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Kronik Böbrek Hastalığında Eritrosit Dağılım Genişliği ile Proteinüri Arasındaki İlişkinin Değerlendirilmesi

Year 2023, Volume: 1 Issue: 2, 35 - 38, 22.06.2023

Abstract

Amaç: Proteinüri, kronik böbrek hastalığı (KBH) ve kardiyovasküler hastalıklar (KVH) için prognostik bir göstergedir. Eritrosit dağılım genişliği (RDW), KVH ve KVH risk faktörleri ile ilişkilidir. Ancak, proteinüri ile RDW arasındaki ilişki yeterince incelenmemiştir. Bu çalışmanın amacı KBH’de RDW ile proteinüri arasındaki ilişkiyi incelemektir.
Gereç ve Yöntem: 1 Temmuz 2015 - 31 Aralık 2016 tarihleri arasında bir eğitim ve araştırma hastanesinin nefroloji polikliniğine başvuran, proteinüri düzeyi 300 mg/gün üzerinde olan ve çalışma kriterlerine uygun, KBH tanısı olan 156 hasta çalışmaya dâhil edildi. Hastaların cinsiyeti, yaşı, kan basıncı, ek hastalıkları, ilaç kullanımı, biyokimyasal tetkikleri, tam kan sayımı, 24 saatlik idrarda total protein düzeyi ve kreatinin klirensi incelendi.
Bulgular: Hastaların 82’si (%53) erkek, 74’ü (%47) kadındı. Hastaların yaş ortalaması 57,84±14,82 yıl idi. Hastaların 90’ında (%58) diyabetes mellitus, 109’unda (%70) hipertansiyon, 29’unda (%19) koroner arter hastalığı, 6’sında (%4) konjestif kalp yetmezliği tanısı mevcuttu. Hastaların ortalama RDW değeri %16,13±1,65 saptandı. RDW değeri; %15,5’in altında, %15,5-16,49 aralığında, %16,5 ve üzerinde olmak üzere 3 grup şeklinde incelendi. Bu gruplarda proteinüri miktarı sırasıyla 3319,02±2389,66 mg/gün, 3307,88±2536,14 mg/gün ve 3460,12±2999,28 mg/gün olarak tespit edildi. Üç grubun proteinüri düzeylerindeki artış karşılaştırıldığında aralarındaki fark istatiksel olarak anlamlı bulunmadı (p=0,97). RDW değeri ile yaş arasında pozitif yönde anlamlı bir ilişki, RDW değeri ile ortalama eritrosit hacmi ve hemoglobin arasında negatif yönde anlamlı bir ilişki saptandı (sırası ile, r=0,174 ve p=0,03; r=-0,290 ve p<0,01; r=-0,164 ve p=0,04).
Sonuç: KBH tanısı olan hastalarda RDW değeri ile proteinüri arasındaki ilişki istatiksel olarak anlamlı bulunmamıştır.

References

  • Müdürlüğü HSG. Türkiye Böbrek Hastalıkları Önleme ve Kontrol Programı 2018-2023. https://hsgm.saglik.gov.tr/depo/birimler/kronik-hastaliklar-engelli-db/hastaliklar/ bobrek_hastaliklari/kitap_ve_makaleler/Turkiye_Bobrek_Hastaliklari_Onleme_ve_Kontrol_ Programi_2018-2023.pdf / adresinden 14/02/2023 tarihinde indirilmiştir.
  • Whittier LW, Gipson DS, Tonelli M, Gilbert S, Perazella MA. Pathophysiology of Chronic Kidney Disease. National Kidney Foundation Primer on Kidney Disease. Altıncı baskı. Philadelphia, Saunders Elsevier,2014;452.
  • Lerma EV BJ, Nissenson AR. Nefroloji ve Hipertansiyonun Esasları. Birinci baskı. Ankara, Güneş Tıp Kitabevleri 2014;275.
  • Verdecchia P, Reboldi GP. Hypertension and microalbuminuria: the new detrimental duo. Blood press 2004;13(4):198-211. DOI: 10.1080/08037050410016456.
  • Bilal A, Farooq JH, Kiani I, Assad S, Ghazanfar H, Ahmed I. Importance of mean red cell distribution width in hypertensive patients. Cureus 2016;8(11). DOI: 10.7759/cureus.902.
  • Tonelli M, Sacks F, Arnold M, Moye L, Davis B, Pfeffer M. Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease. Circulation 2008;117(2):163-8. DOI: 10.1161/CIRCULATIONAHA.107.727545.
  • Ntaios G, Gurer O, Faouzi M, Aubert C, Michel P. Red cell distribution width does not predict stroke severity or functional outcome. Int J Stroke 2012;7(1):2-6.DOI:10.1111/j.1747- 4949.2011.00609.x.
  • Ye Z, Smith C, Kullo IJ. Usefulness of red cell distribution width to predict mortality in patients with peripheral artery disease. Am J Cardiol 2011;107(8):1241-5. DOI: 10.1016/j. amjcard.2010.12.023.
  • Felker GM, Allen LA, Pocock SJ, et al. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Cardiol 2007;50(1):40-7. DOI: 10.1016/j.jacc.2007.02.067.
  • Abul Y, Ozsu S, Korkmaz A, Bulbul Y, Orem A, Ozlu T. Red cell distribution width: a new predictor for chronic thromboembolic pulmonary hypertension after pulmonary embolism. Chron Respir Dis 2014;11(2):73-81. DOI: 10.1177/1479972314525057.
  • Wen Y. High red blood cell distribution width is closely associated with risk of carotid artery atherosclerosis in patients with hypertension. Exp Clin Cardiol 2010;15(3):37.
  • Afonso L, Zalawadiya SK, Veeranna V, Panaich SS, Niraj A, Jacob S. Relationship between red cell distribution width and microalbuminuria: a population-based study of multiethnic representative US adults. Nephron Clin Pract 2011;119(4):c277-c82. DOI: 10.1159/000328918.
  • Zhang M, Zhang Y, Li C, He L. Association between red blood cell distribution and renal function in patients with untreated type 2 diabetes mellitus. Ren Fail 2015;37(4):659-63. DOI: 10.3109/0886022X.2015.1010938.
  • Uslu AU, Yonem O, Aydin B, et al. Red cell distribution width is associated with albuminuria in adults with familial Mediterranean fever. The Kaohsiung J Med Sci 2016;32(4):216-20. DOI: 10.1016/j.kjms.2016.03.009.
  • Li Z-Z, Chen L, Yuan H, Zhou T, Kuang Z-M. Relationship between red blood cell distribution width and early-stage renal function damage in patients with essential hypertension. J Hypertens 2014;32(12):2450-6. DOI: 10.1097/HJH.0000000000000356.
  • Magri CJ, Fava S. Red blood cell distribution width and diabetes-associated complications. Diabetes Metab Syndr 2014;8(1):13-7. DOI: 10.1016/j.dsx.2013.10.012.
  • Xiong X-f, Yang Y, Chen X, et al. Red cell distribution width as a significant indicator of medication and prognosis in type 2 diabetic patients. Sci Rep 2017;7(1):1-9. DOI: 10.1038/ s41598-017-02904-9.
  • Biadgo B, Melku M, Abebe SM, Abebe M. Hematological indices and their correlation with fasting blood glucose level and anthropometric measurements in type 2 diabetes mellitus patients in Gondar, Northwest Ethiopia. Diabetes Metab Syndr Obes 2016:91-9. DOI: 10.2147/ DMSO.S97563.
  • Perlstein TS, Weuve J, Pfeffer MA, Beckman JA. Red blood cell distribution width and mortality risk in a community-based prospective cohort. Arch Intern Med 2009;169(6):588- 94. DOI: 10.1001/archinternmed.2009.55.
  • Jithesh T, Mathew R, Jayapal V, Vijayakumar T. Red cell distribution width and high sensitivity C-reactive protein as risk markers in hypertension. Int J Med Sci Public Health 2012;138-142.
  • Tanindi A, Topal FE, Topal F, Celik B. Red cell distribution width in patients with prehypertension and hypertension. Blood Press 2012;21(3):177-81. DOI: 10.3109/08037051.2012.645335.
  • Solak Y, Yilmaz MI, Saglam M, et al. Red cell distribution width is independently related to endothelial dysfunction in patients with chronic kidney disease. Am J Med Sci 2014; 347 (2): 118–124. DOI:10.1097/maj.0b013e3182996a96.
  • Allen LA, Felker GM, Mehra MR, et al. Validation and potential mechanisms of red cell distribution width as a prognostic marker in heart failure. J Card Fail 2010;16:230–8. DOI: 10.1016/j.cardfail.2009.11.003.
Year 2023, Volume: 1 Issue: 2, 35 - 38, 22.06.2023

Abstract

References

  • Müdürlüğü HSG. Türkiye Böbrek Hastalıkları Önleme ve Kontrol Programı 2018-2023. https://hsgm.saglik.gov.tr/depo/birimler/kronik-hastaliklar-engelli-db/hastaliklar/ bobrek_hastaliklari/kitap_ve_makaleler/Turkiye_Bobrek_Hastaliklari_Onleme_ve_Kontrol_ Programi_2018-2023.pdf / adresinden 14/02/2023 tarihinde indirilmiştir.
  • Whittier LW, Gipson DS, Tonelli M, Gilbert S, Perazella MA. Pathophysiology of Chronic Kidney Disease. National Kidney Foundation Primer on Kidney Disease. Altıncı baskı. Philadelphia, Saunders Elsevier,2014;452.
  • Lerma EV BJ, Nissenson AR. Nefroloji ve Hipertansiyonun Esasları. Birinci baskı. Ankara, Güneş Tıp Kitabevleri 2014;275.
  • Verdecchia P, Reboldi GP. Hypertension and microalbuminuria: the new detrimental duo. Blood press 2004;13(4):198-211. DOI: 10.1080/08037050410016456.
  • Bilal A, Farooq JH, Kiani I, Assad S, Ghazanfar H, Ahmed I. Importance of mean red cell distribution width in hypertensive patients. Cureus 2016;8(11). DOI: 10.7759/cureus.902.
  • Tonelli M, Sacks F, Arnold M, Moye L, Davis B, Pfeffer M. Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease. Circulation 2008;117(2):163-8. DOI: 10.1161/CIRCULATIONAHA.107.727545.
  • Ntaios G, Gurer O, Faouzi M, Aubert C, Michel P. Red cell distribution width does not predict stroke severity or functional outcome. Int J Stroke 2012;7(1):2-6.DOI:10.1111/j.1747- 4949.2011.00609.x.
  • Ye Z, Smith C, Kullo IJ. Usefulness of red cell distribution width to predict mortality in patients with peripheral artery disease. Am J Cardiol 2011;107(8):1241-5. DOI: 10.1016/j. amjcard.2010.12.023.
  • Felker GM, Allen LA, Pocock SJ, et al. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Cardiol 2007;50(1):40-7. DOI: 10.1016/j.jacc.2007.02.067.
  • Abul Y, Ozsu S, Korkmaz A, Bulbul Y, Orem A, Ozlu T. Red cell distribution width: a new predictor for chronic thromboembolic pulmonary hypertension after pulmonary embolism. Chron Respir Dis 2014;11(2):73-81. DOI: 10.1177/1479972314525057.
  • Wen Y. High red blood cell distribution width is closely associated with risk of carotid artery atherosclerosis in patients with hypertension. Exp Clin Cardiol 2010;15(3):37.
  • Afonso L, Zalawadiya SK, Veeranna V, Panaich SS, Niraj A, Jacob S. Relationship between red cell distribution width and microalbuminuria: a population-based study of multiethnic representative US adults. Nephron Clin Pract 2011;119(4):c277-c82. DOI: 10.1159/000328918.
  • Zhang M, Zhang Y, Li C, He L. Association between red blood cell distribution and renal function in patients with untreated type 2 diabetes mellitus. Ren Fail 2015;37(4):659-63. DOI: 10.3109/0886022X.2015.1010938.
  • Uslu AU, Yonem O, Aydin B, et al. Red cell distribution width is associated with albuminuria in adults with familial Mediterranean fever. The Kaohsiung J Med Sci 2016;32(4):216-20. DOI: 10.1016/j.kjms.2016.03.009.
  • Li Z-Z, Chen L, Yuan H, Zhou T, Kuang Z-M. Relationship between red blood cell distribution width and early-stage renal function damage in patients with essential hypertension. J Hypertens 2014;32(12):2450-6. DOI: 10.1097/HJH.0000000000000356.
  • Magri CJ, Fava S. Red blood cell distribution width and diabetes-associated complications. Diabetes Metab Syndr 2014;8(1):13-7. DOI: 10.1016/j.dsx.2013.10.012.
  • Xiong X-f, Yang Y, Chen X, et al. Red cell distribution width as a significant indicator of medication and prognosis in type 2 diabetic patients. Sci Rep 2017;7(1):1-9. DOI: 10.1038/ s41598-017-02904-9.
  • Biadgo B, Melku M, Abebe SM, Abebe M. Hematological indices and their correlation with fasting blood glucose level and anthropometric measurements in type 2 diabetes mellitus patients in Gondar, Northwest Ethiopia. Diabetes Metab Syndr Obes 2016:91-9. DOI: 10.2147/ DMSO.S97563.
  • Perlstein TS, Weuve J, Pfeffer MA, Beckman JA. Red blood cell distribution width and mortality risk in a community-based prospective cohort. Arch Intern Med 2009;169(6):588- 94. DOI: 10.1001/archinternmed.2009.55.
  • Jithesh T, Mathew R, Jayapal V, Vijayakumar T. Red cell distribution width and high sensitivity C-reactive protein as risk markers in hypertension. Int J Med Sci Public Health 2012;138-142.
  • Tanindi A, Topal FE, Topal F, Celik B. Red cell distribution width in patients with prehypertension and hypertension. Blood Press 2012;21(3):177-81. DOI: 10.3109/08037051.2012.645335.
  • Solak Y, Yilmaz MI, Saglam M, et al. Red cell distribution width is independently related to endothelial dysfunction in patients with chronic kidney disease. Am J Med Sci 2014; 347 (2): 118–124. DOI:10.1097/maj.0b013e3182996a96.
  • Allen LA, Felker GM, Mehra MR, et al. Validation and potential mechanisms of red cell distribution width as a prognostic marker in heart failure. J Card Fail 2010;16:230–8. DOI: 10.1016/j.cardfail.2009.11.003.
There are 23 citations in total.

Details

Primary Language Turkish
Subjects ​Internal Diseases
Journal Section Research Article
Authors

Zeynep Öztürk 0000-0001-5859-2502

Erkan Şengül 0000-0003-3461-4740

Semra Selime Çiftlik 0000-0003-0709-3716

Hüseyin Çiftlik 0000-0002-6442-6479

Early Pub Date June 22, 2023
Publication Date June 22, 2023
Submission Date March 23, 2023
Published in Issue Year 2023 Volume: 1 Issue: 2

Cite

AMA Öztürk Z, Şengül E, Çiftlik SS, Çiftlik H. Kronik Böbrek Hastalığında Eritrosit Dağılım Genişliği ile Proteinüri Arasındaki İlişkinin Değerlendirilmesi. Ağrı Med J. June 2023;1(2):35-38.