Evre III kronik böbrek yetmezliği hastalarında serum parathormon ile anemi arasındaki ilişkinin değerlendirilmesi

Giriş ve Amaç: Bu çalışma ile Evre III kronik böbrek yetmezliği hastalarında anemi ile serum parathormon düzeyi arasındaki ilişkinin araştırılması ve bu ilişkinin anemi üzerindeki etkisinin ortaya konması amaçlan-mıştır. Materyal ve Metot: Retrospektif olarak yapılan çalış-maya, 18 ile 70 yaş arasında 34 erkek, 40 kadın olmak üzere toplam 74 kronik böbrek yetmezliği olan hasta dahil edildi. Hastaların anemi parametreleri, serum pa-rathormon düzeyleri, glomerüler filtrasyon hızları (GFH), böbrek fonksiyon testleri, kaydedildi. GFH 30-60 ml/dk arasında olanlar çalışmaya alındı. GFH değerlerine göre sırasıyla 30-39, 40-49, 50-60 ml/dk olarak 3 gruba, gruplar da anemisi olan ve olmayan olarak iki kategoriye ayrıldı. Sonuçlar: Hemoglobindeki değişime etki edebileceği düşünülen tüm potansiyel etkenlere göre düzeltme yapıl-dığında hemoglobin ile ters korelasyon gösteren parat-hormonun anlamlı etkisinin devam ettiği (p=0,013) ancak parathormon düzeyinin artmasıyla hemoglobin düzeyinin azalması arasındaki bu ilişkinin de cinsiyetten bağımsız olarak düşünülemeyeceği görülmüştür (p=0,031). Diğer risk faktörlerine göre düzeltme yapıldığında parathor-mondaki her 100 pg/ml’lik artış kadınlarda hemoglobin düzeyinde 0,6 g/dl’lik (%95 Güven Aralığı: 0,1-1,0), erkek-lerde 1,44 birimlik (0,18-2,60) bir azalmaya neden olmaktaydı. Anemisi olmayan gruba göre anemisi olan grupta albümin düzeyi anlamlı olarak daha düşüktü (p

Anahtar Kelimeler:

Geriyedönük çalışma, Böbrek yetmezliği, kronik, Paratiroid hormonu, Anemi

Evaluation of the relationship between serum parathormone levels and anemia in patients with stage III chronic renal failure

Aim: Hematopoetic system is one of the several systems affected in chronic renal failure. This study was designed to evaluate the relationship between anemia and serum parathormone levels in patients with stage III chronic renal failure; thus we aimed to use this relationship to prove the bone marrow toxicity of parathormone as a cause of anemia in chronic renal failure. Material and Method: Seventy four patients (34 men and 40 women) between 18 and 70 years of age with the diagnosis of chronic renal failure that were followed up at the outpatient clinic were included in this retrospective study. Parameters of anemia, serum parathormone levels, glomerular filtration rates (GFR), and kidney function tests were recorded. Patients with GFR values between 30-60 ml/min were included in this study. According to GFR, patients were separated into three groups as 30-39 ml/min, 40-49 ml/min and 50-60 ml/min, respectively. Groups were also categorised in terms of anemia. Results: After adjusting all factors that could affect hemoglobin, negative correlation between parathormone and hemoglobin levels persisted (p=0.013), however it was determined that this negative relationship should not be considered regardless of sex (p=0,031). After adjusting other risk factors, every 100 pg/ml increase in parathormon caused a reduction of hemoglobin by 0,6 g/dl in women, (95% safety interval: 0,1-1,0) 1,44 g/dl (95% safety interval 0,18-2,60) in men. Patients with anemia had significantly lower values of albumin (p<0,001). When diabetic and non-diabetic groups were compared, the albumin level did not differ significantly (p=0,308). Anemia prevalence was statistically higher in men who had diabetes when compared with those without diabetes (p=0,037); however prevalance of anemia did not differ in women between patients with and without diabetes (p=1,000). In diabetic patients prevalence of anemia was significantly higher in men when compared to women (p=0,002).

Keywords:

Retrospective Studies, Kidney Failure, Chronic, Parathyroid Hormone, Anemia,

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