Murat DAĞDEVİREN, Esin BEYAN, Tanyel Sema DAĞDEVİREN, Esra ÇOPUROĞLU, Yavuz ÇAĞIR, Özlem DOĞAN, Derun Taner ERTUĞRUL, Mustafa ALTAY

Nefropatisi olan ve olmayan diyabetli hastalarda prokalsitonin düzeylerinin değerlendirilmesi

Amaç: Nefropatisi olan ve olmayan diyabetli hastalarda serum prokalsitonin (PCT) düzeylerinin nasıl etkilendiğini araştırarak bu hastalarda PCT’nin bir enflamasyon göstergesi olup olamayacağını belirlemektir.Gereç ve Yöntem: Çalışmaya 175 hasta [75 diyabetik nefropati (grup 1), 75 nefropatisi olmayan diyabetik (grup 2) ve 25 non-diyabetik nefropati (grup 3)] ve 75 sağlıklı gönüllü dahil edildi. Hasta ve kontrol gruplarının serum ve üriner kreatinin, serum high sensitive C-reaktif protein (hsCRP), PCT, beyaz küre, nötrofil, HbA1c ve üriner protein değerleri elde edildi. Üriner protein/kreatinin oranı ve eGFR hesaplandı.Bulgular: Grup 1, 2 ve 3 ile kontrol grubunun PCT değerleri (sırasıyla 0,20-0,19-0,23 ve 0,19) arasında anlamlı bir fark yoktu (p>0,05). Her 3 hasta grubunun hsCRP düzeyleri ise kontrol grubundan yüksekti (p<0,001). Nefropatili hastaların (diyabetik ve non-diyabetik) GFR değerleri ile PCT (p<0,001; r = -0,475) ve hsCRP (p<0,001; r= -0,415) değerleri arasında negatif korelasyon saptandı. Diyabetik nefropatili hastalarda GFR 60’ın altında olanlarla GFR 60 ve üzerinde olanlar karşılaştırıldığında; GFR değerleri 60’dan düşük olanların hsCRP değerleri daha yüksek iken (p<0,05); PCT değerleri arasında fark yoktu (p>0,05). Sonuç: Diyabetli ve diyabetik nefropatili hastaların PCT değerlerinde anlamlı bir artış yoktu. Ancak PCT düzeyi ile GFR arasında negatif korelasyon mevcuttu. Bu durum özellikle ileri evre kronik böbrek hastalığında, etiyolojik nedenden bağımsız olarak PCT değerlerinde artış olabileceğini göstermektedir.

Anahtar Kelimeler:

Diyabet, nefropati, prokalsitonin

Evaluation of procalcitonin levels in nephropathic and non- nephropathic diabetic patients

Aim: To investigate how serum procalcitonin (PCT) levels are affected in diabetic patients with and without nephropathy, and to determine whether PCT may be indicative of an inflammation in these patients.Material and Method: The study included 175 patients [75 diabetic nephropathy (group 1), 75 non-nephropathy diabetic (group 2) and 25 non-diabetic nephropathy (group 3)], and 75 healthy volunteers. Serum and urinary creatinine, serum high sensitive C-reactive protein (HsCRP), PCT, white blood cell, neutrophil, HbA1c and urinary protein values were obtained from patients and control groups. Urinary protein / creatinine ratio and eGFR were calculated.Results: There was no significant difference of PCT values between groups 1, 2, 3 and control group (0.20-0.19-0.23 and 0.19, respectively) (p>0.05). HsCRP levels of all 3 patient groups were higher than the control group (p<0.001). A negative correlation was found between eGFR values, PCT (p<0.001; r = -0.475) and HsCRP (p<0.001; r= -0.415) values in nephropathy patients (diabetic and non-diabetic). Patients with diabetic nephropathy were compared to those with a eGFR of 60 or more with those below eGFR 60. When the eGFR values were lower than 60, the HsCRP values were higher (p<0.05); there was no difference between the PCT values (p>0.05). Conclusion: There was no significant increase in PCT values of diabetic and diabetic nephropathy patients. However, there was a negative correlation between PCT level and eGFR. This suggests that there may be an increase in PCT values, especially in advanced chronic renal disease, regardless of the etiology.

Keywords:

Diabetes, nephropathy, procalcitonin,

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