Kronik böbrek yetmezlikli çocuklarda Fibroblast büyüme faktörü-23 ve Fetuin A düzeylerinin değerlendirilmesi
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Tarih
2015
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info:eu-repo/semantics/openAccess
Özet
Giriş: Çocukluk çağında son dönem böbrek yetmezliği tedavisindeki güncel gelişmeler ve böbrek nakli konusundaki ilerlemeler bu hastaların ortalama yaşam sürelerini belirgin şekilde uzatmıştır. Son yıllarda yapılan çalışmalarda kronik böbrek yetmezliği olan genç erişkinlerin kardiyovasküler hastalıklara ait mortalite ve morbiditelerinin aynı yaş gurubundaki sağlıklı kişilerden çok daha fazla olduğu saptanmıştır.
Amaç: Kronik böbrek yetmezliği olan çocuklarda Fibroblast büyüme faktörü–23, Fetuin a, çeşitli inflamasyon belirteçleri, lipid profilleri ve karotis intima medya kalınlığının aynı yaş gurubundaki sağlıklı çocuklar arasındaki düzeylerinin değerlendirilmesi.
Yöntem: Bu çalışmaya 25 kronik böbrek yetmezlikli hasta ve yası uygun sağlıklı 26 çocuk kontrol grubu alınmıştır. Hastalar ve kontrol grubunun fizik muayeneleri yapılıp; kan basınçları, boyları ve vücut ağırlıkları, vücut kitle indeksleri, glomerüler filtrasyon hızı hesaplandı. Çalışmaya katılan çocuklardan kan örnekleri alınmış hemogram, üre, kreatinin, albümin, total protein, kalsiyum, fosfor, potasyum, paratiroid hormon, lipit profili, serum bFGF düzeyleri, serum Fetuin A düzeyi ölçülmüş ve ultrasonografik olarak karotis İMK’ları değerlendirilmiştir.
Bulgular: Kontrol grubu ile karsılaştırıldığında Sistolik KB, Diyastolik KB, Sağ ve Sol İMK ölçüm değerleri, Glomerüler filtrasyon hızları (GFR),Parathormon (PTH) düzeyi, istatistiksel olarak anlamlı farklılık saptanmıştır P<0,001. Her iki gruptaki tam kan sayımı sonuçları karşılaştırıldığında gruplar arası hemoglobin ve hematokrit düzeyleri istatistiksel olarak anlamlı farklılık gösterdi (P =0,001). Hasta grubunda hastalık süresi ile Fetuin A düzeyi arasında anlamlı bir pozitif korelasyon bulundu (p=0.010). Hasta grubunda FBF–23 ile trigliserid değerleri arasında da istatistiksel olarak anlamlı bir pozitif korelasyon bulundu (p=0.024).Çalışmamızda KBY grubu ile kontrol grubunun FBF–23 düzeyleri karşılaştırıldığında istatistiksel olarak anlamlı fark saptandı (p=0,043). KBY grubu ile kontrol grubunun Fetuin-A düzeyleri karşılaştırıldığında istatistiksel olarak anlamlı bir fark saptanmamıştır (p>0,05).Gruplar arası serum biyokimyasal değerleri karşılaştırıldığında KBY’li grupla kontrol grubu arasında ortalama serum Albümin, üre, kreatinin, ürik asit ve kalsiyum değerleri farkları istatistiksel olarak anlamlı idi (P<0,05).
Sonuç: Çalışmamızda KBY grubu ile kontrol grubunun FBF–23 düzeyleri karşılaştırıldığında istatistiksel olarak anlamlı fark saptanmış olup literatürler ile uyumlu idi. Kronik böbrek yetmezliği bulunan çocuk hastalarda serum fetuin A düzeyi ve FBF–23 düzeylerinin hastalık süresi ve şiddeti ile ilişkisini araştıracak daha fazla sayıda hasta içeren ilave çalışmalara gereksinim olduğunu düşünmekteyiz.
Anahtar sözcükler: Çocukluk çağı, Fibroblast büyüme faktörü (FGF)-23, Fetuin A, kronik böbrek yetmezliği, intima media kalınlığı.
Introduction: Recent developments in the treatment of end-stage renal failure in childhood and progress in kidney transplantation in these patients significantly increased the average life expectancy. In recent studies,compared to healthy ones, young adults with chronic renal failure were found to have more cardiovascular disease mortality and morbidity than the same age group. Objective: Evaluatıng the levels of fetuin A, Fibroblast growth factor–23, various inflammatory markers, lipid profile and carotid intima-media thickness in children with chronic renal failure compared with healthy children of the same age group. Material and methods: In this study, 25 patients with chronic renal failure and 26 healthy children of appropriate age as control group was ıncluded. Patients and control subjects examined phsically and ther blood pressure, height and body weight, body mass index (BMI), glomerular filtration rate were measured. Blood samples from the children participating in the study were taken, hemogram, urea, creatinine, albumin, total protein, calcium, phosphorus, potassium, parathyroid hormone, lipid profile, serum bFGF levels were measured in serum fetuin A levels and carotid intima-media thickness was assessed ultrasonographically. Results: Compared with the control group, systolic BP, diastolic BP, intima-media thickness measurement values for right and left, glomerular filtration rate (GFR), Parathyroid hormone (PTH) level, a statistically significant difference was found P<0,001. When the results of complete blood count in both groups were compared, hemoglobin and hematocrit levels between the groups were found to have statistically significant differences (P =0,001). In patient group, a significant positive correlation was found between disease duration and fetuin A level (p=0.010). In the patient group, a statistically significant positive correlation was found between FBF–23 and triglyceride values(p=0.024). In our study when FBF–23 levels in CRF group and control group were compared, statistically a significant difference was found (p=0,043). In our study when Fetuın-A levels in CRF group and control group were compared, statistically a significant difference was not found (p>0,05).When serum biochemical values between the groups were compared, in the control group and CRF group, the differences ın mean serum albumin, urea, creatinine, uric acid and calcium values were statistically significant (P<0,05). Conclusion: In our study when FBF–23 levels in CRF group and control group were compared, statistically a significant difference was found and it was in accordance with literature. We think that more additional studies consisting of more patients to search for relationship of FBF–23 levels between patient duration and ıts severe is required Key words: Childhood, Fibroblast growth factor (FGF) -23, fetuin A, chronic renal failure, and intima-media thickness.
Introduction: Recent developments in the treatment of end-stage renal failure in childhood and progress in kidney transplantation in these patients significantly increased the average life expectancy. In recent studies,compared to healthy ones, young adults with chronic renal failure were found to have more cardiovascular disease mortality and morbidity than the same age group. Objective: Evaluatıng the levels of fetuin A, Fibroblast growth factor–23, various inflammatory markers, lipid profile and carotid intima-media thickness in children with chronic renal failure compared with healthy children of the same age group. Material and methods: In this study, 25 patients with chronic renal failure and 26 healthy children of appropriate age as control group was ıncluded. Patients and control subjects examined phsically and ther blood pressure, height and body weight, body mass index (BMI), glomerular filtration rate were measured. Blood samples from the children participating in the study were taken, hemogram, urea, creatinine, albumin, total protein, calcium, phosphorus, potassium, parathyroid hormone, lipid profile, serum bFGF levels were measured in serum fetuin A levels and carotid intima-media thickness was assessed ultrasonographically. Results: Compared with the control group, systolic BP, diastolic BP, intima-media thickness measurement values for right and left, glomerular filtration rate (GFR), Parathyroid hormone (PTH) level, a statistically significant difference was found P<0,001. When the results of complete blood count in both groups were compared, hemoglobin and hematocrit levels between the groups were found to have statistically significant differences (P =0,001). In patient group, a significant positive correlation was found between disease duration and fetuin A level (p=0.010). In the patient group, a statistically significant positive correlation was found between FBF–23 and triglyceride values(p=0.024). In our study when FBF–23 levels in CRF group and control group were compared, statistically a significant difference was found (p=0,043). In our study when Fetuın-A levels in CRF group and control group were compared, statistically a significant difference was not found (p>0,05).When serum biochemical values between the groups were compared, in the control group and CRF group, the differences ın mean serum albumin, urea, creatinine, uric acid and calcium values were statistically significant (P<0,05). Conclusion: In our study when FBF–23 levels in CRF group and control group were compared, statistically a significant difference was found and it was in accordance with literature. We think that more additional studies consisting of more patients to search for relationship of FBF–23 levels between patient duration and ıts severe is required Key words: Childhood, Fibroblast growth factor (FGF) -23, fetuin A, chronic renal failure, and intima-media thickness.
Açıklama
Anahtar Kelimeler
Çocukluk çağı, Childhood, Fibroblast büyüme faktörü (FGF)-23, Fibroblast growth factor (FGF) -23, Fetuin A, Kronik böbrek yetmezliği, Chronic renal failure, İntima media kalınlığı, Intima-media thickness
