Ürolityazisli çocuklarda idrar kalsiyum, sitrat oranlarının belirlenmesi
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Date
2010
Authors
Akacı, Okan
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Bu çalışmada, ürolityazisli çocuklar ile sağlıklı çocuklar arasında idrar Na, K, kre, Ca ve sitrat düzeylerinin saptanması, spot idrar örneğinde Ca/kre, Na/kre, K/kre, sit/kre ve Ca/sit oranlarının belirlenmesi, idrar Ca/sit oranının ürolityazis ile olan ilişkisinin saptanması ve taşı olan çocuklar ile sağlıklı çocukların ayırt edilmesini sağlayacak Ca/sit sınır değerinin belirlenmesi amaçlanmıştır.Çalışmaya Ekim 2009 ile Şubat 2010 tarihleri arasında, Uludağ Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Çocuk Nefroloji Bilim Dalı'nda yapıldı. Çocuk Nefroloji polikiniği tarafından ürolityazis tanısıyla izlenmekte olan yaşları 1-18 yaş arasında değişen 121 hasta ile kontrol grubu olarak yaş ve cinsiyet bakımından benzer 107 sağlıklı çocuk çalışmaya dahil edildi.Hastalarımızın yaş ortalaması 8.8±5.0 yıl olup, 65 tanesi kız (%53.7), 56 tanesi erkek (%46.3) idi. UNa atılımı açısından hasta ve sağlıklı grup arasında anlamlı fark yok iken, UK, Ukre ve Usit atılımı sağlıklı grupta daha yüksekti. UCa atılımı ise hasta grubunda daha fazla idi. Ortalama Ca/kre, ve Ca/sit oranı hasta grubunda kontrol grubuna göre anlamlı olarak daha yüksek bulundu. Ortalama Na/kre, K/kre ve sit/kre oranları hasta ve kontrol grubunda farklılık göstermedi. Hasta ve sağlıklı grubun her ikisinin de Ukre atılımı yaş ile birlikte artış gösterdi. Taşı olan hastaların UCa atılımı ile UNa atılımı arasında anlamlı pozitif ilişki saptandı. Her 2 grupta da UCa/kre ve Usit/kre oranları yaşla birlikte azalma gösterirken, UCa/sit oranında yaşla birlikte değişiklik görülmedi. UCa/kre, Usit/kre ve UCa/sit oranlarının her iki grupta da cinsiyetten etkilenmediği görüldü. UCa/sit oranının taşı olan çocuklar ile sağlıklı çocukları ayırmada kullanılabilecek sınır değeri 0.39 mg/mg olarak bulundu.Sonuç olarak; UCa/kre oranı yaş başta olmak üzere birçok faktörden etkilenmektedir. UCa/sit oranı ise yaş ve cinsiyetten etkilenmemektedir. UCa/sit oranının UCa/kre oranına göre daha stabil bir belirteç olması nedeniyle hiperkalsiürik taş oluşumu gözlenen çocuk hastaların tespitinde ve hastaların takibinde kullanılabilecek bir yöntem olduğunu düşünmekteyiz.
In this study, it is aimed to determine the urine Na, K, Cre, Ca and citrate levels, to establish the ratio of spot urine Ca/cre, Na/cre, K/cre, cit/cre and Ca/cit between the children with urolithiasis and normal healthy children, to evaluate the association of urine Ca/cit with urolithiasis and also to determine the cut-off level of Ca/cit for differentiating children with urolithiasis and normal healthy population.This study was performed in Uludag University, Faculty of Medicine, Department of Pediatric Nephrology between October 2009 and February 2010. A total of 121 children aged between 1 and 18 years with urolithiasis who were followed up in Pediatric Nephrology Policlinic and 107 age and gender matched healthy children were included to this study.The mean age of our patients was 8.8±5.0 and 65 of them (53.7%) were female and 56 of them (46.3%) were male. Although there was no significant difference between the patient and control group in terms of Una excretion; UK, Ucre and Ucit excretion were higher in the healthy population. UCa excretion was higher in the patient group. The mean Ca/cre and Ca/cit were significantly higher in the patient group compared with the control group. The mean Na/cre, K/cre and cit/cre levels did not show any difference between the patient and control groups. Ucre excretion increased with age in both patient and control groups. In children with urolithiasis, there was a significant positive correlation between UCa excretion and UNa excretion. In healthy children, there was a positive correlation between UCa excretion and both UNa and Ucit excretion. Although UCa/cre and Ucit/cre ratios decreased with age in both healthy and patient groups, UCa/cit ratio did not show any difference with age. UCa/cre, Ucit/cre and UCa/cit ratios were also not affected by gender in both groups. The cut off level of UCa/cit differentiating the children with urolithiasis and healthy children was found to be 0.39 mg/mg.In conclusion, UCa/cre ratio is affected by several factors, principally age. UCa/cit ratio is not affected by gender and age. We suggest that UCa/cit ratio, which is a more stabil marker than UCa/cre, can be used in determining and following the children with hypercalciüric stones.
In this study, it is aimed to determine the urine Na, K, Cre, Ca and citrate levels, to establish the ratio of spot urine Ca/cre, Na/cre, K/cre, cit/cre and Ca/cit between the children with urolithiasis and normal healthy children, to evaluate the association of urine Ca/cit with urolithiasis and also to determine the cut-off level of Ca/cit for differentiating children with urolithiasis and normal healthy population.This study was performed in Uludag University, Faculty of Medicine, Department of Pediatric Nephrology between October 2009 and February 2010. A total of 121 children aged between 1 and 18 years with urolithiasis who were followed up in Pediatric Nephrology Policlinic and 107 age and gender matched healthy children were included to this study.The mean age of our patients was 8.8±5.0 and 65 of them (53.7%) were female and 56 of them (46.3%) were male. Although there was no significant difference between the patient and control group in terms of Una excretion; UK, Ucre and Ucit excretion were higher in the healthy population. UCa excretion was higher in the patient group. The mean Ca/cre and Ca/cit were significantly higher in the patient group compared with the control group. The mean Na/cre, K/cre and cit/cre levels did not show any difference between the patient and control groups. Ucre excretion increased with age in both patient and control groups. In children with urolithiasis, there was a significant positive correlation between UCa excretion and UNa excretion. In healthy children, there was a positive correlation between UCa excretion and both UNa and Ucit excretion. Although UCa/cre and Ucit/cre ratios decreased with age in both healthy and patient groups, UCa/cit ratio did not show any difference with age. UCa/cre, Ucit/cre and UCa/cit ratios were also not affected by gender in both groups. The cut off level of UCa/cit differentiating the children with urolithiasis and healthy children was found to be 0.39 mg/mg.In conclusion, UCa/cre ratio is affected by several factors, principally age. UCa/cit ratio is not affected by gender and age. We suggest that UCa/cit ratio, which is a more stabil marker than UCa/cre, can be used in determining and following the children with hypercalciüric stones.
Description
Keywords
Çocuk, Ürolityazis, Hiperkalsiüri, Hipositratüri, Children, Urolithiasis, Hypercalciuria, Hypocitraturia
Citation
Akacı, O. (2010). Ürolityazisli çocuklarda idrar kalsiyum, sitrat oranlarının belirlenmesi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.