Erken evre otozomal dominant polikistik böbrek hastalığında fgf23 düzeyi ve arteryel sertlik (Stiffness) ile ilişkisi
Loading...
Date
2012
Authors
Yıldız, Abdülmecit
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Otozomal Dominant Polikistik Böbrek Hastalığında (ODPBH) hastalığında en önemli mortalite nedeni kardiyovasküler (KV) hastalıklardır. ODPBH'nda KV hastalıkların etyolojisi net değildir. Kronik böbrek hastalığına sahip hastalarda ve normal popülasyonda yüksek FGF23 düzeylerinin KV hastalık riskini arttırdığı gösterilmiştir. ODPBH'nda FGF23 düzeyinin arttığı tek bir çalışmada bildirilmiştir. Çalışmamızda erken evre ODPBH'nda FGF 23 düzeyini ve arteriyel sertlik ile ilişkisini araştırmayı planladık.Böbrek fonksiyonları normal 54 (37 erkek, 17 kadın) erken evre ODPB hastası ve 26 (13 erkek, 13 kadın) sağlıklı kontrol grubu çalışmaya alındı. Tüm hastaların FGF23 düzeyi ve aplanasyon tonometri metodu ile arteriyel elastisite ölçümlerinin kantitatif analizi yapıldı.ODPBH grubunda 23 hastada hipertansiyon mevcuttu Hipertansif hastaların tamamı Renin-Anjiyotensin sistemi (RAS) blokeri kullanmaktaydı. ODPBH'nda FGF23 düzeyi sağlıklı kontrol grubu ile karşılaştırıldığında belirgin olarak yüksekti. [sırasıyla 340.2RU/ml (60.4-1770) e karşı 39.8RU/ml (4-82.6) P < 0.001]. Kalsiyum, fosfor D vitamini ve PTH düzeyleri arasında fark yoktu. Büyük (C1) ve küçük (C2) arter elastisitesi ODPBH'nda kontrol grubu ile karşılaştırıldığında belirgin olarak düşüktü. Hipertansif olmayan ODPBH'nda (n=31) küçük arter (C2) elastisitesi sağlıklı kontrol grubuna göre belirgin olarak düşüktü (p değeri 0.004). Hipertansif ODPBH'nda (n=23) ve kontrol grubunda elastisite ölçümleri benzerdi (p değeri 0.241). Arteriyel elastisite ölçümleri (C1, C2) ile FGF23 düzeyleri arasında korelasyon bulunmadı.Çalışmamızda erken evre ODPB hastalarında FGF23 düzeyinin arteriyel sertlikle birlikte belirgin olarak arttığı gösterildi. Ayrıca RAS blokerlerinin ODPBH'nda arteriyel sertlik üzerinde olumlu etkileri olabilir. Daha büyük çalışmalarla ODPB hastalığında FGF23 artışının nedenleri ve bu hasta grubunda KV etkileri araştırılmalıdır.
Most deaths in autosomal dominant polycystic kidney disease (ADPKD) are attributable to cardiovascular disease (CVD). Etiology of CVD is not clear in ADPKD. Elevated levels of FGF23 have been linked to greater risks of CVD in normal and chronic kidney disease population. One paper has been reported to have elevated circulating levels of FGF23 in ADPKD. We investigated the level of FGF23 in early ADPKD patients and association with arterial stiffness in those patientsFifty four. patients with ADPKD (37 male, 17 female) with well-preserved renal function and twenty six healthy subjects (13 male, 13 female) were included in the study. Quantitative analysis of the arterial elasticity was performed by applanation tonometry and serum FGF23 level was measured in all participants.In ADPKD group, twenty three patients were hypertensive. All patients were using RAS blockers in hypertensive group. The mean levels of FGF23 were significantly higher in ADPKD compared to healthy volunteers [340.2RU/ml (60.4-1770) versus 39.8RU/ml (4-82.6)respectively; P < 0.001]. Calcium, phosphorus, vitamin D and PTH levels did not differ. Large (C1) and small (C2) vessel compliance were signi ? cantly lower in the ADPKD patients (p value 0.033, 0.013 respectively). In the group with no hypertensive ADPKD (n=31), small (C2) vessel compliance was significantly lower compared to healthy volunteers(p value 0.004). Measurements of elasticity(C1,C2) in hypertensive ADPKD and control groups were similar There was not a correlation between elacticty measurement (C1, C2) and FGF23 level.FGF23 was substantially elevated with increased arterial stiffness in early ADPKD patients Moreover,RAS blockers may have beneficial effects on arterial stiffness in ADPKD. Additional studies are required to determine possible mechanism for this anomaly and direct vascular effects of FGF23 in ADPKD patients.
Most deaths in autosomal dominant polycystic kidney disease (ADPKD) are attributable to cardiovascular disease (CVD). Etiology of CVD is not clear in ADPKD. Elevated levels of FGF23 have been linked to greater risks of CVD in normal and chronic kidney disease population. One paper has been reported to have elevated circulating levels of FGF23 in ADPKD. We investigated the level of FGF23 in early ADPKD patients and association with arterial stiffness in those patientsFifty four. patients with ADPKD (37 male, 17 female) with well-preserved renal function and twenty six healthy subjects (13 male, 13 female) were included in the study. Quantitative analysis of the arterial elasticity was performed by applanation tonometry and serum FGF23 level was measured in all participants.In ADPKD group, twenty three patients were hypertensive. All patients were using RAS blockers in hypertensive group. The mean levels of FGF23 were significantly higher in ADPKD compared to healthy volunteers [340.2RU/ml (60.4-1770) versus 39.8RU/ml (4-82.6)respectively; P < 0.001]. Calcium, phosphorus, vitamin D and PTH levels did not differ. Large (C1) and small (C2) vessel compliance were signi ? cantly lower in the ADPKD patients (p value 0.033, 0.013 respectively). In the group with no hypertensive ADPKD (n=31), small (C2) vessel compliance was significantly lower compared to healthy volunteers(p value 0.004). Measurements of elasticity(C1,C2) in hypertensive ADPKD and control groups were similar There was not a correlation between elacticty measurement (C1, C2) and FGF23 level.FGF23 was substantially elevated with increased arterial stiffness in early ADPKD patients Moreover,RAS blockers may have beneficial effects on arterial stiffness in ADPKD. Additional studies are required to determine possible mechanism for this anomaly and direct vascular effects of FGF23 in ADPKD patients.
Description
Keywords
Fibroblast growth factor 23, Otozomal dominant polikistik böbrek hastalığı, Arteriyel sertlik, Autosomal dominant polycystic kidney disease, Arterial stiffness
Citation
Yıldız, A. (2012). Erken evre otozomal dominant polikistik böbrek hastalığında fgf23 düzeyi ve arteryel sertlik (Stiffness) ile ilişkisi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.