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İmmünoglobülin A Nefropatisinde Yaşam Süresi ve Yaşam Süresini Etkileyen Faktörler

Survival and the Factors Affecting It in Immunoglobulin A Nephropathy

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2008

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
IgA nephropathy is one of the most widely seen glomerulonephritides. It is one of the major causes of end stage renal disease. The aim of this study was to determine the clinical, biochemical, properties, treatment modalities, renal survival and factors affecting survival of patients with IgA nephropathy followed up in our center. Seventy-five patients (F:M=20:55, mean age=31.9±10.5) who were biopsied in our center between 1990 and 2003 were recruited into the study. The histopathological properties, arterial blood pressures, biochemical values, urinalysis for hematuria and poteinuria and levels of daily proteinuria determined both at the time of biopsy and during last 3 controls were evaluated. The treatments given were recorded. The differences between treated and not treated patients with respect to each type of the therapy were assesed by using Mann-Whitney-U test. The renal survival was calculated by using Kaplan-Meier and the affecting factors by using Cox regression methods. The 5- and 10-year renal survivals were calculated as 78% and 60% respectively when the final end-point was assumed to be doubling of serum creatinine with respect to initial value and/or development of ESRD. The patients who had used omega-3 fatty acids had better renal survivals. The factors affecting the renal survival significantly were initial serum creatinine, interstitial fibrosis and glomerulosclerosis, initial diastolic and final systolic blood pressures. In conclusion some histopathologic findings, biochemical values, arterial blood pressure levels are determined to affect the renal survival. However the natural history of the disease that shows variabilities among individual patients is thought to be one of the major factors affecting the renal survival.
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Abstract (Original Language): 
immünoglobülin A (IgA) nefropatisi dünyada en sık görülen primer glomerülonefritlerden biridir. IgA nefropatisinin son dönem böbrek yetmezliğinin (SDBY) majör etmenlerinden biri olduğu kabul edilmektedir. Son dönemlerde tedavisi açısından yapılan çalışmalarda artış olmasına rağmen kesin kabul görmüş bir tedavi protokolü yoktur. Bu çalışmanın amacı kliniğimizde böbrek biyopsiyle IgA nefropatisi tanısı almış hastaların klinik ve labaratuvar bulgularını, böbrek yaşam süresi ve yaşam süresini etkileyen faktörleri ortaya koymaktır. Kliniğimizde 1990 ve 2003 yılları arasında böbrek biyopsisiyle tanı konulmuş ve izlenmiş 75 hasta (K:E=20:55, ortalama yaş=31.9±10.5 yıl) çalışmaya alındı. Hastaların biyopsi sırasında ve son 3 kontrolde histopatolojik özellikleri, arteryel kan basınçları, biyokimyasal değerleri, proteinüri, hematüri varlığı, 24 saatlik idrarda protein düzeyleri ve izlem süresince aldıkları tedaviler kaydedildi. Hastaların bir tedavi alıp almamalarına göre aralarındaki farklar Mann-Whitney-U testine, böbrek yaşam süreleri Kaplan-Meier yöntemine, yaşam süresine etki eden faktörler ise Cox regresyon modeline göre belirlendi. Serum kreatinin düzeyinin başlangıcın iki katına çıkması ve/veya SDBY gelişmesi son nokta kabul edildiğinde 5 ve 10 yıllık böbrek yaşam süreleri sırasıyla %78 ve %60 olarak hesaplandı. Omega-3 yağ asitlerini kullanan hastaların kullanmayanlara göre böbrek yaşam süresinin anlamlı olarak daha uzun olduğu görüldü. Böbrek yaşam süresini anlamlı olarak etkileyen faktörler başlangıç serum kreatinini, interstisyel fibroz ve glomerüloskleroz varlığı, başlangıçtaki diyastolik kan basıncı ve izlemdeki sistolik kan basıncıydı. Sonuç olarak bazı histopatolojik ve biyokimyasal bulguların, arteryel kan basıncı kontrolünün ve bazı ilaçların böbrek yaşam süresini etkilediği görülmüştür. Hastalığın doğal seyrinin kişiye göre değişiklik göstermesinin de böbrek yaşam süresini etkileyen önemli faktörlerden biri olduğu düşünülmüştür.
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Türk Nefroloji Diyaliz ve Transplantasyon Dergisi /Official Journal of the Turkish Society of Nephrology
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