TR-Dizin İndeksli Açık & Kapalı Erişimli Yayınlar
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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 Long-term clinical outcomes of peritoneal dialysis patients: 9-year experience of a single centre in Turkey(2020) Tekkarismaz, Nihan; Torun, Dilek; 0000-0001-7631-7395; 0000-0002-6267-3695; 32041385; AAD-9088-2021; AAD-9111-2021Background/aim: The aim of this study was to evaluate the clinical outcomes and identity the predictors of mortality in peritoneal dialysis patients. Materials and methods: Medical records of all incident peritoneal dialysis (PD) patients followed up between January 2011 and May 2019 were reviewed retrospectively. All patients were followed up until death, renal transplantation, transfer to haemodialysis or the end of the study Results: A total of 242 patients were included in thestudy: The incidence of peritonitis was 0.18 (ranging from 0 to 14.9) episodes per patient year. Death occurred in 280 (n: 68) of cases. Age, diabetes mellitus, malignancy and refractory heart failure were independent risk factors for all-cause mortality according to multivariate analysis. 'the presence of comorbid disease and diabetes mellitus and patients aged > 65 years were associated with increased risk of mortality and decreased patient survival. Peritonitis history was associated with increased risk of mortality Between peritonitis and peritonitis-free group, there was no significant difference in Kaplan-Meier curves in terms of patient survival. Conclusion: This is the first study to define 9-year mortality predictors in PD patients in our centre. Although peritonitis is the most feared complication of PD, our study showed that peritonitis did ot reduce patient survival.Item Assessment of Hemoglobin Stability in Chronic Hemodialysis Patients Receiving Erythropoietin Therapy and the Effect of Hemoglobin Stability on Risk of Cardiovascular Disease(2019) Guncan, Melda Ulas; Guncan, Sabri; Torun, DilekObjective: Anemia is one of the most important factors that decrease the quality of life in patients with end-stage renal desease receiving hemodialysis treatment. In these patients, Erythropoietin stimulating agents (ESAs) are used in the treatment of anemia. Although the target hemoglobin (Hb) value in chronic renal failure is 11-12 gr/dL, it is suggested that hemoglobin values fluctuate between normal, high and low values in the great majority, leading to cardiovascular structural changes which increase mortality. In this study, we investigated the effect of anemia and hemoglobin fluctuations on mortality rate and the risk of cardiovascular disease in chronic hemodialysis patients who received ESA thearapy. Materials and Methods: Hemoglobin values for 12 months of 181 patients were examined. The target Hb level was 11-12 gr/dL interval and the patients were divided into 6 groups according to the hemoglobin values; persistently low, low-normal, target, normal-high, low-high and persistently high. According to the variability in hemoglobin level, groups were compared in terms of demographic, laboratory characteristics, treatment, risk of cardiovascular disease, hospitalization and death frequency and causes. Result: The total of 181 patients were classified according to Hb levels; 22 (12.2%) patients were persistently-low, 72 (39.8%) were low-normal, 10 (5.5%) were normal-high and 77 (42.5%) patients were low-high Hb group. During the 12 month fallow up, there were no patients in target and high Hb group. The groups were similar in terms of the presence of comorbid diseases such as diabetes, hypertension, coronary artery disease and other demographic characteristics, and there was no difference between groups in terms of cardiovascular disease development. ESA doses and blood transfusion counts and mortality rates were significantly higher in the persistently-low hemoglobin group compared to the other groups. Conclusion: In our study, high rate of anemia and hemoglobin fluctuations were shown in chronic hemodialysis patients and anemia was associated with mortality. However, the possible association of these variables with cardiovascular diseases was not observed. Further studies are needed in the larger hemodialysis patient group to investigate the relationship between hemoglobin fluctuation and mortality and cardiovascular risk.Item Listeriosis in a Patient Undergoing Hemodialysis: A Case Report and Review of the Literature(2017) Tekkarismaz, Nihan; Ozelsancak, Ruya; Torun, Dilek; Aliskan, Hikmet Eda; 0000-0001-7631-7395; 0000-0001-9060-3195; 0000-0002-0788-8319; 0000-0002-6267-3695; AAD-9088-2021; AAE-2282-2021; AAD-5716-2021; AAD-9111-2021Listeria monocytogenes (L. monocytogenes) infection is an uncommon manifestation in patients with chronic renal failure. In this article, we present a case of L. monocytogenes bacteremia in a patient undergoing hemodialysis. In addition, we are also present the listeriosis cases in hemodialysis patients reported so far in the literature. The patient was a 58-year-old man who was undergoing hemodialysis and had been admitted to hospital with fever. On the 5th day of admission, L. monocytogenes was detected in his blood cultures. He responded dramatically to ampicillin treatment. Listeriosis is a disease that requires careful microbiological laboratory examination. If the patient cultures are not analyzed carefully, the disease can be misdiagnosed. Only early diagnosis and adequate treatment can ensure a good prognosis.Item The Evaluation of Clinical Signs in Patients with Suspected Renovascular Hypertension(2018) Tekkarismaz, Nihan; Torun, Dilek; Ozkan, Ugur; Zumrutdal, Aysegul; Acar, Fatma Nurhan Ozdemir; 0000-0001-7631-7395; 0000-0002-5682-0943; 0000-0002-6267-3695; AAD-9088-2021; AAK-1697-2021; AAD-9111-2021OBJECTIVE: Renovascular hypertension (RVH) is the most common yet correctable cause of secondary hypertension if diagnosed early. There are many clinical signs that can suggest RVH. The aim of this study was to find which clinical or laboratory signs are more indicative in diagnosing RVH and in determining which patients should go through renal angiography. MATERIAL and METHODS: The study included 184 patients who presented to our clinic due to hypertension and were under risk of RVH. All patients underwent three-dimensional time-of-flight Magnetic Resonance Angiography with phase-contrast. The patients were divided into two groups as with and without renal artery stenosis, supported by MRA. RESULTS: Advanced age, low body mass index, high serum creatinine level, presence of proteinuria, and patients with diabetes mellitus and coronary artery disease were found to be significant risk factors for RVH. Only the presence of renal asymmetry and the history of coronary artery disease were found to be independent risk factors. CONCLUSION: In conclusion, detailed patient history and the evaluation of renal size are very important for patients with hypertension. Coronary artery disease and a difference in renal size of more than 1.5 cm could be strong indicators of RVH.