Üsküdar University Vocational School of Health Services (SHMYO) Dialysis Program Head, Lecturer Meliha Çakmak's leadership saw the online execution of the 'Overview of Renal Replacement Therapies' event. Providing information on treatment methods applied in kidney failure and the Renal Replacement process, Çakmak stated: “In patients with kidney failure, another underlying chronic disease is always expected. These are diabetes mellitus (DM) and hypertension (HT).”
Providing information about the treatments needed by individuals experiencing kidney failure, Lecturer Meliha Çakmak said: “At this point, it is first necessary to talk about the functions of the kidney related to kidney failure. What do our kidneys do? They play a role in regulating the body's fluid balance. They maintain acid-base and fluid-electrolyte balance. They preserve the body's internal balance, which we call homeostatic. They are responsible for the elimination of toxic substances and metabolic waste. This is actually their most fundamental function. By secreting the hormone renin, they maintain water and sodium balance and are effective in regulating blood pressure. They play a role in glucose synthesis. They play a major role in the secretion of the erythropoietin hormone. In this way, they maintain our body's blood balance. Anemia is quite high in patients with kidney failure. In addition, our kidneys activate vitamin D. In line with this information; patients living with kidneys that have been diagnosed with end-stage renal disease and chronic kidney failure and cannot perform these functions we have listed definitely need treatment. We call these Renal Replacement Therapies. There are two known forms of treatment: Dialysis and Kidney Transplantation. The primary goal of these treatments, under all circumstances, is to extend patients' lifespans and, along with that, to improve their quality of life.”
“Uremia and Renal Replacement Therapy are associated with many complications; Lecturer Meliha Çakmak, discussing in which situations renal replacement therapy methods can be applied, stated: “If you ask in which situations renal replacement therapy is needed in the acute kidney-related period, it is in conditions such as uremia, neuropathy, myopathy, encephalopathy, and pericarditis. Renal replacement therapy is also needed for fluid-nutrition support in any severe sepsis or septic shock occurring due to non-renal causes. In our region, as an earthquake-prone country, Crush Syndrome is observed in our citizens trapped under rubble. Renal replacement therapy is very often preferred in Crush Syndrome, but generally, as I mentioned, in this situation, there are signs of acute kidney failure lasting up to three months. During this process, by regulating the body's fluid-electrolyte and acid-base balance, the kidneys return to their normal functioning state.”
“Hemodialysis is the most preferred and applied in our country”
Lecturer Meliha Çakmak, speaking about the process patients undergo during dialysis treatment, stated: “Dialysis is the process of bringing two solutions face to face through a semi-permeable membrane and removing unwanted substances from the target solutions or adding missing substances back into that solution. In other words, the goal here is to somehow make the blood resemble the most ideal solution. For this; hemodialysate solutions are used with hemodialysis treatment, and peritoneal dialysate solutions are used with peritoneal dialysis treatment. If we look at what hemodialysis is; we aim to re-regulate the fluid-solute content with the help of a special membrane and a special machine. The hemodialysis procedure lasts a total of 4 hours. According to the physician's directive, the hemodialysis treatment plan varies according to the patient's blood values. However, routinely in patients with Chronic Kidney Failure, this procedure lasts approximately 4 hours and is repeated 3 times a week. Special vascular access routes are used for this treatment procedure.”
“The number of devices is higher in private dialysis centers”
Çakmak stated that, looking at the number of hemodialysis devices, according to the Turkish Society of Nephrology's 2019 report, with changes in medical processes and treatment costs, the highest number of dialysis machines are found in private dialysis centers. She added, “This disease was not so widely known before. Now, we can see a dialysis center every two streets. Therefore, the number of devices is higher in private dialysis centers compared to hospitals affiliated with the Ministry of Health or university hospitals.”