Kronik Böbrek Hastaliği Olan Hastalarda Hastalik Progresyonuna Ve Mortaliteye Etki Eden Faktörlerin Analizi

Abstract

Amaç: Kronik böbrek hastalığı hastalarında (KBH) hastalık progresyonu ve ölümü etkileyen değişkenleri araştırmak. Gereç ve Yöntemler: Bu retrospektif kesitsel araştırma tasarımı, 2009 ve 2016 yılları arasında üçüncü basamak hastanenin acil servis ve diğer polikliniklerinde Glomerüler Filtrasyon Hızı (GFR) <60 ml/dk/1.73 m² ile Nefroloji Polikliniğine sevk edilen hastalar üzerinde yapılmıştır. ≥5 ml/dk/yıllık bir GFR düşüş oranı "hızlı ilerleyen" CKD ve <5 ml/dk/yıl "yavaş ilerleyen" CKD olarak tanımlandı. Son noktalar renal replasman tedavisine kabul ve ölümdü. Bulgular: Araştırmaya 464'ü (%63) erkek olmak üzere 737 hasta dahil edildi. Ortalama takip süresi 16.87 ± 18.55 aydı. RAAS blokerleri ve hiperfosfatemi kullanımı böbrek hastalığının ilerleme hızını arttırdı. Koroner arter hastalığı ve yüksek proteinüri düzeylerinin varlığı renal replasman tedavisi (RRT) başlama riskini artırırken, statin ve D vitamini kullanımı bu riski azalttı. Ayrıca, kalp yetmezliği, hiperfosfatemi ve anemi varlığı ölüm riskini artırdı, ancak RAAS blokerleri, D vitamini ve yüksek albümin düzeylerinin kullanılması ölüm riskini azalttı. Sonuç: KBH, önemli bir morbidite ve ölüm oranına sahip kronik bir hastalıktır. Bu hastalığın ilerlemesine neden olan faktörlerin tanınması ve tedavi edilmesi hasta sağkalımını iyileştirecektir.

Keywords

• Kronik Böbrek Hastalığı
• İlerleme
• Mortalite

Analysis of Factors Affecting Disease Progress and Mortality in Patients with Chronic Renal Disease

Abstract

Objective: To investigate the variables influencing disease progression and death in chronic renal disease patients (CKD). Material and Methods: The design of this retrospective cross-sectional research was conducted on patients who were referred to the Nephrology Outpatient Clinic with a Glomerular Filtration Rate (GFR) <60 ml/min/1.73 m² in the emergency department and other outpatient clinics of a tertiary hospital between 2009 and 2016. A GFR decline rate of ≥5 ml/min/year was defined as "rapidly progressive" CKD and <5 ml/min/year as "slowly progressive" CKD. The endpoints were renal replacement therapy admission and death. Results: The research comprised 737 patients, with 464 (63%) of them being men. The average duration of follow-up was 16.87 ± 18.55 months. Using RAAS blockers and hyperphosphatemia increased the rate of progression of renal disease. The presence of coronary artery disease and high proteinuria levels increased the hazard of renal replacement therapy (RRT) initiation, whereas statin and vitamin D use decreased this risk. Furthermore, the presence of heart failure, hyperphosphatemia, and anemia raised the risk of death, but using RAAS blockers, vitamin D, and high albumin levels lowered the risk of mortality. Conclusions: CKD is a chronic illness with a significant morbidity and death rate. Recognizing and treating the factors that cause the progression of this disease will improve patient survival.

Keywords

• Chronic Kidney Disease
• Progression
• Mortality

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