{"id":4018,"date":"2026-10-14T23:34:41","date_gmt":"2026-10-14T22:34:41","guid":{"rendered":"https:\/\/wpcalc.com\/tr\/tisbi\/meld-na-puani-hesaplama\/"},"modified":"2026-10-14T23:34:41","modified_gmt":"2026-10-14T22:34:41","slug":"meld-na-puani-hesaplama","status":"publish","type":"post","link":"https:\/\/wpcalc.com\/tr\/tisbi\/meld-na-puani-hesaplama\/","title":{"rendered":"MELD-Na Puan\u0131 Hesaplama Arac\u0131"},"content":{"rendered":"<section class=\"not-prose calculator-box\" aria-labelledby=\"calculator-title\"><div class=\"flex items-baseline sm:items-center justify-between gap-2 sm:gap-3\"><div class=\"flex flex-col sm:flex-row sm:items-center gap-2\"><span class=\"icon icon-calculator text-primary-700! text-base! dark:text-primary-300!\" aria-hidden=\"true\"><\/span><h2 id=\"calculator-title\" class=\"text-lg font-display font-bold\">Laboratuvar sonu\u00e7lar\u0131n\u0131za g\u00f6re karaci\u011fer hastal\u0131\u011f\u0131n\u0131n ciddiyetini de\u011ferlendirin<\/h2><\/div><div class=\"calcdash-favorite group\">\n  <button type=\"button\" class=\"favorite\" id=\"favorite\" data-favorite-id=\"4018\" data-favorite-title=\"MELD-Na Puan\u0131\" data-favorite-url=\"https:\/\/wpcalc.com\/tr\/tisbi\/meld-na-puani-hesaplama\/\" data-favorite-excerpt=\"Bilirubin, INR, kreatinin ve sodyum de\u011ferlerinizle MELD-Na puan\u0131n\u0131z\u0131 hesaplay\u0131n; kronik karaci\u011fer hastal\u0131\u011f\u0131n\u0131n a\u011f\u0131rl\u0131\u011f\u0131n\u0131 ve 3 ayl\u0131k \u00f6l\u00fcm riskini tahmin edin. Sonucu g\u00f6rmek i\u00e7in laboratuvar de\u011ferlerinizi girin.\" aria-label=\"Favorilere ekle\" data-favorite-icon=\"icon icon-flask\">\n    <span class=\"icon icon-shape-star-empty\" aria-hidden=\"true\"><\/span>\n  <\/button>\n  <div class=\"calcdash-favorite__tip\" aria-hidden=\"true\">\n   <span class=\"favorite-tooltip\" id=\"favorite-tooltip\"><\/span>\n  <\/div>\n  <span class=\"sr-only\" role=\"status\" id=\"favorite-status\"><\/span>\n<\/div><\/div><form action=\"https:\/\/wpcalc.com\/tr\/tisbi\/meld-na-puani-hesaplama\/\" method=\"POST\" class=\"calculator\" id=\"calculator-4018\" data-post=\"4018\"><fieldset class=\"fieldset-input is-2\"><legend class=\"sr-only\">Giri\u015f alanlar\u0131<\/legend><div class=\"field has-term\" id=\"input-1\"><label for=\"field-1\">Serum bilirubin<\/label><div class=\"term\">TBili<\/div>  <div class=\"absolute bottom-0 left-16 top-8 w-2 h-0.5 bg-blue-500\"><\/div><div class=\"field-group\"><input type=\"text\" name=\"serum_bilirubin\" id=\"field-1\" aria-describedby=\"calc-info-1\" data-number inputmode=\"decimal\" autocomplete=\"off\" spellcheck=\"false\" min=\"0.1\" max=\"100\" value=\"2\"\/><div class=\"grid grid-cols-1\"><select id=\"field-2\" name=\"birim\" aria-label=\"Birim\"><option value=\"mgdl\" selected>mg\/dL<\/option><option value=\"umol\">\u00b5mol\/L<\/option><\/select><svg class=\"pointer-events-none col-start-1 row-start-1 mr-2 size-5 self-center justify-self-end text-gray-500 sm:size-4\" viewBox=\"0 0 16 16\" fill=\"currentColor\" aria-hidden=\"true\" data-slot=\"icon\">\n              <path fill-rule=\"evenodd\" d=\"M4.22 6.22a.75.75 0 0 1 1.06 0L8 8.94l2.72-2.72a.75.75 0 1 1 1.06 1.06l-3.25 3.25a.75.75 0 0 1-1.06 0L4.22 7.28a.75.75 0 0 1 0-1.06Z\" clip-rule=\"evenodd\" \/>\n            <\/svg><\/div><\/div><small id=\"calc-info-1\">Kan tahlilinizdeki total bilirubin de\u011feri<\/small><\/div><div class=\"field has-term\" id=\"input-2\"><label for=\"field-3\">INR<\/label><div class=\"term\">INR<\/div>  <div class=\"absolute bottom-0 left-16 top-8 w-2 h-0.5 bg-blue-500\"><\/div><input type=\"text\" name=\"inr\" id=\"field-3\" aria-describedby=\"calc-info-3\" data-number inputmode=\"decimal\" autocomplete=\"off\" spellcheck=\"false\" min=\"0.5\" max=\"10\" value=\"1.5\"\/><small id=\"calc-info-3\">Uluslararas\u0131 normalize oran (protrombin zaman\u0131)<\/small><\/div><div class=\"field has-term\" id=\"input-3\"><label for=\"field-4\">Serum kreatinin<\/label><div class=\"term\">Cr<\/div>  <div class=\"absolute bottom-0 left-16 top-8 w-2 h-0.5 bg-blue-500\"><\/div><div class=\"field-group\"><input type=\"text\" name=\"serum_kreatinin\" id=\"field-4\" aria-describedby=\"calc-info-4\" data-number inputmode=\"decimal\" autocomplete=\"off\" spellcheck=\"false\" min=\"0.1\" max=\"20\" value=\"1.2\"\/><div class=\"grid grid-cols-1\"><select id=\"field-5\" name=\"birim\" aria-label=\"Birim\"><option value=\"mgdl\" selected>mg\/dL<\/option><option value=\"umol\">\u00b5mol\/L<\/option><\/select><svg class=\"pointer-events-none col-start-1 row-start-1 mr-2 size-5 self-center justify-self-end text-gray-500 sm:size-4\" viewBox=\"0 0 16 16\" fill=\"currentColor\" aria-hidden=\"true\" data-slot=\"icon\">\n              <path fill-rule=\"evenodd\" d=\"M4.22 6.22a.75.75 0 0 1 1.06 0L8 8.94l2.72-2.72a.75.75 0 1 1 1.06 1.06l-3.25 3.25a.75.75 0 0 1-1.06 0L4.22 7.28a.75.75 0 0 1 0-1.06Z\" clip-rule=\"evenodd\" \/>\n            <\/svg><\/div><\/div><small id=\"calc-info-4\">Kan tahlili raporunuzdan<\/small><\/div><div class=\"field has-term\" id=\"input-4\"><label for=\"field-6\">Serum sodyum<\/label><div class=\"term\">Na<\/div>  <div class=\"absolute bottom-0 left-16 top-8 w-2 h-0.5 bg-blue-500\"><\/div><input type=\"text\" name=\"serum_sodyum\" id=\"field-6\" aria-describedby=\"calc-unit-6 calc-info-6\" data-number inputmode=\"decimal\" autocomplete=\"off\" spellcheck=\"false\" min=\"100\" max=\"170\" value=\"134\"\/><div class=\"unit\" id=\"calc-unit-6\">mEq\/L<\/div><small id=\"calc-info-6\">De\u011ferler form\u00fclde 125\u2013137 mEq\/L aral\u0131\u011f\u0131na s\u0131n\u0131rland\u0131r\u0131l\u0131r<\/small><\/div><div class=\"field is-checkbox is-single\" id=\"input-5\"><input type=\"checkbox\" id=\"field-7\" value=\"1\"\/><label for=\"field-7\">Son bir haftada en az iki kez diyaliz<\/label><\/div><\/fieldset><div class=\"buttons\"><button type=\"submit\" data-text=\"Yeniden hesapla\" id=\"calculate-button\" data-post=\"4018\">Hesapla<\/button><button type=\"reset\">S\u0131f\u0131rla<\/button><\/div><div class=\"field is-checkbox hidden!\" id=\"field-auto-calc\"><input type=\"checkbox\" id=\"auto-calc\"><label for=\"auto-calc\">Otomatik hesapla<\/label><small>Etkinle\u015ftirilirse, herhangi bir de\u011feri de\u011fi\u015ftirdi\u011finizde sonu\u00e7 otomatik olarak g\u00fcncellenir.<\/small><\/div><div class=\"fieldset-result is-hidden\" aria-labelledby=\"result-title\" aria-live=\"polite\" role=\"region\"> <h3 class=\"result-title bg-gradient-to-r from-primary-50 to-gray-50 dark:from-primary-900 dark:to-gray-800\" id=\"result-title\"><span class=\"icon icon-s-pulse\" aria-hidden=\"true\"><\/span> MELD-Na sonucunuz<\/h3><div class=\"result-box\"><div class=\"field-result\" id=\"output-1\"><span class=\"field-title\"><span>MELD-Na skoru<\/span><span class=\"result-term\">MELD-Na<\/span><\/span><span class=\"field-value\" id=\"result-1\"><\/span><button type=\"button\" class=\"copy-result\" data-tooltip=\"Sonucu kopyala\" aria-label=\"Sonucu kopyala\"><span class=\"copy-icon icon icon-document-copy\" aria-hidden=\"true\"><\/span><\/button><\/div><div class=\"field-result\" id=\"output-2\"><span class=\"field-title\"><span>Temel MELD skoru<\/span><span class=\"result-term\">MELD(i)<\/span><\/span><span class=\"field-value\" id=\"result-2\"><\/span><button type=\"button\" class=\"copy-result\" data-tooltip=\"Sonucu kopyala\" aria-label=\"Sonucu kopyala\"><span class=\"copy-icon icon icon-document-copy\" aria-hidden=\"true\"><\/span><\/button><\/div><div class=\"field-result is-column\" id=\"output-3\"><span class=\"field-title\"><span>3 ayl\u0131k tahmini mortalite<\/span><\/span><span class=\"field-value\" id=\"result-3\"><\/span><button type=\"button\" class=\"copy-result\" data-tooltip=\"Sonucu kopyala\" aria-label=\"Sonucu kopyala\"><span class=\"copy-icon icon icon-document-copy\" aria-hidden=\"true\"><\/span><\/button><\/div><div class=\"field-result is-column\" id=\"output-4\"><span class=\"field-title\"><span>Bu ne anlama geliyor<\/span><\/span><span class=\"field-value\" id=\"result-4\"><\/span><button type=\"button\" class=\"copy-result\" data-tooltip=\"Sonucu kopyala\" aria-label=\"Sonucu kopyala\"><span class=\"copy-icon icon icon-document-copy\" aria-hidden=\"true\"><\/span><\/button><\/div><\/div><div class=\"result-actions\"><button type=\"button\" class=\"copy-link\"><svg viewBox=\"0 0 20 20\" fill=\"currentColor\" aria-hidden=\"true\"><path d=\"M12.232 4.232a2.5 2.5 0 0 1 3.536 3.536l-1.225 1.224a.75.75 0 0 0 1.061 1.06l1.224-1.224a4 4 0 0 0-5.656-5.656l-3 3a4 4 0 0 0 .225 5.865.75.75 0 0 0 .977-1.138 2.5 2.5 0 0 1-.142-3.667l3-3Z\"\/><path d=\"M11.603 7.963a.75.75 0 0 0-.977 1.138 2.5 2.5 0 0 1 .142 3.667l-3 3a2.5 2.5 0 0 1-3.536-3.536l1.225-1.224a.75.75 0 0 0-1.061-1.06l-1.224 1.224a4 4 0 1 0 5.656 5.656l3-3a4 4 0 0 0-.225-5.865Z\"\/><\/svg><span class=\"copy-link__text\">Bu hesaplaman\u0131n ba\u011flant\u0131s\u0131n\u0131 kopyala<\/span><\/button><span class=\"sr-only\" role=\"status\" id=\"copy-link-status\"><\/span><\/div><\/div><a href=\"#respond\" class=\"hidden transition-opacity duration-300 opacity-0 w-50 text-sm justify-center items-center gap-2 px-4 py-2 rounded bg-gray-200 text-gray-700 hover:bg-gray-300\" id=\"leave-comment\"><span class=\"icon icon-comments\" aria-hidden=\"true\"><\/span>Yorum b\u0131rak<\/a><\/form><\/section><section id=\"calc-reactions\" class=\"not-prose hidden my-12 bg-gradient-to-r from-primary-50 to-gray-50 border border-indigo-100 rounded-xl px-6 py-4 shadow-sm\" data-post=\"4018\" aria-live=\"polite\" aria-labelledby=\"calc-reactions-title\"><p id=\"calc-reactions-title\" class=\"text-sm text-gray-500 text-center mb-2\">Bu sonu\u00e7 hakk\u0131nda ne d\u00fc\u015f\u00fcn\u00fcyorsunuz?<\/p><div role=\"group\" aria-labelledby=\"calc-reactions-title\" class=\"grid grid-cols-3 sm:flex sm:flex-row sm:justify-around gap-4 sm:items-center sm:flex-wrap\"><button type=\"button\" aria-pressed=\"false\" class=\"reaction-btn flex flex-col items-center gap-1 text-sm text-gray-700 hover:text-primary-600 cursor-pointer transition-transform hover:scale-105\" data-reaction=\"like\"><span class=\"reaction-count\" data-reaction-count=\"like\">0<\/span><span class=\"reaction text-3xl\" aria-hidden=\"true\">\ud83d\ude00 <\/span><span class=\"reaction-description font-medium\">Be\u011fendim <\/span><\/button><button type=\"button\" aria-pressed=\"false\" class=\"reaction-btn flex flex-col items-center gap-1 text-sm text-gray-700 hover:text-primary-600 cursor-pointer transition-transform hover:scale-105\" data-reaction=\"helpful\"><span class=\"reaction-count\" data-reaction-count=\"helpful\">0<\/span><span class=\"reaction text-3xl\" aria-hidden=\"true\">\ud83d\udca1 <\/span><span class=\"reaction-description font-medium\">Faydal\u0131 <\/span><\/button><button type=\"button\" aria-pressed=\"false\" class=\"reaction-btn flex flex-col items-center gap-1 text-sm text-gray-700 hover:text-primary-600 cursor-pointer transition-transform hover:scale-105\" data-reaction=\"confused\"><span class=\"reaction-count\" data-reaction-count=\"confused\">0<\/span><span class=\"reaction text-3xl\" aria-hidden=\"true\">\ud83d\ude15 <\/span><span class=\"reaction-description font-medium\">Kafam kar\u0131\u015ft\u0131 <\/span><\/button><button type=\"button\" aria-pressed=\"false\" class=\"reaction-btn flex flex-col items-center gap-1 text-sm text-gray-700 hover:text-primary-600 cursor-pointer transition-transform hover:scale-105\" data-reaction=\"disappointed\"><span class=\"reaction-count\" data-reaction-count=\"disappointed\">0<\/span><span class=\"reaction text-3xl\" aria-hidden=\"true\">\ud83d\ude1e <\/span><span class=\"reaction-description font-medium\">Hayal k\u0131r\u0131kl\u0131\u011f\u0131 <\/span><\/button><button type=\"button\" aria-pressed=\"false\" class=\"reaction-btn flex flex-col items-center gap-1 text-sm text-gray-700 hover:text-primary-600 cursor-pointer transition-transform hover:scale-105\" data-reaction=\"inaccurate\"><span class=\"reaction-count\" data-reaction-count=\"inaccurate\">0<\/span><span class=\"reaction text-3xl\" aria-hidden=\"true\">\u274c <\/span><span class=\"reaction-description font-medium\">Hatal\u0131 <\/span><\/button><\/div><div id=\"reaction-message\" class=\"hidden mt-8 rounded-md border border-primary-100 bg-white\/50 backdrop-blur-sm px-4 py-2 text-sm text-center shadow-sm\"><\/div><\/section><div class=\"calcdash-ad not-prose calcdash-ad--calc_result calcdash-ad--in-article\"><ins class=\"adsbygoogle\" style=\"display:block\" data-ad-client=\"ca-pub-1721569815777345\" data-ad-slot=\"6317458308\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\"><\/ins><script>(adsbygoogle = window.adsbygoogle || []).push({});<\/script><\/div>\n<style id=\"wpcoderpro-inline-1\">.formula-box {\r\n\tborder-bottom: none !important;\r\n}<\/style><section class=\"formula-box\" aria-labelledby=\"formula-title\">\r\n\t<div id=\"formula-title\" class=\"not-prose font-display mb-4\"><span class=\"icon icon-formula\" aria-hidden=\"true\"><\/span><h2>MELD-Na Puan\u0131 Form\u00fcl\u00fc<\/h2><\/div>\r\n\t<figure class=\"not-prose formula\">\r\n\t\t<figcaption class=\"formula-title\">Form\u00fcl<\/figcaption>\r\n\t\t<div class=\"text-base text-gray-800\" id=\"formula\">\\[ \\text{MELD(i)} = 10 \\times \\big( 0.957 \\times \\ln(\\text{Cr}) + 0.378 \\times \\ln(\\text{TBili}) + 1.120 \\times \\ln(\\text{INR}) + 0.643 \\big) \\]\\[ \\text{MELD-Na} = \\text{MELD(i)} + 1.32 \\times (137 - \\text{Na}) - 0.033 \\times \\text{MELD(i)} \\times (137 - \\text{Na}) \\]<\/div>\r\n\t<\/figure>\r\n\t<\/p>\n<p><strong>Buradaki:<\/strong><\/p>\n<ul>\n<li>\\(\\text{Cr}\\) \u2014 serum kreatinini, mg\/dL cinsinden (en az 1,0 kabul edilir, 4,0 ile s\u0131n\u0131rlan\u0131r; hasta ge\u00e7en hafta en az iki kez diyalize girdiyse 4,0 olarak al\u0131n\u0131r)<\/li>\n<li>\\(\\text{TBili}\\) \u2014 toplam serum bilirubini, mg\/dL cinsinden (en az 1,0 kabul edilir)<\/li>\n<li>\\(\\text{INR}\\) \u2014 uluslararas\u0131 normalize oran (en az 1,0 kabul edilir)<\/li>\n<li>\\(\\text{Na}\\) \u2014 serum sodyumu, mEq\/L cinsinden; 125\u2013137 aral\u0131\u011f\u0131na s\u0131n\u0131rland\u0131r\u0131l\u0131r<\/li>\n<\/ul>\n<p>\u0130lk denklem, b\u00f6brek fonksiyonu, bilirubin ve p\u0131ht\u0131la\u015fma de\u011ferlerinden \u00f6zg\u00fcn MELD puan\u0131n\u0131 hesaplar; ikincisi ise sodyum d\u00fc\u015ft\u00fc\u011f\u00fcnde puan\u0131 yukar\u0131 do\u011fru d\u00fczeltir; bu, ileri karaci\u011fer hastal\u0131\u011f\u0131nda hiponatremiyi ekledi\u011fi \u00f6l\u00fcm riskini yans\u0131t\u0131r. Nihai puan 1 ile 40 aras\u0131nda kal\u0131r.<\/p>\n<p>\r\n<\/section>\n<style id=\"wpcoderpro-inline-2\">.calculation-box {\r\n\tborder-bottom: none !important;\r\n}<\/style><section id=\"calculation\" class=\"calculation-box\" aria-labelledby=\"calculation-title\">\r\n\t<div id=\"calculation-title\" class=\"not-prose font-display\"><span class=\"icon icon-unordered-list\" aria-hidden=\"true\"><\/span><h2>MELD-Na Puan\u0131 \u2013 Hesaplama \u00d6rne\u011fi<\/h2><\/div>\r\n\r\n<\/p>\n<p><strong>\u00d6rnek:<\/strong> bir hastan\u0131n toplam bilirubini 2 mg\/dL, INR de\u011feri 1,5, kreatinini 1,2 mg\/dL, sodyumu 134 mEq\/L ve hasta ge\u00e7en hafta iki kez diyalize girmi\u015ftir. Diyaliz nedeniyle kreatinin 4,0 mg\/dL olarak al\u0131n\u0131r.<\/p>\n<p>\\[ \\text{MELD(i)} = 10 \\times (0.957 \\times \\ln 4.0 + 0.378 \\times \\ln 2 + 1.120 \\times \\ln 1.5 + 0.643) \\approx 26.9 \\]<\/p>\n<p>\\[ \\text{MELD-Na} = 26.9 + 1.32 \\times (137 - 134) - 0.033 \\times 26.9 \\times (137 - 134) \\approx 28.2 \\]<\/p>\n<p><strong>Sonu\u00e7:<\/strong> MELD-Na puan\u0131 <strong>28<\/strong> (temel MELD \u2248 26,9); bu, yakla\u015f\u0131k %19,6'l\u0131k tahmini 3 ayl\u0131k \u00f6l\u00fcm riskine kar\u015f\u0131l\u0131k gelir.<\/p>\n<p>\n\r\n<\/section>\n<h2>MELD-Na hesaplama arac\u0131 nas\u0131l kullan\u0131l\u0131r?<\/h2>\n<ol>\n<li>Kan tahlili raporunuzdaki <strong>serum bilirubin<\/strong> de\u011ferini girin ve birimi se\u00e7in \u2014 mg\/dL veya \u00b5mol\/L. Raporunuz \u00b5mol\/L cinsindense hesaplama arac\u0131 otomatik olarak d\u00f6n\u00fc\u015ft\u00fcr\u00fcr.<\/li>\n<li>Kan\u0131n ne h\u0131zl\u0131 p\u0131ht\u0131la\u015ft\u0131\u011f\u0131n\u0131 g\u00f6steren <strong>INR<\/strong> (uluslararas\u0131 normalize oran) de\u011ferinizi girin.<\/li>\n<li><strong>Serum kreatinini<\/strong> girin ve do\u011fru birimi se\u00e7in: mg\/dL veya \u00b5mol\/L.<\/li>\n<li><strong>Serum sodyumunu<\/strong> mEq\/L cinsinden girin. 125\u2013137 mEq\/L aral\u0131\u011f\u0131 d\u0131\u015f\u0131ndaki de\u011ferler, form\u00fcl\u00fcn gerektirdi\u011fi \u015fekilde bu aral\u0131\u011fa s\u0131n\u0131rland\u0131r\u0131l\u0131r.<\/li>\n<li>Ge\u00e7erliyse <strong>son bir haftada en az iki kez diyaliz<\/strong> onay kutusunu i\u015faretleyin \u2014 bu, hesaplamada kreatinini 4,0 mg\/dL olarak ayarlar.<\/li>\n<li>MELD-Na puan\u0131n\u0131z\u0131, temel MELD puan\u0131n\u0131, tahmini 3 ayl\u0131k \u00f6l\u00fcm riskini ve puan\u0131n ne anlama geldi\u011fine dair yorumu g\u00f6r\u00fcn.<\/li>\n<\/ol>\n<h2>MELD-Na puan\u0131 nedir?<\/h2>\n<p>MELD-Na puan\u0131 (sodyum dahil Son D\u00f6nem Karaci\u011fer Hastal\u0131\u011f\u0131 Modeli), OPTN\/UNOS gibi nakil kurulu\u015flar\u0131n\u0131n kronik karaci\u011fer hastalar\u0131n\u0131 karaci\u011fer nakli i\u00e7in s\u0131ralamakta kulland\u0131\u011f\u0131 standart ara\u00e7t\u0131r. D\u00f6rt rutin laboratuvar de\u011ferini \u2014 bilirubin, INR, kreatinin ve sodyum \u2014 1 ile 40 aras\u0131nda tek bir say\u0131ya d\u00f6n\u00fc\u015ft\u00fcr\u00fcr. Y\u00fcksek puan, daha a\u011f\u0131r karaci\u011fer hastal\u0131\u011f\u0131 ve \u00fc\u00e7 ay i\u00e7inde \u00f6lme riskinin daha y\u00fcksek oldu\u011fu anlam\u0131na gelir; bu da nakil bekleme listesinde \u00f6nceli\u011fi art\u0131r\u0131r.<\/p>\n<p>\u00d6zg\u00fcn MELD puan\u0131 yaln\u0131zca bilirubin, INR ve kreatinini kullan\u0131yordu. Ancak d\u00fc\u015f\u00fck serum sodyumunun (hiponatremi) siroz ve portal hipertansiyonlu hastalarda \u00f6l\u00fcm\u00fcn ba\u011f\u0131ms\u0131z bir belirleyicisi oldu\u011fu anla\u015f\u0131l\u0131nca 2016'da sodyum d\u00fczeltmesi eklendi. Bilirubin, INR ve kreatinin de\u011ferleri ayn\u0131 olan iki hasta, sodyumlar\u0131 farkl\u0131ysa \u00e7ok farkl\u0131 MELD-Na puanlar\u0131 alabilir: 125 mEq\/L'lik sodyum, temel MELD de\u011ferine ba\u011fl\u0131 olarak puan\u0131 yakla\u015f\u0131k 6\u201310 puan art\u0131rabilir; 137 veya \u00fczeri sodyum ise hi\u00e7bir \u015fey eklemez.<\/p>\n<p>Puan geni\u015f bantlar halinde yorumlan\u0131r. 15'in alt\u0131nda karaci\u011fer fonksiyonu g\u00f6rece korunmu\u015ftur ve \u00e7o\u011fu merkez hastay\u0131 nakil listesine almaz; \u00e7\u00fcnk\u00fc cerrahi risk, hastal\u0131\u011f\u0131n kendisinin riskini a\u015far. 15\u201324 aras\u0131 puanlar orta d\u00fczeyde a\u011f\u0131rl\u0131k g\u00f6sterir ve genellikle nakil de\u011ferlendirmesini ba\u015flat\u0131r. 25\u201334 aras\u0131 puanlar, k\u0131sa vadede \u00f6nemli risk ta\u015f\u0131yan ileri hastal\u0131\u011fa; 35 ve \u00fczeri puan ise acil uzman takibi ve y\u00fcksek nakil \u00f6nceli\u011fi gerektiren \u00e7ok ileri hastal\u0131\u011fa i\u015faret eder.<\/p>\n<p>MELD-Na nesnel laboratuvar de\u011ferlerine dayand\u0131\u011f\u0131 i\u00e7in organ da\u011f\u0131t\u0131m\u0131ndaki \u00f6znelli\u011fi azalt\u0131r. Klinik tart\u0131\u015fmalarda da hastal\u0131k a\u011f\u0131rl\u0131\u011f\u0131n\u0131 anlatan ortak bir dil olarak yararl\u0131d\u0131r \u2014 ama topluluklar i\u00e7in istatistiksel bir tahmindir; tek tek hastalar i\u00e7in kehanet de\u011fildir.<\/p>\n<h2>Varsay\u0131mlar, s\u0131n\u0131rl\u0131l\u0131klar ve pratik ipu\u00e7lar\u0131<\/h2>\n<ul>\n<li><strong>\u00dcst ve alt s\u0131n\u0131rlar \u00f6nemlidir.<\/strong> Hesaplama arac\u0131 resm\u00ee OPTN kurallar\u0131n\u0131 uygular: bilirubin, INR ve kreatinin i\u00e7in en az 1,0 de\u011feri esas al\u0131n\u0131r (1,0'\u0131n alt\u0131ndaki de\u011ferler 1,0 say\u0131l\u0131r), kreatinin 4,0 mg\/dL ile s\u0131n\u0131rlan\u0131r ve sodyum 125\u2013137 mEq\/L aral\u0131\u011f\u0131na s\u0131k\u0131\u015ft\u0131r\u0131l\u0131r. 120 veya 145 sodyum girmek, s\u0131ras\u0131yla 125 veya 137 girmekle ayn\u0131 sonucu verir.<\/li>\n<li><strong>Diyaliz durumu sonucu ciddi bi\u00e7imde de\u011fi\u015ftirir.<\/strong> Hasta kan al\u0131nmadan \u00f6nceki haftada en az iki kez diyalize girdiyse, \u00f6l\u00e7\u00fclen de\u011fere bak\u0131lmaks\u0131z\u0131n kreatinin 4,0 mg\/dL olarak al\u0131n\u0131r. Bu durumda kutuyu mutlaka i\u015faretleyin.<\/li>\n<li><strong>\u00d6l\u00fcm oranlar\u0131 tarihsel tahminlerdir.<\/strong> G\u00f6sterilen y\u00fczdeler (\u22649 puan i\u00e7in yakla\u015f\u0131k %1,9; 10\u201319 i\u00e7in %6,0; 20\u201329 i\u00e7in %19,6; 30\u201339 i\u00e7in %52,6 ve 40 i\u00e7in %71,3) \u00f6zg\u00fcn MELD do\u011frulama kohortlar\u0131ndan gelir. Modern tedavi bir\u00e7ok bantta sa\u011fkal\u0131m\u0131 iyile\u015ftirmi\u015ftir.<\/li>\n<li><strong>Puan her \u015feyi yakalamaz.<\/strong> MELD-Na, karaci\u011fer ensefalopatisi, varis kanamas\u0131, geli\u015fmekte olan hepatorenal sendrom ya da karaci\u011fer kanseri (bu, ayr\u0131 bir istisna s\u00fcreciyle ele al\u0131n\u0131r) gibi komplikasyonlar\u0131 hesaba katmaz. Komplikasyonlu hastalar puanlar\u0131n\u0131n g\u00f6sterdi\u011finden daha a\u011f\u0131r durumda olabilir.<\/li>\n<li><strong>G\u00fcncel tahliller kullan\u0131n.<\/strong> Tek bir dengeli kan alma i\u015fleminden gelen de\u011ferler en anlaml\u0131 sonucu verir. Sodyum veya kreatinin h\u0131zla de\u011fi\u015fiyorsa puan bir haftadan di\u011ferine belirgin bi\u00e7imde kayabilir.<\/li>\n<li><strong>Bu ara\u00e7 bir tan\u0131 arac\u0131 de\u011fildir.<\/strong> MELD-Na puan\u0131 bir\u00e7ok veriden yaln\u0131zca biridir; sonu\u00e7lar\u0131n\u0131z\u0131 bir hepatolog veya nakil merkeziyle g\u00f6r\u00fc\u015f\u00fcn. Karaci\u011fer hastal\u0131\u011f\u0131n\u0131n yan\u0131 s\u0131ra b\u00f6brek fonksiyonunuzu da izliyorsan\u0131z <a href=\"https:\/\/wpcalc.com\/tr\/tisbi\/egfr-hesaplama-ckd-epi-2021\/\">eGFR hesaplama arac\u0131m\u0131z (CKD-EPI 2021)<\/a> ve <a href=\"https:\/\/wpcalc.com\/tr\/tisbi\/diyaliz-dozu\/\">diyaliz dozu (Kt\/V) hesaplama arac\u0131m\u0131z<\/a> da i\u015finize yarayabilir.<\/li>\n<\/ul>\n<h2>\u0130lgili hesaplama ara\u00e7lar\u0131<\/h2>\n<p>Karaci\u011fer hastal\u0131\u011f\u0131ndaki d\u00fc\u015f\u00fck sodyum genellikle dikkatli s\u0131v\u0131 y\u00f6netimi gerektirir \u2014 hipernatremi d\u00fczeltmesi i\u00e7in <a href=\"https:\/\/wpcalc.com\/tr\/tisbi\/serbest-su-acigi\/\">serbest su a\u00e7\u0131\u011f\u0131 hesaplama arac\u0131na<\/a> bak\u0131n. Hiponatreminin nedeni y\u00fcksek kan \u015fekeri ya da y\u00fcksek kan \u015fekeriyle maskelenmi\u015fse, ger\u00e7ek sodyum d\u00fczeyini tahmin etmek i\u00e7in <a href=\"https:\/\/wpcalc.com\/tr\/tisbi\/duzeltilmis-sodyum-hesaplama\/\">d\u00fczeltilmi\u015f sodyum hesaplama arac\u0131n\u0131<\/a> kullan\u0131n.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Bilirubin, INR, kreatinin ve sodyum de\u011ferlerinizle MELD-Na puan\u0131n\u0131z\u0131 hesaplay\u0131n; kronik karaci\u011fer hastal\u0131\u011f\u0131n\u0131n a\u011f\u0131rl\u0131\u011f\u0131n\u0131 ve 3 ayl\u0131k \u00f6l\u00fcm riskini tahmin edin. Sonucu g\u00f6rmek i\u00e7in laboratuvar de\u011ferlerinizi girin.<\/p>\n","protected":false},"author":3168,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[11],"tags":[33],"class_list":["post-4018","post","type-post","status-publish","format-standard","hentry","category-tisbi","tag-tani"],"acf":[],"_links":{"self":[{"href":"https:\/\/wpcalc.com\/tr\/wp-json\/wp\/v2\/posts\/4018","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wpcalc.com\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wpcalc.com\/tr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wpcalc.com\/tr\/wp-json\/wp\/v2\/users\/3168"}],"replies":[{"embeddable":true,"href":"https:\/\/wpcalc.com\/tr\/wp-json\/wp\/v2\/comments?post=4018"}],"version-history":[{"count":0,"href":"https:\/\/wpcalc.com\/tr\/wp-json\/wp\/v2\/posts\/4018\/revisions"}],"wp:attachment":[{"href":"https:\/\/wpcalc.com\/tr\/wp-json\/wp\/v2\/media?parent=4018"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wpcalc.com\/tr\/wp-json\/wp\/v2\/categories?post=4018"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wpcalc.com\/tr\/wp-json\/wp\/v2\/tags?post=4018"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}