Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item The Changing Trends of Peritoneal Dialysis Related Peritonitis and Novel Risk Factors(2015) Ozisik, Lale; Ozdemir, Fatma Nurhan; Tanriover, Mine Durusu; 0000-0002-5682-0943; 0000-0002-3494-8997; 26042343; AAK-1697-2021Aim: Continuous ambulatory peritoneal dialysis (PD) has become a treatment modality for end stage renal disease with a peak of its use in 1990s. The aim of this study was to examine the peritonitis rates, causative organisms and the risk factors of peritonitis in a large group of patients in our center. Methods: The study was conducted in the Nephrology Department of a University Hospital in Turkey. Patients in the PD programme between January 2000 and January 2006 were included. Cohort-specific and subject specific peritonitis incidence, and peritonitisfree survival were calculated. Causative organisms and risk factors were evaluated. Results: Totally 620 episodes of peritonitis occurred in 440 patients over the six years period. Peritonitis rates showed a decreasing trend through the years (0.79 episodes/patient-year 2000-2003 and 0.46 episodes/patient-year 2003-2006). Cohort-specific peritonitis incidence was 0.62 episodes/patient-years and median subject-specific peritonitis incidence was 0.44 episodes/patient-years. The median peritonitis-free survival was 15.25 months (% 95 CI, 9.45-21.06 months). The proportion of gram-negative organisms has increased from 9.8% to 17.3%. There was a significant difference in the percentage of culture negative peritonitis between the first three and the last three years (53.1% vs. 43.2%, respectively). Peritonitis incidence was higher in patients who had been transferred from HD, who had catheter related infection and who had HCV infection without cirrhosis. Conclusions: Our study showed significant trends in the peritonitis rates, causative organisms and antibiotic resistance. Prior HD therapy, catheter related infections and HCV infection were found to be risk factors for peritonitis.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 Effects Of Tacrolimus And Mycophenolate Mofetil On Regression Of Encapsulating Peritoneal Sclerosis İn A Rat Model(2021) Haberal, NihanObjective: Encapsulating peritoneal sclerosis (EPS) is a rare, but potentially fatal complication of peritoneal dialysis. Currently, treatment of peritoneal fibrosis is not fully possible yet. In this study, we aimed to demonstrate the effects of tacrolimus therapy on peritoneal fibrosis and inflammation when administered alone or with mycophenolate mofetil (MMF) in the EPS model induced in rats. Methods: Thirty six Wistar albino rats were separated into six equal groups. Group I was the control group. Group II-VI were administered intraperitoneal chlorhexidine (CH) for induced EPS model in rats. Group II, IV, V, VI were administered isotonic liquid, tacrolimus, tacrolimus and concurrently with CH, tacrolimus and MMF together, respectively. Group III was not administered any drug. All peritoneal samples were stained immunohistochemically with matrix metalloproteinase-2 (MMP-2) antibody. Thickness of peritoneal fibrosis, subserosal large collagen fibers, subserosal fibroblast proliferation and subserosal fibrotic matrix deposition were evaluated. Results: Comparing the experimentally induced EPS groups, the best histopathological results and the largest staining with MMP-2 were achieved in Group VI. Furthermore, in all treatment groups (IV, V, VI) more staining with MMP-2 was detected compared to non-treatment groups (I, II, III) but no statistically significant differences were found among all groups. A statistically significant remission was observed in all histopathological parameters, primarily peritoneal thickness in rats that were administered MMF with tacrolimus, compared to rats which were administered tacrolimus only. Conclusion: Concurrent use of tacrolimus and MMF in the treatment of EPS may be a promising approach.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.Item Factors Associated with Fibromyalgia Syndrome in Peritoneal Dialysis Patients(2019) Ozelsancak, Ruya; Analan, Pinar Doruk; Leblebici, Berrin; 0000-0002-3528-3712; 0000-0002-0788-8319; 30787502; AAA-8043-2021; AAD-5716-2021Purpose: We evaluated the prevalence of fibromyalgia syndrome (FMS) in peritoneal dialysis (PD) patients and whether this syndrome is associated with gender, age, duration of PD, or other laboratory parameters. Methods: A total of 60 chronic PD patients (26 women, 34 men) and 60 healthy controls (30 women, 30 men) were included. We recorded each participant's age, gender, cause of kidney failure, PD duration, laboratory parameters, education level, and symptoms related to FMS, diagnosed according to the 2010 American College of Rheumatology criteria. Results: Eleven patients (18%) in the PD group and nine (15%) in the control group met the diagnostic criteria for FMS. There were no statistically significant differences in age; gender; education level; PD duration; laboratory parameters; or sleepdisturbance, fatigue, or cognitive symptoms between the FMS and non-FMS groups among the PD patients. We next compared control and PD patients with FMS. Both groups were of a similar age and gender and had similar sleep disturbance and cognitive symptoms, but more patients had fatigue in the control group. Conclusions: The prevalence of FMS among PD patients was similar to that in the general population, and FMS was not associated with gender, age, duration of PD, or other laboratory parameters.Item Balance and fall risk in peritoneal dialysis patients(2019) Analan, Pinar Doruk; Ozelsancak, Ruya; 0000-0002-3528-3712; 0000-0002-0788-8319; 30248027; AAA-8043-2021; AAD-5716-2021BACKGROUND: Vestibular, neurological and musculoskeletal functions are affected in patients with renal failure. These problems can in turn affect the balance system in peritoneal dialysis (PD) patients. Previously, postural balance changes were shown in hemodialysis patients. This is the first study that evaluates whether there are similar changes in patients with PD. OBJECTIVE: This study aimed to compare balance and fall risk between patients undergoing PD treatment and healthy subjects, and aimed to determine the correlation between biochemical parameters and fall risk and balance assessments in PD patients. METHODS: This controlled study included 58 patients receiving PD treatment (PD Group) and 75 healthy subjects (Control Group). The Berg Balance Scale (BBS) and Tetrax (R) Interactive Balance System were used for the comparison of balance between groups. For patients in the PD Group, duration of PD, blood pressure, Kt/V-urea (actual mass of urea removed via peritoneal dialysis), and serum biochemical parameters were recorded and correlation analysis was performed between these parameters and balance measurements. RESULTS: There were no statistically significant differences between groups in terms of demographics or BBS scores (p > 0.05). The fall risk of patients in the PD Group was significantly higher than those in the Control Group (p < 0.0001) according to Tetrax measurements. Female gender, older age, higher BMI, and higher blood glucose levels were negatively correlated with balance parameters of PD patients (r > 0.3). There was no statistically significant correlation between duration of PD, blood pressure, and Kt/V-urea with balance parameters or fall risk. CONCLUSIONS: Balance was impaired in patients undergoing PD in comparison to healthy subjects. Fall risk may be evaluated using the Tetrax (R) instead of BBS for this population. Serum glucose level, BMI and age appear to affect balance and fall risk. Therefore, optimization of body weight and normalization of serum glucose levels are important factors for improving balance. The duration of PD, blood pressure, and Kt/V-urea do not affect balance system.