Browsing by Author "Ekmekci C."

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    Pulmonary hypertension in patients with chronic renal failure
    (2007) Havlucu Y.; Kursat S.; Ekmekci C.; Celik P.; Serter S.; Bayturan O.; Dinc G.
    Background: Many etiologies causing pulmonary hypertension (PH) have been reported, and one of the background disease seen with patients with PH is chronic renal failure (CRF); however, the pathogenesis of PH in this group of patients is not explained satisfactorily. Objectives: The aims of this study were to evaluate the incidence of unexplained PH among patients with CRF and to suggest possible etiologic factors. Methods: Two hundred and eleven patients with CRF were evaluated and the ones who have comorbid conditions that cause PH were excluded. Pulmonary arterial pressure (PAP) and cardiac functions were evaluated by Doppler echocardiography. Arteriovenous fistula (AVF) flow was measured by Doppler sonography. The patients were followed for at least 6 months. Results: Forty-eight CRF patients (20 males, 28 females) were included: 23 were predialysis patients, and 25 patients received hemodialysis via AVF. Patients were followed for 7.5 ± 1.01 months. Systolic PAP >35 mm Hg was found in 56% (14/25) of patients receiving hemodialysis (36.8 ± 10.7 mm Hg) and in 39.1% (9/23) of predialysis patients (29.5 ± 9.5 mm Hg). The parathyroid hormone level, cardiac output values and CRF duration were found to be increased in patients with elevated systolic PAP (p < 0.05). AVF flow and AVF duration were positively correlated with systolic PAP in patients receiving hemodialysis (p < 0.05). There was a negative correlation between systolic PAP and residual urine volume (p < 0.05). AVF compression in hemodialysis patients decreased systolic PAP from 36.8 ± 10.7 to 32.8 ± 10.5 mm Hg. Systolic PAP values were increased at the end of the study in the predialysis group, whereas they were decreased at the end of the follow-up in the hemodialysis group (36.9 ± 10.5 and 32.04 ± 10.5 mm Hg, respectively). Conclusions: This study demonstrates a high incidence of PH among patients with CRF. CRF duration, AVF flow, parathyroid hormone level and cardiac output may be involved in the pathogenesis of PH. The effective hemodialysis and dry weight reduction decreased systolic PAP values. Copyright © 2007 S. Karger AG.
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    The relationship between depression - Malnutrition and echocardiographic-blood pressure parameters in chronic hemodialysis patients
    (2008) Kursat S.; Colak H.B.; Toraman A.; Ekmekci C.; Tekce H.; Alici T.
    Aims: The aim is to research the relationship between the degree of depression - malnutrition and inadequate volume control. Methods: The mean age of the 52 patients was 55 ± 14.6 years. Malnutrition score [subjective global assessment (SGA)] and depression score [Taiwanese Depression Questionnaire (TDQ)] of each chronic hemodialysis (CHD) patient were calculated. Then an echocardiographic assessment was carried out with the same device 1 day before the second HD session of the week. The 24 h blood pressure monitoring was performed 1 day before the second HD session of the week. Results: TDQ scores (TDQS) were ≥19 in 41 and <19 in 11 patients. TDQS was found to be significantly high in women (p = 0.01) who were older than 40 years (p = 0.03) and who have low family income (p = 0.03). TDQS was found to be significantly correlated with HD duration (p = 0.034), vena cava inferior collapse index (p = 0.02), malnutrition score (p = 0.011), residual renal function (ml/day) (p = 0.03), level of albumin (p = 0.0009), and iron (p = 0.015). A positive correlation was detected between TDQS and the ratio of mean nighttime blood pressure/ mean daytime blood pressure (p = 0.005, r = 0.394). Depression score was found to be significantly different between normal geometry and left ventricular hypertrophy (eLVH), concentric remodeling and eLVH, and concentric LVH and eLVH. Conclusions: The results show that lesser degrees of nocturnal dip and eLVH are associated with increased degrees of depression, implying that hypervolemia is strongly associated with depression and might be a component of strong relationships involving malnutrition, inflammation, and atherosclerosis in CHD patients. © Springer Science+Business Media B.V. 2008.
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    Correlation of the Volume Control Parameters with Health Related Quality of Life in Renal Transplant Patients
    (Elsevier USA, 2015) Colak H.; Sert I.; Ekmekci C.; Tugmen C.; Kurtulmus Y.; Kursat S.; Töz H.
    Introduction Transplantation is the most effective treatment strategy for end-stage renal failure. We aimed to investigate the correlation of volume control parameters with health-related quality of life (HRQoL) in renal transplantation patients during the pre- and post-transplantation periods. Material and Methods Seventy-seven patients who underwent renal transplantation from deceased donors between January 2011 and January 2013 were included in the study. The biochemical markers, complete blood count, and creatinine levels were measured during pretransplantation and at post-transplantation month 6. The Turkish version of the Short Form 36 (SF-36) health survey questionnaire was used for the assessment of HRQoL. Blood pressure (BP) and echocardiographic measurements were used to evaluate the volume status. Results Significant improvements were achieved in all echocardiographic measurements, biochemical parameters except Ca++, and SF-36 questionnaire domain scores (DSs) except vitality in the post-transplantation period. Systolic BP (SBP), the left atrium index, vena cava inferior collapsibility index (VCCI), and diastolic BP were associated with vitality (P =.02,.03,.05, and.04, respectively); SBP was associated with social functioning (P <.01) and role emotional (P <.01); and left ventricular mass index was associated with mental health (P =.05) DSs during the pretransplantation period. In the post-transplantation period, VCCI, left ventricular mass index, and SBP were associated with general health (P =.02,.05, and.05, respectively); VCCI and SBP were also associated with mental health (P =.05 and.01, respectively); and left atrium index was associated with role emotional (P =.05) DSs. Conclusion Concomitant improvement in the volemic status may contribute to improvements in HRQoL after renal transplantation. © 2015 Elsevier Inc. All rights reserved.