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Fokal Segmental Glomerüloskleroz ve Membranöz Glomerülopatili Hastalarda Antiproteinürik Tedavinin Lipit Düzeylerine Etkisi

The Effect of Antiproteinuric Treatment on Lipid Levels in Patients with Focal Segmental Glomerulosclerosis and Membranous Glomerulopathy

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2013
DOI: 
DOI 10.5262/tndt.2013.1001.10

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
OBJECTIVE: The primary objective of our study was to investigate effects of antiproteinuric treatment on lipid levels of patients with idiopathic focal segmental glomerulosclerosis (FSGS) or membranous glomerulonephritis (MGN). MA TERIAL and M ETHODS: The clinical and laboratory data of the patients were recorded at three-month intervals during 18 months of follow-up. Patients with non-nephrotic proteinuria without hypoalbuminemia received conservative treatment while those with more severe disease received steroid therapy as well. Lipid parameters in the two groups and the factors effective on these parameters were investigated. RESUL TS: Sixty eight patients (36 with FSGS, 32 with MG) were included. The mean age of the patients and the follow-up period were 39.6±16.6 years and 16.4±8.9months, respectively. 36 (53%) patients received steroid therapy. The percentage of patients taking antilipemic treatment was statistically significantly higher in the group taking steroid therapy. LDL cholesterol levels were higher at the beginning in patients taking steroid therapy but the difference disappeared after the ninth month. Total and LDL cholesterol levels showed a negative correlation with albumin levels and a positive correlation with proteinuria level. CONCLU SION: Treatment of hyperlipidemia in nephrotic syndrome should be directed towards increasing serum albumin levels, and therefore treatment of the glomerular disease. Antilipidemic therapies should be considered in patients who do not respond to other antiproteinuric treatment.
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Abstract (Original Language): 
AMA Ç: Çalışmamızın amacı, idiopatik fokal segmental glomerüloskleroz (FSGS) ve membranöz glomerülopati (MGN) tanılı hastalarda antiproteinürik tedavinin lipit düzeylerine etkisini incelemektir. GEREÇ ve YÖN TEML ER: Hastaların 18 aylık takibi boyunca üç ay aralarla klinik ve laboratuar bulguları kaydedildi. Hipoalbüminemisi olmayan ve non-nefrotik düzeyde proteinürisi olan hastalar konservatif tedavi alırken; daha ağır proteinürisi olan hastalar aynı zamanda steroid tedavisi aldı. Her iki grupta da lipit parametreleri ve bu parametreler üzerine etkili faktörler araştırıldı. BUL GULA R: 68 hasta (36 FSGS, 32 MGN) çalışmaya alındı. Ortalama yaşları ve takip süreleri sırası ile 39,6±16,6 yıl ve 16,4±8,9 ay olarak saptandı. 36 (%53) hasta steroid tedavisi aldı. Anti-lipemik ilaç kullanan hasta oranı steroid tedavisi gören hasta grubunda daha yüksekti. Başlangıç LDL kolesterol düzeyleri steroid tedavisi alan grupta daha yüksek olsa da bu fark dokuzuncu aydan sonra kayboldu. Total ve LDL kolesterol düzeyleri albümin ile negatif, proteinüri düzeyi ile pozitif korele bulundu. SONU Ç: Nefrotik sendromda hiperlipideminin tedavisi serum albümin düzeyini yükseltmeye, dolayısıyla glomerüler hastalığın tedavisine yönelik olmalıdır. Anti-lipemik ajanlar diğer antiproteinürik tedaviye yanıt alınamayan hastalarda uygulanmalıdır.
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