C-reaktif protein albumin oranı canlıdan böbrek naklinde ilk yıl mortaliteyi öngörmektedir

Abstract

Amaç: Bu çalışmanın amacı, preoperatif CRP/albumin oranının canlıdan böbrek nakli sonrası ilk yıl mortalite üzerinde etkinliğini değerlendirmektir. Gereç ve Yöntem: Çalışmaya 2011-2020 yılları arasında canlıdan böbrek nakli yapılmış 2143 hastadan ilk yılda ölen 36 hasta mortalite grubu olarak alındı. Kontrol grubu olarak benzer kronik hastalıklara sahip bir yıldan daha uzun süredir takipli olan canlıdan böbrek nakli yapılmış benzer sayıda hasta kontrol grubu olarak alındı. Bulgular: On yıl için ilk yıl mortalitesi %1,67 (36/2143)’dir. Mortalite grubunda hastalar kontrol grubuna göre daha yaşlıdır (53±13 karşılık 43±12, p=0,002). Mortalite grubundaki hastaların diyalizde geçirdiği ortanca süre kontrol grubuna göre uzundur (13 aya karşılık 1 ay, p=0,029). Ortanca CRP/albumin oranı mortalite grubunda daha yüksekti (2,77 karşılık 0,85, p=0,001). CRP ve CRP/albumin oranı, çok değişkenli Cox regresyon analizi sonucunda, canlıdan böbrek nakli sonrası ilk yıl mortaliteye etki eden bağımsız faktörler olarak saptandı (HR=1,040 %95 CI 1,011-1,069; p=0,004 karşılık HR=1,148 %95 CI, 1,044-1,262; p=0,007 sırasıyla). ROC analizi CRP/albumin oranının bir yıllık mortaliteyi tahmin etme gücüne sahip olduğunu gösterirken (AUC 0,650 %95 GA 0,513-0,787, p=0,041). CRP/albumin oranı eşik değerine (1,52) göre yapılan Kaplan-Meier sağkalım analizi iki grup arasında fark olduğunu göstermiştir. Sonuç: Bu çalışma, CRP/albumin oranının canlıdan böbrek nakli sonrasında ilk yıl içerisinde gelişen mortaliteyi öngörmede kullanılabileceğini göstermektedir.

Keywords

• Canlı donörden böbrek nakli
• mortalite
• C-reaktif protein
• albumin

The C-reactive protein-to-albumin ratio predicts one-year mortality in living donor kidney transplantation

Abstract

Aim: The aim of this study was is to evaluate the effectiveness of the preoperative CRP/albumin ratio on first year mortality after living donor kidney transplantation. Material and Method: This retrospective single-center study includes a total of living kidney transplant recipients’ data who were transplanted between 2011-2020 years. Thirty-six patients who died within the first year after kidney transplantation among 2143 living kidney transplant recipients were included in the study group. Patients who have similar comobordities like mortality group patients who survives than one year after living donor kidney transplantation were enrolled as control group. Results: First year mortality was 1.67% (36/2143) in ten years. Patients in the mortality group were older than the control group (53±13 vs 43±12, p=0.002). The median time spent on dialysis in the mortality group was longer than in the control group (13 months vs 1 month, p=0.029). The median CRP/albumin ratio was higher in the mortality group (2.77 vs 0.85, p=0.001). CRP and CRP/albumin ratio were determined as independent factors affecting mortality in the first year after living donor kidney transplantation as a result of multivariate Cox regression analysis (HR=1.040;95% CI, 1.011-1.069; p=0.004 vs HR=1.148 95% CI, 1.044-1.262; p=0.007, respectively). ROC analysis showed that the CRP/albumin ratio had the power to predict one-year mortality (AUC 0.650 95% CI 0.513-0.787, p=0.041). Kaplan-Meier survival analysis showed a statistically significant difference between the two groups in terms of the cut-off value for CRP/albumin ratio (1.52). Conclusion: This study shows that the CRP/albumin ratio can be used to predict mortality in the first year after living donor kidney transplantation.

Keywords

• Living donor kidney transplantation
• mortality
• C-reactive protein
• albumin

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