Bazal Ürik Asid Düzeyi, Sepsiste Akut Böbrek Hasarının Önceden Belirlenmesi İçin Bir Kılavuz Olabilir

Year 2021, , 391 - 395, 15.12.2021

Hakki Yilmaz

https://doi.org/10.54005/geneltip.970853

Abstract

Amaç: Sepsis, yoğun bakım ünitesinde (YBÜ), akut böbrek hasarının (ABH) en önemli nedeni olup %15-20’sinde renal replasman tedavisi ihtiyacı olmaktadır. Ürik asit, hipertansiyon, dislipidemi, yağlı karaciğer, böbrek hastalıkları ve kardiyovasüler hastalıklarla ilişkilidir. Ürik asit seviyelerinin ABH riskinin artması ile bağlantılı olduğu gösterilmiştir. Biz de artmış ürik asit düzeyinin ABH'yı önceden belirlemede rolü olup olmadığını incelemeyi amaçladık.
Gereç ve Yöntem: Bu retrospektif çalışmada, Eylül 2015-Aralık 2017 arasında sepsis nedeni ile YBÜ kabul edilen 105 ardışık hastayı dahil ettik. Kabul esnasındaki klinik laboratuvar testleri ve basitleştirilmiş akut fizyoloji skoru (SAPSII) kaydedildi ve 7 gün boyunca böbrek fonksiyonlarının izlemi yapıldı.
Bulgular: 7 gün içindeki ABH oluşum oranı %47.6 idi. Bazal ürik asit düzeyi ABH gelişen grupta ABH gelişmeyen gruba göre daha yüksekti. Multivariate lojistik regresyon analizinde, serum ürik acid, albumin ve SAPSII; ABH ile bağımsız olarak bağlantılıydı. Serum ürik asit 6.85 mg/dl eşik noktasında sepsis hastalarında ABH'yı belirlemede oldukça etkiliydi ve %72 duyarlılık ve %85.5 özgüllüğe sahipti. Sonuç: Artmış ürik asit düzeyi sepsiste ABH'nın önceden belirlenmesinde yardımcı olabilir.

Keywords

Ürik asit, Akut böbrek hasarı, Sepsis.

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