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Dergiler / Medical Records / 2026 / Sayı: 1

Transkateter Aort Kapak Replasmanı Sonrası Gelişen Akut Böbrek Hasarı, Diyabetik Hastalarda Tek Başına Kötü Prognozu Öngörebilir mi?

Can Acute Kidney Injury After Transcatheter Aortic Valve Replacement Alone Predict Poor Prognosis in Diabetic Patients?

Nur Ozer Sensoy(Bursa Şehir Hastanesi)0000-0001-8809-2250
Fatih Levent(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, BURSA YÜKSEK İHTİSAS SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, KARDİYOLOJİ ANABİLİM DALI)0000-0002-7160-4050
Ece Çelebi Çoskun(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, BURSA YÜKSEK İHTİSAS SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, KARDİYOLOJİ ANABİLİM DALI)0000-0002-0002-8578
Günseli Demir(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, BURSA YÜKSEK İHTİSAS SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ)0009-0007-1996-5266
Fahriye Vatansever(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, BURSA YÜKSEK İHTİSAS SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, KARDİYOLOJİ ANABİLİM DALI)0000-0002-1401-2980
Sayfa
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Yayın Tarihi
2026-02-01
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Bulgular: Toplam 35 hastada (%24,8) ABH gelişti.

📌 3 Maddede Bu Makale

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Amaç & Hipotez:Amaç: Transkateter aort kapak replasmanı (TAVR), cerrahi riski yüksek olan semptomatik şiddetli aort darlığı (AD) hastaları için yerleşik bir tedavi alternatifi haline gelmiştir.
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Temel Bulgular & Veri:Bu çalışmanın amacı, TAVR uygulanan diyabetik hastalarda postoperatif ABH gelişiminin mortalite ve majör kardiyak advers olaylar (MACE) üzerindeki etkisini değerlendirmektir.
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Sonuç & Katkı:Bulgular: Toplam 35 hastada (%24,8) ABH gelişti.
🔬Tür:Klinik Araştırma
📍Kapsam:2017 · 141 hasta
⚙️Değişkenler:Akut böbrek hasarı · diyabetes mellitus · TAVR

Özet

Amaç: Transkateter aort kapak replasmanı (TAVR), cerrahi riski yüksek olan semptomatik şiddetli aort darlığı (AD) hastaları için yerleşik bir tedavi alternatifi haline gelmiştir. Altta yatan komorbiditeler nedeniyle, özellikle diyabetik hastalarda TAVR sonrası akut böbrek hasarı (ABH) sık görülen bir komplikasyon olmaya devam etmektedir. Bu çalışmanın amacı, TAVR uygulanan diyabetik hastalarda postoperatif ABH gelişiminin mortalite ve majör kardiyak advers olaylar (MACE) üzerindeki etkisini değerlendirmektir. Yöntemler: Ocak 2017 - Ocak 2020 tarihleri arasında TAVR uygulanan 141 hasta, ABH gelişimi ve MACE varlığına göre gruplara ayrıldı. ABH gelişen ve gelişmeyen hastalar arasında MACE ve 5 yıllık mortalite oranları karşılaştırıldı. Bulgular: Toplam 35 hastada (%24,8) ABH gelişti. Ayrıca, 36 hastada (%25,5) MACE gözlendi. ABH gelişen hastalarda 5 yıllık mortalite oranı (%42,9 vs. %15,1; p=0,002) ve MACE oranı (%54,3 vs. %16; p<0,001) anlamlı derecede daha yüksekti. MACE gelişimi ile ilişkili parametreler değerlendirildiğinde, univaryant ve multivaryant lojistik regresyon analizlerinde ABH gelişiminin diğer faktörlerden bağımsız olarak MACE için önemli bir belirleyici olduğu tespit edildi (OR=3,92, %95 CI: 1,28-12,02; p=0,017). Sonuçlar: Bu çalışmadan elde edilen en önemli sonuç, şiddetli aort darlığı tanısı ile TAVR uygulanan diyabetik hastalarda ABH gelişiminin, diğer parametrelerden bağımsız olarak MACE ve uzun dönem mortalite üzerinde belirleyici bir etkiye sahip olduğudur.

Abstract

Aim: Transcatheter aortic valve implantation (TAVI) has become a well-recognized treatment option for patients with symptomatic severe aortic stenosis (AS) who are deemed to have a higher risk for surgical intervention. Due to underlying comorbidities, acute kidney injury (AKI) continues to be a common complication, especially in patients with diabetes mellitus after TAVR. The aim of this study is to evaluate the effect of postoperative AKI development in diabetic patients undergoing TAVR on the development of mortality and major adverse cardiac events (MACE) in these patients. Material and Method: A total of 141 patients who underwent TAVR between January 2015 and January 2020 were grouped according to whether they developed AKI and whether they had MACE. MACE and 5-year mortality status were compared according to whether the patients developed AKI. Results: A total of 35 patients were observed to develop AKI (24.8%). Additionally, MACE was observed in 36 patients (25.5%). Five-year mortality rates (42.9% vs. 15.1%; p = 0.002) and MACE rates (54.3% vs. 16%; p < 0.001) were significantly higher in the AKI group. Univariate and multivariate logistic regression analyses identified AKI as a significant independent predictor of MACE development, regardless of other associated parameters (OR = 3.92, 95% CI: 1.28–12.02; p = 0.017). Conclusion: The most important result obtained in this study is that AKI development in diabetic patients who underwent TAVR with the diagnosis of advanced aortic stenosis has an effect on the development of MACE and long-term mortality independently of other parameters.

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Bu Makaleye Atıf Yap

Sensoy, N. O., Levent, F., Çoskun, E. Ç., Demir, G., Vatansever, F. (2026). Transkateter Aort Kapak Replasmanı Sonrası Gelişen Akut Böbrek Hasarı, Diyabetik Hastalarda Tek Başına Kötü Prognozu Öngörebilir mi?. Medical Records, Sayı: 1. https://doi.org/10.37990/medr.1654048

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