Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi
Objective: The efficacy of rituximab has been reported in patients with idiopathic membranous nep... more Objective: The efficacy of rituximab has been reported in patients with idiopathic membranous nephropathy (MN). We aimed to evaluate the relationship between biochemical tests at diagnosis, immunohistochemical profile, and rituximab response in patients with idiopathic MN unresponsive to other therapies in our center. Material and Methods: In this study, nine patients with idiopathic MN who received other immunosuppressive therapies between 2017-2022 and who underwent renal biopsy in our center were evaluated. Pre-treatment phospholipase A2 antibody levels were positive in 6 patients, and antibodies could not be analyzed in 3 patients. All patients received rituximab ≥2 grams after renin-angiotensin-aldosterone system (RAAS) blocker, cyclophosphamide, steroid, and calcineurin inhibitors. Results: Of the nine patients included in the study, 7 (78.2%) were male, and the mean age was 39.713.2 years. Four patients had complete remission (CR) with rituximab treatment, and five had parti...
Çukurova anestezi ve cerrahi bilimler dergisi, Apr 30, 2023
Introduction: Evidence suggests a relationship between electrocardiography (ECG) aVR (augmented v... more Introduction: Evidence suggests a relationship between electrocardiography (ECG) aVR (augmented voltage right) T wave and cardiovascular mortality in hemodialysis patients. The aim of our study was to investigate the relationship between ECG T aVR positivity and overall mortality together with other known risk factors in hemodialysis patients. Materials and methods: One hundred and one hemodialysis patients were retrospectively screened for ECG T aVR wave positivity. In parallel, the relationship between T aVR positivity and age, gender, calcium phosphorus index, heart rate, ECG and echocardiographic parameters, mortality, smoking, presence of diabetes mellitus, hypertension, myocardial infarction were investigated. RESULTS: Univariate analyzes revealed that patients with positive T aVR (16%) had a statistically lower dialysis time and ejection fraction compared to patient with negative T aVR (p=0.041 and p=0.046, respectively). Survival analysis revealed statistically significantly better prognosis for T aVR-negative patients compared to T aVR-positive patients (5-year survival 70.9%, and 45.5%, respectively; p=0.027). Among tested parameters, independent risk factors affecting survival in hemodialysis patients were found to be age (hazard ratio, HR: 1.03), high heart rate (HR: 1.03), smoking (HR: 3.37) and presence of diabetes mellitus (HR: 2.91). CONCLUSIONS: Our results indicate that routine monitorization of T wave in aVR derivation together with evaluation of other risk factors may provide information about the cardiovascular risk profile, mortality and life habits of hemodialysis patients.
PurposeThe effect of subclinical thyroid pathologies on erythropoietin (EPO) treatment has not be... more PurposeThe effect of subclinical thyroid pathologies on erythropoietin (EPO) treatment has not been well defined. The aim of the study is to compare the frequency and dose of EPO administration in patients with subclinical thyroid pathology and euthyroid hemodialysis patients.MethodsA cross‐sectional and retrospective study was conducted with 210 patients. Special conditions were excluded, a total of 191 patients were included. Patients were divided into three groups.ResultsThe incidences of subclinical hypothyroidism, subclinical hyperthyroidism and euthyroidism were 10.5%, 3.1%, and 86.4%, respectively. Statistically significant difference was found between subclinical hypothyroid and euthyroid patients in terms of the number of patients using EPO (p = 0.0207), monthly total EPO doses (p = 0.003), and total monthly EPO doses per weight (p = 0.001).ConclusionThe EPO dose required to achieve similar hemoglobin levels in hemodialysis patients was significantly higher in subclinical hypothyroid patients than in euthyroid patients.
International Urology and Nephrology, Apr 25, 2022
Anemia in patients with chronic kidney disease (CKD) is the result of reduced erythropoietin, dis... more Anemia in patients with chronic kidney disease (CKD) is the result of reduced erythropoietin, disturbed erythropoiesis and decreased lifespan of circulating erythrocytes. Excessive eryptosis or premature suicidal erythrocyte death is characterized by cell shrinkage and phosphatidylserine externalization. This study aimed to explore accelerated eryptosis and accompanying biochemical alterations in CKD patients. A total of 106 CKD patients (59 predialysis [PreD] patients, 26 haemodialysis [HD] patients and 21 peritoneal dialysis [PD] patients) and a control group composed of 29 healthy volunteers were included in this study. Data on superoxide dismutase (SOD) activity (U/mL), annexin-V binding (mean fluorescent intensity, MFI) and intracellular calcium ([Ca2+]i; MFI) as well as the hematologic and biochemical parameters were recorded. The [Ca2+]i levels were 3.05 ± 1.66 MFI, 2.24 ± 0.99 MFI, 2.38 ± 0.87 MFI and 1.71 ± 0.46 MFI in the PreD, HD, PD and control groups, respectively. Other than significantly higher [Ca2+]i levels in the PreD group than in the control group (p < 0.001), no significant difference was noted between study groups in terms of [Ca2+]i. Annexin-V binding was 1.05 ± 0.99 MFI in PreD group, 1.15 ± 0.56 MFI in HD group, 1.06 ± 0.87 MFI in PD group, and 0.88 ± 0.86 MFI in controls. Annexin-V binding was significantly higher in PreD, HD and PD groups compared with the control group (p < 0.001 for each). SOD activity was 0.07 ± 0.07 in the PreD group, 0.13 ± 0.08 in the HD group, 0.14 ± 0.07 in the PD group, and 0.03 ± 0.01 in the control group. SOD activity in both HD and PD groups were significantly higher than control and PreD groups (p < 0.001 for each). Lower albumin, higher ferritin, and higher parathormon levels were found to be correlated with eryptosis biomarkers. Patients treated vs. non-treated with calcium channel blockers had significantly lower annexin-V binding levels (p = 0.013). Patients treated vs. non-treated with erythropoietin (EPO) had elevated annexin-V binding level (p < 0.001) and lower [Ca2+]i (p = 0.014). In conclusion, our findings revealed the presence accelerated eryptosis, as a potential contributing factor to development of anemia, in patients with CKD stages 3-5D. Inflamation and parathormon can also accelerate eryptosis. Favorable effect of CCB and EPO on eryptosis needs to be confirmed in larger scale studies.
Objective: Diabetic nephropathy (DN) is an important cause of end stage renal disease. It has bee... more Objective: Diabetic nephropathy (DN) is an important cause of end stage renal disease. It has been suggested that pentoxifylline, which is used for the treatment of vascular diseases, has anti-inflammatory properties and may have positive effects on diabetic nephropathy. In this study, we aimed to investigate the effect of pentoxifylline treatment on renal functions and proteinuria levels in patients with DN.Material and Methods: Thirty-six DN patients treated with 1200 mg/day pentoxifylline were screened retrospectively. Twenty-four-hour proteinuria and estimated glomerular filtration rate (eGFR) values were recorded at 3rd and 6th months before starting treatment and at 3rd, 6th and 12th months of pentoxifylline treatment.Results: The average age was 51.9±12.3 years. In this patient cohort, 12 were male and 16 were using angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blockers (ARB). Twenty-three patients used pentoxifylline for less than 6 months (group A) and 13 patients used it for more than 6 months (group B). There was no difference between groups A and B regarding the amount of 24-hour proteinuria (Group A: 3.76±2.49 g/day, Group B: 4.72±3.20 g/day, p=0.423) and loss of eGFR (Group A: 37.98±31.2 ml/min, Group B: 34.00±29.99 ml/min, p=0.846).Conclusion: In this study, the effect of pentoxifylline on proteinuria and eGFR loss was not observed in patients with diabetic nephropathy during 1-year follow-up.
Aim: Post-transplant hypomagnesemia is a frequently encountered and significant electrolyte disor... more Aim: Post-transplant hypomagnesemia is a frequently encountered and significant electrolyte disorder and is more common in patients using calcineurin inhibitors (CNIs). This study aimed to evaluate the frequency of hypomagnesemia and accompanying conditions in the outpatient follow-up of renal transplant recipients. Methods: This cross-sectional study included 236 renal transplant patients. Demographic characteristics of the patients and their biochemical values, including drug levels, were recorded. Results: Of the patients, 69 (29.2%) were female, and 194 (82.3%) were living donor recipients. The mean age of the entire group was 43.1 years. The frequency of hypomagnesemia was 40% (10/25) in the first 12 months, 26.1% (23/88) between the 12th and 60th months, 26% (32/123) after 60 months, and 27.5% (65/236) in all patients. In patients with higher levels of tacrolimus compared to those with the target level, the frequency of hypomagnesemia increased in those with a posttransplant p...
Introduction: Evidence suggests a relationship between electrocardiography (ECG) aVR (augmented v... more Introduction: Evidence suggests a relationship between electrocardiography (ECG) aVR (augmented voltage right) T wave and cardiovascular mortality in hemodialysis patients. The aim of our study was to investigate the relationship between ECG T aVR positivity and overall mortality together with other known risk factors in hemodialysis patients. Materials and methods: One hundred and one hemodialysis patients were retrospectively screened for ECG T aVR wave positivity. In parallel, the relationship between T aVR positivity and age, gender, calcium phosphorus index, heart rate, ECG and echocardiographic parameters, mortality, smoking, presence of diabetes mellitus, hypertension, myocardial infarction were investigated. RESULTS: Univariate analyzes revealed that patients with positive T aVR (16%) had a statistically lower dialysis time and ejection fraction compared to patient with negative T aVR (p=0.041 and p=0.046, respectively). Survival analysis revealed statistically significantly...
Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi
Amaç: Diabetik nefropati (DN) son dönem böbrek yetersizliğinin önemli bir nedenidir. Vasküler has... more Amaç: Diabetik nefropati (DN) son dönem böbrek yetersizliğinin önemli bir nedenidir. Vasküler hastalıklarda kullanılan ve anti-inflamatuar özellikleri olan pentoksifilinin diyabetik nefropatide olumlu etkileri olabileceği öne sürülmüştür. Bu çalışmada DN nedeni ile takipte olan ve pentoksifilin kullanan hastaların tedavi öncesi ve sonrası dönemdeki böbrek fonksiyonları ve proteinürileri değerlendirilmiştir. Gereç ve Yöntemler: Kliniğimizde takipte olup pentoksifilin (1200 mg/gün) tedavisi alan 36 diabetik nefropati hastası retrospektif olarak tarandı. Tedavi başlanmadan önceki 3. ve 6. ay; pentoksifilin tedavisinin 3., 6., 9. ve 12. aylardaki günlük proteinüri miktarı ve eGFR (estimated glomerular filtration rate, tahmini glomerüler filtrasyon hızı) değerleri kayıt edildi. Bulgular: Çalışmaya alınan 36 hastanın ortalama yaşı 51,9±12,3 yıl, 12’si erkek ve 16’sı Anjiotensin dönüştürücü enzim (Angiotensin converting enzyme inhibitor, ACEİ) ya da Anjiotensin reseptör blokeri (Angiotensi...
Objective: Depression is the most common psychiatric disorder affecting patients on hemodialysis ... more Objective: Depression is the most common psychiatric disorder affecting patients on hemodialysis (HD) and has been associated with impaired Quality of Life (QoL). This study aimed to investigate the prevalence of depression and the relationship between depression, QoL, and demographic factors in HD patients. Methods: Short form 36 (SF–36) and Beck's depression inventory (BDI) were employed to assess the relationship between depression, QoL and demographics in 50 hemodialysis patients. The relationship between scores of BDI and SF–36, and annual biochemical and demographic data were then evaluated. Results: Mean age of the patients was 56.4 ±16.4 years and the mean HD duration was 57.11 ±39.09 months. The incidence of depression (BDI>14) was 36%. Age, hemoglobin, ferritin, body mass index (BMI), and Kt/V values were observed to be significantly correlated with the QoL scores (p
Metformin iyi tolere edilen bir anti-hiperglisemik ilaç olmasına rağmen tedavisi sırasında mortal... more Metformin iyi tolere edilen bir anti-hiperglisemik ilaç olmasına rağmen tedavisi sırasında mortalitesi yüksek laktik asidoza neden olabilir. Burada laktik asidoz ve böbrek yetersizliği gelişen bir böbrek nakil hastası rapor edilmiştir. Ellibeş yaşında böbrek nakil hastası hastanemize şuur bozukluğu, hipoglisemi ve laktik asidoz ile getirildi. Hastada postrenal akut böbrek yetersizliği saptandı. Hipoglisemi ve destek tedavisini takiben hemodiyaliz sonrası hastanın konfüzyonu dramatik olarak düzeldi. Üreteral taşın çıkarılmasından sonra böbrek fonksiyonları önceki değerlerde normal seyretti. Metformine bağlı gelişen laktik asidozda erken tanı ve geciktirilmeden hemodiyaliz dahil destek redavisi ile morbidite ve mortaliteyi önleyebilir. Ayrıca, akut böbrek yetersizliği gelisme riski yüksek transplant hastaları dahil metformin kullanan hastaların idrar azalması durumunda metformine ara vermesi konusunda eğitilmesi önemli olabilir.Although metformin is a well tolerated anti-hyperglycemic...
Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi
Objective: The efficacy of rituximab has been reported in patients with idiopathic membranous nep... more Objective: The efficacy of rituximab has been reported in patients with idiopathic membranous nephropathy (MN). We aimed to evaluate the relationship between biochemical tests at diagnosis, immunohistochemical profile, and rituximab response in patients with idiopathic MN unresponsive to other therapies in our center. Material and Methods: In this study, nine patients with idiopathic MN who received other immunosuppressive therapies between 2017-2022 and who underwent renal biopsy in our center were evaluated. Pre-treatment phospholipase A2 antibody levels were positive in 6 patients, and antibodies could not be analyzed in 3 patients. All patients received rituximab ≥2 grams after renin-angiotensin-aldosterone system (RAAS) blocker, cyclophosphamide, steroid, and calcineurin inhibitors. Results: Of the nine patients included in the study, 7 (78.2%) were male, and the mean age was 39.713.2 years. Four patients had complete remission (CR) with rituximab treatment, and five had parti...
Çukurova anestezi ve cerrahi bilimler dergisi, Apr 30, 2023
Introduction: Evidence suggests a relationship between electrocardiography (ECG) aVR (augmented v... more Introduction: Evidence suggests a relationship between electrocardiography (ECG) aVR (augmented voltage right) T wave and cardiovascular mortality in hemodialysis patients. The aim of our study was to investigate the relationship between ECG T aVR positivity and overall mortality together with other known risk factors in hemodialysis patients. Materials and methods: One hundred and one hemodialysis patients were retrospectively screened for ECG T aVR wave positivity. In parallel, the relationship between T aVR positivity and age, gender, calcium phosphorus index, heart rate, ECG and echocardiographic parameters, mortality, smoking, presence of diabetes mellitus, hypertension, myocardial infarction were investigated. RESULTS: Univariate analyzes revealed that patients with positive T aVR (16%) had a statistically lower dialysis time and ejection fraction compared to patient with negative T aVR (p=0.041 and p=0.046, respectively). Survival analysis revealed statistically significantly better prognosis for T aVR-negative patients compared to T aVR-positive patients (5-year survival 70.9%, and 45.5%, respectively; p=0.027). Among tested parameters, independent risk factors affecting survival in hemodialysis patients were found to be age (hazard ratio, HR: 1.03), high heart rate (HR: 1.03), smoking (HR: 3.37) and presence of diabetes mellitus (HR: 2.91). CONCLUSIONS: Our results indicate that routine monitorization of T wave in aVR derivation together with evaluation of other risk factors may provide information about the cardiovascular risk profile, mortality and life habits of hemodialysis patients.
PurposeThe effect of subclinical thyroid pathologies on erythropoietin (EPO) treatment has not be... more PurposeThe effect of subclinical thyroid pathologies on erythropoietin (EPO) treatment has not been well defined. The aim of the study is to compare the frequency and dose of EPO administration in patients with subclinical thyroid pathology and euthyroid hemodialysis patients.MethodsA cross‐sectional and retrospective study was conducted with 210 patients. Special conditions were excluded, a total of 191 patients were included. Patients were divided into three groups.ResultsThe incidences of subclinical hypothyroidism, subclinical hyperthyroidism and euthyroidism were 10.5%, 3.1%, and 86.4%, respectively. Statistically significant difference was found between subclinical hypothyroid and euthyroid patients in terms of the number of patients using EPO (p = 0.0207), monthly total EPO doses (p = 0.003), and total monthly EPO doses per weight (p = 0.001).ConclusionThe EPO dose required to achieve similar hemoglobin levels in hemodialysis patients was significantly higher in subclinical hypothyroid patients than in euthyroid patients.
International Urology and Nephrology, Apr 25, 2022
Anemia in patients with chronic kidney disease (CKD) is the result of reduced erythropoietin, dis... more Anemia in patients with chronic kidney disease (CKD) is the result of reduced erythropoietin, disturbed erythropoiesis and decreased lifespan of circulating erythrocytes. Excessive eryptosis or premature suicidal erythrocyte death is characterized by cell shrinkage and phosphatidylserine externalization. This study aimed to explore accelerated eryptosis and accompanying biochemical alterations in CKD patients. A total of 106 CKD patients (59 predialysis [PreD] patients, 26 haemodialysis [HD] patients and 21 peritoneal dialysis [PD] patients) and a control group composed of 29 healthy volunteers were included in this study. Data on superoxide dismutase (SOD) activity (U/mL), annexin-V binding (mean fluorescent intensity, MFI) and intracellular calcium ([Ca2+]i; MFI) as well as the hematologic and biochemical parameters were recorded. The [Ca2+]i levels were 3.05 ± 1.66 MFI, 2.24 ± 0.99 MFI, 2.38 ± 0.87 MFI and 1.71 ± 0.46 MFI in the PreD, HD, PD and control groups, respectively. Other than significantly higher [Ca2+]i levels in the PreD group than in the control group (p < 0.001), no significant difference was noted between study groups in terms of [Ca2+]i. Annexin-V binding was 1.05 ± 0.99 MFI in PreD group, 1.15 ± 0.56 MFI in HD group, 1.06 ± 0.87 MFI in PD group, and 0.88 ± 0.86 MFI in controls. Annexin-V binding was significantly higher in PreD, HD and PD groups compared with the control group (p < 0.001 for each). SOD activity was 0.07 ± 0.07 in the PreD group, 0.13 ± 0.08 in the HD group, 0.14 ± 0.07 in the PD group, and 0.03 ± 0.01 in the control group. SOD activity in both HD and PD groups were significantly higher than control and PreD groups (p < 0.001 for each). Lower albumin, higher ferritin, and higher parathormon levels were found to be correlated with eryptosis biomarkers. Patients treated vs. non-treated with calcium channel blockers had significantly lower annexin-V binding levels (p = 0.013). Patients treated vs. non-treated with erythropoietin (EPO) had elevated annexin-V binding level (p < 0.001) and lower [Ca2+]i (p = 0.014). In conclusion, our findings revealed the presence accelerated eryptosis, as a potential contributing factor to development of anemia, in patients with CKD stages 3-5D. Inflamation and parathormon can also accelerate eryptosis. Favorable effect of CCB and EPO on eryptosis needs to be confirmed in larger scale studies.
Objective: Diabetic nephropathy (DN) is an important cause of end stage renal disease. It has bee... more Objective: Diabetic nephropathy (DN) is an important cause of end stage renal disease. It has been suggested that pentoxifylline, which is used for the treatment of vascular diseases, has anti-inflammatory properties and may have positive effects on diabetic nephropathy. In this study, we aimed to investigate the effect of pentoxifylline treatment on renal functions and proteinuria levels in patients with DN.Material and Methods: Thirty-six DN patients treated with 1200 mg/day pentoxifylline were screened retrospectively. Twenty-four-hour proteinuria and estimated glomerular filtration rate (eGFR) values were recorded at 3rd and 6th months before starting treatment and at 3rd, 6th and 12th months of pentoxifylline treatment.Results: The average age was 51.9±12.3 years. In this patient cohort, 12 were male and 16 were using angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blockers (ARB). Twenty-three patients used pentoxifylline for less than 6 months (group A) and 13 patients used it for more than 6 months (group B). There was no difference between groups A and B regarding the amount of 24-hour proteinuria (Group A: 3.76±2.49 g/day, Group B: 4.72±3.20 g/day, p=0.423) and loss of eGFR (Group A: 37.98±31.2 ml/min, Group B: 34.00±29.99 ml/min, p=0.846).Conclusion: In this study, the effect of pentoxifylline on proteinuria and eGFR loss was not observed in patients with diabetic nephropathy during 1-year follow-up.
Aim: Post-transplant hypomagnesemia is a frequently encountered and significant electrolyte disor... more Aim: Post-transplant hypomagnesemia is a frequently encountered and significant electrolyte disorder and is more common in patients using calcineurin inhibitors (CNIs). This study aimed to evaluate the frequency of hypomagnesemia and accompanying conditions in the outpatient follow-up of renal transplant recipients. Methods: This cross-sectional study included 236 renal transplant patients. Demographic characteristics of the patients and their biochemical values, including drug levels, were recorded. Results: Of the patients, 69 (29.2%) were female, and 194 (82.3%) were living donor recipients. The mean age of the entire group was 43.1 years. The frequency of hypomagnesemia was 40% (10/25) in the first 12 months, 26.1% (23/88) between the 12th and 60th months, 26% (32/123) after 60 months, and 27.5% (65/236) in all patients. In patients with higher levels of tacrolimus compared to those with the target level, the frequency of hypomagnesemia increased in those with a posttransplant p...
Introduction: Evidence suggests a relationship between electrocardiography (ECG) aVR (augmented v... more Introduction: Evidence suggests a relationship between electrocardiography (ECG) aVR (augmented voltage right) T wave and cardiovascular mortality in hemodialysis patients. The aim of our study was to investigate the relationship between ECG T aVR positivity and overall mortality together with other known risk factors in hemodialysis patients. Materials and methods: One hundred and one hemodialysis patients were retrospectively screened for ECG T aVR wave positivity. In parallel, the relationship between T aVR positivity and age, gender, calcium phosphorus index, heart rate, ECG and echocardiographic parameters, mortality, smoking, presence of diabetes mellitus, hypertension, myocardial infarction were investigated. RESULTS: Univariate analyzes revealed that patients with positive T aVR (16%) had a statistically lower dialysis time and ejection fraction compared to patient with negative T aVR (p=0.041 and p=0.046, respectively). Survival analysis revealed statistically significantly...
Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi
Amaç: Diabetik nefropati (DN) son dönem böbrek yetersizliğinin önemli bir nedenidir. Vasküler has... more Amaç: Diabetik nefropati (DN) son dönem böbrek yetersizliğinin önemli bir nedenidir. Vasküler hastalıklarda kullanılan ve anti-inflamatuar özellikleri olan pentoksifilinin diyabetik nefropatide olumlu etkileri olabileceği öne sürülmüştür. Bu çalışmada DN nedeni ile takipte olan ve pentoksifilin kullanan hastaların tedavi öncesi ve sonrası dönemdeki böbrek fonksiyonları ve proteinürileri değerlendirilmiştir. Gereç ve Yöntemler: Kliniğimizde takipte olup pentoksifilin (1200 mg/gün) tedavisi alan 36 diabetik nefropati hastası retrospektif olarak tarandı. Tedavi başlanmadan önceki 3. ve 6. ay; pentoksifilin tedavisinin 3., 6., 9. ve 12. aylardaki günlük proteinüri miktarı ve eGFR (estimated glomerular filtration rate, tahmini glomerüler filtrasyon hızı) değerleri kayıt edildi. Bulgular: Çalışmaya alınan 36 hastanın ortalama yaşı 51,9±12,3 yıl, 12’si erkek ve 16’sı Anjiotensin dönüştürücü enzim (Angiotensin converting enzyme inhibitor, ACEİ) ya da Anjiotensin reseptör blokeri (Angiotensi...
Objective: Depression is the most common psychiatric disorder affecting patients on hemodialysis ... more Objective: Depression is the most common psychiatric disorder affecting patients on hemodialysis (HD) and has been associated with impaired Quality of Life (QoL). This study aimed to investigate the prevalence of depression and the relationship between depression, QoL, and demographic factors in HD patients. Methods: Short form 36 (SF–36) and Beck's depression inventory (BDI) were employed to assess the relationship between depression, QoL and demographics in 50 hemodialysis patients. The relationship between scores of BDI and SF–36, and annual biochemical and demographic data were then evaluated. Results: Mean age of the patients was 56.4 ±16.4 years and the mean HD duration was 57.11 ±39.09 months. The incidence of depression (BDI>14) was 36%. Age, hemoglobin, ferritin, body mass index (BMI), and Kt/V values were observed to be significantly correlated with the QoL scores (p
Metformin iyi tolere edilen bir anti-hiperglisemik ilaç olmasına rağmen tedavisi sırasında mortal... more Metformin iyi tolere edilen bir anti-hiperglisemik ilaç olmasına rağmen tedavisi sırasında mortalitesi yüksek laktik asidoza neden olabilir. Burada laktik asidoz ve böbrek yetersizliği gelişen bir böbrek nakil hastası rapor edilmiştir. Ellibeş yaşında böbrek nakil hastası hastanemize şuur bozukluğu, hipoglisemi ve laktik asidoz ile getirildi. Hastada postrenal akut böbrek yetersizliği saptandı. Hipoglisemi ve destek tedavisini takiben hemodiyaliz sonrası hastanın konfüzyonu dramatik olarak düzeldi. Üreteral taşın çıkarılmasından sonra böbrek fonksiyonları önceki değerlerde normal seyretti. Metformine bağlı gelişen laktik asidozda erken tanı ve geciktirilmeden hemodiyaliz dahil destek redavisi ile morbidite ve mortaliteyi önleyebilir. Ayrıca, akut böbrek yetersizliği gelisme riski yüksek transplant hastaları dahil metformin kullanan hastaların idrar azalması durumunda metformine ara vermesi konusunda eğitilmesi önemli olabilir.Although metformin is a well tolerated anti-hyperglycemic...
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