정기 혈액투석을 위한 동정맥루 형성 시기에 대한 연구

The number of patients and long-term survival rates of chronic renal failure have been increasing since the development of renal replacement therapy. Therefore, continuous follow-up observation on an outpatient basis, vascular access for dialysis and the determination of when to start dialysis have clinical significance associated with the prognosis of these patients. Presently, there is little clinical data about chronic renal failure patients such as, clinical features at initial dialysis, the presence or absence of neph-rologist follow-up, and the types and timing of vas-cular access. The goal of this study therefore was to investigate the clinical features at initial dialysis, presence or absence of follow-up, types and timing of vascular access in 80 patients retrospectively. The results are as below ; 1) The mean age of the patients was 47.814.0 years, and there were 47 male and 33 female patients. 2) Seventeen patients(21.3%) had DM as an underlying disease and 63 patients(78.79%) were non-diabetic patients. 3) At the initial dialysis, the diabetic patients had an average BUN of 79.2 +- 29.6mg/dl, average Cr of 7.82.0mg/dl and an average Ccr of 10.07.0ml/min. The non-diabetic patients had the following averages ' BUN 118.7 37.9mg/dl, Cr 15.36.3mg/dl and Ccr 5.5 4.3ml/min. 4) The initial meeting with a nephrologist prior to dialysis occured as follows : in the diabetic group, 13 patients(76.596) met their nephrologist 12 months before, 3 patients(17.6%) 1 month before, one patient(5.9N) met the specialist one to 3 months before and no one had meeting 4 to 12 month before their dialysis. In the non-diabetic group, 36 patients(63.296) initially visited a nephrologist 12 months before, 16 patients (28.1M) one month before, 3 patients(5.3%) one to 3 months before and 2 patients(3.5%) had a meeting 4 to 12 months before the first dialysis. 5) The timing of native arteriovenous fistula for- mation was as follows; In the diabetic group, 10 patients(66.7%) had an A-V fistula constructed imme- diately upon admission, 2 patients(13.3%) had one constructed one to 3 months before, 2 patients(13.396) had one made 4 to 12 months before, one patient (6.7%) had a fistula created one week to one month before, and no one had a fistula formed 12 months before their initial dialysis. In the non-diabetic group, 36 patients(69.2%) had an A-V fistula constructed on admission ll patients(21.2%), one week to one month before 2 patients(3.8%), one to 3 rnonths before 2 patien