Prediyaliz kronik böbrek hastalığı olan çocuklarda hastalık ilerlemesini etkileyen faktörlerin değerlendirilmesi

Öz

Kronik böbrek hastalığı (KBH), son dönem böbrek hastalığına (SDBH) ilerleyebilen önemli bir sağlık sorunudur. Çalışmamızda prediyaliz KBH tanısı alan çocuklarda hastalığın seyrini etkileyen faktörlerin değerlendirilmesi amaçlandı. Çalışmamızda prediyaliz KBH olan 25 hastanın verileri retrospektif olarak incelendi. Başvuru anında, ikinci ve dördüncü yıldaki laboratuvar bulguları değerlendirildi. Hastaların ortalama takip süresi 6,6 ± 2,27 yıldı. On üç hastada KBH evresinde ilerleme görüldü. Başvuru anındaki glomerul filtrasyon hızı (GFH) ile dördüncü yıl takipteki GFH arasında istatistiksel olarak anlamlı fark vardı (p= 0,043). GFH'de anlamlı azalma olan hastaların başvuru anındaki serum ürik asit düzeyleri, GFH'de azalma olmayan hastalara göre istatistiksel olarak anlamlı derecede yüksekti (p= 0,015). Serum ürik asit düzeyleri GFH'deki düşüş için öngörücü değere sahipti (eğri altındaki alan: 0,82, eşik değer: 6,1 ± 0,89 mg/dL, duyarlılık: %83,1, özgüllük: %67,4, p= 0,028). GFH'si azalan hastalarda, GFH'si düşmeyen hastalara göre hipertansiyon görülme sıklığı daha yüksekti (p= 0,001). Cox regresyon analizinde serum ürik asit düzeyi ile başvuru sırasında hipertansiyon varlığı ve GFH'de azalma arasında anlamlı korelasyonlar bulundu (sırası ile hazard oranı: 1,536, %95 güven aralığı: 1,214-1,903, p= 0,032, hazard oranı: 1,873). , %95 güven aralığı: 1,164-2,287, p= 0,041). Kronik böbrek hastalığının ilerlemesine neden olan faktörlerin belirlenmesi ve bu faktörlerin önlenmesine yönelik tedaviler çocuklarda SDBH'nin ilerlemesini yavaşlatabilir.

Anahtar Kelimeler

• Prediyaliz kronik böbrek hastalığı
• progresyon
• çocukluk çağı

Evaluation of the Factors Affecting Disease Progression in Children with Predialysis Chronic Kidney Disease

Öz

Chronic kidney disease (CKD) is an important health problem that can progress to end-stage renal disease (ESRD). In our study, it was aimed to evaluate the factors affecting disease progression in children with the diagnosis of predialysis CKD. In our study, the data from 25 patients with predialysis CKD were retrospectively reviewed. The laboratory findings were evaluated at the time of admission, at the second and fourth years. The mean follow-up period of the patients was 6.6 ± 2.27 years. Thirteen patients showed progression in the CKD stage. There was a statistically significant difference between the GFR at admission and the GFR at the fourth year follow-up (p=0.043). In patients with a significant decrease in GFR, serum uric acid levels at admission was statistically significantly higher than in patients without a decrease in GFR (p=0.015). Serum uric acid levels had predictive value for the decrease in GFR (area under curve: 0.82, cut-off value:6.1±0.89 mg/dL, sensitivity:83.1%, specificity:67.4%, p=0.028). The frequency of hypertension was higher in patients with a decrease in GFR compared to patients without a decrease in GFR (p=0.001). In Cox regression analysis, significant correlations were found between the serum uric acid levels and the presence of hypertension at admission and a decrease in GFR (hazard ratio:1.536, 95%confidence interval:1.214-1.903, p=0.032, Hazard ratio:1.873, 95%confidence interval:1.164-2.287, p=0.041, respectively).Identification of the factors that cause the progression of chronic kidney disease and treatments to prevent these factors may slow the progression to ESRD in children.

Anahtar Kelimeler

• Predialysis chronic kidney disease
• progression
• childhood

Kaynakça

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