Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Free Triiodothyronine in Hemodialysis Patients Link With Malnutrition and Inflammation(2014) Yavuz, Demet; Sezer, Siren; Yavuz, Rahman; Canoz, Mujdat Batur; Altinoglu, Alpaslan; Elsurer, Rengin; Arat, Zubeyde; Ozdemir, Fatma Nurhan; https://orcid.org/0000-0002-4082-6320; https://orcid.org/0000-0002-7326-8388; https://orcid.org/0000-0002-5682-0943; 24878944; ABG-9980-2021; JYQ-2550-2024; AAK-1697-2021Introduction. Free triiodothyronine (FT3) is a marker of comorbidity in end-stage renal disease and in many acute and chronic diseases. There is lack of data about the link between FT3 levels and malnutrition and inflammation in hemodialysis patients. The objective of the present study was to investigate the link between FT3 and malnutrition and inflammation in hemodialysis patients. Materials and Methods. A total of 84 patients were included in the study (38 men and 46 women; mean age, 56.2 +/- 14.8 years; hemodialysis duration, 95.72 +/- 10.35 months). Serum FT3, free thyroxin, and thyroid-stimulating hormone concentrations were determined. Demographic data and laboratory values were evaluated. Patients' comorbidity status was determined using the Charlson Comorbidity Index (CCI), and malnutrition-inflammation status was determined by Malnutrition-Inflammation Score (MIS). Results. Serum FT3 concentration inversely correlated with age (r = -0.328, P =.002), CCI (r = -0.591, P < .001), C-reactive protein (r = -0.299, P =.01), and MIS (r = -0.671, P < .001), and positively correlated with serum albumin (r = 0.389, P < .001). In multivariate linear regression analysis, FT3 was independently associated with MIS (beta, -0.14; 95% confidence interval, -0.175 to 0.063, P = .003), adjusted for CCI, C-reactive protein level, serum albumin level, and MIS. Conclusions. The results of this study indicate that FT3 is negatively correlated with inflammatory markers, namely C-reactive protein, and it is independently related with MIS in hemodialysis patients. Therefore, we suggest that FT3 can be accepted as an inflammatory marker in hemodialysis patients.Item Echocardiographic Epicardial Adipose Tissue Measurements Provide Information About Cardiovascular Risk in Hemodialysis Patients(2015) Ulusal Okyay, Gulay; Okyay, Kaan; Polattas Solak, Evsen; Sahinarslan, Asife; Pasaoglu, Ozge; Ayerden Ebinc, Fatma; Pasaoglu, Hatice; Boztepe Derici, Ulver; Sindel, Sukru; Arinsoy, Turgay; 0000-0001-6134-8826; 25643907; AAK-7355-2020Epicardial adipose tissue (EAT) is a cardiovascular risk predictor in general population. However, its value has not been well validated in maintainance hemodialysis (MHD) patients. We aimed to assess associations of EAT with cardiovascular risk predictors in nondiabetic MHD patients. In this cross-sectional study, we measured EAT thickness by transthoracic echocardiography in 50 MHD patients (45.8 +/- 14.6 years of age, 37 male). Antropometric measurements, bioimpedance analysis, left ventricular (LV) mass, carotis intima media thickness, blood tests, homeostasis model assessment for insulin resistance (HOMA-IR) and hemodialysis dose by single-pool urea clearence index (spKt/V) were determined. The mean EAT thickness was 3.28 +/- 1.04mm. There were significant associations of EAT with body mass index (=0.590, P<0.001), waist circumference (=0.572, P<0.001), body fat mass (=0.562, P<0.001), percentage of body fat mass (=0.408, P=0.003), percentage of lean tissue mass (=-0.421, P=0.002), LV mass (=0.426, P=0.002), carotis intima media thickness (=0.289, P=0.042), triglyceride/high-density lipoprotein cholesterol ratio (=0.529, P<0.001), 1/HOMA-IR (=-0.386, P=0.006), and spKt/V (=-0.311, P=0.028). No association was exhibited with visfatin C, high-sensitivity C-reactive protein, interleukin-6, and tumor necrosis factor-alpha (for all, P>0.05). Body mass index, waist circumference, body fat mass, percentage of lean tissue mass, LV mass, triglyceride/high-density lipoprotein cholesterol ratio, HOMA-IR, and spKt/V appeared as independent predictors of EAT. EAT was significantly associated with body fat measures, cardiovascular risk predictors, and dialysis dose in MHD patients.Item Management of Chronic Hepatitis in Special Hosts and Special Situations: A Consensus Report of the Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases(2014) Mistik, Resit; Aydin, Mehtap; Aksoy, Suleyman; Altin, Nilgun; Altunal, Nilsun; Avsar, Kemal; Bezirgan, Selma; Buke, Cagri; Celik, Ali Kutta; Celik, Ekrem; Dikici, Nebahat; Hizel, Kenan; Iskender, Serap; Kaya, Ali; Korkmaz, Fatime; Kose, Sukran; Sacligil, Cahide; Sirmatel, Fatma; Tarakci, Huseyin; Turgut, Huseyin; Tutuncu, Ediz; Yulugkural, Zerrin; https://orcid.org/0000-0003-4044-9366; HLX-0937-2023Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases convened a meeting to develop a consensus report on management of chronic hepatitis in special hosts and special situations. Relevant literature and international guidelines were reviewed, and recommendations agreed are presented at the end of each section such as therapy of chronic hepatitis B (CHB) in patients with compensated and decompensated cirrhosis, prevention and therapy of recurrent hepatitis B after liver transplantation, management of fulminant hepatitis B, therapy of CHB in hemodialysis patients, management of CHB in nonliver solid organ transplant recipients, management of CHB in immunosuppressed nontransplant patients, therapy of hepatitis B virus (HBV) and human immunodeficiency virus (HIV) coinfection, management of HBV and hepatitis C virus (HCV) coinfection, management of CHB in alcoholic patients and injecting drug users, therapy of CHB in pregnancy and lactation period, extrahepatic manifestations in HBV infection, HBV, HCV and hepatitis D virus coinfection, therapy of chronic hepatitis C (CHC) in patients with compensated and decompensated cirrhosis, treatment of patients with recurrent HCV infection following liver transplantation, therapy of CHC in hemodialysis patients, management of CHC in nonliver solid organ transplant recipients, therapy of HCV, HBV and HIV coinfection, management of CHC in immunosuppressed nontransplant patients, HCV infection and biological agents, HCV infection and chemotherapy, management of CHC in alcoholic patients and injecting drug users, fatty liver and CHC, hemoglobinopathy and CHC, CHC in pregnancy and lactation period, extrahepatic manifestations in HCV infection.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 Is There A Relationship Between Plantar Foot Sensation and Static Balance, Physical Performance, Fear of Falling, and Quality of Life in Hemodialysis Patients?(2019) Erdoganoglu, Yildiz; Yalcin, Berna; Kulah, Eyyup; https://orcid.org/0000-0001-6041-4254; 30740855; AAJ-5764-2021Introduction: This study was conducted to investigate the relationship between plantar foot sensation and static balance, physical performance, fear of falling, and quality of life in hemodialysis patients. Materials and Methods: The study involved 24 hemodialysis patients and 20 healthy volunteers. Light touch-pressure sensation (Semmes Weinstein Monofilament test kit), two-point discrimination sensation (esthesiometer) and vibration sensation (128 Hz diapason) were used to evaluate plantar foot sensation. Static balance was assessed by the one-leg standing balance test, physical performance by the Timed Up and Go test, fear of falling with the Fall Efficacy Scale, and quality of life with the Ferrans and Powers Quality of Life Index Dialysis Version. Findings: There was a significant difference in plantar foot sensation, static balance, and physical performance of the patients compared to the healthy controls (P < 0.05). There was a strong correlation between static balance and physical performance with foot sensation in the hemodialysis patients (P < 0.05). There was also a strong correlation between static balance, physical performance, and fear of falling in hemodialysis patients (P < 0.05). The correlation between static balance, physical performance, and quality of life in the hemodialysis patients was strong (P < 0.05). Discussion: The most important result of this study is that light touch-pressure sensation, vibration sensation, two-point discrimination sensation, static balance, and physical performance, all of which involve the activity of cutaneous sensory receptors on the sole of the foot, are reduced in individuals who undergo hemodialysis. The findings of this study suggest potential rehabilitation strategies that could be applied to this patient group.Item Fibromyalgia Syndrome in Turkish Hemodialysis Patients(2016) Leblebici, Berrin; Ozelsancak, Ruya; Yilmaz, Emine Ece; Doruk, Pinar; https://orcid.org/0000-0002-6241-268X; https://orcid.org/0000-0002-0788-8319; https://orcid.org/0000-0002-8602-6038; https://orcid.org/0000-0002-3528-3712; 26198740; AAM-3220-2021; AAD-5716-2021; AAA-8043-2021The aim of our study was to evaluate the frequency of fibromyalgia syndrome (FMS) in hemodialysis (HD) patients and to assess whether this syndrome is associated with gender, age, duration of HD, or various laboratory parameters. This study was composed of 221 chronic HD patients (99 females and 122 males), and we recorded each participant's age, gender, causes of kidney failure, HD duration, education level, and symptoms related to FMS, which was diagnosed according to the 2010 American College of Rheumatology criteria. We documented the laboratory parameters for all patients. In addition, patients with FMS filled out the Fibromyalgia Impact Questionnaire. Twenty-two patients met the diagnostic criteria for FMS (9%), and there were no statistically significant differences related to age, gender, or HD duration between FMS and non-FMS groups (P>0.05). In addition, the education levels were lower in patients diagnosed with FMS (P<0.05), and there were statistically significant differences related to sleep disturbance, fatigue, and cognitive symptoms between the two groups (P<0.05) as well. However, their laboratory parameters were similar (P>0.05). There was a higher prevalence of FMS in HD patients than in the general population. Sleep disturbances, fatigue, education level, and cognitive symptoms were associated with FMS, but there was no correlation between the laboratory parameters and this condition.Item Pneumococcal and Influenza Vaccines in Dialysis Patients: Vaccination Information, Rates, and Patient Awareness(2022) Kara, Sibel; Torun, Dilek; Oruc, Ebru; Habesoglu, Mehmet Ali; Akcay, Muserref Sule; GVT-0626-2022Objective: Pneumococcal and influenza vaccination rates are still far below the desired levels in dialysis patients. We aimed to determine the pneumococcal and influenza vaccination information, rates, and knowledge levels of dialysis patients. Methods: The study is a descriptive cross-sectional study in which 307 dialysis patients between 2020 and 2021 were analyzed retrospectively. Demographic characteristics of all patients and vaccination information were obtained from the face-to-face questionnaire and hospital medical records. Results: Of the participants, 52.4% were males, and the mean age was 56 +/- 15.45 years. The pneumococcal vaccination rate was 37.1%, and the influenza vaccination rate was 58.6%. Of 114 patients who had received a pneumococcal vaccine, 91.2% had received a single dose of the vaccine. While the type of vaccine could not be determined in 86.8% of the patients in this group, the rate of vaccination with the 2 types of the pneumococcal vaccine was only 8.8%. Annual vaccination was given to all those who were vaccinated against influenza. In the whole group, the rate of those who had never heard of the pneumococcal vaccine was 24.4%, while this rate was 6.5% for the influenza vaccine. The patients had a very low level of knowledge of both vaccines (41% and 53.7%, respectively). Conclusion: Pneumococcal and influenza vaccination rate of dialysis patients was low. Influenza vaccination had been performed in compliance with the recommended scheme, but the doses of the pneumococcal vaccine were incomplete. Although the level of patient knowledge was low for both vaccines, patients were more aware of the influenza vaccine.Item Serum growth differentiation factor-15 analysis as a malnutrition marker in hemodialysis patients(2021) Turgut, Didem; Topcu, Deniz Ilhan; Alperen, Cemile Cansu; Baskin, Esra; 0000-0002-1219-6368; 0000-0001-7474-5927; 34247467; E-3717-2019Background/aim: Growth differentiation factor (GDF)-15 is related to inflammation and mortality in many conditions. We aimed to determine if an elevated serum GDF-15 level is related to nutritional status of patients on hemodialysis (HD) and mortality. Materials and methods: Routine HD patients (n = 158) were included in the study and followed for 18 months. Some malnutrition/ inflammation scoring indexes (malnutrition/inflammation score (MIS), controlling nutritional status (CONUT) score, and prognostic nutritional index (PNI)), biochemical parameters, and GDF-15 were used to build Cox regression multivariate models to study the association with mortality. Results: Among the patients, 90 (57 %) had a high MIS ( _8), which associates with worse status. The serum GDF-15 level was higher in the same group (p = 0.003). The serum GDF-15 level differentiated malnutrition/inflammation according to the MIS (p = 0.031). Age, GDF15, and C-reactive protein (CRP) were significantly associated with higher all-cause mortality risk. Patients with both age and GDF-15 above the mean had a hazard ratio of 2.76 (p = 0.006) when compared with those both < mean. Conclusion: In HD patients, the GDF-15 level is increased in worse nutritional status. Beyond the MIS, age, GDF-15 and CRP would be used together to estimate the worse clinical outcome in these patients.Item Do Hemodialysis Patients Need Immune Boosting with Vitamin, Mineral, and Probiotic Supplementation during COVID-19 Pandemic?(2021) Gungor, Ozkan; Ulu, Sena; Hasbal, Nuri Baris; Onan, Engin; Turgut, Didem; Arici, MustafaCoronavirus disease 2019 (COVID-19) has been accepted as a global pandemic, and poses a greater risk to the elderly and those with comorbidities. Comorbid diseases (particularly end-stage kidney disease with hemodialysis) and impaired immunity place patients in the high-risk group for COVID-19. In recent studies, it was also mentioned that exaggerated inflammation and a cytokine storm were the underlying causes related to the high mortality in COVID-19 patients. Currently, treatment modalities to balance the immune system of such vulnerable patient groups are essential, to protect them from the disease. Several vitamins (like vitamins C, D, and E), trace elements like zinc, and probiotics have been proposed as immune boosters to protect and combat infectious conditions. It is well known that these vitamins and elements are insufficient in hemodialysis patients. In this review, we aimed to evaluate the immune-boosting mechanisms of vitamins C, D, E, zinc, and probiotics, the studies related to their beneficial effects against infections, and their possible benefits for hemodialysis patients during the COVID-19 pandemic.Item COVID-19: a novel menace for the practice of nephrology and how to manage it with minor devastation?(2020) Ulu, Sena; Gungor, Ozkan; Gok Oguz, Ebru; Hasbal, Nuri Baris; Turgut, Didem; Arici, Mustafa; 0000-0001-7474-5927; 32713282; AAI-9418-2021Coronavirus disease 19 (COVID-19) became a nightmare for the world since December 2019. Although the disease affects people at any age; elderly patients and those with comorbidities were more affected. Everyday nephrologists see patients with hypertension, chronic kidney disease, maintenance dialysis treatment or kidney transplant who are also high-risk groups for the COVID-19. Beyond that, COVID-19 or severe acute respiratory syndrome (SARS) due to infection may directly affect kidney functions. This broad spectrum of COVID-19 influence on kidney patients and kidney functions obviously necessitate an up to date management policy for nephrological care. This review overviews and purifies recently published literature in a question to answer format for the practicing nephrologists that will often encounter COVID-19 and kidney related cases during the pandemic times