Ayça GÜMÜŞDAĞ, Koray DEMİR, Özlem YILDIRIMTÜRK, Emrah BOZBEYOĞLU, Ömer KOZAN

Yüksek Dereceli Atriyoventriküler Blok ile Başvuran Hastalarda Akut Böbrek Hasarı Öngördürücüleri

Giriş: Bu çalışmada yüksek dereceli atriyoventriküler (AV) blok ile koroner yoğun bakıma yatırılmış hastalar da akut böbrek hasarı (ABH) gelişiminin öngördürücülerinin incelenmesi amaçlanmıştır. Bizim bilgilerimize göre yapmış olduğumuz bu çalışma, atriyoventriküler blok ile akut böbrek hasarı arasındaki ilişkiyi incele yen ilk çalışmadır. Hastalar ve Yöntem: Bu retrospektif çalışmaya yüksek dereceli AV blok ile koroner yoğun bakım ünitesine yatırılan 226 hasta dahil edildi. Hastalarda akut böbrek hasarı “Acute Kidney Injury Network” kriterlerine göre tanımlandı. AV blok hastalarında ABH’nın bağımsız öngördürücüleri lojistik regresyon analizi ile tespit edildi. Bulgular: Yüksek dereceli AV blok tanısı ile takip edilen hastalar ABH gelişip gelişmemesine göre iki gruba ayrıldı. Hastaların ortalama yaşı 73 ± 14.61 idi ve hastaların %50’si kadındı. Takipte tüm hastaların %34’ünde ABH geliştiği gözlendi. Çalışmaya dahil edilen tüm hastalarda hastane içi mortalite oranı %6.2 (n= 14) olarak tespit edildi. Lojistik regresyon analizinde tahmini glomerüler filtrasyon hızı (OR: 0.944, 95%CI: 0.927-0.960; p< 0.001), sol ventriküler ejeksiyon fraksiyonu (OR:0.952, 95%CI: 0.925-0.980; p< 0.001) ABH’nın bağımsız prediktörleri olarak bulundu. Sonuç: Bu çalışmada, literatürde ilk defa yüksek dereceli AV blok hastalarında ABH’nın olası öngördürücüle ri ve sıklığı değerlendirildi. Düşük LVEF ve azalmış eGFR’nin, yüksek dereceli AV blok hastalarında AKI’nın bağımsız öngördürücülerinden olduğunu saptadık.

Predictors of Acute Kidney Injury in Patients with High-degree Atrioventricular Block

Introduction: This study aimed to investigate the predictors of acute kidney injury (AKI) in patients with high degree atrioventricular (AV) block. To the best of our knowledge, this is the first study to examine the relationship between high-degree AV block and AKI in coronary intensive care unit (ICU). Patients and Methods: In this retrospective study, 226 patients who were admitted to the coronary ICU of our hospital and diagnosed as high-degree AV block were included. AKI was evaluated according to Acute Kidney Injury Network criteria. Logistic regression analyses were performed to identify the independent predictors of AKI in patients with high-degree AV block. Results: Patients with high-degree AV block were divided into two groups as with or without AKI. Mean age of the patients was 73 ± 14.61, and 50% of the patients were female. AKI was observed in 34% of the coronary ICU with high-degree AV block. In the present study, in-hospital mortality was 6.2% (n= 14) in all patients. In multivariate analyses, eGFR (OR: 0.944, 95% CI: 0.927-0.960; p< 0.001) and LVEF (OR: 0.952, 95% CI: 0.925-0.980; p< 0.001) were found to be independent predictors of AKI in high-degree AV block patients. Conclusion: Our study, in which AKI was evaluated in high-degree AV block patients, revealed the frequency and predictors of AKI development in high-degree AV block patients for the first time. We found that reduced LVEF and decreased eGFR were independent predictors of AKI in high-degree AV block patients.

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ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi