{"id":875,"date":"2021-03-16T16:48:57","date_gmt":"2021-03-16T14:48:57","guid":{"rendered":"http:\/\/skmed.sk\/?p=875"},"modified":"2021-03-16T16:49:01","modified_gmt":"2021-03-16T14:49:01","slug":"zdrave-ranajky-s-skmed-na-temu-11-marec-je-svetovy-den-obliciek-covid-19-ohrozuje-aj-oblicky-pocet-pacientov-ktori-budu-potrebovat-trvalu-dialyzu-moze-stupnut","status":"publish","type":"post","link":"http:\/\/skmed.sk\/?p=875","title":{"rendered":"Zdrav\u00e9 ra\u0148ajky s SK+MED na t\u00e9mu 11. Marec je svetov\u00fd de\u0148 obli\u010diek &#8211; COVID-19 ohrozuje aj obli\u010dky.  Po\u010det pacientov, ktor\u00ed bud\u00fa potrebova\u0165 trval\u00fa dial\u00fdzu m\u00f4\u017ee st\u00fapnu\u0165"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><strong>Zahrani\u010dn\u00e9\n\u0161t\u00fadie ukazuj\u00fa, \u017ee okolo 18% pacientov, ktor\u00ed pri ochoren\u00ed COVID-19 pre\u0161li\nak\u00fatnych zlyhan\u00edm obli\u010diek, m\u00f4\u017eu skon\u010di\u0165 na chronickej dial\u00fdze. COVID-19 je pre\nobli\u010dky hrozbou, nielen v&nbsp;pr\u00edpade \u0165a\u017ek\u00e9ho priebehu ochorenia. Po prekonan\u00ed\ninfekcie je k\u013e\u00fa\u010dov\u00e1 prevencia. Pacienti by mali \u00eds\u0165 za svoj\u00edm praktick\u00fdm\nlek\u00e1rom a&nbsp;sp\u00fdta\u0165 sa ho na prevent\u00edvne vy\u0161etrenie alebo nav\u0161t\u00edvi\u0165&nbsp;nefrologick\u00fa\nambulanciu. Pri pr\u00edle\u017eitosti Svetov\u00e9ho d\u0148a obli\u010diek (11.marec) k&nbsp;tomu\nvyz\u00fdva hlavn\u00e1 nefrologi\u010dka siete dialyza\u010dn\u00fdch stred\u00edsk B. Braun Avitum na\nSlovensku, MUDr. Monika Alaxinov\u00e1, CSc. aj Slovensk\u00e1 asoci\u00e1cia dod\u00e1vate\u013eov zdravotn\u00edckych\npom\u00f4cok (SK+MED).<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Infekcia\npodobn\u00e1 HIV<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Koronav\u00edrus\npo\u0161kodzuje obli\u010dky dvomi sp\u00f4sobmi. Prim\u00e1rne toxicky nap\u00e1da priamo bunky\nobli\u010dkov\u00fdch klbiek a kan\u00e1likov. Okrem toho sekund\u00e1rne \u00fato\u010d\u00ed na obli\u010dky cez\nhor\u00fa\u010dky, dehydrat\u00e1ciu, covidov\u00fa pneum\u00f3niu alebo zasahuje srdce a&nbsp;sp\u00f4sobuje\nseptick\u00fd \u0161ok. <em>\u201eV\u00e4\u010d\u0161ina pacientov m\u00e1 zasiahnut\u00e9 obli\u010dky pr\u00e1ve sekund\u00e1rnou\ncestou, ktor\u00e1 sp\u00f4sobuje zl\u00e9 prekrvenie. Na prekrvenie s\u00fa obli\u010dky ve\u013emi\ncitliv\u00e9,\u201c <\/em>vysvet\u013euje nefrologi\u010dka MUDr. Monika Alaxinov\u00e1, CSc. Prim\u00e1rne\npo\u0161kodenie obli\u010diek v\u00edrusom sp\u00f4sobuje a\u017e stokr\u00e1t vy\u0161\u0161iu koncentr\u00e1ciu enz\u00fdmu\nACE-2 v&nbsp;obli\u010dk\u00e1ch ako napr\u00edklad v&nbsp;p\u013e\u00facach. Tento enz\u00fdm funguje ako\nreceptor koronav\u00edrusu pre vstup do bunky. Pokia\u013e v&nbsp;obli\u010dk\u00e1ch napadne\ntubul\u00e1rne bunky, rozvinie sa tzv. ak\u00fatna tubul\u00e1rna nekr\u00f3za, ke\u010f bunky odumr\u00fa\na&nbsp;po dobu k\u00fdm sa obnovia, mus\u00ed by\u0165 pacient na dial\u00fdze. V\u00edrus taktie\u017e\nnap\u00e1da bunky glomerulu, kde sp\u00f4sobuje po\u0161kodenie podobn\u00e9 ako pri infekcii HIV.\nPo\u010detnos\u0165 tak\u00fdchto priamych napadnut\u00ed zatia\u013e nie je zn\u00e1ma, preto\u017ee potvrdi\u0165 ich\nm\u00f4\u017ee jedine biopsia, ktor\u00e1 sa be\u017ene nevykon\u00e1va. &nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Ned\u00e1vno bola <a href=\"https:\/\/www.brighamhealthonamission.org\/2020\/11\/12\/uncovering-risks-for-severe-aki-in-covid-19-patients\/\">zverejnen\u00e1\n\u0161t\u00fadia<\/a>, do ktorej bolo zapojen\u00fdch 3099 pacientov zo 67 americk\u00fdch\nnemocn\u00edc, ktor\u00ed boli hospitalizovan\u00ed na JIS. Z&nbsp;t\u00fdchto \u013eud\u00ed malo 20% (637\npacientov) ak\u00fatne po\u0161kodenie obli\u010diek, ktor\u00e9 si vy\u017eadovalo dialyza\u010dn\u00fa pomoc.\nMortalita t\u00fdchto pacientov v&nbsp;priebehu jedn\u00e9ho mesiaca od prijatia bola\n55%. <em>\u201eAj na Slovensku sa po\u010det pacientov, ktor\u00ed bud\u00fa potrebova\u0165 dial\u00fdzu,\nm\u00f4\u017ee v&nbsp;d\u00f4sledku koronav\u00edrusu zv\u00fd\u0161i\u0165 o&nbsp;5-10%,\u201c <\/em>dod\u00e1va MUDr. Monika\nAlaxinov\u00e1, CSc. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Prevent\u00edvne\nvy\u0161etrenia po infekcii<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Po prekovan\u00ed\ninfekcie COVID-19 sa ako k\u013e\u00fa\u010dov\u00e1 jav\u00ed prevencia. Ochorenie obli\u010diek sp\u00f4soben\u00e9\nkoronav\u00edrusom m\u00f4\u017ee zosta\u0165 skryt\u00e9 a&nbsp;je nutn\u00e9 ho \u010do najsk\u00f4r odhali\u0165. Sta\u010d\u00ed\niba anal\u00fdza mo\u010du a&nbsp;kvapka krvi. <em>\u201ePacienti, ktor\u00ed boli hospitalizovan\u00ed,\nby mali podst\u00fapi\u0165 kontrolu po troch a&nbsp;potom po \u0161iestich mesiacoch od\nuzdravenia. Prevent\u00edvne vy\u0161etrenie by ale mali absolvova\u0165 v\u0161etci, ktor\u00ed covid\nprekonali, tak\u017ee aj t\u00ed, s&nbsp;miernym priebehom,\u201c <\/em>apeluje hlavn\u00e1 nefrologi\u010dka\nB. Braun Avitum na Slovensku, MUDr. Monika Alaxinov\u00e1, CSc. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Tohtoro\u010dn\u00fd\nSvetov\u00fd de\u0148 obli\u010diek pripad\u00e1 na \u0161tvrtok 11. marca. Za norm\u00e1lnych okolnost\u00ed by\nsa konal de\u0148 otvoren\u00fdch dver\u00ed v&nbsp;nefrologick\u00fdch ambulanci\u00e1ch\na&nbsp;dialyza\u010dn\u00fdch stredisk\u00e1ch po celom Slovensku, ktor\u00e9 by pon\u00fakali bezplatn\u00e9\nvy\u0161etrenia bez objednania. Pand\u00e9mia koronav\u00edrusu v\u0161ak tak\u00e9to aktivity\nneumo\u017e\u0148uje. Nefrol\u00f3govia po celom Slovensku tak vyz\u00fdvaj\u00fa v\u0161etk\u00fdch \u013eud\u00ed, ktor\u00ed\nprekonali COVID-19, aby kontaktovali svojho v\u0161eobecn\u00e9ho lek\u00e1ra so \u017eiados\u0165ou\no&nbsp;prevent\u00edvne vy\u0161etrenie. <em>\u201eVy\u0161etrenie nie je zlo\u017eit\u00e9 a&nbsp;v\u0161eobecn\u00ed\nlek\u00e1ri s\u00fa na to vybaven\u00ed. Bez t\u00fdchto prevent\u00edvnych vy\u0161etren\u00ed sa m\u00f4\u017ee stav\nobli\u010diek v&nbsp;popul\u00e1cii zhor\u0161ova\u0165, preto\u017ee v\u00edrus m\u00f4\u017ee obli\u010dky skuto\u010dne\npo\u0161kodi\u0165 a&nbsp;bez prevencie o&nbsp;tom pacient dlho nemus\u00ed ani vedie\u0165,\u201c <\/em>vysvet\u013euje\nriadite\u013e siete dialyza\u010dn\u00fdch stred\u00edsk B. Braun Avitum, MUDr. Martin Kuncek. V\u0161etci\nostatn\u00ed si m\u00f4\u017eu svoje obli\u010dky otestova\u0165 aspo\u0148 na dia\u013eku pomocou webu <a href=\"http:\/\/www.oblickovakalkulacka.sk\">www.oblickovakalkulacka.sk<\/a>.\nPokia\u013e komuko\u013evek vyjde, \u017ee je v&nbsp;rizikovej skupine, aj on by mal od svojho\npraktick\u00e9ho lek\u00e1ra po\u017eadova\u0165 prevent\u00edvne vy\u0161etrenie. <em>\u201eZa posledn\u00fd rok sme sa\nv&nbsp;boji s&nbsp;koronav\u00edrusom nau\u010dili, \u017ee sp\u00f4sobuje nepredv\u00eddate\u013en\u00e9\nkardiovaskul\u00e1rne, neurologick\u00e9, internistick\u00e9 komplik\u00e1cie, ale neobch\u00e1dza ani\ntak\u00fd d\u00f4le\u017eit\u00fd org\u00e1n, ak\u00fdm s\u00fa pr\u00e1ve obli\u010dky. Pre v\u0161etk\u00fdch pacientov, ktor\u00ed to\nbud\u00fa potrebova\u0165 je d\u00f4le\u017eit\u00e9 zabezpe\u010di\u0165 v\u010dasn\u00fd pr\u00edstup k&nbsp;dialyza\u010dnej\nlie\u010dbe, ale nevyhnutn\u00fd je aj z\u00e1ujem samotn\u00fdch pacientov o&nbsp;prevent\u00edvne\nvy\u0161etrenia,\u201c <\/em>hovor\u00ed Ing. Katar\u00edna Dankov\u00e1, PhD, v\u00fdkonn\u00e1 riadite\u013eka SK+\nMED.&nbsp; <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>O\u010dkovanie ako\ns\u00fa\u010das\u0165 prevencie<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">O\u010dkovanie\npacientov, ktor\u00fdch zdravotn\u00fd stav si vy\u017eaduje dial\u00fdzu, je na Slovensku oproti\nna\u0161\u00edm \u010desk\u00fdm susedom v&nbsp;prvej prioritnej skupine a&nbsp;v&nbsp;tejto chv\u00edli\nje zao\u010dkovan\u00fdch pribli\u017ene 50% pacientov. Na Slovensku je pribli\u017ene 4-tis\u00edc\ndialyzovan\u00fdch pacientov, ktor\u00ed patria medzi najviac ohrozen\u00e9 skupiny \u013eud\u00ed\nv&nbsp;r\u00e1mci celej popul\u00e1cie. <em>\u201eNa Slovensku budeme ma\u0165 \u010doskoro zao\u010dkovan\u00fdch\nv\u0161etk\u00fdch indikovan\u00fdch pacientov, ktor\u00ed maj\u00fa o&nbsp;vakc\u00ednu z\u00e1ujem,\u201c <\/em>potvrdila\nMUDr. Monika Alaxinov\u00e1, CSc. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Menej\ntransplant\u00e1ci\u00ed a zlo\u017eitej\u0161\u00ed proces<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Na Slovensku\nsa pod\u013ea N\u00e1rodnej transplanta\u010dnej organiz\u00e1cie podarilo v&nbsp;uplynulom roku\ntransplantova\u0165 <a href=\"https:\/\/www.nto.sk\/statistika\/\">131\nobli\u010diek<\/a>, pri\u010dom 18 obli\u010diek poch\u00e1dzalo od \u017eij\u00facich darcov. Ide\no&nbsp;pokles o&nbsp;27% oproti roku 2019, kedy sa podarilo transplantova\u0165 a\u017e 173\nobli\u010diek. Za zn\u00ed\u017eenie transplanta\u010dnej aktivity m\u00f4\u017ee predov\u0161etk\u00fdm pand\u00e9mia\nkoronav\u00edrusu. Problematick\u00e1 je aj transplant\u00e1cia obli\u010diek u&nbsp;pacientov,\nktor\u00ed s\u00fa v&nbsp;ak\u00fatnej f\u00e1ze ochorenia COVID-19.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Aj pacienti\npo transplant\u00e1cii m\u00f4\u017eu podst\u00fapi\u0165 o\u010dkovanie, ale rovnako ako\nu&nbsp;dialyzovan\u00fdch pacientov nie je jasn\u00e9 mno\u017estvo protil\u00e1tok, ktor\u00e9 si\ndok\u00e1\u017ee ich imunita vytvori\u0165. Napriek tomu, \u017ee zatia\u013e nie s\u00fa k&nbsp;dispoz\u00edcii\nd\u00e1ta, lek\u00e1ri u\u017e vedia, \u017ee pokia\u013e ochorenie COVID-19 prekon\u00e1 transplantovan\u00fd\npacient, jeho organizmus si vytvor\u00ed pribli\u017ene o&nbsp;tretinu menej protil\u00e1tok\nne\u017e zvy\u0161ok popul\u00e1cie. <\/p>\n","protected":false},"excerpt":{"rendered":"<p>Zahrani\u010dn\u00e9 \u0161t\u00fadie ukazuj\u00fa, \u017ee okolo 18% pacientov, ktor\u00ed pri ochoren\u00ed COVID-19 pre\u0161li ak\u00fatnych zlyhan\u00edm obli\u010diek, m\u00f4\u017eu skon\u010di\u0165 na chronickej dial\u00fdze. COVID-19 je pre obli\u010dky hrozbou, nielen v&nbsp;pr\u00edpade \u0165a\u017ek\u00e9ho priebehu ochorenia. Po prekonan\u00ed infekcie je k\u013e\u00fa\u010dov\u00e1 prevencia. Pacienti by mali \u00eds\u0165 za svoj\u00edm praktick\u00fdm lek\u00e1rom a&nbsp;sp\u00fdta\u0165 sa ho na prevent\u00edvne vy\u0161etrenie alebo nav\u0161t\u00edvi\u0165&nbsp;nefrologick\u00fa ambulanciu. Pri pr\u00edle\u017eitosti Svetov\u00e9ho d\u0148a obli\u010diek (11.marec) k&nbsp;tomu vyz\u00fdva hlavn\u00e1 nefrologi\u010dka siete dialyza\u010dn\u00fdch stred\u00edsk B. Braun Avitum na&hellip;<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-875","post","type-post","status-publish","format-standard","hentry","category-nezaradene"],"_links":{"self":[{"href":"http:\/\/skmed.sk\/index.php?rest_route=\/wp\/v2\/posts\/875","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/skmed.sk\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/skmed.sk\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/skmed.sk\/index.php?rest_route=\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"http:\/\/skmed.sk\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=875"}],"version-history":[{"count":1,"href":"http:\/\/skmed.sk\/index.php?rest_route=\/wp\/v2\/posts\/875\/revisions"}],"predecessor-version":[{"id":876,"href":"http:\/\/skmed.sk\/index.php?rest_route=\/wp\/v2\/posts\/875\/revisions\/876"}],"wp:attachment":[{"href":"http:\/\/skmed.sk\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=875"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/skmed.sk\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=875"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/skmed.sk\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=875"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}