ÇOCUK NEFROLOJİ KLİNİĞİNDE 2008 - 2013 YILLARI ARASINDA KRONİK BÖBREK HASTALIĞI İLE İZLENEN HASTALARIN DEĞERLENDİRİLMESİ

Yıl 2025, Cilt: 26 Sayı: 3, 196 - 202, 16.07.2025

Beste Kipçak Yüzbaşı , Sare Gülfem Özlü , Özlem Erdoğan

https://doi.org/10.18229/kocatepetip.1461387

Öz

AMAÇ: Bu çalışmada, Kronik Böbrek Hastalığı (KBH) tanısıyla takipli hastaların KBH etiyolojisi, evreleri, medikal ve renal replasman tedavilerinin değerlendirilmesi amaçlanmıştır.
GEREÇ VE YÖNTEM: Dr. Sami Ulus Kadın Doğum, Çocuk Sağlığı ve Hastalıkları Eğitim ve Araştırma Hastanesi Çocuk Nefroloji Kliniğinde Ocak 2008-Ocak 2013 tarihleri arasında KBH tanısı alan en az 6 ay süreyle takip ve tedavi edilen 0-19 yaş grubu 193 hastanın dosyası retrospektif olarak incelendi.
BULGULAR: En sık görülen başvuru şikâyetleri; vücutta şişlik, bulantı-kusma ve büyüme geriliğiydi. Evre I’de 9 (%4,7) hasta, evre II’de 35 (%18,1) hasta, evre III’te 48 (%24,9) hasta, evre IV ‘te 40 (%20,7) hasta ve evre V’te 61 (%31,6) hasta bulundu. Yaş grubu ile KBH evreleri karşılaştırıldığında; 0-4 yaş grubunda evre V hasta sayısı (20 hasta - %55,6) daha yüksek saptandı (p:0,035). Etiyolojiye göre yapılan sınıflamada en sık görülen neden ürolojik/tübülointerstisyel hastalıklardı (%47,2). Takip süresince hastaların 78’i (%40,4) sadece konservatif tedavi ile 115 hasta (%59,6) ise renal replasman tedavisi (RRT) ile izlendi. RRT alan hastaların 55’ine periton diyalizi (PD), 46’sına hemodiyaliz (HD) tedavisi uygulanırken 14 hastaya renal transplantasyon yapıldı. Ölüm nedeni 5 hastada (%38,4) kardiyovasküler nedenler, 5 hastada (%38,4) enfeksiyon ve 2 hastada(%15,3) serebrovasküler nedenlerdi.
SONUÇ: Çalışmamız erken evre KBH hastalarının tespitinin büyük önem arz ettiğini göstermiştir. KBH olan hastalarda görülen komplikasyonlar yaşam kalitesini önemli ölçüde etkilemektedir. Çalışmamız KBH’nın erken tanı ve tedavisi, gelişebilecek komplikasyonların tanınmasına olan ihtiyacı vurgulamaktadır.

Anahtar Kelimeler

Çocuk , Etiyoloji , Kronik böbrek hastalığı , Tedavi.

Destekleyen Kurum

YOK

Teşekkür

YOK

EVALUATION OF PATIENTS WITH CHRONIC KIDNEY DISEASE FOLLOWED IN PAEDIATRIC NEPHROLOGY CLINIC BETWEEN 2008 AND 2013

Öz

OBJECTIVE: The aim of this study was to evaluate the etiology, stages, medical and renal replacement therapies of patients followed up with the diagnosis of chronic kidney disease (CKD).
MATERIAL AND METHODS: The files of 193 patients aged 0-19 years who were diagnosed with CKD and followed and treated for at least 6 months in the Paediatric Nephrology Clinic of Dr. Sami Ulus Maternity, Gynaecology, Paediatrics Training and Research Hospital between January 2008 and January 2013 were retrospectively analyzed.
RESULTS: The most common presenting complaints were body swelling, nausea-vomiting, and growth retardation. There were 9 (4.7%) patients in stage I, 35 (18.1%) in stage II, 48 (24.9%) in stage III, 40 (20.7%) in stage IV and 61 (31.6%) in stage V. When age group and CKD stages were compared, the number of stage V patients (20 patients - 55.6%) was higher in the 0-4 age group (p:0.035). The most common etiological classification was urological/tubulointerstitial diseases (47.2%). During the follow-up period, 78 patients (40.4%) were followed up only with conservative treatment, and 115 patients (59.6%) were followed up with renal replacement therapy (RRT). Peritoneal dialysis (PD) was performed in 55 patients, hemodialysis (HD) in 46 patients and renal transplantation was performed in 14 patients. The cause of death was cardiovascular causes in 5 patients (38.4%), infection in 5 patients (38.4%) and cerebrovascular causes in 2 patients (15.3%).
CONCLUSIONS: Our study showed that the detection of early-stage CKD patients is of great importance. Complications in patients with CKD significantly affect the quality of life. Our study emphasizes the need for early diagnosis and treatment of CKD and recognition of complications that may develop.

Anahtar Kelimeler

Child , Etiology , Chronic kidney disease , Treatment.

Kaynakça

• 1. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024;105(4S):117-314.
• 2. Amanullah F, Malik AA, Zaidi Z. Chronic kidney disease causes and outcomes in children: Perspective from a LMIC setting. PLoS One. 2022;17(6):e0269632.
• 3. Becherucci F, Roperto RM, Materassi M, Romagnani P. Chronic kidney disease in children. Clin Kidney J. 2016;9(4):583-91.
• 4. Harada R, Hamasaki Y, Okuda Y, et al. Epidemiology of pediatric chronic kidney disease/kidney failure: learning from registries and cohort studies. Pediatr Nephrol. 2022;37(6):1215-29.
• 5. United States Renal Data System. 2023 USRDS Annual Data Report: Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2023; https://adr.usrds.org/2023/chronic-kidney-disease/5-%23kidney-and-urologic-disease- among-children-and-adolescents (Erişim Tarihi 29.03.2024)
• 6. Kliegman Robert M. (Edited by). Nelson Textbook of Pediatrics In: Claes DJ, Mitsnefes M. Chapter 550.2 Chronic Kidney Disease. 21st edition. 2019:10887-10902.
• 7. Schwartz GJ, Muñoz A, Schneider MF et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol. 2009;20(3):629-37.
• 8. Hogg RJ, Furth S, Lemley KV, et al. National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative clinical practice guidelines for chronic kidney disease in children and adolescents: evaluation, classification, and stratification. Pediatrics. 2003;111(6):1416–21.
• 9. Neyzi O, Günöz H, Furman A. Çocuk Sağlığı ve Hastalıkları Dergisi. 2008;51:1-14.
• 10. Ardissino G, Daccò V, Testa S et al. ItalKid Project. Epidemiology of chronic renal failure in children: data from the ItalKid project. Pediatrics. 2003;111(4 Pt 1):e382-7.
• 11. Mong Hiep TT, Ismaili K, Collart F et al. Clinical characteristics and outcomes of children with stage 3-5 chronic kidney disease. Pediatr Nephrol. 2010;25(5):935-40.
• 12. Areses Trapote R, Sanahuja Ibáñez MJ, Navarro M; Investigadores Centros Participantes en el REPIR II. Epidemiología de la enfermedad renal crónica no terminal en la población pediátrica española. Proyecto REPIR II [Epidemiology of chronic kidney disease in Spanish pediatric population. REPIR II Project]. Nefrologia. 2010;30(5):508-17.
• 13. Soylemezoglu O, Duzova A, Yalçinkaya F, et al. Chronic renal disease in children aged 5-18 years: a population-based survey in Turkey, the CREDIT-C study. Nephrol Dial Transplant. 2012;27 (3):146-51.
• 14. Bek K, Akman S, Bilge I et al. Chronic kidney disease in children in Turkey. Pediatr Nephrol. 2009;24(4):797- 806.
• 15. Plumb L, Magadi W, Casula A et al. Advanced chronic kidney disease among UK children. Arch Dis Child. 2022;107:1043-45.
• 16. Masalskienė J, Rudaitis Š, Vitkevič R, et al. Epidemiology of Chronic Kidney Disease in Children: A Report from Lithuania. Medicina (Kaunas). 2021;57(2):112.
• 17. Chiou YY, Lin CY, Chen MJ et al. Etiology and pediatric chronic kidney disease progression: Taiwan Pediatric Renal Collaborative Study. J Formos Med Assoc. 2016;115(9):752-63.
• 18. Warady BA, Chadha V. Chronic kidney disease in children: the global perspective. Pediatr Nephrol. 2007;22(12):1999-2009.
• 19. Abukwaik WM, Baracco R, Jain A, et al. Clinical profile of children incidentally found to have advanced kidney failure. Pediatr Nephrol. 2022;37(5):1097-103.
• 20. Atkinson MA, Warady BA. Anemia in chronic kidney disease. Pediatr Nephrol. 2018;33(2):227-38.
• 21. Atkinson MA, Furth SL. Anemia in children with chronic kidney disease. Nat Rev Nephrol. 2011;7(11):635-41.
• 22. Staples AO, Greenbaum LA, Smith JM et al. Association between clinical risk factors and progression of chronic kidney disease in children. Clin J Am Soc Nephrol. 2010;5(12):2172-9.
• 23. Wong H, Mylrea K, Feber J, et al. Prevalence of complications in children with chronic kidney disease according to KDOQI. Kidney Int. 2006;70(3):585-90.
• 24. Klıegman Robert M. (Edited by).Nelson Textbook of Pediatrics In: Claes DJ, Goldstein SL. Chapter 550.3 End- Stage Renal Disease. 21st Edition. 2019;21:10903-5.
• 25. Türkiye’de Nefroloji, Diyaliz ve Transplantasyon 2014 Raporu, Türk Nefroloji Derneği https://nefroloji.org.tr/uploads/folders/file/registry_kitabi_2014.pdf(Erişim Tarihi: 24.12.2024)
• 26. Türkiye’de Nefroloji, Diyaliz ve Transplantasyon 2022 Raporu, Türk Nefroloji Derneği https://nefroloji.org.tr/uploads/pdf/REGISTRY2022_web.pdf (Erişim Tarihi: 24.12.2024)
• 27. ANZDATA 46th Annual Report 2023 (data to 2022). ANZDATA 46th Annual Report 2023. November 23, 2023.Accessed21Dec2023.https://www.anzdata.org.au/report/anzdata-46th-annual-report-2023-data-to- 2022/. (ErişimTarihi:29.03.2024)
• 28. Bonthuis M, Vidal E, Bjerre A et al. Ten-year trends in epidemiology and outcomes of pediatric kidney replacement therapy in Europe: data from the ESPN/ERA-EDTA Registry. Pediatr Nephrol. 2021;36(8):2337-48.