GKD Anest Yoð Bak Dern Derg. 2020; 26(1): 32-38 | DOI: 10.5222/GKDAD.2020.76993

Serum Fosfat Düzeyinin Yoðun Bakým Ünitesinde Yatan, Mekanik Ventilatör Tedavisi Gören ve Septik Þok Nedenli Akut Böbrek Hasarý Nedeniyle SRRT Uygulanan Hastalarda Yirmi Sekiz Günlük Mortalite Üzerine Etkileri

Cem Kývýlcým Kaçar, Osman Uzundere, Deniz Kandemir, Ümit Akol, Abdulkadir Yektaþ
TC.SBÜ. Gazi Yaþargil EAH, Diyarbakýr, Anesteziyoloji ve Reanimasyon kliniði

GÝRÝÞ ve AMAÇ: Fosfat sinyal iletimini, enerji üretimini ve mineral metabolizmasýný içeren düzenleyici çoklu metabolik olayda yer alan esansiyel bir mineraldir. Biz bu çalýþmada hastalarýn serum fosfat düzeylerinin fosfat referans deðeri olarak verilen 2,5-4,5 mg/dL alt ve üst sýnýrlarýndan sapmasýnýn 28 günlük mortalite üzerine etkisini araþtýrmayý planladýk.
YÖNTEM ve GEREÇLER: Hastanemiz baþhekimliðinden yazýlý izin alýndýktan sonra hasta dosyalarý retrospektif olarak taranarak yoðun bakým ünitemizde yatan septik þok iliþkili akut böbrek hasarý nedenli sürekli renal replasman tedavisi gören ve 18 yaþ üstü 53 adet hasta çalýþmaya dahil edildi. Hastanemiz biokimya laboratuarýndaki serum fosfat düzeyi referans arlýðý 2,5-4,5 mg/dL olduðundan hastalarýn ortalama serum fosfat düzeylerinin alt sýnýr referans aralýðý olan 2,5 mg/dL ve üst sýnýr referans aralýðý olan 4,5 mg/dL ye göre istatistiksel deðiþimleri hesaplandý.
BULGULAR: Hastalarýn ortalama serum fosfat düzeylerinin fosfat alt sýnýrý olan 2,5 mg/dL ye göre deðiþimi istatistiksel olarak anlamlý yüksekti 4,14±1,72, p<0,001. Gruplardaki fosfat düzeyleri karþýlaþtýrýldýðýnda Grup 1 de Grup 2 ye göre istatistiksel olarak anlamlý yüksekti p=0,047.
TARTIÞMA ve SONUÇ: Fosfat düzeyi mortal hastalarda mortal olmayan hastalara göre istatistiksel olarak anlamlý yüksekti.

Anahtar Kelimeler: Serum fosfat düzeyi, sürekli renal replasman tedavisi, akut böbrek hasarý, septik þok, 28 günlük mortalite

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The Effects of Serum Phosphate on 28-day Mortality in Patients Hospitalized in the Intensive Care Unit, Treated with Mechanical Ventilator Therapy and Treated with CRRT for Septic Shock-Induced Acute Kidney Injury

Cem Kývýlcým Kaçar, Osman Uzundere, Deniz Kandemir, Ümit Akol, Abdulkadir Yektaþ
TR. HSU. Gazi Yaþargil TRH, Diyarbakýr, Department of Anesthesiology and Reanimation

INTRODUCTION: Phosphate is an essential mineral involved in regulatory multiple metabolic events involving signal transduction, energy production and mineral metabolism. In this study, we aimed to investigate the effect of deviation of serum phosphate levels from the upper and lower limits of 2.5-4.5 mg / dL given as the phosphate reference value on 28-day mortality.
METHODS: After obtaining written permission from the head physician of our hospital, 53 patients over 18 years of age who underwent continuous renal replacement therapy due to septic shock related acute kidney injury in our intensive care unit were included in the study retrospectively. Since the serum phosphate level reference range in our hospital's biochemistry laboratory was 2.5-4.5 mg / dL, the mean serum phosphate levels of the patients were statistically lower than the lower limit reference range of 2.5 mg / dL and the upper limit reference range of 4.5 mg / dL. changes were calculated.
RESULTS: The mean serum phosphate levels of the patients were significantly higher than the phosphate lower limit of 2.5 mg / dL 4.14 ± 1.72, p <0.001. When the phosphate values of the groups were compared, it was statistically higher in Group 1 than Group 2 p = 0.047.
DISCUSSION AND CONCLUSION: Phosphate level was significantly higher in mortal patients than non-mortal patients.

Keywords: Serum phosphate levels, continuous renal replacement therapy, acute renal injury, septic shock, 28 day mortality

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ATIF KOPYALA