Kronik böbrek hastalığı olan çocuklarda eritrosit uyarıcı ajan kullanımının ortalama trombosit hacmi, nötrofil/lenfosit oranı ve trombosit/lenfosit oranına etkisi

Year 2019, , 193 - 199, 01.06.2019

Fatma Yazılıtaş , Evra Çelikkaya Fehime Kara Eroğlu , Gökçe Gür Can Evrim Kargın Çakıcı , Tülin Güngör Mehmet Bülbül

https://doi.org/10.21601/ortadogutipdergisi.417743

Abstract

Amaç: Kronik böbrek hastalığı anemi, azalmış trombosit
üretimi, trombosit disfonksiyonu ve trombositoz gibi bazı hematolojik değişikliklerle
ilişkilidir. İnflamatuar belirteçler kronik böbrek hastalığı sürecinde
artmaktadır. Ortalama trombosit hacmi, nötrofil sayısının lenfosit sayısına oranı
ve trombosit sayısının lenfosit sayısına oranı enflamasyonun göstergesidir. Eritrosit
uyarıcı maddeler trombosit sayısını ve trombotik olayları arttırabilir. Bu çalışmada
Kronik böbrek hastalığı olan çocuklarda eritrosit uyarıcı ajan tedavisi sonrası
ortalama trombosit hacmi, nötrofil/lenfosit oranı ve trombosit/lenfosit oranı kullanımı
arasındaki ilişkiyi incelemeyi amaçladık.

Gereç ve Yöntem: Kronik böbrek hastalığı’ tanısı alan ve 2013-2018
yılları arasında eritrosit uyarıcı ajan ile tedavi edilen 30 hastanın dosyaları
retrospektif olarak incelendi.

Bulgular: Çalışmamıza 16 erkek ve 14 kız hasta dahil
edildi. Hastaların ortalama yaşı 10,6±5,4 yıl idi (ortanca 12; 1-17 yaş). Hastaların
12’si diyaliz öncesi, 9’u hemodiyaliz ve 9’u periton diyalizi grubundaydı. Hastaların
ortalama eritrosit uyarıcı ajan kullanım süresi ortanca 12,5 ay (aralık 1-127
ay) idi. Kronik böbrek hastalığı tanılı hastalarda eritrosit uyarıcı ajan ile tedavi
sonrası ortalama trombosit hacmi değerleri tüm gruplarda anlamlı olarak daha yüksek
saptandı. Eritrosit uyarıcı ajan ile tedavi sonrası trombosit/lenfosit oranlarında
anlamlı olarak farklılık gözlenmedi. Trombosit/lenfosit oranı, ortalama trombosit
hacmi, beyaz hücre sayısı ve monosit sayıları ile anlamlı ancak ters bir korelasyona
sahipti. Ortalama trombosit hacmi ve nötrofil/lenfosit oranı ölçümleri diyaliz modalitesinden
etkilenirken trombosit/lenfosit oranının etkilenmediği saptandı.

Sonuçlar: Bu çalışmada, sonuçlarımızdaki nedensellik
ve etki ilişkilerini raporlayamadık. Bununla birlikte, bu basit, ucuz, evrensel
yöntemler nefrologlar tarafından hastaların değerlendirilmesinde ilk adım olarak
kullanılabilir.

Keywords

Kronik böbrek hastalığı, ortalama eritrosit hacmi, nötrofil/lenfosit oranı trombosit/lenfosit oranı, eritrosit uyarıcı ajan

The effect of erythrocyte stimulating agents on mean platelet volume, the platelet/lymphocyte ratio and the neutrophil/lymphocyte ratio in children with chronic kidney disease

Abstract

Aim: Chronic kidney disease is associated with some hematologic changes
such as decreased platelet production, platelet dysfunction and thrombocytosis.
The inflammatory markers increase in chronic kidney disease. Mean platelet volume,
the ratio of neutrophil count to lymphocyte count, and the ratio of platelet count
to lymphocyte count are indicative of inflammation. Erythrocyte stimulating agents
can increase platelet count and thrombotic events. We aimed to determine the relationship
between the use of erythrocyte stimulating agents and mean platelet volume, the
neutrophil/lymphocyte ratio and the platelet/lymphocyte ratio in children with chronic
kidney disease in this study.

Material and Method: The files of 30 patients
diagnosed with chronic kidney disease and treated with erythrocyte stimulating agents
between 2013 and 2018 were reviewed retrospectively.

Results: The mean age of the patients (16 boys and 14 girls) was 10.6
± 5.4 years (median 12; 1-17 years). Twelve of them were in pre-dialysis, 9 in hemodialysis
and 9 in peritoneal dialysis group. The mean duration of use of erythrocyte stimulating
agents was 29.2 ± 34.8 months (median 12.5; 1-127 months). Mean platelet volume
values after treatment with erythrocyte stimulating agents
in chronic kidney disease patients were significantly higher in all groups.
The platelet/lymphocyte ratio values after treatment with erythrocyte stimulating
agents were not significant different in all groups. The platelet/lymphocyte ratio
had a significant but opposite correlation with mean platelet volume, white cell
count and monocyte counts. Mean platelet volume and the neutrophil/lymphocyte ratio
measurements were affected by dialysis modality. However the platelet/lymphocyte
ratio was not affected.

Conclusions: In this small retrospective
study, we could not report causality and effect associations in our results. Nevertheless, these simple, cheap,
universal methods may be used as the first step in the evaluation of patients by
nephrologists.

Keywords

Children, chronic kidney disease, mean platelet volume, platelet/lymphocyte ratio, neutrophil/lymphocyte ratio

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