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Dergiler / Düzce Tıp Fakültesi Dergisi / 2025 / Volume: 27 Issue: 3

Diyaliz Hastalarında Yükselmiş Kadmiyum Düzeyleri ve Bunların İnflamasyon, Oksidatif Stres ve Malnütrisyon ile İlişkisi

Elevated Cadmium Levels in Dialysis Patients and Their Links to Inflammation, Oxidative Stress, and Malnutrition

Kursad Onec(DÜZCE ÜNİVERSİTESİ)0000-0003-3866-2838
Yasemin Erten(GAZI UNIVERSITY)0000-0002-4073-5525
Özge Paşaoğlu(GAZI UNIVERSITY)0000-0002-5221-9034
Fatma Ayerden Ebinç(GAZI UNIVERSITY)0000-0002-7893-3498
Gülay Ulusal Okyay(GAZI UNIVERSITY)0000-0003-0770-1283
Salih İnal(GAZI UNIVERSITY)0000-0001-5792-9265
Hatice Paşaoğlu(GAZI UNIVERSITY)0000-0001-8343-7432
Serpil Müge Değer(GAZI UNIVERSITY)0000-0002-7635-2382
Sayfa
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Yayın Tarihi
2025-12-25
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Bulgular: Hem HD hem de PD hastalarında, tam kan Cd ve cCd düzeyleri, sağlıklı kontrollere kıyasla anlamlı derecede yüksekti (sırasıyla, p=0,021 ve p=0,001), ancak iki diyaliz yöntemi arasında anlamlı bir fark saptanmamıştır.

📌 3 Maddede Bu Makale

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Amaç & Hipotez:Amaç: Bu çalışmanın amacı, hemodiyaliz (HD) ve periton diyalizi (PD) hastaları ile sağlıklı bireyler arasında kandaki kadmiyum (Cd) düzeylerini karşılaştırmak ve Cd düzeylerinin inflamatuar, oksidatif ve beslenme belirteçleri ile ilişkisini değerlendirmektir.
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Temel Bulgular & Veri:Gereç ve Yöntemler: Bu kesitsel çalışmaya 61 diyaliz hastası (31 HD, 30 PD) ve 15 sağlıklı kontrol dahil edilmiştir.
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Sonuç & Katkı:Bulgular: Hem HD hem de PD hastalarında, tam kan Cd ve cCd düzeyleri, sağlıklı kontrollere kıyasla anlamlı derecede yüksekti (sırasıyla, p=0,021 ve p=0,001), ancak iki diyaliz yöntemi arasında anlamlı bir fark saptanmamıştır.
🔬Tür:Research Article
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Cadmium · Chronic kidney disease · Hemodialysis

Özet

Amaç: Bu çalışmanın amacı, hemodiyaliz (HD) ve periton diyalizi (PD) hastaları ile sağlıklı bireyler arasında kandaki kadmiyum (Cd) düzeylerini karşılaştırmak ve Cd düzeylerinin inflamatuar, oksidatif ve beslenme belirteçleri ile ilişkisini değerlendirmektir. Gereç ve Yöntemler: Bu kesitsel çalışmaya 61 diyaliz hastası (31 HD, 30 PD) ve 15 sağlıklı kontrol dahil edilmiştir. Tam kan Cd düzeyleri atomik absorbsiyon spektrometrisi ile ölçülmüş ve hemoglobin düzeyine göre düzeltilmiştir (cCd). Serum interlökin-6 (IL-6), yüksek duyarlılıklı C-reaktif protein (hs-CRP), malondialdehit (MDA) ve ileri oksidasyon protein ürünleri (AOPP) inflamasyon ve oksidatif stresin göstergeleri olarak analiz edilmiştir. Bulgular: Hem HD hem de PD hastalarında, tam kan Cd ve cCd düzeyleri, sağlıklı kontrollere kıyasla anlamlı derecede yüksekti (sırasıyla, p=0,021 ve p=0,001), ancak iki diyaliz yöntemi arasında anlamlı bir fark saptanmamıştır. Korelasyon analizlerinde Cd düzeylerinin inflamasyon ve oksidatif stres belirteçleri olan IL-6 (rs=0,338, p=0,003), hs-CRP (rs=0,464, p=0,001), MDA (rs=0,464, p=0,001) ve AOPP (rs=0,454, p=0,001) ile pozitif yönde korelasyon gösterdiği belirlenmiştir. Buna karşılık, cCd düzeylerinin serum albümin konsantrasyonları ile negatif yönde anlamlı korelasyon gösterdiği saptanmıştır (rs=-0,454, p=0,001). Sonuç: Cd birikimi, tedavi yönteminden bağımsız olarak diyaliz hastalarında belirgin şekilde artmıştır ve bu sistemik inflamasyon, oksidatif hasar ve bozulmuş beslenme durumu ile yakından ilişkilidir. Çevresel Cd maruziyeti, kronik böbrek hastalığında (KBH) olumsuz klinik sonuçlara katkıda bulunan yeterince tanınmamış bir faktör olabilir ve Cd yükünü azaltmaya yönelik önleyici stratejiler, bu hasta grubunda prognozu iyileştirmeye katkı sağlayabilir.

Abstract

Aim: This study aimed to compare blood cadmium (Cd) levels between hemodialysis (HD) and peritoneal dialysis (PD) patients and healthy controls, and to evaluate the associations between Cd levels and inflammatory, oxidative, and nutritional markers. Material and Methods: Sixty-one dialysis patients (31 HD, 30 PD) and 15 healthy controls were included in this cross-sectional study. Whole-blood Cd was measured by atomic absorption spectrometry and corrected for hemoglobin (cCd). Serum interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), malondialdehyde (MDA), and advanced oxidation protein products (AOPP) were analyzed as indicators of inflammation and oxidative stress. Results: Both whole-blood Cd and cCd levels were significantly higher in both HD and PD patients compared with healthy controls (p=0.021 and p=0.001, respectively), while no statistically significant difference was observed between the two dialysis modalities. Correlation analyses demonstrated that Cd levels were positively correlated with inflammatory and oxidative stress markers, including IL-6 (rs=0.338, p=0.003), hs-CRP (rs=0.464, p=0.001), MDA (rs=0.464, p=0.001), and AOPP (rs=0.454, p<0.001). In contrast, cCd levels showed a significant negative correlation with serum albumin concentrations (rs=-0.454, p=0.001). Conclusion: Cd accumulation is markedly increased in dialysis patients regardless of treatment modality and is closely linked to systemic inflammation, oxidative damage, and reduced nutritional status. Environmental Cd exposure may represent an under-recognized contributor to adverse clinical outcomes in chronic kidney disease (CKD), and preventive strategies to minimize Cd burden may help improve prognosis in this population.

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Bu Makaleye Atıf Yap

Onec, K., Erten, Y., Paşaoğlu, Ö., Ebinç, F. A., Okyay, G. U., İnal, S., Paşaoğlu, H., Değer, S. M. (2025). Diyaliz Hastalarında Yükselmiş Kadmiyum Düzeyleri ve Bunların İnflamasyon, Oksidatif Stres ve Malnütrisyon ile İlişkisi. Düzce Tıp Fakültesi Dergisi, Volume: 27 Issue: 3. https://doi.org/10.18678/dtfd.1808654

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