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DIGITAL BENZERİ İMMÜN REAKTİF MADDE (DLIS) : KURU AĞIRLIĞIN BELİRLENMESİNDE YENİ BİR UFUK MU ?

DIGITALIS-LIKEIMMUNOREACTIVE SUBSTANCE (DLIS) : A NEW HORIZON IN DETERMINING THE DRY WEIGHT ?

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2002

Key Words:

Keywords (Original Language):

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Abstract (2. Language): 
Perfect assessment of dry weight in hemodialysis patients has a vital importance. Intravascular hypervolemia increases the levels of digitalis-like immunoreactive substance (DLIS) and atrial natriuretic peptide (ANP). Since endogenous DLIS gives cross-reaction to anti-digoxin antibodies, the levels of DLIS were determined by two seperate techniques, FPIA (fluorescence polarization enzyme immunoassay) and MEIA (microparticle enzyme immunoassay). The basal levels of DLIS-FPIA,DLIS-MEIA and ANP in forty-two hemodialysis patients were significantly higher compared to control (n:20) (p<0.05). The strong positive correlation between DLIS-FPIAandDLIS-MEIA (r:0.894, p<0.001) made us think that these two markers could be used interchangeably. Compared to the corresponding parameters of forty-two hemodialysis patients, DLIS and ANP levels of eleven patients, selected as hypervolemic by conventional criteriae, were higher. After three months of ultrafiltration treatment, we determined that the levels of DLIS and ANP decreased significantly approaching control levels. We concluded that the tests of DLIS and ANP were useful to assess dry weight and to determine the intravascular volume response to ultrafiltration treatment
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Abstract (Original Language): 
Hemodiyaliz hastalarında kuru ağırlığın hatasız olarak ölçülmesi yaşamsal önem taşımaktadır. Intravasküler hipervolemi digital benzeri immiinreaktif madde (digitalis-like immunoreactive substance:DLIS) ve atrial natriüretik peptid (ANP) düzeylerini arttırmaktadır. Endojen DLIS'in anti-digoksin antikorları ile verdiği çapraz reaksiyon nedeniyle, DLIS düzeyleri FPIA (floresan polarizasyon enzim immünassay) ve MEIA (mikropartikül enzim immünassay) yöntemleriyle belirlenmiştir. İncelemeye alınan 42 hemodiyaliz hastasının bazal DLIS-FPIA, DLIS-MEIA ve ANP düzeyleri kontrol grubundan (n:20) daha yüksek bulunmuştur (p<0.05). DLIS-FPIA ve DLIS-MEIA arasındaki kuvvetli pozitif korelasyon (r:0.894,p<0.001), bu iki testin birbiri yerine kullanılabileceğini düşündürmüştür. Tüm hemodiyaliz hastaları içinden konvansiyonel kriterlere göre hipervolemik olduğu saptanan 11 hastanın DLIS ve ANP düzeyleri, genel diyaliz populasyonunun benzer parametrelerinden daha yüksek bulunmuştur. Üç aylık ultrafiltrasyon işleminin sonunda DLIS ve ANP düzeylerinin anlamlı olarak azaldığı ve kontrol grubu değerlerine ulaştığı belirlenmiştir. DLIS ve ANP testlerinin kuru ağırlığı belirlemede yararlı olduğu ve ultrafiltrasyona alınan yanıtın değerlendirilmesinde tanısal değere sahip olduğu sonucuna varılmıştır.
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  • 3
153-157
  • Turkish

REFERENCES

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