Relationship of Hematological Parameters with Progression in Patients with Chronic Renal Failure in Stage 3-4-5 Without Dialysis Treatment

Yıl 2019, Cilt: 11 Sayı: 4, 161 - 175, 29.06.2020

Sultan Türel Uğur Ergün , Ali Kırık

Öz

Chronic Renal Failure (CRF) is a common chronic disease in the world and in our country. CRF is a disease that can be prevented or delayed progression when detected early with basic tests. In this study, it was aimed to investigate the relationship between progression and changes in hematological parameters in patients with CRF and whether they can be used as predictive parameters. The data obtained from patients with stage 3-4-5 CRF were retrospectively analyzed between 18-85 years of age who applied to the Nephrology Polyclinic of Balıkesir University Hospital between January 2016 - December 2017. Demographic data and hemogram values (hemoglobin, neutrophil, lymphocyte, platelet, neutrophil lymphocyte ratio, platelet lymphocyte ratio, mean platelet volume (MPV), red cell distribution (RDW), MPV/Plt) and biochemistry values (urea, creatinine, uric acid, glomerular filtration rate (GFR), spot urine protein, spot urine creatinine, spot urine protein / creatinine) and hemogram after 12 months on average, same parameters in biochemistry examinations were examined. The distribution of patient ages (mean ± ss) according to CRF stages was calculated as 64 ± 15 in stage 3, 62 ± 13 in stage 4, and 58 ± 14 years in stage 5. In our study, hemoglobin and platelet values were found to be significantly different between the groups (p <0.05). There was no statistically significant difference between the groups in terms of neutrophil, lymphocyte, RDW, MPV, N/L, P/L and MPV/Plt measurements. Hemoglobin, lymphocyte and platelet levels were found to be significantly higher in low-stage CRF patients than in advanced stages. No statistically significant difference was found between the groups in terms of neutrophil, RDW, MPV, N/L, P/L and MPV/Plt measurements. Developing new and easily accessible parameters is critical to predict CRF progression. Hematological parameters; both can be calculated on the hemogram without the need for additional examinations and can be performed in all health institutions. In particular, it shows that MPV/Platelet and Hb values can be used to predict progression.

Anahtar Kelimeler

Chronic Renal Failure (CRF), hematological parameters, predictor

Diyaliz Tedavisi Almayan Evre 3-4-5 Kronik Böbrek Yetmezliği Olan Hastalarda Hematolojik Parametrelerin Progresyon İle İlişkisi

Öz

Bu çalışmada KBY’li olgularda progresyon ile hematolojik parametrelerdeki değişimin ilişkisini ve öngördürücü parametreler olarak kullanılıp kullanılamayacağı
araştırılmak istenmiştir. Çalışmamızda Ocak 2016 - Aralık 2017 tarihleri arasında Balıkesir Üniversitesi Tıp Fakültesi Hastanesi Nefroloji Polikliniğine başvuran 18-85 yaş arası evre 3-4-5 KBY tanılı hastalardan elde edilen veriler retrospektif olarak incelendi. Hastaların demografik verileri ile ilk başvurudaki hemogram değerleri (hemoglobin, nötrofil, lenfosit, platelet, nötrofil lenfosit oranı, trombosit lenfosit oranı, ortalama trombosit hacmi (MPV), eritrosit dağılım genişliği (RDW), MPV/Plt) ile biyokimya değerleri (üre, kreatinin, ürik asit, glomerüler filtrasyon hızı (GFR), spot idrar protein, spot idrar kreatinin, spot idrarda protein/kreatinin) ve ortalama 12 ay sonraki hemogram, biyokimya incelemelerindeki aynı parametreler incelendi. KBY evrelerine göre hasta yaşlarının dağılımı (ort±ss) evre 3’te 64±15, evre 4’te 62±13 ve evre 5’te 58±14 yıl olarak hesaplandı. Çalışmamızda hemoglobin ve platelet değerlerinin gruplar arasında anlamlı bir şekilde farklı olduğu saptanmıştır
(p<0.05). Gruplar arasında nötrofil, lenfosit, RDW, MPV, N/L, P/L ve MPV/Plt ölçümleri açısından ise istatistiksel olarak anlamlı bir fark bulunmamıştır. Hemoglobin, lenfosit ve platelet düzeyleri düşük evreli KBY’lilerde, ileri evrelilere göre anlamlı şekilde daha yüksek bulundu. Çalışmada gruplar arasında nötrofil, RDW, MPV,
N/L, P/L ve MPV/Plt ölçümleri açısından ise istatistiksel olarak anlamlı bir fark saptanmamıştır. KBY progresyonunu öngörmek için yeni ve kolay ulaşılabilir parametrelerin geliştirilmesi büyük önem taşımaktadır. Hematolojik parametreler; hem ek tetkik ihtiyacı olmadan hemogram üzerinden hesaplanabilir hem de tüm
sağlık kuruluşlarında yapılabilir incelemelerdir. Özellikle MPV/Trombosit ve Hb değerlerinin progresyonu predikte etmek için kullanılabileceğini göstermektedir.

Anahtar Kelimeler

Kronik Böbrek Yetmezliği (KBY), hematolojik parametreler, prediktör

Kaynakça

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