Wos İndeksli Açık & Kapalı Erişimli Yayınlar
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Item Utility Of Continuous Performance Test (MOXO-CPT) In Children With Pre-Dialysis Chronic Kidney Disease, Dialysis And Kidney Transplantation(2022) Buyukkaragoz, Bahar; Soysal Acar, A. Sebnem; Ekim, Mesiha; Bayrakci, Umut Selda; Bulbul, Mehmet; Caltik Yilmaz, Aysun; Bakkaloglu, Sevcan A.; 000829126000001Background Children with chronic kidney disease and on kidney replacement therapy may have neurocognitive and psychosocial disorders. Although kidney transplantation improves quality of life, psychological problems may exist in children who undergo kidney transplantation. Herein, we aimed to investigate attention-deficit hyperactivity disorder-like symptoms with MOXO-continuous performance test in children with pre-dialysis chronic kidney disease, dialysis and kidney transplantation. Methods The MOXO-continuous performance test measures four domains of attention-deficit hyperactivity disorder-like symptoms, including attention, timeliness, hyperactivity and impulsivity. Patients with at least three scores < - 1.5 standard deviations were considered as positive to MOXO-continuous performance test. Test scores of the pre-dialysis chronic kidney disease, dialysis (divided into peritoneal dialysis and hemodialysis subgroups) and kidney transplantation groups were compared. Correlations of test scores with the patient's clinical and laboratory characteristics and effects of hospitalizations and schooling were assessed. Results Seventy-two patients aged 13.3 +/- 3.4 years (23 with kidney transplantation, 23 on dialysis and 26 with pre-dialysis chronic kidney disease) were evaluated. Overall MOXO-continuous performance test positivity was 29%. No differences were detected between the three groups concerning total or z scores. Attention and timeliness z scores were significantly higher in females (p = 0.004 and p = 0 .008 , respectively). Age was positively correlated to attention and timeliness total scores (p = 0.000, r = 0.445 and p = 0.004, r = 0.243, respectively), and inversely correlated to hyperactivity total scores (p = 0.000, r = - 0.415). Conclusions Prevalence of attention-deficit hyperactivity disorder-like symptoms in the study population was much higher than that of pediatric attention-deficit hyperactivity disorder. We believe that the MOXO-continuous performance test is a valid supportive measure for evaluation of attention-deficit hyperactivity disorder diagnosis in children with various stages of chronic kidney disease or on kidney replacement therapy.Item Associations between nutritional factors and excessive daytime sleepiness in older patients with chronic kidney disease(2021) Heybeli, Cihan; Soysal, Pinar; Oktan, Mehmet Asi; Smith, Lee; Celik, Ali; Kazancioglu, Rumeyza; 0000-0001-7903-1106; 34448151; AHC-6473-2022Background Excessive daytime sleepiness (EDS) is prevalent in not only older adults, but also patients with chronic kidney disease (CKD), and is associated with higher risks of morbidity and mortality. Aims The aim of the present study is to determine associations between EDS and nutritional status and serum nutrient levels in older patients with CKD. Methods This cross-sectional study included 367 patients (aged >= 65 years) with CKD (eGFR < 60 ml/min/1.73 m(2) and/or > 30 mg/day of albuminuria for > 3 months). EDS was recorded using the Epworth Sleepiness Scale (a score of >= 11). Malnutrition was diagnosed according to the Mini Nutritional Assessment (MNA) tool (a score of < 17). Results The mean age was 81 +/- 7 years, and 248 (67%) were female. EDS was seen in 99 (26.9%) patients. Those with EDS had significantly lower MNA scores and more frequent malnutrition than those without EDS (p < 0.05). In multivariable analysis adjusted for age, sex, cerebrovascular disease, dementia, number of drugs, and number of urinations at night, and the Charlson Comorbidity Index the relationship between malnutrition and EDS persisted (OR 2.58, 95% CI 1.38-4.83, p = 0.003). There was no significant difference between the presence of EDS and serum levels or deficiencies of vitamin D, vitamin B-12, and folate (p > 0.05). Conclusions EDS is associated with malnutrition in older patients with CKD. Therefore, EDS and nutritional status should be evaluated together in clinical practice. However, future studies are needed to determine the direction of the association between malnutrition and EDS and to evaluate if dietary intervention can improve EDS.Item NT-proBNP level in stage 3-4 chronic kidney disease and mortality in long-term follow-up: HAPPY study subgroup analysis(2020) Simsek, Mustafa Aytek; Degertekin, Muzaffer; Cabbar, Ayca Turer; Hunuk, Burak; Akturk, Serkan; Erdogmus, Siyar; Mutlu, Bulent; Kozan, Omer; 32633264Objective: This was an investigation of the relationship between the N-terminal pro-brain natriuretic peptide (NT-proBNP) level and mortality in patients with stage 3-4 chronic kidney disease (CKD). Methods: This study was designed as a subgroup analysis of the Heart Failure Prevalence and Predictors in Turkey (HAPPY) study. The HAPPY study included 4650 randomly selected individuals from the 7 geographical regions of Turkey. A total of 191 subjects from the original cohort with an estimated glomerular filtration rate (eGFR) <60 mL/min/1.1.73 m(2) were enrolled in this study and the relationship between NT-proBNP and mortality was investigated. Prognostic variables for total and cardiovascular mortality were also examined using Cox regression analysis. Results: The mean length of follow-up was 76.12 +/- 22.45 months. The mean NT-proBNP level was 423.54 +/- 955.88 pg/mL. During follow-up, 51 subjects (26.7%) died from any cause and 36 subjects (18.8%) died from a cardiovascular cause. The presence of hypertension (hazard ratio [HR]: 1.89; 95% confidence interval [CI]: 1.01-3.50; p=0.048), anemia (HR: 2.49; 95% CI: 1.20-5.15; p=0.014), male gender (HR: 2.64; 95% CI: 1.44-4.86; p=0.002) and log NT-proBNP (HR: 4.93; 95% CI: 2.83-8.58; p<0.001) were independent variables for total mortality. The presence of hypertension (HR: 2.47; 95% CI: 1.09-5.56; p=0.029), male gender (HR: 2.79; 95% CI: 1.38-5.62; p=0.004), eGFR (HR: 0.94; 95% CI: 0.91-0.98; p=0.005) and log NT-proBNP (HR: 6.31; 95% CI: 3.11-12.81; p<0.001) were independent predictors of cardiovascular mortality. Conclusion: NT-proBNP was found to be an independent prognostic marker in patients with stage 3-4 CKD.Item Retarding chronic kidney disease (CKD) progression: a practical nutritional approach for non-dialysis CKD(2016) Sezer, Siren; Bellizzi, Vincenzo; Carrero, Jan Jesus; Chauveau, Philippe; Cozzolino, Mario; Cupisti, Adamasco; D'Alessandro, Claudia; De Nicola, Luca; Fiaccadori, Enrico; Johansson, Lina; Minutolo, Roberto; Molina, Pablo; Ter Wee, Pieter; Teta, Daniel; Wanner, Christoph; Calella, Patrizia; Fouque, DenisThis is a case report on a patient with non-dialysis chronic kidney disease (CKD) in whom several nutritional issues are briefly discussed from a practical point of view. The article is accompanied by an editorial published in this Journal in relation to the 2nd International Conference of the European Renal Nutrition working group at ERA-EDTA-" Retarding CKD progression: readily available through comprehensive nutritional management?"and focuses on several practical topics associated with the nutritional approach for the conservative treatment of non-dialysis CKD. The article is divided into 3 sections-basic nutritional assessment, nutritional targets, and nutritional follow-up in non-dialysis CKD-linked to 3 consecutive steps of the clinical follow-up of the patient and the related nutritional concerns and intervention. First visit: Baseline nutritional assessment and basic nutritional considerations in non-dialysis chronic kidney disease (CKD) What nutritional assessment/monitoring for protein-energy wasting (PEW) should be employed? Is a body mass index (BMI) of 21 kg/m2 adequate? What phosphate target should be pursued? What are the nutritional habits in patients with incident CKD? What protein needs and amount of dietary protein should be pursued? Does the quality of protein matter? What amount of dietary salt should be employed? How should this be obtained? How should normal serum phosphate be achieved? What diet should be recommended? Is a vegetarian diet an option? Second visit: Major nutritional targets in non-dialysis CKD Consequences of unintentional weight loss What is the role of the renal dietitian in helping the patient adhere to a renal diet? Intermediate visits: Nutritional follow-up in non-dialysis CKD What treatment for calcium/parathyroid hormone (PTH) will affect CKD progression? Final visits: Would a dietary recall/intensive dietary education improve adherence with the diet? Would a very-low-protein diet (VLPD)/ketodiet be indicated for this patient?Item Cardiac effects of hemodialysis in children with chronic kidney disease(2018) Noyan, Aytul; Arslan, Alev; Kucukosmanoglu, Osman; Ozbarlas, NazanPurpose: The aim of the study was to evaluate cardiac functions before and after hemodialysis in children with chronical renal failure. Materials and Methods: The study comprised 24 children undergoing hemodialysis more then six months. Conventional and tissue Doppler echocardiography was performed, NT-proBNP levels were measured before and after hemodialysis. Echocardiographic results were compared regard to hydration status which measured with body composition monitor and hypotension event during dialysis. Results: Myocardial performance indices which gained with tissue Doppler echo were high in 22 patient. Mitral E/A ratio significantly decreased after hemodialysis. NT-proBNP levels were high but no difference was determined after dialysis. Nine patient experienced hypotension but nonsignificant difference was detected regarding echocardiographic findings and NT-proBNP levels. Conclusion: Diastolic dysfunction is frequent in chronical renal failure. Tissue Doppler echocardiography and myocardial performance index supply a more proper evaluation of global and regional cardiac function in chronical renal failure due to less hydration affectability. NT-proBNP should be monitored for cardiac dysfunction in chronical renal failure. Body composition monitor should be used in children for setting the ultrafiltration volume.