Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi Üniversitesi, Tıp Fakültesi, Turkey
Approval Date: 2019
Thesis Language: Turkish
Student: BETÜL KÜBRA TÜZÜN
Supervisor: GALİP GÜZ
Abstract:Renal transplantation is considered to the optimal treatment of end-stage renal disease. Although the number of transplantation from cadaveric donors tried to be increased, the ratio of kidney transplantation from living donors is still very high and prominent. It has been suggested that decreased renal function may be associated with proteinuria and hypertension in the late period as well as unavoidable surgical complications in the early period. In this study, long term renal functions in renal transplantation donors and its relationship with transforming growth factor beta-1 were investigated. The donors who donated to the kidney between 1999 and 2018 years at Transplantation Unit, Gazi University Faculty of Medicine were included in the study. The control group consisted of 100 people who had known no systemic disease. The age and gender distribution of control group who were referred to the general internal medicine outpatient clinic of the same center were similar to the donors. In both groups, renal function parameters (creatinine, sodium, potassium, protein, albumin, uric acid and protein / creatinine in spot urine), complete blood count were studied. In addition, TGF-B1 polymorphism was studied in donors. Renal function parameters of renal transplant donors were compared with control group and the parameters in the preoperative phase of donors. Simultaneously, 55 the relationship between renal function of donors and donor TGF-B1 polymorphism were investigated. The study included 72 (53 female, 19 male) kidney donors and 100 (69 female, 31 male) healthy controls. The mean age of the donor group was 50 ± 12 years and the mean age of the control group was 47 ± 11 years. The mean postoperative creatinine levels of donors were significantly higher than the mean creatinine levels of the control group (0.96 ± 0.2 vs 0.72 ± 0.2 mg / dL p <0.001). Mean GFR values of donors were significantly lower than the GFR values of control group (76 ± 20 vs 107 ± 22 mL / min / 1.73 m2) after transplantation. Postoperative creatinine levels were significantly higher and postoperative eGFR values were significantly lower in patients who had C / C genotype at codon 25 than those carrying G / G genotype (p: 0.01 and 0.006). The risk of the glomerular filtration rate falling below 60 mL / min / 1.73 m2 in the patients carrying the C / C genotype at codon 25 were higher than those carrying G / G genotype (OR:4,74 %95 CI: 1,482-15,212; p:0,009). Postoperative eGFR values of the patients with C / C and T / C genotypes at codon 10 were lower than those with T / T genotype, but there was no significant difference (p: 0.1). Correlation analysis revealed a negative correlation between C / C and T / C genotypes and postoperative GFR values. Consequently, TGF-β1 gene with C / C genotype at codon 25 in donors has been shown to be associated with a decrease in renal function. A negative correlation has been found between C / C and T / C genotype at codon 10 and postoperative GFR values .Renal transplantation causes decrease in renal functions in donors 56 during long term follow-up (compared to healthy volunteers and donors own renal functions in preoperative phase). It is observed that the decrease in renal functions in some donors is higher and this situation is associated with TGF β1 gene polymorphisms. However, in order to clarify the relationship between the TGF-β1 gene and renal function; studies that have properties such as being prospective, on larger sample group, including the investigation of the polymorphisms and renal functions of recipient are also needed.