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Premise Factors of Mortality in Acute Kidney Injury

Yıl 2015, Cilt: 16 Sayı: 3, 192 - 197, 27.08.2015
https://doi.org/10.18229/ktd.15191

Öz

Objective: Procalcitonin (PCT), C-Reactive Protein, serum amyloid A (SAA) and serum cholesterol values are
early markers for inflammation, infection and malnutrition. In development acute kidney injury (AKI) infection,
oral intake disorders, dehydratation and malnutrition
have important place. These factors are important in the
early detection of treatment.
Material and Methods: Between January 2013-2014 in
our nephrology clinic followed 182 patients and diagnosed AKI with RIFLE (risk, injury, failure, loss, end stage
renal failure) and AKIN (acute kidney injury network) criterias. Patients were compared according to nutritional
and inflammatory markers with healthy control group
(52 patients).
Results: Albumin, CRP, procalcitonin and SAA values in
AKI patients favor compared with healthy control group
and results were statistically significant (p <0.001 and p
= 0.002). Again, leukocytes, cholesterol, LDL cholesterol,
triglyceride levels were higher in died AKI patients (p =
0.016, p = 0.032, p = 0.03 and p = 0.026) Addition to these
values in patients who died, Infection and comorbidity
diseases were important factors. In infections found sepsis and pneumonia. HDL cholesterol levels did not differ
between patients (p = 0.52).
Conclusion: Inflammation, malnutrition, sepsis are highly prevalent diseases in AKI patients. Patients who died
in AKI (% 4,94), CRP, PCT, SAA, albumin, and cholesterol
levels were higher. Treatment and following these values
were important.

Kaynakça

  • Palevsky PM. Epidemiology of acute renal fai- lure: The tip of the iceberg. Clin J Am Soc Nephrol 2006;1(1):6-7.
  • Ympa YP, Sakr Y, Reinhart K, Vincent JL. Has morta- lity from acute renal failure decreased? A systematic review of the literature. Am J Med 2005;118(8):827
  • Macedo E, Bouchard J, Mehta RL. Renal recovery following acute kidney injury. Curr Opin Crit Care 2008;14(6):660-5.
  • Ishani A, Xue JL, Himmelfarb J, et al. Acute kidney injury increases risk of ESRD among elderly. J Am Soc Nephrol 2009;20(1):223-28.
  • Bagshaw SM, George C, Bellomo R. Early acute kidney injury and sepsis: a multicentre evaluation. Crit Care 2008;12(47):1-9.
  • Wiedermann CJ, Wiedermann W, Joannidis M. Hy- poalbuminemia and acute kidney injury: A meta-a- nalysis of observational clinical studies. İntensive Care Med 2010;36(10):1657-65.
  • Druml W. Nutritional management of acute renal failure. Am J Kidney Dis 2001;37(1):89-94.
  • Chertow GMAK, Lew NL, Lazarus JM, Lowrie EG. Prealbumin is as important as albümin in the nutri- tional assessment of hemodialysis patients. Kidney İnt 2000;58(6):2512-17.
  • Perez-Valdivieso JR, Bes-Rastrollo M, Mone- dero P, de Irala J, Lavilla FJ. İmpact of prealbumin levels on mortality in patients with acute kidney injury: An observational cohort study. J Ren Nutr 23. Sipe JD, Cohen AS. History of the amyloid fibril. J 2008;18(3):262-8. Struct Biol 2000;130(2-3):88-98
  • Fraunberger P, Nagel D, Walli AK, Seidel D. Serum cholesterol and mortality in patients with multiple organ failure. Crit Care Med 2000;28(10):3574-5.
  • Pinilla JC, Hayes P, Laverty W, Arnold C, Laxdal V: The C-reactive protein to prealbumin ratio correlates with the severity of multiple organ dysfunction. sky P. Acute renal failure-definition outcome mea- Surgery 1998;124(4):799-805. sures, animal models, fluid therapy and information
  • Coca SG, Yalavarthy R, Concato J, Parikh CR. Biomarkersfort he diagnosis and risk stratification tiative (ADQI) Group. Crit Care 2004;8(4):204-12. of acute kidney injury: A systematic review. Kidney İnt 2008;73(9):1008-16.
  • Mehta RL, Kellum JA, Shah SV, Molitoris BA, Dirkes S. Sepsis and inflammation: İmpact on acute kidney injury. Nephrol Nurs J 2013;40(2):125
  • Assicot M, Gendrel D, Carsin H, Raymond J, Gu- ilbaud J, Bohuon C. High serum procalcitonin con- centrations in patients with sepsis and infection. 2012;2(1):1-36. Lancet 1993;341(8844):515-8.
  • Becker KL, Snider R, Nylen ES. Procalcitonin as- say in systemic inflammation, infection and sep- sis: Clinical utility and limitations. Crit Care Med 2008;36(3):941-52.
  • Enguix A, Rey C, Concha A, Medina A, Coto D, Dieguez MA. Comparison of procalcitonin with C-re- children. İntensive Care Med 2001;27(1):211-5.
  • Obialo CI, Okonofua EC, Nzerue MC, Tayade AS, Riley LJ. Role of hypoalbuminemia and hypocholes- terolemia as copredictors of mortality in acute renal failure. Kidney İnt 1999;56(3):1058-63.
  • Nie X, Wu B, He Y, Huang X, Dai Z, Miao Q, Song H. Serum procalcitonin predicts development of acute kidney injury in patients with suspected infe- ction. Clin Chem Lab Med 2013;51(8):1655-61.
  • Murugan R, Kellum JA. Acute Kidney İn- jury: What’s the prognosis? Nat Rev Nephrol 2011;7(4):209-17.
  • Ballou SP, Kushner I. C-reactive protein andthea- cutephaseresponse. AdvİnternMed 1992;37(1):313
  • Xie Q, Zhou Y, Xu Z, Yang Y, Kuang D, You H, Ma S. The ratio of CRP to prealbumin levels predict morta- lity in patients with hospital-acquired acute kidney injury. BMC Nephrol 2011;12(30):1-8.
  • Bellomo R, Ronco C, Kellum JA, Mehta RL, Palev- technology needs: The Second İnternational Con- sensus Conference of the Acute Dialysis Quality İni- Ronco C, Warnock DG, Levin A. Acute Kidney İnjury Network: Report of an initiative to improve outco- mes in acute kidney injury. Crit Care 2007;11(2):31.
  • KDIGO Clinical practice guideline for acute kidney injury. Kidney International Supplements

Akut Böbrek Hasarında Mortalitede Öncül Faktörler

Yıl 2015, Cilt: 16 Sayı: 3, 192 - 197, 27.08.2015
https://doi.org/10.18229/ktd.15191

Öz

Amaç: Prokalsitonin (PCT), C-Reaktif Protein (CRP), serum amiloid A (SAA), albümin ve serum kolesterol değerleri enflamasyon, enfeksiyon ve malnütrisyonun erken belirteçlerindendir. Akut böbrek hasarının (ABH) gelişiminde enfeksiyon, oral alım bozukluğu, dehidratasyon ve malnütrisyon önemli yer tutmaktadır. Bu etkenlerin erken saptanması tedavide önem arz etmektedir.

Gereç ve Yöntem: Ocak 2013-2014 tarihleri arasında Nefroloji Kliniğimizde takip edilen 182 hastaya RIFLE (Risk, injury, failure, loss, end stage renal failure) ve AKIN (acute kidney injury network) kriterlerine göre ABH tanısı konmuştur. Hastalar nutrisyonel ve enflamatuar belirteç- lere göre sağlıklı kontrol grubuyla (52 hasta) kıyaslanmış- tır.

Bulgular: ABH da albümin, CRP, prokalsitonin ve SAA değerleri hasta grubu lehine, sağlıklı kontrol grubuyla karşılaştırıldığında anlamlı bulunmuştur (p < 0,001 ve p = 0,002) Yine lökosit, kolesterol, LDL kolesterol, trigliserit değerleri karşılaştırıldığında ölen ABH hastalarında yüksek saptanmıştır (p = 0,016, p = 0,032, p = 0,03 ve p = 0,026). Ölen hastalarda bu değerlerle beraber enfeksiyonve ek hastalıklar önemli bir etkendi. Enfeksiyonlar arasında sepsis ve pnömoniye rastlanmaktaydı. Hastaların HDL kolesterol değerleri arasında fark saptanmamıştır (p = 0,52).

Sonuç: ABH hastalarında enflamasyon, malnütrisyon, sepsis yüksek oranda görülmektedir. ABH da ölen hastalarda (% 4,94) CRP, PCT, SAA, albümin, kolesterol değerleri yüksek saptanmış olup bu değerler tedavi ve izlemde önemini korumaktadır.

Kaynakça

  • Palevsky PM. Epidemiology of acute renal fai- lure: The tip of the iceberg. Clin J Am Soc Nephrol 2006;1(1):6-7.
  • Ympa YP, Sakr Y, Reinhart K, Vincent JL. Has morta- lity from acute renal failure decreased? A systematic review of the literature. Am J Med 2005;118(8):827
  • Macedo E, Bouchard J, Mehta RL. Renal recovery following acute kidney injury. Curr Opin Crit Care 2008;14(6):660-5.
  • Ishani A, Xue JL, Himmelfarb J, et al. Acute kidney injury increases risk of ESRD among elderly. J Am Soc Nephrol 2009;20(1):223-28.
  • Bagshaw SM, George C, Bellomo R. Early acute kidney injury and sepsis: a multicentre evaluation. Crit Care 2008;12(47):1-9.
  • Wiedermann CJ, Wiedermann W, Joannidis M. Hy- poalbuminemia and acute kidney injury: A meta-a- nalysis of observational clinical studies. İntensive Care Med 2010;36(10):1657-65.
  • Druml W. Nutritional management of acute renal failure. Am J Kidney Dis 2001;37(1):89-94.
  • Chertow GMAK, Lew NL, Lazarus JM, Lowrie EG. Prealbumin is as important as albümin in the nutri- tional assessment of hemodialysis patients. Kidney İnt 2000;58(6):2512-17.
  • Perez-Valdivieso JR, Bes-Rastrollo M, Mone- dero P, de Irala J, Lavilla FJ. İmpact of prealbumin levels on mortality in patients with acute kidney injury: An observational cohort study. J Ren Nutr 23. Sipe JD, Cohen AS. History of the amyloid fibril. J 2008;18(3):262-8. Struct Biol 2000;130(2-3):88-98
  • Fraunberger P, Nagel D, Walli AK, Seidel D. Serum cholesterol and mortality in patients with multiple organ failure. Crit Care Med 2000;28(10):3574-5.
  • Pinilla JC, Hayes P, Laverty W, Arnold C, Laxdal V: The C-reactive protein to prealbumin ratio correlates with the severity of multiple organ dysfunction. sky P. Acute renal failure-definition outcome mea- Surgery 1998;124(4):799-805. sures, animal models, fluid therapy and information
  • Coca SG, Yalavarthy R, Concato J, Parikh CR. Biomarkersfort he diagnosis and risk stratification tiative (ADQI) Group. Crit Care 2004;8(4):204-12. of acute kidney injury: A systematic review. Kidney İnt 2008;73(9):1008-16.
  • Mehta RL, Kellum JA, Shah SV, Molitoris BA, Dirkes S. Sepsis and inflammation: İmpact on acute kidney injury. Nephrol Nurs J 2013;40(2):125
  • Assicot M, Gendrel D, Carsin H, Raymond J, Gu- ilbaud J, Bohuon C. High serum procalcitonin con- centrations in patients with sepsis and infection. 2012;2(1):1-36. Lancet 1993;341(8844):515-8.
  • Becker KL, Snider R, Nylen ES. Procalcitonin as- say in systemic inflammation, infection and sep- sis: Clinical utility and limitations. Crit Care Med 2008;36(3):941-52.
  • Enguix A, Rey C, Concha A, Medina A, Coto D, Dieguez MA. Comparison of procalcitonin with C-re- children. İntensive Care Med 2001;27(1):211-5.
  • Obialo CI, Okonofua EC, Nzerue MC, Tayade AS, Riley LJ. Role of hypoalbuminemia and hypocholes- terolemia as copredictors of mortality in acute renal failure. Kidney İnt 1999;56(3):1058-63.
  • Nie X, Wu B, He Y, Huang X, Dai Z, Miao Q, Song H. Serum procalcitonin predicts development of acute kidney injury in patients with suspected infe- ction. Clin Chem Lab Med 2013;51(8):1655-61.
  • Murugan R, Kellum JA. Acute Kidney İn- jury: What’s the prognosis? Nat Rev Nephrol 2011;7(4):209-17.
  • Ballou SP, Kushner I. C-reactive protein andthea- cutephaseresponse. AdvİnternMed 1992;37(1):313
  • Xie Q, Zhou Y, Xu Z, Yang Y, Kuang D, You H, Ma S. The ratio of CRP to prealbumin levels predict morta- lity in patients with hospital-acquired acute kidney injury. BMC Nephrol 2011;12(30):1-8.
  • Bellomo R, Ronco C, Kellum JA, Mehta RL, Palev- technology needs: The Second İnternational Con- sensus Conference of the Acute Dialysis Quality İni- Ronco C, Warnock DG, Levin A. Acute Kidney İnjury Network: Report of an initiative to improve outco- mes in acute kidney injury. Crit Care 2007;11(2):31.
  • KDIGO Clinical practice guideline for acute kidney injury. Kidney International Supplements
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Makaleler-Araştırma Yazıları
Yazarlar

Yavuz Ayar Bu kişi benim

Emel İşıktaş Sayılar Bu kişi benim

Alparslan Ersoy Bu kişi benim

Hakan Düğer Bu kişi benim

Çağatay Ak Bu kişi benim

Abdülkadir Göçken Bu kişi benim

Mahmut Yavuz Bu kişi benim

Yayımlanma Tarihi 27 Ağustos 2015
Yayımlandığı Sayı Yıl 2015 Cilt: 16 Sayı: 3

Kaynak Göster

APA Ayar, Y., Sayılar, E. İ., Ersoy, A., Düğer, H., vd. (2015). Akut Böbrek Hasarında Mortalitede Öncül Faktörler. Kocatepe Tıp Dergisi, 16(3), 192-197. https://doi.org/10.18229/ktd.15191
AMA Ayar Y, Sayılar Eİ, Ersoy A, Düğer H, Ak Ç, Göçken A, Yavuz M. Akut Böbrek Hasarında Mortalitede Öncül Faktörler. KTD. Ağustos 2015;16(3):192-197. doi:10.18229/ktd.15191
Chicago Ayar, Yavuz, Emel İşıktaş Sayılar, Alparslan Ersoy, Hakan Düğer, Çağatay Ak, Abdülkadir Göçken, ve Mahmut Yavuz. “Akut Böbrek Hasarında Mortalitede Öncül Faktörler”. Kocatepe Tıp Dergisi 16, sy. 3 (Ağustos 2015): 192-97. https://doi.org/10.18229/ktd.15191.
EndNote Ayar Y, Sayılar Eİ, Ersoy A, Düğer H, Ak Ç, Göçken A, Yavuz M (01 Ağustos 2015) Akut Böbrek Hasarında Mortalitede Öncül Faktörler. Kocatepe Tıp Dergisi 16 3 192–197.
IEEE Y. Ayar, “Akut Böbrek Hasarında Mortalitede Öncül Faktörler”, KTD, c. 16, sy. 3, ss. 192–197, 2015, doi: 10.18229/ktd.15191.
ISNAD Ayar, Yavuz vd. “Akut Böbrek Hasarında Mortalitede Öncül Faktörler”. Kocatepe Tıp Dergisi 16/3 (Ağustos 2015), 192-197. https://doi.org/10.18229/ktd.15191.
JAMA Ayar Y, Sayılar Eİ, Ersoy A, Düğer H, Ak Ç, Göçken A, Yavuz M. Akut Böbrek Hasarında Mortalitede Öncül Faktörler. KTD. 2015;16:192–197.
MLA Ayar, Yavuz vd. “Akut Böbrek Hasarında Mortalitede Öncül Faktörler”. Kocatepe Tıp Dergisi, c. 16, sy. 3, 2015, ss. 192-7, doi:10.18229/ktd.15191.
Vancouver Ayar Y, Sayılar Eİ, Ersoy A, Düğer H, Ak Ç, Göçken A, Yavuz M. Akut Böbrek Hasarında Mortalitede Öncül Faktörler. KTD. 2015;16(3):192-7.

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