Kronik Böbrek Hastalığı Hastalarında PWV Değişimi ile eGFR Değişimi Arasındaki İlişkinin Zaman İçinde İncelenmesi

Öz

Amaç: Bu çalışmanın amacı, kronik böbrek hastalığı (KBH) olan hastalarda arteriyel sertliğin bir ölçüsü olan nabız dalga hızı (PWV) ile böbrek fonksiyonunun bir göstergesi olan tahmini glomerüler filtrasyon hızı (eGFR) arasındaki uzunlamasına ilişkiyi araştırmaktır. Yöntemler: Renal replasman tedavisi almayan toplam 55 KBH hastası (Evre 3-5) yaklaşık dört yıl boyunca prospektif olarak takip edildi. PWV ve eGFR, başlangıçta ve takip sonunda ölçüldü. Hastalar, eGFR progresyonuna göre stabil ve progresif düşüş olmak üzere iki gruba ayrıldı. Demografik, klinik ve laboratuvar verileri toplandı. PWV (ΔPWV) ve eGFR (ΔeGFR) değişiklikleri arasındaki ilişki analiz edildi. Sonuçlar: PWV değişiklikleri ile eGFR değişiklikleri arasında anlamlı bir korelasyon bulunmadı (P>.05). Progresif grupta stabil gruba kıyasla eGFR'de anlamlı bir düşüş görülürken (P=.001), ΔPWV gruplar arasında anlamlı bir farklılık göstermedi. Yaş, kan basıncı ve başlangıç ​​PWV gibi değişkenler gruplar arasında anlamlı bir farklılık göstermedi. eGFR ilerlemesi olan hastalarda parathormon ve fosfor seviyeleri daha yüksek, hemoglobin ve albümin seviyeleri ise daha düşüktü. Sonuç: Dört yıllık takip süresince, KBH hastalarında arteriyel sertlikteki (PWV) değişiklikler, böbrek fonksiyonundaki (eGFR) değişikliklerle anlamlı bir ilişki göstermedi. Korelasyon eksikliği, ayrı patofizyolojik mekanizmaların vasküler sertliği ve böbrek fonksiyonu bozulmasını yönetebileceğini düşündürmektedir. Bu karmaşık etkileşimleri açıklığa kavuşturmak için moleküler düzeyde analizler de dahil olmak üzere daha ileri çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• Kronik böbrek hastalığı
• arteriyel sertlik
• nabız dalga hızı
• glomerüler filtrasyon hızı
• böbrek fonksiyonlarında azalma
• prospektif çalışma.

Examining the Relationship Between PWV Change and eGFR Change Over Time in Chronic Kidney Disease Patients

Abstract

Objective: This study aimed to investigate the longitudinal relationship between pulse wave velocity (PWV), a measure of arterial stiffness, and estimated glomerular filtration rate (eGFR), an indicator of renal function, in patients with chronic kidney disease (CKD). Methods: A total of 55 CKD patients (Stage 3–5), not on renal replacement therapy, were prospectively followed for approximately four years. PWV and eGFR were measured at baseline and at the end of follow-up. Patients were divided into two groups based on eGFR progression: stable and progressive decline. Demographic, clinical, and laboratory data were collected. The association between changes in PWV (ΔPWV) and eGFR (ΔeGFR) was analyzed. Results: No significant correlation was found between changes in PWV and changes in eGFR (P>.05). While there was a significant decline in eGFR in the progressive group compared to the stable group (P=.001), ΔPWV did not significantly differ between the groups. Variables such as age, blood pressure, and baseline PWV were not significantly different between groups. Parathormone and phosphorus levels were higher, and hemoglobin and albumin levels were lower in patients with eGFR progression. Conclusion: Over a four-year follow-up, changes in arterial stiffness (PWV) were not significantly associated with changes in renal function (eGFR) among CKD patients. The lack of correlation suggests that separate pathophysiological mechanisms may govern vascular stiffness and kidney function deterioration. Further studies, including molecular-level analyses, are required to clarify these complex interactions.

Keywords

• Chronic kidney disease
• arterial stiffness
• pulse wave velocity
• glomerular filtration rate
• renal function decline
• prospective study

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