Periton Diyalizi Hastalarında Yeni Bir Endotel Fonksiyonu Belirteci: Apelin

Abstract

Özet. AbstractAmaç: Son dönem böbrek yetersizliginde en önemli mortalité sebebi kardiyovasküler hastaliklardir (KVH). KVH patogenezinde en önemli basamaklardan birisi endotel disfonksiyonudur (ED). Apelin son yillarda kardiyovasküler sistem ve endotel fizyolojisinde önemli rolleri gösterilmij bir peptiddir. Çalijmamizda periton diyalizi (PD) hastalannda apelin ile endotel fonksiyonlan arasindaki ilijkiyi incelemeyi planladik.Yöntem: Haseki Egitim ve Arajtirma Hastanesi PD Ünitesi'nden takipli 42 hasta çalijmaya alindi. Endotel fonksiyonlan ultrasonografik olarak akim aracili dilatasyon (AAD) yüzdesi ile degerlendirildi. Hastalarda aliñan kan örneklerinde rutin biyokimyasal tetkikler ve apelin ölcümü yapildi. Bulgular: Apelin ile AAD yüzdesi arasmda négatif korelasyon saptandi (r=-0.334, p=0.03). AAD yüzdesi ile trigliserid ve çok düjük dansiteli Iipoprotein (VLDL) düzeyleri arasmda pozitif korelasyon oldugu görüldü (sirasiyla r=0.310, p=0.046; r=0.304, p=0.05). AAD yüzdesi ile sistolik kan basmci ve diyastolik kan basinci arasinda anlamli négatif korelasyon mevcuttu (sirasiyla r=0.565, p=<0.001; r=0.560, p=<0.001). Hipertansiyon olan grupta olmayan gruba göre AAD yüzdesi belirgin olarak düjük bulundu (sirasiyla 9.0±5.8 ve 14.9+6.6; p=0.01).Sonuç: ED PD hastalannda hipertansiyon ve lipid profili ile yakm ilijkilidir Apelin ise PD hastalarinda ED agsmdan yeni bir belirteç ve tedavi alternatifi olarak kullanilabilir. (Haseki Tip Bùlteni2013; 51:5-10) Anahtar Kelimeler: Apelin, endotel disfonksiyonu, periton diyalizi Aim: The most important cause of death in end-stage renal disease is cardiovascular diseases (CVDs). Endothelial dysfunction (ED) is one of the most important steps in the pathogenesis of CVD Apelin is a peptide recently found to have important roles in cardiovascular and endothelial physiology; and we planned in our study to examine the relationship between apelin and endothelial functions in peritoneal dialysis (PD) patients. Methods:Forty-two patients who were followed up in the PD unit at Haseki Training and Research Hospital were involved. Endothelial functions were evaluated ultrasonographically by flow-mediated dilation (FMD) test. Apelin levels and routine laboratory tests were studied from the blood samples obtained from the patients. Results: There was a negative correlation between apelin and FMD percentage (r=-0.334, p=0.03). FMD percentage positively correlated with triglycéride and very low density Iipoprotein levels (r=0.310, p=0.046; r=0.304, p=0.05, respectively). FMD percentage significantly positively correlated with systolic and diastolic blood pressure (r=0.565,p=<0.001; r=0.560,p=<0.001, respectively). FMD was significantly lower patients with hypertension, compared to those without hypertension (9±5.8 vs. 14.9±6.6; p=0.01). Conclusion: ED is closely related with hypertension and lipid profile in PD patients. Apelin may be used as a new marker for ED and a treatment alternative in PD patients. (The Medical Bulletin of Haseki 2013; 51: 5-10)