Böbrek işlev bozukluğu veya diyabetin eşlik ettiği kronik kalp yetersizliğinde hiperkalemi: TREAT HF gerçek yaşam verileri
Yıl: 2021 Cilt: 49 Sayı: 3 Sayfa Aralığı: 198 - 205 Metin Dili: Türkçe DOI: 10.5543/tkda.2021.58675 İndeks Tarihi: 28-01-2022
Böbrek işlev bozukluğu veya diyabetin eşlik ettiği kronik kalp yetersizliğinde hiperkalemi: TREAT HF gerçek yaşam verileri
Öz: Amaç: Kronik böbrek hastalığı (KBH) ve diabetes mellitus (DM), kalp yetersizliği (KY) hasta grubunda sık görülen komorbid durumlardır. Hiperkalemi riski KY hastalarında yüksektir ve hastaları optimal KY tedavisinden alıkoymaktadır. Bu çalışmada; gerçek yaşamdaki klinik uygulamada KBH veya DM olan KY hastalarında hiperkalemi prevalansını değerlendirmek amacıyla TREAT HF verileri analiz edildi Yöntemler: TREAT HF, çok merkezli, ulusal, gözlemsel çalışmalar yapan kayıt çalışmasıdır. Bu çalışmada kronik KY tanısı alan 1028 hastanın potasyum ve glomeruler filtrasyon hızı (eGFR) değeri analiz edildi. Potasyum >5 mEq/L olarak tanımlanan hiperkalemi KBH, DM, ilaç kullanımı ve New York Heart Association’a (NYHA) göre değerlendirildi. Bulgular: Tüm hastaların %14.3’ünde (n=147) hiperkalemi (>5 mEq/L) saptandı. eGFR<60 mL/dk/1.73 m2olan hastalarda hiperkalemi, eGFR≥60 mL/dk/1.73 m2 olanlara göre çok daha yaygındı (sırasıyla %17.7 ve %12 p=0.011). Evre-1 böbrek fonksiyonuna sahip hastaların %10.9’unda (n=23), Evre-2 hastaların %12.6’sında (n=50), Evre-3 hastaların %17.0’ında (n=52) ve Evre 4-5 böbrek fonksiyon bozukluğu olan hastaların %19.5’inde (n=22) hiperkalemi saptandı. Hiperkalemi DM’li hastalarda da anlamlı olarak daha yüksekti (%20.5’e karşı %12.3, p=0.001). Ayrıca, eGFR<60 mL/dk/1.73 m2olan diyabetik hastalarda hiperkalemi görülme oranı çok daha yüksek saptandı (%25.2). NYHA sınıfı kötüleştikçe hiperkalemi görülme oranı artmaktaydı (NYHA-I: %9.8, NYHA-II: %12.8, NYHA-III: %14.4 ve NYHA-IV: %23.4, p=0.032). Renin anjiyotensin aldosteron sistemi (RAAS) inhibitörü alan Evre 4-5 KBH olan hastalarda, RAAS inhibitörü almayanlara göre daha fazla hastada hiperkalemi saptandı (sırasıyla %23.4 ve %12.5). Sonuç: Bu çalışmanın sonuçları; gerçek yaşamdaki klinik uygulamada, tüm KY olgularının %14.3’ünde, KBH olguların %17.7’sinde ve DM’li hastaların %20.5’inde hiperkalemi olduğunu göstermektedir. Hiperkalemi riski, böbrek fonksiyonu veya NYHA sınıfı kötüleştikçe artmakta ve RAAS inhibitörü tedavisi alanlarda daha yüksek bulunmaktadır.
Anahtar Kelime: Hyperkalemia in chronic heart failure with renal dysfunction or diabetes mellitus: Results from the TREAT HF study
Öz: Objective: Chronic kidney disease (CKD) and diabetes mellitus (DM) are common comorbidities in heart failure (HF). Patients with HF are at a high risk of hyperkalemia, and are therefore undertreated with respect to disease-modifying therapies. The Turkish Research Team-Heart Failure (TREAT HF) data were analyzed for the evaluation of hyperkalemia in real-life clinical practice in HF patients with CKD or DM. Methods: The TREAT HF is a multicenter, national, observational registry. In this study, potassium levels of 1028 patients with HF were analyzed. Hyperkalemia is defined as blood potassium levels >5 mEq/L and evaluated based on the CKD, DM, HF medications, and New York Heart Association (NYHA) classes. Results: Overall, 14.3% of patients (n=147) were found to have hyperkalemia. Hyperkalemia was more prevalent in patients with estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2than those with eGFR ≥60 mL/min/1.73 m2 (17.7% and 12%, respectively, p=0.010). Hyperkalemia was present in 10.9% (n=23) of patients with stage 1, 12.6% (n=50) with stage 2, 17.0% (n=52) with stage 3, and 19.5% (n=22) with stage 4-5 CKD. Hyperkalemia was higher in patients with DM (20.5% vs 12.3%, p=0.001). Furthermore, hyperkalemia was much higher in patients with DM with eGFR <60 mL/min/1.73 m2(25.2%). The rate of hyperkalemia increased across NYHA categories (NYHA-I: 9.8%, NYHA-II: 12.8%, NYHA-III: 14.4%, and NYHA-IV: 23.4%, p=0.030). In patients with stage 4-5 CKD who were receiving renin-angiotensin-aldosterone system (RAAS) inhibitor therapy, more patients had hyperkalemia than those not receiving RAAS inhibitor therapy (23.4% and 12.5%, respectively). Conclusion: In clinical practice, 14.3% of all patients with HF, 17.7% of all patients with CKD, and 20.5% of all patients with DM have hyperkalemia. The risk of hyperkalemia increases with advanced stages of CKD or NYHA and the risk is higher in patients receiving RAAS inhibitor therapy.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | MURAT S, Kaya H, Çavuşoğlu Y, YILMAZ M (2021). Böbrek işlev bozukluğu veya diyabetin eşlik ettiği kronik kalp yetersizliğinde hiperkalemi: TREAT HF gerçek yaşam verileri. , 198 - 205. 10.5543/tkda.2021.58675 |
| Chicago | MURAT Selda,Kaya Hakkı,Çavuşoğlu Yüksel,YILMAZ MEHMET BIRHAN Böbrek işlev bozukluğu veya diyabetin eşlik ettiği kronik kalp yetersizliğinde hiperkalemi: TREAT HF gerçek yaşam verileri. (2021): 198 - 205. 10.5543/tkda.2021.58675 |
| MLA | MURAT Selda,Kaya Hakkı,Çavuşoğlu Yüksel,YILMAZ MEHMET BIRHAN Böbrek işlev bozukluğu veya diyabetin eşlik ettiği kronik kalp yetersizliğinde hiperkalemi: TREAT HF gerçek yaşam verileri. , 2021, ss.198 - 205. 10.5543/tkda.2021.58675 |
| AMA | MURAT S,Kaya H,Çavuşoğlu Y,YILMAZ M Böbrek işlev bozukluğu veya diyabetin eşlik ettiği kronik kalp yetersizliğinde hiperkalemi: TREAT HF gerçek yaşam verileri. . 2021; 198 - 205. 10.5543/tkda.2021.58675 |
| Vancouver | MURAT S,Kaya H,Çavuşoğlu Y,YILMAZ M Böbrek işlev bozukluğu veya diyabetin eşlik ettiği kronik kalp yetersizliğinde hiperkalemi: TREAT HF gerçek yaşam verileri. . 2021; 198 - 205. 10.5543/tkda.2021.58675 |
| IEEE | MURAT S,Kaya H,Çavuşoğlu Y,YILMAZ M "Böbrek işlev bozukluğu veya diyabetin eşlik ettiği kronik kalp yetersizliğinde hiperkalemi: TREAT HF gerçek yaşam verileri." , ss.198 - 205, 2021. 10.5543/tkda.2021.58675 |
| ISNAD | MURAT, Selda vd. "Böbrek işlev bozukluğu veya diyabetin eşlik ettiği kronik kalp yetersizliğinde hiperkalemi: TREAT HF gerçek yaşam verileri". (2021), 198-205. https://doi.org/10.5543/tkda.2021.58675 |
| APA | MURAT S, Kaya H, Çavuşoğlu Y, YILMAZ M (2021). Böbrek işlev bozukluğu veya diyabetin eşlik ettiği kronik kalp yetersizliğinde hiperkalemi: TREAT HF gerçek yaşam verileri. Türk Kardiyoloji Derneği Arşivi, 49(3), 198 - 205. 10.5543/tkda.2021.58675 |
| Chicago | MURAT Selda,Kaya Hakkı,Çavuşoğlu Yüksel,YILMAZ MEHMET BIRHAN Böbrek işlev bozukluğu veya diyabetin eşlik ettiği kronik kalp yetersizliğinde hiperkalemi: TREAT HF gerçek yaşam verileri. Türk Kardiyoloji Derneği Arşivi 49, no.3 (2021): 198 - 205. 10.5543/tkda.2021.58675 |
| MLA | MURAT Selda,Kaya Hakkı,Çavuşoğlu Yüksel,YILMAZ MEHMET BIRHAN Böbrek işlev bozukluğu veya diyabetin eşlik ettiği kronik kalp yetersizliğinde hiperkalemi: TREAT HF gerçek yaşam verileri. Türk Kardiyoloji Derneği Arşivi, vol.49, no.3, 2021, ss.198 - 205. 10.5543/tkda.2021.58675 |
| AMA | MURAT S,Kaya H,Çavuşoğlu Y,YILMAZ M Böbrek işlev bozukluğu veya diyabetin eşlik ettiği kronik kalp yetersizliğinde hiperkalemi: TREAT HF gerçek yaşam verileri. Türk Kardiyoloji Derneği Arşivi. 2021; 49(3): 198 - 205. 10.5543/tkda.2021.58675 |
| Vancouver | MURAT S,Kaya H,Çavuşoğlu Y,YILMAZ M Böbrek işlev bozukluğu veya diyabetin eşlik ettiği kronik kalp yetersizliğinde hiperkalemi: TREAT HF gerçek yaşam verileri. Türk Kardiyoloji Derneği Arşivi. 2021; 49(3): 198 - 205. 10.5543/tkda.2021.58675 |
| IEEE | MURAT S,Kaya H,Çavuşoğlu Y,YILMAZ M "Böbrek işlev bozukluğu veya diyabetin eşlik ettiği kronik kalp yetersizliğinde hiperkalemi: TREAT HF gerçek yaşam verileri." Türk Kardiyoloji Derneği Arşivi, 49, ss.198 - 205, 2021. 10.5543/tkda.2021.58675 |
| ISNAD | MURAT, Selda vd. "Böbrek işlev bozukluğu veya diyabetin eşlik ettiği kronik kalp yetersizliğinde hiperkalemi: TREAT HF gerçek yaşam verileri". Türk Kardiyoloji Derneği Arşivi 49/3 (2021), 198-205. https://doi.org/10.5543/tkda.2021.58675 |
