Bulent GUL, Mehmet Çağatay ÇİÇEK

Otozomal Dominant Polikistik Böbrek Hastalığında Bilgisayarlı Tomografi Kullanımı

Otozomal Dominant Polikistik Böbrek Hastalığı (ODPBH), kalıtsal böbrek hastalıkları arasında en yaygın görülendir. Böbreklerde çok sayıda kist oluşumu ve gelişimi ile karakterize sistemik ve ilerleyici bir hastalıktır. ODPBH prognozunu belirlemede yaygın olarak Mayo sınıflandırması kullanılmaktadır. Bu sınıflamada kullanılan bilgisayarlı tomografi (BT), ODPBH’da sık görülen taş hastalığını ortaya çıkarmada da faydalı olabilir. Nefroloji polikliniğinde takip edilen 69 ODPBH’lı hasta çalışmaya dahil edildi. Hastaların Mayo evrelemesi yapılırken çekilen BT’leri incelendi. BT bazlı volüm böbrek hacimleri hesaplandı, kistik yapılar ve nefrolityasis açısından değerlendirildi. CKD-EPI formülüne göre glomerular filtrasyon hızları hesaplandı (eGFR), hastalar ODPBH’nın ekstra-renal bulguları açısından tarandı. Hastaların yaş ortalaması 47±13 yıl saptandı, %45’i (n=31) kadın cinsiyetindeydi. Hastaların %34.8’inde (n=24) böbrek taşı saptandı, taş olanların %25’i bilateral nefrolityazisdi. Total böbrek hacmi ile eGFR arasında anlamlı negatif korelasyon saptandı (r=-0.6, p<0.001). Taşı olan ve olmayan grup arasında eGFR ve total böbrek hacmi arasında farklılık saptanmadı, sırasıyla 87 (54-109) vs 83 (49-106) ml/dk/1.73m2 (p=0.805), 961 mm3 (695-1936) vs 1219 mm3 (600-1663) (p=0.623). Sonuç olarak prognoz belirleme için yapılan hacim ölçümlemesinde BT kullanımı böbrek taşlarını belirlemede ilave bir fayda sağlayabilir.

Anahtar Kelimeler:

: ODPBH, Nefrolityazis, Bilgisayarlı tomografi, Mayo evrelemesi

Computed Tomography Use in Autosomal Dominant Polycystic Kidney Disease

Autosomal Dominant Polycystic Kidney Disease (ADPBD) is the most common inherited kidney disease. It is a systemic and progressive disease characterized by the formation and development of multiple cysts in the kidneys. The Mayo classification is widely used to determine the prognosis of ADPKD. Computed tomography (CT) can be used in this classification and may also be useful in revealing the common stone disease in ADPKD. 69 patients with ADPKD followed in the nephrology outpatient clinic were included in the study. CT scans of the patients taken during Mayo staging were examined. CT-based volume kidney volumes were calculated and evaluated in terms of cystic structures and nephrolithiasis. Glomerular filtration rates (eGFR) were calculated according to the CKD-EPI formula, and patients were screened for extra-renal signs of ADPKD. The mean age of the patients was 47±13 years, 45% (n=31) were female. Renal stones were detected in 34.8% (n=24) of the patients, and 25% of those with stones had bilateral nephrolithiasis. There was a significant negative correlation between total kidney volume and eGFR (r=-0.6, p<0.001). There was no difference in eGFR and total kidney volume between the group with and without stones, respectively, 87 (54-109) vs. 83 (49-106) ml/min/1.73m2 (p=0.805), 961 mm3 (695-1936) vs. 1219 mm3 (600-1663) (p=0.623). As a result, the use of CT in volume measurement for prognosis may provide an additional benefit in detecting kidney stones.

Keywords:

ADPKD, Nephrolithiasis, Computed tomography, Mayo staging,

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