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Bone Pain Assessment and Relationship with Parathyroid Hormone and Health-Related Quality of Life in Hemodialysis

Elsurer, Rengin | Afsar, Baris | Mercanoglu, Esra

Article | 2013 | RENAL FAILURE35 ( 5 ) , pp.667 - 672

Renal osteodystrophy is a common problem in renal failure patients. Bone pain is a common manifestation of renal osteodystrophy. The aim of the study was to assess the intensity of chronic bone pain via visual analog scale (VAS) and its relationship with parathyroid hormone, health-related quality of life (HRQoL), and depression in hemodialysis patients. Ninety-five patients recruited were asked to rate chronic bone pain via VAS. Depressive symptoms and HRQoL were assessed by Beck Depression Inventory (BDI) and Short-Form 36, respectively. VAS was positively correlated with intact parathyroid hormone (r (_) +0.322, p (-) 0.001), pho . . .sphorus (r- +0.300, p -0.003), alkaline phosphatase (r- +0.275, p = 0.009), and negatively correlated with physical component (r= - 0.320, p 0.002) and mental component summary scores (r = -0.247, p = 0.016). In multivariate linear regression analysis, logVAS was independently associated with serum phosphorus (beta = 0.072, 95% confidence interval: 0.020-0.123, p = 0.007), log intact parathyroid hormone (beta = 0.176, 95% confidence interval: 0.041-0.310, p = 0.011), and physical component summary score (beta = -0.018, 95% confidence interval: -0.031-(-0.005), p - 0.008). VAS is correlated with bone metabolism markers, namely, intact parathyroid hormone, and may be used to assess the intensity of chronic bone pain. The intensity of chronic bone pain is related with HRQoL in hemodialysis patients Daha fazlası Daha az

Acinetobacter co-infection and coagulase-negative Staphylococcus: case report and literature review

Elsurer, Rengin | Afsar, Baris

Article | 2010 | RENAL FAILURE32 ( 4 ) , pp.515 - 517

Continuous ambulatory peritoneal dialysis (CAPD) is a safe, convenient, and cost-effective therapy in end-stage renal disease. The major complication of peritoneal dialysis (PD) is peritonitis. Gram-positive cocci are isolated in majority of the episodes. Among gram-negative bacteria, Acinetobacter species have been reported in peritonitis, sometimes as a concomitant that may be asymptomatic and require no treatment. Little has been written about the clinical features and outcome of PD-related peritonitis caused by co-infection of Acinetobacter species with other pathogens. We herein present a case of peritonitis caused by co-infect . . .ion with Acinetobacter species and coagulase-negative staphylococci, which resulted in patient dropout and mortality. We review the literature about Acinetobacter peritonitis and current treatment protocols Daha fazlası Daha az

The association between therapeutic outcomes and VEGF G-1154A and C-936T gene polymorphisms in patients with glomerulonephritis

Terzi, Hatice | Kayatas, Mansur | Korkmaz, Serdal | Yildiz, Gursel | Candan, Ferhan

Article | 2014 | RENAL FAILURE36 ( 6 ) , pp.904 - 907

Background: In this present study, we aimed to investigate the association between therapeutic outcomes and vascular endothelial growth factor (VEGF) G-1154A and C-936T gene polymorphisms in patients with glomerulonephritis. Methods: Thirty-eight patients with glomerulonephritis diagnosed by renal biopsy were included to the study. All patients had proteinuria at least 1 gram (g)/day in urine analysis. At the end of a yearly therapy, patients with proteinuria less than 0.5 g/day were accepted as in complete remission and they were termed as group 1. The patients with proteinuria over 0.5 g/day were accepted as in no remission and th . . .ey were termed as group 2. Results: The mean age of patients in group 1 and group 2 was 35.88 +/- 13.80 years and 37.30 +/- 13.89 years, respectively. There were nine (50%) male and nine (50%) female patients in group 1. In group 2, seven (35%) male and 13 (65%) female patients were present. Although VEGF G-1154A (GG) gene polymorphism was found in 55% of group 2 patients, and 22.2% of group 1 patients, but the differences did not reach statistical significance. There were no statistical differences between groups in terms of other gene polymorphisms. Namely, we obtained no statistical differences between therapeutic outcomes and gene polymorphisms. Conclusions: There is a significant difference between groups in terms of VEGF G-1154A (GG) gene polymorphism, but the minority of the patient population has led to not to reach statistical significance. So, this gene polymorphism has to be investigated in larger studies Daha fazlası Daha az

Effect of percutaneous nephrolithotomy on renal functions in children: assessment by quantitative SPECT of Tc-99m-DMSA uptake by the kidneys

Cicekbilek, Izzet | Resorlu, Berkan | Oguz, Ural | Kara, Cengiz | Unsal, Ali

Article | 2015 | RENAL FAILURE37 ( 7 ) , pp.1118 - 1121

Objective: To determine the impact of percutaneous nephrolithotomy (PNL) on global and regional renal function in children. Methods: In total, 40 children (41 renal units) undergoing PNL were included in this prospective study. All patients were evaluated using quantitative single-photon emission computed tomography (QSPECT) with technetium-99 m-dimercaptosuccinic acid (Tc-99m-DMSA) examinations before and 3 months after surgery. Results: The mean age was 9.5 years (range, 3-16), and the mean stone size was 3.4 cm (range, 2-6.5). Of the cases, 39 (95%) were managed as being stone-free after a single session of PNL. After additional . . .treatment procedures, 40 (97.5%) of the cases were managed as being stone-free. Of the 41 renal units, new focal cortical defects on Tc-99m-DMSA scans were seen in 4 (9.7%) patients. Total relative uptake in the treated kidneys increased from 42.3% to 44.1%. The mean creatinine level before PNL was 1.18 +/- 0.45 (0.8-1.6) mg/dL compared with 1.16 (0.7-1.5) mg/dL by the end of the follow-up period (not statistically significantly different, p>0.05). Conclusions: PNL in children is a safe and feasible method for the maximal clearance of stones. QSPECT of Tc-99m-DMSA confirmed that renal function is preserved or even improved after percutaneous stone removal Daha fazlası Daha az

HbA1c Is Related with Uremic Pruritus in Diabetic and Nondiabetic Hemodialysis Patients

Afsar, Baris | Afsar, Rengin Elsurer

Article | 2012 | RENAL FAILURE34 ( 10 ) , pp.1264 - 1269

Objective: Uremic pruritus (UP) remains a frequent problem in hemodialysis (HD) patients and is related to mortality. Poor glycemic control, as evaluated by hemoglobin A1c (HbA1c), is also associated with morbidity and mortality in HD patients. In this study, we investigated the relationship between UP and HbA1c in HD patients. Methods: Sociodemographic, clinical, and laboratory variables, depressive symptoms, and health-related quality of life were assessed. Severity of UP was evaluated by visual analogue scale (VAS). The scale consisted of a 10 cm horizontal line marked from 0 (denoting no itch) to 10 (denoting worst possible imag . . .inable itch). Results: Totally, 75 patients (male/female, 41/34; diabetic/nondiabetic, 29/46; age, 51.9 +/- 13.5 years) were included. The VAS pruritus score was higher in diabetic patients compared with nondiabetic patients (4.7 +/- 2.8 vs. 3.0 +/- 1.0, p : 0.015). In diabetics, VAS pruritus score was independently related with calcium-phosphorus product (beta : +0.637, p < 0.0001), intact parathyroid hormone (beta : +0.343, p : 0.017), HbA1c (beta : +0.310, p : 0.027), and Beck depression score (beta : +0.474, p : 0.002). In nondiabetics, VAS pruritus score was independently related with calcium-phosphorus product (beta: +0.486, p : 0.004), intact parathyroid hormone (beta : +0.302, p : 0.041), and HbA1c (beta : +0.341, p : 0.033). In the whole patient group, VAS pruritus score was independently related with calcium-phosphorus product (beta : +0.372, p : 0.001), intact parathyroid hormone (beta : +0.241, p : 0.008), HbA1c (beta : +0.227, p : 0.031), and Beck depression score (beta : +0.298, p : 0.003). Conclusions: In both diabetic and nondiabetic patients, HbA1c is closely related with pruritus in HD patients Daha fazlası Daha az

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