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Ozturk S, Gursu M, Arici M, Sahin I, Eren N, Yilmaz M, Koyuncu S, Karahisar Sirali S, Ural Z, Dursun B, Yuksel E, Uzun S, Sipahi S, Ahbap E, Yazici H, Altunoren O, Tunca O, Ayar Y, Gok Oguz E, Yilmaz Z, Kahvecioglu S, Asicioglu E, Oruc A, Ataman R, Aydin Z, Huddam B, Dolarslan ME, Azak A, Bakırdogen S, Yalcin AU, Karadag S, Ulu MS, Gungor O, Ari Bakir E, Odabas AR, Seyahi N, Yildiz A, Ates K. Evaluation of Outcomes of Peritoneal Dialysis Patients in the Post-COVID-19 Period: A National Multicenter Case-Control Study from Turkey. Nephron Clin Pract 2022; 147:272-280. [PMID: 36183694 DOI: 10.1159/000526234] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 07/14/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION There are not enough data on the post-CO-VID-19 period for peritoneal dialysis (PD) patients affected from COVID-19. We aimed to compare the clinical and laboratory data of PD patients after COVID-19 with a control PD group. METHODS This study, supported by the Turkish Society of Nephrology, is a national, multicenter retrospective case-control study involving adult PD patients with confirmed COVID-19, using data collected from April 21, 2021, to June 11, 2021. A control PD group was also formed from each PD unit, from patients with similar characteristics but without COVID-19. Patients in the active period of COVID-19 were not included. Data at the end of the first month and within the first 90 days, as well as other outcomes, including mortality, were investigated. RESULTS A total of 223 patients (COVID-19 group: 113, control group: 110) from 27 centers were included. The duration of PD in both groups was similar (median [IQR]: 3.0 [1.88-6.0] years and 3.0 [2.0-5.6]), but the patient age in the COVID-19 group was lower than that in the control group (50 [IQR: 40-57] years and 56 [IQR: 46-64] years, p < 0.001). PD characteristics and baseline laboratory data were similar in both groups, except serum albumin and hemoglobin levels on day 28, which were significantly lower in the COVID-19 group. In the COVID-19 group, respiratory symptoms, rehospitalization, lower respiratory tract infection, change in PD modality, UF failure, and hypervolemia were significantly higher on the 28th day. There was no significant difference in laboratory parameters at day 90. Only 1 (0.9%) patient in the COVID-19 group died within 90 days. There was no death in the control group. Respiratory symptoms, malnutrition, and hypervolemia were significantly higher at day 90 in the COVID-19 group. CONCLUSION Mortality in the first 90 days after COVID-19 in PD patients with COVID-19 was not different from the control PD group. However, some patients continued to experience significant problems, especially respiratory system symptoms, malnutrition, and hypervolemia.
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Affiliation(s)
- Savas Ozturk
- Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Meltem Gursu
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey
| | - Mustafa Arici
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Istanbul, Turkey
| | - Idris Sahin
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Malatya Inonu University, Malatya, Turkey
| | - Necmi Eren
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Murvet Yilmaz
- Division of Nephrology, Department of Internal Medicine, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Sumeyra Koyuncu
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Semahat Karahisar Sirali
- Division of Nephrology, Department of Internal Medicine, Ankara Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Zeynep Ural
- Division of Nephrology, Department of Internal Medicine, Ankara Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Belda Dursun
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Enver Yuksel
- Division of Nephrology, Department of Internal Medicine, Diyarbakir Gazi Yasargil Training and Research Hospital, University of Health Sciences, Diyarbakir, Turkey
| | - Sami Uzun
- Division of Nephrology, Department of Internal Medicine, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Savaş Sipahi
- Division of Nephrology, Department of Internal Medicine, Sakarya University Medical Faculty Education and Research Hospital, Sakarya, Turkey
| | - Elbis Ahbap
- Division of Nephrology, Department of Internal Medicine, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Halil Yazici
- Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Orcun Altunoren
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Onur Tunca
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Yavuz Ayar
- Division of Nephrology, Department of Internal Medicine, Bursa City Hospital, Bursa Faculty of Medicine, University of Health Sciences, Bursa, Turkey
| | - Ebru Gok Oguz
- Division of Nephrology, Department of Internal Medicine, Diskapi Yildirim Beyazit Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Zulfukar Yilmaz
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Diyarbakir Dicle University, Diyarbakir, Turkey
| | - Serdar Kahvecioglu
- Division of Nephrology, Department of Internal Medicine, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Ebru Asicioglu
- Division of Nephrology, Department of Internal Medicine, Pendik Training and Research Hospital, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Aysegul Oruc
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Rezzan Ataman
- Division of Nephrology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Zeki Aydin
- Division of Nephrology, Department of Internal Medicine, Darica Training and Research Hospital, University of Health Sciences, Kocaeli, Turkey
| | - Bulent Huddam
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Murside Esra Dolarslan
- Division of Nephrology, Department of Internal Medicine, Trabzon Kanuni Training and Research Hospital, University of Health Sciences, Trabzon, Turkey
| | - Alper Azak
- Division of Nephrology, Department of Internal Medicine, Balikesir Atatürk Education and Research Hospital, Balikesir, Turkey
| | - Serkan Bakırdogen
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Ahmet Uğur Yalcin
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Serhat Karadag
- Division of Nephrology, Department of Internal Medicine, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Memnune Sena Ulu
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Bahçeşehir University, Istanbul, Turkey
| | - Ozkan Gungor
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Elif Ari Bakir
- Division of Nephrology, Department of Internal Medicine, Dr. Lutfi Kirdar City Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ali Rıza Odabas
- Division of Nephrology, Department of Internal Medicine, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Nurhan Seyahi
- Division of Nephrology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Alaattin Yildiz
- Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Kenan Ates
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Ankara University, Ankara, Turkey
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Murt A, Riza Altiparmak M, Pekpak M, Ataman R. MO919: Persistence of Antibodies After SARS-COV-2 Vaccines in Haemodialysis Patients: A 6 Months Follow-Up. Nephrol Dial Transplant 2022. [PMCID: PMC9383925 DOI: 10.1093/ndt/gfac084.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND AND AIMS As COVID-19 related mortality is higher in haemodialysis patients than in the general population, proper vaccination strategies against the SARS-CoV-2 virus have utmost importance. It has been previously shown that mRNA vaccines (e.g. BNT162b2) can generate >95% of seropositivity in haemodialysis patients [1]. On the other hand, the seropositivity rate reached by the inactivated vaccine (CoronaVac®) was around 80%. In this study, we aimed to analyse the persistence of SARS-CoV-2 antibodies in haemodialysis patients for 6 months and compare it with the healthy controls. METHOD Haemodialysis patients who were vaccinated either by BNT162b2 or CoronaVac® and who continued their regular controls for 6 months were involved in the study. Those who had previous or active SARS-CoV-2 infection, who had malignancies and those who had received immunosuppressive drugs in the previous 12 month were excluded from the study. SARS-CoV-2 IgG levels were measured by a commercial test after the first doses of the vaccines and at the end of the sixth month. Healthy healthcare workers who were vaccinated with similar vaccine schemes were taken as the control group. RESULTS We recruited 85 haemodialysis patients who had received their first doses of either vaccine. Of them, 4 patients died; 3 patients were hospitalized because of COVID-19 infection during the follow-up; 9 patients missed at least one of their regular controls; and 2 patients were diagnosed with malignancy. A total of 26 patients experienced asymptomatic or mild COVID-19 infection during the follow-up period. SARS-CoV-2 IgG levels were measured at the end of the sixth month for the remaining 41 patients. Sero-positivity significantly decreased at the end of the sixth month for both vaccines, but the BNT162b2 group (n = 22) still had better seropositivity than CoronaVac® (n = 19) group (81% versus 50%; P = .03). In contrast, the seropositivity of healthy controls, even with the inactivated vaccine, was 96%. When one booster dose was applied, 90% of seropositivity could be maintained in the BNT162b2 group at the sixth month. CONCLUSION BNT162b2 vaccine generates more persistent antibodies than inactivated vaccines in haemodialysis patients. However, when compared with the healthy controls at the end of the sixth month, antibody titers decrease more profoundly in haemodialysis patients. The booster dose can maintain the antibody levels and should be applied at least every 6 months.
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Affiliation(s)
- Ahmet Murt
- Nephrology, Cerrahpasa Medical Faculty, Istanbul Universtiy-Cerrahpasa, Turkey, Turkey
| | | | - Meltem Pekpak
- Nephrology, Cerrahpasa Medical Faculty, Istanbul Universtiy-Cerrahpasa, Turkey, Turkey
| | - Rezzan Ataman
- Nephrology, Cerrahpasa Medical Faculty, Istanbul Universtiy-Cerrahpasa, Turkey, Turkey
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Sari F, Karayalcin B, Suleymanlar G, Akcicek F, Ataman R, Akpolat T, Bozfakioglu S, Gultekin M, Ersoy F. 99mTc MDP Bone Scan Findings in CKD-MBD: Could the “Superscan” Image be Useful in Excluding Adynamic Bone Disease? Turk J Nephrol 2021. [DOI: 10.5152/turkjnephrol.2021.4727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Altiparmak MR, Demirel H, Mert A, Serdengecti K, Ataman R. Toxic Shock Syndrome in Two CAPD Patients with Staphylococcus Aureus Exit-Site Infection. Perit Dial Int 2020. [DOI: 10.1177/089686080302300216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Toxic shock syndrome (TSS) is an illness defined by the occurrence of fever, rash, hypotension, multiple organ system dysfunction, and desquamation. Nonmenstrual TSS is often associated with surgical or nonsurgical cutaneous infections, which are rarely purulent or inflamed (Reingold AL, et al. Nonmenstrual toxic shock syndrome: a review of 130 cases. Ann Intern Med 1982; 96:871–4). Toxic shock syndrome associated with peritoneal exit-site infection but without peritonitis is extremely unusual (Sherbotie JR, et al. Toxic shock syndrome with Staphylococcus aureus exit-site infection in a patient on peritoneal dialysis. Am J Kidney Dis 1990; 15:80–3). We describe 2 patients that met the Centers for Disease Control case definition of TSS secondary to a peritoneal dialysis catheter exit-site infection with signs of mild inflammation and growth of Staphylococcus aureus, but with no evidence of peritonitis.
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Affiliation(s)
- Mehmet R. Altiparmak
- Division of Nephrology Department of Internal Medicine, Cerrahpasa Medical Faculty Istanbul, Turkey
| | - Hande Demirel
- Department of Pulmonary Diseases, Cerrahpasa Medical Faculty Istanbul, Turkey
| | - Ali Mert
- Department of Clinical Bacteriology and Infectious Disease Cerrahpasa Medical Faculty Istanbul, Turkey
| | - Kamil Serdengecti
- Division of Nephrology Department of Internal Medicine, Cerrahpasa Medical Faculty Istanbul, Turkey
| | - Rezzan Ataman
- Division of Nephrology Department of Internal Medicine, Cerrahpasa Medical Faculty Istanbul, Turkey
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Akpolat T, Dilek M, Yavuz M, Utas C, Ozener Ç, Karayaylali I, Yilmaz E, Ersoy F, Camsari T, Ataman R, Bozfakioglu S, Akcicek F, Ates K, Arinsoy T. Low Seroconversion Rates in CAPD Patients Compared to Hemodialysis Patients: Potential Advantages for Transplant Candidates. Perit Dial Int 2020. [DOI: 10.1177/089686080202200414] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Melda Dilek
- Turkish Multicenter PD Study Group (TULIP), Turkey
| | - Mahmut Yavuz
- Turkish Multicenter PD Study Group (TULIP), Turkey
| | - Cengiz Utas
- Turkish Multicenter PD Study Group (TULIP), Turkey
| | - Çetin Ozener
- Turkish Multicenter PD Study Group (TULIP), Turkey
| | | | - Emin Yilmaz
- Turkish Multicenter PD Study Group (TULIP), Turkey
| | - Fevzi Ersoy
- Turkish Multicenter PD Study Group (TULIP), Turkey
| | | | | | | | | | - Kenan Ates
- Turkish Multicenter PD Study Group (TULIP), Turkey
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Alagoz S, Yalin S, Gulcicek S, Oruc M, Trabulus S, Pekpak M, Ataman R, Altiparmak M, Seyahi N. SP762LONG TERM EVOLUTION OF THE MINERAL METABOLISM AFTER RENAL TRANSPLANTATION. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx157.sp762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Akgol C, Kara E, Sakaci T, Ahbap E, Basturk T, Koc Y, Sahutoglu T, Alagoz S, Gulcicek S, Unsal A, Ataman R, Seyahi N. SP778EFFECTS OF CHRONIC HCV INFECTION ON GRAFT AND PATIENT SURVIVAL IN RENAL TRANSPLANT RECIPIENTS. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv202.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Soylu H, Oruc M, Demirkol O, Saygili E, Ataman R, Altiparmak M, Pekmezci S, Seyahi N. Survival of Renal Transplant Patients: Data From a Tertiary Care Center in Turkey. Transplant Proc 2015; 47:348-53. [DOI: 10.1016/j.transproceed.2014.10.054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 10/09/2014] [Accepted: 10/28/2014] [Indexed: 01/30/2023]
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Ozener C, Arikan H, Karayaylali I, Utas C, Bozfakioglu S, Akpolat T, Ataman R, Ersoy F, Camsari T, Yavuz M, Akcicek F, Yilmaz ME. The impact of diabetes mellitus on peritoneal dialysis: the Turkey Multicenter Clinic Study. Ren Fail 2013; 36:149-53. [PMID: 24131086 DOI: 10.3109/0886022x.2013.843275] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE It is well established that diabetic peritoneal dialysis (PD) patients have a higher mortality rate than the other PD population. This study was designed to determine the overall predictors of survival and compared mortality and morbidity between diabetic and non-diabetic Turkish PD patients. METHODS We conducted a multicenter retrospective study with 915 PD patients [217 had diabetes mellitus (DM)]. Serum albumin, PTH, HbA1c, co-morbid diseases, dialysis adequacy (Kt/V), and peritoneal transport characteristics as well as peritonitis episodes and ultrafiltration failure during the follow-up period were recorded. RESULTS DM patients were older and had more co-morbidities than non-DM patients. Peritonitis rates were higher in DM patients (one episode per 35.9 patient months) compared to non-DM patients (one episode per 41.5 patient months) (p < 0.001). On Kaplan-Meier analysis, patient survival was significantly lower in DM patients with the 2-, 3- and 5-year patient survival rates of 90.8%, 87.8% and 78.2% in non-diabetics and 80.9%, 70.4% and 61.2% in diabetics, respectively. On Cox regression analysis, DM (HR 1.5, p = 0.022), age (HR 1.03, p < 0.001), baseline serum albumin (HR 0.39, p < 0.001), heart failure (HR 0.038, p = 0.038), peripheral artery disease (HR 1.83, p = 0.025) and amputation (HR 4.1, p = 0.009) at baseline were significant predictors of overall mortality. CONCLUSIONS Patient survival is lower in diabetic compared to non-diabetic patients on PD. Peritonitis rates were also higher in diabetic PD patients. DM, older age, albumin level and cardiovascular co-morbidities are predictors of mortality.
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Affiliation(s)
- Cetin Ozener
- Turkish Multicenter Peritoneal Dialysis Study Group , Istanbul , Turkey and
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Ozgur N, Seyahi N, Sili U, Oruc M, Mete B, Ataman R, Pekmezci S. Candidal psoas abscess following persistent pyuria in a renal transplant recipient. Int Urol Nephrol 2012; 46:269-73. [PMID: 23136029 DOI: 10.1007/s11255-012-0316-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Accepted: 10/04/2012] [Indexed: 11/26/2022]
Abstract
Candidal infections occur commonly in renal transplant recipients especially in genitourinary system. Although the epidemiology of candiduria has not been well characterized in renal transplant population, it is the most common cause of fungal infections. However, candidal psoas abscess is very rare in the literature. We report a 42-year-old male renal transplant recipient with prolonged pyuria and candiduria followed by candidal psoas abscess formation. The treatment consisted of prolonged antifungal therapy along with percutaneous drainage. However, eventually, a surgical drainage had to be performed for the successful eradication.
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Affiliation(s)
- Nurgul Ozgur
- Division of Nephrology, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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Akpolat T, Kaya C, Utaş C, Arinsoy T, Taşkapan H, Erdem E, Yilmaz ME, Ataman R, Bozfakioğlu S, Özener Ç, Karayaylali I, Kazancioğlu R, Çamsari T, Yavuz M, Ersoy F, Duman S, Ateş K. Arm circumference: its importance for dialysis patients in the obesity era. Int Urol Nephrol 2012; 45:1103-10. [PMID: 22752452 DOI: 10.1007/s11255-012-0219-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2012] [Accepted: 06/04/2012] [Indexed: 11/28/2022]
Abstract
PURPOSE The purposes of this study were to investigate the association between arm circumference and body mass index (BMI) and to discuss problems, mainly arm circumference and cuff size mismatch, that could affect the reliability of home blood pressure monitoring (HBPM) among peritoneal dialysis (PD) and hemodialysis (HD) patients. METHODS 525 PD and 502 HD patients from 16 centers were included in the study. A two-part questionnaire was used to gather information from the participants. Arm circumferences were categorized into four groups according to the British Hypertension Society cuff size recommendations. RESULTS Mean BMI and arm circumference of all participants were 25.0 kg/m(2) and 27.6 cm, respectively. There was a significant correlation between BMI and arm circumference. The mean BMI and arm circumference values were higher in PD patients than in HD patients. Requirement of a large-sized adult cuff was more common among PD patients compared to HD patients (14 % vs 8 %, p = 0.002). CONCLUSIONS Since HBPM is a useful tool for clinicians to improve BP control, nephrologists should be aware of the problems related to HBPM in dialysis patients and take an active role to increase the reliability of HBPM.
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Affiliation(s)
- Tekin Akpolat
- Department of Nephrology, Ondokuz Mayis University School of Medicine, Samsun, 55139, Turkey.
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Liu J, Liu J, Liu Y, Xu Y, Zhao X, Qian J, Sun B, Xing C, Kanda R, Hamada C, Nakano T, Wakabayashi K, Io H, Horikoshi S, Tomino Y, Ishimatsu N, Miyamoto T, Morimoto H, Nakamata J, Baba R, Kanegae K, Serino R, Kabashima N, Otsuji Y, Doi Y, Tamura M, Nakamata J, Morimoto H, Baba R, Ishimatsu N, Miyamoto T, Kanegae K, Serino R, Kabashima N, Otsuji Y, Doi Y, Tamura M, Kusumoto T, Fukami K, Yamagishi SI, Ueda S, Kaida Y, Hazama T, Nakayama Y, Ando R, Obara N, Okuda S, Tamura M, Matsumoto M, Miyamoto T, Kanegae K, Furuno Y, Serino R, Kabashima N, Otsuji Y, Bang-Gee H, Mazzotta L, Rosati A, Carlini A, Henriques VT, Zangiacomi Martinez E, Divino-Filho JC, Pecoits-Filho R, Cardeal Da Costa JA, Henriques VT, Henriques VT, Gama Axelsson T, Lindholm B, Carrero JJ, Heimburger O, Stenvinkel P, Qureshi AR, Akazawa M, Uno T, Kanda E, Maeda Y, Aktsiali M, Aktsiali M, Antonopoulou S, Tsiolaki K, Bakirtzi N, Patrinou A, Georgopoulou M, Liaveri P, Afentakis N, Tsirpanlis G, Hasegawa T, Nishiwaki H, Hirose M, Komukai D, Tayama H, Koiwa F, Yoshimura A, Lui SL, Lui S, Yung S, Tang C, Ng F, Lo WK, Chan TM, Koo HM, Doh FM, Yoo DE, Oh HJ, Yoo TH, Choi KH, Kang SW, Han DS, Han SH, Fernandes N, Fernandes N, Bastos MG, Gianotti Franco MR, Chaoubah A, Gloria Lima MD, Pecoits-Filho R, Divino-Filho JC, Qureshi AR, Kang S, Do J, Cho K, Park J, Yoon K, Chen JB, Cheng BC, Chen TC, Su YJ, Wu CH, Park Y, Jeon J, Tsikeloudi M, Pateinakis P, Patsatsi K, Manou E, Sotiriadis D, Tsakiris D, Teixeira L, Rodrigues A, Carvalho MJ, Cabrita A, Mendonca D, Kang S, Do J, Park J, Cho K, Yoon K, Bruschi M, Candiano G, Santucci L, Luzio S, Cannavo R, Ghiggeri GM, Verrina E, Varadarajan Y, Raju B, Cho KH, Do J, Kang S, Park JW, Yoon KW, Kim TW, Kimmel M, Braun N, Latus J, Alscher MD, Struijk D, Van Esch S, Krediet RT, Fernandes N, Van den Beukel T, Hoekstra T, Tirapani L, De Andrade Bastos K, Pecoits-Filho R, Qureshi AR, Bastos M, Dekker F, Divino-Filho JC, Yasuhisa T, Kanai H, Harada K, Kawai Y, Sugiyama H, Ito Y, Tsuruya K, Yoshida H, Maruyama H, Goto S, Nakayama M, Nakamoto H, Morinaga H, Matsuo S, Makino H, DI Gioia MC, Gallar P, Laso N, Rodriguez I, Cobo G, Oliet A, Hynostroza J, Herrero JC, Mon C, Ortiz M, Vigil A, Tomo T, Portoles J, Uta S, Uta S, Tato AM, Lopez-Sanchez P, Rivera M, Rodriguez-Pena R, Del Peso G, Ortega M, Felipe C, Tsampikaki E, Aperis G, Kaikis A, Paliouras C, Karvouniaris N, Maragaki M, Alivanis P, Kortus-Gotze B, Hoferhusch T, Hoyer J, Martino F, Kaushik M, Rodighiero MP, Creapldi C, Ronco C, Lacquaniti A, Lacquaniti A, Donato V, Fazio MR, Lucisano S, Cernaro V, Lupica R, Buemi M, Aloisi C, Uno T, Akazawa M, Kanda E, Maeda Y, Bavbek Ruzgaresen N, Secilmis S, Yilmaz H, Akcay A, Duranay M, Akalin N, Akalin N, Altiparmak MR, Trabulus S, Yalin AS, Ataman R, Serdengecti K, Schneider K, Bator B, Niko B, Braun N, Peter F, Ulmer C, Joerg L, Martin K, Dagmar B, German O, Fabian R, Juergen D, Stephan S, Dominik A, Latus J, Latus J, Ulmer C, Fritz P, Rettenmaier B, Hirschburger S, Segerer S, Biegger D, Lang T, Ott G, Kimmel M, Alscher MD, Braun N, Habib M, Korte M, Hagen M, Dor F, Betjes M, Habib M, Hagen M, Korte M, Zietse R, Dor F, Betjes M, Latus J, Latus J, Ulmer C, Fritz P, Rettenmaier B, Biegger D, Lang T, Ott G, Scharpf C, Kimmel M, Alscher MD, Braun N, Habib M, Korte M, Zietse R, Betjes M, Chang TI, Shin DH, Oh HJ, Kang SW, Han DS, Yoo TH, Han SH, Choi HY, Lee YK, Kim BS, Han SH, Yoo TH, Park HC, Lee HY, Horimoto N, Tuji K, Kitamura S, Sugiyama H, Makino H, Isshiki R, Isshiki R, Iwagami M, Tsutsumi D, Mochida Y, Ishioka K, Oka M, Maesato K, Moriya H, Ohtake T, Hidaka S, Kobayashi S, Higuchi C, Tanihata Y, Ishii M, Sugimoto H, Sato N, Kyono A, Ogawa T, Nishimura H, Otsuka K, Cho KH, Do JY, Kang S, Park JW, Yoon KW, Kim TW, Du Halgouet C, Latifa A, Anne Sophie V, Emmanuel D, Christine R, Francois V, Grzelak T, Czyzewska-Majchrzak L, Kramkowska M, Witmanowski H, Czyzewska K, Janda K, Krzanowski M, Dumnicka P, Sulowicz W, Rroji M, Seferi S, Barbullushi M, Likaj E, Petrela E, Thereska N, Cabiddu G, Dessi E, Arceri A, Laura P, Manca E, Conti M, Cao R, Pani A, Liao CT, Vega Vega O, Mendoza de la Garza A, Correa-Rotter R, Ueda A, Nagai K, Morimoto M, Hirayama A, Owada S, Tonozuka Y, Saito C, Saito C, Yamagata K, Matsuda A, Tayama Y, Ogawa T, Iwanaga M, Noiri C, Hatano M, Kiba T, Kanozawa K, Katou H, Hasegawa H, Mitarai T, Ros-Ruiz S, Ros-Ruiz S, Fuentes-Sanchez L, Jironda-Gallegos C, Gutierrez-Vilches E, Garcia-Frias P, Hernandez-Marrero D, Kang S, Lee S, Cho K, Park J, Yoon K, Do J, Lai X, Chen W, Guo Z, Braide M, Cristina V, Popa SG, Maria M, Eugen M, Martino F, DI Loreto P, DI Loreto P, Ronco C, Rroji M, Seferi S, Barbullushi M, Petrela E, Spahia N, Likaj E, Thereska N, Sanchez Macias LO, Sanchez Macias LO, Lares Castellanos KI, Hernandez Pacheco JA, Vega Vega O, Correa Rotter R, Pedro Ventura A, Olivia S, Teixeira L, Joana V, Francisco F, Maria Joao C, Antonio C, Rodrigues AS, Atas N, Erten Y, Erten Y, Onec K, Inal S, Topal S, Akyel A, Celik B, Okyay GU, Tavil Y, Zeiler M, Monteburini T, Agostinelli RM, Marinelli R, Santarelli S, Erten Y, Erten Y, Inal S, Onec K, Atas N, Okyay GU, Yaylaci C, Sahin G, Tavil Y, Guz G, Sindel S, Pinho A, Cabrita A, Malho Guedes A, Fragoso A, Carreira H, Pinto I, Bernardo I, Leao P, Janda K, Janda K, Krzanowski M, Kusnierz-Cabala B, Dumnicka P, Krasniak A, Chowaniec E, Tabor-Ciepiela B, Sulowicz W, Turkmen K, Ozbek O, Kayrak M, Samur C, Guler I, Tonbul HZ, Rusai K, Herzog R, Kratochwill K, Kuster L, Aufricht C, Meier CM, Fliser D, Schilling MK, Klingele M, Fukasawa M, Fukasawa M, Takeda M, Kamiyama M, Song YR, Kim HJ, Kim SG, Kim JK, Noh JW, Lee YK, Yoon JW, Koo JR. Peritoneal dialysis. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Loh ZY, Yap CW, Anantharaman V, How P, Hirata M, Aizawa K, Yogo K, Tashiro Y, Takeda S, Endo K, Fukagawa M, Serizawa KI, Fujii H, Fujii H, Kono K, Nakai K, Goto S, Hirata M, Shinohara M, Kitazawa R, Kitazawa S, Fukagawa M, Nishi S, Oruc A, Korkmaz S, Bal O, Yilmaztepe Oral A, Ersoy A, Gullulu M, Ketteler M, Martin K, Amdahl M, Cozzolino M, Goldsmith D, Sharma A, Khan S, Ketteler M, Martin K, Amdahl M, Cozzolino M, Goldsmith D, Sharma A, Khan S, Chitalia N, Afzali B, Edozie F, Manghat P, Wierzbicki A, Hampson G, Goldsmith D, Corradini M, Iannuzzella F, Manenti L, Ciarrocchi A, Albertazzi L, Somenzi D, Pasquali S, Calabria Baxmann A, Barcellos Menon V, Froeder L, Medina-Pestana JO, Barbosa Carvalho A, Pfeferman Heilberg I, Sola L, De Souza N, Flores J, Perico N, Yuste C, Garcia DE Vinuesa MS, Luno J, Goicoechea MA, Barraca D, Panizo N, Quiroga B, Kim SM, Kwon SK, Kim HY, Cournoyer S, Bell R, Berbiche D, Menard L, Viaene L, Evenepoel P, Meijers B, Overbergh L, Mathieu C, Pasquali M, Rotondi S, Conte C, Pirro G, Mazzaferro S, Frasheri A, Marangella M, Tartaglione L, Park JS, Koo TY, Kim GH, Kang CM, Lee CH, Hiemstra TF, Casian A, Boraks P, Jayne D, Schoenmakers I, Schmiedeke B, Niemann M, Schmiedeke D, Davydenko I, Emmert A, Pilz S, Obermayer-Pietsch B, Weidemann F, Breunig F, Wanner C, Drechsler C, Shiizaki K, Ito C, Onishi A, Nakazawa E, Ogura M, Kusano E, Ermolenko V, Mikhaylova N, Mikhaylova N, Vartanjan K, Levchuk D, Dobrina E, Capusa C, Stancu S, Maria D, Vladu I, Barsan L, Garneata L, Mota E, Mircescu G, Capusa C, Stancu S, Barsan L, Ilyes A, Dorobantu N, Petrescu L, Mircescu G, Martinez-Gallardo R, Martinez-Gallardo R, Ferreira F, Garcia-Pino G, Luna E, Caravaca F, De Jager DJ, Grootendorst DC, Postmus I, De Goeij MCM, Boeschoten EW, Sijpkens YWJ, Dekker FW, Halbesma N, Wuthrich RP, Covic A, Gaillard S, Rakov V, Louvet L, Buchel J, Steppan S, Passlick-Deetjen J, Massy ZA, Akalin N, Akalin N, Altiparmak MR, Trabulus S, Yalin AS, Seyahi N, Ataman R, Serdengecti K, Donate-Correa J, Martinez-Sanz R, Muros-de-Fuentes M, Garcia J, Garcia P, Cazana V, Mora-Fernandez C, Navarro-Gonzalez JF, Chitalia N, Afzali B, Edozie F, Manghat P, Wierzbicki A, Hampson G, Goldsmith D, Berutti S, Marranca D, Soragna G, Erroi L, Migliardi M, Marangella M, Corradini M, Iannuzzella F, Belloni L, Somenzi D, Parmeggiani M, Pasquali S, Camerini C, Pezzotta M, Zani R, Movilli E, Cancarini G, Anwar S, Pruthi R, Kenchayikoppad S, Reyes J, Dasilva I, Furlano M, Calero F, Montanes R, Ayasreh N, Del Pozo M, Estorch M, Rousaud F, Ballarin JA, Bover J, Resende A, Dias CB, Dos Reis L, Jorgetti V, Woronik V, Panuccio V, Panuccio V, Enia G, Tripepi R, Cutrupi S, Pizzini P, Aliotta R, Zoccali C, Yildiz I, Sagliker Y, Demirhan O, Tunc E, Inandiklioglu N, Tasdemir D, Acharya V, Zhang L, Golea O, Sabry A, Ookalkar D, Capusa C, Radulescu D, Garneata L, Mircescu G, Ben Maiz H, Chen CH, Rome JP, Benzegoutta M, Paylar N, Eyupoglu K, Karatepe E, Esenturk M, Yavascan O, Grzegorzevska A, Shilo V, M-Mazdeh M, Francesco RC, Gouda Z, Adam SM, Emir I, Ocal F, Usta E, Kiralp N, Sagliker C, S Ozkaynak P, Sagliker HS, Bassuoni M, El-Wakil HS, Akar H, Yenicerioglu Y, Kose E, Sekin O. Mineral and bone disease - CKD 1-5. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Seyahi N, Cebi D, Altiparmak MR, Akman C, Ataman R, Pekmezci S, Serdengecti K. Progression of coronary artery calcification in renal transplant recipients. Nephrol Dial Transplant 2011; 27:2101-7. [PMID: 21965591 DOI: 10.1093/ndt/gfr558] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Cardiovascular disease is the leading cause of mortality among renal transplant recipients. In the general population, coronary artery calcification (CAC) and progression of CAC are predictors of future cardiac risk. We conducted a study to determine the progression of CAC in renal transplant recipients; we also examined the factors associated with progression and the impact of the analytic methods used to determine CAC progression. METHODS We used multi-detector computed tomography to examine CAC in 150 prevalent renal transplant recipients, who did not have a documented cardiovascular disease. A baseline and a follow-up scan were performed and changes in CAC scores were evaluated in each patient individually, to calculate the incidence of CAC progression. Multivariate logistic regression analysis was used to evaluate the determinants of CAC progression. RESULTS Baseline CAC prevalence was 35.3% and the mean CAC score was 60.0 ± 174.8. At follow-up scan that was performed after an average of 2.8 ± 0.4 years, CAC prevalence increased to 64.6% and the mean CAC score to 94.9 ± 245.7. Progression of individual CAC score was found between 28.0 and 38.0%, depending on the method used to define progression. In patients with baseline CAC, median annualized rate of CAC progression was 11.1. Baseline CAC, high triglyceride and bisphosphonate use were the independent determinants of CAC progression. CONCLUSIONS Renal transplantation does not stop or reverse CAC. Progression of CAC is the usual evolution pattern of CAC in renal transplant recipients. Beside baseline CAC, high triglyceride level and bisphosphonate use were associated with progression of CAC.
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Affiliation(s)
- Nurhan Seyahi
- Department of Internal Medicine, Division of Nephrology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
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Aptaramanov B, Seyahi N, Alagoz S, Pekmezci S, Ataman R, Tasci H, Serdengecti K. A Comparison of Mycophenolate Mofetil With Mycophenolate Sodium in Renal Transplant Recipients on Tacrolimus-Based Treatment. Transplant Proc 2011; 43:833-6. [DOI: 10.1016/j.transproceed.2011.01.096] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Seyahi N, Kahveci A, Cebi D, Altiparmak MR, Akman C, Uslu I, Ataman R, Tasci H, Serdengecti K. Coronary artery calcification and coronary ischaemia in renal transplant recipients. Nephrol Dial Transplant 2010; 26:720-6. [PMID: 20621931 DOI: 10.1093/ndt/gfq413] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cardiovascular disease is the leading cause of mortality among renal transplant recipients. Data on the relationship between coronary artery calcification (CAC) and coronary ischaemia in renal transplantation patients are scant. We conducted a study to determine the prevalence and determinants of CAC in these patients; we also examined the frequency of coronary ischaemia in patients with moderate and severe CAC. METHODS We used multi-detector spiral computed tomography to examine CAC in 178 consecutive renal transplant recipients. Angina pectoris was sought with the Rose questionnaire. The extent of calcification was measured by Agatston score. Myocardial perfusion scintigraphy was performed in patients with moderate and severe CAC. Multivariate logistic and linear regression analysis was used to evaluate the determinants of CAC presence and CAC score, respectively. RESULTS CAC was present in 72 patients (40.4%), mean CAC score was 113.7±275.5 (median: 0 and range: 0-1712). Age, time on transplantation and Rose angina pectoris were the independent determinants of both CAC presence and high CAC scores in all multivariate models. Coronary ischaemia was detected in 17.1% of the patients with moderate-to-severe CAC. CONCLUSIONS CAC is highly prevalent in renal transplant recipients; it is associated with symptoms of coronary ischaemia. Time on transplantation is an independent determinant of CAC. Future studies to evaluate the prognostic significance of CAC in these patients are necessary.
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Affiliation(s)
- Nurhan Seyahi
- Department of Internal Medicine, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey.
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Oygar DD, Altiparmak MR, Murtezaoglu A, Yalin AS, Ataman R, Serdengecti K. Fungal peritonitis in peritoneal dialysis: risk factors and prognosis. Ren Fail 2009; 31:25-8. [PMID: 19142806 DOI: 10.1080/08860220802546446] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Although less common than bacterial peritonitis, fungal peritonitis is associated with much higher morbidity and mortality. In this study, we aimed to determine the risk factors for fungal peritonitis in peritoneal dialysis patients. The records of 109 peritoneal dialysis patients were analyzed. A total of 86 episodes of peritonitis attacks were recorded. Nine (10.5%) of these attacks were fungal peritonitis attacks. The fungal peritonitis attack rate of the population was 1 attack per 480.1 patient months. In order to determine predisposing factors for fungal peritonitis patients, patients with bacterial peritonitis and with no peritonitis admitted immediately before and after those with fungal peritonitis were used as controls. There was no statistically significant difference between the bacterial and fungal peritonitis groups with respect to symptoms and signs. Obligatory peritoneal dialysis treatment due to access or other medical problems (p = 0.04) and serum albumin levels (p = 0.01) were found to be significantly related with fungal peritonitis (p = 0.04). The mortality rate was 11.1%. When compared with the mortality rate of bacterial peritonitis (1.8%) during the same period, it was found to be significantly higher (p = 0.0001). The catheter removal was performed within 2-7 days (mean = 5.2 days) of the fungal peritonitis attacks. In conclusion, we decided that because fungal peritonitis attacks end up with high morbidity and mortality, prompt diagnosis and removal of the catheter is mandatory. Diagnosis highly depends on culture results, as signs and symptoms usually do not differ from that of bacterial peritonitis. Low serum albumin levels and obligatory peritoneal dialysis treatment are found to be the risk factors for fungal peritonitis.
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Affiliation(s)
- Duriye Deren Oygar
- University of Istanbul Cerrahpasa Medical Faculty, Nephrology Department, Kocamustafapasa, Istanbal, Turkey.
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Seyahi N, Kahveci A, Bolayirli M, Akman C, Altiparmak MR, Apaydin S, Ataman R, Sariyar M, Serdengecti K, Erek E. Coronary Artery Calcification and Chronically Decreased GFR in Living Kidney Donors. Am J Kidney Dis 2007; 49:143-52. [PMID: 17185155 DOI: 10.1053/j.ajkd.2006.10.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2006] [Accepted: 10/11/2006] [Indexed: 11/11/2022]
Abstract
BACKGROUND In the presence of decreased glomerular filtration rate (GFR), the risk of morbidity and mortality caused by cardiovascular disease (CVD) is increased markedly. Increased coronary artery calcification (CAC) is proposed as a pathogenetic link between CVD and chronic kidney disease. We examined the frequency and severity of CAC in living kidney donors to test the hypothesis that decreased GFR is associated with increased CAC. METHODS We used multidetector spiral computed tomography to examine CAC in 101 living kidney donors and 99 age- and sex-matched healthy control subjects without diabetes and a history of coronary artery disease. The extent of calcification was measured by means of the Agatston score. GFR was calculated by using the abbreviated Modification of Diet in Renal Disease formula. The frequency of risk factors for coronary artery disease was compared in kidney donors and controls, and the relation between kidney donors' clinical characteristics and the presence or absence of CAC was examined. RESULTS CAC frequency and mean calcification scores were similar between kidney donors (13.9%; 4.5 +/- 22.6) and controls (17.2%; 13.2 +/- 89.2). CAC was not associated with decreased GFR, and the correlation between CAC and GFR was not statistically significant. Kidney donors with calcification were more likely to be older (P = 0.003) and male (P = 0.001). Age- and sex-adjusted analysis showed an association between greater parathormone levels (odds ratio, 1.023; 95% confidence interval, 1.001 to 1.045; P = 0.037) and CAC in kidney donors. CONCLUSION A mild decrease in GFR without the presence of diabetes does not seem to be associated with increased CAC. These findings need to be confirmed in different and larger study populations.
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Affiliation(s)
- Nurhan Seyahi
- Department of Internal Medicine, Division of Nephrology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey.
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Kahveci A, Seyahi N, Seyahi E, Altiparmak MR, Ataman R, Serdengecti K. Homozygous factor V Leiden mutation and disseminated thrombosis in a patient with nephrotic syndrome. J Nephrol 2007; 20:103-6. [PMID: 17347983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
We report the case of a young male patient with nephrotic syndrome and multiple venous thromboses. The patient presented various aggregated thrombophilic risk factors. He was found to be homozygous for factor V Leiden mutation and his anticardiolipin antibody and homocysteine levels were high. The association between nephrotic syndrome and venous thrombosis is well known. However the presence of disseminated thrombosis should prompt an intensive work-up for the detection of thrombotic risk factors and aggressive anticoagulant therapy.
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Affiliation(s)
- Arzu Kahveci
- Division of Nephrology, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University, Istanbul - Turkey
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Taskapan H, Ersoy FF, Passadakis PS, Tam P, Memmos DE, Katopodis KP, Ozener C, Akcicek F, Camsari T, Ates K, Ataman R, Vlachojannis JG, Dombros NA, Utas C, Akpolat T, Bozfakioglu S, Wu G, Karayaylali I, Arinsoy T, Stathakis CP, Yavuz M, Tsakiris DJ, Dimitriades AD, Yilmaz ME, Gültekin M, Oreopoulos DG. Severe vitamin D deficiency in chronic renal failure patients on peritoneal dialysis. Clin Nephrol 2006; 66:247-55. [PMID: 17063991 DOI: 10.5414/cnp66247] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
UNLABELLED The aim of this study was to evaluate the prevalence of vitamin D deficiency in chronic renal failure (CRF) patients on peritoneal dialysis (PD) and to correlate the findings with various demographic and renal osteodystrophy markers. METHOD This cross-sectional, multicenter study was carried out in 273 PD patients with a mean age of 61.7 +/- 10.9 years and mean duration of PD 3.3 +/- 2.2 years. It included 123 female and 150 male patients from 20 centers in Greece and Turkey, countries that are on the same latitude, namely, 36-42 degrees north. We measured 25(OH)D3 and 1.25(OH)2D3 levels and some other clinical and laboratory indices of bone mineral metabolism. RESULTS Of these 273 patients 92% (251 patients) had vitamin D deficiency i.e. serum 25(OH)D3 levels less than 15 ng/ml, 119 (43.6%) had severe vitamin D deficiency i.e., serum 25(OH)D3 levels, less than 5 ng/ml, 132 (48.4%) had moderate vitamin D deficiency i.e., serum 25(OH)D3 levels, 5-15 ng/ml, 12 (4.4%) vitamin D insufficiency i.e., serum 25(OH)D3 levels 15 - 30 ng/ml and only 10 (3.6%) had adequate vitamin D stores. We found no correlation between 25(OH)D3 levels and PTH, serum albumin, bone alkaline phosphatase, P, and Ca x P. In multiple regression analyses, the independent predictors of 25(OH)D3 were age, presence of diabetes (DM-CRF), levels of serum calcium and serum 1.25(OH)2D3. CONCLUSION We found a high prevalence (92%) of vitamin D deficiency in these 273 PD patients, nearly one half of whom had severe vitamin D deficiency. Vitamin D deficiency is more common in DM-CRF patients than in non-DM-CRF patients. Our findings suggest that these patients should be considered for vitamin D supplementation.
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Affiliation(s)
- H Taskapan
- Inonu University Medical School, Department of Medicine, Division of Nephrology, Malatya, Turkey.
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Jeloka TK, Ersoy FF, Yavuz M, Sahu KM, Camsari T, Utaş C, Bozfakioglu S, Ozener C, Ateş K, Ataman R, Akçiçek F, Akpolat T, Karayaylali I, Arinsoy T, Mehmet EY, Süleymanlar G, Burdzy D, Oreopoulos DG. What is the optimal dwell time for maximizing ultrafiltration with icodextrin exchange in automated peritoneal dialysis patients? Perit Dial Int 2006; 26:336-40. [PMID: 16722026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023] Open
Abstract
BACKGROUND Icodextrin is increasingly being used in automated peritoneal dialysis (APD) for the long dwell exchange to maintain adequate ultrafiltration (UF). However, the UF reported in the literature varies with different dwell times: from 200 to 500 mL with 12 - 15 hour dwells. In order to maximize UF, it is important to know the relationship between dwell time and UF when using icodextrin in APD patients. With this knowledge, decisions can be made with respect to dwell period, and adjustments to the dialysis prescription can be made accordingly. METHODS We prospectively studied this relationship in 36 patients from Canada and Turkey. All patients did the icodextrin day exchange manually after disconnecting themselves from overnight cycler dialysis. Dwell period was increased by 1 hour every week, from 10 to 14 hours. Ultrafiltration was noted for each icodextrin exchange. Mean UF for each week (i.e., dwell period) was compared by repeated measures ANOVA. RESULTS We found no difference in mean UF with increasing dwelt time: 351.73 +/- 250.59 mL at 10 hours versus 371.75 +/- 258.25 mL at 14 hours (p = 0.83). We also compared mean UF between different subgroups and found that males (p = 0.02 vs females) and high transporters (p = 0.04 vs low) had higher mean UF. Further analysis of maximal UF showed no correlation to age, sex, diabetic status, transport category, creatinine clearance, Kt/V, duration on peritoneal dialysis, or duration of icodextrin use. CONCLUSION Icodextrin-related UF in APD patients is not related to demographic factors and does not increase significantly beyond 10 hours.
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Ogutmen B, Yildirim A, Sever MS, Bozfakioglu S, Ataman R, Erek E, Cetin O, Emel A. Health-Related Quality of Life After Kidney Transplantation in Comparison Intermittent Hemodialysis, Peritoneal Dialysis, and Normal Controls. Transplant Proc 2006; 38:419-21. [PMID: 16549136 DOI: 10.1016/j.transproceed.2006.01.016] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to compare the quality of life (QOL) in renal transplantation patients. QOL is one of the important indicators of the effects of medical treatment. In this cross-sectional study, QOL was analyzed in 302 renal transplant recipients compared with 64 hemodialysis (HD) patients, 207 (PD) peritoneal dialysis patients, and 278 normal controls (NC) matched as closely as possible to the grafted patients regarding age, gender, education, and occupation. All groups were asked to estimate their subjective QOL by responding to sociodemographic data, Turkish adapted instruments of the Nottingham Health profile (NHP), and the Short-form 36 (SF-36). Transplant recipients were significantly younger than the HD and PD patients (P < .0001). There was no statistically significant differences between normal controls and transplant patients ages. Among the three renal replacement methods, QOL in transplants was clearly better than that in HD or PD patients (P < .0001). The QOL measured by the NHP and SF-36 scale showed that the normal population was statistically significantly better than the transplant recipients (P < .0001). Transplant renal replacement therapy provides a better QOL compared with other replacement methods.
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Affiliation(s)
- B Ogutmen
- Department of Nephrology, Marmara University, Istanbul, Turkey.
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Ersoy FF, Passadakis SP, Tam P, Memmos ED, Katopodis PK, Ozener C, Akçiçek F, Camsari T, Ateş K, Ataman R, Vlachojannis JG, Dombros AN, Utaş C, Akpolat T, Bozfakioğlu S, Wu G, Karayaylali I, Arinsoy T, Stathakis PC, Yavuz M, Tsakiris JD, Dimitriades CA, Yilmaz ME, Gültekin M, Karayalçin B, Yardimsever M, Oreopoulos DG. Bone mineral density and its correlation with clinical and laboratory factors in chronic peritoneal dialysis patients. J Bone Miner Metab 2006; 24:79-86. [PMID: 16369903 DOI: 10.1007/s00774-005-0650-3] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2004] [Accepted: 07/15/2005] [Indexed: 10/25/2022]
Abstract
The aim of this study was to assess the clinical and laboratory correlations of bone mineral density (BMD) measurements among a large population of patients on chronic peritoneal dialysis (PD). This cross-sectional, multicenter study was carried out in 292 PD patients with a mean age of 56 +/- 16 years and mean duration of PD 3.1 +/- 2.1 years. Altogether, 129 female and 163 male patients from 24 centers in Canada, Greece, and Turkey were included in the study. BMD findings, obtained by dual-energy X-ray absorptiometry (DEXA) and some other major clinical and laboratory indices of bone mineral deposition as well as uremic osteodystrophy were investigated. In the 292 patients included in the study, the mean lumbar spine T-score was -1.04 +/- 1.68, the lumbar spine Z-score was -0.31 +/- 1.68, the femoral neck T-score was -1.38 +/- 1.39, and the femoral neck Z score was -0.66 +/- 1.23. According to the WHO criteria based on lumbar spine T-scores, 19.2% of 292 patients were osteoporotic, 36.3% had osteopenia, and 44.4% had lumbar spine T-scores within the normal range. In the femoral neck area, the prevalence of osteoporosis was slightly higher (26%). The prevalence of osteoporosis was 23.3% in female patients and 16.6% in male patients with no statistically significant difference between the sexes. Agreements of lumbar spine and femoral neck T-scores for the diagnosis of osteoporosis were 66.7% and 27.3% and 83.3% for osteopenia and normal BMD values, respectively. Among the clinical and laboratory parameters we investigated in this study, the body mass index (BMI) (P < 0.001), daily urine output, and urea clearance time x dialysis time/volume (Kt/V) (P < 0.05) were statistically significantly positive and Ca x PO(4) had a negative correlation (P < 0.05) with the lumbar spine T scores. Femoral neck T scores were also positively correlated with BMI, daily urine output, and KT/V; and they were negatively correlated with age. Intact parathyroid hormone levels did not correlate with any of the BMD parameters. Femoral neck Z scores were correlated with BMI (P < 0.001), and ionized calcium (P < 0.05) positively and negatively with age, total alkaline phosphatase (P < 0.05), and Ca x P (P < 0.01). The overall prevalence of fractures since the initiation of PD was 10%. Our results indicated that, considering their DEXA-based BMD values, 55% of chronic PD patients have subnormal bone mass-19% within the osteoporotic range and 36% within the osteopenic range. Our findings also indicate that low body weight is the most important risk factor for osteoporosis in chronic PD patients. An insufficient dialysis dose (expressed as KT/V) and older age may also be important risk factors for osteoporosis of PD patients.
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Affiliation(s)
- Fettah Fevzi Ersoy
- Division of Nephrology, Department of Medicine, Akdeniz University Medical School, 07070 Dumlupinar Bulvari, Kampus, Antalya, Turkey.
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24
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Uzun H, Ozmen Keles M, Ataman R, Aydin S, Kalender B, Uslu E, Simsek G, Halac M, Kaya S. Serum cystatin C level as a potentially good marker for impaired kidney function. Clin Biochem 2005; 38:792-8. [PMID: 16005452 DOI: 10.1016/j.clinbiochem.2005.05.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2004] [Revised: 05/18/2005] [Accepted: 05/19/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To evaluate the diagnostic significance of serum cystatin C levels in clinical practice. DESIGN AND METHODS Serum (99m)Tc-DTPA clearance was compared with serum cystatin C, creatinine, beta(2)-microglobulin levels and creatinine clearance in a group of patients aged 42.61 +/- 7.55 years with glomerular filtration rates of 10-60 mL/min/1.73 m(2) (n = 52) and healthy controls aged 43.90 +/- 12.06 years (n = 52). RESULTS No effect of sex on serum cystatin C levels was observed, but average levels increased with age. No significant difference was evident between the mean cystatin C levels of three blood samples taken at 1 month intervals from healthy subjects. Reference clearance was correlated with creatinine clearance (r = 0.957), cystatin C (r = 0.828), beta(2)-microglobulin (r = 0.767) and creatinine (r = 0.682). 60 mL/min/1.73 m(2) was chosen as the borderline for receiver-operating characteristics analysis. The values for the cut-off point, sensitivity, specificity and the area under curve were determined for cystatin C as 1.36 mg/L, 98%, 99% and 0.99 +/- 00.1, respectively; for creatinine, the values were 103 micromol/L, 80%, 100% and 0.97 +/- 0.01, respectively, and for beta(2)-microglobulin, the values were 2.51 mg/L, 86%, 92% and 0.94 +/- 0.02, respectively. CONCLUSION Serum cystatin C level can be used as a marker for renal damage.
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Affiliation(s)
- Hafize Uzun
- Department of Biochemistry, Cerrahpasa Medicine Faculty, Istanbul University, Cerrahpasa Tip Fakültesi, Temel Bilimler-Biokimya Anabilim Dali, 34303 Cerrahpasa-Istanbul, Turkey.
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25
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Seyahi N, Altiparmak MR, Kahveci A, Yetik H, Kanberoglu K, Serdengecti K, Ataman R, Erek E. Association of conjunctival and corneal calcification with vascular calcification in dialysis patients. Am J Kidney Dis 2005; 45:550-6. [PMID: 15754277 DOI: 10.1053/j.ajkd.2004.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Conjunctival and corneal calcification (CCC) is a well-known and easily detectable extraskeletal calcification, but its association with vascular calcification was not investigated previously. The aim of this study is to investigate the relationship of CCC with vascular calcification and bone metabolism parameters in dialysis patients. METHODS We evaluated 63 patients (30 men, 33 women; mean age, 43.5 +/- 13.4 years) who were on dialysis therapy for more than 6 months. Forty-four patients were on peritoneal dialysis and 19 patients were on hemodialysis therapy. The same observer evaluated the presence of CCC by using a slit-lamp microscope, and a total CCC score was recorded for each patient. Fifty-two age- and sex-matched healthy controls also were evaluated by using the same method. Biochemical data were collected from patient files. Bone mineral density (BMD) of the lumbar spine and femoral neck was measured, and the presence of vascular calcification was assessed by using x-ray examinations of the pelvis and hands. RESULTS Mean CCC score in patients was significantly higher than that in controls (6.2 +/- 5.1 versus 1.3 +/- 1.8; P = 0.001). CCC score correlated significantly with duration of renal replacement therapy ( r s = 0.392; P = 0.002), serum phosphorus level ( r s = 0.259; P = 0.042), and calcium x phosphorus product ( r s = 0.337; P = 0.007). However, we did not find a significant correlation with calcium, parathyroid hormone, alkaline phosphatase, albumin, or C-reactive protein level or BMD. The frequency of vascular calcification was significantly greater in patients with a high CCC score (CCC score > or = 10) compared with a low CCC score (< or =3; 56.3% versus 5.6%; P = 0.002). CONCLUSION Evaluation of CCC score is an easy, fast, and noninvasive method. It seems that CCC score can be used as an additional tool to assess the status of extraskeletal calcification in dialysis patients.
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Affiliation(s)
- Nurhan Seyahi
- Department of Nephrology, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey.
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Altiparmak MR, Pamuk ON, Ataman R, Serdengeçti K. Continuous Ambulatory Peritoneal Dialysis in Familial Mediterranean Fever Amyloidosis Patients with End-Stage Renal Failure: A Single-Centre Experience from Turkey. ACTA ACUST UNITED AC 2004; 98:c119-23. [PMID: 15627789 DOI: 10.1159/000081553] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2003] [Accepted: 06/21/2004] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Familial Mediterranean fever (FMF) is an autosomal recessive disease characterised by recurrent fever attacks and polyserositis which may lead to the development of AA amyloidosis and end-stage renal disease (ESRD). In this study, we aimed to evaluate the efficacy of continuous ambulatory peritoneal dialysis (CAPD) in FMF-amyloidosis patients with ESRD. METHODS Forty age- and sex-matched patients undergoing CAPD at our centre between 1996 and 2002 were included in the study. Of these, 10 had FMF-amyloidosis, 10 had diabetes mellitus (DM), 10 had chronic glomerulonephritis (CGN) and 10 had chronic interstitial nephritis (CIN). Efficiency of CAPD, development of complications, presence of other diseases and survival were compared. RESULTS With the onset of ESRD, the frequency of FMF peritonitis attacks decreased, with less attacks occurring during CAPD in FMF-amyloidosis patients (p < 0.05). There was no significant difference between the FMF-amyloidosis group and other groups in terms of efficiency of CAPD, peritoneal function, complications and survival. DM patients had a shorter survival period compared with CGN and CIN patients (p < 0.05), but there was no survival difference between FMF-amyloidosis patients and other groups (p > 0.05). CONCLUSIONS We conclude that CAPD is an effective and safe renal replacement therapy for FMF-amyloidosis patients with ESRD.
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Affiliation(s)
- Mehmet Riza Altiparmak
- Department of Nephrology, Cerrahpaşa Medical Faculty, University of Istanbul, Istanbul, Turkey.
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27
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Sever MS, Erek E, Vanholder R, Koc M, Yavuz M, Aysuna N, Ergin H, Ataman R, Yenicesu M, Canbakan B, Demircan C, Lameire N. Lessons learned from the catastrophic Marmara earthquake: factors influencing the final outcome of renal victims. Clin Nephrol 2004; 61:413-21. [PMID: 15224805 DOI: 10.5414/cnp61413] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND During catastrophic earthquakes, crush syndrome is the second most frequent cause of death after the direct impact of trauma. The Marmara earthquake, which struck Northwestern Turkey in August 1999, was characterized by 639 crush syndrome victims with acute renal problems. The factors influencing their final outcome have been the subject of this study. PATIENTS/METHODS Within the first week of the disaster questionnaires asking about 63 clinical and laboratory variables were sent to 35 reference hospitals that treated the victims. Information obtained by means of these questionnaires, including the factors with a potential influence on outcome, was submitted to analysis. RESULTS Overall mortality rate was 15.2%. In univariate analysis, nonsurvivors were older (p = 0.048); the highest mortality rates were observed among the victims coming from the closest cities to the reference hospitals. Admission within the first 3 days of the disaster (p = 0.016), with oliguria (p = 0.042), lower figures for blood pressure (p < 0.001), platelets (p = 0.004) and serum albumin (p = 0.005) were associated with mortality. Also, higher body temperature (p = 0.013) and serum potassium (p < 0.001) as well as suffering from thoracic or abdominal traumas, extremity amputations and medical complications other than renal failure (for all 4: p < 0.0001) in addition to need of dialysis support (p = 0.015) and mechanical ventilation (p < 0.0001) indicated higher risk of death. In the multivariate analysis, age (p = 0.030, OR = 1.02), presence of disseminated intravascular coagulation (p = 0.001, OR = 4.49), abdominal trauma (p = 0.012, OR = 4.05) and amputations (p = 0.010, OR = 2.81) were predictors of mortality. Dialyzed patients were characterized by higher mortality rates than nondialyzed victims (17.2% versus 9.3%, p = 0.015). CONCLUSION Outcome of the renal victims of catastrophic earthquakes is influenced by the type of trauma, comorbid events and complications observed during the clinical course as well as epidemiological features such as age, distance to reference hospitals and time lapse between disaster and admission to reference hospitals.
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Affiliation(s)
- M S Sever
- Department of Nephrology, Istanbul School of Medicine, Istanbul, Turkey.
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28
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Karayaylali I, Seyrek N, Akpolat T, Ateş K, Ozener C, Yilmaz ME, Utas C, Yavuz M, Akcicek F, Arinsoy ST, Ataman R, Bozfakioglu S, Camsari T, Ersoy F. The prevalence and clinical features of tuberculous peritonitis in CAPD patients in Turkey, report of ten cases from multi-centers. Ren Fail 2004; 25:819-27. [PMID: 14575289 DOI: 10.1081/jdi-120024296] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To determine the rate, risk factors and outcome of Tuberculous Peritonitis (TBP) in patients treated with continuous ambulatory peritoneal dialysis (CAPD) in our units. DESIGN Retrospectively, we reviewed the medical data of all CAPD patients from 12 centers for TBP, covering the period between 1986 and December 2002. SETTING All patients were from 12 renal clinics at tertiary-care university hospitals. RESULTS Ten cases of TBP were identified among the CAPD patients in our centers. There were five male and five female patients with a mean age of 37.2 years. None of the patients had tuberculosis history, 6 patients had predominance of PNL. One patient had coincidental bacterial peritonitis. Two patients were successfully treated without the removal of the Tenckhoff catheter. CONCLUSION TBP in CAPD patients is a very rare complication. In contrast to predominance of lymphocytes in nonuremic patients with tuberculous peritonitis, CAPD patients with tuberculous peritonitis may have predominance of PNL on examination of the peritoneal fluid. Since TBP has high morbidity and mortality, early diagnosis and treatment of disease are extremely important for improving outcome.
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Affiliation(s)
- Ibrahim Karayaylali
- Department of Nephrology, Medical Faculty, Cukurova University, Adana, Turkey.
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Erek E, Sever MS, Akoglu E, Sariyar M, Bozfakioglu S, Apaydin S, Ataman R, Sarsmaz N, Altiparmak MR, Seyahi N, Serdengecti K. Cost of renal replacement therapy in Turkey. Nephrology (Carlton) 2004; 9:33-8. [PMID: 14996307 DOI: 10.1111/j.1440-1797.2003.00218.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND RESULTS By the end 2000, 22224 patients were on renal replacement therapy (RRT) in Turkey. We investigated the cost of RRT in three medical faculties and one private dialysis centre. Yearly expenses were US dollars 22759 for haemodialysis (HD), US dollars 22350 for continuous ambulatory peritoneal dialysis (CAPD), and US dollars 23393 and US dollars 10028, respectively, for the first and second years of transplantation (Tx). In the first year, renal Tx was significantly more expensive than CAPD. However, after the first year of renal transplantation, Tx became significantly more economical than both CAPD and HD. The sum of all yearly RRT expenses for the country was US dollars 488958709, which corresponds to nearly 5.5% of Turkey's total health expenditure. CONCLUSION Measures such as early construction of vascular access, promoting home dialysis and the reuse of the dialysers, strict control of the use of some expensive drugs like erythropoietin and active vitamin D, and also increasing the number of transplantations, especially if pre-emptive transplantation is possible, should be taken into account in order to reduce these expenses.
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Affiliation(s)
- Ekrem Erek
- University of Istanbul, Cerrahpasa Medical Faculty, Department of Nephrology, Istanbul, Turkey.
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30
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Passadakis P, Ersoy F, Tam P, Memmos D, Siamopoulos K, Ozener C, Akçiçek F, Camsari T, Ates K, Ataman R, Vlachojannis J, Dombros N, Utas C, Akpolat T, Bozfakioglu S, Wu GG, Karayaylali I, Arinsoy T, Stathakis C, Yavuz M, Tsakiris D, Dimitriades A, Yilmaz ME, Gültekin M, Karayalçin B, Challa A, Polat N, Oreopoulos DG. Serum levels of prostate-specific antigen and vitamin D in peritoneal dialysis patients. Adv Perit Dial 2004; 20:203-8. [PMID: 15384827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Measuring the free:total ratio of prostate-specific antigen (f/t-PSA) can improve the specificity of single-serum PSA values, distinguishing between benign prostatic hyperplasia (BPH) and prostatic carcinoma (PCa) in men over the age of 50. Additionally, clinical trials have shown that dihydroxyvitamin D3 can slow the rate of PSA rise in PCa patients. However, little is known regarding the applicability of those findings in men undergoing chronic peritoneal dialysis (CPD). In the present study, we investigated the prevalence of increased serum PSA levels among CPD patients and correlated those values with serum levels of vitamin D [25-hydroxyvitamin D3 and 1,25-dihydroxyvitamin D3]. We undertook a cross-sectional study of 71 male CPD patients without a known history of prostate cancer from 24 centers in Canada, Greece, and Turkey. All of the patients were more than 50 years of age. In these patients, we measured serum concentrations of PSA, free PSA (f-PSA), total PSA (t-PSA), prostate alkaline phosphatase (PAP), 25-hydroxyvitamin D3, 1,25-dihydroxyvitamin D3, and intact parathyroid hormone (iPTH). We recorded serum PSA levels < 4 ng/mL in 62 patients (87.3%, group A) and levels > 4 ng/mL in 9 patients (12.7%, group B). The f/t-PSA ratio was < 0.25 in 16 patients (22.5%). Group B patients were older than those in group A (median: 73 years vs. 65 years, p < 0.01) and had a lower body weight (median: 66.5 kg vs. 76.7 kg, p < 0.05). We observed no statistically significant difference between the two groups for serum 1,25-dihydroxyvitamin D3 (median: 9.8 ng/mL vs. 10.1 ng/mL) or 25-hydroxyvitamin D3 (8 ng/mL vs. 8.2 ng/mL) levels. Also, we observed no correlation between vitamin D levels and f/t-PSA, but iPTH levels were significantly higher in group A (200.5 pg/mL vs. 61.2 pg/mL, p < 0.04). Also, serum PAP levels correlated significantly with PSA (r = 0.49, p = 0.01) and with f-PSA (r = 0.56, p = 0.000). Our results showed no clear relationship between vitamin D and serum levels of PSA or-of f/t-PSA in PD patients. However, further studies are needed to better define the uses of these PSA markers in PD patients because, in such patients, other relevant factors might be implicated in their predictive value.
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31
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Uzel B, Altiparmak MR, Ataman R, Serdengeçti K. Acute renal failure due to carnitine palmitoyltransferase II deficiency. Neth J Med 2003; 61:417-20. [PMID: 15025419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Carnitine palmitoyltransferase II (CPT-II) deficiency is the most common long-chain fatty acid oxidation defect, resulting in rhabdomyolysis and acute renal failure (ARF). There are three forms of CPT-II deficiency: the neonatal, infantile and adult form. We report an adult form of CPT-II deficiency in a patient who presented with attacks of exercise-induced rhabdomyolysis and ARF.
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Affiliation(s)
- B Uzel
- Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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Altiparmak MR, Pamuk ON, Toptaş T, Pamuk GE, Ataman R, Serdengeçti K. Psoriatic arthritis associated with adult polycystic kidney disease, seminal vesicle, and epididymal cysts. Eur J Intern Med 2003; 14:265-268. [PMID: 12919845 DOI: 10.1016/s0953-6205(03)00071-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Patients with seminal vesicle and epididymal cysts are mostly asymptomatic. To date, only one patient presenting with bloody ejaculate and acute scrotum has been reported. Different extrarenal manifestations and the association of adult polycystic kidney disease (APKD) with some connective tissue diseases are known. We report on a 60-year-old male patient with bloody ejaculate and acute scrotum who had been diagnosed as having APKD 1 year earlier and whose past medical history revealed inflammatory low back pain, psoriasis, and the diagnosis of psoriatic arthritis. Cultures of urine and ejaculate were sterile, and the patient's renal functions were normal. Ultrasound showed epididymal and seminal vesicle cysts in addition to hepatic and renal cysts. Our case is the first in which psoriatic arthritis accompanied APKD, seminal vesicle cysts, and epididymal cysts. We also review other APKD cases that have accompanied seminal vesicle cysts.
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Affiliation(s)
- Mehmet Riza Altiparmak
- Division of Nephrology, Cerrrahpaşa Medical Faculty, University of Istanbul, Istanbul, Turkey
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Altiparmak MR, Demirel H, Mert A, Serdengecti K, Ataman R. Toxic shock syndrome in two CAPD patients with Staphylococcus aureus exit-site infection. Perit Dial Int 2003; 23:191-3. [PMID: 12713088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
Toxic shock syndrome (TSS) is an illness defined by the occurrence of fever, rash, hypotension, multiple organ system dysfunction, and desquamation. Nonmenstrual TSS is often associated with surgical or nonsurgical cutaneous infections, which are rarely purulent or inflamed (Reingold AL, et al. Nonmenstrual toxic shock syndrome: a review of 130 cases. Ann Intern Med 1982; 96:871-4). Toxic shock syndrome associated with peritoneal exit-site infection but without peritonitis is extremely unusual (Sherbotie JR, et al. Toxic shock syndrome with Staphylococcus aureus exit-site infection in a patient on peritoneal dialysis. Am J Kidney Dis 1990; 15:80-3). We describe 2 patients that met the Centers for Disease Control case definition of TSS secondary to a peritoneal dialysis catheter exit-site infection with signs of mild inflammation and growth of Staphylococcus aureus, but with no evidence of peritonitis.
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Affiliation(s)
- Mehmet R Altiparmak
- Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul, Turkey
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Altiparmak MR, Apaydin S, Trablus S, Serdengecti K, Ataman R, Ozturk R, Erek E. Systemic fungal infections after renal transplantation. Scand J Infect Dis 2002; 34:284-8. [PMID: 12064692 DOI: 10.1080/00365540110077470] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
In a retrospective evaluation, the incidence of systemic fungal infections (SFIs) in 296 kidney graft recipients admitted to our center between 1986 and 1999 was found to be 4%. Eighteen percent of 28 recipients transplanted in India and 8% of 12 recipients transplanted in Russia developed SFI. In contrast, SFI was encountered in only 2% of recipients transplanted at our center. The median time of diagnosis of SFI was 5 months after transplantation. The lungs and central nervous system were the most frequently affected sites. The most common etiologic agent was Aspergillus fumigatus (n = 7) but Candida spp. (n = 1), Rhizopus spp. (n = 1) and Cryptococcus neoformans (n = 1) were also encountered. In 2 patients, 2 different pathogens were isolated at the same time: A. fumigatus and Rhizopus spp. in 1 patient and Candida spp. and A. fumigatus in another. In order to determine predisposing factors for SFI, patients admitted immediately before and after those with SFI were used as controls: long-term hospitalization, long-term antibiotic use and post-transplant diabetes mellitus were found to be predisposing factors. Eight patients were treated with antifungal drugs and a good response to liposomal amphotericin B therapy was obtained in 3/5. Nine patients (75%) with SFI died. As SFIs are associated with a high mortality rate in renal transplant recipients, antifungal therapy, especially with liposomal amphotericin B, should be started whenever fungal infection is suspected, even before the results of microbiologic and/or histologic examinations are known.
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Affiliation(s)
- Mehmet Riza Altiparmak
- Department of Internal Medicine, Cerrahpasa Medical Faculty, University of Istanbul, Turkey
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35
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Tuglular S, Yalcinkaya F, Paydas S, Oner A, Utas C, Bozfakioglu S, Ataman R, Akpolat T, Ok E, Sen S, Düsünsel R, Evrenkaya R, Akoglu E. A retrospective analysis for aetiology and clinical findings of 287 secondary amyloidosis cases in Turkey. Nephrol Dial Transplant 2002; 17:2003-5. [PMID: 12401861 DOI: 10.1093/ndt/17.11.2003] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Secondary amyloidosis is the most frequent of the various types of systemic amyloidosis, the epidemiology of which is not yet fully known. The aim of our study was to evaluate retrospectively the collective data for the aetiological distribution, clinical findings and approaches to the management of secondary amyloidosis in Turkey. METHODS Data from a simple questionnaire addressing aetiology, and demographic and clinical characteristics of patients with biopsy-proven secondary amyloidosis was retrospectively analysed. Eleven nephrology clinics contributed data for this study. RESULTS The 11 contributing centres provided a total of 287 cases (102 female, 185 male). The aetiological distribution was as follows: familial Mediterranean fever (FMF) 64%, tuberculosis 10%, bronchiectasis and chronic obstructive lung disease 6%, rheumatoid arthritis 4%, spondylarthropathy 3%, chronic osteomyelitis 2%, miscellaneous 4%, unknown 7%. Oedema accompanied by proteinuria was present in 88% of the cases, hepatomegaly in 17%, and splenomegaly in 11%. The mean systolic and diastolic blood pressures were 115+/-26 and 73+/-15 mmHg respectively. The family history was positive in 16%; 73% of the cases were on colchicine treatment when the questionnaire was administered. Thirty-eight per cent of the cases had progressed to ESRD and were on renal replacement therapy. CONCLUSIONS FMF is the leading cause of secondary amyloidosis in Turkey, followed by tuberculosis. Oedema accompanied by proteinuria is the most prominent presenting finding, and hypotension seems to be common among these patients.
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Affiliation(s)
- Serhan Tuglular
- Department of Internal Medicine, Marmara University Medical Faculty, Istanbul, Turkey.
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Altiparmak MR, Pamuk ON, Pamuk GE, Apaydin S, Ataman R, Serdengeçti K. Amyloid goitre in familial Mediterranean fever: report on three patients and review of the literature. Clin Rheumatol 2002; 21:497-500. [PMID: 12447634 DOI: 10.1007/s100670200122] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Familial Mediterranean fever (FMF) is a hereditary disease, the most threatening complication of which is systemic amyloidosis. The thyroid gland may be asymptomatically involved in most patients with systemic amyloidosis secondary to FMF. However, clinically detectable thyroid goitre is quite rare, and until now only nine cases of thyroid goitre secondary to amyloid deposition in FMF have been reported. Of 1,100 FMF patients regularly followed up at our centre, thyroid goitre due to the accumulation of amyloid substance could be detected in only three (0.27%). In this report, we summarise the clinical and laboratory features of these patients. All three patients were euthyroid. Total thyroidectomy was performed for compressive symptoms in one patient and for aesthetic purposes in the other two. In countries with a high prevalence of FMF, such as Turkey, secondary amyloidosis of the thyroid gland should be borne in mind in long-standing FMF patients.
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Affiliation(s)
- M R Altiparmak
- Cerrrahpaşa Medical Faculty, University of Istanbul, Istanbul, Turkey
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Abstract
Drug-induced ototoxicity might sometimes be a problem in end-stage renal failure (ESRF) patients. However, ototoxicity secondary to isoniazid intake has not been reported in ESRF until now. During the last decade, ototoxicity was diagnosed in 16.6% (7/42) of our ESRF patients undergoing hemodialysis (HD) who also used antituberculosis therapy. Streptomycin was not included in any of these regimens, isoniazid was used by all 7 patients with ototoxicity and there was reversal of hearing loss in 2 of these patients after discontinuation of isoniazid. In our ESRF-HD patients who developed ototoxicity during the course of antituberculosis therapy, isoniazid was probably the responsible agent either alone or it added to the side effects of other drugs.
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Affiliation(s)
- Mehmet Riza Altíparmak
- Department of Nephrology, Cerrahpaşa Medical Faculty, University of Istanbul, No:14 Daire:10, Kadíköy-Istanbul, Turkey.
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Akpolat T, Dilek M, Yavuz M, Utas C, Ozener C, Karayaylali I, Yilmaz E, Ersoy F, Camsari T, Ataman R, Bozfakioglu S, Akcicek F, Ates K, Arinsoy T. Low seroconversion rates in CAPD patients compared to hemodialysis patients: potential advantages for transplant candidates. Perit Dial Int 2002; 22:520-3. [PMID: 12322827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
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Altiparmak MR, Pamuk ON, Pamuk GE, Hamuryudan V, Ataman R, Serdengecti K. Colchicine neuromyopathy: a report of six cases. Clin Exp Rheumatol 2002; 20:S13-6. [PMID: 12371628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Colchicine has been in use for therapeutic purposes for many years. It can, however, cause subacute onset muscle and peripheral nerve toxicity in patients with chronic renal failure. In this report we describe 6 patients who developed neuromyopathy after the administration of colchicine. All patients presented with proximal muscle weakness, elevated serum creatine kinase (CK) levels, and neuropathy and/or myopathy on electromyography (EMG). The diagnosis of colchicine toxicity was confirmed in all cases by the normalization of CK levels and EMG after discontinuation of the drug. Toxicity developed in 4 renal failure patients on therapeutic doses of the drug, while one patient took a massive dose for suicidal reasons, and the other was on high-dose therapy. Patients using colchicine--especially those with renal failure--should be warned about the side effects of the drug and physicians should be careful in the administration of the drug.
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Affiliation(s)
- M R Altiparmak
- Department of Nephrology, Cerrahpasa Medical School, University of Istanbul, Turkey.
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Abstract
In this study, we retrospectively evaluated all attacks of diarrhoea in our renal transplant recipients that came to our medical attention between 1985 and 2000. Also, the clinical features of patients with diarrhoea were compared with the features of recipients without diarrhoea. We diagnosed 41 attacks of diarrhoea in 39 (12.6%) of 308 renal transplant recipients during this time period. An aetiology was detected in 33 (80.5%) of all diarrhoeal episodes and in seven (17.1%) of those the specific agent was diagnosed with the help of stool microscopy. The most frequent causes of diarrhoeal attacks were infectious agents (41.5%) and drugs (34%). Six (14.6%) episodes of diarrhoea were chronic and six were nosocomial. About two-thirds of diarrhoea developed within the late post-transplant period (>6 months). When recipients with diarrhoea were compared with those without diarrhoea, it was seen that diarrhoeal patients had significantly higher creatinine and significantly lower albumin levels when compared with the latter group (p < 0.05). Also, the frequency of antibiotic usage was significantly higher in diarrhoeal patients than in the control group (p < 0.05). Four (10.2%) patients with diarrhoea died despite institution of the appropriate therapy. Two of these deaths were primarily related to diarrhoea and the aetiological agent was Clostridium difficile in both these cases. During the 15-yr study period, 3.6% of all deaths and 5.1% of infection-related deaths in transplant recipients were secondary to diarrhoea. As a result, we observed that infections and drugs were the most frequent causes for diarrhoea in our series of renal transplant recipients. Also, diarrhoea was an important cause of mortality in this patient population.
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Affiliation(s)
- Mehmet Riza Altiparmak
- Department of Nephrology, Cerrahpaşa Medical Faculty, University of Istanbul, Istanbul, Turkey.
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Altiparmak MR, Apaydin S, Ataman R, Tabak F, Mert A, Serdengecti K, Erek E. Fever of unknown origin in uremic patients: a controlled prospective study. Scand J Infect Dis 2002; 33:851-3. [PMID: 11760168 DOI: 10.1080/713933774] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Twenty-nine uremic patients with fever of unknown origin (FUO) admitted to our clinic between 1994 and 1998 were evaluated prospectively. A group of 50 consecutive non-uremic patients with FUO followed up during the same period was used for comparison. The causes of FUO found in the uremic and non-uremic groups, respectively were as follows: infectious diseases, 69 vs. 44% (p = 0.03); collagen vascular diseases, 6.9 vs. 6%; neoplasms, 3.4 vs. 26%; miscellaneous causes, 3.4 vs. 16%; and undiagnosed, 17.2 vs. 8%. Tuberculosis was the most common cause of FUO in both groups. The spectrum of underlying conditions for FUO in our uremic patients differed from that in the non-uremic patients and the uremic patients had a very high propensity for infectious diseases, especially tuberculosis.
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Affiliation(s)
- M R Altiparmak
- Department of Internal Medicine, Cerrahpasa Medical Faculty, University of Istanbul, Turkey
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Kalender B, Erk M, Pekpak MA, Apaydin S, Ataman R, Serdengeçti K, Sariyar M, Erek E. The effect of renal transplantation on pulmonary function. Nephron Clin Pract 2002; 90:72-7. [PMID: 11744808 DOI: 10.1159/000046317] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In patients with chronic renal failure, mechanical and hemodynamic changes could occur in the lungs without obvious pulmonary symptoms and findings and their effects could pave the way to pulmonary functional disorders. In this study, pulmonary functional disorders and especially alveolocapillary defects, which are frequently seen in uremia, were determined in renal transplanted patients. Pulmonary functions and diffusion capacity were assessed in uremic patients (n = 20) and in successfully transplanted patients (n = 20) without any lung disease or pulmonary edema symptoms and findings. Patients were selected randomly among outpatients who were followed up in a Nephrology and Transplantation Unit. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and peak expiratory flow (PEF25-75) were measured. Single breath carbon monoxide diffusion test and diffusion lung capacity adjusted for hemoglobin concentration (DLAdj) were done. The means of the spirometric values such as FVC, FEV1 and FEV1/FVC were normal in the nondialyzed uremic group, but the PEF25-75 value (68.7%) and diffusion capacity (DLAdj 72.7%) were found to be slightly low. There were 2 patients with normal values and 18 patients with some functional abnormalities in this nondialyzed uremic group. The means of all spirometric parameters and diffusion capacities were found to be normal in the transplanted group. There were 7 patients with normal function and 13 patients with some functional abnormalities in this transplanted group. When the nondialyzed uremic group and the transplanted group were compared statistically, significant differences were found between their spirometric values (except for FVC) and their diffusion capacities. Even though the uremic patients did not show any symptoms, their pulmonary function tests, especially diffusion capacity, were found to be disturbed. Although the transplanted patients as a group had normal mean spirometric values and diffusion capacity there were nevertheless many individual transplanted patients with defective diffusion capacity and abnormal spirometric values.
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Affiliation(s)
- Betül Kalender
- Department of Nephrology, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.
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Altiparmak MR, Ataman R, Ozaras R, Tahan V, Aydin S, Uzun H, Serdengecti K, Soysal T. Relative erythrocytosis of patients with end stage renal failure undergoing CAPD. Ren Fail 2002; 24:29-35. [PMID: 11921696 DOI: 10.1081/jdi-120002658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND AND AIM Although the majority of patients with end stage renal failure have anemia, some have relative erythrocytosis. Patients treated with continuous ambulatory peritoneal dialysis (CAPD) having relative erythrocytosis were studied in order to determine the factors that would be responsible. METHODS Nine out of 89 CAPD patients (10%) were identified as having relative erythrocytosis. Age-, sex- and duration of disease-matched eight patients undergoing CAPD were taken as control. Beside factors of etiologies of renal failure, smoking, renal cysts, viral hepatitides, residual renal function, the adequacy of CAPD, nutritional status, hypertension, serum levels of erythropoietin, IL-1, IL-6, TNF-, and IGF-1 levels were also investigated. RESULTS Relative erythrocytosis occurred most often in diabetic and amyloidosis patients. None of the parameters studied were found to be significantly different between groups. During 2-year follow-up, although statistically non-significant, patients having relative erythrocytosis seemed to have higher mortality rate due to vascular complications. CONCLUSION No single factor seemed to explain erythrocytosis in patients undergoing CAPD. Being diabetic or with amyloidosis may increase the risk.
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MESH Headings
- Adult
- Amyloidosis/complications
- Antigens, CD
- Diabetes Complications
- Erythropoietin/analysis
- Female
- Hepatitis, Viral, Human/complications
- Humans
- Hypertension/complications
- Insulin-Like Growth Factor I/analysis
- Interleukin-1/blood
- Interleukin-6/blood
- Kidney/physiopathology
- Kidney Diseases, Cystic/complications
- Kidney Failure, Chronic/complications
- Kidney Failure, Chronic/therapy
- Male
- Peritoneal Dialysis, Continuous Ambulatory
- Polycythemia/etiology
- Receptors, Tumor Necrosis Factor
- Receptors, Tumor Necrosis Factor, Type I
- Risk Factors
- Smoking
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Altiparmak MR, Pamuk ON, Pamuk GE, Mert A, Ataman R, Serdengeçti K. Prevalence of serum antibodies to hepatitis B and C viruses in patients with primary glomerulonephritis. J Nephrol 2001; 14:388-91. [PMID: 11730272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
We retrospectively analysed the medical records of patients who underwent renal biopsy in our nephrology department over the past 8 years. Our aim was to discover the frequency of hepatitis B (HBV) and hepatitis C virus (HCV) in patients with primary glomerulonephritis (GN) in Turkey, a moderately endemic country for both infections. The study included 144 male and 104 female patients aged between 12-70 years. The frequency of HBsAg and anti-HCV were found to be similar to healthy controls, respectively 6.5% and 1.6% (p>0.05). As is true for low endemic countries, HBV and HCV infections might be rarely associated with GN in Turkey.
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Affiliation(s)
- M R Altiparmak
- Department of Nephrology, Cerrahpaşa Medical Faculty, University of Istanbul, Turkey
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Apaydin S, Altiparmak MR, Serdengeçti K, Ataman R, Oztürk R, Erek E. Mycobacterium tuberculosis infections after renal transplantation. Scand J Infect Dis 2001; 32:501-5. [PMID: 11055654 DOI: 10.1080/003655400458776] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The incidence of tuberculosis was found to be 5.8% (16/274) in 274 kidney graft recipients in our centre between 1986 and 1998. The kidney recipients were evaluated retrospectively. A total of 51 recipients received isoniazid prophylaxis for 6 months. The prevalence of tuberculosis was found similar (6% vs. 8.8%, p = 0.15) between recipients with prophylaxis and no prophylaxis. Eight patients were recipients of cadaveric donor kidneys and 8 were recipients of living donor kidneys. Lungs were the most frequently affected site, as in the normal population. M. tuberculosis grew in 7 patients. In 5 patients, M. tuberculosis was also detected on direct microscopy and polymerase chain reaction. In 4 patients, diagnosis was made on clinical grounds and later confirmed by positive response to therapy. In 8 patients, invasive procedures were performed for diagnosis. Five patients had miliary tuberculosis at the time of diagnosis. In 3 patients dissemination occurred during follow-up. Nine patients responded to anti-tuberculous therapy while still preserving their graft function, 1 patient rejected the graft while under treatment and returned to haemodialysis. Five patients (31%) died. Since the risk of dissemination of tuberculosis is high in these patients, anti-tuberculous therapy should be started whenever clinical findings suggestive of tuberculosis are present, even in the absence of any microbiological and/or histological evidence.
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Affiliation(s)
- S Apaydin
- Department of Nephrology, Cerrahpasa Medical Faculty, Istanbul, Turkey
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46
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Apaydin S, Ataman R, Cansiz H, Serdengeçti K, Oztürk R, Dervişoglu S, Erek E, Ulkü U. Rhinocerebral mucormycosis in a kidney transplant recipient. Nephron Clin Pract 2000; 79:117-8. [PMID: 9609479 DOI: 10.1159/000045009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Apaydin S, Sariyar M, Erek E, Ataman R, Yiğitbaş R, Hamzaoğlu I, Serdengeçti K, Ulkü U. Hypercalcemia and hyperparathyroidism after renal transplantation. Nephron Clin Pract 2000; 81:364-5. [PMID: 10050101 DOI: 10.1159/000045313] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Taşkapan H, Ozener C, Ateş K, Akçiçek F, Yavuz M, Yilmaz ME, Ataman R, Bozfakioglu S, Camsari T, Ersoy FF, Karayaylali I, Akpolat T, Utaş C. The rate, risk factors, and outcome of fungal peritonitis in CAPD patients: experience in Turkey. Perit Dial Int 2000; 20:338-41. [PMID: 10898053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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49
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Kalender B, Apaydin S, Altiparmak MR, Pekpak M, Sariyar M, Ataman R, Serdengeçti K, Erek E. Opportunistic pulmonary infection after renal transplantation. Transplant Proc 2000; 32:563-5. [PMID: 10812114 DOI: 10.1016/s0041-1345(00)00891-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- B Kalender
- University of Istanbul, Cerrahpaşa Medical Faculty, Transplantation Unit, Istanbul, Turkey
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50
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Apaydin S, Ataman R, Serdengeçt K, Tüzüner N, Polat E, Erek E, Ulkü U. Visceral leishmaniasis without fever in a kidney transplant recipient. Nephron Clin Pract 1997; 75:241-2. [PMID: 9041551 DOI: 10.1159/000189541] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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