Spot İdrar Ürik Asit/Kreatinin Oranı Vezikoüreteral Reflüde Renal Skarı Gösteren Bir Bulgu Olabilir Mi?
Öz
Amaç
Artmış idrar ürik asit atılımının vezikoüreteral reflü (VUR) ile ilşkili
olduğu gösterilmiştir. Bu çalışmanın amacı idrar ürik asit/kreatinin oranının
VUR hastalığında renal skar için bir gösterge olup olamayacağının araştırılmasıdır.
Materyal
– Metod
Bu çalışma için VUR tanısı konmuş hastaların dosyaları geriye dönük olarak taranmıştır.
Sekonder VUR, 3 yaş altındakiler ve yetersiz değerlendirmesi olan hastalar
çalışma dışı bırakılmıştır. Yaş, cinsiyet, VUR durumu, dimerkaptosüksinik asit
(DMSA) sintigrafi bulguları, hipertansiyon varlığı, mikroalbuminuri, vücut
kitle indeksi sonuçları kaydedilmiştir. Serum ve idrar ürik asit, kalsiyum ve
kreatinin değerleri ölçülmüştür. İdrar ürik asit/kreatinin ve idrar
kalsiyum/kreatinin oranları yaşa gore hesaplanmıştır. Herhangi bir predikte
edici faktörü değerlendirmek için geriye dönük regresyon analizi yapıldı.
Bulgular
Çalışmaya toplam 76 hasta dahi edilmiştir. Ortalama yaş 8.2±3.7 olarak
bulunmuştur. Hastalardan 49’u kız ve 27’si de erkektir. Toplamda 51 hastada
renal skar saptanmış olup 25 hastada renal skar saptanmamıştır. Çalışma grubunda
22 hastada mikroalbuminüri mevcut iken 5 hastada hipertansiyon bulunmuştur.
Hiperürikozüri 23 hastada (%30.7) var iken yalnızca 1 hastada (%1.3)
hiperkalsiüri vardı. İdrar ürik asit/kreatinin oranı ile renal skar,
mikroalbminüri ve hipertansiyon arasında ilişki saptanmamıştır (p değeri tümü
için >0.05) . Ayrıca idrar
kalsiyum/kreatinin oranı da bahsedilen parametrelerle ilişkili bulunmamıştır.
Sonuçlar
Çalışmamızın
sonuçlarına göre ürik asit/kreatinin oranının vezikoüreteral reflülü hastalarda
renal skarı gösteren bir bulgu olmadığı saptanmıştır.
Anahtar Kelimeler
Kaynakça
- 1. Mattoo TK MR: Vesicoureteral reflux and renal scarring. In: Pediatric nephrology. edn. Edited by Avner ED HW, Niaudet P, Yoshikawa N. Berlin: Springer; 2009: 1311–28.
- 2. Madani A, Kermani N, Ataei N et al. Urinary calcium and uric acid excretion in children with vesicoureteral reflux. Pediatr Nephrol. 2012;27:95-9.
- 3. Mahyar A, Dalirani R, Ayazi P et al. The association of hypercalciuria and hyperuricosuria with vesicoureteral reflux in children. Clin Exp Nephrol. 2017;21:112-6.
- 4. Mattoo TK. Vesicoureteral reflux and reflux nephropathy. Adv Chronic Kidney Dis. 2011;18:348-54.
- 5. Mathew R MT: Vesicoureteral Reflux. In: Comprehensive pediatric nephrology, . 1st edn. Edited by Geary DF SF. Philadelphia: Mosby Elsevier; 2008: 499–525.
- 6. Lin KY, Chiu NT, Chen MJ et al. Acute pyelonephritis and sequelae of renal scar in pediatric first febrile urinary tract infection. Pediatr Nephrol. 2003;18:362-5.
- 7. Rodenbach KE, Schneider MF, Furth SL et al. Hyperuricemia and Progression of CKD in Children and Adolescents: The Chronic Kidney Disease in Children (CKiD) Cohort Study. Am J Kidney Dis. 2015;66:984-92.
- 8. Corry DB, Eslami P, Yamamoto K, Nyby MD, Makino H, Tuck ML. Uric acid stimulates vascular smooth muscle cell proliferation and oxidative stress via the vascular renin-angiotensin system. J Hypertens. 2008;26:269-75.
- 9. Filiopoulos V, Hadjiyannakos D, Vlassopoulos D. New insights into uric acid effects on the progression and prognosis of chronic kidney disease. Ren Fail. 2012;34:510-20.
- 10. Kanbay M, Huddam B, Azak A et al. A randomized study of allopurinol on endothelial function and estimated glomular filtration rate in asymptomatic hyperuricemic subjects with normal renal function. Clin J Am Soc Nephrol. 2011;6:1887-94.
Can spot urinary uric acid/creatinine ratio be used as a surrogate for renal scarring in vesicoureteral reflux?
Öz
Objective: Increased urinary excretion of uric acid has been shown to be associated with vesicoureteral reflux (VUR). The aim of this study is evaluate if urinary uric acid/creatinine ratio can be used as a surrogate for renal scarring in VUR.
Method: Retrospective chart analysis was made to identify patients who were diagnosed with VUR. Those with secondary VUR, <3 years of age, and inadequate evaluation were excluded. Age, gender, VUR status, dimercaptosuccinic acid (DMSA) scintigraphy findings, presence of hypertension and microalbuminuria, and body mass index values were noted. Uric acid, calcium and creatinine levels for both urine and serum were measured. Urinary uric acid/creatinine and calcium/creatinine ratios were assessed for age. Backward logistic regression analysis was used for determining any predictors.
Results: A total of 76 patients were eligible for the study. Mean age was 8.2±3.7 years. There were 49 females and 27 males. Fifty-one patients had renal scars while 25 had no scars. Microalbuminuria was present in 22 patients. Hypertension was detected in 5 patients. Hyperuricosuria was found in 23 patients (30.7%) while hypercalciuria was found only in 1 patient (1.3%). There was no correlation between urinary uric acid/creatinine and renal scarring, microalbuminuria and hypertension. Also, no correlation was found between urinary calcium/creatinine levels and aforementioned parameters (p values >0.05, for all).
Conclusions: Our results indicate that urinary uric acid/creatinine ratio would not be used as surrogate for renal scarring in VUR.
Anahtar Kelimeler
Kaynakça
- 1. Mattoo TK MR: Vesicoureteral reflux and renal scarring. In: Pediatric nephrology. edn. Edited by Avner ED HW, Niaudet P, Yoshikawa N. Berlin: Springer; 2009: 1311–28.
- 2. Madani A, Kermani N, Ataei N et al. Urinary calcium and uric acid excretion in children with vesicoureteral reflux. Pediatr Nephrol. 2012;27:95-9.
- 3. Mahyar A, Dalirani R, Ayazi P et al. The association of hypercalciuria and hyperuricosuria with vesicoureteral reflux in children. Clin Exp Nephrol. 2017;21:112-6.
- 4. Mattoo TK. Vesicoureteral reflux and reflux nephropathy. Adv Chronic Kidney Dis. 2011;18:348-54.
- 5. Mathew R MT: Vesicoureteral Reflux. In: Comprehensive pediatric nephrology, . 1st edn. Edited by Geary DF SF. Philadelphia: Mosby Elsevier; 2008: 499–525.
- 6. Lin KY, Chiu NT, Chen MJ et al. Acute pyelonephritis and sequelae of renal scar in pediatric first febrile urinary tract infection. Pediatr Nephrol. 2003;18:362-5.
- 7. Rodenbach KE, Schneider MF, Furth SL et al. Hyperuricemia and Progression of CKD in Children and Adolescents: The Chronic Kidney Disease in Children (CKiD) Cohort Study. Am J Kidney Dis. 2015;66:984-92.
- 8. Corry DB, Eslami P, Yamamoto K, Nyby MD, Makino H, Tuck ML. Uric acid stimulates vascular smooth muscle cell proliferation and oxidative stress via the vascular renin-angiotensin system. J Hypertens. 2008;26:269-75.
- 9. Filiopoulos V, Hadjiyannakos D, Vlassopoulos D. New insights into uric acid effects on the progression and prognosis of chronic kidney disease. Ren Fail. 2012;34:510-20.
- 10. Kanbay M, Huddam B, Azak A et al. A randomized study of allopurinol on endothelial function and estimated glomular filtration rate in asymptomatic hyperuricemic subjects with normal renal function. Clin J Am Soc Nephrol. 2011;6:1887-94.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Surgical Science Research Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Mart 2021 |
| Kabul Tarihi | 28 Mart 2021 |
| Yayımlandığı Sayı | Yıl 2021 |