3 results
Search Results
Now showing 1 - 3 of 3
Article Main Outcomes of the Diyal-Tr Study: Regional\rdifferences of Mortality and Morbidity in Chronic\rhemodialysis Patients(Aves, 2022) Kızılırmak, Pınar; Ecder, Süleyman Tevfik; Ateş, Kenan; Arıcı, Mustafa; Sezer, Siren; Kaptanoğulları, Hakan; Arınsoy, Selim Turgay; Ecder, Tevfik; Arinsoy, TurgayObjective: Variations in care at national or global level may have an impact on the prognosis of patients on chronic hemodialysis.\rWe aimed to describe regional differences in all-cause mortality or cardiovascular morbidity in chronic hemodialysis\rpatients in Turkey.\rMethods: We enrolled 2461 patients who were initiated chronic hemodialysis in 93 centers in Turkey between January 27,\r2017, and February 09, 2018. We included 2-year follow-up data of 1877 patients in this prospective study. The primary\routcome, the rate of composite endpoint of all-cause mortality or cardiovascular morbidity, was compared between geographical\rregions. Secondary outcomes were the rates of hospitalization and infections.\rResults: In total, 552 patients (29.4%) developed the primary outcome. The highest and lowest rates of primary outcome\roccurred in the Mediterranean (34.5%) and Southeastern (26.5%) & Central Anatolian regions (26.5%), respectively, with no\rsignificant differences across regions (P = .82). Hospitalization events were detected in 377 patients (20.1%). The highest\rrate of hospitalization was detected in the Black Sea region (33.8%), and the lowest (7.6%) in the Southeastern region. The\rregions did not differ in hospitalization rates (P = .88). Infections occurred in 11.3% (n = 212) of the patients. The highest and\rlowest rates of infections occurred in the Aegean (18.2%) and the Southeastern (2.9%) regions, respectively. We detected\rsignificant difference between geographic regions (P = .02).\rConclusions: Our study showed that almost 3 in every 10 chronic hemodialysis patients reached the primary endpoint\rof all-cause mortality/cardiovascular morbidity during the 2 years of follow-up. The occurrence of this outcome does not\rseem to exhibit geographical variation across the country.Article Hemodiyaliz Hastalarında Sevelamer Vasküler Sertliği Düzeltmekte ve Serum Ürik Asit Düzeyini Azaltmaktadır(2024) Demirci, Bahar Gürlek; Tutal, Emre; Bal, Zeynep; Erkmen, Mehtap; Sezer, Siren; Akdogan, MehtapAmaç: Sevelamer, pleotropik etkisi ile prebiyotik olarak etki gösterebilir. Bu çalışmanın amacı sevelamerin ürik asit, HbA1c, lipid profili ve arteryel sertlik progresyonu üzerine etkisinin gösterilmesidir. Gereç ve Yöntem: Hemodiyalize giren ve aynı fosfor bağlayıcıyı (FB) 3 yıl kullanan 151 hasta çalışmaya dahil edildi. Hastalar kullandıkları FB’ye göre sevelamer bazlı FB (grup 1) ve kalsiyum bazlı FB (grup 2) olarak 2 gruba ayrıldı. Üç yıllık takipte biyokimyasal parametreler kayıt edildi. Arteryel sertlik başlangıçta ve 3. yılın sonunda aortik nabız dalga hızı (PWv) ölçümü ile belirlendi. Bulgular: Üç yıllık takipte ortalama ürik asid düzeyleri grup 1’de azalmışken grup 2’de stabil kaldı. Grup 1’deki hastaların %22,4’ünde ortalama ürik asid düzeylerinde 2 mg/dL’den fazla azalma saptandı. Diyabetik hastalarda HbA1c düzeyleri grup 1’de grup 2’ye göre daha düşüktü. PWv düzeyleri çalışmanın başında her 2 grup için de benzerdi. Ancak 3. yılın sonunda PWv düzeyleri grup 1’de grup 2’ye göre daha düşük saptandı. Sonuç: Sevelamer pleiotropik etki ile ürik asit düzeyini, düşük yoğunluklu lipoprotein-kolesterolü, HbA1c düzeyini azaltarak, fazla kalsiyum alımını engelleyerek kardiyovasküler riski azaltmaktadır. Hemodiyalize giren hastalarda sevelamer, kalsiyum bazlı fosfor bağlayıcılara göre arteryel sertlik progresyonunu da azaltarak kardiyovasküler risk profilini düzeltir.Article Covid-19 Pandemic: Depression and Sleep Quality in Hemodialysis Patients(2022) Yavuz, Demet; Balakbabalar, Ayse Pinar Doğru; Demirağ, Mehmet Derya; Sezer, SirenIntroduction: Depression and sleep disturbance are prevalent comorbidities in hemodialysis patients. This study aimed to investigate the relationship between depressive mood, sleep disturbance, and the fear of COVID-19 Scale in hemodialysis patients during the pandemic process. Material and Method: 116 hemodialysis patients followed up in our clinic and volunteered were included in the study. The socio- demographic characteristics of the patients and the laboratory test results studied in their routine follow-ups were obtained from the file records. Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and the Fear of COVID-19 Scale (FCV-19S) were applied through face-to-face interviews. Results: 116 patients (70 males, 46 females) with a hemodialysis duration of 40 months (13-295) and age of 60.2±13.3 years were included in the study. The patients were divided into two groups according to their PSQI score as good sleeper (PSQI ≤ 5, n=66) and poor sleeper (PSQI >5, n=50). When evaluated by gender 28 (56%) female patients were in the poor sleeper group (p=0.002). Dialysis time was longer, BDI score and FCV-19 scale were higher in the poor sleeper group than the good sleeper group. PSQI score was positively correlated with dialysis time (r=0.259 p=0.005), BDI score (r=0.279 p=0.002), and FCV-19 scale (r=0.304 p=0.001). In the Multiple Logistic Regression analysis established to evaluate the risk factors affecting sleep quality, BDI was determined as an independent risk factor for poor sleep (OR: 1.084, 95%CI [1.021-1.152], p=0.008). Subjects were divided into two groups according to their BDI scores as those with depressive mood (BDI score ≥ 17, n=47) (40.5%) and those without (BDI score < 17, n=69) (59.5%). Thirty-two of the cases with depressive mood were women (68.1%) (p<0.001). There was a female predominance in the depressed patient group. The economic status was worse in the depressed group compared to the non-depressed group, and the PSQI score and FVC-19 scale were higher. In addition, BDI score was positively correlated with age (r=0.225 p =0.015), female gender (r=0.473 p=0.001), poor economic status (r=0.576 p =0.001), FVC-19 scale (r=0.330 p =0.001), while negatively correlated with serum albumin level (r=-0.279 p=0.003) and serum creatinine level (r=-0.2455 p =0.008). In the Multiple Logistic Regression model established, female gender (OR: 7.857, 95%CI [2.463-25.065], p<0.001) and poor economic status (OR: 7.569, 95%CI [2,300-24,908], p=0.001) were determined as independent risk factors for depressive mood. Conclusion: Nearly half of the patients had sleep disorders and depressive mood. Patients in the depressive mood and poor sleep group had a higher FVC-19 scale. We think it would be beneficial not to ignore the increased frequency of depressive mood and sleep disorders in hemodialysis patients during the COVID-19 pandemic.
