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Pathohistological analysis of kidney tissue in obese patients and obesity impact evalution of the chronic renal failure progression

dc.contributor.advisorBasta-Jovanović, Gordana
dc.contributor.otherSimić-Ogrizović, Sanja
dc.contributor.otherŠumarac-Dumanović, Mirjana
dc.contributor.otherPantić, Igor
dc.contributor.otherĆelić, Dejan
dc.creatorJordanova, Elena A.
dc.date.accessioned2020-02-14T14:30:46Z
dc.date.available2020-02-14T14:30:46Z
dc.date.available2020-07-03T08:52:23Z
dc.date.issued2019-09-25
dc.identifier.urihttp://nardus.mpn.gov.rs/handle/123456789/11849
dc.identifier.urihttp://eteze.bg.ac.rs/application/showtheses?thesesId=7209
dc.identifier.urihttps://fedorabg.bg.ac.rs/fedora/get/o:20924/bdef:Content/download
dc.identifier.urihttp://vbs.rs/scripts/cobiss?command=DISPLAY&base=70036&RID=51746319
dc.description.abstractGojaznost je definisana povećanjem masne mase tela koja dovodi do narušavanja zdravlja. Gojazne osobe imaju veliki rizik za razvoj sleep apnea sindroma, hiperlipidemije, hipertenzije, koronarne vaskularne bolesti, insulinske rezistenzije i dijabetesa. Poslednjih 15 godina ekvivalentan porast prevalence gojaznosti i terminalne bubrežne slabosti uslovio je i povećan interes za ispitivanje uloge gojaznosti u nastanku gojaznošću uslovljene bolesti bubrega. Gojaznost ne samo da ubrzava progresiju već postojećeg bubrežnog oštećenja, već je i sama po sebi nezavistan faktor rizika za nastanak bubrežnog oštećenja. Najpoznatija bubrežna bolest nastala zbog gojaznosti je gojaznošću uslovljena glomerulopatija (GUG), entitet koji se karakteriše proteinurijom, glomerulomegalijom, progresivnom glomerulosklerozom i smanjenjem funkcije bubrega. Ovaj patohistološki entitet je sekundarna forma bolesti glomerula kod gojaznih bolesnika sa morfološkim karakteristikama fokalno segmentne glomeruloskleroze (FSGS) i uvećanjem glomerula ili samo uvećanjem glomerula. Srećom, sve gojazne osobe neće razviti GUG. Cilj: Cilj ove doktorske disertacije je utvrditi parametre morfometrijske i fraktalne analize glomerula, klinički tok i ishod nakon dve godine praćenja gojaznih i negojaznih ispitanika. Metode: Studija je obavljena na Klinici za nefrologiju, Kliničkog centra Srbije u periodu od 2015. do 2017.godine. Patohistološka analiza tkiva bubrega obavljena je na Institutu za patologiju, Medicinskog fakulteta. U studiju je uključeno 125 ispitanika (77 muškaraca, prosečne starosti 46.92±15.10 godina) kod kojih postavljena dijagnoza: fokalno segmentne glomeruloskleroze, IgA nefropatije, membranoznog glomerulonefritisa, membranoproliferativnog glomerulonefritisa, bolest minimalnih promena, dijabetesne nefropatije i nefroangioskleroze. Na osnovu indeksa telesne mase ispitanici su podeljeni u dve grupe: gojazni (BMI ≥ 27 kg/m2- 63 ispitanika, prosečne starosti 50.1±15.1 godina) i negojazni (BMI< 27 kg/m2- 62 ispitanika, prosečne starosti 44.1±14.5 godina). Na dan biopsije, 6, 12 i 24 meseca nakon biopsije praćeni su sledeći parametri: koncentracija hemoglobina, kreatinina, ukupnih proteina, albumina, holesterola, triglicerida, proteinurije u 24h urinu. Jačina glomerulske filtracije (JGF) procenjena je formulama: Cockcroft-Gault# (Cockcroft-Gault -BMI < 27 kg/m2 i Cockcroft- GaultLBW - BMI ≥27 kg/m2) i CKD- EPI...sr
dc.description.abstractObesity is defined as abnormal or excessive fat accumulation that presents a risk to health. Obese persons are at a greater risc to develop sleep apnea syndrome, hyperlipidemia, hypertension, coronary vascular disease, insulin resistance and diabetes. During the last 15 years there has been an equivalent dramatic rise in the prevalence of obesity and end stage renal disease, increasing the interest on the role of obesity- related kidney disease. Obesity not only increases the risk preexisting renal disease progression, but is itself also the independent risk factor of renal injury. The best known renal disease secondary to obesity is obesity related glomerulopathy (ORG), a distinct entity featuring proteinuria, glomerulomegalia, progressive glomerulosclerosis and renal functional decline. This pathohistological entity is described as a secondary form of glomerular disease in obese patients with morphological characteristics of focal segmental glomerulosclerosis (FSGS) and enlargement of the glomeruli, or only by enlargement of the glomeruli. Fortunately, not all obese persons develop ORG. Aim: The aim of this dissertation was to evaluate the glomerular morphometry, fractal analysis parameters, clinical features and two years outcome in obese and non-obese patients. Methods: The study was performed at the Clinic of Nephrology, Clinical center of Serbia in the period between 2015 and 2017 year. The pathohistological analysis of kidney tissue was done at the Institute for Pathology, School of Medicine. The study included 125 patients (77 males, mean age 46.92±15.10 years) who were diagnosed with one of the following diseases: focal segmental glomerulosclerosis (FSGS), IgA nephropathy, membranous glomerulonephritis, membranoproliferative glomerulonephritis, minimal change disease, diabetic nephropathy and nephroangiosclerosis. Based on BMI patients were divided into two groups: obese (BMI≥ 27 kg/m2- 63 patients, mean age 50.1±15.1 years) and non-obese (BMI< 27 kg/m2- 62 patients, age 44.1±14.5 years). At the time of the kidney biopsy, 6, 12 and 24 months after the biopsy following parameters were determined: haemoglobine concentration, serum concentration of creatinine, total proteins, albumin, cholesterol, triglyceride and 24-hour urine protein test. The estimated glomerular filtratio rate (eGFR) was calculated according to formulas: Cockcroft- Gault# (Cockcroft-Gault -BMI < 27 kg/m2 and Cockcroft-GaultLBW - BMI ≥27 kg/m2) and CKD- EPI...en
dc.formatapplication/pdf
dc.languagesr
dc.publisherУниверзитет у Београду, Медицински факултетsr
dc.rightsopenAccessen
dc.sourceУниверзитет у Београдуsr
dc.subjectORGsr
dc.subjectORGen
dc.subjectmorfometrijasr
dc.subjectremisijasr
dc.subjectishod bolestisr
dc.subjectfraktalna analizasr
dc.subjectmorphometryen
dc.subjectremissionen
dc.subjectpatients outcomeen
dc.subjectfractal analysisen
dc.titlePatohistološka analiza tkiva bubrega gojaznih bolesnika i ispitivanje uticaja gojaznosti na progresiju hronične bubrežne slabostisr
dc.title.alternativePathohistological analysis of kidney tissue in obese patients and obesity impact evalution of the chronic renal failure progressionen
dc.typedoctoralThesis
dc.rights.licenseBY-NC-ND
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/10576/IzvestajKomisije21875.pdf
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/10575/Disertacija.pdf


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