Ahmet ELMAS TANER, İlke AKIN MUNGAN, Yılmaz TABEL, Aysun KARABULUT BAY, Mehmet ÖNCÜL

Erken doğmuş yenidoğanlarda total parenteral beslenmenin böbrek işlevleri üzerine etkileri

Amaç: Erken doğmuş yenidoğanlarda total parenteral beslenmenin böbrek işlevleri üzerine etkilerini değerlendirmek için; serumda sistatin C, idrarda β2 mikroglobülin, glütatyon-S-transferaz π ve N-asetil β-D glükozaminidaz düzeylerini saptayarak, total parenteral beslenme alanlar ile enteral beslenen kontrol grubu hastaların böbrek işlevlerinin karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: Bu çalışma; gestasyonel yaşları 28-34 hafta arasında olan 104 erken doğmuş hastada yapıldı. Total parenteral beslenen 50 (Erkek/Kız: 23/27 ve ortalama ağırlıkları 1258±212,3 g) ve enteral beslenen 54 (Erkek/Kız: 20/34 ve ortalama ağırlıkları 1608±206,1 g) erken doğan bebek bu çalışmaya alındı. Total parenteral beslenme alan grupta üçüncü günden sonra total parenteral beslenme başlanırken, minimal enteral beslenmeye ortalama 6,3±2,4 günlerde ve tam enteral beslenmeye ortalama 24,5±6,3 günlerde geçildi. Enteral yolla beslenen gruba ise birinci gün anne sütü orogastrik/nazogastrik sonda ile veya ağızdan başlandı. Tüm hastaların üçüncü ve 30. günlerdeki serumdaki sistatin C, glükoz, BUN, kreatinin, total protein, albümin, AST, ALT, ALP, sodyum, potasyum, kalsiyum, fosfor ve idrardaki; N-asetil-β-D glükozaminidaz, glütatyon S-transferaz π, β2-mikroglobülin, sodyum, kreatinin, yoğunluk, pH ölçümleri değerlendirildi. Çalışma için etik kurul onayı alındı (2008/16). Bulgular: Total parenteral beslenme alan hastalar ile enteral beslenen hastaların üçüncü gün değerleri arasında anlamlı fark yokken, 30. gündeki serum sistatin C, idrar β2 mikroglobülin, glütatyon-S-transferaz π ve N-asetil β-D glükozaminidaz değerleri karşılaştırıldığında total parenteral beslenme grubunda enteral beslenenlere göre anlamlı olarak yüksek olduğu saptandı (p

Effects of total parenteral nutrition on renal function in preterm neonate

Aim: The aim of this study was to establish serum sistatine C, urine β2 microglobulin, gluthatione-S -transferase π and N-acetyle β-D glucosaminidase levels in order to evaluate the effect of total parenteral nutrition on renal function in premature infants. In addition, we aimed to compare the renal functions between premature infants receiving total parenteral nutrition and control groups receiving enteral feeding. Material and Method: A hundred four premature infants with a gestational age between 28 and 34 weeks were included in the study. The parenteral nutrition group consisted of 50 infants (male/female; 23/27 and mean weight 1258±212.3 g) and the enteral nutrition group consisted of 54 infants (male/female; 20/34 and mean weight 1608±206.1 g). In the parenteral nutrition group; total parenteral group nutrition was initiated on the 3rd day in the enteral nutrition group, minimal enteral nutrition was started on a mean of 6.3±2.4 days and total enteral nutrition was started on a mean of 24.5±6.3 days. Breastmilk was given orally or by orogastric/nasogastric tube at first day of life in the enteral group. On the 3rd and 30th day of life, blood samples of all patients were obtained for evaluating biochemical parameters and cystatin C and urine samples were obtained for evaluation of N-acetyl β-D glucosaminidase, gluthatione-S-transferase π, β2 microglobulin, sodium, creatinin levels, density and pH of the urine. The study was approved by the ethics commite (2008/16). Results: When we compared the patients who received total parenteral nutrition and enteral nutrition on the 3rd and 30th days, serum cystatin C, urinary β2 microglobulin, gluthatione-S-transferase π and N-acetyl- β-D glucosaminidase excretions were similar on the 3rd day however were significantly higher on the 30th day in samples of the patients receiving total parenteral nutrition (p

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