Diyaliz hastalarında lipid peroksidasyon ve antioksidan kapasitesi: farklı diyaliz membranları ile yapılan tek bir diyaliz seansının etkileri

Amaç: Bu çalışmanın amacı diyaliz hastalarının lipid peroksidasyon ve antioksidan savunma kapasitelerini tespit etmek ve değişik tipteki diyaliz membranlarının bu parametreler üzerine etkilerini göstermektir. Metot: Çalışmaya 54 diyaliz hastası ve kontrol grubu olarak 30 sağlıklı birey alındı. 54 diyaliz hastasının 10’u periton diyalizi, 44’ü hemodiyaliz hastasından oluşmaktaydı. Hemodiyaliz hastaları polikarbonat (n10) ya da hemophan membran (n34) kullanılarak hemodiyalize alınmaktaydı. Polikarbonat membran kullanılan grupta, sonraki diyaliz seansında membranlar vitamin-E kaplı dializer ile değiştirildi. Antioksidan savunma kapasitesi ve lipid peroksidasyonunu belirlemek için total antioksidan durumu ve malondialdehid seviyeleri diyaliz öncesi ve diyaliz sonrasında çalışıldı. Sonuçlar: Kontrol grubu ile karşılaştırıldığında tüm diyaliz hastalarında plazma total antioksidan seviyesi daha düşük (1.510.2 mmol/L ‘ye karşı 1.750.20 mmol/L p0.05) ve malondialdehit seviyesi daha yüksek (2.21.17 nmol/mL’ ye karşı 0.600.20nmol/mL p0.05) bulundu. Bir hemodiyaliz seansı sonrasında tüm diyaliz membranları için parametrelerde anlamlı değişiklik tespit edilmedi. Sonuç: Tüm diyaliz hastaları artmış bir oksidatif duruma sahiptirler. Farklı tipte diyaliz membranları ile yapılan tek bir diyaliz seansı oksidan ve anti-oksidan seviyelerini anlamlı olarak değiştirmiyor gibi gözükmektedir.Objective: To estimate lipid peroxidation and the antioxidant defense capacity of dialysis patients and the effects of different types of dialysis membranes on these parameters. Methods: Fifty-four dialysis patients and 30 healthy controls were included in this study. Ten of the dialysis patients were on continuous ambulatory peritoneal dialysis treatment and the rest were on hemodialysis with either polycarbonate membrane (n10) or hemophan membrane (n34). Polycarbonate membranes were switched with a vitamin E-coated dialyzer in the subsequent dialysis session. Total antioxidant status and malondialdehyde levels were studied to determine the antioxidant defense capacity and lipid peroxidation, respectively, before and after the dialysis session. Results: Plasma total antioxidant status levels were lower (1.51±0.2 mmol/l vs. 1.75±0.20 mmol/l p<0.05) and malondialdehyde levels were higher (2.2±1.17 nmol/ml vs. 0.60±0.20 nmol/ml p<0.05) in all dialysis patients compared to the control group. After one hemodialysis session, there were no significant alterations in parameters for either type of dialysis membrane. Conclusion: All dialysis patients have an increased oxidative status. A single hemodialysis session with different dialysis membranes does not seem to significantly change the oxidant or antioxidant levels

Peritonitis and Risk Factors in Peritoneal Dialysis Patients

The aim of this study was to evaluate the frequency, risk factors and treatment outcomes in continuous ambulatory peritoneal dialysis (CAPD) patients with peritonitis. Fifty-five CAPD patients followed in our peritoneal dialysis unit between January 2000-September 2003 were enrolled. Data of the patients included demographic properties, educational status, symptoms at diagnosis, physical examination findings, laboratory findings, results of peritoneal fluid cultures and the treatment was given to the patients at the beginning were collected retrospectively from their hospital files. Of the 55 patients on PD 35 peritonitis episodes was found in 23 (41.8%) patients, and tunnel infections in 4 (7.2%) patients. The most common presenting complaints of the patients with an average of 29 months prevalence of peritonitis included abdominal pain and tenderness. In 9 (25.7%) patients with peritonitis, a microorganism has been isolated from their peritoneal fluid. Of the patients experiencing peritonitis 5 (21.7%) were changed to hemodialysis while 2 (8.6%) lost their lives. Diabetes mellitus and the first 12 months of the peritoneal dialysis were determined to be risk factors for episodes of peritonitis. Peritonitis is still continues to be an important problem for the dialysis patient group. Because of the increased risk in diabetic patients and those starting peritoneal dialysis for the first time careful follow up is necessary