Geriatrik Nefroloji

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DOI :10.26650/B/CH12CH47.2023.014.08   IUP :10.26650/B/CH12CH47.2023.014.08    Tam Metin (PDF)

Protei̇nüri̇si̇ Olan Yaşlı Hastaya Yaklaşım

Şükrü Ulusoy, Gülsüm Özkan

Dünya Sağlık Örgütü’nün (DSÖ) son verilerine göre, 2030 yılına kadar dünyadaki her 6 kişiden 1’inin 60 yaş ve üzerinde olacağı öngörülmektedir. 2020 yılında 60 yaş ve üzeri nüfusun sayısı 1 milyardan 1,4 milyara yükselmiştir. Yine DSÖ tahminlerine göre 2050 yılına kadar, 60 yaş ve üzeri dünya nüfusu iki katına çıkacağı (2,1 milyar), 80 yaş ve üzeri kişilerin sayısının 2020 ile 2050 yılları arasında üç katına çıkarak 426 milyona ulaşması beklenmektedir.1 Dolayısı ile tüm dünyada yaş ortalaması artmakta ve yaşın beraberinde getirdiği komorbiditelerin tanı, tedavi ve komplikasyonlarının yönetimi giderek artan ilgi odağı olmaktadır. Ancak yaşam süresinin uzaması sağlıklı yaşam beklentisini beraberinde getirirken, sağlıklı yaşlanma henüz istenilen düzeyde sağlanamamaktadır. Sağlıklı yaşlanma yada komorbiditesi olan yaşlı hastaların yönetimi için öncelikle yaşlanma ile organ sistemlerinde oluşan fizyolojik değişimleri kavramak, fizyolojik ve patolojik süreçlerin ayrımını yapmak, yaşlanma ile sıklığı artan bazı komorbit hastalıkların organ etkilenimlerini bilmek ve medikal tedavileri yaşlanma sürecine uygun olarak yönetmek çok önemlidir. 



Referanslar

  • 1. https://www.who.int/news-room/fact-sheets/detail/ageing-and health#:~:text=At%20this%20time%20 the%20share,2050%20to%20reach%20426%20million. google scholar
  • 2. Lindeman RD, Tobin J, Shock NW. Longitudinal studies on the rate of decline in renal function with age. J Am Geriatr Soc. 1985;33(4):278-85. google scholar
  • 3. Martin JE, Sheaff MT. Renal ageing. J Pathol 2007; 211:198. google scholar
  • 4. Kubo M, Kiyohara Y, Kato I, et al. Risk factors for renal glomerular and vascular changes in an autops-y-based population survey: the Hisayama study. Kidney Int 2003; 63:1508. google scholar
  • 5. Mancilla E, Avila-Casado C, Uribe-Uribe N, et al. Time-zero renal biopsy in living kidney transplantation: a valuable opportunity to correlate predonation clinical data with histological abnormalities. Transplan-tation 2008; 86:1684. google scholar
  • 6. Kappel B, Olsen S. Cortical interstitial tissue and sclerosed glomeruli in the normal human kidney, related to age and sex. A quantitative study. Virchows Arch A Pathol Anat Histol 1980; 387:271. google scholar
  • 7. Hodgin JB, Bitzer M, Wickman L, et al. Glomerular Aging and Focal Global Glomerulosclerosis: A Po-dometric Perspective. J Am Soc Nephrol. 2015;26:3162-78. google scholar
  • 8. Denic A, Alexander MP, Kaushik V, et al. Detection and Clinical Patterns of Nephron Hypertrophy and Nephrosclerosis Among Apparently Healthy Adults. Am J Kidney Dis 2016; 68:58. google scholar
  • 9. Denic A, Lieske JC, Chakkera HA, et al. The Substantial Loss of Nephrons in Healthy Human Kidneys with Aging. J Am Soc Nephrol 2017; 28:313. google scholar
  • 10. Roseman DA, Hwang SJ, Oyama-Manabe N, et al. Clinical associations of total kidney volume: the Fra-mingham Heart Study. Nephrol Dial Transplant 2017; 32:1344. google scholar
  • 11. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int Suppl 2013; 3:136. google scholar
  • 12. Pottel H, Hoste L, Yayo E, Delanaye P. Glomerular Filtration Rate in Healthy Living Potential Kidney Donors: A Meta-Analysis Supporting the Construction of the Full Age Spectrum Equation. Nephron 2017; 135:105. google scholar
  • 13. Hallan SI, Dahl K, Oien CM, et al. Screening strategies for chronic kidney disease in the general popula-tion: follow-up of cross sectional health survey. BMJ 2006; 333:1047. google scholar
  • 14. Eknoyan G, Hostetter T, Bakris GL, et al. Proteinüria and other markers of chronic kidney disease: a posi-tion statement of the national kidney foundation (NKF) and the national institute of diyabetes and digestive and kidney diseases (NIDDK). Am J Kidney Dis. 2003;42:617-22. google scholar
  • 15. Carroll MF, Temte JL. Proteinüria in adults: a diagnostic approach. Am Fam Physician. 2000;62:1333-40. google scholar
  • 16. Polkinghorne KR. Detection and measurement of urinary protein. Curr Opin Nephrol Hypertens. 2006;15:625-30. google scholar
  • 17. Verma V, Kant R, Sunnoqrot N, Gambert SR. Proteinüria in the elderly: evaluation and management. Int Urol Nephrol. 2012;44:1745-51. google scholar
  • 18. Morcos SK, el-Nahas AM, Brown P, Haylor J. Effect of iodinated water soluble contrast media on urinary protein assays. BMJ 1992; 305:29. google scholar
  • 19. Carroll MF, Temte JL. Proteinüria in adults: a diagnostic approach. Am Fam Physician 2000; 62:1333. google scholar
  • 20. Shidham G, Hebert LA. Timed urine collections are not needed to measure urine protein excretion in clinical practice. Am J Kidney Dis 2006; 47:8. google scholar
  • 21. Naresh CN, Hayen A, Craig JC, Chadban SJ. Day-to-day variability in spot urine protein-creatinine ratio measurements. Am J Kidney Dis 2012; 60:561. google scholar
  • 22. Lim D, Lee DY, Cho SH, et al. Diagnostic accuracy of urine dipstick for proteinüria in older outpatients. Kidney Res Clin Pract. 2014;33:199-203. google scholar
  • 23. Oni MO, Oguntibeju OO. Clinical and diagnostic importance of proteinüria: a review. Afr J Biotechnol. 200;7:3166-3172. google scholar
  • 24. Barratt J, Topham P. Urine proteomics: the present and future of measuring urinary protein components in disease. CMAJ 2007; 177:361. google scholar
  • 25. Carter JL, Tomson CR, Stevens PE, Lamb EJ. Does urinary tract infection cause proteinüria or microalbu-minuria? A systematic review. Nephrol Dial Transplant 2006; 21:3031. google scholar
  • 26. Garg AX, Kiberd BA, Clark WF, Haynes RB, Clase CM. Albuminuria and renal insufficiency prevalence guides population screening: results from the NHANES III. Kidney Int. 2002;61:2165-75. google scholar
  • 27. Ebert N, Jakob O, Gaedeke J, van der Giet M, Kuhlmann MK, Martus P, Mielke N, Schuchardt M, Tölle M, Wenning V, Schaeffner ES. Prevalence of reduced kidney function and albuminuria in older adults: the Berlin Initiative Study. Nephrol Dial Transplant. 2017;32:997-1005. google scholar
  • 28. Nunes Filho JCC, Camurça DS, Rocha GA, et al. Chronic kidney disease prevention campaign: relationship between proteinüria and elderly people. J Bras Nefrol. 2022: S0101-28002022005057401. google scholar
  • 29. Wang HB, Yang QH, Jiang X, Cui XF, Liu R. Tubular proteinüria is the dominant type of proteinüria in an elderly community population in China. Int Urol Nephrol. 2015;47:1541-6. google scholar
  • 30. Fioretto P, Mauer M. Histopathology of diyabetic nephropathy. Semin Nephrol. 2007; 27:195-207 google scholar
  • 31. Gibb DM, Tomlinson PA, Dalton NR et al. Renal tubular proteinüria and microalbuminuria in diyabetic patients. Arch Dis Child. 1989; 1:129-134. google scholar
  • 32. Hong CY, Hughes K, Chia KS et al. Urinary alpha1- microglobulin as a marker of nephropathy in type 2 diyabetic Asian subjects in Singapore. Diyabetes Care. 2003; 2:338-342. google scholar
  • 33. Boulware LE, Jaar BG, Tarver-Carr ME, Brancati FL, Powe NR. Screening for proteinüria in US adults: A cost-effectiveness analysis. JAMA. 2003; 290: 3101-3114 google scholar
  • 34. Abrass CK. Renal biopsy in the elderly. Am J Kidney Dis. 2000;35:544-6. google scholar
  • 35. Kyle RA. Monoclonal gammopathy of undetermined significance and solitary plasmacytoma. Hematol Oncol Clin N Am. 2009; 11:71-87. google scholar
  • 36. Nair R, Bell JM, Walker PD: Renal biopsy in patients aged 80 years and older. Am J Kidney Dis. 2004; 44: 618-626. google scholar
  • 37. Abrass CK: Treatment of membranous nephropathy in the elderly. Semin Nephrol.2003; 23: 373-378. google scholar
  • 38. Uezono S, Hara S, Sato Y, Komatsu H, Ikeda N, Shimao Y, Hayashi T, Asada Y, Fujimoto S, Eto T: Renal biopsy in elderly patients: a clinicopathological analysis. Ren Fail.2006; 28: 549-555. google scholar


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