressive condition characterized by the gradual loss of kidney function. In addition to the impairment of renal function, chronic kidney disease can manifest with various systemic effects such as anemia, renal bone disease, cardiovascular disorders, and coagulation disorders. Patients with chronic kidney disease exhibit complex changes in coagulation and fibrinolysis factors, which can lead to complications such as thrombosis, embolism, or increased bleeding tendency. Increased platelet activation, high levels of fibrinogen, and alterations in coagulation factors are some of the mechanisms contributing to increased coagulability in patients. On the other hand, platelet count and function abnormalities, as well as reduced coagulation factors, can result in an increased bleeding tendency. Patients often require anticoagulation therapy, especially if they have atrial fibrillation or deep vein thrombosis. However, the use of anticoagulant medications can further increase the risk of bleeding in these patients. Therefore, careful assessment of the benefit-risk balance of anticoagulation therapy is crucial for each patient.

• Keywords: kronična bubrežna bolest; hemostaza; poremećaji koagulacije
• Keywords (english): chronic kidney disease; hemostasis; coagulation disorders
• Language: croatian
• URN:NBN: urn:nbn:hr:105:306269
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-10-31 09:16:17