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İç Anadolu’da Akut Böbrek Yetmezliği Seyri

Trends in Acute Renal Failure in Central Anatolia

Journal Name:

Publication Year:

DOI: 
10.5262/tndt.2013.1003.04

Keywords (Original Language):

Abstract (2. Language): 
OBJECTIVE: Our main purpose was to evaluate the epidemiological properties and mortality rate of this study and to evaluate the etiology and factors associated with mortality in patients with ARF. MATERIAL and METHODS: In this prospective observational study a total of 541 patients with ARF were assessed between January 2008 - January 2012. The etiological spectrum and predictors of mortality were evaluated in this population. RESULTS: The mean age was 64.9 ± 15.6 years and the majority of patients were male. The most common etiology of ARF was medical causes. Diarrheal disease and drug-induced ARF were the major medical causes. One hundred and fi fty four patients needed dialysis. The most common cause of death was cardiopulmonary failure. In multivariate analysis, dialysis necessity, age, C-reactive protein, serum sodium, serum phosphorus, serum albumin, and hemoglobin were independently associated with death after adjusting for other variables. CONCLUSION: ARF resulting from medical diseases was higher compared to surgical causes. Use of medication with antibiotics and non-steroid anti-infl ammatory drugs was predominantly increased; however the main cause was diarrheal disease. Hypoalbuminemia, anemia, dialysis requirement and hyperphosphatemia were found to be the main predictors of mortality in patients with ARF.
Abstract (Original Language): 
AMAÇ: Akut böbrek yetmezliği (ABY), yıllar içinde tedavisinde hayli gelişmeler olmasına rağmen hala yüksek ölüm oranlarına sahiptir. Bu yüzden sebepleri ve ölümle ilişkili öngörüye katkıda bulunan belirteçler ayrıntılı bir şekilde araştırılmıştır. Bu çalışmamızda, ABY nedenlerinin yıllar içerisindeki değişiklikleri ile ölüme katkıda bulunan nedenleri ortaya koymayı amaçladık. GEREÇ ve YÖNTEMLER: Bu prospektif tek merkezli gözlemsel çalışma üniversitemiz nefroloji bölümünde 541 ABY’li hastayı kapsayacak şekilde Ocak 2008- Ocak 2012 arasında yapılmıştır. Takip esnasında hemogram, biyokimyasal parametreler ve ABY nedenleri ile hastalık ilişkili ölümler kaydedilmiştir. BULGULAR: Çalışmamızdaki hastaların önemli bir kısmı erkek ve ortalama yaş 64.9 ± 15.6 yıl olarak bulunmuştur. En sık ABY nedenleri arasında oral alım bozukluğu-ishal ile ilaç kaynaklı nedenler göze çarpmıştır. Hastalarımızın 154’ü takip esnasında diyaliz gereksinimi doğmuştur. En sık ölüm nedeni ise kalp kaynaklı ölümler ilk sırayı almaktadır. Renal biyopsi yapılan hastalar içinde patolojik tanı açısından en fazla akut interstisyel nefrit tanısı konmuştur. Çok değişkenli analizde, diyaliz gereksinimi, yaş, C-reaktif protein, serum fosfor, albumin ve hemoglobin seviyeleri sağkalım ile bağımsız şekilde ilişkili bulunmuştur. SONUÇ: Daha önceki merkez verilerimiz gözönünde bulundurulduğunda, nonsteroid anti infl amatuvar ilaç ve antibiyotik kaynaklı ABY olgularında artış saptanırken, sağkalımla ilişkili parametreler benzer şekilde hipoalbuminemi, anemi, diyaliz gereksinmi ve hiperfosfatemi olarak bulunmuştur.

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