Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Pregnancy and Its Outcomes in Hemodialysis Patients in Turkey(2022) Tekkarismaz, Nihan; 34844294Background/aim: This study aimed to investigate pregnancy frequency and evaluate the factors affecting live births in hemodialysis (HD) patients. Materials and methods: Female HD patients whose pregnancy was retrospectively reported between January 1, 2014, and December 31, 2019. The duration of HD, primary disease, and the information on whether the pregnancy resulted in abortion, stillbirth, or live birth, whether the HD duration was prolonged after diagnosing the pregnancy and whether it accompanied preeclampsia were recorded. Results: In this study, we reached 9038 HD female patients' data in the study. A total of 235 pregnancies were detected in 145 patients. The mean age was 35.42 (35 +/- 7.4) years. The mean age at first gestation was 30.8 +/- 6.5 years. The average birth week was 32 (28 -36) weeks. A total of 53.8% (no = 78) of the patients had live birth, 51.7% (no = 70) had at least one abortion in the first 20 weeks, and 13.1% (no = 19) had at least one stillbirth after 20 weeks. The rate of patients' increased numbers of dialysis sessions during pregnancy was 71.7%. The abortion rate was 22.4% in those with increased HD sessions, whereas 79.3% in those not increased HD sessions (p < 0.001). Live birth frequency was 67.2% in the increased HD sessions group and 3.4% in those who did not differ in HD sessions (p < 0.001). Conclusion: For the first time, we reported pregnancy outcomes in HD female patients, covering all regions of Turkey. It has been observed that; increasing the number of HD sessions in dialysis patients will decrease fetal and maternal complications and increase live birth rates.Item Comparison of Temporomandibular Joint Disorders Between Patients Treated with Hemodialysis versus Peritoneal Dialysis(2022) Tekkarismaz, Nihan; Somay, Efsun; 0000-0001-8251-6913; AAP-9684-2021Objective: The primary aim of this study was to investigate the difference, if any, in the frequency of temporomandibular joint disorders between patients with end-stage kidney disease (ESKD) and healthy individuals. Our secondary aim was to compare the frequency of temporomandibular joint disorders between patients with end-stage kidney disease treated with hemodialysis versus peritoneal dialysis. Methods: All participants completed a questionnaire and underwent a dental evaluation to confirm temporomandibular joint disorder. Results: The frequencies of temporomandibular joint disorders were 13% and 8.9% in the patient and control groups (P =.35), respectively, and 13.4% and 12% in the hemodialysis and peritoneal dialysis groups, respectively (P = 0.85). Conclusions: We observed no difference in temporomandibular joint disorder frequency between patients with end-stage kidney disease who received hemodialysis and peritoneal dialysis as kidney replacement therapy and between patients with ESKD and healthy individuals. Further large-scale studies are warranted to gain a deeper understanding of this topic.Item The Higher Mortality Is Associated with Heart Valve Disease in End Stage Kidney Disease; A Single Center Experience(2018) Ozelsancak, Ruya; Tekkarismaz, Nihan; Torun, Dilek; Micozkadioglu, Hasan; 0000-0002-6267-3695; 0000-0001-7631-7395; 0000-0001-5142-5672; 0000-0002-0788-8319; AAD-9111-2021; AAD-9088-2021; AAE-7608-2021; AAD-5716-2021Item mHLA-G Expression on CD4+CD25(High) T Cell and CD16+Natural Killer Cell Associated with Clinical Status in Renal Transplantation Patients(2016) Basturk, Bilkay; Kantaroglu, Bircan; Noyan, Aytul; Arel, Ilker; Tekkarismaz, Nihan; https://orcid.org/0000-0002-8784-1974; https://orcid.org/0000-0001-7631-7395; AAD-6918-2021; AAD-5713-2021; AAD-9088-2021Item What is the Level of Awareness About the Foods Containing Inorganic Phosphorus in Patients with Chronic Renal Failure(2017) Tekkarismaz, Nihan; Torun, Dilek; Ozelsancak, Ruya; 0000-0001-7631-7395; 0000-0002-6267-3695; 0000-0002-0788-8319; AAD-9088-2021; AAD-9111-2021; AAD-5716-2021Item Predictive Factors of Mortality in Granulomatosis with Polyangiitis: A Single-Center Study(2021) Tufan, Muge Aydin; Tekkarismaz, Nihan; 0000-0002-2686-9762; 0000-0001-7631-7395; 34870176; AAJ-9057-2021; AAD-9088-2021Objectives: The aim of this study was to identify predictors of mortality in granulomatosis with polyangiitis (GPA) patients and to seek the ways of improving survival in GPA patients. Patients and methods: Between January 2005 and June 2020, a total of 60 patients (26 males, 34 females; median age: 49 years; range, 19 to 75 years) who were diagnosed with GPA were retrospectively analyzed. Demographic, clinical, laboratory, and radiological findings of all patients were recorded. Survival rates were analyzed using the Kaplan-Meier plot. Results: The median follow-up was 36 months, and 10 (16.7%) patients died during the study period. Univariate analysis showed that the prognostic values were attributed to high serum creatinine levels (>2.1 mg/dL; p=0.01), proteinuria (p=0.01), dialysis-requiring renal damage at the time of diagnosis (p=0.01) or at any time during follow-up (p=0.01), low lymphocyte levels (p=0.01), hypoalbuminemia (p=0.04), absence of upper respiratory tract involvement (p=0.01), presence of lung involvement with cavitary lesions (p=0.01), high Birmingham Vascular Activity Score (p=0.02), and history of serious infection (p=0.01). In the multivariate analysis, the presence of renal damage requiring dialysis at any time during follow-up (relative risk [95% confidence interval]: 21 [4.1-18.3]; p=0.01) was found to be an independent predictor of mortality. Immunosuppressive drugs exerted no effect on mortality, and the most common causes of death were infections (50%). Conclusion: The presence of dialysis-requiring renal damage is the most important risk factor for mortality in GPA patients. These patients should be followed more closely and carefully to improve survival.Item Factors affecting relapse in patients with Granulomatosis Polyangiitis: a single-center retrospective cohort study(2021) Aydin Tufan, Muge; Tekkarismaz, Nihan; Yucel, Ahmet Eftal; 0000-0001-7631-7395; 0000-0002-2686-9762; 33315347; AAD-9088-2021; AAJ-9057-2021Background and aim: This study aimed to determine the frequency of relapse, the risk factors for relapse, and the correlation of relapse with immunosuppressive regimens in patients with granulomatosis polyangiitis (GPA). Materials and methods: The demographic characteristics, the clinical, laboratory, and radiological findings, the immunosuppressive treatment regimens, and the remission and relapse rates of 50 patients with GPA were obtained retrospectively from medical records. Results: The mean relapse-free survival rates at years 1, 3, and 5 were 82%, 60%, and 50%, respectively. Increased relapse rates were observed in patients who had cavitary lung lesions (52.2% vs. 22.2%, p = 0.04) and in those who had elevated serum creatinine levels (1.8 vs. 0.9, p = 0.00). The patients received two different types of remission induction therapies; 36% of them received the combination therapy involving cyclophosphamide (CYC) and rituximab (RTX), and 62% received CYC alone. Relapse was observed in 22.3% of the patients who received the combination remission induction therapy and in 61.3% of the patients who received CYC alone (P = 0.003). Conclusion: An increased risk of relapse was observed in patients who had cavitary lung lesions and in those who had elevated serum creatinine levels. The combined use of RTX and CYC for the remission therapy in GPA reduced the relapse rates compared with the use of CYC alone.Item EVALUATION OF EPICARDIAL FAT AND CAROTID AND FEMORAL INTIMA-MEDIA THICKNESSES IN GERIATRIC PATIENTS WITH END-STAGE RENAL DISEASE(2020) Gunesli, Aylin; Yilmaz, Mustafa; Yalcin, Cigdem; Tekkarismaz, Nihan; Alkan, Ozlem; 0000-0002-2557-9579; 0000-0001-5483-8253; 0000-0001-7631-7395; S-6973-2016; AAM-4284-2021; AAD-9088-2021Introduction: Although atherosclerotic cardiovascular diseases and cardiovascular risks are known to increase in patients with end-stage renal disease, it is not clear whether these risks increase in the geriatric patient population as well. This study aims to evaluate these risks in geriatric patients with end-stage renal disease by evaluating epicardial fat and carotid and femoral intima-media thicknesses, known as markers, for subclinical atherosclerosis and cardiovascular risks. Materials and Methods: This cross-sectional study included 52 patients who started to receive chronic hemodialysis treatment after the age of 65 years (mean age 73.92 +/- 5.63) years with end-stage renal failure and 51 healthy volunteers (mean age: 74.49 +/- 4.63 years). Epicardial fat and carotid and femoral intima-media thicknesses were measured and compared between these groups. Results: Carotid intima-media and epicardial fat thicknesses were significantly higher in the patient group than in the control group (0.91 +/- 0.08 vs. 0.71 +/- 0.1 mm, p<0.001 and 0.84 +/- 0.17 vs. 0.75 +/- 0.17 cm, p=0.01, respectively). However, no significant difference was observed in femoral intima-media thickness between the two groups (0.58 +/- 0.07 vs. 0.56 +/- 0.97 mm, p=0.266). Correlation analysis revealed a significant positive correlation between the duration of dialysis and epicardial fat and carotid intima-media thicknesses (r=0.611, p<0.001 and r=0.337, p=0.015, respectively). Furthermore, regression analysis revealed a significant relationship between the duration of dialysis and carotid intima-media thickness (beta=0.657, p=0.001). Conclusion: Epicardial fat and carotid intima-media thicknesses increase in geriatric patients with end-stage renal disease but with no significant changes in femoral intima-media thickness, indirectly suggesting that subclinical atherosclerosis and cardiovascular risks are increased in these patients.Item Long-term clinical outcomes of peritoneal dialysis patients: 9-year experience of a single centre in Turkey(2020) Tekkarismaz, Nihan; Torun, Dilek; 0000-0001-7631-7395; 0000-0002-6267-3695; 32041385; AAD-9088-2021; AAD-9111-2021Background/aim: The aim of this study was to evaluate the clinical outcomes and identity the predictors of mortality in peritoneal dialysis patients. Materials and methods: Medical records of all incident peritoneal dialysis (PD) patients followed up between January 2011 and May 2019 were reviewed retrospectively. All patients were followed up until death, renal transplantation, transfer to haemodialysis or the end of the study Results: A total of 242 patients were included in thestudy: The incidence of peritonitis was 0.18 (ranging from 0 to 14.9) episodes per patient year. Death occurred in 280 (n: 68) of cases. Age, diabetes mellitus, malignancy and refractory heart failure were independent risk factors for all-cause mortality according to multivariate analysis. 'the presence of comorbid disease and diabetes mellitus and patients aged > 65 years were associated with increased risk of mortality and decreased patient survival. Peritonitis history was associated with increased risk of mortality Between peritonitis and peritonitis-free group, there was no significant difference in Kaplan-Meier curves in terms of patient survival. Conclusion: This is the first study to define 9-year mortality predictors in PD patients in our centre. Although peritonitis is the most feared complication of PD, our study showed that peritonitis did ot reduce patient survival.Item Dialysis modality and sexual dysfunction in male patients(2020) Tekkarismaz, Nihan; Tunel, Munevver; Ozer, Cevahir; 0000-0001-7631-7395; 0000-0002-7850-6912; 0000-0001-7140-1803; 0000-0001-6037-7991; 32627887; AAD-9088-2021; AAM-2222-2020; AAD-8660-2021Sexual dysfunction is an under-recognised problem in due to very limited number of studies in the literature. This study aims to evaluate the sexual dysfunction related effects of dialysis modality among male patients with chronic renal failure. All patients were asked to complete 2 questionnaires: Hospital Anxiety Depression Scale [HADS] and International Index of Erectile Function [IIEF-5]. A total of 51 patients who completed the questionnaires were included in the study. 31 of them were under haemodialysis (HD) treatment, and 20 were under peritoneal dialysis (PD) treatment. After adjustment for age and HADS score, there was no statistically significant difference between HD and PD groups in terms of the mean IIEF scores (55 vs. 40,p = .058), and the frequency of sexual dysfunction (12.9% vs. 30%,p = .163). Age (r = -0.553), blood pressure (r = -0.299/ -0.374), use of iron (r = -0.333), lipid levels (r = -0.281/ -0.276) and HADS-D score (r = -0.276) inversely associated with IIEF score (p < .05). To conclude, sexual dysfunction is more common in patients who receive PD therapy than those who receive HD therapy. Older age, higher blood pressure, iron treatment, higher lipid levels and the presence of depression were associated with higher prevalance of sexual dysfunction.