Pub Date : 2017-05-22DOI: 10.5262/TNDT.2017.1002.09
E. Hur, S. Budak, K. Mağden, G. Yıldız, U. Soyaltin, B. Toka, N. Turan, S. Çelikörs, B. Altundal, A. Tunç, A. Yılmaz, A. Sivri, S. Sezer, S. Duman
OBJECTIVE: Hypervolemia and malnutrition are often undiagnosed risk factors for hemodialysis (HD). Our aim was to investigate the long-term effects of hypervolemia and malnutrition evaluated by bioimpedance spectroscopy (BIS) on survival. (Clinical Trials. Gov Identifier: NCT01468363). MATERIAL and METHODS: A total of 431 Prevalent HD patients were followed for 32.2±14.4 months. The patients underwent BIS measurement, a medical history was obtained, and routine tests were analyzed at the baseline and at the end of the study. Hospitalizations and complications of HD were recorded. RESULTS: The mean age was 59.4±14.6 (10-92) years with a total of 431 (53.6% males) patients of which 125 died. The percentage of diabetics was 47%, erythropoietin use 67%, and diuretic use 40%. Predialysis systolic blood pressure (BP) was 133.4±25.8 and diastolic BP 79.2±12.4 mm Hg. The rate of diabetes, and the number of hospitalizations and blood transfusions were higher in the patients who died. Diastolic BP as a clinical hypervolemia finding, BIS hypervolemia indicator of over hydration (OH), and extracellular water (ECW) were all increased, and fat tissue index as a malnutrition finding was decreased in patients who died. There were significant rates of anemia and hypoalbuminemia in this group as well. The cumulative survival was lower in hypervolemic patients as assessed by relative hydration status OH/ECW. CONCLUSION: Hypervolemia and malnutrition are the long-term mortality indicators in hemodialysis. Early diagnosis and treatment is important. Clinical findings may not be sufficient and laboratory and BIS methods can be used for diagnosis. KEy wORDS: Overhydration, Bioimpedance, Malnutrition, Fat tissue index, Mortality
{"title":"The Relationship Between Bioimpedance-Measured Volume and Nutritional Parameters and Mortality in Hemodialysis Patients","authors":"E. Hur, S. Budak, K. Mağden, G. Yıldız, U. Soyaltin, B. Toka, N. Turan, S. Çelikörs, B. Altundal, A. Tunç, A. Yılmaz, A. Sivri, S. Sezer, S. Duman","doi":"10.5262/TNDT.2017.1002.09","DOIUrl":"https://doi.org/10.5262/TNDT.2017.1002.09","url":null,"abstract":"OBJECTIVE: Hypervolemia and malnutrition are often undiagnosed risk factors for hemodialysis (HD). Our aim was to investigate the long-term effects of hypervolemia and malnutrition evaluated by bioimpedance spectroscopy (BIS) on survival. (Clinical Trials. Gov Identifier: NCT01468363). MATERIAL and METHODS: A total of 431 Prevalent HD patients were followed for 32.2±14.4 months. The patients underwent BIS measurement, a medical history was obtained, and routine tests were analyzed at the baseline and at the end of the study. Hospitalizations and complications of HD were recorded. RESULTS: The mean age was 59.4±14.6 (10-92) years with a total of 431 (53.6% males) patients of which 125 died. The percentage of diabetics was 47%, erythropoietin use 67%, and diuretic use 40%. Predialysis systolic blood pressure (BP) was 133.4±25.8 and diastolic BP 79.2±12.4 mm Hg. The rate of diabetes, and the number of hospitalizations and blood transfusions were higher in the patients who died. Diastolic BP as a clinical hypervolemia finding, BIS hypervolemia indicator of over hydration (OH), and extracellular water (ECW) were all increased, and fat tissue index as a malnutrition finding was decreased in patients who died. There were significant rates of anemia and hypoalbuminemia in this group as well. The cumulative survival was lower in hypervolemic patients as assessed by relative hydration status OH/ECW. CONCLUSION: Hypervolemia and malnutrition are the long-term mortality indicators in hemodialysis. Early diagnosis and treatment is important. Clinical findings may not be sufficient and laboratory and BIS methods can be used for diagnosis. KEy wORDS: Overhydration, Bioimpedance, Malnutrition, Fat tissue index, Mortality","PeriodicalId":42328,"journal":{"name":"Turkish Nephrology Dialysis and Transplantation Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46023058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-22DOI: 10.5262/TNDT.2017.1002.16
S. Sarıtaş, N. Dundar, A. Anıl, C. Alparslan, F. Can, D. Çavuşoğlu, Ö. Öztekin, O. Yavascan
1 Tepecik Training and Research Hospital, Clinic of Pediatrics, İzmir, Turkey 2 İzmir Katip Çelebi University Faculty of Medicine, Department of Pediatric Neurology, İzmir, Turkey 3 İzmir Katip Çelebi University Faculty of Medicine, Department of Pediatric Intensive Care, İzmir, Turkey 4 Tepecik Training and Research Hospital, Clinic of Pediatric Nephrology, İzmir, Turkey 5 Tepecik Training and Research Hospital, Department of Radiology, İzmir, Turkey doi: 10.5262/tndt.2017.1002.16
{"title":"Fibromuscular Dysplasia: A Rare Case of Renal Artery Stenosis Presenting with Stroke","authors":"S. Sarıtaş, N. Dundar, A. Anıl, C. Alparslan, F. Can, D. Çavuşoğlu, Ö. Öztekin, O. Yavascan","doi":"10.5262/TNDT.2017.1002.16","DOIUrl":"https://doi.org/10.5262/TNDT.2017.1002.16","url":null,"abstract":"1 Tepecik Training and Research Hospital, Clinic of Pediatrics, İzmir, Turkey 2 İzmir Katip Çelebi University Faculty of Medicine, Department of Pediatric Neurology, İzmir, Turkey 3 İzmir Katip Çelebi University Faculty of Medicine, Department of Pediatric Intensive Care, İzmir, Turkey 4 Tepecik Training and Research Hospital, Clinic of Pediatric Nephrology, İzmir, Turkey 5 Tepecik Training and Research Hospital, Department of Radiology, İzmir, Turkey doi: 10.5262/tndt.2017.1002.16","PeriodicalId":42328,"journal":{"name":"Turkish Nephrology Dialysis and Transplantation Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46082669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-22DOI: 10.5262/TNDT.2017.1002.11
Feray Gökdoğan, Duygu Kes, Gülay Turgay, D. Tuna
OBJEcTIVE: This study aimed to determine home application by hemodialysis patients for hypertension management. MATERIAL and METhOdS: The population of the descriptive study included a total of 279 patients who were treated at the hemodialysis centers of two state hospitals, one private hospital and one training and research hospital situated within Karabük province. A total of 120 patients who were over 18 years of age, had hypertension, could communicate, and whose clinic state were stable, who did not have any mental and psychiatric disorder and who accepted to participate in the research voluntarily were included in the sample. RESuLTS: It was determined that 59.2% of the patients who participated in the study did not measure their blood pressures at home regularly; 44.6% did not take their medication regularly and did not know the name and dosages of their medication (60.7% and 64.3% respectively); 73.2% had stopped taking medication without the physician’s knowledge; 85% used salt in meals; and 70.8% and 46.7% respectively did not comply with the liquid limitation. cOncLuSIOn: It is important to reveal the effects of a nursing care approach for supporting hypertension self-management at home of our patients based on their individual characteristics through studies focusing on regular training, monitoring and providing consultancy services. kEY wORdS: Hypertension, Hemodialysis, Nursing, Home care * Çalışma, yazarları tarafından 25. Ulusal Böbrek Hastalıkları, Diyaliz ve Transplantasyon Hemşireliği Kongresi’nde sunulmuştur (21-25 Ekim 2015, Antalya).
目的：本研究旨在确定血液透析患者在家应用高血压治疗的情况。材料和方法：描述性研究的人群包括279名患者，他们在卡拉布省的两家州立医院、一家私立医院和一家培训研究医院的血液透析中心接受治疗。共有120名年龄在18岁以上、患有高血压、能够交流、临床状态稳定、没有任何精神和精神障碍、自愿接受参与研究的患者被纳入样本。结果：59.2%的参与研究的患者没有定期在家测量血压；44.6%的患者不定期服药，不知道药物名称和剂量（分别为60.7%和64.3%）；73.2%的患者在医生不知情的情况下停止服药；85%的人在膳食中使用盐；70.8%和46.7%不符合液限。cOncLuSIOn：重要的是，通过专注于定期培训、监测和提供咨询服务的研究，揭示护理方法在支持患者在家自我管理方面的效果。kEY wORdS：高血压、血液透析、护理、家庭护理*Çalışma，yazarlarıtarafından 25。Ulunal Böbrek Hastalıkları，Diyaliz ve Transplantasion Hemşireliği Kongresi'nde sunulmuştur（2015年埃基姆21-25日，安塔利亚）。
{"title":"Hemodiyaliz Hastalarının Hipertansiyon Yönetimine İlişkin Evde Yaptıkları Uygulamalar","authors":"Feray Gökdoğan, Duygu Kes, Gülay Turgay, D. Tuna","doi":"10.5262/TNDT.2017.1002.11","DOIUrl":"https://doi.org/10.5262/TNDT.2017.1002.11","url":null,"abstract":"OBJEcTIVE: This study aimed to determine home application by hemodialysis patients for hypertension management. MATERIAL and METhOdS: The population of the descriptive study included a total of 279 patients who were treated at the hemodialysis centers of two state hospitals, one private hospital and one training and research hospital situated within Karabük province. A total of 120 patients who were over 18 years of age, had hypertension, could communicate, and whose clinic state were stable, who did not have any mental and psychiatric disorder and who accepted to participate in the research voluntarily were included in the sample. RESuLTS: It was determined that 59.2% of the patients who participated in the study did not measure their blood pressures at home regularly; 44.6% did not take their medication regularly and did not know the name and dosages of their medication (60.7% and 64.3% respectively); 73.2% had stopped taking medication without the physician’s knowledge; 85% used salt in meals; and 70.8% and 46.7% respectively did not comply with the liquid limitation. cOncLuSIOn: It is important to reveal the effects of a nursing care approach for supporting hypertension self-management at home of our patients based on their individual characteristics through studies focusing on regular training, monitoring and providing consultancy services. kEY wORdS: Hypertension, Hemodialysis, Nursing, Home care * Çalışma, yazarları tarafından 25. Ulusal Böbrek Hastalıkları, Diyaliz ve Transplantasyon Hemşireliği Kongresi’nde sunulmuştur (21-25 Ekim 2015, Antalya).","PeriodicalId":42328,"journal":{"name":"Turkish Nephrology Dialysis and Transplantation Journal","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41835279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-22DOI: 10.5262/tndt.2017.1002.17
B. Eser, I. Dogan, O. Yayar, S. Çalışkan
Mechanical and technical complications associated with a peritoneal dialysis catheter are seen frequently but inserting the catheter into the bladder is a rare complication. The Tenchkoff catheter was inserted into the bladder accidentally in a 64-year-old male patient and this complication was understood by the beginning of peritoneal dialysis (PD). This is the first case reported in the national literature. It is presented to highlight the importance of this complication that may be asymptomatic until the initiation of PD treatment.
{"title":"Rare Complication in Tenchkoff Catheter Insertion: Placement in the Bladder","authors":"B. Eser, I. Dogan, O. Yayar, S. Çalışkan","doi":"10.5262/tndt.2017.1002.17","DOIUrl":"https://doi.org/10.5262/tndt.2017.1002.17","url":null,"abstract":"Mechanical and technical complications associated with a peritoneal dialysis catheter are seen frequently but inserting the catheter into the bladder is a rare complication. The Tenchkoff catheter was inserted into the bladder accidentally in a 64-year-old male patient and this complication was understood by the beginning of peritoneal dialysis (PD). This is the first case reported in the national literature. It is presented to highlight the importance of this complication that may be asymptomatic until the initiation of PD treatment.","PeriodicalId":42328,"journal":{"name":"Turkish Nephrology Dialysis and Transplantation Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43388345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-22DOI: 10.5262/TNDT.2017.1002.05
A. Soylu, H. Eroglu, S. Çamlar, M. Türkmen, S. Kavukçu
OBJECTIVE: Congenital anomalies of the kidney and urinary tract (CAKUT) are the leading cause of chronic renal disease in childhood. Abnormal intrauterine conditions as well as genetic disorders play role in CAKUT development. We evaluated antenatal factors in CAKUT. MATERIAL and METHODS: The study and control groups included 140 CAKUT cases and 140 children without urinary malformation, respectively. Both groups were compared for antenatal (gestational period, prematurity, oligohydramios, preeclampsia, gestational diabetes, accompanying malformation, in vitro fertilization), maternal (age, body weight at pregnancy onset, weight gain during pregnancy, systemic disease, smoking, alcohol, medications) and familial (consanguinity, renal disease, urinary malformation) parameters. RESULTS: The study group had a shorter gestational period (38.8±2.9 vs. 39.5±0.9 week, p=0.004), but higher prematurity (9.3% vs. 0.7%, p=0.001), parity (≥2 parity 57.9% vs. 41.4%, p=0.006), oligohydramnios (6.4% vs. 0%, p=0.002), accompanying malformation (15.7% vs. 5.7%, p=0007), weight gain in pregnancy (18.8±2.9 vs. 18.1±2.8 kg, p=0.047) and familial renal disease (7.9% vs. 2.1%, p=0.028) rates. In vitro fertilization was present in only two cases in the study group. CONCLUSION: Weight gain in pregnancy and increased parity may be risk factors for CAKUT. Population-based studies are needed to determine the role of subfertility. KEy wORDS: CAKUT, Maternal weight, Parity, Risk factors, Subfertility
{"title":"Prenatal Risk Factors for Congenital Anomalies of the Kidney and Urinary Tract","authors":"A. Soylu, H. Eroglu, S. Çamlar, M. Türkmen, S. Kavukçu","doi":"10.5262/TNDT.2017.1002.05","DOIUrl":"https://doi.org/10.5262/TNDT.2017.1002.05","url":null,"abstract":"OBJECTIVE: Congenital anomalies of the kidney and urinary tract (CAKUT) are the leading cause of chronic renal disease in childhood. Abnormal intrauterine conditions as well as genetic disorders play role in CAKUT development. We evaluated antenatal factors in CAKUT. MATERIAL and METHODS: The study and control groups included 140 CAKUT cases and 140 children without urinary malformation, respectively. Both groups were compared for antenatal (gestational period, prematurity, oligohydramios, preeclampsia, gestational diabetes, accompanying malformation, in vitro fertilization), maternal (age, body weight at pregnancy onset, weight gain during pregnancy, systemic disease, smoking, alcohol, medications) and familial (consanguinity, renal disease, urinary malformation) parameters. RESULTS: The study group had a shorter gestational period (38.8±2.9 vs. 39.5±0.9 week, p=0.004), but higher prematurity (9.3% vs. 0.7%, p=0.001), parity (≥2 parity 57.9% vs. 41.4%, p=0.006), oligohydramnios (6.4% vs. 0%, p=0.002), accompanying malformation (15.7% vs. 5.7%, p=0007), weight gain in pregnancy (18.8±2.9 vs. 18.1±2.8 kg, p=0.047) and familial renal disease (7.9% vs. 2.1%, p=0.028) rates. In vitro fertilization was present in only two cases in the study group. CONCLUSION: Weight gain in pregnancy and increased parity may be risk factors for CAKUT. Population-based studies are needed to determine the role of subfertility. KEy wORDS: CAKUT, Maternal weight, Parity, Risk factors, Subfertility","PeriodicalId":42328,"journal":{"name":"Turkish Nephrology Dialysis and Transplantation Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47328746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-22DOI: 10.5262/TNDT.2017.1002.19
M. C. Şirin, C. Elmas, N. Ağuş, C. Alparslan, N. Yılmaz, O. Yavascan
Haemophilus influenzae, particularly in children, causes local and systemic infections such as meningitis, pneumonia, epiglottitis, otitis media, sinusitis and bacteremia. This bacterium has rarely been implicated as the causative agent of urinary tract infections (UTIs) in children. Most of the reported cases on UTIs due to H. influenzae were associated with urinary tract abnormalities and/or recurrent UTIs. Because of the inability of H. influenzae to grow in standard media commonly used for urine cultures, the true incidence of UTIs due to this potential pathogen is unknown. In this report, we present a case of UTI caused by H. influenzae in a 17-year-old boy with bilateral nephrolithiasis and hydronephrosis. To our knowledge, this is the first reported case of UTI caused by H. influenzae in Turkey.
{"title":"An Unexpected Agent in a Child with Urinary Tract Infection: Haemophilus influenzae","authors":"M. C. Şirin, C. Elmas, N. Ağuş, C. Alparslan, N. Yılmaz, O. Yavascan","doi":"10.5262/TNDT.2017.1002.19","DOIUrl":"https://doi.org/10.5262/TNDT.2017.1002.19","url":null,"abstract":"Haemophilus influenzae, particularly in children, causes local and systemic infections such as meningitis, pneumonia, epiglottitis, otitis media, sinusitis and bacteremia. This bacterium has rarely been implicated as the causative agent of urinary tract infections (UTIs) in children. Most of the reported cases on UTIs due to H. influenzae were associated with urinary tract abnormalities and/or recurrent UTIs. Because of the inability of H. influenzae to grow in standard media commonly used for urine cultures, the true incidence of UTIs due to this potential pathogen is unknown. In this report, we present a case of UTI caused by H. influenzae in a 17-year-old boy with bilateral nephrolithiasis and hydronephrosis. To our knowledge, this is the first reported case of UTI caused by H. influenzae in Turkey.","PeriodicalId":42328,"journal":{"name":"Turkish Nephrology Dialysis and Transplantation Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46925365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-22DOI: 10.5262/TNDT.2017.1002.13
Nilgün Savaş, Ertuğrul Erken, Faruk Kutluturk, Ayse Yilmaz, S. Kaya, A. Demir, B. Ozturk
OBJEctIvE: Oxidative stress has been found to be associated with diabetes mellitus (DM) and its complications. Exhaled breath condansate (EBC) is a method based on air cooling and condensation. This study aims to investigate a possible association between oxidative markers (8-isoprostane, Nitric Oxide (NO), Leukotriene E4 (LTE4)) in exhaled breath and microalbuminuria in diabetic patients and determine the effects of diabetes on respiratory functions. mAtErIAl and mEthODS: Forty-seven patients with type 2 DM were enrolled. Group 1 consisted of 25 patients without microalbuminuria (F/M:17/8) and Group 2 of 22 with microalbuminuria (F/M:14/8). Twenty-five healthy volunteers (F/M:18/7) were also included. Respiratory function tests and 24h urine microalbumin measurements were performed in all groups. NO was measured with colorimetry, 8-isoprostane and LTE4 levels were determined with EIA in EBC samples. rESUltS: Oxidative marker levels were similar among the patient groups and healthy controls. No correlation was observed between microalbuminuria and oxidative markers. Respiratory functions were significantly lower in Group 2. cONclUSION: There was no significant difference in oxidative markers measured with EBC for diabetic patients with or without microalbuminuria. We attributed these results to small sample size and possible factors effecting EBC. Comprehensive studies using EBC with larger sample size might reveal a possible relation between oxidative stress and diabetic nephropathy. KEY wOrDS: Oxidative stress, Diabetes mellitus, Microalbuminuria, EBC
{"title":"Mikroalbüminürisi Olan ve Olmayan Tip 2 Diyabetes Mellitus Hastalarında Ekshale Soluk Havası İnflamatuvar Belirteç Düzeyleri ve Solunumsal Parametreler","authors":"Nilgün Savaş, Ertuğrul Erken, Faruk Kutluturk, Ayse Yilmaz, S. Kaya, A. Demir, B. Ozturk","doi":"10.5262/TNDT.2017.1002.13","DOIUrl":"https://doi.org/10.5262/TNDT.2017.1002.13","url":null,"abstract":"OBJEctIvE: Oxidative stress has been found to be associated with diabetes mellitus (DM) and its complications. Exhaled breath condansate (EBC) is a method based on air cooling and condensation. This study aims to investigate a possible association between oxidative markers (8-isoprostane, Nitric Oxide (NO), Leukotriene E4 (LTE4)) in exhaled breath and microalbuminuria in diabetic patients and determine the effects of diabetes on respiratory functions. mAtErIAl and mEthODS: Forty-seven patients with type 2 DM were enrolled. Group 1 consisted of 25 patients without microalbuminuria (F/M:17/8) and Group 2 of 22 with microalbuminuria (F/M:14/8). Twenty-five healthy volunteers (F/M:18/7) were also included. Respiratory function tests and 24h urine microalbumin measurements were performed in all groups. NO was measured with colorimetry, 8-isoprostane and LTE4 levels were determined with EIA in EBC samples. rESUltS: Oxidative marker levels were similar among the patient groups and healthy controls. No correlation was observed between microalbuminuria and oxidative markers. Respiratory functions were significantly lower in Group 2. cONclUSION: There was no significant difference in oxidative markers measured with EBC for diabetic patients with or without microalbuminuria. We attributed these results to small sample size and possible factors effecting EBC. Comprehensive studies using EBC with larger sample size might reveal a possible relation between oxidative stress and diabetic nephropathy. KEY wOrDS: Oxidative stress, Diabetes mellitus, Microalbuminuria, EBC","PeriodicalId":42328,"journal":{"name":"Turkish Nephrology Dialysis and Transplantation Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47402159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-22DOI: 10.5262/tndt.2017.1002.08
Y. Kandur, Yeşim Özdemir Atikel, Bahar Büyükkaragöz, Ş. Göral, İ. Yenicesu, S. Bakkaloğlu
OBJECTIVE: Therapeutic plasma exchange (TPE) has been used in many diseases as primary or adjunctive therapy. We present our TPE experience in a pediatric nephrology practice setting. MATERIAL and METHODS: We retrospectively evaluated the indications and outcomes of TPE performed between 2008-2013 on the basis of the 2013 American Society for Apheresis Guidelines. RESULTS: One hundred and sixteen TPEs were performed in 15 patients (6 male / 9 female, mean age 12.9±3.5 years). The indications were hemolytic uremic syndrome (HUS) in 7 (four atypical) patients, pre-transplant TPE in 3 patients with focal segmental glomerulosclerosis (FSGS), treatment-resistant membranoproliferative glomerulonephritis (MPGN) in 1 patient, antibody mediated rejection (AMR) in 3 patients, and thrombotic microangiopathy (TMA) in 1 renal transplantation patient. Six months after TPE, hypertension persisted in two of seven and proteinuria in three of seven HUS patients, although all HUS patients had normal creatinine levels. Similarly, serum creatinine and urinary protein excretion were within the normal range in all FSGS patients and in one patient with AMR. Thrombocytopenia and anemia resolved and the blood creatinine level decreased in a patient with TMA. CONCLUSION: Although adherence to adult TPE guideline indications is around 50%, treatment results of TPE are satisfactory in 2/3 of our pediatric nephrology patients. Pediatric TPE Guidelines based on pediatric evidence-based data will help achieve better clinical outcomes in children. KEy wORDS: Plasmapheresis, Nephrology, Pediatric
{"title":"Therapeutic Plasma Exchange in Pediatric Patients with Nephrologic Diseases: Results from a Single Center","authors":"Y. Kandur, Yeşim Özdemir Atikel, Bahar Büyükkaragöz, Ş. Göral, İ. Yenicesu, S. Bakkaloğlu","doi":"10.5262/tndt.2017.1002.08","DOIUrl":"https://doi.org/10.5262/tndt.2017.1002.08","url":null,"abstract":"OBJECTIVE: Therapeutic plasma exchange (TPE) has been used in many diseases as primary or adjunctive therapy. We present our TPE experience in a pediatric nephrology practice setting. MATERIAL and METHODS: We retrospectively evaluated the indications and outcomes of TPE performed between 2008-2013 on the basis of the 2013 American Society for Apheresis Guidelines. RESULTS: One hundred and sixteen TPEs were performed in 15 patients (6 male / 9 female, mean age 12.9±3.5 years). The indications were hemolytic uremic syndrome (HUS) in 7 (four atypical) patients, pre-transplant TPE in 3 patients with focal segmental glomerulosclerosis (FSGS), treatment-resistant membranoproliferative glomerulonephritis (MPGN) in 1 patient, antibody mediated rejection (AMR) in 3 patients, and thrombotic microangiopathy (TMA) in 1 renal transplantation patient. Six months after TPE, hypertension persisted in two of seven and proteinuria in three of seven HUS patients, although all HUS patients had normal creatinine levels. Similarly, serum creatinine and urinary protein excretion were within the normal range in all FSGS patients and in one patient with AMR. Thrombocytopenia and anemia resolved and the blood creatinine level decreased in a patient with TMA. CONCLUSION: Although adherence to adult TPE guideline indications is around 50%, treatment results of TPE are satisfactory in 2/3 of our pediatric nephrology patients. Pediatric TPE Guidelines based on pediatric evidence-based data will help achieve better clinical outcomes in children. KEy wORDS: Plasmapheresis, Nephrology, Pediatric","PeriodicalId":42328,"journal":{"name":"Turkish Nephrology Dialysis and Transplantation Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48516232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-22DOI: 10.5262/TNDT.2017.1002.15
İ. Kılıç, İ. Kurultak, S. Ustundag
Rectus sheath hematoma is a rare but well-known cause of acute abdominal pain. Rectus sheath hematoma is largely misdiagnosed as seen rarely. As a fatal disorder it must be suspected especially in patients receiving anticoagulant therapy for any reason. Heparin exposure during hemodialysis sessions and uremic bleeding diathesis causes chronic hemodialysis patients to be vulnerable to rectus sheath hematoma. Rectus sheath hematoma may be mild and self-limiting but also be so severe that it threatens life because of hypotensive shock and anemia-related risks. The patient may present without symptoms, with abdominal pain or with hemodynamic shock. We present a case report describing a patient with recurrent abdominal pain due to rectus sheath hematoma exacerbating after hemodialysis sessions.
{"title":"Atypical Presentation of Rectus Sheath Hematoma in a Hemodialysis Patient: Recurrent Abdominal Pain After Dialysis Sessions","authors":"İ. Kılıç, İ. Kurultak, S. Ustundag","doi":"10.5262/TNDT.2017.1002.15","DOIUrl":"https://doi.org/10.5262/TNDT.2017.1002.15","url":null,"abstract":"Rectus sheath hematoma is a rare but well-known cause of acute abdominal pain. Rectus sheath hematoma is largely misdiagnosed as seen rarely. As a fatal disorder it must be suspected especially in patients receiving anticoagulant therapy for any reason. Heparin exposure during hemodialysis sessions and uremic bleeding diathesis causes chronic hemodialysis patients to be vulnerable to rectus sheath hematoma. Rectus sheath hematoma may be mild and self-limiting but also be so severe that it threatens life because of hypotensive shock and anemia-related risks. The patient may present without symptoms, with abdominal pain or with hemodynamic shock. We present a case report describing a patient with recurrent abdominal pain due to rectus sheath hematoma exacerbating after hemodialysis sessions.","PeriodicalId":42328,"journal":{"name":"Turkish Nephrology Dialysis and Transplantation Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46393148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-22DOI: 10.5262/TNDT.2017.1002.18
Fatih Yılmaz, M. Bilici, Şebnem Karaçay Özkalaycı, Ali Borazan
{"title":"İntravenöz İmmünglobulin Tedavisi ile İlişkili Akut Böbrek Hasarı: Olgu Sunumu","authors":"Fatih Yılmaz, M. Bilici, Şebnem Karaçay Özkalaycı, Ali Borazan","doi":"10.5262/TNDT.2017.1002.18","DOIUrl":"https://doi.org/10.5262/TNDT.2017.1002.18","url":null,"abstract":"","PeriodicalId":42328,"journal":{"name":"Turkish Nephrology Dialysis and Transplantation Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46647686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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