Çocuklarda Tekrarlayan İdrar Yolu Enfeksiyonlarının Serum ve İdrar Çinko Konsantrasyonları İle İlişkisi

Year 2022, Volume: 22 Issue: 3, 166 - 171, 29.12.2022

Yüksel Hakan Aydoğmuş , Aslı Çelebi Tayfur , Aysun Çaltık Yılmaz , Bahar Büyükkaragöz , Sibel Akpınar Tekgündüz

https://doi.org/10.26650/jchild.2022.1086003

Abstract

Amaç: Doğal immünite cevabındaki defekt ve ürotelyal bariyerdeki fonksiyon bozukluğu idrar yolu enfeksiyonu patogenezinin iki ana unsurunu oluşturmaktadır. Doğal immunite ve kazanılmış immunitenin fonksiyonları orta derecede çinko eksikliği durumlarında etkilenmektedir. Bu çalışmada çocuklarda serum çinko konsantrasyonu, idrar çinko/kreatinin oranı ve tekrarlayan idrar yolu enfeksiyonları arasındaki ilişkiyi değerlendirmeyi amaçladık. Yöntem: Tekrarlayan idrar yolu enfeksiyonu olan çocuklar ve sağlıklı çocuklar çalışmaya dahil edildi. Hasta grubu tekrarlayan idrar yolu enfeksiyonu alt gruplarına ayrıldı. Grup 1 en az iki veya daha fazla akut üst idrar yolu enfeksiyonu geçiren ya da bir kez üst idrar yolu yanında bir ya da daha fazla alt idrar yolu enfeksiyonu geçiren hastalardan oluşturuldu. Grup 2 ise sadece üç ve üçten fazla alt idrar yolu enfeksiyonu geçiren hastalardan oluşturuldu. Kontrol grubu ile tekrarlayan idrar yolu enfeksiyonu tanısı alan hastalar demografik özellikleri ve serum çinko ve idrar çinko/kreatinin oranlarıyla karşılaştırıldı. Bulgular: Otuz üç tekrarlayan idrar yolu enfeksiyonu olan hasta ve 33 sağlıklı çocuk çalışmaya dahil edildi. Ortalama serum çinko düzeyi ve ortalama idrar çinko/kreatinin oranı tekrarlayan idrar yolu enfeksiyonu olan hastalarda sırasıyla 6,6±1,66 umol/l ve 16,44±13,04 umol/g saptandı. Kontrol grubu ve hasta grubu arasında anlamlı istatistiksel fark saptanmadı. Grup 1 ve Grup 2 arasında anlamlı istatistiksel fark saptanmadı. Sonuç: Çinko eksikliğinin çocuklarda tekrarlayan idrar yolu enfeksiyonlarına etkisini saptamak için daha fazla çalışmaya ihtiyaç vardır.

Keywords

Çinko, tekrarlayan idrar yolu enfeksiyonu, çocuk, serum çinko konsatrasyonu, spot idrar çinko/ kreatinin oranı

The Association Between Serum and Urine Zinc Concentrations and Recurrent Urinary Tract Infections in Children

Abstract

Objective: Two major host factors in the pathogenesis of urinary tract infection are a defect in innate immune responses and a decrease in urothelial barrier function (UTI). Even in the cases of moderate zinc deficiency, innate and adaptive immune system functions are impaired. The aim of this study was to assess the association between serum zinc concentration, urinary zinc/creatinine ratio, and recurrent UTIs in children. Methods: In this study, children with recurrent UTIs and healthy children were enrolled. The patient group was divided into subgroups based on the nature of recurrent UTIs. Group 1 consisted of patients who had had ≥2 acute upper UTIs or 1 episode of upper UTI plus ≥1 episode of lower UTI. Group 2 consisted of the patients who had had ≥3 acute lower UTIs but no acute upper UTIs. The demographic characteristics, serum zinc levels, and urine zinc/creatinine ratios of the patients with recurrent UTIs were compared to those of the control group. Results: Thirty-three patients with recurrent UTIs and 33 healthy children were enrolled in the study. The mean serum zinc level and mean urine zinc/creatinine ratio of patients with recurrent UTIs were 6.6±1.66 umol/l and 16.44±13.04 umol/g, respectively. There was no statistically significant difference between patients and controls and between patients in Group 1 and patients in Group 2 in terms of serum zinc concentration and urine zinc/creatinine ratio, respectively. Conclusion: Further studies are needed to identify the impact of zinc deficiency on the recurrence of UTI in children.

Keywords

Children, recurrent urinary tract infection, serum zinc concentration, spot urine zinc/creatinine ratio, zinc

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