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Son Dönem Böbrek Yetmezliği Hastalarının 5 Yıllık Retrospektif Analizi: Tek Merkez Deneyimi

A Retrospective Analysis of Five Year Data of End-Stage Renal Disease Patients: A Single Center Experience

Journal Name:

Publication Year:

DOI: 
10.5262/tndt.2011.1002.07
Abstract (2. Language): 
ObjectI ves : CKD is a worldwide threat to public health. Approximately 1.8 million people are currently being treated with renal replacement therapy including hemodialysis, peritoneal dialysis and transplantation. The etiology and factors affecting the progression of chronic kidney disease to endstage renal disease (ESRD) differ in industrialized and underdeveloped countries. Study DesIg n: The aim of the study was to investigate the etiologies of ESRD, factors affecting progression to ESRD and mortality rates of patients between 2000-2004, in Konya, a city in the Middle Anatolian region of Turkey. MA TERIAL and Metho dS: We included 417 end-stage renal disease patients (207 female and 210 male) between 16-90 years old receiving RRT for the first time in the study. CKD was diagnosed by GFR measurement that was calculated by MDRD formula. Co-morbidity was expressed using Wright- Khan index. Res ults : We showed that there was an increased rate of diabetic nephropathy between 2003 and 2004. The increased rate of diabetic nephropathy was found to be statistically significant in the last two years (p<0.005). There was also significant negative correlation between mortality and diastolic BP (r: -0.143, p: 0.05) and the education level of the patients (r: -0.159, p: 0.0002). There was a positive correlation between mortality and serum urea levels (r: 0.193, p: 0.0001), HD through a catheter for the first time (r: 0.140, p: 0.0006), and receiving HD by a continuous RRT modality (r: 0.163, p: 0.0001). ConclusIo n: Our study showed that advanced age, increased mean arterial BP before the first RRT, having CVD or DM as an etiology of ESRD, increased erythrocyte sedimentation rate (ESR), decreased serum albumin levels and the presence of co-morbid diseases were the main factors that affected survival of the patients.
Abstract (Original Language): 
Amaç: Kronik böbrek hastalığı tüm dünyayı tehdit eden bir sorundur.Yaklaşık olarak 1.8 milyon kişi periton diyalizi, hemodiyaliz ve transplantasyon ile tedavi edilmektedir. KBY etiyolojisi ve ilerlemeye neden olan etmenler gelişmiş ve gelişmekte olan ülkelerde farklılık göstermektedir. Bu çalışmada 2000-2004 yılları arasında Türkiye’nin İç Anadolu bölgesinde yer alan Konya ilinde son dönem böbrek yetmezliği hastalarının etiyolojileri, hastalığın ilerlemesine neden olan etmenleri ve mortalite nedenlerini araştırmayı hedefledik. GEREÇ ve Yönte mLER: Çalışmamıza yaşları 16-90 arasında son dönem böbrek yetmezliği bulunan 417 hasta (207 kadın, 210 erkek) alındı. KBH tanısı MDRD formülü kullanılarak konuldu. Yandaş hastalıklar Wright-Khan ko-morbidite indeksi kullanılarak değerlendirildi. Bulgular: Çalışmamızda, 2003-2004 yılları arasında diyabetik nefropati sıklığında artış saptandı (p<0,005). Mortalite ile hastaların diyastolik kan basıncı ve eğitim durumu arasında istatistiksel olarak anlamlı negatif korelasyon saptanırken, serum üre düzeyi, HD’e kateter yoluyla girmek ve RRT olarak HD’e devam edilmesi arasında anlamlı olarak pozitif korelasyon bulundu. Sonuç: Çalışmamızda, ileri yaş, ilk RRT öncesinde yüksek ortalama kan basıncı varlığı, kardiyovasküler hastalık mevcudiyeti, SDBY nedeni olarak diyabetin saptanması, artmış ESH, serum albumin düzeyinin düşüklüğü ve ko-morbid hastalıkların varlığı ile hastaların yaşam süreleri arasında ilişki tespit edildi.
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REFERENCES

References: 

1. World Health Organization-Burden of Disease Project available at:
http://www.3.who_int/whosis/menu.cfm?path=evidence blaoS
2. Coresh J, Selvin E, Stevens LA, Manzi J, Kusek JW, Eggers P, Van
Lente F, Levey AS: Prevalence of chronic kidney disease in the
United States. JAMA 2007; 298(17): 2038-2047
3. Erek E, Süleymanlar G, Serdengeçti K: TND Registry Grubu: Türk
Nefroloji Dernegi Kayit Sistemi Raporlari 1992–2008. Available at:
http//www.tsn.org.tr/
4. Orzano AJ, Scott JG: Diagnosis and treatment of obesity in adults:
An applied evidence-based review. J Am Board Fam Pract 2004;
17(5): 359-369
5. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA,
Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella
EJ; National Heart, Lung, and Blood Institute Joint National
Committee on Prevention, Detection, Evaluation, and Treatment
of High Blood Pressure; National High Blood Pressure Education
Program Coordinating Committee: The Seventh Report of the Joint
National Committee on Prevention, Detection, Evaluation, and
Treatment of High Blood Pressure: The JNC 7 report. JAMA 2003;
289(19): 2560-2572
6. Satman I, Yilmaz T, Sengül A, Salman S, Salman F, Uygur S, Bastar
I, Tütüncü Y, Sargin M, Dinççag N, Karsidag K, Kalaça S, Ozcan C,
King H: Population-based study of diabetes and risk characteristics
in Turkey: Results of the Turkish diabetes epidemiology study
(TURDEP). Diabetes Care 2002; 25(9): 1551-1556
7. Levey AS, Eckardt KU, Tsukamoto Y, Levin A, Coresh J, Rossert J,
De Zeeuw D, Hostetter TH, Lameire N, Eknoyan G: Definition and
classification of chronic kidney disease: A position statement from
Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int
2005; 67(6): 2089-2100
Türkmen K et al : A Retrospective Analysis of Five Year Data of End-Stage
Renal Disease Patients
162 Turk Neph Dial Transpl 2011; 20 (2): 156-162
Türk N efroloji D iyaliz ve Transplantasyon D ergisi
Turkish Nephrology, Dialysis and Transplantation Journal
8. Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen
S, Kusek JW, Van Lente F; Chronic Kidney Disease Epidemiology
Collaboration: Using standardized serum creatinine values in the
modification of diet in renal disease study equation for estimating
glomerular filtration rate. Ann Intern Med 2006; 145(4): 247-254
9. Wright LF: Survival in patients with end-stage renal disease. Am J
Kidney Dis 1991; 17(1): 25-28
10. Khan IH, Catto GR, Edward N, Fleming LW, Henderson IS,
MacLeod AM: Influence of coexisting disease on survival on renalreplacement
therapy. Lancet 1993; 341(8842): 415-418
11. Kazmi WH, Obrador GT, Khan SS, Pereira BJ, Kausz AT: Late
nephrology referral and mortality among patients with end-stage
renal disease: A propensity score analysis. Nephrol Dial Transplant
2004; 19(7): 1808-1814
12. Haroun MK, Jaar BG, Hoffman SC, Comstock GW, Klag MJ,
Coresh J: Risk factors for chronic kidney disease: A prospective
study of 23,534 men and women in Washington County, Maryland.
J Am Soc Nephrol 2003; 14(11): 2934-2941
13. United States Renal Data System: Annual data report. Incidence and
prevalence of ESRD. Am J Kidney Dis 2003; 42: 37-173
14. Chadban SJ, Briganti EM, Kerr PG, Dunstan DW, Welborn TA,
Zimmet PZ, Atkins RC: Prevalence of kidney damage in Australian
adults: The AusDiab kidney study. J Am Soc Nephrol 2003; 14:
131-138
15. Sahin I, Yildirim B, Cetin I, Etikan I, Ozturk B, Ozyurt H, Tasliyurt
T: Prevalence of chronic kidney disease in the Black Sea Region,
Turkey, and investigation of the related factors with chronic kidney
disease. Ren Fail 2009; 31(10): 920-927
16. Suleymanlar G, Utas C, Arinsoy T, Ates K, Altun B, Altiparmak
MR, Ecder T, Yilmaz ME, Camsari T, Basci A, Serdengecti K: A
population-based survey of Chronic Renal Disease In Turkey-the
CREDIT study. Nephrol Dial Transplant 2010
17. Satman I, Yilmaz MT: Dünyada ve Türkiye’de obezite
epidemiyolojisi. Aktüel Tıp Dergisi 2001; 6: 9-12
18. Rayner HC, Pisoni RL, Bommer J, Canaud B, Hecking E, Locatelli
F, Piera L, Bragg-Gresham JL, Feldman HI, Goodkin DA, Gillespie
B, Wolfe RA, Held PJ, Port FK: Mortality and hospitalization in
haemodialysis patients in five European countries: Results from the
dialysis outcomes and practice patterns study (DOPPS). Nephrol
Dial Transplant 2004; 19(1): 108-120
19. Goodkin DA, Young EW, Kurokawa K, Prutz KG, Levin NW:
Mortality among hemodialysis patients in Europe, Japan and the
United States: Case-mix effects. Am J Kidney Dis 2004; 44: 16-21
20. Chantrel F, Enache I, Bouiller M, Kolb I, Kunz K, Petitjean P,
Moulin B, Hannedouche T: Abysmal prognosis of patients with type
2 diabetes entering dialysis. Nephrol Dial Transplant 1999; 14(1):
129-136
21. Vonesh EF, Snyder JJ, Foley RN, Collins AJ: The differential impact
of risk factors on mortality in hemodialysis and peritoneal dialysis.
Kidney Int 2004; 66(6): 2389-2401
22. Miskulin DC, Martin AA, Brown R, Fink NE, Coresh J, Powe NR,
Zager PG, Meyer KB, Levey AS; Medical Directors, Dialysis Clinic,
Inc: Predicting 1 year mortality in an outpatient haemodialysis
population: A comparison of comorbidity instruments. Nephrol Dial
Transplant 2004; 19(2): 413-420
23. Iseki K, Kawazoe N, Fukiyama K: Serum albumin is a strong
predictor of death in chronic dialysis patients. Kidney Int 1993;
44(1): 115-119

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