Serra SÜRMELİ DÖVEN, Harika KAYACAN, Semra ERDOĞAN, Ali DELİBAŞ

Nefrotik sendromlu hastalarda trombosit indekslerinin değerlendirilmesi

Amaç: Trombositlerin nefrotik sendrom patogenezinde önemli rolü vardır. Bu çalışmada trombosit indekslerinin nefrotik sendromda belirteç olarak kullanılması araştırıldı. Yöntem: Ocak 2017-Şubat 2018 tarihleri arasında merkezimizde Çocuk Nefroloji Polikliniği’nde takip edilen 39 hasta çalışmaya dahil edildi. Katılımcılar, steroide duyarlı nefrotik sendrom (n= 26) ve steroide dirençli nefrotik sendrom (n= 13) olarak iki gruba ayrıldı. Hastaların nötrofil, lenfosit, lökosit, trombosit sayıları, ortalama trombosit hacmi, trombosit dağılım genişliği, platelekrit ve trombosit sayıları retrospektif olarak elde edildi. Yaş ve cins olarak uyumlu 30 sağlıklı kontrolden de aynı parametreler elde edildi ve hasta grubuyla karşılaştırıldı. Bulgular: Hasta grubunda kontrol grubuna göre sırasıyla lökosit, nötrofil, trombosit ve platelekrit değerleri daha yüksek saptandı [(10.83 ± 4.98 x103/µl, 8.96 ± 2.30 x103/µl, P= 0.043), (6.96 ± 4.95 x103/ µl, 4.54 ± 2.39 x103/ µl, P=0.010), (379.49 ± 120.87 x103/µl, 328.83 ± 69.42 x103/ µl, P=0.032), (0.38 ± 0.11%, 0.33 ± 0.06%, P=0.012) ]. Steroid direnci açısından değerlendirildiğinde steroide dirençli nefrotik sendrom grubunda platelekrit değeri kontrole göre daha yüksek bulundu (%0.42 ± 0.14, %0.33 ± 0.06) (P= 0.007). Sonuç: Platelekrit, steroide dirençli nefrotik sendromda steroid direncini gösteren bir belirteç olarak kullanılabilir. Bu bulguyu desteklemek için daha geniş hasta grubuyla çalışmalar yapılmalıdır.

Anahtar Kelimeler:

Trombositler, trombosit aktivasyonu, nefrotik sendrom

Evaluation of platelet indices as novel markers for nephrotic syndrome

Aim: Platelets play an important role in the pathogenesis of nephrotic syndrome, and the aim in this study is to evaluate platelet indices as markers of this disorder. Methods: A total of 39 patients with nephrotic syndrome, who were followed by the pediatric nephrology department in our center from January 2017 to January 2018, were included in the study. The participants were divided into two groups, as those with steroid-sensitive nephrotic syndrome (n= 26) and those with steroid-resistant nephrotic syndrome (n= 13). Laboratory parameters, including neutrophils, lymphocytes, white blood cells, platelet counts, mean platelet volume, platelet distribution width, plateletcrit and platelet large cell ratios were reviewed retrospectively. Similar parameters from a control group comprising 30 age- and sex-matched healthy subjects were also evaluated and compared with the study groups. Results: White blood cells, neutrophil, platelet and plateletcrit values were found to be greater in the nephrotic syndrome patients than in the controls [(10.83 ± 4.98 x103/µl, 8.96 ± 2.30 x103/µl, P= 0.043), (6.96 ± 4.95 x103/ µl, 4.54 ± 2.39 x103/ µl, P=0.010), (379.49 ± 120.87 x103/µl, 328.83 ± 69.42 x103/ µl, P=0.032), (0.38 ± 0.11%, 0.33 ± 0.06%, P=0.012) respectively]. Plateletcrit values were greater in the steroid-resistant nephrotic syndrome group when compared to the control group (0.42 ± 0.14%, 0.33 ± 0.06%) (P= 0.007). Conclusion: Plateletcrit could serve as a marker for steroid-resistant nephrotic syndrome, although further studies involving larger samples should be carried out to determine changes in platelet indices that occur in association with nephrotic syndrome.

Keywords:

Blood platelets, nephrotic syndrome, platelet activation,

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