Wos İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4807
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Item Risk Factors and Treatment Options for Persistent Hyperparathyroidism After Kidney Transplantation(2020) Kirnap, Nazli Gulsoy; Kirnap, Mahir; Sayin, Burak; Akdur, Aydincan; Tutuncu, Neslihan Bascil; Haberal, Mehmet; 0000-0002-8726-3369; 0000-0002-3462-7632; 0000-0002-1816-3903; 0000-0001-8287-6572; 31924405; AAA-3068-2021; AAJ-8097-2021; ABG-5027-2020; J-3707-2015Background. Kidney transplantation (KT) corrects secondary hyperparathyroidism. However, persistent hyperparathyroidism (pHPT) may be observed in some patients post-KT. This study aims to evaluate the risk factors and treatment options for pHPT. Materials and methods. The study population comprises 1054 patients who underwent KT between January 2001 and May 2019. Serum samples were analyzed for calcium (Ca), phosphorus, creatinine, intact parathyroid hormone (iPTH) and estimated glomerular filtration rate. Results. The prevalence of pHPT following KT is 14%. Ninety pHPT patients were compared with 550 non-pHPT patients. The median duration of pre-KT dialysis was longer, and pre-KT serum Ca, P, and iPTH levels were significantly higher in the pHPT group than the non-HPT group. The pHPT of 46 patients (51%) received medical treatment. The remaining 44 patients (49%) had parathyroidectomy (PTx) if symptoms or signs (or both) of pHPT continued. Subtotal PTx was performed in 35 patients, and minimally invasive PTx was performed in 9 patients. Conclusion. Based on our study results, the most important risk factors for post-KT pHPT are long dialysis duration and high pre-KT iPTH levels. In patients who underwent KT, if pHPT lasts longer than 1 year, surgical treatment is the recommended approach. Based on our experience, the treatment method to be performed in pHPT should be 3+1/2 PTx.Item Effects of Renal Transplantation and Hemodialysis on Patient's General Health Perception and Oral Health-Related Quality of Life: A Single-Center Cross-Sectional Study(2020) Oduncuoglu, Bahar Fusun; Alaaddinoglu, Emine Elif; Colak, Turan; Akdur, Aydincan; Haberal, Mehmet; 0000-0002-8726-3369; 0000-0002-8372-7840; 0000-0002-3462-7632; 0000-0003-0647-9481; 32113695; AAA-3068-2021; AAJ-8554-2021; AAJ-8097-2021; AAQ-4792-2020Background. Patients with end-stage renal disease have a lower quality of life compared to the general population. Oral health-related quality of life (OHRQoL) is of particular interest as good oral health could influence general health. This study aimed to compare dental and periodontal health status, OHRQoL, and general health perception of renal transplant (TX) and hemodialysis patients (HD) with that of healthy controls. Methods. The study included 64 TX, 63 HD, and 61 healthy patients. TX patients were also grouped according to the time elapsed after transplantation and currently use of immunosuppressive agents. The numbers of decayed, missing, and filled teeth were recorded as DMFT, and periodontal health status was evaluated. Patients' general health perceptions and OHRQoL were assessed using Short Form-36, Oral Health Impact Profile-14, and OHRQoL-United Kingdom questionnaires. Results. The HD groups presented significantly higher DMFT scores and periodontal scores than TX and control groups. OHRQoL-United Kingdom total scores of TX and HD groups were lower than controls (P < .05). Oral Health Impact Profile-14 total scores revealed that HD groups' OHRQoL was significantly lower than TX and control groups (P < .05). Perceptions of general health of TX patients were higher than in the HD group. Conclusions. Renal transplantation has shown to increase quality of life and OHRQoL compared to hemodialysis therapy. Neither the immunosuppressive agent nor the time elapsed after transplantation were observed to be significant factors affecting OHRQoL.Item The Effect of Renal Transplantation on Cardiac Functions(2020) Yilmaz, Kerem Can; Akgun, Arzu Neslihan; Keskin, Suzan; Ciftci, Orcun; Moray, Gokhan; Muderrisoglu, Haldun; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0001-8926-9142; 33229768; AAJ-8097-2021; W-5233-2018; AAJ-1331-2021Chronic renal failure is a well-known risk factor for cardiovascular poor outcome. Despite advances in dialysis and renal transplantation, these patients still have high cardiovascular morbidity and mortality. The aim of our study was to evaluate the changes in blood parameters and echocardiographic parameters of patients undergoing renal transplantation in our center. One hundred and eighty-three patients who underwent renal transplantation between September 2012 and January 2016 were included in the study. Pre- and postoperative hemoglobin values, lipid profiles, ejection fractions, presence of left ventricular hypertrophy, presence of diastolic dysfunction, and valve pathologies were retrospectively scanned. Data were obtained from all patients in terms of blood parameters, but we compared 92 patients' echocardiographic data because of lack of both pre- and postoperative echocardiography records. In our study, 124 patients (67.8%) were male, and the mean age was 42.6 +/- 14.4 years. Hemoglobin levels (11.2 +/- 1.98, 12.7 +/- 2.2 mg/dL, P <0.001) and high-density lipoprotein (HDL) values (37.6 +/- 10.5, 46.6 +/- 13.6 mg/dL, P <0.001) were found to be different significantly. In echocardiographic evaluation, there was no difference between pre- and postoperative ejection fractions in 92 patients. However, patients with preoperative ejection fraction <50% had a significant increase in postoperative ejection fraction (40.1 +/- 6.2, 48.4% +/- 9.4%, P = 0.012). Renal transplantation can improve left ventricle ejection fraction in patients with basal ejection fraction less than 50% and also provide a significant increase in hemoglobin and HDL levels in all patients. This suggests that renal transplantation may reverse the process for dilated cardiomyopathy and may improve cardiac function in patients with low ejection fraction. However, transplantation should be performed as early as possible in these patients.