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Kardiyoloji Pratiğinde Albüminüri/Proteinüri: Kardiyologlar İdrar Testi İstiyorlar mı?

Albuminuria/Proteinuria in Cardiology Practice: Do Cardiologists Ask For Urine Testing?

Journal Name:

Publication Year:

DOI: 
10.5262/tndt.2014.1001.09
Abstract (2. Language): 
OBJECTIVE: Even a small amount of albumin in urine is predictive of cardiovascular morbidity and mortality, not only in patients with diabetes or hypertension but also in the general population. We hypothesized that determination of urinary protein excretion is usually not included in the laboratory work-up of most patients in cardiology practice. MATERIAL and METHODS: One thousand forty two patients who underwent coronary angiography during a one-year period were included. The total number of urine tests for evaluating albuminuria/ proteinuria ordered for the patients during the 12 months preceding angiography was recorded. Types of urine tests were recorded as routine dipstick urinalysis, 24 hour urine collection for albuminuria or proteinuria, and protein/creatinine or albumin/creatinine ratios. RESULTS: No urine tests were ordered in 642 (61.6%) patients. Spot urinalysis for dipstick proteinuria was the most common test for proteinuria evaluation (35.7% of the patients). 24-hour urine collection for albuminuria/proteinuria was ordered in 56 (5.4%) patients and spot urine albumin or protein/ creatinine ratio in 56 (5.4%) patients. CONCLUSION: This study has shown that urine testing is rarely ordered in a high-risk population who had coronary angiography. Omission of such an important, but easy to measure parameter in assessing risk status may jeopardize the overall care of these patients.
Abstract (Original Language): 
AMAÇ: Çok sayıda çalışmada, idrarda az miktarda albümin atılımının bile kardiyovasküler olayların ve tüm nedenlere ve kardiyovasküler olaylara bağlı mortalitenin önemli bir belirteci olduğu gösterilmiştir. İdrarda albüminüri incelemesi, yüksek riskli durumlarda standart bakımın bir kalite belirteci olarak kabul edilebilir. Bu çalışmada, koroner anjiyografi yapılan hastalarda idrar testinin istenme sıklığı incelendi. GEREÇ ve YÖNTEMLER: Bir yıllık süre içinde koroner anjiyografi yapılan 1044 hasta çalışmaya dahil edildi. İşlem tarihinden önceki on iki aylık dönemde proteinüri saptamak için yapılmış olan idrar tetkikleri hastanenin bilgisayarlı tıbbi kayıt sistemi kullanılarak kaydedildi. İdrar tetkikleri; spot idrarda dipstik testi, spot idrar albümin/kreatinin veya protein/kreatinin oranı ve yirmidört saatlik idrarda albüminüri veya proteinüri olarak sınıfl andırıldı. BULGULAR: Çalışmaya alınan hastaların 642 sinde (%61,6) herhangi bir yöntemle proteinüri incelenmemişti. Proteinüri incelemek için kullanılan en sık yöntem spot idrar dipstik testiydi. (%35,7). 24 saatlik idrarda albümin veya protein 56 hastada (%5,4) ve spot idrarda albümin/kreatinin oranı veya protein/kreatinin oranı 56 hastada (%5,4) incelenmişti. SONUÇ: Bu çalışmada, koroner anjiyografi yapılan yüksek riskli hastalarda idrar testinin nadiren kullanıldığı gösterilmiştir. Risk değerlendirmesinde bu kadar önemli ve aynı zamanda kolay ölçülebilir bir parametrenin kullanılmaması, bu hastaların tedavi yönetiminde eksikliğe sebep olabilir.
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