\u010cT 1 – Ud\u00e1losti<\/p>\n\n\n\n
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A\u017e milion lid\u00ed v \u010cesku \u017eije s chronick\u00fdm\u00a0onemocn\u011bn\u00edm<\/strong>\u00a0ledvin v r\u016fzn\u00fdch stadi\u00edch a polovina o n\u011bm nev\u00ed. Org\u00e1n toti\u017e a\u017e do posledn\u00ed f\u00e1ze, kdy u\u017e selh\u00e1v\u00e1, nebol\u00ed.<\/p>\n\n\n\n Medic\u00edna m\u00e1 p\u0159itom k dispozici \u010d\u00edm d\u00e1l v\u00edc\u00a0l\u00e9k\u016f<\/strong>, kter\u00e9 v\u00fdznamn\u011b pom\u00e1haj\u00ed, pokud se ale nasad\u00ed v\u010das. Praktici proto navrhli \u010dast\u011bj\u0161\u00ed prevenci a ministerstvo dokon\u010duje p\u0159\u00edslu\u0161nou vyhl\u00e1\u0161ku. Platit by mohla od p\u0159\u00ed\u0161t\u00edho roku.<\/p>\n\n\n\n Ve 40. Letech se zotavuje u\u017e z druh\u00e9 transplantace, poprv\u00e9 mu ledvinu darovala matka p\u0159ed 20 lety. Kdo mu zachr\u00e1nil \u017eivot te\u010f, nev\u00ed.<\/p>\n\n\n\n David Neplech, pacient po dvoj\u00ed transplantaci ledvin redaktorka \u010cT David Neplech, pacient po dvoj\u00ed transplantaci ledvin redaktorka \u010cT Ond\u0159ej Viklick\u00fd, p\u0159ednosta Transplantcentra, p\u0159ednosta Kliniky nefrologie IKEM redaktorka \u010cT Ludmila Bezd\u00ed\u010dkov\u00e1, praktick\u00e1 l\u00e9ka\u0159ka, Praha) Petr \u0160onka, p\u0159edseda Sdru\u017een\u00ed praktick\u00fdch l\u00e9ka\u0159\u016f<\/strong> Venu\u0161e \u0160kampov\u00e1, \u0159editelka odboru zdravotn\u00ed p\u00e9\u010de, MZ Ludmila Bezd\u00ed\u010dkov\u00e1, praktick\u00e1 l\u00e9ka\u0159ka, Praha) redaktorka \u010cT Z\u00e1kladn\u00edm \u00fakolem ledvin je separovat z krve odpadn\u00ed l\u00e1tky. To zaji\u0161\u0165uj\u00ed nefrony. P\u0159edstavit si je tedy m\u016f\u017eeme jako miniaturn\u00ed filtra\u010dn\u00ed stanice. V ka\u017ed\u00e9 z ledvin je jich a\u017e 1,5 milionu. Kdy\u017e se p\u0159et\u00ed\u017e\u00ed, postupn\u011b kolabuj\u00ed. \u010clov\u011bk to ale roky nemus\u00ed poci\u0165ovat. P\u0159\u00edznaky selh\u00e1n\u00ed se objevuj\u00ed teprve, kdy\u017e funguje jejich posledn\u00ed p\u011btina. To u\u017e je ale na z\u00e1chranu org\u00e1n\u016f pozd\u011b a pacient je odk\u00e1zan\u00fd na dial\u00fdzu nebo transplantaci. Pr\u00e1v\u011b proto je kl\u00ed\u010dov\u00fd v\u010dasn\u00fd z\u00e1chyt.<\/p>\n\n\n\n Ivan Rychl\u00edk, p\u0159edseda \u010cesk\u00e9 nefrologick\u00e9 spole\u010dnosti , moder\u00e1torka \u010cT Loni podstupovalo dial\u00fdzu na 6000 pacient\u016f. Jen VZP na jejich l\u00e9\u010dbu vydala p\u0159es \u010dty\u0159i miliardy. Dal\u0161\u00edch 6000 lid\u00ed v p\u00e9\u010di nefrolog\u016f bylo po transplantaci.<\/p>\n\n\n\n Na zm\u00edn\u011bnou dial\u00fdzu u\u017e lidi nemusej\u00ed jenom do nemocnice. V posledn\u00edch p\u011bti letech p\u0159ibylo t\u011bch, kte\u0159\u00ed ji podstupuj\u00ed doma. Je jich na 200 a ka\u017ed\u00fd rok se p\u0159id\u00e1v\u00e1 v pr\u016fm\u011bru 20 dal\u0161\u00edch. V\u0161e pln\u011b hrazeno poji\u0161\u0165ovnou.<\/p>\n\n\n\n Vy\u010distit, opatrn\u011b nap\u00edchnout a pak spustit p\u0159\u00edstroj. \u00dakony, kter\u00e9 Dana Hanu\u0161ov\u00e1 u\u017e dob\u0159e zn\u00e1, p\u0159esto\u017ee zdravotnici nikdy ned\u011blala, star\u00e1 se o nemocn\u00e9ho man\u017eela. \u017de mu selh\u00e1vaj\u00ed ledviny, se dozv\u011bd\u011bl p\u0159ed p\u011bti lety.<\/p>\n\n\n\n Dominik Hanu\u0161, pacient s dom\u00e1c\u00ed dial\u00fdzou redaktorka \u010cT Dana Hnu\u0161ov\u00e1, man\u017eelka pacienta Dominik Hanu\u0161, pacient s dom\u00e1c\u00ed dial\u00fdzou Dominik Hanu\u0161, pacient s dom\u00e1c\u00ed dial\u00fdzou , redaktorka \u010cT Ivana Jordanov, vedouc\u00ed l\u00e9ka\u0159ka, Dializa\u010dn\u00ed st\u0159edisko Praha \u2013 Homolk, B-Braun , redaktorka \u010cT Ivana Jordanov, vedouc\u00ed l\u00e9ka\u0159ka, Dializa\u010dn\u00ed st\u0159edisko Praha \u2013 Homolk, B-Braun , redaktorka \u010cT Ivan Rychl\u00edk, p\u0159edseda \u010cesk\u00e9 nefrologick\u00e9 spole\u010dnosti , redaktorka \u010cT Dana Hnu\u0161ov\u00e1, man\u017eelka pacienta , redaktorka \u010cT \u010cT 1 – Ud\u00e1losti A\u017e milion lid\u00ed v \u010cesku \u017eije s chronick\u00fdm\u00a0onemocn\u011bn\u00edm\u00a0ledvin v r\u016fzn\u00fdch stadi\u00edch a polovina o n\u011bm nev\u00ed. Org\u00e1n toti\u017e a\u017e do posledn\u00ed […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":55813,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-58333","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/58333","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=58333"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/58333\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/55813"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=58333"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=58333"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=58333"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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Ledvina se uchytila dob\u0159e, v\u00fdborn\u011b funguje a po transplantaci jsem, dneska je to t\u00fdden.<\/p>\n\n\n\n
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David Neplech m\u00e1 probl\u00e9my s ledvinami od d\u011btstv\u00ed. \u017de prvn\u00ed darovan\u00fd org\u00e1n p\u0159est\u00e1v\u00e1 plnit funkci, poc\u00edtil loni v l\u00e9t\u011b.<\/p>\n\n\n\n
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Ve chv\u00edli, kdy\u017e odch\u00e1z\u00ed, tak v\u00e1s nebol\u00ed. Tam jsou p\u0159\u00edznaky, otoky, otoky nohou, jo, to jsem m\u011blo opuchlou nohu, tak u\u017e jsem v\u011bd\u011bl, \u017ee je n\u011bco \u0161patn\u011b.<\/p>\n\n\n\n
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Chronick\u00e9 selh\u00e1n\u00ed ledvin ro\u010dn\u011b v \u010cesku postihne kolem 2000 lid\u00ed, polovina z nich o probl\u00e9mech do t\u00e9 doby nev\u00ed.<\/p>\n\n\n\n
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My jsme d\u011blali takovej zaj\u00edmavej screening v IKEMu, kdy jsme pacienty, kter\u00fd le\u017e\u00ed nebo jsou vy\u0161et\u0159ov\u00e1ni na ambulanc\u00edch ne nefrologick\u00fdch, to znamen\u00e1, \u017ee jsou t\u0159eba na hepatogastroenterologii, na diabetologii nebo na kardiologii, tak jsme u nich provedli screening, je to celkem asi 3000 pacient\u016f, u kter\u00fdch jsme vy\u0161et\u0159ili funkci ledvin a zhruba 25 % z nich m\u00e1 p\u0159\u00edtomnou pr\u00e1v\u011b b\u00edlkovinu mo\u010di, v\u016fbec to nev\u00ed.<\/p>\n\n\n\n
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Pr\u00e1v\u011b b\u00edlkovina v mo\u010di m\u016f\u017ee nazna\u010dovat probl\u00e9m s ledvinami, nov\u011b ji maj\u00ed praktici \u010dast\u011bji testovat b\u011bhem preventivn\u00edch prohl\u00eddek.<\/p>\n\n\n\n
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Tak vy jdete dneska na preventivn\u00ed prohl\u00eddku. Proto\u017ee m\u00e1te kardiovaskul\u00e1rn\u00ed onemocn\u011bn\u00ed<\/strong>, nech\u00e1me nabrat i parametry funkce ledvin.<\/p>\n\n\n\n
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Budeme nov\u011b vlastn\u011b vy\u0161et\u0159ovat ty parametry funkce ledvin u pacient\u016f s cukrovkou, s hypertenz\u00ed, se srde\u010dn\u00edm selh\u00e1n\u00edm a tak\u00e9 u asymptomatick\u00fdch zdrav\u00fdch pacient\u016f od 50 let vlastn\u011b ka\u017ed\u00e9 dva roky.<\/p>\n\n\n\n
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Ta novela vyhl\u00e1\u0161ky o preventivn\u00edch prohl\u00eddk\u00e1ch je po vnitrorezortn\u00edm p\u0159ipom\u00ednkov\u00e9m \u0159\u00edzen\u00ed. Nepl\u00e1nujeme tam n\u011bjak\u00e9 p\u0159evratn\u00e9 zm\u011bny, kter\u00e9 by se v\u00fdznamn\u011b li\u0161ily od toho n\u00e1vrhu praktick\u00fdch l\u00e9ka\u0159\u016f<\/strong>.<\/p>\n\n\n\n
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Ot\u00e1zka je, v jak\u00e9 frekvenci, zda je skute\u010dn\u011b p\u0159\u00ednosem, \u017ee ka\u017ed\u00e9 dva roky i \u010dlov\u011bk, kter\u00fd t\u0159eba v t\u011bch 50 bude m\u00edt \u00fapln\u011b norm\u00e1ln\u00ed hodnoty, \u017ee m\u00e1 smysl ho ka\u017ed\u00e9 dva roky znovu kontrolovat.<\/p>\n\n\n\n
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Podle Ludmily Bezd\u00ed\u010dkov\u00e9 je d\u016fle\u017eit\u00e9 se soust\u0159edit na prvotn\u00ed p\u0159\u00ed\u010diny rozvoje\u00a0onemocn\u011bn\u00ed<\/strong>\u00a0ledvin, \u0159e\u0161it obezitu, vysok\u00fd krevn\u00ed tlak a nezdrav\u00fd \u017eivotn\u00ed styl. <\/p>\n\n\n\n
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V p\u0159\u00edpad\u011b, \u017ee ten pacient je l\u00e9\u010den v t\u00e9 \u010dasn\u00e9 f\u00e1zi, kdy u\u017e je jasn\u00e9, \u017ee n\u011bjak\u00e9 chronick\u00e9 onemocn\u011bn\u00ed<\/strong> ledvin m\u00e1, a to \u010d\u00edslo je ohromuj\u00edc\u00ed, proto\u017ee k odlo\u017een\u00ed zah\u00e1jen\u00ed dial\u00fdzy dojde o v\u00edce ne\u017e 26 let.<\/p>\n\n\n\n
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Hlavn\u00edmi faktory, kter\u00e9 funkci ledvin ovliv\u0148uj\u00ed a m\u016f\u017eou v\u00e9st a\u017e k jejich selh\u00e1n\u00ed, jsou diabetes, obezita a vysok\u00fd krevn\u00ed tlak, kapacitu org\u00e1n\u016f sni\u017euj\u00ed taky jeho opakuj\u00edc\u00ed se z\u00e1n\u011bty.<\/p>\n\n\n\n
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Bylo to pro m\u011b n\u011bco hrozn\u00fdho, j\u00e1 jsem se rozhodl, \u017ee jako na dial\u00fdzu, ne, \u017ee si vezmu ty l\u00e9ky<\/strong> a rad\u0161i teda budu \u017e\u00edt jenom kr\u00e1tkou dobu, no, ale pak m\u011b profesor doporu\u010dil, \u017ee vlastn\u011b je i ta dom\u00e1c\u00ed dial\u00fdza, jo?<\/p>\n\n\n\n
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Tu nemocni\u010dn\u00ed podstoupil jen jednou, pak u\u017e mu s dial\u00fdzou pom\u00e1hala man\u017eelka. Prvn\u00ed t\u0159i m\u011bs\u00edce pod dohledem zdravotn\u00ed sestry, te\u010f u\u017e j\u00ed o pomoc vol\u00e1 z\u0159\u00eddka.<\/p>\n\n\n\n
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M\u00e1m obavu ka\u017ed\u00fd den, j\u00e1 prost\u011b poka\u017ed\u00fd, kdy\u017e man\u017eela napojuju, tak prost\u011b poka\u017ed\u00fd m\u00e1m…<\/p>\n\n\n\n
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Ona je tr\u00e9mistka.<\/p>\n\n\n\n
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J\u00e1 jsem tr\u00e9mistka.<\/p>\n\n\n\n
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P\u0159esto je podle nich dom\u00e1ci dial\u00fdza jednozna\u010dne v\u00fdhoda. Dominik Hanu\u0161 tr\u00e1v\u00ed na p\u0159\u00edstroji p\u011bt dn\u00ed v t\u00fddnu 3,5 hodiny denn\u011b, zato v soukrom\u00ed a bez nutnosti doj\u00ed\u017ed\u011bt do nemocnice.<\/p>\n\n\n\n
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Dialyzujeme t\u0159ikr\u00e1t t\u00fddn\u011b 4\u20135 hodin, m\u00e1me tady zhruba asi 50 pacient\u016f, kter\u00e9 dialyzujeme ve dvou sm\u011bn\u00e1ch. Jehli\u010dkou bereme krev, kter\u00e1 jde do dialyza\u010dn\u00edho monitoru, zde prob\u00edh\u00e1 vlastn\u011b cyklus \u010di\u0161t\u011bn\u00ed p\u0159es kapil\u00e1ru a zase potom zp\u00e1tky p\u0159es pumpu d\u00e1v\u00e1me krev.<\/p>\n\n\n\n
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Nejen \u010de\u0161t\u00ed pacienti. Ka\u017ed\u00fd m\u011bs\u00edc takto o\u0161et\u0159\u00ed minim\u00e1ln\u011b i jednoho turistu.<\/p>\n\n\n\n
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M\u011bli jsme tady pacienty z USA, z Izraele, z arabsk\u00fdch zem\u00ed, tak\u017ee se sna\u017e\u00edme jim vyj\u00edt vst\u0159\u00edc.<\/p>\n\n\n\n
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Tuzemsk\u00fdm pacient\u016fm pak nab\u00edz\u00ed pomoc za\u0159\u00eddit zase dial\u00fdzu v zahrani\u010d\u00ed, pokud se rozhodnou vycestovat. To lid\u00e9, co se l\u00e9\u010d\u00ed doma, \u0159e\u0161it nemus\u00ed.<\/p>\n\n\n\n
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Obvykle ten pacient pot\u0159ebuje taky m\u00e9n\u011b l\u00e9k\u016f<\/strong> a obvykle i jeho kvalita \u017eivota je mnohem lep\u0161\u00ed, tak\u017ee jsou i pacienti, kte\u0159\u00ed s dom\u00e1c\u00ed dial\u00fdzou dok\u00e1\u017eou b\u011b\u017en\u011b cestovat zcela bez probl\u00e9m\u016f.<\/p>\n\n\n\n
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Hanu\u0161ovi takto pravideln\u011b vyr\u00e1\u017e\u00ed t\u0159eba na v\u00fdlet s karavanem.<\/p>\n\n\n\n
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Dial\u00fdzu si m\u016f\u017eete d\u00e1t dovnit\u0159 a nebo pak tady m\u00e1te prostor, kdy vlastn\u011b m\u016f\u017eete si d\u00e1t vaky sem.<\/p>\n\n\n\n
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Aspo\u0148 \u010d\u00e1ste\u010dn\u011b se tak mohli vr\u00e1tit k aktivit\u00e1m, kter\u00e9 m\u011bli r\u00e1di p\u0159edt\u00edm, ne\u017e se diagn\u00f3zu dozv\u011bd\u011bli. <\/p>\n","protected":false},"excerpt":{"rendered":"