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    Öğe
    A general approach and management in complications of hemodialysis catheters: Review
    (Turkiye Klinikleri, 2007) Daniş R.; Özmen Ç.; Akin D.; Yazanel O.
    Central venous catheters are commonly used vascular access for hemodialysis in renal failure. Semi-rigid double-lumen polyurethane catheters may be considered for short-time use (up to 2-3 weeks). Soft silicone double-lumen or twin-catheters, preferably with subcutaneous tunneling, are highly desirable for prolonged usage. The complications related with catheters may be evaluated under three topics: insertion complications, thrombosis, and infection. Infections is the most common cause of the nosocomial sepsis and the most serious complication in dialysis centers. Catheter dysfunction is one of the common complications. The internal jugular route should be considered for mid-term use in order to facilitate the patient's mobilization and to reduce the risk of infection. The subclavian route should be avoided because of the risk of stenosis and/or thrombosis of the outflow vein. Catheter insertion must be performed by a trained physician with ultrasound guidance. Complications associated with insertion, infection, and thrombosis are a major source of morbidity and mortality in end stage renal disease patients. Diagnosis and management of these complications are discussed in details. Copyright © 2007 by Türkiye Klinikleri.
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    Öğe
    Hyaluronic acid as a new biomarker to differentiate acute kidney injury from chronic kidney disease
    (Iranian Society of Nephrology, 2017) Akin D.; Ozmen S.; Yilmaz M.E.
    Introduction. It may be difficult to differentiate acute kidney injury from chronic kidney disease in patients with no past medical reports of kidney function. This study aimed to investigate the role of serum hyaluronic acid (HA), which is known as a marker of fibrosis, in differential diagnosis of kidney failure. Materials and Methods. A total of 90 patients (52 women and 38 mne) admitted to our renal unit with uremia for the first time were included. Serum HA level was measured. The diagnostic role of the test was investigated using the receiver operator curve curves. Results. The mean age of the patients was 54.6 ± 17.9 years. The diagnosis was chronic kidney disease (CKD) in 41.1%, acute kidney injury (AKI) in 48.9%, AKI on CKD in 6.7% (3 died without a diagnosis). The mean serum HA was significantly higher in the CKD group (146.1 ± 119.3 ng/mL) than the AKI group (68.9 ± 69.1 ng/ mL; P <.001). Serum HA significantly correlated with proteinuria (r = 0.717, P <.001) and serum albumin level (r = - 0.599, P <.001) in the CKD group only. Serum HA cutoff level of 61 ng/dL had a sensitivity of 82% and specificity of 67% for differential diagnosis of AKI and CKD. Conclusions. Serum HA level may be used as tool to differentiate AKI from CKD. Further larger studies are warranted to clarify the definite the role of this marker. © 2017, Iranian Society of Nephrology. All rights reserved.