Renální insuficience je významným faktorem ovlivňujícím schopnost organismu udržovat vnitřní prostředí. V klinicky definovaných případech je u pacientů nutná náhrada eliminační funkce ledvin. Technické metody umožňují eliminaci toxických metabolitů, dochází ovšem také k eliminaci některých léčiv. Z tohoto pohledu je významné posouzení rizika kumulace léčiv u renální insuficience, stejně tak jako vlivu eliminační metody na clearance látek a přizpůsobení dávky, případně intervalu dávkování. Pro odhad eliminace léčiva je nezbytné zohlednit jak vlastnosti použité eliminační metody, tak farmakokinetické parametry léčiva.
Renal insufficiency is a significant factor affecting body's ability to maintain the internal homeostasis. In clinically defined cases, renal replacement therapy is required. Technical methods allow not only the elimination of toxic metabolites but also the elimination of certain drugs. According to this, it is crucial to determine the drug cummulation risk. In addition, quantitative drug clearance provided by the elimination method is as much relevant in order to provide dose and interval adjustment. To estimate drug elimination, both properties of the elimination methods and pharmacokinetic parameters of the drug should be taken into account.
- MeSH
- Renal Dialysis * methods trends utilization MeSH
- Renal Elimination * physiology drug effects MeSH
- Pharmacokinetics MeSH
- Hemodiafiltration methods trends utilization MeSH
- Hemofiltration methods trends utilization MeSH
- Pharmaceutical Preparations metabolism MeSH
- Humans MeSH
- Interdisciplinary Communication MeSH
- Renal Replacement Therapy * methods instrumentation utilization MeSH
- Peritoneal Dialysis methods trends utilization MeSH
- Renal Insufficiency diagnosis complications therapy MeSH
- Statistics as Topic MeSH
- Kidney Transplantation methods trends utilization MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- Angiotensin II Type 1 Receptor Blockers therapeutic use MeSH
- Renal Insufficiency, Chronic diagnosis etiology drug therapy MeSH
- Diabetes Mellitus, Type 2 drug therapy complications prevention & control MeSH
- Diabetic Nephropathies * diagnosis complications prevention & control MeSH
- Dialysis methods utilization MeSH
- Glomerulosclerosis, Focal Segmental drug therapy MeSH
- Sodium-Glucose Transporter 2 Inhibitors MeSH
- Drug Evaluation methods utilization MeSH
- Glomerular Filtration Rate physiology drug effects MeSH
- Hypertension drug therapy complications prevention & control MeSH
- Diabetes Complications * MeSH
- Humans MeSH
- Meta-Analysis as Topic MeSH
- Proteinuria urine prevention & control MeSH
- Renin-Angiotensin System physiology drug effects MeSH
- Statistics as Topic MeSH
- Kidney Transplantation methods utilization MeSH
- Sodium-Glucose Transporter 2 * adverse effects therapeutic use MeSH
- Check Tag
- Humans MeSH
- MeSH
- Renal Dialysis * economics MeSH
- Humans MeSH
- Pilot Projects MeSH
- Insurance Carriers economics MeSH
- Kidney Transplantation * economics utilization MeSH
- Universal Health Insurance economics organization & administration statistics & numerical data MeSH
- Check Tag
- Humans MeSH
- Publication type
- Newspaper Article MeSH
Akutní renální selhání je závažný, život ohrožující stav spojený s poruchou metabolizmu a často s rozvojem uremického syndromu. Příčiny mohou být prerenální (porucha cirkulace), renální (patologie ledvinné tkáně) nebo postrenální (obstrukce močových cest). Stav často vyžaduje akutní dialýzu. V případě přítomnosti obstrukce močových cest je nutno urgentně zajistit derivaci moče. Při nefron-šetřících výkonech na ledvinách je nutné minimalizovat dobu teplé ischémie jako prevenci akutní tubulární nekrózy.
Acute renal failure is life-threatening situation associated with severe metabolic pathology rarely presented with uremia. Causes could be pre-renal (insufficient blood supply), renal (renal parenchyma pathology) or post-renal (urinary tract obstruction). Acute situation usually needs acute haemodialysis. It is mandatory to set urinary diversion in case of urinary tract obstruction presence immediately. It is necessary to minimize warm ischemia time during nefron-sparing procedures on renal parenchyma as the acute tubular necrosis prevention.
- MeSH
- Acute Kidney Injury * diagnosis etiology therapy MeSH
- Kidney Failure, Chronic * diagnosis etiology prevention & control MeSH
- Dialysis methods standards utilization MeSH
- Urinary Diversion methods utilization MeSH
- Humans MeSH
- Metabolic Diseases etiology therapy MeSH
- Urinary Tract physiopathology pathology MeSH
- Natriuretic Agents physiology secretion MeSH
- Acid-Base Imbalance diagnosis etiology prevention & control MeSH
- Kidney Cortex Necrosis * diagnosis etiology therapy MeSH
- Risk Factors MeSH
- Practice Guidelines as Topic MeSH
- Statistics as Topic MeSH
- Kidney Transplantation utilization MeSH
- Uremia diagnosis etiology prevention & control MeSH
- Vasopressins physiology isolation & purification secretion MeSH
- Check Tag
- Humans MeSH
- MeSH
- Communication * MeSH
- Congresses as Topic MeSH
- Humans MeSH
- Kidney Transplantation * methods psychology trends education utilization MeSH
- Donor Selection * MeSH
- Patient Education as Topic * MeSH
- Nurse Clinicians * ethics organization & administration psychology education utilization MeSH
- Tissue and Organ Procurement MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Female MeSH
- MeSH
- Biomedical Research methods trends MeSH
- Diabetes Mellitus, Type 1 * epidemiology genetics therapy MeSH
- Diabetic Nephropathies diagnosis therapy MeSH
- Humans MeSH
- Metabolic Diseases * diagnosis therapy MeSH
- Pancreatic Diseases diagnosis therapy MeSH
- Kidney Transplantation methods trends utilization MeSH
- Pancreas Transplantation * methods trends utilization MeSH
- Check Tag
- Humans MeSH
- Publication type
- Interview MeSH
- MeSH
- Kidney Failure, Chronic * diagnosis etiology prevention & control psychology therapy MeSH
- Dialysis methods utilization MeSH
- Humans MeSH
- Peritoneal Dialysis utilization MeSH
- General Practitioners * psychology MeSH
- Kidney Transplantation psychology utilization MeSH
- Physician-Patient Relations MeSH
- Check Tag
- Humans MeSH
- MeSH
- CTLA-4 Antigen drug effects MeSH
- Immunosuppression Therapy methods MeSH
- Humans MeSH
- Nephrology * methods trends MeSH
- Kidney Diseases diagnosis drug therapy therapy MeSH
- Graft Rejection prevention & control MeSH
- Kidney Transplantation * methods trends utilization MeSH
- Living Donors MeSH
- Check Tag
- Humans MeSH
- Publication type
- Newspaper Article MeSH
V diagnostice a terapii subvezikální obstrukce u pacientů v konečném stadiu renálního onemocnění jsou přítomny některé odlišnosti od běžné populace (variabilita reziduální diurézy, změněné subjektivní vnímání mikčních obtíží, ovlivnění objektivních urodynamických měření základním onemocněním, změny v cirkadiálním rytmu produkce moči a další). Respektování těchto odlišností a jejich implementace do diagnostického a terapeutického procesu umožňuje optimální načasování diagnostických a terapeutických procedur u této skupiny pacientů a snižuje četnost komplikací.
Some differences exist in the diagnosis and therapy of bladder outflow obstruction between the general population and patients with end stage renal disease. They include, but are not limited to, variability in the degree of residual diuresis, altered bladder sensation, end stage renal disease-induced changes in urodynamic parameters, and differences in circadian diuresis. Understanding and recognizing these differences, as well as their implications in diagnostic and therapeutic procedures, including optimal timing of diagnosis and treatment, within this group of patients, will lead to better treatment outcomes and a lower rate of complications.
- MeSH
- Kidney Failure, Chronic * diagnosis epidemiology complications MeSH
- Diabetes Mellitus MeSH
- Renal Dialysis methods utilization MeSH
- Drug Therapy MeSH
- Glomerular Filtration Rate MeSH
- Prostatic Hyperplasia * diagnosis complications therapy MeSH
- Comorbidity MeSH
- Creatinine isolation & purification MeSH
- Humans MeSH
- Urinary Tract surgery physiopathology pathology MeSH
- Urinary Bladder Neck Obstruction * diagnosis complications therapy MeSH
- Prostatism diagnosis complications therapy MeSH
- Statistics as Topic MeSH
- Kidney Transplantation methods utilization MeSH
- Urologic Surgical Procedures, Male methods utilization MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- Humans MeSH
- Kidney Transplantation * methods statistics & numerical data utilization MeSH
- Living Donors MeSH
- Check Tag
- Humans MeSH
- Publication type
- Newspaper Article MeSH
