Browsing by Publisher "TURK NEFROLOJI DIYALIZ TRANSPLANTASYON DERGISI"
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Item Colistin and Acute Renal Failure: A Centre's Experience(TURK NEFROLOJI DIYALIZ TRANSPLANTASYON DERGISI) Hür, E; Çetinturk, A; Eminoglu, V; Sungur, M; Tavsan, Ö; Piskinpasa, SV; Severcan, E; Karaca, N; Duman, SOBJECTIVE: Colistin is a polymyxin antibiotic with a polypeptide structure and is effective against gram-negative bacilli. Although its use had decreased due to its side effects, it has increased again in recent years, especially for multi-drug resistant Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter and Enterobacteriaceae. In the present study, patients that received colistin at one center were retrospectively analysed in terms of nephrotoxicity. MATERIAL and METHODS: Patients hospitalized and treated with colistin in the intensive care unit between January 2012 and August 2013 were analyzed. Demographic data; biochemical tests at baseline, daily during hospitalization and after discharge; and the initial, maintenance and total doses of colistin were evaluated. RESULTS: The mean age was 62 +/- 13 (31-86) years for the 27 patients with 17 (63%) males that were followed-up for an average duration of 63 +/- 89 days. During follow-up, 18 patients (66.7%) developed acute renal failure (ARF) and 17 (63%) of died. There were 12 (66.7%) mortalities in the ARF group and 5 (55%) in the group without ARF (p> 0.05). The total colistin dose and leukocyte count were higher in the ARF group with 3.75 +/- 2.34 g and 12.04 +/- 5.05/mm(3) than the non-ARF group at 3.32 +/- 1.86 g and 7.60 +/- 3.7/mm(3) but did not reach statistical significance. CONCLUSION: ARF increases the mortality in ICU patients. Although colistin is an effective therapeutic agent used for resistant infections, we have to avoid higher doses due to its potential side effect of ARF.Item Recurrent Renal Cell Carcinoma in a Pregnant Hemodialysis Patient(TURK NEFROLOJI DIYALIZ TRANSPLANTASYON DERGISI) Çolak, HB; Inci, A; Kutsal, DA; Gök, F; Baytur, YB; Lekili, M; Kürsat, SRenal 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.Item Factors Affecting QT Dispersion During Hemodialysis in End-Stage Renal Disease Patients(TURK NEFROLOJI DIYALIZ TRANSPLANTASYON DERGISI) Alici, T; Tekçe, H; Degirmenci, M; Özgür, B; Kürsat, SAim: To investigate the situation of the cardiac arrhythmia in the cases within the chronic haemodialysis program and its pathogenesis. Materials and Method: Sixty-four patients who admitted to the department of nephrology in our hospital with chronic renal failure requiring haemodialysis were taken into our study. In order to determine and asses the QT dispersion before and after haemodialysis, conventional ECG records with 12 derivations were taken. Results: Pre-haemodialysis QT and QTc dispersion were calculated as 49.6 +/- 24 msn and 57 +/- 29 msn; post-haemodialysis QT and QTc dispersion were calculated as 75 +/- 33 msn and 93 +/- 38 msn, reflecting significant changes (p<0.001). Of the electrolyte values taken before and after haemodialysis, K+ was shown to have a significant change (p<0.001). Positive correlation was observed between the decrease in K+ and the increase in QT dispersion (p<0.05). Negative correlation was observed between the QT dispersion increase and the amount of ultrafiltration (p<0.05). Discussion: QT and QTc dispersion increases were affected by the decrease in K+ value and the amount of ultrafiltration that occurred during haemodialysis. This indicates that the gradual reduction in K+ and optimization of ultrafiltration levels will increase the threshold of arrhythmia being one of the causes of cardiac mortality.Item The Results of the 24-Hour Ambulatory Blood Pressure Monitoring of the Essential Hypertension Patients Using Diuretic or Not(TURK NEFROLOJI DIYALIZ TRANSPLANTASYON DERGISI) Çolak, HL; Alici, T; Tekçe, H; Kursat, SResearchers have discovered that blood pressure (BP) varies in a diurnal manner throughout a 24-hour period, being higher during the day and lower at night. Most people have a dipping BP pattern characterized by a nighttime BP that is 10-20% lower than their daytime BP. First time treated essential hypertensive non-diabetic patients in Hypertension and Nephrology Outpatient Clinic were randomly allocated to two different groups according to their hydrochlorothiazide usage status in addition to other antihypertensive drugs. Age, gender, body mass index (BM)), duration of hypertension and initial fasting blood sugar, total cholesterol, HDL-cholesterol, LDL-cholesterol, uric acid. BUN, creatinine, Na, K, calcium levels were not different betwe en the groups. During their follow-up, the attainment of 140(90 mmHg or less blood pressure levels for three consecutive monthly controls prompted the implementation of 24-hour ambulatory blood pressure monitoring (ABPM). The interval between the first office visit and the last control was also comparable between the groups. At the last clinic visit, the groups were again compared for BMI. and the same biochemical parameters. There was not any statistically significant difference between the subgroups. Twenty-four-hour ABPM results were also comparable. These findings suggest that the same blood pressure target can be achieved in essential hypertensives with the combinalion therapy regardless of die use of hydrochlorothiazide.