Mustafa ERGİN, Ebru GOK OGUZ, Ozlem YAYAR, Kadir Gokhan ATİLGAN, Sanem OZTEKİN, Mehmet Deniz AYLİ

Böbrek nakilli hastalarda rejeksiyon gelişimi için risk faktörler

Amaç: Bu çalışmada, kendi hasta populasyonumuzda böbrek nakil rejeksiyonu gelişimi için risk faktörü olabilecek parametrelerin değerlendirilmesini amaçladık.Gereç ve Yöntem: Organ nakli ünitemizde yapılan nakil böbrek biyopsilerin sonuçları retrospektif olarak değerlendirildi. Hastaların demografik özellikleri, primer böbrek hastalıkları, eşlik eden hastalıkları ve perkütan iğne biyopsisi anındaki laboratuar verileri kaydedildi. 45 hastaya yapılan 49 adet biyopsi verileri karşılaştırıldı.Bulgular: Böbrek nakilli 45 hastaya yapılan toplam 49 biyopsi incelendiğinde biyopsi yapılma endikasyon sıklığı en sık olarak 34 biyopsi (%69.4) ile akut böbrek hasarı idi. Histopatolojik inceleme ile 23 (% 46.7) biyopside rejeksiyon saptandı. BK nefropati saptanan biyopsi sayısı 4 iken (%8.1), ilaç toksisitesi olarak kalsinörin inhibitörü toksisitesi 10 biyopside (%20.5) ve kronik allograft nefropatisi de 11 biyopside (%22.6) görüldü. 1 biyopside (%2.1) tekrarlayan glomerulonefrit saptandı. Rejeksiyon saptanan grup rejeksiyon saptanmayan grupla karşılaştırıldığında biyopsi anında serum glukoz, ürik asit ve total kolesterol düzeylerinin yüksek, hemoglobin değerlerinin daha düşük olduğu belirlenmiştir (hepsi için. Lojistik regresyon analizi ile, ürik asit ve glukoz yüksekliği rejeksiyon gelişimi için bağımsız risk belirleyicileri olarak tanımlanmıştır.Sonuç: Hiperürisemi ve hipergliseminin böbrek nakli sonrası rejeksiyon gelişimini öngörebileceği düşünülmüştür.

Anahtar Kelimeler:

kidney transplantation, rejection, uric acid

Risk factors for development of rejection in kidney transplant patients

Purpose: The aim of this study was to evaluate the parameters that may be a risk factor for the development of rejection in our patient population.Materials and Methods: The results of the biopsies performed in our organ transplantation unit were evaluated retrospectively. Demographic data of the patients about primary renal disease, concomitant disease and laboratory data in the time of biopsy were recorded. Forty-nine biopsies made for 45 patients and the results were compared.Results: The most common cause of kidney biopsy was acute renal injury (34 biopsies, 69.4%). Histopathological examination revealed rejection in 23 (46.7%) biopsies. BK nephropathy was detected in 4 patients (8,1%), while the calcineurin inhibitor toxicity was found in 10 patients (20.5%). Chronic allograft nephropathy was observed in 11 biopsies (22.6%) and recurrent glomerulonephritis was detected in 1 biopsy (2.1%). Serum glucose, uric acid and total cholesterol levels were higher and hemoglobin levels were lower in the rejection group. By logistic regression analysis, uric acid and glucose elevation were defined as independent risk determinants for the development of rejection.Conclusion: Hyperuricemia and hyperglycemia may predict the development of rejection after renal transplantation.

Keywords:

kidney transplantation, rejection, uric acid,

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