AI Summary & Key Takeaways
AI InsightIt was found that RFR of the COPD patients was significantly lower than the controls by both PI and RI values (p<0.01 and p<0.01, respectively).
📌 3 Key Takeaways
Abstract
Oedema, which can not be explained by a cardiovascular, renal, or any other systemic disease is a common complication of chronic obstructive pulmonary disease (COPD) and it is a poor prognostic sign. These patients are usually hypercapnic and in chronic respiratory failure and their renal blood flow is reduced but increases when the clinical status improves. Renal functional reserve (RFR) is an index of the capacity of the kidney to increase its function, by vasodilatation of glomerular arterioles and recruitment of dormant nephrons in response to stimuli such as oral protein load, amino acid and dopamine infusion. Doppler ultrasonography indices like renal artery pulsatility index (PI) and/or renal artery resistivity index (RI) can be used to calculate RFR in a noninvasive way. Twenty-one moderate or severe COPD patients (without any known renal disease) and 13 healthy controls were enrolled to study if there was any change in the RFR of the COPD patients when compared with the controls. The baseline PI and RI values were not different statistically in both groups and RFR was calculated by comparing the PI and RI values at baseline to 75th minute where the most prominent change was observed after oral protein load. It was found that RFR of the COPD patients was significantly lower than the controls by both PI and RI values (p<0.01 and p<0.01, respectively). These results suggest that decreased RFR may be useful to detect an early stage of impaired renal functions in COPD patients.
Özet
Kronik obstrüktif akciger hastaligi (KOAH) olgularinda herhangi bir kardiyovasküler, renal ya da sistemik hastalikla açiklanamayan ödem gelismesi sik görülen ve kötü prognoz isareti oldugu bilinen bir komplikasyondur. Bunlar genellikle hiperkapnik ve kronik solunum yetmezligindeki hastalar olmaktadir. Bu hastalarda renal kan akiminin azaldigi ve klinik düzelmeye paralel olarak da bir dereceye kadar artis gösterdigi bildirilmistir. Normal olarak böbreklerin oral protein yüklenmesi, aminoasit ve dopamin infüzyonu gibi uyaranlara glomerüler filtrasyon hizini ve renal kan akimini artirarak yanit verme yetenegi vardir ve buna renal fonksiyonel rezerv (RFR) denilmektedir. RFR'nin degerlendirilmesinde Doppler ultrasonografisi ile yapilan invazif olmayan ve güvenilir yöntemler olan renal arter pulsatilite indeksi (PI) ve/veya renal arter rezistivite indeksi (RI) ölçümleri kullanilabilmektedir. KOAH'li kisilerin RFR'lerinde bir degisiklik olup olmadigini arastirmak amaciyla, bilinen herhangi bir renal hastaligi olmayan 21 orta veya agir KOAH olgusu ve kontrol grubu olarak 13 saglikli kisi çalismaya dahil edilmistir. Bazal PI ve RI degerleri istatistiksel açidan farkli olmayan KOAH ve kontrol gruplarinin, oral protein yüklemesinden sonra en yüksek degisikligin gözlendigi 75. dakikadaki degerlere göre hesaplanan RFR degerleri KOAH grubunda kontrol grubuna göre anlamli sekilde düsük bulunmustur (PI ve RI için sirasiyla p<0.01 ve p<0.01). Sonuç olarak, RFR degerlendirmesinin, KOAH hastalarinin renal fonksiyonlarindaki bozulmanin erken dönemde saptanmasinda yararli olabilecegi düsünülmüstür.