Page 6 - renaliz67.indd

Renaliz-67

6 DÜNDEN BUGÜNE PERİTON DİYALİZİ

Prof. Dr. Ayşe BALAT
İstanbul Aydın Üniversitesi Tıp Fakültesi / Çocuk Nefroloji & Romatoloji BD

Diyabete Bağlı Böbrek Hastalığı
Dünden Bugüne Periton Diyalizi
Diyaliz Nedir? • %XUXQ NDQDPDVÖ YFXGXQ ]DUDUOÖ PDGGHOHUGHQ
temizlenmeVL LoLQ ID\GDOÖGÖU

• <DUÖ JHoLUJHQ ELU ]DU DUDFÖOÖùÖ\OD NDQ LOH X\JXQ GL\DOL] VROV\RQX • $WHü RODQ ELULQGH VDùÖUOÖN EXUXQ NDQDPDVÖ YH\D
DUDVÖQGD VÖYÖ-VROW GHùLüLPL WHPHOOL ELU WHGDYL üHNOLGLU LVKDO ROXUVD KDVWDOÖN ELWL\RU GHPHNWLU
'U $\üH %DODW )D]OD RODQ KHU üH\ $UDo $UDFÖ $UÖQPD YH • $FDED NDQÖ fazla RODQ ELU
NLüLGHQ NDQ DOÖS az olan
úVWDQEXO $\GÖQ hQLYHUVLWHVL 7ÖS )DNOWHVL GRùDOD G|Qü ELULQH YHUPHN PPNQ
dRFXN Nefroloji & Romatoloji %LOLP 'DOÖ RODFDN PÖ"
8OXVODUDUDVÖ .DWÖOÖPOÖ dRFXN 1HIURORML .RQJUHVL
1- 0D\ÖV %RGUXP

%|EUHN \HWPH]OLùL Ödem-3DUDVHQWH]
$WHüL ROPD\DQ ELU NLüLGH LüWDKVÖ]OÖN NDOS DùUÖVÖ EDü G|QPHVL
DùÖ]GD DFÖPVÖ WDW YDUVD YFXGXQ WHPL]OHQPH\H LKWL\DFÖ YDUGÖU • +LSRNUDW- Galen; SDUDVHQWH]
hUH • &HOVXV \\ - SHULWRQ NDWHWHUL NXUüXQ-EURQ]
gGHPOL ELU KDVWDQÖQ NDUÖQ GDPDUODUÖQGDNL VX GLUHQH HGLOLUVH • Paul of Aegina \\ - |]HO ELU ELVWUL icat etti
L\LOHüLU« gGHP YH\D DPSL\HP RODQ ELU KDVWD DoÖOGÖùÖQGD LOWLKDS YH\D • $OEXFDVLV EX ELVWUL\L JHOLüWLUGL
VX\XQ KHSVL ELUGHQ ERüDOWÖOÖUVD NHVLQOLNOH |OU« d,.,û <2//$5,
(VNL <XQDQ
%DùÖUVDNODU Oral PHPEUDQODU &LOW DOWÖ GRNXVX
GXGDN HWUDIÖQGD NULVWDO GHSR]LWOHU $EGRPHQ
.|W üH\OHUL DWPDN LoLQ .$1$ 3OHYUD
*LULüLQL HQJHOOHPHN LoLQ $d .$/ Diyare
.DODQÖQÖ DWPDN LoLQ $/77$1-h677(1 d,.$5 'LDPDQGRSRXORV 7 Am J 1HSKURO 1997
'LDPDQGRSRXORV 7 Am J 1HSKURO 1997 ÖDEM

Ödem-3DUDVHQWH] 16.yy- 3DUDFHOFXV- gGHP Periton; « 6WUHWFK Around »
1. 'LUHWLN • 0ÖVÖUOÖODU PXP\DODPD VÖUDVÖQGD Lo
2. Purgatif RUJDQODUÖQ HWUDIÖQÖQ ELU NHVH WDUDIÖQGDQ
.HQGL LGUDUÖQÖ LoPHN ¶·1DVÖO NL \DùPXU oRN \DùDUVD \HU\] VDUÖOGÖùÖQÖ IDUNHWWL
*|EHN DOWÖQGDQ SDUPDN X]DNOÖNWD LQVL]\RQ « ÖVODQÖU ER]XOXU IRQNVL\RQ J|UHPH] KDOH • *DOHQ YH DQWLN oDùÖQ |QGH JHOHQ SHN oRN
gelir. KHNLPL \DUDOÖ JODG\DW|UOHULQ DoÖN NDUQÖQGDNL
¶·«$OWÖQ JPü YH\D EURQ] NDQO \HUOHüWLU +DVWDQÖQ &HQQHWWH RODùDQGÖüÖ ELU \DùÖü ROXUVD SHULWRQX J|]OHPOHGL
QDE]ÖQD EDN ]D\ÖIVD NDQO oÖNDU üDUDS \D GD EH\D] \HU\]QGHNL LQVDQODU GD HWNLOHQLU YH • (UNHQ G|QHPGHNL DQDWRPLVWOHU YH
\XPXUWD\D EDWÖUÖOPÖü ELU SDQVXPDQ \DS +DVWD\Ö \DWÖU EX VX RQODUÖQ LoLQH G|NOU«·· FHUUDKODU SHULWRQHDO PHPEUDQÖQ JHQLüOLùLQL
úEQ-L 6LQD WDYXN VX\X oRUED YH\D NROD\ KD]PHGHFHùL JÖGDODU YHU \]H\OHULQL YH HNOHULQL LVLPOHQGLUGL DQFDN
LüOHYLQGH \D GD LQFH \DSÖVÖQGD D\UÖQWÖ
( 980- JQ SDQVXPDQÖ oÖNDU NDQO \HQLGHQ WDN ELUD] GDKD 3DUDFHOVXV- 1493-1541
ID]OD VX oHN EXQX YH ]HULQGH WHNUDUOD«·· YHUPHGL
«,QWHUPLWDQW Diyaliz» 1550-0ÖVÖU SDSLUVOHUL • +FUHQLQ WDQÖPODQPDVÖQGDQ VRQUD
'LDPDQGRSRXORV 7 Am J 1HSKURO 1997 DQDWRPLVWOHULQ LOJLVLQL oHNPH\H EDüODGÖ«
'LDPDQGRSRXORV 7 Am J 1HSKURO 1997

1743ĺúON SDUDVHQWH] YH SHULWRQHDO ODYDM
• 1854- *UDKDP VÖùÖU PHVDQHVL NXOODQDUDN NROORLGOHULQ YH NULVWDORLGOHULQ • 1862-Von 5HFNOLQJKDXVVHQ LON NH] SHULWRQXQ PDNURVNRELN YH KFUHVHO
D\UÖODELOGLùLQL J|VWHUGL
• “2]PRWLN *oµ RODUDN DGODQGÖUÖODQ ELU VUHFL WDQÖPODGÖ YH ´oHPEHUµ WLSL DQDWRPLVLQL WDQÖPODGÖ ¶·SHULWRQ VHPLSHUPHDEOH ELU PHPEUDQGÖU··
(üLW PLNWDUODUGD ELU GL\DOL]|U JHOLüWLUGL • 1877-G Wegner ;
Burgundy üDUDEÖ + %ULVWRO VX\X • +D\YDQ GRNXVXQXQ PROHNOOHULQ VHoLFL RODUDN JHoHELOGLùL ELU ¶·\DUÖ
JHoLUJHQ ]DU·· RODUDN NXOODQÖODELOHFHùLQL EHOLUWWL 'HùLüLN ÖVÖODUGDNL VÖYÖ SHULWRQD YHULOLQFH YFXW ÖVÖVÖ GHùLüPHNWHGLU
<RùXQ GHNVWUR] JOLVHULQ YHULOLQFH SHULWRQGDQ JHOHQ VÖYÖ DUWPDNWDGÖU LON 8)
7ROHUDQV N|W DVLW
ROXüXPXQGD azalma 'Öü GQ\D LOH YFXW DUDVÖQGD \DUÖ JHoLUJHQ ELU ]DU YDUGÖU • 1894-6WDUOLQJ YH 7XEE\; 3HULWRQ YH SOHYUDGDQ LNL \|QO PROHNOHU JHoLü
ROPDNWDGÖU ú]RWRQLN VÖYÖ JHoLüL KÖ]OÖ VHUXP JHoLüL \DYDüWÖU
ûDUDS PLNWDUÖ DUWÖUÖOGÖ ¶·'L\DOL]··

ú<ú/(û0( *UDKDP 7 3KLORV 7UDQV 6oc /RQG 1854

• \]\ÖOÖQ LON oH\UHùLQGH PD LoLQ IL]\RORMLN WHPHO ROXüWXUXOGX • *Peritoneal PHPEUDQ Na YH GLùHU PLQHUDOOHUH NDUüÖ JHoLUJHQGLU
• 1923- Georg Ganter (8QLY. of :XU]EXUJ - LQVDQODUGD LON NH] 6)
• 6ÖYÖODUÖQ RVPRODOLWHVL ile SHULWRQHDO XOWUDILOWUDV\RQ SHULWRQHDO NDYLWH ile • .DUÖQ |Q GXYDUÖQD ÖVÖ X\JXODQPDVÖ SHULWRQ ERüOXùX LOH NDQ DUDVÖQGDNL PDGGH NXOODQDUDN SHULWRQHDO ODYDM WHNQLùLQL D\UÖQWÖODUÖ\OD WDQÖPODGÖ
LQWUDYDVNOHU NRPSDUWPDQ DUDVÖQGDNL NoN PROHNOOHULQ DEVRUSVL\RQX YH LNL JHoLüLQL DUWÖUPDNWDGÖU |QHULOHUGH EXOXQGX ([SHULPHQWDO oDOÖüPD 6) LOH SHULWRQHDO
\|QO DNÖüÖ DUDVÖQGDNL LOLüNL YXUJXODQGÖ GHùLüLP VUHVL 2- VDDWWLU
• %X DUWÖüWDQ YD]RGLODWDV\RQ VRUXPOXGXU • 1923- $%' YH $OPDQ\D ¶·úQWHUPLWWHQW PD··
• 1918- 'DPDU \ROX EXOXQDPD\DQ DùÖU GHKLGUDWH oRFXNODUD LQWUDSHULWRQHDO VÖYÖ • 1927- H. +HXVVHU YH H. Werder &ÖYD ]HKLUOHQPHVL VRQXFX ABY
X\JXODPDVÖ SHULWRQ PHPEUDQÖQÖQ WHGDYL DPDoOÖ LON NXOODQÖPÖ • 1922-Putnam; +D\YDQ oDOÖüPDODUÖ- Diyaliz PHPEUDQÖ RODUDN ¶·\DüD\DQ SHULWRQ·· JHOLüHQ KDVWD\D ¶·FRQWLQXRXV IORZ 3'·· LNL NDWHWHU NXOODQDUDN
¶·3OD]PD YH SHULWRQHDO VÖYÖ DUDVÖQGD SDVLI JHoLüL VDùOD\DQ R]PRWLN ELU GHQJH YDUGÖU··
• GH infüzyon RVPRODOLWHVLQGHQ EDùÖPVÖ] RODUDN SHULWRQD YHULOHQ VÖYÖQÖQ UH G]H\L D]DOPDVÖQD UDùPHQ KDVWDODU ND\EHGLOGL 'U *HRUJ *DQWHU
¶· VDDW LoLQGH WDPDPHQ HPLOGLùL·· EHOLUWLOGL *Orlow WN. $UFK f 3K\V Pflüger 1895 • 1934-5RVHQDN úON NH] R]PRWLN DMDQ RODUDN ¶·JOXNR]··X NXOODQDUDN
**.ODSS R. Mitt *UHQ]JHE der Med u &KLU 1902
/HDWKHV JB 6WDUOLQJ EH. J 3K\VLRO 1895 ***&ODUN AJ. J 3KDUPDFRO 1921 D\QÖ WHNQLùL GHQHGL UH G]H\L D]DOGÖ DPD NOLQLN \LQH EDüDUÖVÖ]GÖ
+DPEXUJHU HJ. $UFKLY f 3K\V du %RLV-Reymond 1895 Putnam 7-. Am J 3K\VLRO 1922 • 1938- 5KRDGV ELNDUERQDW GHVWHùL LoLQ ODNWDW HNOHQHELOHFHùLQL
&XQQLQJKDP 56. Am J 3K\VLRO 1920 3XWQDP 7J. Am J 3K\VLRO 1923
6FKHFKWHU AJ YH DUN Am J 'LV &KLOG 1933 EHOLUWWL
*DQWHU * 0XQFK Med :VFKU 1923
*%ODFNIDQ KD Maxcy .). Am J 'LV &KLOG 1918 +HXVVHU + :HUGHU + %UXQ·V Beitr /LQ &KLU 1927
*:HLQEHUJ M. =WVFKU f .LQGHUKHLONXQGH 1921 %DOi]V - 5RVHQDN 6 :LHQ Klin :VFKU 1934
5KRDGV -( $P - 0HG 6FL 1938

1946-3'·QLQ LON EDüDUÖOÖ NXOODQÖPÖ .RPSOLNDV\RQODU 7HNQLN VRUXQODU«
• *Boen SHULWRQHDO diyalizat LoHULùLQLQ IRUPOQ ROXüWXUGX
1946- - )LQH • 1950- +DQJL WHNQLN 3HULWRQD XODüÖP \ROX" Diyalizat" $NÖP KÖ]Ö" $VHWDW mEq /
$ 6HOLJPDQ + )UDQN • Peritonal ODYDM VUHNOL DNÖü KDOLQGH PL ROPDOÖ (LNL NDWHWHU ile Na : 130-140 mEq /
%RVWRQ R. Reid • AUDOÖNOÖ PÖ ROPDOÖ (infüzyon YH drenaj LoLQ D\QÖ NDWHWHU NXOODQÖODUDN *OXNR]: 1.5- J G/
úQJLOWHUH - 2. Dünya
VDYDüÖ VRQUDVÖ 'HYDPOÖ • Hedef ¶·(n GüN VÖ]ÖQWÖ YH SHULWRQLW RUDQÖ·· • %X IRUPO \ÖOODUFD DVHWDWÖQ \HULQL ODNWDW DOÖQFD\D NDGDU NXOODQÖOGÖ
PD LOH G]HOHQ LON ABY • $UWKXU *UROOPDQ ÖQ oDOÖüPDODUÖQGDQ VRQUD PD VROV\RQX SHULWRQ
ROJXODUÖ ELOGLULOGL ERüOXùXQGD EHOOL ELU VUH EÖUDNÖOPD\D EDüODQGÖ

*Boen 67 3HULWRQHDO GLDO\VLV 7KHVLV $PVWHUGDP
)UDQN +$ 6HOLJPDQ +$ )LQH J. JAMA 1946 7KH 1HWKHUODQGV 8QLYHUVLW\ RI $PVWHUGDP
Reid 5 Penfold JB -RQHV RN. /DQFHW 1946 Grollman $ 7XUQHU /% 0DFOHDQ -$ $UFK ,QWHUQ 0HG
$EERWW :( 6KHD 3 $P - 0HG 6FL 1946

www.anadolubv.org.tr Sağlıklı Yaşam için Altı Ayda Bir Sağlık Kontrolünden Geçiniz - ABV o