Böbrek Nakli Alıcılarında Histopatolojik ve Laboratuvar Bulguları Arasındaki İlişki

Öz

Amaç: Bu retrospektif çalışmada, böbrek nakli olan hastaların yüksek kreatinin düzeyi ve proteinüri nedenlerini bulmayı amaçladık.Gereç ve Yöntemler: Araştırma verileri hasta dosyalarından ve hastane veri tabanından alınmıştır.Bulgular: 92 hastadan böbrek greft biyopsisi alındı. 24'ü kadın, 68'i erkekti. Biyopsilerin histopatolojik incelemesinde 20 sınırda değişiklik, 2 akut antikor aracılı rejeksiyon AAAR , 10 kronik aktif AAR, 7 akut T hücre aracılı rejeksiyon THAR , 8 birincil hastalık nüksü veya de novo glomerulonefrit, 1 koagülasyon nekrozu tespit edildi. 9 tübüler atrofi ve interstisyel fibrozis, 6 kalsinörin inhibitörü ilaç toksisitesi ve 7 polyomavirüs nefropatisi tanısı verildi. Ortalama kreatinin 2,58 ± 1,1 mg/dl idi. Proteinüri değerleri 83-12600 mg/gün ve ortalama proteinüri 2142 ± 2619 mg/gün idi. Proteinürinin 1000 mg/gün' den azında 2 akut AAR, 3 kronik aktif AAR, 21 akut THAR-borderline, 7 kronik aktif THAR ve diğer grubunda 12 biyopsi vardı. Proteinürinin 1000-3500 mg/gün arasında 5'i kronik aktif AAR, 2 akut THAR-borderline, 5 kronik aktif THAR ve diğer grupta 11 biyopsi vardı. 3500 mg/gün üzerindeki proteinüri, 2 kronik aktif AAR, 4 akut THAR-borderline, 8 kronik aktif THAR ve diğer grupta 7 biyopsi vardı. Rejeksiyon, rejeksiyon olmayan ve polyomavirüs nefropatisi olarak üç gruba ayırdığımız zaman proteinüri açısından istatistiksel olarak anlamlı bir fark rejeksiyon olmayan grup ve polyomavirüs nefropatisi grubu arasında çıktı.Sonuç: Renal allogreftte görülen disfonksiyon ve proteinüriye farklı tanı yaklaşımı nedeniyle renal allogreft biyopsilerinin tanıları merkezden merkeze farklılık gösterebilir

Anahtar Kelimeler

• Proteinüri, Rejeksiyon, Böbrek nakil biyopsisi

The Relationship Between Histopathological and Laboratory Findings in Kidney Transplant Recipients

Abstract

Objective: In this retrospective study, we aimed to clarify the reasons for high creatinine levels and proteinuria in kidney transplants.Material and Methods: The research data were obtained from patient files and the hospital database.Results: Ninety-two patients, consisting of 24 females and 68 males, were biopsied. Histopathological examination of the biopsy samples showed borderline changes in 20 patients, acute antibody-mediated rejection AMR in two, chronic active AMR in 10, acute T-cell-mediated rejection TCMR in seven, recurrence of the primary disease or de novo glomerulonephritis in eight, coagulation necrosis in one, tubular atrophy and interstitial fibrosis in nine, calcineurin inhibitor drug toxicity in six, and polyomavirus nephropathy in seven. Average creatinine was 2.58±1.1 mg/dl. The proteinuria levels ranged from 83 to 12600 mg/day with the average value being 2142±2619 mg/day. Among the patients with a proteinuria value of less than 1000 mg/day, two had acute AMR, three chronic active AMR, 21 acute TCMR-borderline, and seven chronic active TCMR, and 12 biopsies revealed other causes. For the 1000-3500 mg/day proteinuria group, five chronic active AMR, two acute TCMRborderline, and five chronic active TCMR were identified, and 11 biopsies indicated other causes. Lastly, of the patients with a proteinuria level of greater than 3500 mg/day, two had chronic active AMR, four acute TCMR-borderline, and eight chronic active TCMR, and seven biopsies revealed other conditions. Conclusion: Diagnosis of renal allograft biopsies may vary from one center to another due to

Keywords

• Proteinuria, Rejection, Renal Transplant Biopsy

Kaynakça

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