| Abstract | Cilj istraživanja: Cilj istraživanja bio je prikazati demografske karakteristike bolesnika na
kroničnoj hemodijalizi i utvrditi prevalenciju fibrilacije/undulacije atrija uz prikaz odabira
antikoagulantne terapije i prevalencije komorbiditeta.
Ispitanici i metode: Presječna studija provedena je u Klinici za bolesti srca i krvnih žila kao i
u Zavodu za nefrologiju i hemodijalizu KBC-a Split te u Domu zdravlja Splitsko-dalmatinske
županije (ispostava Trogir, Sinj, Makarska, Imotski). Pretraživanjem medicinske
dokumentacije prikupljali su se podaci koji su uključivali opće demografske karakteristike
bolesnika kao i elektrokardiografski zapis, prisutnost komorbiditeta, primjena antikoagulantne
terapije i preboljeni tromboembolijski događaj.
Rezultati: U Zavodu za nefrologiju i hemodijalizu KBC-a Split te u Domu zdravlja Splitskodalmatinske županije (ispostava Trogir, Sinj, Makarska, Imotski) ukupno se dijalizira 216
pacijenata. Medijan životne dobi pacijenata iznosio je 70 godina. Udio muškaraca među
dijaliziranim bolesnicima bio je 60,2% muškaraca, a žena 39,8%. Prosječno vrijeme liječenja
hemodijalizom iznosilo je tri godine. Fibrilacija/undulacija atrija utvrđena je u 17,9%
pacijenata. Prosječna dob pacijenata s FA/UA iznosila je 77 godina dok je prosječna dob
pacijenata bez aritmije bila 66 godina. Tromboembolijski incident u povijesti bolesti imalo je
23,7% bolesnika. Srednja vrijednost CHA2DS2–VASc scorea u promatranoj skupini pacijenata
iznosila je četiri boda. Srednja vrijednost HAS-BLED algoritma iznosila je tri boda. Pridružene
komorbiditete imalo je 97,4% pacijenata. Najzastupljeniji komorbiditeti bili su hipertenzija
(68,4%) i dijabetes (39,5%). Tromboprofilaksa se provodila u 78,9% pacijenata. Najviše se
primjenjivao varfarin (47,4%) dok je niskomolekularni heparin koristilo 13,2% , apixaban
2,60%, a antiagregacijsku terapiju čak 15,8% bolesnika.
Zaključak: Od ukupno 216 pacijenata koji su sudjelovali u našem istraživanju,
fibrilacija/undulacija atrija nađena je u njih 38. Pacijenti s FA/UA bili su u prosjeku stariji od
onih bez aritmije. Primijećena je visoka prevalencija komorbiditeta, od kojih je najzastupljenija
bila hipertenzija. Tromboembolijski incident nađen je u povijesti bolesti u 23,7% pacijenata s
FA i KBB. Tromboprofilaksa se provodila u 78,9% pacijenata, a najčešće korišten lijek bio je
varfarin. |
| Abstract (english) | Aim of the study: The aim of the research was to present demographic characteristics of
hemodialysis patients and to determine the prevalence of atrial fibrillation/undulation and to
show the choice of anticoagulant therapy and the prevalence of comorbidities.
Subjects and methods: Cross-sectional study conducted in the Department of Cardiovascular
Diseases, as well as in the Department of Nephrology and Hemodialysis of KBC Split and in
the Split-Dalmatia County Health Center (Trogir, Sinj, Makarska, Imotski branches). Data was
collected by searching the medical records. Data included the patient's general demographic
characteristics as well as ECG, presence of comorbidities, use of anticoagulant therapy and data
regarding occurence of thromboembolic event.
Results: A total of 216 patients underwent dialysis in the Department of Nephrology and
Hemodialysis of KBC Split and in the Split-Dalmatia County Health Center (Trogir, Sinj,
Makarska, Imotski branches). The median age of the patients was 70 years. In our resarch 60.2%
of patients were men and 39,8% women. The average duration of hemodialysis treatment was
three years. Atrial fibrillation/undulation was found in 17.9% of patients. The average age of
patients with atrial fibrillation/undulation was 77 years, while the average age of patients
without arrhythmia was 66 years. 23.7% of patients had a thromboembolic incident in their
medical history. The mean value of the CHA2DS2–VASc score in the observed group of patients
was four points. The mean value of the HAS-BLED algorithm was three points. Associated
comorbidities were present in 97.4% of patients. The most prevalent comorbidities were
hypertension (68.4%) and diabetes (39.5%). Thromboprophylaxis was performed in 78.9% of
patients. Warfarin was used by 47.4% patients, while low-molecular-weight heparin was used
by 13.2%, apixaban by 2.60%, and antiplatelet therapy by 15.8% of patients.
Conclusion: Out of a total of 216 patients who participated in our study, atrial
fibrillation/undulation was found in 38 of them. Patients with FA/UA were on average older
than those without arrhytmia. Hypertension was the most prevalent comorbidity. A
thromboembolic incident was found in 23.7% of patients. Thromboprophylaxsis was performed
in 78.9% and warfarin was the most frequently used drug. |
