Fatih Orkun KUNDAKTEPE, Mustafa Genco ERDEM, Şerife Ayşen HELVACI

Tip 2 diyabetik bireylerde kreatinin klirensini hesaplamada kullanılan üç farklı yöntemin karşılaştırılması

Amaç: Diyabetik bireyler için kullanılabilecek en uygun kreatinin klirensi hesaplama metodunu belirlemek amaçlandı. Yöntem: Çalışmaya Okmeydanı Eğitim Araştırma Hastanesi iç hastalıkları ve diyabet polikliniklerine başvurmuş 100 tane tip 2 diyabetik hasta dahil edildi. Hipertansiyon, akut böbrek yetersizliği tanısı almış veya böbrek nakil alıcısı olan diyabetik hastalar çalışma dışı bırakıldı.Bulgular: Cockcroft-Gault değerini kestirmede tek ve çok değişkenli modellerde yaş, ağırlık, kreatininin anlamlı (hepsi için p<0,050) etkisi gözlenmiştir. MDRD değerini kestirmede tek değişkenli modelde yaş, kreatininin; çok değişkenli modelde ise yalnızca kreatininin anlamlı bağımsız (p=0,001) etkisi gözlenmiştir. 24 saatlik idrarda kreatinin klirensi değerini kestirmede tek değişkenli modelde yaş, ağırlık, kreatinin değerinin anlamlı (hepsi için p<0,050) etkisi gözlenmişken; çok değişkenli modelde ise yalnızca ağırlık değerinin anlamlı bağımsız (p=0,001) etkisi gözlenmiştir. Sonuç: Bu çalışmada üç yöntem de birbirleriyle uyumlu sonuç verdi. Tip II diyabetik hastalarda böbrek fonksiyonlarını değerlendirmek için üç yöntemin tamamı kullanılabilir, ancak 24 saatlik idrar yöntemiyle kreatinin klirensi, üst üste iki hasta ziyareti ve daha karmaşık bir biyokimya laboratuvarı gerektirir; bizim görüşümüze göre, bu yöntem diğer iki yönteme alternatif olarak kullanılabilir.

Anahtar Kelimeler:

Kreatinin klirensi, glomeruler filtrasyon hızı, tip 2 diyabet

Comparison of three different creatinine clearance calculation methods in patients with type 2 diabetes mellitus

Aim: To determine the most accurate and useful method for calculating creatinine clearance by comparing the results of different methods. Methods: One hundred type 2 diabetic patients who have been followed by Okmeydani Training and Research Hospital Internal Medicine and/or diabetes outpatient clinics were included in this study. Individuals with hypertension, acute kidney disease and renal transplantation were excluded from the study.Results: Glomerular filtration rate (GFR) calculated with Cockcroft-Gault formula was significantly affected by creatinine, weight, and age (p<0.050 for all). GFR measured with Modification of Diet in Renal Disease (MDRD) formula was significantly affected by creatinine and age (p<0.050 for all) in a univariate model; in a multivariate model, this was significantly independently affected by creatinine (p=0.001). GFR measured with 24h urine was significantly affected by creatinine, weight, and age (p<0.050 for all) in a univariate model; in a multivariate model, this was significantly independently affected by weight (p=0.001). Conclusion: In this study, those three methods revealed similar results. All of three methods can be used for evaluating renal functions in Type II diabetic patients but creatinine clearance with 24 hours urine method requires two patient visits in a row and a more complex biochemistry laboratory; so in our opinion, this method may be used as an alternative to the other two methods.

Keywords:

Creatinine clearance, glomerular filtration rate, type 2 diabetes,

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