Nurdan YILDIZ, Salim ÇALIŞKAN, Levent KABASAKAL, Lale SEVER, Nil ARISOY

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Sistatin C: böbrek işlevleri azalmakta olan çocuklarda glomerüler filtrasyon hızı ölçümünde daha yararlı bir değişken olabilir mi?

Amaç: Bu çal›flmada böbrek ifllevleri azalmakta olan çocuklarda glomerül filtrasyon h›z› tayininde serum sistatin C’nin kreatinine göre daha iyi bir de¤iflken olup olmad›¤› araflt›r›ld›. Gereç ve Yöntem: Göztepe E¤itim-Araflt›rma Hastanesi ve Cerrahpafla T›p Fakültesi Çocuk Nefroloji Poliklinikleri’nde izlenen 100 çocuk (53 k›z/47 erkek) çal›flmaya al›nd›. Çal›flmada alt›n standart olarak dietilen triamin penta asetat (DTPA) klirensi al›nd›. Dietilen triamin penta asetat klirensi 80mL/dak/1,73m2’nin üstünde olan olgular birinci gruba (n=64), alt›ndakiler ikinci gruba (n=36) al›nd›. Olgular›n serum sistatin C ve kreatinin düzeyleri ölçüldü, glomerül filtrasyon h›z› Schwartz formülüyle (GFH schw) hesapland›. De¤iflkenlerin tan›sal de¤erleri ROC analizi ile de¤erlendirildi. Tüm çocuklar›n ailelerinden imzalanm›fl ayd›nlat›lm›fl onay formu al›nd›. Bulgular: Olgular›n 53’ü k›z, 47’si erkek olup yafllar› ortalama 8,4±5,1 (0,17-20,5) y›l idi. Birinci gruba 64 olgu, ikinci gruba 36 olgu al›nd›. Olgular›n serum sistatin C ve kreatinin düzeyleri ile GFHSchw aras›nda her iki grupta anlaml› bir iliflki saptand› (p<0,01). Serum kreatinin ve sistatin C düzeyleri ile GFHDTPA aras›nda böbrek ifllevi azalm›fl olgularda anlaml› bir iliflki bulundu, böbrek ifllevleri normal olgularda ise iliflki bulunmad›. Sonuçlar ROC analiziyle  ¤erlendirildi¤inde serum sistatin C ve GFHSchw için ROC e¤risi alt›nda kalan alan de¤erleri istatistiksel olarak anlaml› bulundu ancak alan de¤erleri aras›nda belirgin farkl›l›k gözlenmedi. Çıkarımlar: Serum sistatin C düzeyleri GFH ölçümünde yararl› ancak serum kreatinin ve GFHSchw‘e üstünlü¤ü olmayan bir de¤iflkendir. Böbrek ifllevleri normal ve azalm›fl çocuklarda GFH izleminde GFHSchw basit ve yeterli bir yöntemdir.
Anahtar Kelimeler:

Böbrek işlevleri, glomerül filtrasyon hızı, Schwartz formülü, sistatin C

Cystatin C: can it be more reliable marker for estimation of glomerular filtration rate in children with reduced renal function?

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Türk Pediatri Arşivi-Cover
  • ISSN: 1306-0015
  • Yayın Aralığı: 4
  • Başlangıç: 2015
  • Yayıncı: Alpay Azap
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