PubMed İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4810
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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 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 timesItem Evaluation of sleep bruxism and temporomandibular disorders in patients undergoing hemodialysis(2020) Somay, E.; Tekkarismaz, N.; 33047693Background: Chronic renal failure can cause anxiety, stress, and decrease the life quality. Therefore, this may lead to sleep bruxism, temporomandibular disorders (TMDs), and related health problems. Aim: This study evaluated the incidence of sleep bruxism and TMDs in patients undergoing hemodialysis and compared it with that of healthy individuals. Subjects and Methods: A total of 137 patients (68 hemodialysis patients and 69 healthy individuals) participated in this study. They all filled out a form about age, sex, educational status, marital status, sleep disorders, sleep bruxism, temporomandibular problems, and ice/hard things chewing habits. We performed a muscle examination and used a questionnaire to evaluate the causes of TMD. Parafunctional habits and emotional stress status were examined with these YES/NO question forms. Teeth attritions and six common symptoms (limited mouth opening, deviation/deflexion, clicking, muscle sensitivity, pain, and presence of linea alba) of TMDs and sleep bruxism were evaluated via a clinical examination. The level of significance was determined at P < 0.05. Results: Parafunctional habits such as sleep bruxism (55.1%) (P = 0.010), emotional stress (69.1%) (P = 0.006), sleep disorders (47,1%) (P = 0.000), unilateral chewing (54.4%) (P = 0.040), gum-chewing (45.6%) (P = 0.000), ice chewing (23.5%) (P = 0,000), and hard things biting habits (7.4%) (P = 0.028) were statistically higher in the hemodialysis group than the control group. Deviation/deflexion and presence of linea alba were more frequent in the hemodialysis group than the control group. Conclusions: It can be concluded that hemodialysis patients are more sensitive to TMDs, sleep bruxism and related dental health problems than healthy individuals.Item Relationship between plasma YKL-40 levels and endothelial dysfunction in chronic kidney disease(2019) Keskin, Gul Sema; Helvaci, Ozant; Yayla, Cagri; Pasaoglu, Ozge T.; Keskin, Caglar; Arinsoy, Turgay; Deric, Ulver B.; 30763987Background/aim: We aimed to evaluate the relationship between YKL-40 and endothelial dysfunction in chronic kidney disease. Materials and methods: Twenty-nine hemodialysis patients, 101 patients with nondialytic (stage 2, 3, 4, and 5 ND) chronic kidney disease (CKD), and 38 healthy individuals as a control group were included. YKL-40 levels were measured by ELISA. Endothelial dysfunction was indirectly measured by flow-mediated dilatation percentage (FMD) in the brachial artery. Results: YKL-40 levels were higher in CKD patients than controls and highest in HD patients (P = 0.001). FMD values were lower in nondialytic CKD patients and lowest in HD patients (P = 0.001). YKL-40 negatively correlated with eGFR and FMD values (r = -0.674 and r = -0.471, respectively). Conclusion: This study shows that YKL-40 increases with CKD stage and is negatively correlated with FMD measurements.Item Pulmonary hypertension associates with malnutrition and body composition hemodialysis patients(2015) Genctoy, Gultekin; Arikan, Serap; Eldem, Olcay; 25410114Background/Aim: The prevalence of pulmonary hypertension (PH) is reported between 17 and 56% in hemodialysis (HD) patients. Pathogenesis of PH in HD patients is still unclear. Malnutrition associating impaired pulmonary function tests in HD patients previously reported. Present study aimed to investigate an association between PH and nutrition and inflammation HD patients. Patients/Methods: Total 179 HD patients (109 M, 70 F) were included. Pulmonary artery pressure (PAP) and ejection fraction (EF) percentage was determined by echocardiography after a midweek HD session. Bioimpedance analyses were performed after dialysis. Percent body fat mass truncal fat (%), total body water (%), body-mass index was determined. Serum 25-OH vitamin D, albumin, lipid parameters, C-reactive protein (CRP), calcium, phosphorus, parathyroid hormone, ferritin levels, and hemogram were studied. Results: Pulmonary hypertension (PAP >35 mmHg) was found in 48 (26.8%) of 179 patients studied. Body-mass index (BMI) was negatively correlated with PAP (r = -0.34; p = 0.02). HD vintage, prevalence of diabetes, sex, type of vascular access were not different between patients with PH and without PH. Patients with PH were older (68.1 +/- 14.4; 61.3 +/- 14.7; p = 0.005). Percent body fat (19.8 +/- 8.1% vs. 28.1 +/- 10%; p = 0.001), albumin (3.4 +/- 0.5 g/dl vs. 3.9 +/- 3.3 g/dl; p = 0.0001), truncal fat (16.8 +/- 10.7 vs. 26.4 +/- 10.5; p = 0.001), triglyceride (147.9 +/- 88.5 vs. 182.1 +/- 97.7 mg/dl; p = 0.03), and total cholesterol (146.9 +/- 34.5 vs. 169.5 +/- 43 mg/dl; p = 0.004) levels were significantly lower in patients with PH than with no PH. Logistic regression analysis revealed that increased percent body fat, albumin, and total cholesterol associate with a decreased risk of PH. Conclusion: Present study demonstrated a significant association between malnutrition and PH in HD patients. Those results should be confirmed by further prospective studies including cytokine levels and spirometric measurements.