PATHOGENESIS AND INTENSIVE TREATMENT OF ACUTE HEMODYNAMIC DISORDERS DURING PROGRAMMED HEMODIALYSIS

S.B.IMAMVERDIYEV, E.A.GULIYEV, F.CH.ALMAMMADOV

Azerbaijan Medical University, Baku, AZERBAIJAN

Despite the significant results obtained in recent years in the treatment of chronic renal insufficiency by the method of hemodialysis, sufficient occurrence of hemodynamic disorders of various characters significantly influences treatment of such patients. According to the information given by different authors, hemodynamic disorders during the hemodialysis treatment were one of the reasons of death in these patients. Therefore, development of pathogenetic treatment of hemodynamic disorders during hemodialysis is quite urgent at present. The investigations were conducted on 217 patients divided into 2 groups and treated by hemodialysis treatment programmed for chronic renal insufficiency. The first group included 57 patients in which programmed hemodyalisis treatment was carried out by traditional treatment methods. In 160 patients that constituted the second group the programmed hemodialysis treatment was carried out based on special treatment principles prepared by us. Thus, the patients were prescribed 10 – 20% 50,0 – 100,0 ml albumin, 250,0 ml 5% parisol or 5% 500,0 ml selemin, and 5 or 10 mg (subject to the age of patients) concor (in the for of tables) + 5, 10, 20 mgr (max 40 mgr) lisinopril or max 40 mgr enalapril. During the programmed hemodyalisis the activity of rennin, the vasopressin content in the plasma and oncotic pressure of plasma were determined for the clarification of the pathogenesis of hemodynamic disorders. It was determined during the conducted examinations that in the patients of the first group the main reason of hemodynamic disorders was increased activity of renin and vasopressin content. The oncotic pressure in the patients of the group reduced significantly. The offered treatment regimen prevented the sharp increase of the activity of rennin, vasopressin content and sharp reduction of oncotic pressure. All these lead to more favorable level of hemodynamic indicators in the patients of the second group.

Date: 2014-12-28; view: 874