Browsing by Author "Kutsal, DA"

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    Recurrent Renal Cell Carcinoma in a Pregnant Hemodialysis Patient
    Çolak, HB; Inci, A; Kutsal, DA; Gök, F; Baytur, YB; Lekili, M; Kürsat, S
    Renal cell carcinoma is the most common renal neoplasm reported in pregnancy. A successful pregnancy outcome is very important in women with serious chronic renal failure. Our case was a pregnant women diagnosed with renal failure due to a renal mass in the second trimester of her pregnancy. A healthy baby was delivered following intensified hemodialysis sessions.
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    The Relationship between Malnutrition Subgroups and Volume Parameters in Pre-Dialysis Patients
    Kutsal, DA; Kürsat, S; Inci, A; Ulman, C; Ütük, IO
    There are two types of malnutrition in patients with chronic renal failure (CRF); type 1 and type 2. The aim of this study was to investigate the relationship between malnutrition and inflammation and also the relationship between malnutrition and volume status. Ninety-four pre-dialysis CRF patients were included in the study. Nutritional status of the patients was calculated using the subjective global assessment. Scores of 1-5 were given according to the severity of the symptoms and physical examination findings. Serum inflammation markers [high-sensitive C-reactive protein (hs-CRP), interleukin-1 beta, interleukin-6 and tumor necrosis factoralfa] and nutrition parameters (albumin, pre-albumin, transferrin, fetuin-A, insulin like growth factor-1 and insulin-like growth factor-binding protein-3)] were measured in all the patients. Serum N-terminal pro-brain natriuretic peptide levels and echocardiography were performed to evaluate the volume status of the patients. The mean age of the patients was 59.6 +/- 13.3 years, the mean malnutrition score was 17.2 +/- 6.01, the mean and the median of hs-CRP levels were 18.5 +/- 40.7 and 5.6 mg/L, respectively, the mean albumin level was 3.46 +/- 0.48 and the mean creatinine clearance was 23.7 +/- 13.5 mL/min. A positive correlation between malnutrition scores with inflammation and volume parameters was found in the bivariate and multivariate analysis. In the multiple regression analysis, volume parameters proved to be the most important factors influencing malnutrition scores. Thus, the elimination of volume excess would ameliorate both inflammation and malnutrition. This hypothesis needs to be supported or proved with prospective studies.
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    Functional bowel disorders and associated risk factors in hemodialysis patients in Turkey
    Gök, EG; Inci, A; Çoban, M; Kutsal, DA; Kürsat, S
    Background/Aims: Functional bowel disorders (FBDs) impair the quality of life in patients with end-stage renal disease (ESRD). The aim of our study was to determine the prevalence and distribution of the subtypes of FBDs in hemodialysis (HD) patients. Materials and Methods: This prospective, cross-sectional study included 80 patients who received HD for more than 3 months (patient group) and 80 healthy controls (control group). FBDs were diagnosed according to the Rome II diagnostic criteria by excluding organic pathologies. Results: Forty-six (57.5%) patients were males, and their average age was 62.13 +/- 12.92 (23-90) years. The mean duration of dialysis was 57.48 +/- 59.23 (3-312) months, and the mean Kt/V (K: dialyzer clearance of urea, t: dialysis time, V: volume of distrubition of urea) value was 1.53 +/- 0.31. The rate of FBDs was significantly higher in the patient group than in the control group (p=0.01). In total, 7.5% of the patients had irritable bowel syndrome, 3.8% had functional bloating, and 16.3% had functional constipation. FBDs were significantly higher in women (p=0.004). While there was no statistically significant difference between patients with and those without FBDs in terms of the presence of additional diseases, smoking, alcohol use, educational level, marital status, and residential areas (p>0.05), serum phosphorus (P) levels were significantly higher in the patients with FBDs (p=0.03). Conclusion: FBDs and their functional constipation subtype are more common in HD patients than in the healthy population in Turkey. FBDs are most frequently observed in females and housewives with high serum P levels.