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8 listopada – Ogólnopolski Dzień Osób Dializowanych. Jak przewlekła choroba nerek wpływa na proces gojenia się ran?

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Ogólnopolskie Stowarzyszenie Osób Dializowanych oraz środowiska pacjenckie na 8 listopada zainaugurowały pierwsze w Polsce obchody Ogólnopolskiego Dnia Osób Dializowanych. Dzień ten ma również znaczenie w kontekście leczenia trudno gojących się ran, ponieważ przewlekła choroba nerek często towarzyszy cukrzycy i może dodatkowo upośledzać proces gojenia ran.

Celem inicjatywy Ogólnopolskiego Dnia Osób Dializowanych jest zwrócenie uwagi na problemy i potrzeby chorego dializowanego oraz podnoszenie świadomości na temat profilaktyki i leczenia chorób nerek.

– Informacji o powołaniu Ogólnopolskiego Dnia Osób Dializowanych towarzyszy nasz osobisty apel o zwiększenie działań edukacyjnych oraz realnej pomocy, która może poprawić jakość życia i ułatwić funkcjonowanie osób dializowanych w społeczeństwie. To także wyrażenie wdzięczności dializowanych dla osób sprawujących nad nimi opiekę medyczną i dla ich opiekunów – mówi Iwona Mazur, prezes Ogólnopolskiego Stowarzyszenia Osób Dializowanych.

Przewlekła choroba nerek może upośledzać proces gojenia ran

Choroba nerek towarzysząca cukrzycy może mieć negatywny wpływ na leczenie ran. Przewlekłą chorobę nerek diagnozuje się u około 50 proc. osób z cukrzycą typu 2., natomiast u blisko 35 proc. w momencie przeszczepu nerki diagnozuje się cukrzycę typu 2.

W przebiegu cukrzycy przewlekła choroba nerek m.in. zmniejsza dostarczenie tlenu do tkanek. Ponadto cukrzycowa choroba nerek upośledza proces gojenia, m.in. poprzez utratę białka z moczem, zmniejszenie syntezy erytropoetyny oraz zmian struktury naczyń krwionośnych, powodujących usztywnienie błony środkowej naczyń krwionośnych i przyspieszenie procesu tworzenia blaszek miażdżycowych, co zmniejsza perfuzję narządową. Zaburzenia funkcji nerek mogą nasilać utrzymywanie się stanu zapalnego w ranie, a także wzmagać lub indukować chorobę nerek u pacjentów z długo utrzymującą się raną. Stosowana antybiotykoterapia stwarza m.in. ryzyko nefrotoksyczności. W przypadku współistnienia przewlekłej choroby nerek z cukrzycą ważny jest zatem dobór odpowiedniej antybiotykoterapii.

W Polsce na przewlekłą chorobę nerek cierpi 4,5 mln Polaków

Prof. dr hab. Beata Naumnik, konsultant wojewódzki ds. nefrologii, Kierownik I Kliniki Nefrologii i Transplantologii z Ośrodkiem Dializ Uniwersytetu Medycznego w Białymstoku, zaznacza, że problem przewlekłej choroby nerek (PChN) dotyczy nawet 12-14 proc. polskiego społeczeństwa, czyli prawie 4,5 mln Polaków. Ekspertka wskazuje, że nieleczone schorzenie może prowadzić do konieczności leczenia nerkozastępczego (dializy otrzewnowej lub hemodializy) lub transplantacji nerki.

– Kluczem do skutecznej profilaktyki jest jak najwcześniejsze wykrycie choroby, które pozwala na opóźnienie jej rozwoju od kilku do kilkunastu lat i kontynuowanie w miarę normalnego życia bez konieczności np. rezygnacji z pracy i znacznej części codziennych aktywności – wyjaśnia prof. Naumnik.

Dr n. med. Marta Serwańska-Świętek, nefrolog, transplantolog, zastępca dyrektora medycznego DaVita Polska, sieci stacji dializ, która wsparła inicjatywę Ogólnopolskiego Stowarzyszenia Osób Dializowanych, dodaje:

– Pamiętajmy, że nawet w zaawansowanym stadium choroby nerek mogą nie dawać żadnych wyraźnych objawów, mówi się, że chore nerki nie bolą. Dlatego tak ważna jest profilaktyka w postaci regularnych, wykonywanych minimum raz w roku, a jeśli cierpimy na inne przewlekłe schorzenia nawet częściej, badań stężenia kreatyniny we krwi i badań ogólnych moczu – dodaje ekspertka.

 

Przeczytaj także: Cytomegalia jako powikłanie po przeszczepieniu nerki

 

Źródła:

Materiał prasowy

B. Mrozikiewicz-Rakowska, A. Volodkina, M. Zygmunciak, Czy umiemy efektywnie leczyć rany u chorych z cukrzycą oraz towarzyszącą marskością wątroby i przewlekłą chorobą nerek? Opis przypadku, Leczenie Ran 2018: 15(3), str. 147-151

 

Przeczytaj bezpłatnie pokrewny artykuł w czasopiśmie „Chirurgia Plastyczna i Oparzenia”:

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