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Effects of ACE gene polymorphism on vitamin D therapy according to parathyroid hormone level in patients on hemodialysis

Kulah E. | Sezer S. | Uyar M. | Arat Z. | Ozdemir F.N.

Article | 2006 | Advances in Therapy23 ( 5 ) , pp.778 - 786

Medical management is still far from optimal in secondary hyperparathyroidism. This may be explained, at least in part, by genetic differences. The aim of this study was to evaluate the association of genetic influences of angiotensin-converting enzyme (ACE) gene polymorphisms with response to vitamin D therapy among patients on hemodialysis (HD). Eighty-two patients (female/male, 34/48; mean age, 47.5±15.3 y; HD duration time, 76.6±33.2 mo) with endstage renal disease who were on maintenance HD were included in the study. Five-year retrospective demographic, clinical, laboratory, and treatment data (5-y cumulative doses of phosphat . . .e-binding drugs and oral and intravenous cumulative doses of active vitamin D) were retrieved from patients' hospital records. ACE gene polymorphisms of patients were documented and were used to group patients as follows: The insertion/deletion polymorphism group (I/D) consisted of (1) group non-DD (n=43), who had the DI or II allele, and (2) group DD (n=39), who had the DD allele. Patients with the DD allele (group DD) of ACE gene polymorphism had (1) significantly elevated mean 5-y intact parathyroid hormone levels when compared with the non-DD group (P=.009), and (2) significantly elevated oral and intravenous 5-y cumulative doses of vitamin D. Oral and intravenous 5-y cumulative doses of vitamin D used in group DD patients were significantly higher than those in group I patients (P=.038 and P=.037, respectively). Knowledge of genetic differences among patients on HD may be useful to the clinician in planning treatment strategy. ACE gene polymorphism may have an effect on hyperparathyroidism, as is seen in patients on HD. Patients from this group who have resistant hyperparathyroidism may be candidates for ACE inhibitor therapy. ©2006 Health Communications Inc Daha fazlası Daha az

A Rare Complication After Hemodialysis Intervention: Radial Artery Pseudoaneursym

Coskun, Elif

Article | 2017 | TURKISH NEPHROLOGY DIALYSIS AND TRANSPLANTATION JOURNAL26 ( 3 ) , pp.351 - 353

Pseudoaneurysms of the radial artery are extremely rare. In this article, a radial artery pseudoaneurysm that developed after the intervention for hemodialysis at the antecubital area in a 60-year-old female patient undergoing routine hemodialiysis for chronic renal failure was described. The most important causes of pseudoaneurysms in cardiovascular surgery are catheter applications and new arteriovenous shunts on the forearm. Although rare, the complication of radial artery pseudoaneurysm should be kept in mind in this patient population due to the risk of serious morbidity.

Role of the VEGF 936 gene polymorphism and VEGF-A levels in the late-term arteriovenous fistula thrombosis in patients undergoing hemodialysis

Candan, Ferhan | Yildiz, Gursel | Kayatas, Mansur

Article | 2014 | INTERNATIONAL UROLOGY AND NEPHROLOGY46 ( 9 ) , pp.1815 - 1823

Vascular access is vital for hemodialysis patients. A major factor that facilitates arteriovenous (AV) fistula failure is stenosis and thrombosis due to intimal hyperplasia developing in the venous segment of AV fistula. It has been reported that VEGF accelerated re-endothelialization, reduction in intimal thickening, and/or mural thrombus formed in the injured vascular structures. In this study, we aimed to identify the effect of the VEGF 936 gene polymorphism and vascular endothelial growth factor-A (VEGF-A) levels in the late period of AV fistula loss in hemodialysis patients. The study was carried out with a patient group of 42 . . .individuals who experienced two or more fistula thrombosis in the late period after the AV fistula operation and also a control group of 38 patients who have not had any AV fistula thrombosis history for 3 years or more. All participants were assessed for VEGF-936C/T gene polymorphism and VEGF-A levels. VEGF-936C/T genotypes were determined in the large proportion in the control group (31.6 %), while VEGF-936C/C genotypes were determined in a large proportion in the patient group (90.5 %). Individuals carrying the VEGF-936C/C genotype had an increased risk of 5.54 for getting AV fistula thrombosis. The VEGF-A levels of patient group (27.3 +/- A 43.5 pg/ml) were significantly lower than those of the control group (70.7 +/- A 53.1 pg/ml). There is an increased risk of AV fistula thrombosis in individuals carrying the VEGF-936C/C genotype. The other renal replacement modalities should be considered in patients with this genotype. As a result, it will be possible to prevent the morbidity and mortality due to fistula failure Daha fazlası Daha az

Bioimpedance and echocardiography used interchangeably in volume comparison of dialysis patients

Hur E. | Yildiz G. | Budak Kose S. | Kokturk F. | Musayev O. | Güngör, Özkan | Magden K.

Article | 2012 | Hippokratia16 ( 4 ) , pp.329 - 334

Background: Euvolemia is a major issue in chronic kidney disease. The present study compares cardiac condition and volume status in peritoneal dialysis (PD) and hemodialysis (HD) patients and points out importance of volume control. Methods: From a single-center center, 81 PD and 89 HD patients were enrolled. Echocardiography and body composition analysis using bioimpedance spectroscopy (BIS) technique were performed. Overhydration (OH) and extracellular water (ECW) in liters and OH/ECW % were used as volume indices. Results: Patients were younger (47.6±14. 5 and 53.1±11.8 years, p< 0.05), daily urine volume higher (1068±926 vs 2 . . .90±444 ml, p <0.001) and dialysis vintage was shorter (30.1±18.6 vs 53.6±35.4 months, p<0.001), systolic blood pressure was lower (127.5±15.4 vs 140.3±18.9 mmHg, p<0.001) in PD than HD group respectively. Volume indices were (OH, OH/ECW %, ECW/height, ECW to Intracellular Water ratios (E/I) (p<0.05)) significantly higher in HD patients compared to PD patients. Over all 66 of 170 patients (39%) had OH/ECW % <5 and OH/ECW % ratio was positively correlated with Left atrium index (R2:0.105, p<0.05). Interventricular septum diameter and Left ventricular mass index (1.41±0.24 and 159.6±48.2 vs. 1.27±0.17 cm and 115.8±37 g/m2, p<0.001) were increased in HD than in PD group. After multivariate adjustment OH/ECW increased with: HD and diabetic patients. LVH increased with: HD group, OH/ECW (%) and SBP significantly. Conclusion: Overhydration was more common among HD. Excess fluid may lead adverse effect in organ functions especially cardiac condition. This indicates that the current clinical and technical tools to achieve euvolemia are insufficient and that an additional tool, such as BIS, could be useful in the diagnosis of overhydration Daha fazlası Daha az

The effects of continuous ambulatory peritoneal dialysis and hemodialysis on serum pepsinogen concentrations in patients with chronic renal failure

Aydemir S. | Borazan A. | Acikgoz S. | Ustundag Y. | Yilmaz A.

Article | 2005 | Tohoku Journal of Experimental Medicine205 ( 3 ) , pp.263 - 268

Pepsinogen, the precursors of pepsin, is classified into two subtypes: pepsinogen I (PG I) and pepsinogen II (PG II). Patients with impaired renal function are associated with elevated concentrations of serum pepsinogen. Contradictory results have been reported about the effect of dialysis on the serum pepsinogen levels, as the previous studies were conducted only in a particular period of dialysis. We therefore investigated the effect of continuous ambulatory peritoneal dialysis (CAPD) or hemodialysis on serum pepsinogen levels in patients with chronic renal failure (CRF) before and after dialysis treatment. Thirty-four patients wi . . .th CRF were enrolled in this study and were treated by CAPD (n = 22) or hemodialysis (n = 12). As a control group, subjects with normal renal function were included (n = 20). Serum PG I and PG II levels were measured in control subjects and CRF patients before dialysis treatment and after three-month dialysis treatment. Before dialysis treatment, serum PG I levels were significantly higher in CRF patients than control subjects. In patients treated by CAPD, the serum PG I levels were significantly decreased but its levels were still higher than the values of the control subjects, whereas PG I levels remained unchanged in patients treated by hemodialysis. There were no differences in serum PG II levels between control subjects and CRF patients before or after dialysis treatment. Thus, CAPD is more effective than hemodialysis in the clearance of PG I. © 2005 Tohoku University Medical Press Daha fazlası Daha az

Antibody response following hepatitis B vaccination in dialysis patients: Does depression and life quality matter?

Afsar, Baris | Elsurer, Rengin | Eyileten, Tayfun | Yilmaz, M. Ilker | Caglar, Kayser

Article | 2009 | VACCINE27 ( 42 ) , pp.5865 - 5869

Previously, it was demonstrated that antibody production against hepatitis B virus (HBV) surface antigen (anti-HBs) achieved in hemodialysis patients is suboptimal. Decreased health-related quality of life (HRQOL) and depression is common among hemodialysis patients. This study evaluated whether HRQOL and depressive behavior are associated with antibody response against HBV surface antigen in hemodialysis patients. Depressive symptoms and HRQOL were assessed by Beck Depression Inventory (BDI) and Medical Outcomes Study Short Form (SF-36), respectively. Patients were separated into non-seroconversion (anti-HBs antibody titers 10 IU/L . . .) groups. Among 188 patients, 37 (19.7%) were diagnosed as nonresponsive to vaccination (anti-HBs antibody titers Daha fazlası Daha az

The effect of hemodialysis adequacy on ventricular repolarization in end-stage kidney disease

Kalaycı B. | Onan E. | Paydaş S. | Kaya B. | Adam Ü. | Besli S. | Kalaycı S.

Article | 2019 | Turk Kardiyoloji Dernegi Arsivi47 ( 7 ) , pp.572 - 580

Objective: Ventricular repolarization (VR) markers may predict ventricular arrhythmias and cardiac arrest. The aim of this study was to investigate the acute effects of a hemodialysis (HD) session and HD adequacy on VR markers in HD patients. Methods: This cross-sectional study was conducted at 2 university hospitals with 83 patients and VR markers were measured before and after an HD session: QT, QTc, QT minimum, QT maximum, dispersion of QT (QTd), T-peak to T-end (Tp-e) interval, and Tp-e/QT. Kt/V measurements calculated using the second generation Daugirdas formula were used to indicate dialysis adequacy. The patients were divide . . .d into 2 groups according to the Kt/V value. Group 1 patients had a Kt/V of ?1.6 with a standard dialysis dose, and Group 2 comprised those with a measurement of >1.6 with a high dialysis dose. Results: There were 36 patients in Group 1 and 47 patients in Group 2. There were statistically significantly more female patients in Group 2 (p=0.016). After an HD session, heart rate increased, blood pressure decreased, and the QT, QTc, QT maximum, QTd, Tp-e interval, and Tp-e/QT were prolonged ( Daha fazlası Daha az

What Is the Meaning of Increased Myocardial Injury Enzymes during Hemodialysis? A Tissue Doppler Imaging Study

Yildiz, Gursel | Kayatas, Mansur | Candan, Ferhan | Yilmaz, Mehmet Birhan | Zorlu, Ali | Sarikaya, Savas

Article | 2013 | CARDIORENAL MEDICINE3 ( 2 ) , pp.136 - 153

Background: Cardiovascular death is decreasing in the general population; however, it appears in still higher rates and even increases gradually in hemodialysis (HD) patients. This situation has led to a debate about cardiovascular adverse effects of HD which lead to significant changes in cardiac and hemodynamic events. It is known that troponins are often elevated in HD patients, and high levels of troponin are associated with increased mortality. Therefore, it is difficult to interpret the value of elevations in chronic kidney disease patients. Methods: Echocardiographic and biochemical parameters of 41 patients treated with HD w . . .ere evaluated before and after a HD session. Results: HD led to an increased heart rate, and tissue Doppler imaging parameters such as early diastolic mitral peak velocity (E)/early diastolic myocardial peak velocity (e) and septal e decreased significantly after HD. HD caused an increase in troponin I, myoglobin and cardiac creatine kinase (CK MB) levels (p = 0.019, p < 0.001 and p = 0.018, respectively). A decrease in the left ventricular peak systolic myocardial (LV S') velocity (p = 0.011) was detected in patients with increased levels of cardiac damage markers (group 2) compared to those without increased levels of cardiac damage markers (group 1) in HD. Conclusion: A decrease in LV S' velocity was found to be an independent predictor of an increase of myocardial injury enzymes in HD (odds ratio = 1.099; p = 0.039). We concluded that HD may lead to significant acute stress upon the myocardium. Copyright (c) 2013 S. Karger AG, Base Daha fazlası Daha az

Influence of single hemodialysis session on serum paraoxonase-1, arylesterase activity, total oxidant status and total antioxidant status

Yildiz G. | Aydin H. | Magden K. | Yilmaz A. | Hür E. | Candan F.

Article | 2014 | Minerva Medica105 ( 1 ) , pp.79 - 87

Aim. Chronic kidney disease(CKD) and hemodialysis (HD) are associated with increased oxidative stress. Cardiovascular diseases (CVD) are the most important cause of mortality in these patients. Increased cardiovascular risk is associated with oxidative stress. The aim of this study was to evaluate whether the duration of single session hemodialysis may affect oxidative stress parameters on the patients with end-stage renal disease (ESRD). Methods. Total oxidant status (TOS) and oxidative stress index (OSI) as oxidative markers and total antioxidant status (TAOS), paraoxonase1 (PON1) and arylesterase (ARES) as antioxidant markers wer . . .e compared hemodialysis therapy before and after the treatment. Results. TOS levels before hemodialysis were found as 4.4±2.4 µmol H2O2 Equiv/L, TAOS 2.1±0.3 µmol trolox Equiv./L, OSI 0.2±0.1%, PON1 levels 58.5±35.6 U/L and ARES levels 22±0.2 U/L while after the HD the respective values were 1.4±1.2 µmol H2O2 Equiv/L, 1.4±0.5 µmol trolox Equiv./L, 0.1±0.1%, 54.3±31.3 U/L, 21.8±0.1 U/L. A significant decreasing was observed in TOS TAOS OSI and ARES values before the HD compared to after the HD (P=0.0001, P=0.0001, P=0.0001, P=0.031, respectively). Conclusion. This study shows oxidant (TOS, OSI) and antioxidant (TAOS, ARES) markers were found to be significantly decrease after the HD compared to pre-hemodialysis. Although reverse is expected it is found that oxidants (indirectly ROS) did not increase and antioxidant reserve decreased in HD Daha fazlası Daha az

Hormone profiles and their relation with menstrual cycles in patients undergoing hemodialysis [Hemodi·yali·z hastalarinda hormon profi·lleri· ve menstruel si·klusla i·li·şki·si·]

Arikan D.C. | Bozkurt S. | Arikan I. | Turgut E.

Article | 2011 | Turk Jinekoloji ve Obstetrik Dernegi Dergisi8 ( 1 ) , pp.32 - 39

Objective: To investigate the etiology of menstrual disorders among patients undergoing hemodialysis due to chronic renal failure by assessing menstrual history, serum hormone levels and other biochemical factors. Material and methods: Thirty patients undergoing hemodialysis and 30 healthy women at reproductive age were enrolled in our study. Demographic characteristics, hormonal and biochemical data, sonographically measured endometrial thickness values of the subjects were compared. In addition, the present and the pre-hemodialysis menstrual pattern of the patients undergoing hemodialysis were recorded. The hormonal, hematological . . . and biochemical data of the patients were compared according to their menstrual patterns. Results: No statistical significance was seen between age, BMI, gravida, parity, abortion and curettage among groups (p>0.05). Hemoglobin and hematocrit levels were significantly lower in the hemodialysis group than in the control (p0.05). Mean serum LH and prolactin levels were significantly higher in the hemodialysis group compared to the control (p0.05). Serum LH and prolactin levels were higher and serum FSH, estradiol and TSH levels were lower in patients who developed amenorrhea after hemodialysis treatment when compared to non-amenorrheic subjects. However, these differences were not statistically significant (p>0.05). Discussion: The most important factor in the etiology of menstrual disorders seen in chronic renal failure patients was high serum LH and prolactin levels. Hemodialysis is a successful treatment that extends life expectancy and ameliorates the hypothalamo- pituitary-ovarian axis in chronic renal failure patients Daha fazlası Daha az

Vascular access type, health-related quality of life, and depression in hemodialysis patients: a preliminary report

Afsar, Baris | Elsurer, Rengin | Covic, Adrian | Kanbay, Mehmet

Article | 2012 | JOURNAL OF VASCULAR ACCESS13 ( 2 ) , pp.215 - 220

Purpose: Arteriovenous fistulas (AVF) are the vascular access of choice for hemodialysis (HD) compared with arteriovenous grafts (AVG) and central venous catheters (CVC). In spite of increasing recognition of importance of a patient's perception of health-related quality of life (HRQOL) and depression, few studies have assessed the association of vascular access type with HRQOL and depression. The purpose of our study was to examine HRQOL and depression among patients with different vascular access. Methods: Severity of symptoms of depression and HRQOL were assessed by Beck Depression Inventory (BDI) and Short Form-36 (SF-36), respe . . .ctively. Vascular access was reported as one of three options; AVF, AVG, and CVC. Results: In total, 136 patients were included; 104 had AVF, 15 had AVG, and 17 had CVC. BDI and HRQOL parameters differed among patients with different vascular access types. In post hoc analysis, BDI and HRQOL subscales were not different between patients with AVF and AVG. Patients with CVC had lower physical functioning (P:.001), role-physical limitation (P:.015), general health perception (P:.017), vitality (P:.010), social functioning (P:.004), role-emotional (P:.008), mental health (P:.001), physical component summary score (P:.017), and mental component summary score (P:.006) when compared to patients with AVF. Patients with CVC had lower physical functioning (P:.044), role-emotional (P:.044) and mental health scores (P:.04) when compared to patients with AVG. Conclusions: Having a CVC may negatively influence HRQOL in HD patients. Vascular access type does not seem to be related to depressed mood in HD Daha fazlası Daha az

Assessment of tumor markers in patients with chronic renal failure

Engin H. | Borazan A. | Aydemir S. | Yilmaz A.

Article | 2007 | Turkish Journal of Cancer37 ( 4 ) , pp.143 - 147

In this study; serum levels of different tumor markers such as alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), cancer antigen 125 (CA 125), cancer antigen 19-9 (CA 19-9), cancer antigen 15-3 (CA 15-3), and prostatespecific antigen (PSA) in 36 predialysis, 42 hemodialysis (HD), 42 continuous ambulatory peritoneal dialysis (CAPD) patients and 32 healthy volunteers as control group who did not present any clinical symptoms or signs of neoplasia with negative hepatitis markers were studied. The mean serum levels of CEA and CA 19-9 were found to be higher than the control group in predialysis, HD and CAPD patients. Serum levels . . .of CA 125 in CAPD group was found to be higher as compared to the other groups. Serum AFP, CA 15-3 and PSA levels were similar in all groups. In conclusion, serum tumor markers do not have any diagnostic utility and may be unreliable for monitoring malignancies in uremic patients Daha fazlası Daha az

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