Edip ERKUŞ, Süleyman KARAKÖSE, Pervin ÖZKAN KURTGÖZ, Vedat GENÇER, İbrahim GÜNEY

KRONİK BÖBREK HASTALIĞINDA ARTERİYEL SERTLİĞİN BÖBREK PROGRESYONU VE MORTALİTE ÜZERİNE ETKİSİ

Amaç: Nabız dalga hızı (PWV), vasküler kalsifikasyon tanısında kullanılan elektron beam bilgisayarlı tomografi (EBCT) ile korelasyon gösterir ve kronik böbrek hastalığında (KBH) arteriyel sertlik değerlendirmesi için sıklıkla kullanılır. Literatürde KBH’ da arteriyel sertlik ile böbrek progresyonu ve mortalite arasındaki ilişki hakkında çok az çalışma vardır. Bu çalışmada KBH’da arteriyel sertlik ile böbrek hastalığının progresyonu ve mortalite arasındaki ilişkiyi araştırdık. Gereç ve Yöntem: Aralık 2014-Haziran 2015 tarihleri arasında nefroloji polikliniğine başvuran evre 3-5 kronik böbrek hastaları çalışmaya alındı. Hastalar en az dört yıl takip edildi. Birincil sonlanım noktaları bir renal replasman tedavisi başlanması (renal transplantasyon, hemodiyaliz veya periton diyalizi) ve ölümdür. Nabız dalga hızı (PWV) Mobil-O-Graph NG (Stemberg Germany Stolberg Germany) arteriograf cihazı kullanılarak ölçüldü. Bulgular: Çalışma 4 yıl boyunca düzenli kontrole gelen 194 hasta ile tamamlandı. Bu süre zarfında 194 hastanın 89’unda renal replasman tedavisi (72 hemodiyaliz, 17 renal transplantasyon) gerekti ve 15’i öldü. 90 hasta nefroloji polikliniğinde prediyaliz KBH’sı olarak izlenmektedir. Artan PWV, mortalitenin bağımsız bir prediktif belirteci olarak tespit edildi. Sonuç: Bu çalışmada, PWV’deki artışın mortalitenin bağımsız bir belirteci olduğunu bulduk. Bu anlamda, PWV’nin izlenmesinin ve bu yönde önlemler alınmasının arteriyel sertliğin mortalite üzerindeki etkisini azaltabileceğini gösterdik.

Anahtar Kelimeler:

Arteriyel sertlik, mortalite, kronik böbrek hastalığı

THE EFFECT OF ARTERIAL STIFFNESS ON DISEASE PROGRESSION AND MORTALITY IN CHRONIC KIDNEY PATIENTS

Objective: Pulse wave velocity (PWV) is frequently used for arterial stiffness assessment in chronic renal disease (CRD). There are very few studies in the literature about the relationship between arterial stiffness and renal progression leading to mortality in CRD. Herein, we searched the relationship between arterial stiffness, and progression of kidney disease, leading to mortality in CRD patients. Methods: 194 stage 3-5 CRD patients were included in the study. The patients were followed at least four years. The primary endpoints were initiation a renal replacement treatment and death. PWV was measured using the Mobil-O-Graph NG arteriography device. Results: The study was completed with 194 patients within four years. During this period, out of 194 patients, 89 needed a renal replacement treatment (72 hemodialysis patients, 17 renal transplantation) and 15 died. Ninety of them are still being followed as predialysis CKD patient in the nephrology outpatient clinic. Increased PWV was detected as an independent predictive marker of mortality. Conclusion: Our study demonstrated that PWV might be an independent predictor of mortality. In this sense, monitoring the PWV and taking measures in this direction can reduce the effect of arterial stiffness on mortality.

Keywords:

Arterial stiffness, mortality, chronic renal disease,

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