Edip ERKUŞ, İbrahim GÜNEY, Zafer BÜYÜKTERZİ

RUTİN HEMODİYALİZ HASTALARINDA SERUMDA SOLUBLE KLOTHO SEVİYESİ İLE KARDİYOVASKÜLER HASTALIKLAR VE MORTALİTE ARASINDAKİ İLİŞKİ

Amaç: Serum sKlotho, bazı insan populasyonlarında ve hayvan deneylerinde kardiyovasküler hastalık veya ölüm riskini belirlemede rol oynar. Bu çalışmada rutin hemodiyaliz hastalarında 18 aylık takip sonrası sKlotho düzeyleri ile ekokardiyografik parametreler ve 30 aylık takipteki mortalite arasındaki ilişki araştırıldı. Gereç Ve Yöntem: Farklı sKlotho oranları (≥1,24 ng/ml ve <1,24 ng/ml) ve yaşları (<54 ve ≥54) olan hasta grupları karşılaştırıldı. Bulgular: sKlotho <1,24 ve ≥1,24 grupları arasında hesaplanan sol ventrikül kütle indeksi ve sol ventrikül kütle parametreleri arasında anlamlı fark bulunmadı. İki farklı yaş (<54 yaş ve ≥54 yaş) grubu arasında hesaplanan sol ventrikül kütle indeksi ve sol ventrikül kütle parametreleri arasında anlamlı fark bulunmadı. 30 ay takip edilen 136 hastada sKlotho ile tüm nedenlere bağlı ölüm arasındaki ilişkiyi belirlemek için, ölen 34 hasta ve yaşayan 102 hastadan oluşan iki grup karşılaştırıldı. Bu iki grup arasında yaş, giriş kreatinin, sodyum bikarbonat, C-reaktif protein, albümin düzeyi ve Diabetes Mellitus varlığı açısından anlamlı fark gözlendi. Sklotho değerleri açısından iki grup arasında belirgin bir fark olmamasına rağmen, ölen grupta sKlotho düzeyi daha düşük bulundu. Sonuç: sKlotho'nun uzun dönemde üremik kardiyomiyopatiyi öngörmede uygun bir gösterge olmadığını, ancak sKlotho düzeylerinin daha geniş hasta popülasyonlu çalışmalarda mortaliteyi öngörmede yararlı olabileceğini düşünüyoruz.

Anahtar Kelimeler:

Kardiyomiyopati, Hemodiyaliz, sKlotho

THE ASSOCIATION BETWEEN SERUM SOLUBLE KLOTHO LEVEL AND CARDIOVASCULAR DİSEASE AND MORTALİTY IN ROUTİNE HEMODIALYSIS PATIENTS

Aim: Serum sKlotho plays a role in identifying the risk of cardiovascular disease or death in some human populations and animal experiments. In this study, the relationship between sKlotho levels and echocardiographic parameters after 18 months of follow-up and mortality at 30 months of follow-up in routine hemodialysis patients was investigated. Matarial and Method: Groups of patients with different sKlotho rates (≥1.24 ng/ml and <1.24 ng/ml) and ages (<54 years and ≥54 years) were compared. Results: No significant difference was found between the left ventricular mass index and left ventricular mass parameters calculated between the sKlotho <1.24 and ≥1.24 groups. No significant difference was found between the left ventricular mass index and left ventricular mass parameters calculated between the two different age (<54 years and ≥54 years) groups. In order to determine the association between sklotho and all-reason mortality in 136 patients followed for 30 months, two groups of 34 patients who died and 102 patients who survived were compared. A significant difference was observed between these two groups in terms of age, entry creatinine, sodium bicarbonate, C-reactive protein, albumin level and existence of Diabetes Mellitus. Although there was no considerable distinction in the two groups with regards to sklotho values, the sklotho level was found to be lower in the deceased group. Conclusion: We think that sKlotho is not an appropriate indicator to predict uremic cardiomyopathy in the long term, but sKlotho levels may be useful in predicting mortality in studies with larger patient populations.

Keywords:

Cardiomyopathy, Hemodialysis, sKlotho,

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