Özan ÖZKAYA, Sevim GÖNEN, Talia İLERİ, Necla BUYAN, Oğuz SÖYLEMEZOĞLU

Sürekli ayaktan periton diyalizi uygulanan çocuk hastalarda peritoneal fibrozis gelişiminde erken tanı

Sürekli ayaktan periton diyalizi (SAPD) uygulanan hastalarda zamanla mezotelyal hücre kaybı ve bunun sonucunda gelişebilecek peritoneal fibrozis nedeni ile tedavi devam ettirilememektedir. Periton zarı değişikliklerini değerlendirmek için pratik yöntemlerin geliştirilmesine ihtiyaç duyulmaktadır. Bu çalışmada SAPD hastalarında serum ve diyalizatta CA125 ve prokollajen III düzeyleri ölçülerek mezotel hücrelerindeki değişimi değerlendirmek amaç edinildi. Klinik yönden stabil ve yaş ortalaması 8,6 ± 6,2 yıl olan onaltı hasta çalışmaya dahil edildi. Serum ile diyalizatta tedavi başlangıcında ve 12 ay sonrasında CA125 ve prokollajen III düzeyleri ölçüldü. Hastaların periton geçirgenliğini değerlendirmek amacıyla aynı dönemlerde peritoneal eşitlenme testi (PET) yapıldı. Diyaliz başlangıcı ve 12. ayında serum prokollajen III düzeyleri sırasıyla 15,45 ± 2,95 mg/L ve 15,52 ± 2,28 mg/L, diyalizatta ise 36,18±7,84 mg/L ve 39,4±18,0 mg/L bulundu (p>0.05). Serum CA125 düzeyleri diyaliz başlangıcında 13,91±3,26 U/ml iken bir yıl sonrasında 9,25±3,21 U/ml ölçüldü (p>0.05). Diyalizat CA125 düzeyleri ise birinci dönemde 15,86±4,13 U/ml olarak ölçülürken ikinci dönemde 6,43±2,69 U/ml düzeyine düştü ve aradaki farkın anlamlı olduğu saptandı (p

Early diagnosis of peritoneal fibrosis ın children treated by continuous ambulatory peritoneal dialysis

The present study is aimed to give an insight to mesothelial changes occur during continuous ambulatory peritoneal dialysis (CAPD) in children. Cancer antigen 125 (CA125) and procollagen III provide a way to study the mesothelial cells and peritoneal fibrotic process. For this purpose we measured CA125 and procollagen III prospectively in serum and dialysate of children who were under the CAPD treatment. Sixteen clinically stable CAPD patients with a mean age of 8,6±6,2 year were included in this study. CA125, and procollagen III were measured in serum and dialysates of patients in the initiation of CAPD and then 12 months after the treatment. In all patients a peritoneal equilibrion test (PET) was performed to determine the peritoneal permeability. Median follow-up time was 1.2 year and during this time no patient developed ultrafiltration failure. Serum procollagen III levels were 15,45±2,95 mg/L and 15,52±2,28 mg/L, where dialysate levels were 36,18±7,84 mg/L and 39,4±18,0 mg/L respectively (p>0.05) in patients before and 12 months after treatment. At the beginning CA125 serum levels were 13,91±3,26 U/ml and 12 months after CAPD levels were 9,25±3,21 U/ (p>0.05). However dialysate CA125 levels decreased from 15,86±4,13 U/ml to 6,43±2,69 U/ml 12 months after treatment (p

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