Yıl: 2024 Cilt: 10 Sayı: 1 Sayfa Aralığı: 100 - 107 Metin Dili: Türkçe DOI: 10.53394/akd.1136799 İndeks Tarihi: 27-03-2024

Renal Replasman Tedavisi Almayan Evre 3-5 Kronik Böbrek Hastalığı Olan Hastalarda Vitamin D Düzeyinin İnflamatuvar Parametreler ve Proteinüri ile İlişkisi

Öz:
Amaç: Kronik böbrek hastalığı (KBH) ve proteinürisi olan hastalarda artan inflamasyon ve oksidatif stresin kardiyovasküler mortaliteyi artırdığı gösterilmiştir. Vitamin D’nin (VD) organizmada birçok işlevinin olduğu son dekatlarda VD reseptörünün farklı dokularda gösterilmesiyle anlaşılmıştır. Biz bu çalışmada KBH olan hastalarda VD düzeyinin, inflamatuvar parametreler ve proteinüri ile ilişkisini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Bu çalışmaya nefroloji polikliniğinde takip edilen ve henüz renal replasman tedavisi almamış, evre 3-5 KBH hastaları arasından dahil etme kriterlerini karşılayan 314 hasta alındı. Katılımcıların verileri retrospektif ve kesitsel olarak incelendi. Demografik özellikleri, kreatinin, tahmini glomerüler filtrasyon hızı (GFH), serum kalsiyum, albumin, fosfor, 25(OH)D3 parathormon (PTH), spot idrarda protein/kreatinin oranı, nötrofil, lenfosit, platelet, nötrofil/lenfosit oranı (NLO) ve platelet/lenfosit oranı (PLO) kaydedildi. Serum 25(OH)D3 düzeyine göre; VD eksikliği olanlar, (<10 ng/ml), VD yetersizliği olanlar (10-29 ng/ml) ve VD düzeyi normal olanlar (>29 ng/ml) olmak üzere 3 grup oluşturuldu. Gruplar, inflamatuvar parametreler ve proteinüri düzeyi yönünden karşılaştırıldı. Analizler SPSS 23.0 programı ile yapıldı. Bulgular: VD grupları arasında inflamatuvar parametreler (CRP, NLO ve PLO) açısından fark saptanmadı. Spot idrarda protein/kreatinin oranı; VD eksikliği olanlarda, hem VD yetersizliği olanlardan (p=0,007) hem de VD düzeyi normal olanlardan (p=0,001) yüksekti. Ayrıca yapılan korelasyon analizinde VD düzeyi ile proteinüri arasında negatif korelasyon olduğu görüldü (r:-0,267; p<0,01). Nefrotik düzeyin altında proteinürisi olan bireylerde de VD düzeyi ve proteinüri ilişkisinin korunduğu saptandı (p=0,018). Sonuç: VD eksikliği olan hastalarda proteinüri miktarı daha yüksek saptandı. Ayrıca proteinüri düzeyi ile VD düzeyinin negatif korelasyon gösterdiği ve bu ilişkinin nefrotik düzeyin altında proteinürisi olan hastalarda da korunduğu görüldü. Bu noktada renal ve kardiyovasküler açıdan önemli bir risk faktörü olan proteinürinin azaltılması noktasında VD’nin rolü gündeme gelebilir.
Anahtar Kelime: D vitamini ve proteinüri Kronik böbrek hastalığı ve inflamasyon İnflamasyon Proteinüri

The Association of Vitamin D Status with Inflammatory Parameters and Proteinuria in Patients with Stage 3-5 Chronic Kidney Disease who are not on Renal Replacement Therapy

Öz:
Objective: It has been demonstrated that increased oxidative stress and inflammation are associated with increased cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD) and proteinuria. In recent years, it has been understood that vitamin D (VD) has many roles, with the demonstration of the VD receptor in many tissues. In this study, we wanted to assess the association of VD level with inflammatory parameters and proteinuria in individuals with CKD. Material and Methods: The study included 314 patients who were followed up in the nephrology outpatient clinic with the diagnosis of CKD, had not received renal replacement therapy yet and met the inclusion criteria. The data of the participants were analyzed retrospectively and cross-sectionally. Demographic characteristics, creatinine, estimated glomerular filtration rate (eGFR), serum calcium, albumin, phosphorus, 25(OH)D3, parathormone (PTH), spot urine protein/creatinine ratio, neutrophil, lymphocyte, platelet, neutrophil/lymphocyte ratio (NLR) and platelet /lymphocyte ratio (PLR) were recorded. According to serum 25(OH)D3 level; three groups were formed those with VD deficiency (<10 ng/ml), those with VD insufficiency (10-29 ng/ml), and those with normal VD level (>29 ng/ml). The groups were compared in terms of inflammatory parameters and proteinuria levels. Analyses were performed by using the SPSS 23.0 program. Results: There is no difference between the VD groups in terms of inflammatory parameters (CRP, NLR, and PLR). The protein/creatinine ratio in spot urine is higher in patients with VD deficiency than both those with VD insufficiency (p=0.007) and those with normal VD levels (p=0.001). In addition, a negative correlation was found between VD level and proteinuria (r=-0.267; p<0.01). It was found that the association between VD level and proteinuria was preserved in individuals with proteinuria below the nephrotic level (p=0.018). Conclusion: It was observed that the proteinuria level was negatively correlated with the VD level and reached higher values in those with VD deficiency. At this point, the role of VD in reducing proteinuria, which is an important factor in renal and cardiovascular terms, may become a current issue.
Anahtar Kelime: Vitamin D and proteinuria Chronic kidney disease and inflam- mation Inflammation Proteinuria

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA DOĞRUEL H, bora f, Ersoy F (2024). Renal Replasman Tedavisi Almayan Evre 3-5 Kronik Böbrek Hastalığı Olan Hastalarda Vitamin D Düzeyinin İnflamatuvar Parametreler ve Proteinüri ile İlişkisi. , 100 - 107. 10.53394/akd.1136799
Chicago DOĞRUEL HAKAN,bora feyza,Ersoy Fettah Fevzi Renal Replasman Tedavisi Almayan Evre 3-5 Kronik Böbrek Hastalığı Olan Hastalarda Vitamin D Düzeyinin İnflamatuvar Parametreler ve Proteinüri ile İlişkisi. (2024): 100 - 107. 10.53394/akd.1136799
MLA DOĞRUEL HAKAN,bora feyza,Ersoy Fettah Fevzi Renal Replasman Tedavisi Almayan Evre 3-5 Kronik Böbrek Hastalığı Olan Hastalarda Vitamin D Düzeyinin İnflamatuvar Parametreler ve Proteinüri ile İlişkisi. , 2024, ss.100 - 107. 10.53394/akd.1136799
AMA DOĞRUEL H,bora f,Ersoy F Renal Replasman Tedavisi Almayan Evre 3-5 Kronik Böbrek Hastalığı Olan Hastalarda Vitamin D Düzeyinin İnflamatuvar Parametreler ve Proteinüri ile İlişkisi. . 2024; 100 - 107. 10.53394/akd.1136799
Vancouver DOĞRUEL H,bora f,Ersoy F Renal Replasman Tedavisi Almayan Evre 3-5 Kronik Böbrek Hastalığı Olan Hastalarda Vitamin D Düzeyinin İnflamatuvar Parametreler ve Proteinüri ile İlişkisi. . 2024; 100 - 107. 10.53394/akd.1136799
IEEE DOĞRUEL H,bora f,Ersoy F "Renal Replasman Tedavisi Almayan Evre 3-5 Kronik Böbrek Hastalığı Olan Hastalarda Vitamin D Düzeyinin İnflamatuvar Parametreler ve Proteinüri ile İlişkisi." , ss.100 - 107, 2024. 10.53394/akd.1136799
ISNAD DOĞRUEL, HAKAN vd. "Renal Replasman Tedavisi Almayan Evre 3-5 Kronik Böbrek Hastalığı Olan Hastalarda Vitamin D Düzeyinin İnflamatuvar Parametreler ve Proteinüri ile İlişkisi". (2024), 100-107. https://doi.org/10.53394/akd.1136799
APA DOĞRUEL H, bora f, Ersoy F (2024). Renal Replasman Tedavisi Almayan Evre 3-5 Kronik Böbrek Hastalığı Olan Hastalarda Vitamin D Düzeyinin İnflamatuvar Parametreler ve Proteinüri ile İlişkisi. Akdeniz Tıp Dergisi, 10(1), 100 - 107. 10.53394/akd.1136799
Chicago DOĞRUEL HAKAN,bora feyza,Ersoy Fettah Fevzi Renal Replasman Tedavisi Almayan Evre 3-5 Kronik Böbrek Hastalığı Olan Hastalarda Vitamin D Düzeyinin İnflamatuvar Parametreler ve Proteinüri ile İlişkisi. Akdeniz Tıp Dergisi 10, no.1 (2024): 100 - 107. 10.53394/akd.1136799
MLA DOĞRUEL HAKAN,bora feyza,Ersoy Fettah Fevzi Renal Replasman Tedavisi Almayan Evre 3-5 Kronik Böbrek Hastalığı Olan Hastalarda Vitamin D Düzeyinin İnflamatuvar Parametreler ve Proteinüri ile İlişkisi. Akdeniz Tıp Dergisi, vol.10, no.1, 2024, ss.100 - 107. 10.53394/akd.1136799
AMA DOĞRUEL H,bora f,Ersoy F Renal Replasman Tedavisi Almayan Evre 3-5 Kronik Böbrek Hastalığı Olan Hastalarda Vitamin D Düzeyinin İnflamatuvar Parametreler ve Proteinüri ile İlişkisi. Akdeniz Tıp Dergisi. 2024; 10(1): 100 - 107. 10.53394/akd.1136799
Vancouver DOĞRUEL H,bora f,Ersoy F Renal Replasman Tedavisi Almayan Evre 3-5 Kronik Böbrek Hastalığı Olan Hastalarda Vitamin D Düzeyinin İnflamatuvar Parametreler ve Proteinüri ile İlişkisi. Akdeniz Tıp Dergisi. 2024; 10(1): 100 - 107. 10.53394/akd.1136799
IEEE DOĞRUEL H,bora f,Ersoy F "Renal Replasman Tedavisi Almayan Evre 3-5 Kronik Böbrek Hastalığı Olan Hastalarda Vitamin D Düzeyinin İnflamatuvar Parametreler ve Proteinüri ile İlişkisi." Akdeniz Tıp Dergisi, 10, ss.100 - 107, 2024. 10.53394/akd.1136799
ISNAD DOĞRUEL, HAKAN vd. "Renal Replasman Tedavisi Almayan Evre 3-5 Kronik Böbrek Hastalığı Olan Hastalarda Vitamin D Düzeyinin İnflamatuvar Parametreler ve Proteinüri ile İlişkisi". Akdeniz Tıp Dergisi 10/1 (2024), 100-107. https://doi.org/10.53394/akd.1136799