Çocuklarda akut glomerülonefrit: Üçüncü basamak sağlık merkezinde yedi yıllık deneyim
Yükleniyor...
Tarih
2012
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Modestum Publishing Ltd.
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmanın amacı üçüncü basamak bir üniversite hastanesinde akut glomerulonefrit (AGN)’li çocukların
klinik ve laboratuvar özelliklerini irdelemektir.
Gereç ve yöntem: Çocuk Nefroloji Kliniğinde 2004-2011
yılları arasında AGN tanısıyla yatırılarak tedavi edilen çocukların kayıtları geriye dönük olarak incelendi. Hastalar
<5 yaş, 5-10 yaş ve >10 yaş üstü olmak üzere üç gruba
ayrıldı. Hastaların hastaneye başvuru anındaki özellikleri
olarak kan basıncı, diürez durumu, serum üre ve kreatinin değerleri, elektrolit düzeyleri ve kompleman C3 ve C4
faktörleri, tam kan sayımı ve idrar analiz bulguları kaydedildi. Ayrıca başlatan enfeksiyon, uygulanan tedaviler,
klinik seyir ve sonuç belirlenerek kaydedildi ve elde edilen
veriler analiz edildi.
Bulgular: Hastaneye yatırılarak izlenen 63’ü kız (%28,8),
157’si erkek (%71,2), toplam 220 AGN’li çocuk incelendi. Tetikleyen enfeksiyon olarak, tonsillofarenjit 133
(%60,5) hastada, piyoderma 12 hastada (%5,5), ve diğer
enfeksiyonlar 27 hastada (%12,2) saptanırken; 48 hastada (%21,8) herhangi bir enfeksiyon bulunmadı. Hastaların %81,4’ünde ödem, %73,6’sında hipertansiyon,
%22,6’sinda akciğerde staz bulguları saptandı. Hastaların %89,1’inde C3 düşüklüğü ve %45,9’unda azotemi
gözlendi. Hematüri %95,4 hastada, nefritik proteinüri
%80,5’unda, lökositüri %37,6’sında görüldü. Diürez 180
(%82) hastada bir haftada normale geldi. Düretik tedavisi
ile kan basıncı kontrol altına alınamayan 45 hastaya (%20
,5) ilave vazodilatör ilaçlar verildi. Üç hastada hemodiyaliz
yapıldı. Ancak AGN yaş grupları arasında, C3 düşüklüğü
(p=0.018) ve anemi sıklığı (p=0.006) farklı bulunurken,
diğer klinik ve laboratuvar bulgular bakımından anlamlı
farklılık saptanmadı (p>0.05).
Sonuç: Akut glomerülonefrit çocuklarda klinik ve laboratuvar özellikler yaş gruplarına göre C3 düşüklüğü ve anemi sıklığı dışında anlamlı farklılık göstermedi.
Objectives: The aim of this study was to examine clinical and laboratory characteristics of children with AGN in a tertiary university hospital. Materials and methods: Hospital records of children which hospitalized with AGN diagnosis in Pediatric Nephrology Unit, between 2004 and 2011, were retrospectively reviewed. Patients were divided into three subgroups as age <5 years, 5-10 years and >10 years. Characteristics at hospital admission including, blood pressure, diuresis state, serum urea, creatinine and electrolyte levels, complement factors C3 and C4, complete blood count and urine analysis results were recorded. Data about primary infection, treatments, disease course and outcome were recorded and analyzed. Results: Totally 220 children (157 male, 71.2%; 63 female, 28.8%) were included. Probable etiological infections were tonsillopharyngitis in 133 (60.5%), pyoderma in 12 (5.5%), other infections in 27 (12.2%) children. In 48 (21.8) children with AGN, no primary infection were detected. Edema was found in 81.4% of patients, hypertension in 73.6%, and pulmonary stasis in 22.6%. Low C3 levels were found in 89.1%, azotemia in 45.9%, hematuria in 95.4%, nephritic proteinuria in 80.5%, and leukocyturia in 37.6% of patients. Diuresis was enabled within one week in 82%. Additional vasodilators were given to 45 (20.5%) patients, and hemodialysis was performed to three. Except for frequency of low C3 (p=0.018) and anemia (p=0.006), no significant differences were found in clinical and laboratory findings between age groups (p>0.05). Conclusions: No difference was found in clinical and laboratory features of AGN based on age groups, excluding low C3 and anemia frequency. J Clin Exp Invest 2012; 3 (3): 357-362.
Objectives: The aim of this study was to examine clinical and laboratory characteristics of children with AGN in a tertiary university hospital. Materials and methods: Hospital records of children which hospitalized with AGN diagnosis in Pediatric Nephrology Unit, between 2004 and 2011, were retrospectively reviewed. Patients were divided into three subgroups as age <5 years, 5-10 years and >10 years. Characteristics at hospital admission including, blood pressure, diuresis state, serum urea, creatinine and electrolyte levels, complement factors C3 and C4, complete blood count and urine analysis results were recorded. Data about primary infection, treatments, disease course and outcome were recorded and analyzed. Results: Totally 220 children (157 male, 71.2%; 63 female, 28.8%) were included. Probable etiological infections were tonsillopharyngitis in 133 (60.5%), pyoderma in 12 (5.5%), other infections in 27 (12.2%) children. In 48 (21.8) children with AGN, no primary infection were detected. Edema was found in 81.4% of patients, hypertension in 73.6%, and pulmonary stasis in 22.6%. Low C3 levels were found in 89.1%, azotemia in 45.9%, hematuria in 95.4%, nephritic proteinuria in 80.5%, and leukocyturia in 37.6% of patients. Diuresis was enabled within one week in 82%. Additional vasodilators were given to 45 (20.5%) patients, and hemodialysis was performed to three. Except for frequency of low C3 (p=0.018) and anemia (p=0.006), no significant differences were found in clinical and laboratory findings between age groups (p>0.05). Conclusions: No difference was found in clinical and laboratory features of AGN based on age groups, excluding low C3 and anemia frequency. J Clin Exp Invest 2012; 3 (3): 357-362.
Açıklama
Anahtar Kelimeler
Akut glomerulonefrit, Çocukluk çağı, Klinik bulgular, Laboratuvar değerleri, Yaş grupları, Acute glomerulonephritis, Childhood, Clinical findings, Laboratory findings, Age grops
Kaynak
Journal of Clinical and Experimental Investigations
WoS Q Değeri
Scopus Q Değeri
Cilt
3
Sayı
3
Künye
Güneş, A., Ece, A., Yel, S., Yolbaş, İ., Uluca, Ü., Tan, İ. ve diğerleri. (2012). Çocuklarda akut glomerülonefrit: Üçüncü basamak sağlık merkezinde yedi yıllık deneyim. Journal of Clinical and Experimental Investigations, 3(3), 357-362.
