Diyaliz hastalarında sistemik immün inflamasyon indeksi mortaliteyi öngörebilir

Öz

Amaç: Böbrek yetmezliğinde artmış inflamasyon söz konusudur. Serum ferritini bir akut faz reaktanıdır. Sistemik immün inflamasyon indeksi, kardiyovaskuler hastalıklarda ve kanserlerde prognostic önemi olduğu gösterilen, nötrofil, lenfosit ve trombosit sayılarından hesaplanan yeni bir belirteçtir. Bu çalışma, sistemik immün inflamasyon indeksinin diyaliz hastalarının mortalite riskini belirlemede kullanılabilirliğini ve mortalite ile ferritin düzeyleri arasındaki ilişkiyi belirlemeyi amaçlamaktadır. Gereç ve Yöntemler: Çalışmaya 84 hemodiyaliz ve periton diyaliz hastası alındı. Hastaların bazal demografik, klinik ve laboratuvar verileri, tıbbi kayıtlardan elde edildi. Mutlak nötrofil lenfosit oranının, mutlak platelet ile çarpımı ile sistemik immün inflamasyon indeksi elde edildi. Sonuç: Hastaların ortalama yaşı 51.3 ± 20.1olup, ortalama takip süreleri 60 (6 ~ 85) aydı. Takip süresince hastaların 45(%53) ü öldü. Hastalar medyan ferritin düzeyine göre analiz edildi. Kaplan-Meier analizine göre ferritinin yüksek olduğu grupta mortalitenin daha yüksek olduğu saptandı (log-rank test, P = 0.029). Yine hastalar medyan sistemik immün inflamasyon indeksine göre analiz edildi. Kaplan-Meier analizine göre sitemik immün inflamasyon indeksinin yüksek olduğu grupta daha yüksek mortalite oranları saptandı (log-rank test, P = 0.029). Çok değişkenli regresyon analizinde yaş (HR 1.060, P=0.00), Kt/V (HR 0.161, P=0.014), CRP (HR1.001, P=0.0429) ve Sistemik immün inflamasyon indeksi (HR 1.001, P=0.00) ve ferritin (HR) 1.001, P=0.013) tüm nedenlere bağlı ölümlerin en önemli belirleyicileriydi. Tartışma: Yeni bir inflamatuar belirteç olan Sistemik immün inflamasyon indeks ve ferritin, diyaliz hastalarında tüm nedenlere bağlı ölümlerle ilişkilidir. Diyaliz hastalarında inflamasyonun Sistemik immün inflamasyon indeks ve ferritin düzeyleri ile takip edilebileceğini düşünüyoruz.

Anahtar Kelimeler

• Diyaliz
• Enflamasyon
• Sistemik immün inflamasyon indeks

Systemic immune inflammation index may predict mortality in dialysis patients

Öz

Renal failure patients have increased inflammation. Serum ferritin is an acute phase reactant. Systemic immune inflammation index is a new marker calculated using lymphocyte, neutrophil, and platelet counts and have been shown to be a prognostic marker for cardiovascular disease and cancers. This study aims to determine the availability of Systemic immune inflammation index in determining the mortality risk of dialysis patients and the relationship between mortality and ferritin levels. Material and Methods: This retrospective, multicenter study enrolled 84 patients on peritoneal dialysis and hemodialysis. Baseline demographic, clinical and laboratory data, were obtained from medical records. Inflammatory indices were defined as NLR: absolute neutrophil count divided by absolute lymphocyte count and SII: absolute platelet count multiplied by NLR. Results: Mean age was 51.3 ± 20.1 years and the mean follow-up time was 60 (6 ~ 85) months. During the follow-up period, 45 (53%) patients died. Study population was analyzed according to median ferritin level. Kaplan-Meier curves showed higher mortality in patients in the high ferritin group (log-rank test, P = 0.029) Study population was analyzed according to median SII values. Kaplan-Meier survival analysis showed higher mortality in the group with the higher SII (log-rank test, P = 0.029) In multivariate regression analysis age (HR 1.060, P=0.00), Kt/V(HR 0.161,P=0.014), CRP(HR1.001,P=0.0429 and SII(HR 1.001, P=0.00), and ferritin (HR 1.001, P=0.013) were the most important determinants of all-cause mortality. Conclusion: SII, a novel inflammatory marker, and ferritin are related to all-cause mortality in dialysis patients. We believe that inflammation can be followed with SII and ferritin levels.

Anahtar Kelimeler

• Diyaliz
• Enflamasyon
• Sistemik immün inflamasyon indeks

Kaynakça

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