Hemodiyaliz Hastalarında Mortaliteye Etkisi Olan Kan Parametreleri ve Ekokardiyografi Bulguları

Year 2022, Volume: 55 Issue: 2, 74 - 77, 31.08.2022

Recep Alanlı , Murat Bülent Küçükay , Şahin Mürsel , İzzet Yavuz , Fatma Kaymakamtorunları Deniz , Osman Tolga Kaskatı , Metin Yıldırımkaya

https://doi.org/10.20492/aeahtd.1019834

Cited By: 1

Abstract

Giriş: Bu çalışmada hemodiyalize giren hastaların demografik özellikleri, eşlik eden hastalıkları, kan parametreleri ve EKO bulguları ile mortalite arasındaki ilişkinin saptanması hedeflendi.
Gereç ve Yöntem: Bu çalışma; Temmuz 2017 ile Temmuz 2021 tarihleri arasında kronik böbrek hastalığı nedeniyle düzenli hemodiyalize giren 755 hasta ile retrospektif olarak yapıldı. Onsekiz yaşından küçükler ve 60 günden az hemodiyalize girenler çalışmaya alınmadı.
Bulgular: C- reaktif protein, ferritin, eritrosit dağılım hacmi, alkalen fosfataz yüksekliği, 65 yaşından büyük olmak, albumin, kalsiyum, protein eksikliği ve ejeksiyon fraksiyonu (EF) düşüklüğü ile ölüm arasında ilişki olduğu saptandı. Yaş, albümin düzeyi, hipertansiyon, hiperlipidemi ve EF düzeyleri ile mortalite arasında korelasyon bulundu.
Sonuç: Hemodiyalize giren hastalarda; ileri yaş, albumin eksiliği ve EF düşüklüğü ile hiperlipidemi varlığında mortalite riski yüksek olup, bu hastaların daha dikkatli takip edilmesi gerekmektedir. Ayrıca antihipertansif ilaçların koruyucu özelliği olup, uygun olan her hastaya antihipertansif ilaç verilmesi önerilir.

Keywords

Albumin;, ejeksiyon farksiyonu, esansiyel hipertansiyon, hemodiyaliz, hiperlipidemi

Supporting Institution

Yok

Project Number

Yok

Laboratory Test Paramaters and Echocardiography Findings that Affect Mortality in Hemodialysis Patients

Abstract

Aim: To determine demographic characteristics, concomitant diseases, relationships between mortality and laboratory test parameters and echocardiography findings.
Material and Method: Between July 2017 and July 2021, 755 patients who were undergoing hemodialysis because of chronic kidney disease regularly were inspected retrospectively. Patients under 18 years of age and patients who were undergoing hemodialysis for less than two months were excluded.
Results: Age over 65 years, increased levels of C-reactive protein, ferritin, red cell diameter width, alkaline phosphatase, and decreased levels of albumin, calcium, total protein and low ejection fraction (EF) in echocardiography were found to have significant relationships. There were correlation between mortality and age, albumin levels, existence of hypertension, hyperlipidemia and low EF values.
Conclusion: Advanced age, low albumin levels and low EF values and existence of hyperlipidemia and hypertension result in increased risk of mortality in hemodialysis patients. These patients must be carefully monitored. Anti-hypertensive medications have protective effects, and must be preferred whenever possible in hemodialysis patients.

Keywords

Albumin, ventricular ejection fraction, hemodialysis, essential hypertension, hyperlipidemia

Project Number

Yok

References

• .Ma L, Zhao S. Risk factors for mortality in patients undergoing hemodialysis: A systematic review and meta-analysis. Int J Cardiol. 2017;238:151-158.
• Lozano R, Naghavi M, Foreman K, et al.; Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;15;380(9859):2095-128
• Wang H, Liu J, Xie D, et al. Elevated serum uric acid and risk of cardiovascular or all-cause mortality in maintenance hemodialysis patients: A meta-analysis. Nutr Metab Cardiovasc Dis. 2021;31(2):372-381.
• Hong WP, Lee YJ. The association of dialysis adequacy, body mass index, and mortality among hemodialysis patients. BMC Nephrol. 2019;22;20(1):382.
• Mitsopoulos E, Lysitska A, Zanos S, et al. Normal white blood cell counts predict long-term mortality of hemodialysis patients. Int Urol Nephrol. 2020; 52(4):783-790.
• Ryu SY, Kleine CE, Hsiung JT, et al. Association of lactate dehydrogenase with mortality in incident hemodialysis patients. Nephrol Dial Transplant. 2021;36(4):704-712.
• Ravel V, Streja E, Molnar MZ, et al. Association of aspartate aminotransferase with mortality in hemodialysis patients. Nephrol Dial Transplant. 2016;(5):814-22.
• Kim S, Molnar MZ, Fonarow GC, et al. Mean platelet volume and mortality risk in a national incident hemodialysis cohort. Int J Cardiol. 2016;220:862-70.
• Hickson LJ, Negrotto SM, Onuigbo M, et al. Echocardiography Criteria for Structural Heart Disease in Patients With End-Stage Renal Disease Initiating Hemodialysis. J Am Coll Cardiol. 2016 ;67(10):1173-1182.
• Zhu J, Tang C, Ouyang H, et al. Prediction of All-Cause Mortality Using an Echocardiography-Based Risk Score in Hemodialysis Patients. Cardiorenal Med. 2021;11(1):33-43.
• Erdoğmuş Ş, Kaymakamtorunları F. Hemodiyaliz Hastalarinda Mortalite ile İlişkili faktörler: Türkiye’nin Doğu Anadolu Bölgesinden Tek Merkezli Bİr Veri. Ankara Üniversitesi Tıp Fakültesi Mecmuası – 2020;73(3):239-246.
• Zhang T, Li J, Lin Y, et al. Association Between Red Blood Cell Distribution Width and All-cause Mortality in Chronic Kidney Disease Patients: A Systematic Review and Meta-analysis. Arch Med Res. 2017;48(4):378-385.
• Qureshi AR, Alvestrand A, Divino-Filho JC, et al. Inflammation, malnutrition, and cardiac disease as predictors of mortality in hemodialysis patients. J Am Soc Nephrol. 2002; 1:28-36.
• Block GA, Klassen PS, Lazarus JM, et al. Mineral metabolism, mortality, and morbidity in maintenance hemodialysis. J Am Soc Nephrol. 2004;15(8):2208-18.
• Regidor DL, Kovesdy CP, Mehrotra R, et al. Serum alkaline phosphatase predicts mortality among maintenance hemodialysis patients. J Am Soc Nephrol. 2008;19(11):2193-203.
• Nakano T, Hiyamuta H, Yotsueda R, at al. Higher Cholesterol Level Predicts Cardiovascular Event and Inversely Associates With Mortality in Hemodialysis Patients: 10-Year Outcomes of the Q-Cohort Study. Ther Apher Dial. 2020; (4):431-438.
• Zhou H, Sim JJ, Shi J, et al. β-Blocker Use and Risk of Mortality in Heart Failure Patients Initiating Maintenance Dialysis. Am J Kidney Dis. 2021;77(5):704-712.
• Tanaka M, Yamashita T, Koyama M, et al. Impact of use of angiotensin II receptor blocker on all-cause mortality in hemodialysis patients: prospective cohort study using a propensity-score analysis. Clin Exp Nephrol. 2016;20(3):469-78.
• Wetmore JB, Mahnken JD, Phadnis MA, et al. Relationship between calcium channel blocker class and mortality in dialysis. Pharmacoepidemiol Drug Saf. 2015;24(12):1249-58.
• Rroji M, Cafka M, Seferi S, et al. The potential effect of cardiac function on pulmonary hypertension, other risk factors, and its impact on survival in dialysis patients. Int Urol Nephrol. 2021;53(2):343-351.
• Siqueira TM, Ferreira PA, Monteiro Júnior Fd, et al. Echocardiographic parameters as cardiovascular event predictors in hemodialysis patients. Arq Bras Cardiol. 2012;99(2):714-23.