The assessment of oxidative stress on patients with chronic renal failure at different stages and on dialysis patients receiving different hypertensive treatment

The aim of this study is to evaluate the oxidativestress in predialysis, hemodialysis (HD) and peritoneal dialysispatients and to test the effects of antihypertensive drugsand volume control on oxidative stress parameters. The studywas composed of five groups as follows: control group(n = 30), predialysis group (n = 30), peritoneal dialysisgroup (n = 30), hemodialysis group, (normotensive withstrict volume control, n = 30), hemodialysis group (normotensivewith medication, n = 30). Plasma malondialdehyde(MDA), erythrocyte superoxide dismutase (SOD), catalase(CAT), glutathione peroxidase (GSHPx) and routine biochemicalparameters were studied in all patients. Hemodialysispatients with strict volume control (HDvc) had lowerlevels of MDA than other patient groups (p\0.001), andCAT, SOD values had highest level other patient groups(p\0.001). The treatment of hypertensionwith strict volumecontrol in chronic renal failure patients causes less damage tothe antioxidant capacity.</p

Böbrek yetmezliği hastalarında periton diyalizi ve farklı hemodiyaliz membranlarının eser element düzeyi üzerine etkisi

Hemodiyalizde kullanılan low flux ve high flux membran tipleri bulunmaktadır. Türk Nefroloji Derneği 2010 verilerine göre ülkemizde %27,5 oranında high flux, %72,5 oranında low flux membran kullanılmaktadır. Membran isimlendirmelerindeki farklılığın temel anlamı, por çapları ile ilişkilidir. High flux membranlarda por genişliği daha fazla olup, low flux membranlarda porlar daha küçük çaplıdır. Bu farklılık sonucunda, high flux membran kullanılan diyalizlerde hastada bulunan üremik toksinler, B2 mikroglobulinin temizlenmesi daha başarılı olmaktadır. Porların geniş olmasının verdiği bu avantajların yanında çeşitli dezavantajlar da bulunmaktadır ki, bunlardan biriside diyalizat sıvısında bulunan çeşitli moleküllerin kana geri geçmesi olarak bilinen backflow’dur. Bu nedenle farklı diyaliz membranları kullanılmasının, insan vücudunda bulunan eser elementlerin oranında değişikliğe neden olabileceğini hipotezine dayanarak ilgili çalışmayı planladık. Bu çalışma kapsamında, periton diyalizi ve hemodiyaliz hastalarında bulunan eser elementlerin düzeyi araştırılmış olup, yaygın olarak kullanılan hemodiyaliz membranlarının eser elementler üzerine etkisi araştırılmıştır.</p

Antibody production against COVID-19 in hemodialysis patients

ABSTRACTIntroduction: Dialysis patients may have a very high prevalence and death rate for COVID-19. The aim of this study is to show the level of antibody against SARS-CoV-2 in hemodialysis and staff working in the same dialysis center. Methods: Anti-SARS-CoV-2 IgG antibodies were studied in 156 hemodialysis patients and 27 staff. After a 5-minute resting period, blood pressure was measured and then subsequent to an approximately 12- hour fasting period, blood sample were drawn for biochemistry parameters and anti-SARS-CoV-2 IgG antibodies. Results: Three of hemodialysis patients were diagnosed with COVID-19 in March and their PCR tests were positive. The symptoms of these patients were extreme fatigue and muscle weakness. Anti-SARSCoV- 2 IgG antibodies tests were performed on all patients and staff in July. In total, 13/156 (8.3%) patients were diagnosed as COVID-19 based on anti-SARSCoV- 2 antibodies. The other 10 patients were asymptomatic. The staff and 143 hemodialysis patients had IgG (-). Hemodialysis patients who had anti-SARS-CoV-2 IgG (+) antibodies had decreased level of haemoglobin and high levels of C-reactive protein and alkaline phosphatase. Conclusions: Antibody tests are particularlyimportant for detecting people with COVID-19 who have few or no symptoms. It has also been seen that the spread of infection in the dialysis center can be prevented by very strict precautions.</p

Single-dose-dexketoprofen-induced acute kidney injury due to massive rhabdomyolysis

A 70-year-old male patient was admitted complaining of weakness and pain in his arms and lower limbs. His serum creatine kinase and serum creatinine were markedly elevated (36,248 IU/L and 2.8 mg/dL, respectively). He had taken dexketoprofen trometamol because of a common cold, which had developed the previous night. Acute kidney injury caused by dexketoprofen-induced rhabdomyolysis was diagnosed by ruling out other possible causes, such as dermato/polymyositis, myxedema, brucellosis, and hepatitis. Dexketoprofen administration was stopped. As diuresis did not restore spontaneously, the patient was treated with I.V. alkaline solutions and mannitol. Hemodialysis was performed because of anuria and severe metabolic acidosis. The patient's renal function later recovered. In conclusion, dexketoprofen may be a potential risk factor for acute kidney injury and rhabdomyolysis

The effect of hemodialysis, peritoneal dialysis and renal transplantation on nutritional status and serum micronutrient levels in patients with end-stage renal disease; Multicenter, 6-month period, longitudinal study

Purpose: Nutritional status and micronutrient levels of end stage renal disease (ESRD) patients may vary depending on the mode of renal replacement therapy (RRT). We aimed to compare the effects of hemodialysis, peritoneal dialysis (PD) and renal transplantation (RT) on micronutrient levels and nutritional status in ESRD patients. Patients and Methods: A total of 77 ESRD patients who had not received RRT were included in this prospective longitudinal study. All ESRD patients underwent a blood serum analysis that assessed the micronutrients such as selenium, copper, zinc, chromium, retinol, thiamine and vitamin B6 as well as a nutritional status assessment. After the baseline assessments and the initiation of RRT was accomplished, all patients were followed for 6 months. Results: The study showed significant improvements in subjective global assessment scores (percentage increases in score A were 26.6 and 36.6; p= 0.039 and p= 0.001; respectively), mid-arm circumference and the skin-fold thicknesses (p < 0.001, p < 0.001; respectively) in the RT and hemodialysis groups. The examinations at sixth month revealed a significant increase in body weight (4.8 kg; p= 0.002) and albumin levels (0.6 g/dL; p < 0.001) in only RT group. Zinc, thiamin and vitamin B6 were the most deficient micronutrients (44.1 %, 24.7 % and 35.1 %; respectively) in ESRD patients. There was a significant increase in selenium and retinol levels (p= 0.020 and p < 0.001; respectively) but a significant decrease in thiamin levels (p= 0.041) in RT patients. A significant increase in retinol levels (p= 0.028) and a significant decrease in thiamin levels (p= 0.022) was observed in the hemodialysis patients. However, no significant change in micronutrient levels was observed in the PD patients. Conclusion: The results support the recommendation that ESRD patients should be supplemented with watersoluble vitamins, especially thiamine and vitamin B6, and trace elements, especially zinc. RT appears to be superior to other modes of RRT when examining SGA score, anthropometric measurements, albumin and micronutrient levels