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Malnütrisyon ve Böbrek Fonksiyonları

Malnutrition and Renal Functions

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2006

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Background: Malnutrition is the most common cause of mortality in the world. Previous studies have confirmed significant alterations in renal functions in malnutrition. There is no data about urinary excretion of N-acetyl-P-D-glucosaminidase (NAG) and alanin aminopeptidase (AAP) in malnutrition. Objective: We investigated renal functions and renal tubular damage in children with malnutrition. Methods: Patients with malnutrition (n=20) and healthy controls (n=10) were included into the study. Blood and urine creatinine, Na, K, C l , Ca, P, M g and uric acid levels were studied. Urine N-acetyl-P--D-glucosaminidase (NAG) and alanin aminopeptidase (AAP) levels were measured. Endogen creatinine clearance, tubu¬ lar P reabsorbtion (TRP), fractional Na and K excretion (FENa, FEK), renal failure index were calculated. Na/Cr, K/Cr, Ca/Cr, P/Cr, Mg/Cr, uric acid/Cr ratios were calculated. Results: Serum total protein, albumin, calcium and P levels were significantly lower in children with PEM (p<0.05). Urine P le¬ vels and endogen creatinine clearance were significantly lower in children with PEM (p<0.05). Calcium excretions, calcium/creatinine and sodium/potassium ratios were significantly higher in children with PEM (p<0.05). Urine NAG and A A P levels in children with PEM were low but there was no statistically significant difference (p>0.05). Discussion: We demonstrated that children with malnutrition had a decreased glomerular filtration rate and increased urinary excretion of Na, K, Ca. We consider that there is no tubular damage in malnutrition but there are functional changes in kidney.
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Abstract (Original Language): 
Giriş: Malnütrisyon, t üm dünyada ölüm sebepleri arasında oldukça sık görülmektedir. Protein enerji malnütrisyonunda böbrek hemodinamiğinde, böbrek konsantrasyon kapasitesinde ve böbrek asit atılımında değişiklik olmaktadır. Malnütrisyonda, N-asetil-^-Dglukozaminidaz (NAG) ve alanin aminopeptidazın (AAP) idrarla atılımına ait çalışma bulunmamaktadır. Amaç: Bu çalışmanın amacı, protein enerji malnütrisyonunda böbrek fonksiyonlarını ve böbreklerde tübüler hasar oluşumunu araştırmaktır. Yöntem: Çalışmaya malnütrisyonu olan 20 çocuk ve 10 sağlıklı çocuk alındı. T üm çocukların, idrar ve kan kreatinin, Na, K, C l , Ca, P, M g ve ürik asit düzeylerine bakıldı. İdrar N-asetil-P-D-glukozaminidaz (NAG) ve alanin aminopeptidaz (AAP) düzeyleri ölçüldü. Endojen kreatinin klirensi, tübüler P geri emilimi (TRP), fraksiyone Na ve K ekskresyonu (FENa, FEK) hesaplandı. Na/Cr, K/Cr, Ca/Cr, P/Cr, Mg/Cr, ürik asit/Cr oranları belirlendi. Bulgular: Serum total protein, albümin, kalsiyum ve P düzeyleri manütrisyonlu çocuklarda anlamlı düzeyde düşük bulundu (p<0.05). İdrar P düzeyleri, endojen kreatinin klirensi malnütrisyonlu çocuklarda daha düşüktü (p<0.05). İdrarda kalsiyum atılımı, kalsiyum/ kreatinin ve sodyum/potasyum oranları malnütrisyonlu ço¬ cuklarda daha yüksek, P/kreatinin oranı ise daha düşük bulundu (p<0.05). İdrar NAG ve idrar A A P düzeyleri malnütrisyonlu çocuklarda daha düşük olmakla beraber, istatistiksel olarak anlamlı fark saptanmadı (p>0.05). Tartışma: Sonuç olarak, çalışmamızda, malnütrisyonlu çocuk¬ larda glomerüler filtrasyon hızının azaldığı ve idrarla Na, K, Ca atı¬ lımında artış olduğu görülmüştür. Elde ettiğimiz veriler, malnütrisyonda böbrekte tübüler hasar olmadığını, ancak fonksiyonel deği¬ şiklikler olduğunu düşündürmektedir.
FULL TEXT (PDF): 
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  • 2
94-100
  • Turkish

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Official Journal of the Turkish Society of Nephrology / Türk Nefroloji Diyaliz ve Transplantasyon Dergisi
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9 Malnutrition and Renal Functions
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