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Role of Hemodiafiltration in the treatment of the renal failure"


Author: Cornea Natalia
Degree:doctor of medicine
Speciality: 14.00.40 - Urology
Year:2013
Scientific adviser: Adrian Tanase
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution: State University of Medicine and Pharmacy "Nicolae Testemitanu"

Status

The thesis was presented on the 5 December, 2012
Approved by NCAA on the 14 June, 2013

Abstract

Adobe PDF document0.35 Mb / in romanian

Keywords

acute renal failure, end stage renal disease, hemodiafiltration, dialysis, uraemic toxins, interleucin 6, β2-microglobulin

Summary

The dissertation work consists of 193 edited pages. It consists of introduction, 4 chapters, conclusions, practical recommendations, bibliography comprising 289 references, 74 figures, 16 tables. The obtained results were published in 20 scientific works.

Field of research: Urology-Nephrology

Purpose of study: to establish the role of HDF in the complex treatment of patients with ARF and ESRD by benchmarking the clinical efficacy of dialysis treatments (HDF versus HD).

Research objectives: 1. To estimate the influence of HDF on the evolution and prognosis of patients with ARF. 2. To monitor the effects of HDF and / or HD on the evolution of clinical signs and homeostasis in patients with ARF. 3. To determine the dynamics of some uraemic toxins depending on extracorporeal treatment method used and appreciation of the quality and effectiveness of HD and HDF using Kt/V and URR in patients with ESRD. 4. To assess the impact of HDF on clinical and laboratory parameters in patients with ESRD. 5. To establish HDF as a safe method of treatment.

Scientific novelty and originality: study allowed for the first time in Moldova to demonstrate the HDF role in the treatment of ARF and ESRD.

The problem solved in scientific thesis is to argue choosing the type of replacement extracorporeal treatment in ARF and ESRD depending on ethiopathogenetic aspects and existing complications. HDF indications and safety were established. Decrease in frequency and intensity of ESRD complications was appreciated and ARF prognosis was improved.

Theoretical significance of the work. The results highlight the data related to the timeliness and benefits of the extrarenal method of treatment – hemodiafiltration in the complex treatment of patients with ARF and ESRD.

Practical value of the work. Conducted research fills the gaps in knowledge about homeostasis in acute or chronic dialysis patients and provides opportunity to improve the body's internal balance in patients with ARF and ESRD.

Implementation of scientific results: The results of research have been implemented in daily medical practice in Dialysis and Renal Transplantation Center CRH and Chisinau Emergency Hospital.