Tugba IZCI DURAN, Saliha YİLDİRİM, Burak SAYİN

Renal transplant hastalarında idrar sodyum atılımının metabolik sendrom, hipertansiyon ve greft fonksiyonu ile ilişkisinin değerlendirilmesi

Amaç: Renal transplant (RT) hastalarında idrar sodyum atılımı ile metabolik sendrom, hipertansiyon, greft fonksiyonu arasındaki ilişkinin değerlendirilmesidir. Materyal-Metod: Nakil polikliniğinde düzenli takip edilen 152 RT alıcısı çalışmaya alındı. Hastaların demografik özellikleri, ofis kan basıncı değerleri, boy, kilo, vücut kitle indeksi, bel ve kalça ölçümleri, immunsüpresif ilaçlar, diğer ilaçlar ve biyokimyasal parametreleri kaydedildi. Tüm RT alıcılarında ilk sabah idrarında spot üriner sodyum ve spot üriner protein atılımları ölçüldü. Hastalar spot üriner sodyumdaki medyan değeri 57'ye göre düşük sodyum atılımı (≤57) ve yüksek sodyum atılımı (≥58) olarak gruplandırıldı. Bulgular: Düşük sodyum grubunda; kadınlarda kreatinin değerleri anlamlı derecede düşük (p<0,001) ve eGFR yüksek saptandı (p=0,03). Yüksek sodyum grubunda; BUN ve kreatinin düzeyleri cinsiyete göre karşılaştırıldığında erkeklerde anlamlı derecede yüksek bulundu (sırasıyla p=0,04 ve p=0,02). EF ölçümü erkeklerde kadınlardan anlamlı derecede düşüktür (p=0,008). Metabolik sendromu olan ve olmayan hastaların spot idrar sodyum atılımları karşılaştırıldığında her iki grupta spot idrar sodyum atılım değerleri arasında fark saptanmadı (p=0,99). Sonuç: Spot idrar sodyum atılımı, RT hastalarında sodyum alımını değerlendirmek için kullanılabilecek ucuz ve nispeten etkili bir tarama yöntemi olarak görülebilir. Özellikle erkek cinsiyet, böbrek fonksiyon bozukluğu ve yüksek tansiyonu olan RT alıcılarında daha değerli bir takip yöntemi olarak kabul edilebilir.

Anahtar Kelimeler:

Böbrek nakli, greft fonksiyonu, hipertansiyon, metabolik sendrom, spot idrar sodyum

Evaluation of the relationship of urinary sodium excretion with metabolic syndrome, hypertension, and graft function in renal transplant patients

Aim: To evaluate the relationship between high sodium intake determined by spot urinary sodium excretion with metabolic syndrome, hypertension, and graft function in renal transplant (RT) recipients. Materials and methods: 152 RT recipients were enrolled. The demographic characteristics, office blood pressure (BP) values, height, weight, body mass index, waist and hip measurements, immunesuppressive drugs, other medications and biochemical parameters of the patients were recorded. Spot urinary sodium and spot urinary protein excretions were measured in the first morning urine in all the RT recipients. The patients were grouped as low sodium excretion (≤57) and high sodium excretion (≥58) based on the median value of 57 in spot urinary sodium. Results: In the low sodium group; creatinine values were found to be significantly lower (p<0.001) and eGFR was high in female patients (p=0.03). The mean protein in spot urine was found to be lower in women (p=0.03). In the high sodium group; BUN and creatinine levels were significantly higher in male patients than in female patients (p=0.04 and p=0.02, respectively). Ejection fraction was found to be significantly lower in male patients than in female patients (p=0.008). Spot urinary sodium excretion of patients with and without metabolic syndrome were compared and no difference was found between spot urinary sodium excretion values in both groups (p=0.99). Conclusion: Spot urinary sodium excretion can be seen as an inexpensive and relatively effective screening method that can be used to evaluate sodium intake in RT patients. It can be considered as a more valuable follow-up method especially in RT recipients with male gender, kidney dysfunction and high BP.

Keywords:

Böbrek nakli, greft fonksiyonu, hipertansiyon, metabolik sendrom, spot idrar sodyum,

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