Relationship of Hematological Parameters with Progression in Patients with Chronic Renal Failure in Stage 3-4-5 Without Dialysis Treatment
Abstract
Chronic Renal Failure (CRF) is a common chronic disease in the world and in our country. CRF is a disease that can be prevented or delayed progression when detected early with basic tests. In this study, it was aimed to investigate the relationship between progression and changes in hematological parameters in patients with CRF and whether they can be used as predictive parameters. The data obtained from patients with stage 3-4-5 CRF were retrospectively analyzed between 18-85 years of age who applied to the Nephrology Polyclinic of Balıkesir University Hospital between January 2016 - December 2017. Demographic data and hemogram values (hemoglobin, neutrophil, lymphocyte, platelet, neutrophil lymphocyte ratio, platelet lymphocyte ratio, mean platelet volume (MPV), red cell distribution (RDW), MPV/Plt) and biochemistry values (urea, creatinine, uric acid, glomerular filtration rate (GFR), spot urine protein, spot urine creatinine, spot urine protein / creatinine) and hemogram after 12 months on average, same parameters in biochemistry examinations were examined. The distribution of patient ages (mean ± ss) according to CRF stages was calculated as 64 ± 15 in stage 3, 62 ± 13 in stage 4, and 58 ± 14 years in stage 5. In our study, hemoglobin and platelet values were found to be significantly different between the groups (p <0.05). There was no statistically significant difference between the groups in terms of neutrophil, lymphocyte, RDW, MPV, N/L, P/L and MPV/Plt measurements. Hemoglobin, lymphocyte and platelet levels were found to be significantly higher in low-stage CRF patients than in advanced stages. No statistically significant difference was found between the groups in terms of neutrophil, RDW, MPV, N/L, P/L and MPV/Plt measurements. Developing new and easily accessible parameters is critical to predict CRF progression. Hematological parameters; both can be calculated on the hemogram without the need for additional examinations and can be performed in all health institutions. In particular, it shows that MPV/Platelet and Hb values can be used to predict progression.
References
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- 8.Harris MI, Flegal KM, Cowie CC, Eberhardt MS, Goldstein DE, Little RR, Wiedmeyer HM, Byrd-Holt DD. Prevalence of diabetes, impaired fasting glucose and impaired glucose tolerance in US adults. The Third National Health and Nutrition Examination Survey, 1988-1994. Diabetes Care 1998, 21:518-24.
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- 13.Levey AS, Coresh J. Chronic kidney disease. Lancet 2012, 379: 165-80.
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- 15.Johnson ES, Thorp MI, Platt RW, et al. Predicting the risk of the dialysis and transplant among patinets with CKD: a retrospective cohort study. Am J Kidney Dis. 2008; 52: 653-660.
- 16.Levin A, Djurdjev O, Duncan J, et al. Hemoglobin at time of referral prior to dialysis predicts survival: an association of hemoglobin with long-term outcomes. Nephrol Dial Transplant. 2006; 21:370.
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- 18.Levin A, Djurdjev O, Beaulieu M, et al. Variability and risk factors for kidney disease progression and death followivg attainment of stage 4 CKD in a referred cohort. Am J Kidney Dis. 2008;52: 661-671.
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- 23.Binnetoğlu E, Şengül E, Halhallı G, et al. Is neutrophil lymphocyte ratio an ındicator for proteinuria in chronic kidney disease? J Clin Lab Anal. 2014;28:487–92.
- 24.Iijima R, Ndrepepa G, Mehilli J, et al. Relationship between platelet count and 30-day clinical outcomes after percutaneous coronary interventions. Pooled analysis of four ISAR trials. Thromb Haemost. 2007; 98:852–7.
- 25.Smith RA, Bosonnet L, Raraty M, Sutton R, Neoptolemos JP, Campbell F, et al. Preoperative platelet lymphocyte ratio is an independent significant prognostic marker in resected pancreatic ductal adenocarcinoma. Am J Surg. 2009; 197:466–72.
- 26.Turkmen K, Erdur FM, Ozcicek F, Ozcicek A, Akbas EM, Ozbicer A, Demirtas L. Platelet-to-lymphocyte ratio better predicts inflammation than neutrophil-to-lymphocyte ratio in end-stage renal disease patients. Hemodial Int. 2013 Jul;17(3):391-6.
- 27.Verdoia M, Barbieri L, Schaffer A. Impact of renal function on mean platelet volume and its relationship with coronary artery disease. A single –center cohort study. 2016; 141:139-114.
- 28. Geun Oh, Sung Chung, Yoo Park, Jung Hong, Hye Lee, Hyun Chung, Je You, Jong Park. Mean Platelet Volume to Platelet Count Ratio as a Promising Predictor of Early Mortality in Severe Sepsis. SHOCK. 2017; 47(3):323–330.
Diyaliz Tedavisi Almayan Evre 3-4-5 Kronik Böbrek Yetmezliği Olan Hastalarda Hematolojik Parametrelerin Progresyon İle İlişkisi
Abstract
Bu çalışmada KBY’li olgularda progresyon ile hematolojik parametrelerdeki değişimin ilişkisini ve öngördürücü parametreler olarak kullanılıp kullanılamayacağı
araştırılmak istenmiştir. Çalışmamızda Ocak 2016 - Aralık 2017 tarihleri arasında Balıkesir Üniversitesi Tıp Fakültesi Hastanesi Nefroloji Polikliniğine başvuran 18-85 yaş arası evre 3-4-5 KBY tanılı hastalardan elde edilen veriler retrospektif olarak incelendi. Hastaların demografik verileri ile ilk başvurudaki hemogram değerleri (hemoglobin, nötrofil, lenfosit, platelet, nötrofil lenfosit oranı, trombosit lenfosit oranı, ortalama trombosit hacmi (MPV), eritrosit dağılım genişliği (RDW), MPV/Plt) ile biyokimya değerleri (üre, kreatinin, ürik asit, glomerüler filtrasyon hızı (GFR), spot idrar protein, spot idrar kreatinin, spot idrarda protein/kreatinin) ve ortalama 12 ay sonraki hemogram, biyokimya incelemelerindeki aynı parametreler incelendi. KBY evrelerine göre hasta yaşlarının dağılımı (ort±ss) evre 3’te 64±15, evre 4’te 62±13 ve evre 5’te 58±14 yıl olarak hesaplandı. Çalışmamızda hemoglobin ve platelet değerlerinin gruplar arasında anlamlı bir şekilde farklı olduğu saptanmıştır
(p<0.05). Gruplar arasında nötrofil, lenfosit, RDW, MPV, N/L, P/L ve MPV/Plt ölçümleri açısından ise istatistiksel olarak anlamlı bir fark bulunmamıştır. Hemoglobin, lenfosit ve platelet düzeyleri düşük evreli KBY’lilerde, ileri evrelilere göre anlamlı şekilde daha yüksek bulundu. Çalışmada gruplar arasında nötrofil, RDW, MPV,
N/L, P/L ve MPV/Plt ölçümleri açısından ise istatistiksel olarak anlamlı bir fark saptanmamıştır. KBY progresyonunu öngörmek için yeni ve kolay ulaşılabilir parametrelerin geliştirilmesi büyük önem taşımaktadır. Hematolojik parametreler; hem ek tetkik ihtiyacı olmadan hemogram üzerinden hesaplanabilir hem de tüm
sağlık kuruluşlarında yapılabilir incelemelerdir. Özellikle MPV/Trombosit ve Hb değerlerinin progresyonu predikte etmek için kullanılabileceğini göstermektedir.
References
- 1.Akpolat T, Utag C, Süleymanlar G. Nefroloji El Kitabı, Akpolat T, Yalçın A. U. ed. Kronik Böbrek Yetmezliği İstanbul, Güzel Sanatlar Matbaası, 2011:273–305.
- 2.KDIGO 2012 “Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease.” Kidney Int Suppl. 2013, 3: 1-150.
- 3.Clinical Practice Guidelines For Chronic Kidney Disease: Evaluation, Classification and Stratification, National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKFK/DOQI),2002:43-45.
- 4.Kızıltan G, Türker P. Böbrek Hastalıkları ve Beslenme Tedavisi. In: Prof. Dr. Emel Tüfekçi Alphan editors. Hastalıklarda Beslenme Tedavisi. Ankara: Hatiboğlu Yayınevi; 2013. p.639-697.
- 5.Crowe E, Halpin D, Stevens P; Guideline Development Group. Early identification and management of chronic kidney disease: summary of NICE guidance. BMJ 2008;29:337.
- 6.Türkiye Böbrek Hastalıkları Önleme ve Kontrol Programı. T.C. Sağlık Bakanlığı Yayın No:946, Ankara, 2014:5-10.
- 7.Türkiye‟de Nefroloji, Diyaliz Ve Transplantasyon- Registry 2015. Ankara: Türk Nefroloji Derneği, 2016, Süleymanlar G, Altıparmak MR, Seyahi N, Trabulus S. Türkiye‟de Nefroloji, Diyaliz ve Transplantasyon-Registry 2012. Türk Nefroloji Derneği Yayınları, Ankara, 2013.
- 8.Harris MI, Flegal KM, Cowie CC, Eberhardt MS, Goldstein DE, Little RR, Wiedmeyer HM, Byrd-Holt DD. Prevalence of diabetes, impaired fasting glucose and impaired glucose tolerance in US adults. The Third National Health and Nutrition Examination Survey, 1988-1994. Diabetes Care 1998, 21:518-24.
- 9.Kenny SJ, Aubert RE, Geiss LS. Prevalence and incidence of non-insulin independent diabetes. In: National Diabetes Group, ed. Diabetes in America, Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, 1995, 47-68.
- 10.Türkiye‟de Nefroloji, Diyaliz Ve Transplantasyon- Registry 2015. Ankara: Türk Nefroloji Derneği, 2016.
- 11.Collins AJ, Kasiske B, Herzog C et al. Excerpts from the United States Renal Data System 2003 Annual Data Report: atlas of end-stage renal disease in the United States. Am J Kidney Dis. 2003; 42:1-230. 14.
- 12.Yamagata K, Yagisawa T, Nakai S, Nakayama M, Imai E, Hattori M, Iseki K, Akiba T. Prevalance and incidence of chronic kidney disease stage G5 in Japan. Clin Exp Nephrol. 2015, 19:54-64.
- 13.Levey AS, Coresh J. Chronic kidney disease. Lancet 2012, 379: 165-80.
- 14.Becker GJ, Fairley KF. Urinalysis. In Massry SG, Glassock RJ, ed. Textbook of Nephrology, 4th ed, Philadelphia, Lippincott Williams & Wilkins, 2001, 1765-1783.
- 15.Johnson ES, Thorp MI, Platt RW, et al. Predicting the risk of the dialysis and transplant among patinets with CKD: a retrospective cohort study. Am J Kidney Dis. 2008; 52: 653-660.
- 16.Levin A, Djurdjev O, Duncan J, et al. Hemoglobin at time of referral prior to dialysis predicts survival: an association of hemoglobin with long-term outcomes. Nephrol Dial Transplant. 2006; 21:370.
- 17.Mohanram A, Zhang Z, Shahinfar S, et al. Anemia and end-stage renal disease in patients with type 2 diabetes and nephropathy. Kidney Int 2004;66:1131.
- 18.Levin A, Djurdjev O, Beaulieu M, et al. Variability and risk factors for kidney disease progression and death followivg attainment of stage 4 CKD in a referred cohort. Am J Kidney Dis. 2008;52: 661-671.
- 19.Keane WF, Zhang Z, Lyle P, et al. Risk score for predicting outcomes in patients with tip 2 diabetes and nephropaty: The RENAAL Study. Clin J Am Soc Nephrol 2006; 1:761-767.
- 20.Al-Najjar Y, Goode KM, Zhang J et al. Red cell distrubition width: an inexpensive and powerful prognostic marker in heart failure. Eur J Heart Fail 2009; 11: 1155-1162.
- 21.Ye Z, Smith C, Kullo IJ. Usefulness of red cell distrubiton width to predict mortality in patient with periferal artery disease. Am J Cardiol 2011;107:1241-1245.
- 22.Okyay GU, Inal S, Oneç K, et al. Neutrophil to lymphocyte ratio in evaluation of ınflammation in patients with chronic kidney disease. Ren Fail. 2013; 35 :29–36.
- 23.Binnetoğlu E, Şengül E, Halhallı G, et al. Is neutrophil lymphocyte ratio an ındicator for proteinuria in chronic kidney disease? J Clin Lab Anal. 2014;28:487–92.
- 24.Iijima R, Ndrepepa G, Mehilli J, et al. Relationship between platelet count and 30-day clinical outcomes after percutaneous coronary interventions. Pooled analysis of four ISAR trials. Thromb Haemost. 2007; 98:852–7.
- 25.Smith RA, Bosonnet L, Raraty M, Sutton R, Neoptolemos JP, Campbell F, et al. Preoperative platelet lymphocyte ratio is an independent significant prognostic marker in resected pancreatic ductal adenocarcinoma. Am J Surg. 2009; 197:466–72.
- 26.Turkmen K, Erdur FM, Ozcicek F, Ozcicek A, Akbas EM, Ozbicer A, Demirtas L. Platelet-to-lymphocyte ratio better predicts inflammation than neutrophil-to-lymphocyte ratio in end-stage renal disease patients. Hemodial Int. 2013 Jul;17(3):391-6.
- 27.Verdoia M, Barbieri L, Schaffer A. Impact of renal function on mean platelet volume and its relationship with coronary artery disease. A single –center cohort study. 2016; 141:139-114.
- 28. Geun Oh, Sung Chung, Yoo Park, Jung Hong, Hye Lee, Hyun Chung, Je You, Jong Park. Mean Platelet Volume to Platelet Count Ratio as a Promising Predictor of Early Mortality in Severe Sepsis. SHOCK. 2017; 47(3):323–330.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Research Article |
| Authors | |
| Publication Date | June 29, 2020 |
| Published in Issue | Year 2019 Volume: 11 Issue: 4 |
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