Yeni̇ tani almiş evre v kroni̇k böbrek hastalarinda volüm yükü beli̇rteçleri̇ni̇n karşilaştirmasi

Aim: The main reason of hypertension at chronic kidney disease is extracellular fluid overload. The early diagnose of volume overload is vital because the cardiovascular diseases are the most well known morbidity and mortality reason at that period. In case of determining the volume overload; bioelectrical impedance analysis, diameter of VCI and pro-BNP may be used besides conventional diagnose methods. In this study, the relationship of volume overload that was determined by multifrequency BIS with NT-proBNP, diameter of VCI and blood pressure was evaluated at newly diagnosed stage V chronic kidney disease patients. Material and Methods: A total of 85 patients with late stage renal disease that did not take renal replacement therapy were enrolled in this study. The OH and ECW values of patients were measured by multifrequency BIS device. Relative tissue fluid (RTF) was determined by OH/ECW ratio. RTF over %15 is related with mortality. We seperated the patients into two groups as having RTF over and under %15. Diameter of VCI were measured by using ECHO and NT-pro-BNP by immunoassay method at both of the groups. Blood pressures of the patients were measured during clinical follow up. The statistical analysis of data was performed by using Statistical Package for Social Sciences version16.0. Results: A total of 85 patients( 49 male, 36 female) aged 51.99±16.80 were enrolled in this study. There were 49 patients at group 1 (RDS over %15) and 36 patients at group 2 (RDS under %15). Age (p=0.684), gender (p=0.873), urea(p=0.52), creatinine (p=0.143), GFR(p=0.56), TVS (p=0.710) ISS (p=0.052) level differences between the two groups were not found statistically significant. But the systolic blood pressure (p=0,004), diastolic blood pressure (p=0,01), proteinuria (p=0,019), daily urine volume (p=0,042), volume overload (p<0,001), ESS (p=0,006), albumine (p<0,001), diameter of vena cava inferior (p<0,001) and pro BNP (0,016) values were found statistically significant between the two groups. Conclusion: The late stage renal disease patients that did not have volume control with renal replacement therapy has got volume overload, high systolic and diastolic blood pressure levels, high pro BNP values and increases at vena cava inferior diameter. Volum overload was significant at patients with low serum albumine levels, low daily urine output and with high proteinuria. Key Words : Late stage renal disease, BIA, relative tissue fluid, diameter of VCI, pro-BNP Evaluation of Fluid Overload at Newly Diagnosed Chronic Kidney Disease Patients