Complications of Renal Replacement Therapy in End Stage Renal Disease patients . ( in Buddhachinaraj Hospital Jan 2000

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??????????????????????????????????????????????????
???? ???????????????????????????????
???????????????- ?????? ???????? ?.? 2543 -
?.? 2544
Complications of Renal Replacement Therapy
in End Stage Renal Disease patients . ( in
Buddhachinaraj Hospital Jan 2000 Dec 2001 .
)
???.?????? ???????????? ???.?????
???????????? ???.?????????? ????????
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????????????????
????????????????????????????????????????? ( End
stage renal disease ESRD ) ?????????????????????
?????????????? ??????????????????????
????????????????????????????????????????????????
??????? 3 ???? HD , CAPD , KT
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????????????
?????????????????????????????????????????????????
????????????????? ( End Stage Renal Disease
ESRD ) ???????????????????????????????
????????? ?????? ???????????? ( HD )
???????????????????? ( CAPD ) ???
??????????????????? ( Kidney transplantation
KT )
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??????????
??????????????????????????????????????? ( ESRD
) ??????????????????? ( Hemodialysis ) ,
???????????????????? ( CAPD )
???????????????? ( KT ) ????????????????????????
????????????????? ??????? ?
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???????? 1. ????????? ESRD
????????????????????????????????????
??.?????????? 2 . ?????????????????? Pt.
ESRD ????????????????????????? RRT
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?????????????
??????????? EDWARD F. VONESH and JOHN MORAN
??????????????????????????????????????????????????
??? HD ??? PD ???? 1987-1993 ???????????
Cohort ???????????????? ??? ?????????
????????? ESRD ?????????????????????????????????
?????????????? PD ??????? HD
???????????????????????????????????????? HD ???
PD ???????????????? transplantation
???????????????????????? (RR. PDHD)
??????????????????????????????????????????????????
??????????????????????????????
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??????????????????
Variables Independent ??????? ESRD
???????????????????? HD , CAPD ??? KT
????????????????????? Dependent
???????????????????????
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??????? ESRD
????????????????? HD
????????????????? CAPD
????????????????? RT
Medical records ( OPD IPD cards )
????????????
YES
NO

• ????????????????????????????????????

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???????????????????
1. ???????????????????? ERSD
???????????????? ???????? ?.?.
?????????? 2. ????????????????????????????????
???????????? ????? 3.
?????????????????? ??? ?????????????????????
????????????????????????????????????? 4.
????????????????????????????????????????? ???
????????????????????? ??????????????????????

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????????????????
Target population ??????? ESRD
??????????????????????????????????( HD )
???????????????????? ( CAPD ) ???????????????????
?????? ( RT ) ????????????????????????????
?????? ?.?. 43 - ?.?. 44 Sample size
??????? ESRD ??? case ???????????????????????????
???????( Hemodialysis ) ???????????????? ( CAPD )
????????????????????????? ( RT )
????????????-???????????????? ?????? ?.?. 43
- ?.?. 44
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????????????

• Retrospective cohort study
• 2542 2543 2544
  2545

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• Bias
• Information Omission / Imprecision of
  medical records
• Confounder Age , Sex , Cause of ESRD ,
  Co-morbidity , and Behavior
• Tools
• Medical records

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??????????
Complications - Infection - Rejection
- Ultrafiltration failure - UTI
Chronic renal failure End stage renal
disease Renal replacement therapy Dialysis
Hemodialysis CAPD KT
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- Other ?????????????????? ?????? CVA ,
Portal Hypertension , DVT , Hemorrhoid ,
Hydroceal , BPH , Hepatitis , bilateral
quadricep rupture , pneumonia , bronchitis

• - Metabolic complications
• malnutrition
• Electrolyte imbalance
• lipid metabolism
• Uremic symptom
• - Cardiovascular symptom
• - Hernia
• GI Disorder
• - Hematologic disorder

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?????????????????? ??????????????
????????????????????? 2 ???????
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??????????
???????? 1 ?????????????????????????????? RRT
?????????
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(No Transcript)
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(No Transcript)
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(No Transcript)
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???????? 3 ?????????????????????????????? HD
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(No Transcript)
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???????? 4 ?????????????????????????????? CAPD
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(No Transcript)
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???????? 5 ?????????????????????????????????????
? KT
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(No Transcript)
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???????? 6 ?????????????????????????????????????
???? RRT
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???????? 7 ????????? ESRD?????????????????????????
??? ???????????????????????????
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(No Transcript)
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???????? 8 ????????????????????????? ESRD
????????????????????????? RRT
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????
- ?????????????????? ???????????????????????????
?? 108 ?? ?????????? 59 ???????????? 49 ??
(??.?????????? 1 ?.?. 43 31 ?.?.44 ) -
??????????????????????????? CAPD -
????????????????????? 40 ?? ???????????????????
?? ?????? CAPD ??? HD
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- ???????????????????????? 40 ??
?????????????????????????? KT -
???????????????????? ??? Hypertensive nephropathy
27.78 - ????????????episode of complication /
person-month ?????????????? CAPD gt HD gt
KT - complication ????????????????????? HD ???
CAPD ????????? infection ??????
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- ????????????? KT ?? Acute allograft renal
rejection ????????? - ????????????????????????
??????????????? infection, metabolic
complication ??? cardiovascular diseases
??????????????????????????????????? CAPD
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???????
1. ?????????????????????????????????? 2.
????????????????????????????? 3.
??????????????????????? 4. ?????? F/U
??????????????????????? ???????????? ???????
????????????????????
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THE END