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TİP 2 DÎABETÎK HASTALARDA GLOMERÜLER FÎLTRASYON HIZI DEĞİŞİKLİKLERİ VE İLİŞKİLİ FAKTÖRLER

GLOMERULAR FILTRATION RATE CHANGES IN TYPE 2 DIABETES AND RELATED FACTORS

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Abstract (2. Language): 
The aim of this study was to estimate glomerular filtration rate (GFR) in patients with type 2 diabetes mellitus and to search for factors determining GFR. One hundred and eight (70 female, 29 male) patients were included in the study. Serum lipid and HbAlc levels were measured. In random urine samples urinary albumin and creatinine concentrations were determined and albumin / creatinine ratio was calculated. GFR was estimated by using Tc 99m-DTPA with gamma camera. Fundoscopic examination was performed in all patients. A negative correlation between GFR and age (r=-0.25, p<0.03) and a positive correlation between GFR and body mass index were found. There was no correlation between GFR and diabetes duration, blood pressure, serum HbAlc and lipid levels. GFR was significantly decreased in patients with microalbuminuria than normoalbuminuria (p<0.05) and in patients with macroalbuminuria than with microalbuminuria (p<0.005). GFR was also decreased in patients with retinopathy than without retinopathy (p<0.05). There was no significant difference between patients with and without hypertension. GFR was also lower in male patients and in patients using insulin (p<0.05 and p<0.01, respectively). In conclusion, renal function should be evaluated by GFR estimation in type 2 diabetic patients with micro- or macroalbuminuria, with retinopathy and on insulin therapy.
Abstract (Original Language): 
Çalışmamızda Tip 2 diabetik olgularda glomerüler filtrasyon hızının (GFR) ölçülmesi ve GFR değişikliklerini belirleyen faktörlerin araştırılması amaçlandı. Çalışmaya serum kreatinin düzeyleri normal 108 hasta (79 kadın, 29 erkek) alındı. Serum lipid ve HbAlc düzeylerine bakıldı. Spot idrarda albumin ve kreatinin tayini yapılarak idrar albumin / kreatinin oranı hesaplandı. GFR Tc 99m-DTPA kullanılarak gama kamera ile ölçüldü. Hastaların fundoskopik muayenesi yapıldı. GFR ile yaş arasında negatif (r=-0.25, p=0.03); VKİ arasında pozitif (r=0.21, p=0.03) anlamlı korelasyon saptandı. GFR ile diabet süresi, kan basıncı, serum HbAlc, ve lipid düzeyleri arasında korelasyon yoktu. GFR mikroalbuminürisi olan olgularda normoalbuminüriklere, makroalbuminürisi olanlarda mikroalbuminüriklere göre düşüktü (sırasıyla, p<0.05 ve p<0.005). GFR retinopatisi olan olgularda da olmayanlara göre düşük bulundu (p<0.05). Hipertansiyonu olan ve olmayan olguların GFR 'lerinde ise anlamlı fark yoktu. GFR erkeklerde ve insülin kullananlarda da düşüktü (sırasıyla, p<0.05 ve p<0.01). Sonuç olarak mikro- veya makroalbuminürik, retinopatisi olan ve insülin kullanan tip 2 diabetik hastalarda böbrek fonksiyonları GFR ile değerlendirilmelidir.
FULL TEXT (PDF): 
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