Cemile PEHLİVANOĞLU, Zeynep YURUK YİLDİRİM, Alev YILMAZ, Asuman GEDİKBAŞI, Nurinisa KARAGÖZ, Nurver AKINCI, Aysel KIYAK, Gül ÖZÇELİK, Yasemin ÖZLÜK, İşin KILIÇASLAN, Ayşe ÖZAĞARI, Bağdagül YAVAŞ, Sevinç EMRE

ÇOCUKLARDA SERUM HOMOSİSTEİN DÜZEYİ İLE IgA NEFROPATİSİ ARASINDAKİ OLASI İLİŞKİ

Amaç: Deneysel ve epidemiyolojik çalışmalar, yüksek serum homosistein düzeylerinin renal hasara yol açabileceğini ve kronik böbrek hastalığı gelişimi için önemli bir risk faktörü olabileceğini göstermektedir. Çalışmamızın amacı IgA nefropatisi ve Henoch- Schönlein purpura nefriti olan hastalarda serum homosistein düzeyleri ile kresent oluşumu arasında bir ilişki olup olmadığını belirlemektir. Gereç ve Yöntemler: Üç pediatrik nefroloji merkezinde son beş yılda biyopsi ile IgA nefropatisi, Henoch-Schönlein purpura nefriti ve idiopatik kresentik glomerulonefrit tanısı alan 31 hasta ve 25 sağlıklı kontrol çalışmaya alındı. Bulgular: Hastaların homosistein düzeyleri normal değerin üst sınırından ve kontrollerden de daha yüksekti (p=0,0001). Biyopside kresent görülen ve görülmeyen hastalar arasında da homosistein düzeyleri açısından anlamlı fark yoktu (p>0,05). Proteinüri varlığı ve şiddeti ile homosistein düzeyleri arasında ilişki saptanmadı (p>0,05). Sonuç: Serum homosistein düzeyleri IgA nefropatisi ve Henoch- Schonlein purpura nefriti olan hastalarda yüksek bulunmuştur. Sonuçlarımız, bu hasta grubunda yüksek serum homosistein düzeylerinin segmental glomerüloskleroz ile ilişkili olabileceğini düşündürmektedir.

Anahtar Kelimeler:

IgA nefropatisi, homosistein, kresent

A POSSIBLE RELATIONSHIP BETWEEN SERUM HOMOCYSTEINE LEVEL AND IgA NEPHROPATHY IN CHILDREN

Objective: The evidences from experimental and epidemiological studies suggests that elevated serum homocysteine levels may lead to renal injury and may be a significant risk factor for the development of chronic kidney disease. The aim of this study was to investigate a possible relationship between serum homocysteine level and crescent formation in children with IgA nephropathy and Henoch-Schonlein purpura nephritis. Material and Methods: A total of 31 patients diagnosed as biopsy proven IgA nephropathy and Henoch-Schonlein purpura nephritis and idiopathic crescentic glomerulonephritis in three Pediatric Nephrology centers within the last five years and 25 healthy controls were enrolled in the study. Results: Homocysteine levels of patients were higher than the upper limit of normal value and also higher than the controls (p=0.0001). There was no significant difference between the patients with or without crescent formation regarding homocysteine levels (p>0.05). Presence or severity of proteinuria was not related to homocysteine levels (p>0.05). Conclusion: Serum homocysteine levels are elevated in patients with IgA nephropathy and Henoch-Schonlein purpura nephritis. Our results suggest that elevated serum homocysteine levels may be related to segmental glomerulosclerosis in these patient groups.

Keywords:

IgA nephropathy, homocysteine, crescent,

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