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Öğe Anticardiolipin antibodies in hemodialysis patients with hepatitis C and their role in fistula failure(Dustri-Verlag Dr Karl Feistle, 2009) Ozmen, S.; Danis, R.; Akin, D.; Batun, S.Background/Aims: Several conflicting results are presently reported regarding raised IgG and IgM-anticardiolipin antibodies (ACA) titers in hemodialysis (HD) patients and their role in vascular access dys-function. We aimed to determine the prevalence of both IgM and IgG-ACA titers and to analyze retrospectively their role in primary and secondary arteriovenous fistula (AVF) failure in a homogeneous group of HD patients with chronic hepatitis C. Methods: This study included 103 adults on maintenance hemodialysis with chronic hepatitis C infection. All participants had blood samples drawn predialysis and after an overnight fast. Analysis included biochemistry, IgG and IgM ACA, Anti-HCV, HBsAg, serum HCV RNA and HCV genotyping. Results: The prevalence of IgG-ACA was 14.6% (15/103). No patient had a positive value of the IgM-ACA test. HCV replication was detected in 52 of 76 patients. The most common HCV genotype was genotype 1 (90%). The percentage of females was higher in ACA(+) group (p = 0.038). There were no significant differences between subjects with and without ACA-IgG regarding other parameters studied. No difference in regard to AVF survival was detected between ACA(+) and ACA(-) groups (p > 0.05). Conclusion: We found no significant differences in primary or secondary AVF failure between patients with elevated and normal ACA. Therefore, we conclude that AVFF may be caused by factors other than ACA in these patients. More prospective studies are needed to confirm this observation.Öğe Does the direction of arterial needle in AV fistula cannulation affect dialysis adequacy?(Dustri-Verlag Dr Karl Feistle, 2008) Ozmen, S.; Kadiroglu, A. K.; Ozmen, C. A.; Danis, R.; Sit, D.; Akin, D.; Yilmaz, M. E.Aim: The direction of arterial access needles in fistulas and grafts has been a subject of some controversy and there is no study comparing the results either direction of arterial needle placement in cannulation of arteriovenous fistula. We compared mean urea reduction rate (URR) and Kt/V in the same HD patients when dialyzed via antegrade or retrograde arterial needle cannulation. Materials and methods: This was a study involving 22 adults oil maintenance hemodialysis for more than 6 months. Doppler US examinations of arteriovenous fistula were performed in all Subjects. Pre-dialysis and post-dialysis blood samples were obtained at the patient's midweek HD treatment 4 times a month for each direction. Arterial needle was placed in retrograde direction for the first month. Oil the second month, the direction of arterial needle was converted to antegrade. Means were compared by paired t-test. Results: Mean URR and eKt/Vof retrograde cannulation were 74.2 +/- 7.2% and 1.57 +/- 0.33. The results were indifferent statistically from those of antegrade cannulation (73.0 +/- 8.7% and 1.57 +/- 0.35 (p = 0.123)). Mean fistula blood flow was 931 +/- 483 ml/min. No cannulation complication was observed during the study period for both directions. Conclusions: Both antegrade and retrograde arterial needle placement may be preferred according to center experience without concern of HD adequacy. Longterm outcomes of antegrade and retrograde arterial needle placement such as AVF failure, thrombosis, and stenosis warrant further studies.Öğe Parathyroid hormone as a marker for the differential diagnosis of acute and chronic renal failure(Taylor & Francis Ltd, 2007) Ozmen, S.; Danis, R.; Akin, D.; Cil, T.; Yazanel, O.It is often difficult to distinguish acute renal failure clinically from chronic renal failure, especially in patients who do not have records of their medical history. We investigated the magnitude of iPTH increase in ARF and the potential role of i1PTH as a marker for differential diagnosis of ARF and CRF in new patients referred to our renal unit. We prospectively analyzed 122 (ARF n = 64, CRF n = 58) patients referred to our renal unit with serum creatinine higher than 2 mg/dL. ROC curve analysis was performed to investigate role of iPTH for differentiating ARF from CRF. The sensitivity, specificity, and positive predictive value of iPTH in discrimination of ARF and CRF were calculated. There was no statistically significant difference regarding the means of age, sex distribution, and serum chemistry between patients with ARF or CRF. But serum iPTH (D < 0.0001) levels were lower in patients with ARF than in those with CRF. A cutoff, set at 170pg/mL for iPTH to discriminate patients with CRF, yielded a sensitivity of 88% and a specificity of 89%. This study confirms that the iPTH measurement is of clinical value in differentiating acute from chronic renal failure.Öğe The role of lean body mass for GFR estimation in patients with CKD whit various BMI(Springer, 2008) Ozmen, S.; Kaplan, M. A.; Kaya, H.; Akin, D.; Danis, R.; Bellur, B. Kizilkan; Yazanel, O.[Abstract Not Available]Öğe Ultrasound as a diagnostic tool to differentiate acute from chronic renal failure(Dustri-Verlag Dr Karl Feistle, 2010) Ozmen, C. A.; Akin, D.; Bilek, S. U.; Bayrak, A. H.; Senturk, S.; Nazaroglu, H.Aim Renal ultrasound (US) is the most appropriate method for imaging renal failure; however, considerable overlap in renal size and renal echogenicity exists between normally and abnormally functioning kidneys We compared the sonographic features of kidneys in patients with renal failure to investigate the potential role of renal US to distinguish acute from chronic renal failure and assessed the diagnostic role of body surface area-corrected renal length compared to measured renal length Materials and methods We included 127 consecutive patients with serum creatinine levels higher than 3 mg/dl and 33 healthy volunteers The subjects with acute renal failure (ARF) and chronic renal failure (CRF) were compared for renal length, parenchymal thickness, parenchymal echogenicity, distinctness of the corticomedullary junction, and the presence of stones and cysts Results: No significant differences in age, serum albumin, creatinine, weight, height, or gender distribution were found between patients with ARF and those with CRF, except in serum hemoglobin. The flat and left kidney parenchymal thickness and renal length were significantly greater in ARF patients than in those with CRF (p < 0 0001). The mean parenchymal thickness and renal length were similar in ARF patients and the control group Grade I hyperechogenicity was the most common finding during sonography Conclusions Renal length, parenchymal thickness, and echogenicity differed significantly between patients with acute and chronic renal failure A renal US examination is still the most appropriate method for imaging renal failure and should be combined with other tests to distinguish acute from chronic renal failure
