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KRONİK HEMODİYALİZ HASTALARINDA HEMODİYALİZ YETERLİLİĞİNİN HOMOSİSTEİN DÜZEYLERİNE ETKİSİ

THE EFFECT OF ADEQUATE HEMODIALYSIS ON HOMOCYSTEINE LEVELS IN PATIENTS WITH CHRONIC RENAL FAILURE

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2001

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Background: Hyperhomocysteinaemia, which is an independent cardiovascular risk factor, is common in chronic haemodialysis (HD) patients. In chronic haemodialysis patients, the effect of dialysis adequacy on homocysteine levels is object of research. Treatment with folic acid lowers tHcy in haemodialysis patients. However, in most patients normohomocysteinaemic levels can not be provided. We studied the influence of dialysis adequacy on homocysteine levels. Material and method: Thirty patients were taken in this study. They had entered in dialysis for more than one years and also taken Bl2 and folic acid. Kt/V ratios, serum albumine, folic acid, Bl2, predialysis and postdialysis total serum homocysteine (tsHcy) were measured in-patients. Non-parametric 'Wilcoxon's rank, Spearman rank correlation and multiple linear regression' tests were used in statistically analysis. Results: tsHcy were found predialysis as 10.7+9.0 (3.55-37.7) jmol/L and postdialysis 5.3+4.29 (2.25¬23.85) jmol/L (p=0.004). Predialysis tsHcy correlated significantly with Kt/V 1.26+0.15 (0.86-1.5) and serum concentrations of albumin 3.58+0.39 (2.7-4.2) gr/dl (r=-0.621, p<0.0001, r=-0.764, p<0.0001) respectively. There was not a meaningful relation between tsHcy and serum cobalamines 637.5+181.7 (260-983) pg/ml (r=-0.3, p=0.107). In contrary tsHcy correlated significantly with serum folic acid 12.2+5.2 (3-20) ng/ml (r=-0.830, p<0.0001). In a multiple linear regression analysis, Kt/V and serum folic acid levels significantly predicted tsHcy (r=-0.387, p=0.003, r=-0,487, p=0.001). Conclusions: It was seen that there was a meaningful relation between tsHcy and Kt/V, serum concentrations of albumin and folic acid levels. In conclusion; dialysis adequacy, serum concentrations of albumin and folic acid are effective factors on tsHcv levels.
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Abstract (Original Language): 
Amaç: Bağımsız bir kardiyovasküler risk faktörü olan hiperhomosisteinemi kronik hemodiyaliz hastalarında yaygındır. Kronik hemodiyaliz hastalarında hemodiyaliz etkinliğinin homosistein düzeylerine etkisi araştırma konusudur. Folik asid tedavisi ile homosistein düzeyleri düşmekle birlikte bir çok hastada normal homosistein düzeyleri sağlanamaz. Biz hemodiyaliz etkinliğinin homosistein düzeylerine olan etkisini araştırdık. Materyal ve metot: Bir yıldan daha uzun süre hemodiyalize giren, Bn ve folik asid kullanmakta olan 30 hasta çalışmaya alındı. Hastalarda Kt/V oranları, serum albümin, diyaliz öncesi ve sonrası total serum homosistein (tsHcy), folik asid ve kobalamin düzeyleri ölçüldü. Nonparametrik 'Wilcoxon 's rank, Spearman rank korelasyon ve multiple linear regresyon' testleri istatistiksel analizde kullanıldı. Sonuçlar: tsHcy, diyaliz öncesi 10.7+9.0 (3.55-37.7) \moVL, diyaliz sonrası 5.3+4.29 (2.25-23.85) jmol/L bulundu (p=0.004). tsHcy ile Kt/V 1.26+0.15 (0.86-1.5), ve serum albümin düzeyleri 3.58+0.39 (2.7-4.2) g/dl arasında anlamlı ilişki vardı (r=-0.621, p<0.0001, r=-0.764, p<0.0001). tsHcy ile serum B12 vitamin düzeyleri 637.5±181.7 (260-983) pg/ml arasında anlamlı ilişki yokken (r=-0.3, p=0.107), folik asit düzeyleri 12.2+5.2 (3¬20) ng/ml ile anlamlı ilişki vardı (r=-0.830, p<0.0001). Kt/V ve serum folik asid düzeyleri tsHcy için bağımsız belirleyiciler olarak bulundu (r=-0.387, p=0.003, r=- 0,487, p=0.001)). Tartışma: tsHcy ile Kt/V, serum albümin düzeyleri ve folik asid düzeyleri arasında anlamlı ilişki görülmektedir. Sonuç olarak diyaliz yeterliliği, serum albümin ve folik asid düzeyleri tsHcy düzeyleri üzerinde etkili faktörlerdir.
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  • 4
219-222
  • Turkish

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