Kronik böbrek hastalarında tükürük üre, ürik asit, kreatinin düzeyleri ve stres eksenleri
Küçük Resim Yok
Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: KBH, ileri yaşlarda yaygın görülen, ilerleyici, geri dönüşümsüz ve ölüm oranı yüksek olan bir hastalıktır. Böbrek fonksiyon kaybıyla karakterize olan bu hastalıkta üre, ürik asit ve kreatinin gibi üremik metabolitler kanda birikir. Bu metabolitlerin, tükürük gibi vücut sıvılarına yansıma düzeyiyle ilgili yeterli bilgi bulunmamaktadır. Ayrıca, toksik etkili bu metabolitlerin, vücudun iki önemli stres ekseni olan OSS ve HPA aksı üzerine etkileri de yeterince bilinmemektedir. Mevcut tez çalışmasının amacı, KBH'da kanda biriken bu metabolitlerin (üre, ürik asit, kreatinin) tükürüğe yansıma düzeyini ve stres eksenlerini (OSS ile HPA) etkileme derecesini ortaya koymaktır. Materyal ve Metot: Tez çalışmasına, aylık takiplerle hastaneye başvuran kronik böbrek hastaları (n=35) ve sağlıklı bireyler (n=35) dâhil edildi. Katılımcıların, sabah saatlerinde (09:00-12:00) kan ve tükürük örnekleri alınarak üre, ürik asit ve kreatinin düzeyi ölçüldü. HPA aktivitesini belirlemek amacıyla tükürük kortizol ölçümleri yapıldı. OSS aktivitesini belirlemek için 5 dakikalık EKG kayıtları yaparak KHD parametreleri hesaplandı. Bulgular: KBH'da kan üre, ürik asit, kreatinin düzeyleri ile tükürük üre ve ürik asit düzeyleri yüksek bulundu (p<0.05). Kan ile tükürükteki üre düzeyleri (r = 0.370) ve ürik asit düzeyleri (r = 414) pozitif ilişkiliydi (p<0.05). KBH'da tükürük kortizol düzeyi yüksek (p<0.05), KHD ise düşüktü (p<0.05). Sonuç: KBH'da üremik metabolitlerin tümü kanda artış göstermişken tükürükte ise üre ve ürik asit yükselmiştir. Bu bulgu, KBH'da üreminin ortaya konmasında tükürüğün non-invazif bir medyum olarak kullanılabileceğini göstermektedir. Ayrıca, KBH'da kortizolün artması ve KHD'nin düşmesi bu hastalarda stresin yüksek olduğunu göstermektedir. Fakat bu stres durumun üremiden ziyade artan psikolojik yük ile ilgili olabileceği değerlendirilmiştir. Anahtar Kelimeler: HPA, KBH, KHD, Kortizol, Kreatinin, OSS, Stres, Üre, Ürik Asit
Aim: CKD is a progressive, irreversible disease that is common in older ages and has a high mortality rate. In this disease, which is characterized by loss of kidney function, uremic metabolites such as urea, uric acid and creatinine accumulate in the blood. There is not enough information about the reflection level of these metabolites in body fluids such as saliva. In addition, the effects of these toxic metabolites on the ANS and HPA axis, two important stress axes of the body, are not well known. The aim of the current thesis is to reveal the level of reflection of these metabolites (urea, uric acid, creatinine) accumulated in the blood in CKD into saliva and the degree to which they affect the stress axes (ANS and HPA). Material and Method: Chronic kidney patients (n=35) who were admitted to the hospital with monthly follow-ups and healthy individuals (n=35) were included in the thesis study. Blood and saliva samples were taken from the participants in the morning (09:00-12:00 h) and their urea, uric acid and creatinine levels were measured. Salivary cortisol measurements were made to determine HPA activity. To determine ANS activity, HRV parameters were calculated by making 5-minute ECG recordings. Results: Blood urea, uric acid, creatinine levels and salivary urea and uric acid levels were found to be high in CKD (p<0.05). Blood and saliva urea levels (r = 0.370) and uric acid levels (r = 414) were positively correlated (p<0.05). In CKD, salivary cortisol level was high (p<0.05) and HRV was low (p<0.05). Conclusion: In CKD, uremic metabolites were all increased in blood but only urea and uric acid were increased in saliva. This finding shows that saliva can be used as a non-invasive medium to detect uremia in CKD. Additionally, the increase in cortisol and decrease in HRV in CKD indicate that stress is high in these patients. However, it has been evaluated that this stressful situation may be related to increased psychological burden rather than uremia. Keywords: ANS, CKD, Cortisol, Creatinine, HPA, HRV, Stress, Urea, Uric Acid
Aim: CKD is a progressive, irreversible disease that is common in older ages and has a high mortality rate. In this disease, which is characterized by loss of kidney function, uremic metabolites such as urea, uric acid and creatinine accumulate in the blood. There is not enough information about the reflection level of these metabolites in body fluids such as saliva. In addition, the effects of these toxic metabolites on the ANS and HPA axis, two important stress axes of the body, are not well known. The aim of the current thesis is to reveal the level of reflection of these metabolites (urea, uric acid, creatinine) accumulated in the blood in CKD into saliva and the degree to which they affect the stress axes (ANS and HPA). Material and Method: Chronic kidney patients (n=35) who were admitted to the hospital with monthly follow-ups and healthy individuals (n=35) were included in the thesis study. Blood and saliva samples were taken from the participants in the morning (09:00-12:00 h) and their urea, uric acid and creatinine levels were measured. Salivary cortisol measurements were made to determine HPA activity. To determine ANS activity, HRV parameters were calculated by making 5-minute ECG recordings. Results: Blood urea, uric acid, creatinine levels and salivary urea and uric acid levels were found to be high in CKD (p<0.05). Blood and saliva urea levels (r = 0.370) and uric acid levels (r = 414) were positively correlated (p<0.05). In CKD, salivary cortisol level was high (p<0.05) and HRV was low (p<0.05). Conclusion: In CKD, uremic metabolites were all increased in blood but only urea and uric acid were increased in saliva. This finding shows that saliva can be used as a non-invasive medium to detect uremia in CKD. Additionally, the increase in cortisol and decrease in HRV in CKD indicate that stress is high in these patients. However, it has been evaluated that this stressful situation may be related to increased psychological burden rather than uremia. Keywords: ANS, CKD, Cortisol, Creatinine, HPA, HRV, Stress, Urea, Uric Acid
Açıklama
Sağlık Bilimleri Enstitüsü, Fizyoloji Ana Bilim Dalı
Anahtar Kelimeler
Fizyoloji, Physiology
