Araştırma Makalesi
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Yıl 2020, Cilt: 9 Sayı: 3, 116 - 124, 21.12.2020
https://doi.org/10.47493/abantmedj.2020.20

Öz

Proje Numarası

Yok

Kaynakça

  • 1. Zareba W. Initiation of dialysis: Trigger or cause of cardiovascular events? Kidney international2015;88(5):942-4.
  • 2. Kalantar-Zadeh K, Regidor D, Kovesdy C, Wyck D, Bunnapradist S, Horwich T. Fluid retention is associated with cardiovascular mortality in patients undergoing long-term hemodialysis. Circulation [Internet]. 2009 [cited 2016 Mar 18]; 119 (5): 671-9.
  • 3. Chazot C, Wabel P, Chamney P, Moissl U, Wieskotten S, Wizemann V. Importance of normohydration for the long-term survival of haemodialysis patients. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2012 Jun;27(6):2404-10.
  • 4. Moissl UM, Wabel P, Chamney PW, Bosaeus I, Levin NW, Bosy-Westphal A, et al. Body fluid volume determination via body composition spectroscopy in health and disease. Physiological measurement2006 Sep;27(9):921-33.
  • 5. Onofriescu M, Mardare NG, Segall L, Voroneanu L, Cusai C, Hogas S, et al. Randomized trial of bioelectrical impedance analysis versus clinical criteria for guiding ultrafiltration in hemodialysis patients: effects on blood pressure, hydration status, and arterial stiffness. International urology and nephrology2012 Apr;44(2):583-91.
  • 6. Linssen GC, Bakker SJ, Voors AA, Gansevoort RT, Hillege HL, de Jong PE, et al. N-terminal pro-B-type natriuretic peptide is an independent predictor of cardiovascular morbidity and mortality in the general population. European heart journal2010 Jan;31(1):120-7.
  • 7. Kamano C, Osawa H, Hashimoto K, Nishimura S, Saito SK, Kashiwagi T, et al. N-Terminal pro-brain natriuretic peptide as a predictor of heart failure with preserved ejection fraction in hemodialysis patients without fluid overload. Blood purification2012;33(1-3):37-43.
  • 8. Madsen LH, Ladefoged S, Corell P, Schou M, Hildebrandt PR, Atar D. N-terminal pro brain natriuretic peptide predicts mortality in patients with end-stage renal disease in hemodialysis. Kidney Int2007 Mar;71(6):548-54.
  • 9. Wang AY, Lai KN. Use of cardiac biomarkers in end-stage renal disease. Journal of the American Society of Nephrology : JASN2008 Sep;19(9):1643-52.
  • 10. Agarwal R. B-type natriuretic peptide is not a volume marker among patients on hemodialysis. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2013 Dec;28(12):3082-9.
  • 11. Wizemann V, Wabel P, Chamney P, Zaluska W, Moissl U, Rode C, et al. The mortality risk of overhydration in haemodialysis patients. Nephrology Dialysis Transplantation2009;24(5):1574-9.
  • 12. Sarnak MJ, Levey AS, Schoolwerth AC, Coresh J, Culleton B, Hamm LL, et al. Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Hypertension (Dallas, Tex : 1979)2003 Nov;42(5):1050-65.
  • 13. Shoji T, Tsubakihara Y, Fujii M, Imai E. Hemodialysis-associated hypotension as an independent risk factor for two-year mortality in hemodialysis patients. Kidney international2004;66(3):1212-20.
  • 14. Chou JA, Kalantar-Zadeh K. Volume balance and intradialytic ultrafiltration rate in the hemodialysis patient. Current heart failure reports2017;14(5):421-7.
  • 15. Mamat R, Kong NC, Ba’in Ay, Shah SA, Cader R, Wong V, et al. Assessment of body fluid status in hemodialysis patients using the body composition monitor measurement technique. Journal of clinical nursing2012;21(19pt20):2879-85.
  • 16. Kim H-N, Januzzi Jr JL. Natriuretic peptide testing in heart failure. Circulation2011;123(18):2015-9.
  • 17. Vickery S, Price CP, John RI, Abbas NA, Webb MC, Kempson ME, et al. B-type natriuretic peptide (BNP) and amino-terminal proBNP in patients with CKD: relationship to renal function and left ventricular hypertrophy. American journal of kidney diseases2005;46(4):610-20.
  • 18. Martinez-Rumayor A, Richards AM, Burnett JC, Januzzi Jr JL. Biology of the natriuretic peptides. The American journal of cardiology2008;101(3):S3-S8.
  • 19. Sommerer C, Beimler J, Schwenger V, Heckele N, Katus H, Giannitsis E, et al. Cardiac biomarkers and survival in haemodialysis patients. European journal of clinical investigation2007;37(5):350-6.
  • 20. Raimann JG, Abbas SR, Liu L, Zhu F, Larive B, Kotanko P, et al. Agreement of single-and multi-frequency bioimpedance measurements in hemodialysis patients: an ancillary study of the Frequent Hemodialysis Network Daily Trial. Nephron Clinical Practice2014;128(1-2):115-26.

KRONİK HEMODİYALİZ HASTALARINDA HİPERVOLEMİ İLE SERUM N-TERMİNAL PRO-BEYİN NATRİÜRETİK PEPTİD (NT-PROBNP) DÜZEYLERİNİN İLİŞKİSİ

Yıl 2020, Cilt: 9 Sayı: 3, 116 - 124, 21.12.2020
https://doi.org/10.47493/abantmedj.2020.20

Öz

Amaç: Hemodiyaliz hastalarında volüm durumunun değerlendirilmesi için kullanılacak en iyi yöntemin ne olduğu belirsizliğini korumaktadır. Bu çalışmanın amacı kronik hemodiyaliz hastalarında N-terminal pro-beyin natriüretik peptit (NT-proBNP) düzeyleri ile Bioempedans Spektroskopisi (BIS) ölçümleri arasındaki ilişkiyi araştırmak ve hipervolemiyi öngördürecek NT-proBNP düzeylerini saptamaktır.
Gereç ve yöntemler: Çalışmaya toplam 34 hasta dâhil edildi. BIS ölçümleri hafta içi diyaliz öncesinde yapıldı ve 6 ay süreyle ayda bir sefer ölçümler tekrarlandı. Ölçümlerle eş zamanlı olarak NT-proBNP düzey tayini de yapıldı. Hastalara ait laboratuar ve demografik verilere medikal kayıtlardan erişildi. Yapılan 6 ölçümün tamamında OH/Hücre Dışı Sıvı Volümü (OH/HDS) oranı 0.15’den daha fazla olan hastalar hipervolemik olarak kabul edildi. Diğer analizler 6 aylık verilerin aritmetik ortalamaları üzerinden yapıldı.
Bulgular: Çalışmaya katılan toplam 34 hastanın 27’si (%79.4) erkek, 7’si (%20.6) kadındı. Hipervolemik olan hastaların serum fosfor düzeyleri 5.2 ± 1.2 mg/dl iken hipervolemik olmayan hastaların fosfor düzeyleri 3.9 ± 0.9 mg/dl idi (p= 0.03). Hipervolemisi olan hastalarda serum parathormon seviyeleri [704.0 pg/ml (266.0 – 1318.0)] olmayanlara göre [325.0 pg/ml (207.0–450.0)] anlamlı düzeylerde daha yüksek saptandı (p= 0.049). Tüm çalışma grubunun ortalama NT-proBNP düzeyi 8156.4 ng/ml (3304.0 – 28113.0) idi. Hipervolemik olan grupta ortalama NT-proBNP düzeyleri anlamlı ölçüde daha yüksek bulundu [10762.3 ng/ml (7471.6- 23608.8), 5210.0 ng/ml (1995.0 – 11681.8); p= 0.028)].
Çok değişkenli regresyon analizlerinde NT-proBNP düzeylerinin hipervolemi için belirleyici güce sahip olduğu görüldü [OR1.014 (1.003-1.034), p= 0.01], NT-proBNP için 7287 pg/ml ve üstündeki değerlerin %81 sensitivite %47 spesifite ile hipervolemik hastaları saptayabileceği saptandı.

Sonuç: Kronik hemodiyaliz hastalarında NT-proBNP düzeyleri hipervolemiyi öngördürücü güce sahiptir.

Destekleyen Kurum

Yok

Proje Numarası

Yok

Teşekkür

Biyoempedans ölçümlerini titizlikle yapan ve değerlendiren Dr. Arzu İsmailvelioğlu, Hem. Emine Kaba ve Hem. Naciye Kanbur Güden'e bu katkıları için en içten teşekkürlerimi sunarım

Kaynakça

  • 1. Zareba W. Initiation of dialysis: Trigger or cause of cardiovascular events? Kidney international2015;88(5):942-4.
  • 2. Kalantar-Zadeh K, Regidor D, Kovesdy C, Wyck D, Bunnapradist S, Horwich T. Fluid retention is associated with cardiovascular mortality in patients undergoing long-term hemodialysis. Circulation [Internet]. 2009 [cited 2016 Mar 18]; 119 (5): 671-9.
  • 3. Chazot C, Wabel P, Chamney P, Moissl U, Wieskotten S, Wizemann V. Importance of normohydration for the long-term survival of haemodialysis patients. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2012 Jun;27(6):2404-10.
  • 4. Moissl UM, Wabel P, Chamney PW, Bosaeus I, Levin NW, Bosy-Westphal A, et al. Body fluid volume determination via body composition spectroscopy in health and disease. Physiological measurement2006 Sep;27(9):921-33.
  • 5. Onofriescu M, Mardare NG, Segall L, Voroneanu L, Cusai C, Hogas S, et al. Randomized trial of bioelectrical impedance analysis versus clinical criteria for guiding ultrafiltration in hemodialysis patients: effects on blood pressure, hydration status, and arterial stiffness. International urology and nephrology2012 Apr;44(2):583-91.
  • 6. Linssen GC, Bakker SJ, Voors AA, Gansevoort RT, Hillege HL, de Jong PE, et al. N-terminal pro-B-type natriuretic peptide is an independent predictor of cardiovascular morbidity and mortality in the general population. European heart journal2010 Jan;31(1):120-7.
  • 7. Kamano C, Osawa H, Hashimoto K, Nishimura S, Saito SK, Kashiwagi T, et al. N-Terminal pro-brain natriuretic peptide as a predictor of heart failure with preserved ejection fraction in hemodialysis patients without fluid overload. Blood purification2012;33(1-3):37-43.
  • 8. Madsen LH, Ladefoged S, Corell P, Schou M, Hildebrandt PR, Atar D. N-terminal pro brain natriuretic peptide predicts mortality in patients with end-stage renal disease in hemodialysis. Kidney Int2007 Mar;71(6):548-54.
  • 9. Wang AY, Lai KN. Use of cardiac biomarkers in end-stage renal disease. Journal of the American Society of Nephrology : JASN2008 Sep;19(9):1643-52.
  • 10. Agarwal R. B-type natriuretic peptide is not a volume marker among patients on hemodialysis. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2013 Dec;28(12):3082-9.
  • 11. Wizemann V, Wabel P, Chamney P, Zaluska W, Moissl U, Rode C, et al. The mortality risk of overhydration in haemodialysis patients. Nephrology Dialysis Transplantation2009;24(5):1574-9.
  • 12. Sarnak MJ, Levey AS, Schoolwerth AC, Coresh J, Culleton B, Hamm LL, et al. Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Hypertension (Dallas, Tex : 1979)2003 Nov;42(5):1050-65.
  • 13. Shoji T, Tsubakihara Y, Fujii M, Imai E. Hemodialysis-associated hypotension as an independent risk factor for two-year mortality in hemodialysis patients. Kidney international2004;66(3):1212-20.
  • 14. Chou JA, Kalantar-Zadeh K. Volume balance and intradialytic ultrafiltration rate in the hemodialysis patient. Current heart failure reports2017;14(5):421-7.
  • 15. Mamat R, Kong NC, Ba’in Ay, Shah SA, Cader R, Wong V, et al. Assessment of body fluid status in hemodialysis patients using the body composition monitor measurement technique. Journal of clinical nursing2012;21(19pt20):2879-85.
  • 16. Kim H-N, Januzzi Jr JL. Natriuretic peptide testing in heart failure. Circulation2011;123(18):2015-9.
  • 17. Vickery S, Price CP, John RI, Abbas NA, Webb MC, Kempson ME, et al. B-type natriuretic peptide (BNP) and amino-terminal proBNP in patients with CKD: relationship to renal function and left ventricular hypertrophy. American journal of kidney diseases2005;46(4):610-20.
  • 18. Martinez-Rumayor A, Richards AM, Burnett JC, Januzzi Jr JL. Biology of the natriuretic peptides. The American journal of cardiology2008;101(3):S3-S8.
  • 19. Sommerer C, Beimler J, Schwenger V, Heckele N, Katus H, Giannitsis E, et al. Cardiac biomarkers and survival in haemodialysis patients. European journal of clinical investigation2007;37(5):350-6.
  • 20. Raimann JG, Abbas SR, Liu L, Zhu F, Larive B, Kotanko P, et al. Agreement of single-and multi-frequency bioimpedance measurements in hemodialysis patients: an ancillary study of the Frequent Hemodialysis Network Daily Trial. Nephron Clinical Practice2014;128(1-2):115-26.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makaleleri
Yazarlar

Özgür Akın Oto 0000-0003-0928-8103

Proje Numarası Yok
Yayımlanma Tarihi 21 Aralık 2020
Gönderilme Tarihi 10 Ağustos 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 9 Sayı: 3

Kaynak Göster

APA Oto, Ö. A. (2020). KRONİK HEMODİYALİZ HASTALARINDA HİPERVOLEMİ İLE SERUM N-TERMİNAL PRO-BEYİN NATRİÜRETİK PEPTİD (NT-PROBNP) DÜZEYLERİNİN İLİŞKİSİ. Abant Medical Journal, 9(3), 116-124. https://doi.org/10.47493/abantmedj.2020.20
AMA Oto ÖA. KRONİK HEMODİYALİZ HASTALARINDA HİPERVOLEMİ İLE SERUM N-TERMİNAL PRO-BEYİN NATRİÜRETİK PEPTİD (NT-PROBNP) DÜZEYLERİNİN İLİŞKİSİ. Abant Med J. Aralık 2020;9(3):116-124. doi:10.47493/abantmedj.2020.20
Chicago Oto, Özgür Akın. “KRONİK HEMODİYALİZ HASTALARINDA HİPERVOLEMİ İLE SERUM N-TERMİNAL PRO-BEYİN NATRİÜRETİK PEPTİD (NT-PROBNP) DÜZEYLERİNİN İLİŞKİSİ”. Abant Medical Journal 9, sy. 3 (Aralık 2020): 116-24. https://doi.org/10.47493/abantmedj.2020.20.
EndNote Oto ÖA (01 Aralık 2020) KRONİK HEMODİYALİZ HASTALARINDA HİPERVOLEMİ İLE SERUM N-TERMİNAL PRO-BEYİN NATRİÜRETİK PEPTİD (NT-PROBNP) DÜZEYLERİNİN İLİŞKİSİ. Abant Medical Journal 9 3 116–124.
IEEE Ö. A. Oto, “KRONİK HEMODİYALİZ HASTALARINDA HİPERVOLEMİ İLE SERUM N-TERMİNAL PRO-BEYİN NATRİÜRETİK PEPTİD (NT-PROBNP) DÜZEYLERİNİN İLİŞKİSİ”, Abant Med J, c. 9, sy. 3, ss. 116–124, 2020, doi: 10.47493/abantmedj.2020.20.
ISNAD Oto, Özgür Akın. “KRONİK HEMODİYALİZ HASTALARINDA HİPERVOLEMİ İLE SERUM N-TERMİNAL PRO-BEYİN NATRİÜRETİK PEPTİD (NT-PROBNP) DÜZEYLERİNİN İLİŞKİSİ”. Abant Medical Journal 9/3 (Aralık 2020), 116-124. https://doi.org/10.47493/abantmedj.2020.20.
JAMA Oto ÖA. KRONİK HEMODİYALİZ HASTALARINDA HİPERVOLEMİ İLE SERUM N-TERMİNAL PRO-BEYİN NATRİÜRETİK PEPTİD (NT-PROBNP) DÜZEYLERİNİN İLİŞKİSİ. Abant Med J. 2020;9:116–124.
MLA Oto, Özgür Akın. “KRONİK HEMODİYALİZ HASTALARINDA HİPERVOLEMİ İLE SERUM N-TERMİNAL PRO-BEYİN NATRİÜRETİK PEPTİD (NT-PROBNP) DÜZEYLERİNİN İLİŞKİSİ”. Abant Medical Journal, c. 9, sy. 3, 2020, ss. 116-24, doi:10.47493/abantmedj.2020.20.
Vancouver Oto ÖA. KRONİK HEMODİYALİZ HASTALARINDA HİPERVOLEMİ İLE SERUM N-TERMİNAL PRO-BEYİN NATRİÜRETİK PEPTİD (NT-PROBNP) DÜZEYLERİNİN İLİŞKİSİ. Abant Med J. 2020;9(3):116-24.