KOAH Atak Hastalarında Ürik Asit ve Ürik Asit/Kreatinin Önemi

Year 2024, Volume: 21 Issue: 3, 516 - 519

Zeliha Demir Giden , Ramazan Giden , Elif Demir

https://doi.org/10.35440/hutfd.1582780

Abstract

Amaç: KOAH alevlenmelerle seyreden kronik inflamatuvar bir hastalıktır ve hipoksemi, özellikle alevlenmeler esnasında şiddetlenir. Ürik asit/kreatinin oranının hipoksiye bağlı anaerobik deği-şiklikleri göstermesinin ürik asit seviyesinden daha sensitif olduğu ve KOAH gibi hipoksemiyi or-taya çıkaran primer hastalıkların fonksiyonel parametreleri ile daha ilişkili olduğu gösterilmiştir. Bu çalışmada KOAH atak ile acil servise başvuran hastalarda yatış kararının verilmesinde ürik asit ve ürik asit/ kreatinin oranının etkinliğini araştırmayı amaçladık.
Materyal ve metod: Çalışmaya acil servise KOAH atak nedeni ile başvuran 80 hasta dahil edilmiş-tir. Bu hastaları yoğun bakım yatışı, servis yatışı ve taburcu edilen olmak üzere 3 gruba ayırdık. Hastaların demografik özellikleri, komorbiditeleri, acil servise başvuru anındaki saturasyon, üre, ürik asit, kreatinin değerleri ve ürik asit/kreatinin oranı analiz edildi.
Bulgular: 80 hastanın 35’i yoğun bakıma, 30’u servise yatırılmış ve 15’i ise acil servisten taburcu edilmiştir. Grupların acile başvuru saturasyon değerleri arasında istatistiksel olarak anlamlı fark-lılık tespit edilirken (p<0.05) üre, ürik asit, kreatinin değeri ve ürik asit/kreatinin oranı gruplar arasında istatistiksel olarak anlamlı değildi (p>0.05).
Sonuç: Yaptığımız çalışmanın sonucunda KOAH akut atak ile acile başvuran hastalarda hipoksi arttıkça ürik asit ve ürik asit/kreatinin oranının istatistiksel olarak etkilenmediğini ve bu paramet-relerin hastaneye yatışı öngörüde faydalı olamayacağı kanısına vardık.

Keywords

KOAH, Üre, Ürik asit/kreatinin

The Importance of Uric Acid and Uric Acid/Creatinine in COPD Attack Patients

Abstract

Background: COPD is a chronic inflammatory disease with exacerbations and hypoxemia is par-ticularly severe during exacerbations. Uric acid/creatinine ratio has been shown to be more sen-sitive than uric acid level in showing anaerobic changes due to hypoxia and more correlated with functional parameters of primary diseases that elicit hypoxemia such as COPD. In this study, we aimed to investigate the effectiveness of uric acid and uric acid/creatinine ratio in making hospi-talization decisions in patients admitted to the emergency department with COPD attack.
Materials and Methods: The study included 80 patients admitted to the emergency department due to COPD attack. We divided these patients into 3 groups as intensive care unit admission, ward admission and discharged patients. Demographic characteristics, comorbidities, saturation, urea, uric acid, creatinine values and uric acid/creatinine ratio at the time of presentation to the emergency department were analyzed.
Results: Of the 80 patients, 35 were admitted to intensive care, 30 were admitted to the ward, and 15 were discharged from the emergency room. While statistically significant difference was found between the saturation values of the groups at emergency admission, urea, uric acid, cre-atinine values and uric acid/creatinine ratio were not statistically significant between the groups (p<0.05).
Conclusions: As a result of our study, we concluded that uric acid and uric acid/creatinine ratio were not statistically affected by increasing hypoxia in patients admitted to the emergency de-partment with acute attack of COPD and that these parameters may not be useful in predicting hospitalization.

References

• 1. Goldcopd.org [homepage on the Internet]. Global Initiative for Chronic Obstructive Lung Disease (GOLD). 2021 Global Strategy for Prevention, Diagnosis and Management of COPD. [updated 26 June 2024, cited 9 July 2024] Available from: https://goldcopd.org/wp-content/uploads/2020/11/GOLD-REPORT-2021-v1.1-25Nov20_WMV.pdf
• 2. Agusti A, Faner R. Chronic obstructive pulmonary disease pathogenesis. Clin Chest Med. 2020;41:307-24.
• 3. Agustí A, Vogelmeier C, Faner R. COPD 2020: changes and challenges. Am J Physiol-Lung Cell Mol Physiol. 2020;319(5):879-83.
• 4. Bingöl Z, Çağatay T. Kronik Obstrüktif Akciğer Hastalığı (KOAH) Olgularında Alevlenme Nedenleri Tanı, Tedavi ve Risk Grubu Olgularda Farkındalık. Klinik Tıp Aile Hekimliği. 2016; 8(5):21-3.
• 5. Erdinç E, Erk M, Tatlıcılıoğlu T, Kocabaş A, Serdem M, Umut S, ve ark. Toraks Derneği Kronik Obstrüktif Akciğer Hastalığı Tanı ve Tedavi Rehberi. Turgut Yayıncılık, İstanbul, 2000:1:1-25.
• 6. Elsayed NM, Nakashima JM, Poslethwait EM. Measurement of uric acid as a marker of oxygen tension in the lung. Arch Biochem Biophys. 1993;302:228-32.
• 7. Sahebjami H. Changes in urinary uric acid excretion in obst-ructive sleep apnea before and after therapy with nasal con-tinuous positive airway pressure. Chest. 1998; 113:1604-8.
• 8. Aranzazu RG, Angeles SA, Estefana LC, Domingo GA, Auxili-adora RF, Bernal CC, Capoteet F. Blood Uric Acid Levels in Patients With Sleep-Disordered Breathing. Arch Bronconeu-mol. 2006;42:492-500.
• 9. Braghiroli A, Sacco C, Erbetta M, Ruga V, Donner CF. Over-night urinary acid: creatinine ratio for detection of sleep hy-poxemia. Validation study in chronic obstructive pulmonary disease and obstructive sleep apnea before and after treat-ment with nasal continuous positive airway pressure. Am Rev Respir Dis. 1993;148:173-8.
• 10. Garcia PE, Padilla Nl, Shum C. Serum uric acid to creatinine ratio in patients with chronic obstructive pulmonary disease. Lung. 2007;185:21-4.
• 11. Leyva F, Anker S, Swan JW, et al. Serum uric acid as an index of impaired oxidative metabolism in chronic heart failure. Eur Heart J. 1997;18:858–65.
• 12. Celli BR, MacNee W. ATS/ERS Task Force. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J. 2004;23:932–4.
• 13. Özyılmaz SÖ, Özyılmaz İ, Serdar OA, & Uzaslan E. Kronik Obstrüktif Akciğer Hastalığı olan Hastalarda Akut Atağın Şiddeti ile Ürik Asit ve Ürik Asit Kreatinin Oranı Arasındaki İlişki. Medical Bulletin of Haseki/Haseki Tip Bulte-ni. 2013;51:4.
• 14. Guler A. Kronik obstrüktif akciger hastaligi ile tiroid hormon-lan ve ürik asit düzeyleri arasındaki ilişki. Uzmanlik Tezi, is-tanbul: Süreyyapaşa Gögüs Hastaliklari ve Gögüs Cerrahisi Egitim ve Araştırma Hastanesi, 2008.
• 15. Lee H, Hong Y, Lim MN, Bak SH, Kim MJ, Kim K, et al. Inf-lammatory biomarkers and radiologic measurements in ne-ver-smokers with COPD: A cross-sectional study from the CODA cohort. Chron Respir Dis. 2018;15(2):138–45.
• 16. Nicks ME, O’Brien MM, Bowler RP. Plasma Antioxidants Are Associated with Impaired Lung Function and COPD Exacerba-tions in Smokers. COPD J Chronic Obstr Pulm Dis. 2011;8(4):264–9.
• 17. Tanwar Y, Singh C, Chakrabarty S. Comparison of Serum Uric Acid Levels in Patients with Stable Chronic Obstructive Pul-monary Disease and Patients with Acute Exacerbation. The Journal of the Association of Physicians of In-dia. 2022;70(4);11-2.
• 18. Kır E, Güven Atıcı A, Güllü YT, Köksal N, Tunçez İH. The rela-tionship between serum uric acid level and uric acid/creatinine ratio with chronic obstructive pulmonary di-sease severity (stable or acute exacerbation) and the deve-lopment of cor pulmonale. International journal of clinical practice. 2021;75(8):14303.
• 19. Büyükbayram G, Yüceer Ö, & Oymak FS. The Relationship between Serum Uric Acid Levels and Early Mortality in Chro-nic Obstructive Pulmonary Disease Cases during Exacerba-tion. Sarcoidosis, Vasculitis, and Diffuse Lung Disea-ses. 2022;39(2).
• 20. Barmehziar S, Fadaii A, Samadian F, Shakiba A, & Koolaji S. Investigating the role of uric acid and uric acid‐to‐creatinine ratio as a predictive factor of chronic obstructive pulmonary disease exacerbation in 2019. The Clinical Respiratory Jour-nal. 2023;17(10):1025-37.