Akut böbrek yetmezliğinde hiperüriseminin rolü

Year 2022, Volume: 3 Issue: 3, 234 - 240, 26.09.2022

Elmas Uysal , Fatih Seğmen , Deniz Erdem

https://doi.org/10.47582/jompac.1166061

Abstract

Amaç: Akut böbrek yetmezliği (ABY) yoğun bakım hastalarında mortaliteyi etkileyen en önemli faktörlerden biridir. Bu çalışmanın amacı, ürik asit düzeyleri ile akut böbrek hasarı (AKI) / ABY arasında bir ilişki olup olmadığını aydınlatmaktır.
Gereç ve Yöntem: Bu retrospektif çalışmamıza, önceden böbrek hastalığı olmayan ve glomerüler filtrasyon hızı (GFR) 80-120 ml/dakika olan hastanemiz yoğun bakım ünitesine kabul edilen toplam 1000 hasta dahil edildi. Yoğun bakım ünitesinde AKI gelişimi RIFLE kriterleri ile değerlendirildi. AKI gelişen hastalarda renal replasman tedavisi endikasyonu olup olmadığına bakıldı. Bilinci kapalı kişiler ve COVID-19 hastaları dahil yoğun bakım ünitesindeki tüm hastalar analize dahil edilmiştir.
Bulgular: Bireylerin %27,1’inde (n=271) AKI görüldü. AKI’lı hastaların %44.3’üne (n=120) hemodiyaliz uygulanmıştı. Hemodiyaliz nedenleri olguların %36’sında iskemi, %32’sinde sepsis ve multifaktöriyel nedenler idi. Potasyum dışındaki tüm parametrelerde (üre, kreatinin, ürik asit ve sodyumda) başlangıca göre artmıştı (p<0,001) ve başlangıç ​​ölçümlerine göre istatistiksel olarak anlamlı bir fark bulundu. Tanı anında başlangıca göre tüm değerler artarken, GFR değerinde azalma gözlendi (p<0,001). Hemodiyalize giren hastaların ürik asit ölçümleri arasında istatistiksel olarak anlamlı fark vardı (p<0,05) ve ürik asit ölçümleri başlangıca göre arttı.
Sonuç: Bu çalışmanın sonuçlarına göre serum ürik asit düzeyinin azalmış böbrek fonksiyonu için bağımsız bir risk faktörü olduğu gösterilebilir. Ek olarak, yüksek ürik asit seviyeleri yoğun bakım ünitesinde hemodiyaliz, morbidite ve mortalitenin artmasına neden olur.

Keywords

Hemodiyaliz, akut böbrek yetmezliği, hiperürisemi, ürik asit, yoğun bakım ünitesi

Supporting Institution

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Project Number

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The role of hyperuricemia in acute renal failure

Abstract

Objective: Acute renal failure is one of the most important factors affecting mortality in intensive care patients. The aim of this study was to elucidate whether there was a relationship between uric acid levels and/or acute kidney imjury/failıre (AKI).
Material and Method: A total of 1000 individuals who were admitted to intensive care unit (ICU) of our institution without any prior renal disease and glomerular filtration rate (GFR) of 80-120 ml/minutes, have been enrolled in this retrospective analysis. The development of AKI in the ICU were evaluated via RIFLE criteria. In patients who developed AKI, it was checked whether there was an indication for renal replacement therapy (RRT). All patients in the ICU including the unconscious indivuduals and COVID-19 patients have been included in the analysis.
Results: Acute renal failure (ARF) was observed in 27.1% (n=271) of the individuals. Hemodialysis had been administered in 44.3% (n=120) of patients with ARF. The reasons for hemodialysis were ischemia in 36%, sepsis and multifactorial reasons in 32% of the subjects. A statistically significant difference was found compared to the initial measurements in urea, creatinine, uric acid and sodium (Na) increased compared to baseline (p<0.001) as all parameters except potassium (K). All values from baseline increased at the time of diagnosis, while a decrease was observed in the GFR value (p<0.001). There was a statistically significant difference between the uric acid measurements of the patients undergoing hemodialysis (p<0.05) and uric acid measurements were increased compared to baseline.
Conclusion: Regarding the results of this study one can conclude that serum uric acid level has been shown to be an independent risk factor for decreased renal function. Additionally, elevated uric acid levels lead to increased hemodialysis, morbidity and mortality in the ICU.

Keywords

Acute renal failure, hemodialysis, hyperuricemia, uric acid, intensive care unit

Project Number

yok

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