master's thesis
Utjecaj inhibitora renin-angiotenzin-aldosteronskog sustava na krvnu sliku kod bolesnika s bubrežnim transplantatom

Marta Žutelija (2016)
Sveučilište u Rijeci
Medicinski fakultet
Katedra za internu medicinu
Metadata
TitleUtjecaj inhibitora renin-angiotenzin-aldosteronskog sustava na krvnu sliku kod bolesnika s bubrežnim transplantatom
AuthorMarta Žutelija
Mentor(s)Lidija Orlić (thesis advisor)
Abstract
RAAS inhibitori često su korišteni lijekovi kod bolesnika s bubrežnim transplantatom zbog povoljnog antihipertenzivnog i renoprotektivnog učinka, ali postoji oprez oko njihovog korištenja zbog moguće pojave hiperkalijemije, renalne disfunkcije i anemije. Cilj ovog istraživanja bio je procijeniti utjecaj RAAS inhibitora na serumske razine Hb i Htc te na funkciju bubrežnog transplantata kod transplantiranih bolesnika sa stabilnim bubrežnim transplantatom u ovisnosti o početnim višim ili nižim vrijednostima Hb i Htc. U istraživanje je uključeno 270 bolesnika sa stabilnim bubrežnim transplantatom. Osim druge propisane antihipertenzivne terapije 169 bolesnika koristilo je RAAS inhibitore. Kako bi se procijenio utjecaj RAAS inhibitora na Hb i Htc kod bolesnika s početnim nižim ili višim vrijednostima ovih parametara, samo oni koji su uzimali RAAS inhibitore podijeljeni su u dvije skupine: jednu s višim vrijednostima Hb i Htc (početne vrijednosti Hb ≥150 g/L i Htc ≥45%) i drugu s nižim vrijednostima Hb i Htc (početne vrijednosti Hb ≤150 g/L i Htc ≤45%). Kod bolesnika s početnim višim vrijednostima Hb i Htc došlo je do značajnog pada u vrijednostima Hb i Htc, a u grupi bolesnika s početnim nižim vrijednostima Hb i Htc došlo je do značajnog porasta u vrijednostima Hb i Htc nakon dvanaestomjesečnog perioda praćenja. Korištenje RAAS inhibitora bilo je povezano s trendom usporavanja insuficijencije bubrežnog transplantata. Na temelju rezultata zaključuje se da RAAS inhibitori snižavaju razinu Hb i Htc samo kod transplantiranih bolesnika s početnim višim vrijednostima, a kod onih s početnim nižim vrijednostima imaju povoljan utjecaj na eritropoezu i funkciju bubrežnog presatka.
Keywordschronic kidney disease kidney transplantation angiotensin-converting enzyme inhibitors angiotensin II receptor type 1 blockers
Committee MembersSrđan Novak (committee chairperson)
Goran Hauser (committee member)
Alemka Brnčić-Fischer (committee member)
GranterSveučilište u Rijeci
Medicinski fakultet
Lower level organizational unitsKatedra za internu medicinu
PlaceRijeka
StateCroatia
Scientific field, discipline, subdisciplineBIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Internal Medicine
Study programme typeuniversity
Study levelintegrated undergraduate and graduate
Study programmeMedicine
Academic title abbreviationdr. med.
Genremaster's thesis
Language Croatian
Defense date2016-07-15
Parallel abstract (English)
RAAS inhibitors are often prescribed medications in the kidney transplant population due to their beneficial antihypertensive and renoprotective effects, but there is the caution about their usage because of possible hyperkalemia, renal dysfunction and anemia. The aim of this study was to evaluate the effect of RAAS inhibitors on serum Hb and Htc and renal graft function in stable renal transplant recipients in respect with initially higher or lower Hb and Htc values. In this study 270 stable renal transplant recipients have been evaluated. Besides other prescribed antihypertensive therapy, 169 of them have been taking RAAS inhibitors. To evaluate the effect of RAAS inhibitors on Hb and Htc in patients with initially higher or lower levels of these parameters, only those who have been taking RAAS inhibitors were stratified into two groups: one with higher Hb and Htc (initial Hb ≥ 150 g/L and Htc ≥ 45%) and another one with lower Hb and Htc (initial Hb b 150 g/L and Htc b 45%) values. Patients with initially higher Hb and Htc had a significant decrease in Hb and Htc and those with initially lower Hb and Htc had a significant increase in Hb and Htc levels after 12-months of follow-up. The use of RAAS inhibitors has been associated with a trend of slowing renal insufficiency. In conclusion, RAAS inhibitors lower Hb and Htc only in those renal transplant recipients with initially higher levels. In those with initially lower levels they have beneficial impact on erythropoiesis and kidney graft function.
Parallel keywords (Croatian)kronična bubrežna bolest transplantacija bubrega inhibitori angiotenzin konvertirajućeg enzima antagonisti tip 1 receptora angiotenzina II
Resource typetext
Access conditionAccess restricted to students and staff of home institution
Terms of usehttp://rightsstatements.org/vocab/InC/1.0/
URN:NBNhttps://urn.nsk.hr/urn:nbn:hr:184:816695
CommitterBosa Licul