Erişkin Nefrotik Sendromlu Olgularda Hiperüriseminin Böbrek Sonlanımları Üzerine Etkisi

Amaç: Bu çalışmanın amacı erişkin nefrotik sendromlu olgularda, tanı anındaki hiperüriseminin sıklığını tespit etmek ve hiperüriseminin böbrek sonlanımına etkisinin olup olmadığını araştırmaktır. Gereç ve Yöntemler: Nefroloji Kliniği’ne, 2010-2021 yılları arasında başvuran ve böbrek biyopsisi yapılan olgular değerlendirmeye alındı. Hastaların laboratuvar ve takip veriler değerlendirilerek istatistiksel analiz yapıldı. Bulgular: Çalışmaya dahil edilen 106 hastanın%59,4’ü erkek olup ortalama yaş 49,4 yıldı. Olguların%72,6’ü primer, geri kalanlar ise sekonder nefrotik sendrom hastasıydı. Olguların 54 (%51) ’ünde hiperürisemi tespit edildi. ortalama ürik asit düzeyi 6,80±1,77 mg/dl idi. Primer nefrotik sendromda hiperürisemi sıklığı %47,4 sekonder nefrotik sendromda ise %62,1 idi. Primer nefrotik sendromlu hastaların %62,3’ünde,sekonder nefrotik sendromlulaların ise %17,2’sinde izlemde tedaviye yanıt alındı (p<0,0001). Hiperürisemisi olanlarda (n=54) glomerüler filtrasyon hızı daha düşük(54,4±31,0’e karşı 72,67±35,5 ml/dk. p=0.007) ve steril piyüri oranları ise daha fazlaydı (%38,9’a karşı %19,6; p=0,03). Sonuç: Hiperürisemi erişkin nefrotik sendromlu olguların yarısında görülmektedir. Bu durum böbrek yetmezliğinin şiddetiyle ilişkilidir.

Anahtar Kelimeler:

hiperürisemi, nefrotik sendrom, böbrek sonlanım

THE EFFECT OF HYPERURICEMIA ON RENAL OUTCOMES IN ADULT PATIENTS WITH NEPHROTIC SYNDROME

Objective: The aim of this study is to determine the frequency of hyperuricemia at the time of diagnosis and to investigate whether hyperuricemia has an effect on renal outcome in adult patients with nephrotic syndrome. Material and Methods: Patients who applied to the Nephrology Clinic between 2010-2021 and underwent kidney biopsy were evaluated. Statistical analysis was performed by evaluating the laboratory and follow-up data of the patients. Results: Of the 106 patients included in the study, 59.4% were male and the mean age was 49.4 years. Of the cases, 72.6% had primary and the rest had secondary nephrotic syndrome. Hyperuricemia was detected in 54 (51%) of the cases. The mean uric acid level was 6.80 mg/dl. The frequency of hyperuricemia in primary nephrotic syndrome was 47.4% and 62.1% secondary nephrotic syndrome. Response to treatment was observed in 62.3% of patients with primary nephrotic syndrome and 17.2% of patients with secondary nephrotic syndrome (p<0.0001). In patients with hyperuricemia (n=54), the glomerular filtration rate was lower (54.4 vs. 72.67 ml/min. p=0.007) and the rate of sterile pyuria pyuria was higher (38.9vs 9.6%; p=0.03). Conclusion: Hyperuricemia is seen in half of adult nephrotic syndrome cases This situation is correlated with the severity of the kidney failure.

Keywords:

hyperuricemia, nephrotic syndrome, renal outcome,

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1.Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008. Arthritis Rheum. 2011;63:3136-41.
2.Desideri G , Castaldo G, Lombardi A, Mussap M, Testa A, R Pontremoli et al. Is it time to revise the normal range of serum uric acid levels? Eur Rev Med Pharmacol Sci. 2014;18:1295-306.
3.Sofue T, Nakagawa N, Kanda E, Nagasu H, Matsushita K , Nangaku M et al. Prevalences of hyperuricemia and electrolyte abnormalities in patients with chronic kidney disease in Japan: A nation wide, cross-sectional cohort study using data from the Japan Chronic Kidney Disease Database (J-CKD-DB). PLoSOne. 2020;15:e0240402.
4.Xiao H, Li Q, Wang F, Yao Y, Zhong X. Relationship between hyperuricemia and primary nephrotic syndrome in children. Zhonghua Er Ke Za Zhi. 2014:52:859-62.
5.Xie T, Chen M , Tang X, Yin H, Wang X, Li G et al. Hyperuricemia is an independent risk factorfor renal pathological damage and poor prognosis in lupus nephritis patients. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2016;41:1052-7.
6.Song SH, Oh TR, Choi HS, Kim CS, Ryu DR, Kim SG et al. Hyperuricemia is a risk factor for the progression to end-stage renal disease in minimal change disease. Kidney Res Clin Pract. 2021;40:411-8.