Davut AKIN, Mehmet Tuğrul SEZER, Oğuzhan AKSU, Atila ALTUNTAŞ

Kronik Böbrek Yetmezlikli Hastalarda Sinakalset Kullanımının Hematolojik Parametreler Uzerine Etkisi

Giriş: Kronik böbrek yetmezliği hastalarında aneminin nedenleri arasında; eritropoietin (EPO) eksikliğidirenci, demir eksikliği ve üremiktoksinler gibi faktörler yer alır. EPO'nun etkisine karşı dirençte parathormon (PTH) seviyeleri de rol oynamaktadır. Sekonderhiperparatiroidide kalsimimetik bir ajan olam sinakalset başarılı bir şekilde kullanılmaktadır. Hiperparatiroidinin kontrol altına alınması,EPO'ya olan direncin azalmasına ve hedef hemoglobin (Hb) değerlerine daha kısa bir süre içinde ulaşılmasına katkı sağlayabilir. Bu nedenlesinakalsetin hemoglobin değerleri üzerine etkisi araştırıldı.Materyal Metod: Diyaliz hastalarından sinakalset tedavisi alanlar çalışma grubunu, almayanlarda kontrol grubunu oluşturdu. Çalışmayatoplam 24 hasta alındı. Hastalarda fraksiyonel üre klirensini ölçen KtN oranı hemodiyaliz için 21.2, periton diyalizi için 21.7olarak kabuledildi, ferritin 200 ng/ml, transferin satürasyonu %20 ve PTH 300 pg/ml kabul kriteri sayıldı. Hastaların demografik verileri, çalışmanınbaşladığı tarihteki ve 3. ay sonundaki eritropoetin rezistan indeksi (ERİ), Hb değeri, EPO dozu lÜ/kg/haf kaydedildi. Veriler uygunistatistiksel yöntemle karşılaştırıldı.Bulgular: Her iki grupta diyaliz yaşı, Kt/V, kalsiyum (Ca), fosfor (P), CaxP, Hb değerleri başlangıç ve 3. ay sonundaki değerlerikarşılaştırıldığında birbirine benzerdi. Sinekalset ve kontrol grubundaki 3. aydaki Hb artışı anlamlı olarak saptandı (sırasıyla p=0.031,p=0.028). Başlangıç ve 3. aydaki PTH değerleri sinakalset grubunda kontrol grubuna göre anlamlı olarak daha yüksek saptandı (p

The Effect of Cinacalcet on Hematological Parameters in Patients with Chronic Kidney Disease

Introduction: The reasons of anemia seen in patients with chronic (CRF) include eritropoeitin deficiency--resistance, iron deficiency andüremic toxins. Elevated PTH levels play role in resistance to EPO's effect. Cinecalcet is successfully used in secondary hyperparatiroidism.The control of hyperparatiroidism can contribute to diminishing of resistance to EPO and to sooner acquiring of target hemoglobin levels.Because of this the effect of cinecalcet on hemoglobin levels has been researched.Material and Methods: The dialysis patients given cinecalcet are the study group and the patients not given cinecalcet are the controlgroup. The study included 24 patients. The acceptance criterias to the study are patients Kt/V hemodialysis 21.2 for peritone dialysis,ferritin levels2 200, transferrin saturation %20 and PTH 2300 pg/ml. The index of eritropoeitin resistance at the beginning and at the endof months, hemoglobine, the EPO dosage IU/kg/week is recorded. The data is compared with appropriate statistical methods.Results: The dialysis age, Kt/V, Ca, P, CaxP Hb values were similar at the beginning and after months in both groups. The rises of Hb inthe groups are meaningful. The PTH levels of the cinecalcet given group, at the beginning and after months, are meaningfully higher thanthe control group (p

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