İpek Kaplan BULUT, Nida DİNÇEL, Ebru YILMAZ, Orhan Deniz KARA, Kadriye ÖZDEMİR, Sevgi MİR

Kronik diyaliz tedavisi alan çocuklarda eritropoetin kullanımının ortalama trombosit hacmine etkisi

Amaç: Bu çalışmada diyaliz uygulanan çocuklarda ortalama trombosit hacmi (OTH) ve eritropoetin (EPO) kullanımı arasındaki ilişkinin incelenmesi amaçlanmıştır. Yöntemler: Çalışmada 16 hemodiyaliz (HD), 20 periton diyalizi (PD) olmak üzere 36 hastanın eritropoetin öncesi ve sonrası OTH değerleri retrospektif olarak incelendi. Hastalar haftalık eritropoetin alımı 150 Ü/kg'ın altında (düşük EPO) ve 150 Ü/kg üzerinde (yüksek EPO) olmak üzere 2 gruba ayrıldı. Hastaların yaşları, vücut ağırlıkları, kronik böbrek yetmezliğine neden olan primer hastalıkları, uygulanan diyaliz tedavi yöntemleri, EPO dozları kaydedildi. EPO başlanmadan önce ve başlandıktan 4 hafta sonra alınan kan örneklerinde tam kan sayımı (hemogram) yapılarak OTH değerleri kaydedildi..Bulgular: Hemodiyaliz grubunun EPO sonrası OTH değerlerinde EPO öncesi OTH değerlerine göre anlamlı yükselme (8,18±1,52 fL ve 9,20±1,46 fL, p=0,046) saptanırken, PD grubunda ise EPO sonrası değerlerde yükselme olmasına rağmen, fark istatistiksel anlamlılık sınırına çok yakın bulundu (8,28±1,80 fL ve 9,39±1,50 fL, p=0,051).Yüksek dozda EPO alan HD hastalarında EPO sonrası OTH değerleri artmış olarak bulundu (7,81 ± 1,04 ve 9,61 ± 1,05 fL; p=0,06). Düşük doz EPO kullananlarda ise farklılık görülmedi (8,64 ± 1,97 ve 8,67 ± 1,81 fL; p>0,05). PD hastalarında ise EPO dozu OTH değerleri üzerinde etkili bulunmadı (9,57 ± 1,58 ve 9,10 ± 1,42 fL; p>0,05).Sonuç: HD uygulanan çocuklarda EPO'nun OTH düzeylerini etkilediği, ancak PD hastalarında OTH düzeylerinin EPO tedavisinden etkilenmediği görüldü. Hekimler tromboz riski yüksek hastalarda yüksek doz EPO kullanırken dikkatli olmalıdır

Effect of erythropoietin use on mean platelet volume in children undergoing chronic dialysis

Objective: In this study, it was aimed to determine the relationship between erythropoietin (EPO) use and mean platelet volume (MPV) in the children undergoing dialysis. Methods: MPV values before and after EPO use in 36 patients (16 hemodialysis - HD, 20 peritoneal dialysis PD) were retrospectively evaluated. Patients were divided into two groups according to weekly EPO need as; given less than 150 U/kg defined as low EPO and more than 150 U/kg as high EPO groups. The age, weight, primary cause of chronic renal failure, dialysis methods and EPO dosages of patients were recorded. Blood samples were taken before and 4 weeks after EPO usage and MPV values were noted from complete blood counts.Results: While significant increase was seen in the MPV values after EPO in comparison to MPV values before EPO in the HD group (8.18±1.52 fL vs. 9.20±1.46 fL; p=0.046); near significant difference was found in the MPV levels after EPO (8.28±1.80 fL vs. 9.39±1.50 fL; p=0,051) in PD group. In HD patients when high dose of EPO was given, MPV levels were found to be significantly elevated (7.81 ± 1.04 vs 9.61 ± 1.05; p=0.06) after EPO. However, no difference was seen with the lowe dose EPO subgroup (8.64 ± 1.97 ve 8.67 ± 1.81; p>0,05). No effect of EPO dose was found on MPV values in PD patients (9.57 ± 1.58 ve 9.1 ± 1.42; p>0.05).Conclusion: It was observed that EPO influenced MPV values in children undergoing HD, while no effect of erythropoietin was found on MPV values of PD patients. Physicians should be careful while using high dose erythropoietin in children with high thrombosis risk. J Clin Exp Invest 2014; 5 (3): 415-419

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