Yavuz AYAR, Emel İşıktaş SAYILAR, Alparslan ERSOY, Hakan DÜĞER, Çağatay AK, Abdülkadir GÖÇKEN, Mahmut YAVUZ

Akut Böbrek Hasarında Mortalitede Öncül Faktörler

Amaç: Prokalsitonin (PCT), C-Reaktif Protein (CRP), serum amiloid A (SAA), albümin ve serum kolesterol değerleri enflamasyon, enfeksiyon ve malnütrisyonun erken belirteçlerindendir. Akut böbrek hasarının (ABH) gelişiminde enfeksiyon, oral alım bozukluğu, dehidratasyon ve malnütrisyon önemli yer tutmaktadır. Bu etkenlerin erken saptanması tedavide önem arz etmektedir.Gereç ve Yöntem: Ocak 2013-2014 tarihleri arasında Nefroloji Kliniğimizde takip edilen 182 hastaya RIFLE (Risk, injury, failure, loss, end stage renal failure) ve AKIN (acute kidney injury network) kriterlerine göre ABH tanısı konmuştur. Hastalar nutrisyonel ve enflamatuar belirteç- lere göre sağlıklı kontrol grubuyla (52 hasta) kıyaslanmış- tır.Bulgular: ABH da albümin, CRP, prokalsitonin ve SAA değerleri hasta grubu lehine, sağlıklı kontrol grubuyla karşılaştırıldığında anlamlı bulunmuştur (p < 0,001 ve p = 0,002) Yine lökosit, kolesterol, LDL kolesterol, trigliserit değerleri karşılaştırıldığında ölen ABH hastalarında yüksek saptanmıştır (p = 0,016, p = 0,032, p = 0,03 ve p = 0,026). Ölen hastalarda bu değerlerle beraber enfeksiyonve ek hastalıklar önemli bir etkendi. Enfeksiyonlar arasında sepsis ve pnömoniye rastlanmaktaydı. Hastaların HDL kolesterol değerleri arasında fark saptanmamıştır (p = 0,52).Sonuç: ABH hastalarında enflamasyon, malnütrisyon, sepsis yüksek oranda görülmektedir. ABH da ölen hastalarda (% 4,94) CRP, PCT, SAA, albümin, kolesterol değerleri yüksek saptanmış olup bu değerler tedavi ve izlemde önemini korumaktadır.

Anahtar Kelimeler:

Enflamasyon, enfeksiyon, malnütrisyon, akut böbrek hasarı

Premise Factors of Mortality in Acute Kidney Injury

Objective: Procalcitonin (PCT), C-Reactive Protein, serum amyloid A (SAA) and serum cholesterol values areearly markers for inflammation, infection and malnutrition. In development acute kidney injury (AKI) infection,oral intake disorders, dehydratation and malnutritionhave important place. These factors are important in theearly detection of treatment.Material and Methods: Between January 2013-2014 inour nephrology clinic followed 182 patients and diagnosed AKI with RIFLE (risk, injury, failure, loss, end stagerenal failure) and AKIN (acute kidney injury network) criterias. Patients were compared according to nutritionaland inflammatory markers with healthy control group(52 patients).Results: Albumin, CRP, procalcitonin and SAA values inAKI patients favor compared with healthy control groupand results were statistically significant (p <0.001 and p= 0.002). Again, leukocytes, cholesterol, LDL cholesterol,triglyceride levels were higher in died AKI patients (p =0.016, p = 0.032, p = 0.03 and p = 0.026) Addition to thesevalues in patients who died, Infection and comorbiditydiseases were important factors. In infections found sepsis and pneumonia. HDL cholesterol levels did not differbetween patients (p = 0.52).Conclusion: Inflammation, malnutrition, sepsis are highly prevalent diseases in AKI patients. Patients who diedin AKI (% 4,94), CRP, PCT, SAA, albumin, and cholesterollevels were higher. Treatment and following these valueswere important.

Keywords:

Inflammation, infection, malnutrition, acute kidney injury,

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