Böbrek nakli yapılan hastalarda proteinüri sıklığı ve nedenleri

Yıl 2016, Cilt: 2 Sayı: 1, 4 - 11, 08.03.2016

Alirıza Ünsal Mehmet Tanrısev Cemalettin Oluç

Öz

Amaç: Bu çalışmada böbrek nakli yapılan hastalarda proteinüri sıklığı ve nedenleri araştırıldı. Hastalar ve yöntemler: Çalışmaya böbrek nakli yapılan ve Tepecik Eğitim ve Araştırma Hastanesi Nefroloji Kliniği’nde takip edilen 100 hasta (68 erkek, 32 kadın; ort. yaş 42.1±11.4 yıl; dağılım 17-68 yıl) dahil edildi. Hastaların demografik özellikleri, biyokimyasal verileri, immünsüpresif tedavileri ve biyopsi sonuçları poliklinik takip dosyalarından retrospektif olarak kaydedildi.

Bulgular: 1000 mg/gün üzerindeki değerler proteinüri olarak tanımlandı ve 36 hastada proteinüri saptandı. Bu 36 hastanın 16’sına biyopsi yapıldı. Akut rejeksiyonlar proteinürinin önde gelen nedenlerindendi. Ayrıca, proteinüri düzeyi 1000 mg/gün’ün altında olan 64 hastanın 21’ine renal biyopsi uygulandı. Bu grupta nonspesifik biyopsi sonuçları en sık rastlanan bulgulardı. İmmünsüpresif ilaç kullanımı açısından 1000 mg/gün’den fazla proteinürisi olan hasta oranları benzerdi. Böbrek nakli yapılan hastalarda proteinüri sıklılığı %36 idi. Demografik veriler açısından gruplar arasında anlamlı farklılık yoktu.

Sonuç: Proteinüri düzeyleri daha yüksek olan hastalarda akut rejeksiyon en yaygın biyopsi sonucuydu. Beklenenin tersine, immünsüpresif tedavinin mTOR inhibitörlerinde anlamlı proteinüri sıklığı gözlenmedi.

Anahtar Kelimeler

İmmunsüpresif tedavi, böbrek nakli, proteinüri

Kaynakça

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