Çocuklarda Akut Böbrek Hasarı Sonrası Uzun Dönem Böbrek Fonksiyonları

Year 2021, Volume: 15 Issue: 6, 507 - 512, 26.11.2021

Fatma Zehra Öztek Çelebi , Fatma Yazılıtaş , Özlem Aydoğ , Mehmet Bülbül

https://doi.org/10.12956/tchd.703781

Abstract

Amaç: Geçirilmiş Akut Böbrek Hasarı (ABH) atağının kronik böbrek hastalığı gibi uzun vadeli sonuçları olduğu yaygın olarak kabul edilmektedir. Ancak ABH atağından sonra gelişen böbrek fonksiyonlarındaki bozulma için risk faktörleri pediatrik yaş grubunda iyi tanımlanmamıştır. Bu çalışmanın amacı, hastane yatışlarında ABH atağından geçen çocukların 1. ve 5. yıl böbrek fonksiyonlarını değerlendirmek ve böbrek fonksiyonlarını etkileyen risk faktörlerini belirlemektir.

Gereç ve Yöntemler: 2008-2012 yılları arasında ABH atağı geçiren 219 hasta çalışmaya dâhil edildi. 62 hasta 1 yıldan az yaşadı. Geriye kalan 157 hastanın 1. ve 5. yıldaki serum kreatinin konsantrasyonları geriye dönük olarak incelendi.

Bulgular: ABH atağı sırasında ≤2 yaş olan ve Yetmezlik + Kayıp grubunda olan hastaların ABH sonrası birinci ve beşinci yıllardaki hesaplanmış Glomerular Filtrasyon Hızı (hGFH) değerleri ABH atağı sırasında > 2 yaş olan ve Risk + Hasar grubunda olan hastalara göre anlamlı olarak daha düşüktü. Hastaların % 25.7’sinde ve % 40.3’ünde ABH sonrası sırasıyla 1. ve 5. yılda düşük hGFH vardı. Lojistik regresyon modelinde, ABH’dan sonraki 1. ve 5. yılda düşük hGFH’ya sahip olmakla ilişkili faktörler küçük yaşta ABH atağı geçirmek olarak bulundu; fakat ABH’nın derecesi düşük hGFH’nı etkilemiyordu.

Sonuç: Geçirilmiş ABH atağı, çocuklarda uzun dönem böbrek fonksiyonlarını olumsuz yönde etkileyebilir. ABH atağı sırasında infant yaş grubunda olmak ve ileri ABH evresine sahip olmak, uzun dönemde, kötü böbrek fonksiyonları ile ilişkilidir.

Keywords

Akut Böbrek Hasarı, Çocuk, Kronik Böbrek Hastalığı, Akut Böbrek Yetmezliği, Pediatri, Renal Fonksiyon

The Long-Term Renal Functions After An Episode of Acute Kidney Injury in Children

Abstract

Objective: It is widely accepted that an acute kidney injury (AKI) episode has long-term consequences such as chronic kidney disease. But the risk factors for poor renal outcome after an AKI episode are not well defined in paediatric age group. The aim of this study is to evaluate the first and fifth-year renal functions of the patients who undergo AKI during their hospital admission and to determine the risk factors affecting renal functions.

Material and Methods: 219 patients who underwent AKI from 2008 to 2012 were included in this study. 62 patients survived less than 1 year. The first and the fifth-year serum creatinine concentrations of the remaining 157 patients were reviewed retrospectively.

Results: Patients who were ≤2 years of age and patients who were in Failure+Loss group at the time of AKI had significantly lower estimated Glomerular Filtration Rate (eGFR) values in the first and fifth year after AKI compared to patients who were>2 years of age and patients who were in Risk+Injury group. 25.7% and 40.3% of the patients had abnormal eGFR in the first and fifth year after AKI respectively. In a logistic regression model, factors associated with having abnormal eGFR in the first and fifth year after AKI included younger age but not an advanced degree of AKI.

Conclusion: The previous episode of AKI could cause harmful effects on renal functions of children in the long term. Younger age and advanced stage of AKI are associated with worse renal functions after an episode of AKI.

Keywords

Acute Kidney Injury, Chronic Kidney Disease, Acute Renal Failure, Paediatrics, Renal Function

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