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Diltiazemin Böbrek İşlevleri Üzerine Kısa Dönem Etkileri: Bir Kontrollü Klinik Çalışma

Short Term Effects of Diltiazem on Renal Functions: A Controlled Clinical Study

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DOI: 
DOI 10.5262/tndt.2012.1002.05
Abstract (2. Language): 
Obj ectı ve: We aimed to study acute effects of diltiazem on renal functions and its renoprotective effects in patients with chronic kidney disease (CKD). MATER IAL and Methods : Among patients with CKD followed-up in our unit, fifty patients using diltiazem as a part of their treatment(the treatment group) and fifty patients not using diltiazem (the control group) were selected. Besides demographic parameters; blood pressures, creatinine, proteinuria and creatinine clearance levels at the baseline, first week, and third and sixth months were recorded. Results : The groups were matched for the mean creatinine clearance at baseline. The course of mean creatinine clearance were similar in both groups (p=0.29). There was no significant change in serum creatinine or creatinine clearance after initiation of diltiazem in the treatment group. Baseline proteinuria was higher in treatment group (p=0.012). Proteinuria at the sixth month was significantly higher in the control group compared with basal and first week levels (p<0.001 and p=0.007, respectively). But there was no change in the treatment group regarding proteinuria. Serum albumin levels were not statistically significantly different in the groups (p=0.69). Conc lusion : Diltiazem has no acute effect on serum creatinine and creatinine clearance in patients with CKD. It may prevent the probable increase in proteinuria.
Abstract (Original Language): 
Amaç : Çalışmamızda, diltiazemin böbrek işlevleri üzerine akut etkilerini ve kronik böbrek hastalığı (KBH) olan hastalarda böbrek koruyucu etkilerini çalışmayı amaçladık. GEREç ve Yönt emLER : Ünitemizde izlenmekte olan KBH hastalarından, tedavilerinin bir parçası olarak diltiazem kullanan elli hasta (tedavi grubu) ile diltiazem kullanmayan elli hasta (kontrol grubu) çalışma için seçildi. Demografik göstergeler yanında kan basınçları, kreatinin, proteinüri ve kreatinin klirensi değerleri başlangıçta, ilk haftada ve üçüncü ile altıncı aylarda kaydedildi. Bulgular: Başlangıç değerlendirmesinde gruplar kreatinin klirensi açısından tam olarak benzerdi. Ortalama kreatinin klirensinin seyri her iki grupta benzerdi (p=0.29). Tedavi grubunda, diltiazen başlanmasından itibaren serum kreatinin ve kreatinin klirensi değerlerinde anlamlı değişiklik yoktu. Başlangıç proteinüri değerleri tedavi grubunda daha yüksekti (p=0.012). Kontrol grubunda altıncı aydaki proteinüri değerleri, başlangıç ve ilk hafta değerleri ile karşılaştırıldığında anlamlı olarak yüksekti (p<0.001 ve p=0.007). Fakat tedavi grubunda proteinüri açısından değişiklik yoktu. Serum albümin düzeyleri tedavi ve kontrol gruplarında istatistiksel anlamlı olarak farklı değildi (p=0.69). Son uç: Diltiazemin diabetikler de dahil olmak üzere proteinürisi olan hastalarda serum kreatinin ve kreatinin klirensi değerleri üzerine akut etkisi yoktur. Proteinürideki muhtemel artmayı engelleyebilir.
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