Nefrotik sendromlu 0-18 yaş arası çocukların değerlendirilmesi
Küçük Resim Yok
Tarih
2019
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Biz bu çalışmamızda kliniğimizde nefrotik sendrom tanısı ile izlenen hastaların sosyodemografik yapısını, tanı yaklaşımlarını, klinik verilerinin belirlenmesini ve uygulanan tedavi yöntemleri ile prognoza etkili olan faktörleri değerlendirmeyi amaçladık. Gereç ve Yöntemler: 2004-2019 yıllarını kapsayan 15 yıllık sürede İnönü Üniversitesi Tıp Fakültesi Turgut Özal Tıp Merkezi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Çocuk Nefroloji Bilim Dalı'nda izlenen 0-18 yaş arası primer idiyopatik nefrotik sendrom tanısı alan 256 hastanın dosyası geriye dönük olarak incelendi. Dosyasında tüm verileri yeterli olan ve yeterli takip süresi olan 220 hasta çalışmaya dâhil edildi. Bulgular: Hastalarımızın 137'si erkek, 83'ü kız olup erkek/kız oranı 1,65 idi. Olguların ortalama başlangıç yaşı 4,8±2,6 yıl idi (0,1-16 yıl). Ailesinde böbrek hastalığı öyküsü %16,4 iken anne-baba akrabalığı %25,9 idi. Olgularımızın %55,4'ü Malatya'dan başvurmuştu. Hastalarımızda mikroskobik hematüri %24,5, hipertansiyon ise %28,2 oranında vardı. Hastaların ortalama kolesterol düzeyi 336±102 mg/dl, serum albümini 1,39±0,5 g/dl, serum total proteini 4,1±0,6 g/dl, BUN değeri 13,2±9,4 mg/dl, serum kreatinini 0,43±0,29 mg/dl ve 24 saatlik idrar protein miktarı ortalaması 123,6±76,9 mg/dl idi. Biyopsi yapılan hastaların; 32'si FSGS, 18'i MLH, 11'i MPGN, 3'ü IgM nefropatisi, 2'si herediter nefrit, 2'si MezPGN, 1'i MGN, 1'i konjenital NS ve 2'si de diğer sebepler olarak saptandı. Toplam 193 hasta (%87,7) steroide duyarlı iken 27 hasta (%12,2) steroide dirençliydi. Toplam 78 hasta (%35,5) relapsız takip edilirken, 120 hasta (%54,5) bir kez de olsa relaps geçirmiş (relapsing), 22 hasta (%10) ise sık relapslı idi. Takiplerinde hastalarımızın mortalite oranı %2,7 olarak saptandı. Sonuç: Bu çalışma ile bölgemizdeki primer nefrotik sendromlu çocukları ilk kez kapsamlı bir şekilde değerlendirmiş olduk. Hastalarımızın verileri büyük oranda literatür ile uyumlu bulunmuştur. Anahtar Kelimeler: Çocuk, nefrotik sendrom, seyir, tedavi
Aim: In this study, our aim was to assess the sociodemographic structure, diagnostic approaches, determination of clinical data, treatment methods applied and the factors effective on prognosis in patients followed with a diagnosis of nephrotic syndrome in our clinic. Material and Methods: The files of 256 patients diagnosed with primary idiopathic nephrotic syndrome between the ages of 0 and 18 who were followed in İnönü University Faculty of Medicine Turgut Özal Medical Centre Department of Pediatric Diseases, Field of Pediatric Nephrology during a period of 15 years between 2004 and 2019 were examined retrospectively. 220 patients whose data were sufficient and who had a sufficient follow-up time were included in the study. Results: 137 of our patients were male, 83 were female and the ratio of male/female was 1,65. Average onset age of the cases was 4,8±2,6 years (0,1-16 years). Renal disease history in the family was 16,4% and the rate of consanguineous marriage was 25,9%. 55,4% of our cases had referred to our clinic from Malatya. 24% of our patients were found to have microscopic hematuria, 28,2% were found to have hypertension. Average cholesterol level of the patients was 336±102 mg/dl, average serum albumin was 1,39±0,5 g/dl, average serum total protein was 4,1±0,6 g/dl, average BUN value was 13,2±9,4 mg/dl, average serum creatinin was 0,43±0,29 mg/dl and average 24-hour urine protein amount was 123,6±76,9 mg/dl. Of the patients who received biopsy, 32 were determined as FSGS, 18 as MLH, 11 as MPGN, 3 as IgM nephropathy, 2 as hereditary nephrite, 2 as MezPGN, 1 as MGN, 1 as congenital NS and 2 as other reasons. While a total of 193 patients (87,7%) were sensitive to steroid, 27 patients (12,2%) were found to be resistant to steroid. While 78 (35,5%) of the patients were followed with no relapse, 120 (54,5%) patients were relapsing and 22 (10%) patients had frequent relapses. In their follow-up, mortality rate of our patients was found as 2,7%. Conclusion: With this study, we assessed children with primary nephrotic syndrome in our area comprehensively for the first time. The data of our study were in parallel with the literature to a great extent. Keywords: Child, nephrotic syndrome, course, treatment
Aim: In this study, our aim was to assess the sociodemographic structure, diagnostic approaches, determination of clinical data, treatment methods applied and the factors effective on prognosis in patients followed with a diagnosis of nephrotic syndrome in our clinic. Material and Methods: The files of 256 patients diagnosed with primary idiopathic nephrotic syndrome between the ages of 0 and 18 who were followed in İnönü University Faculty of Medicine Turgut Özal Medical Centre Department of Pediatric Diseases, Field of Pediatric Nephrology during a period of 15 years between 2004 and 2019 were examined retrospectively. 220 patients whose data were sufficient and who had a sufficient follow-up time were included in the study. Results: 137 of our patients were male, 83 were female and the ratio of male/female was 1,65. Average onset age of the cases was 4,8±2,6 years (0,1-16 years). Renal disease history in the family was 16,4% and the rate of consanguineous marriage was 25,9%. 55,4% of our cases had referred to our clinic from Malatya. 24% of our patients were found to have microscopic hematuria, 28,2% were found to have hypertension. Average cholesterol level of the patients was 336±102 mg/dl, average serum albumin was 1,39±0,5 g/dl, average serum total protein was 4,1±0,6 g/dl, average BUN value was 13,2±9,4 mg/dl, average serum creatinin was 0,43±0,29 mg/dl and average 24-hour urine protein amount was 123,6±76,9 mg/dl. Of the patients who received biopsy, 32 were determined as FSGS, 18 as MLH, 11 as MPGN, 3 as IgM nephropathy, 2 as hereditary nephrite, 2 as MezPGN, 1 as MGN, 1 as congenital NS and 2 as other reasons. While a total of 193 patients (87,7%) were sensitive to steroid, 27 patients (12,2%) were found to be resistant to steroid. While 78 (35,5%) of the patients were followed with no relapse, 120 (54,5%) patients were relapsing and 22 (10%) patients had frequent relapses. In their follow-up, mortality rate of our patients was found as 2,7%. Conclusion: With this study, we assessed children with primary nephrotic syndrome in our area comprehensively for the first time. The data of our study were in parallel with the literature to a great extent. Keywords: Child, nephrotic syndrome, course, treatment
Açıklama
Anahtar Kelimeler
Çocuk Sağlığı ve Hastalıkları, Child Health and Diseases
