Kronik Böbrek Yetmezliği Hastalarında Renal ve Tiroid Fonksiyon Testlerinin Değerlendirilmesi

Year 2020, , 52 - 57, 31.12.2020

Mustafa Yöntem , Birgül Erbil Behiç Selman Erdoğdu

https://doi.org/10.47112/neufmbd.795441

Abstract

Böbreğin, normalde tiroid hormonlarının metabolizmasında, parçalanmasında ve atılmasında önemli bir rol oynadığı bilinmektedir. Bu durumda böbrek fonksiyonunda meydana gelen bir bozulmanın, tiroid fizyolojisini de etkilemesi beklenmektedir. Çalışmamızda; hemodiyaliz tedavisi gören kronik böbrek yetmezliği olan hastalarda, tek bir hemodiyaliz seansının tiroid fonksiyonuna etkisini araştırmayı ve hemodiyaliz hastalarında tiroid fonksiyon testleri ve bazı biyokimyasal parametreleri sağlıklı gruplarla karşılaştırmayı amaçladık. 29 hastadan (ortalama yaş: 46.17 ± 14.93) diyaliz öncesi ve sonrasında aldığımız kan örnekleri ile kontrol grubu olan 28 sağlıklı katılımcıdan (ortalama yaş: 40.79 ± 14.42) aldığımız kan örnekleri otoanalizör ile analiz edildikten sonra istatistiksel olarak değerlendirildi. Diyaliz öncesi ve sonrası örnekler karşılaştırıldığında TT4, FT3 ve FT4 değerleri istatistiki olarak anlamlı bulundu (sırasıyla p < 0.01, p < 0.05 ve p < 0.05). Ayrıca; diyaliz sonrası ve kontrol grubunun örnekleri incelendiğinde, TT3 ve TSH düzeylerinde bir anlamlılık tespit edilmezken (p > 0.1), aynı grubun TT3 (p < 0.01), FT3 (p < 0.001) ve TSH (p < 0.05) değerleri arasında istatistiki olarak önemli düzeyde bir anlamlılık tespit edilmiştir. Buna ek olarak, diyaliz öncesi grupta kreatinin-FT4 (p < 0.01) ve diyaliz sonrası grupta kreatinin-üre (p < 0.001) değerlerinin de pozitif bir korelasyon gösterdiği tespit edilmiştir. Bu çalışmada kronik böbrek yetmezliği olan hastalarda tiroid bozukluklarının teşhisinde tiroid fonksiyon testlerinin önemini değerlendirerek tiroid fonksiyon testlerinin hemodiyaliz hastalarının tedavisinde önemli olabileceği kanaatine vardık.

Keywords

Kronik Böbrek Yetmezliği, Hemodiyaliz, Tiroid fonksiyon testleri

Evaluation of Renal and Thyroid Function Tests in Chronic Renal Failure Patients

Abstract

It is known that the kidney normally plays an important role in the metabolism, degradation and excretion of several thyroid hormones. Accordingly, deterioration in renal function is expected to lead to disturbing thyroid physiology. In the study, we aimed to investigate the effect of a single hemodialysis session on thyroid function in patients with chronic renal failure that have hemodialysis treatment, and also to compare thyroid function tests and some biochemical parameters in hemodialysis patients with healthy groups. We collected blood samples which were drawn pre- and after-dialysis sessions from 29 patients (mean age: 46.17 ± 14.93) and 28 healthy participants (mean age: 40.79 ± 14.42) as control group, and analysed using an autoanalyzer followed by statistical analysis. TT4, FT3 and FT4 values were found statistically significant (p < 0.01, p < 0.05 and p < 0.05, respectively) in comparison of pre- and post-dialysis samples. Also, the findings of the study revealed that there was a significant difference only among the parameters of TT3 (p < 0.01), FT3 (p < 0.001) and TSH (p < 0.05) for the healthy participants and dialysis group in spite of any statistically significance was not detected in the values of TT3 and TSH parameters of the same group (p > 0.1). In addition, statistical results proved that creatinine - FT4 values (p < 0.01) in the pre-dialysis group and creatinine - urea values in the post-dialysis group (p < 0.001) were correlated positively. We evaluated the significance of the thyroid function tests during the diagnosis of thyroid disorders in patients with chronic kidney failure in the present study and found that thyroid function tests could be crucial for the treatment of hemodialysis patients.

Keywords

Chronic renal failure, Hemodialysis, Thyroid function tests

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