İlknur ÇÖL MADENDAĞ, Mefkure ERASLAN ŞAHİN, Yusuf MADENDAĞ, Erdem ŞAHİN, Çiğdem KARAKÜKÇÜ

Hiperemezis gravidarumun maternal böbrek sağlığı üzerine etkisi: Maternal serumda nötrofil jelatinaz ile ilişkili lipokalin düzeylerinin araştırılması

Amaç: Hiperemezis gravidarum (HG), hamile kadınların % 0,8-2,0'ında meydana gelen ve böbrek hasarına yol açabilen ciddi bir durumdur. İskemik perfüzyon hasarı birkaç dakika içinde, renal distal tübüler hücreler, nötrofil jelatinaz ile ilişkili lipokalini (NGAL) serbest bırakır. Bu çalışmanın amacı HG başlangıcından sonra maternal serumdaki NGAL seviyelerini ve HG şiddeti ile böbrek iskemisi ve böbrek hasarı arasındaki ilişkiyi değerlendirmektir.Yöntem: Kontrol grubu benzer demografik özelliklere sahip sağlıklı gönüllülerden oluşturuldu. HG hastaları Pregnancy-Unique Quantification of Emesis Ölçeğine göre hastalık şiddetine göre üç gruba ayrıldı: hafif (≤6); orta (7-12); ve şiddetli (≥13). Demografik parametreler, biyokimyasal parametreler ve serum NGAL düzeyleri gruplar arasında karşılaştırıldı.Bulgular: Serum glukoz, serum kan üre azotu, serum kreatinin, serum fosfor, aspartat aminotransferaz ve alanin aminotransferaz düzeyleri gruplar arasında benzerdi. Serum sodyum seviyeleri şiddetli HG grubunda diğer tüm HG gruplarına göre anlamlı derecede yüksekti. İdrar ozmolaritesi orta ve şiddetli HG gruplarında kontrol ve hafif HG gruplarına göre anlamlı derecede yüksekti. Gruplar arasında serum NGAL düzeylerinde anlamlı fark yoktu.Sonuç: Bulgularımız HG ile komplike olan hastalarda serum NGAL seviyelerinin değişmediğini göstermiştir.

Anahtar Kelimeler:

Neutrophil gelatinase-associated lipocalin, Hyperemesis gravidarum, Dehidrasyon

Effect of hyperemesis gravidarum on maternal renal health: An investigation of the levels of neutrophil gelatinase-associated lipocalin in maternal serum

Aim: Hyperemesis gravidarum (HG) is a severe condition that occurs in 0.8–2.0% of pregnant women and can lead to kidney damage. Within minutes of ischemic perfusion injury, renal distal tubular cells release neutrophil gelatinase-associated lipocalin (NGAL). The aim of this study was to assess the levels of NGAL in maternal serum after HG onset and the association between HG severity, renal ischemia, and subsequent kidney damage.Methods: In this case-control study, the control group comprised healthy volunteers with similar demographic characteristics. The HG patients were divided into three groups according to disease severity based on the Pregnancy-Unique Quantification of Emesis scale as follows: Mild (≤6); moderate (7–12); and severe (≥13). Demographic parameters, biochemical parameters, and serum NGAL levels were compared among the groups.Results: Serum glucose, serum blood urea nitrogen, serum creatinine, serum phosphorus, aspartate aminotransferase, and alanine aminotransferase levels were similar among the groups. Serum sodium levels were significantly higher in the severe HG group than in all other HG groups. Urine osmolarity was significantly higher in the moderate and severe HG groups than in the control and mild HG groups. There were no differences in serum NGAL levels among the groups.Conclusion: Our results suggested that serum NGAL levels were not altered in patients complicated by HG.

Keywords:

Neutrophil gelatinase-associated lipocalin, Hyperemesis gravidarum, Dehydration,

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