Is dialysis adequacy a useful predictor for sexual function in males and females with end-stage renal disease?

Introduction: The development of sexual dysfunction (SD) in dialysis patients is multifactorial. We aimed to evaluate whether adequate dialysis had an effect on the development of SD in male and female patients undergoing dialysis due to end stage renal disease. Anxiety, depression, health-related quality of life and the other risk factors related to dialysis were also evaluated in terms of SD

Effect of Intravenous Active Vitamin-D Treatment on the Left Ventricular Mass Index in Chronic Hemodialysis Patients with Secondary Hyperparathyroidism

Objective: We investigated the effect of active D vitamin therapy on echocardiographic examination results in hemodialysis patients with hyperparathyroidism. Materials and Methods: This prospective study involved 20 patients who undergoing HD for a total of 12 hours per week at least 6 months. Patients with serum intact parathormone level (iPTH) >= 20.8 pmol/L, phosphorus level 3.5 - 5.5 mg/dL, calcium level <9.5 mg/dL included in this study. Before and after 6 months active vitamin D treatment, left ventricular mass index (LVMI) of all patients were investigated by echocardiography. Results: The mean age was 51.2 +/- 15.0 Ten patients were female and ten patients were male. The mean iPTH level in serum before and six months after active vitamin-D treatment were 35.97 +/- 16.41 and 24.92 +/- 13.28 pmol/L respectively (p<0.001). Before and six months after active vitamin-D treatment the mean LVMI were 294.40 +/- 103.2 gr/m(2) and 250.40 +/- 101.44 gr/m(2) respectively. LVMI was statistically significant decreased after six months treatment compared to before treatment (p<0.001). Conclusion: Increased serum iPTH levels in patients undergoing HD decrease with active vitamin-D treatment and this results in significant reduction in LVMI. Our results show that treatment of hyperparathyroidism plays an important role in correcting LVH

Comparison of geriatric nutritional risk index and creatinine index in short-term mortality prediction in maintenance hemodialysis patients

Background/aim: The aim of this study is to analyze and compare the predictive values of the Geriatric Nutritional Risk Index (GNRI) and Creatinine Index (CI) in the short-term mortality of maintenance hemodialysis patients and to determine their best cut-offs. Material and Methods: A total of 169 adult hemodialysis patients were included in this retrospective, cross-sectional, and single-center study. The demographic, clinical, and laboratory data of the month in which the patients were included in the study were obtained from their medical files and computer records. All-cause death was the primary outcome of the study during a 12-month follow-up alter baseline GNRI and CI calculations. Results: The mean age of the study population was 57 +/- 16 years (49.7% were women, 15% were diabetic). During the one-year observation period, 19 (11.24%) of the cases died (8 CV deaths). The optimal cut-off value for GNRI was determined as 104.2 by ROC analysis [AUC = 0.682 +/- 0.06, (95% CI, 0.549-0.815), p = 0.01]. The low GNRI group had a higher risk for all-cause and CV mortality compared to the higher GNRI group (p = 0.02 for both in log-rank test). The optimal sex-specific cut-off was 12.18 mg/kg/day for men [AUC = 0.723 +/- 0.07, (95% CI, 0.574-0.875), p = 0.03] and was 12.08 mg/kg/day for females [AUC = 0.649 +/- 0.13, (95% CI, 0.384- 0.914), p = 0.01]. Patients with lower sex-specific CI values had higher all-cause and CV mortality (p = 0.001 and p = 0.009 in log-rank test, respectively). In multivariate cox models, both GNRI [HR = 4.904 (% 95 CI, 1.77-13.56), p = 0.002] and sex-specific CI [HR = 5.1 (95% CI, 1.38-18.9), p = 0.01] predicted all-cause mortality. The association of GNRI with CV was lost [HR = 2.6 (CI 95%, 0.54-13.455), p = 0.22], but low CI had a very strong association with CV mortality [HR = 11.48 (CI 95%, 1.25 -104), p = 0.03]. Conclusion: In hemodialysis patients, GNRI and CI have similar powers in predicting all-cause short-term mortality. The association of CI with all-cause death depends on gender. On the other hand, sex-specific CI predicts CV mortality better than GNRI

Leptin Parameters are Associated with Inflammation and Both Anthropometric and Serum Markers of Protein-Energy Wasting in Hemodialysis Patients

OBJECTIVE: Protein-energy wasting (PEW) and inflammation are common and related to increased cardiovascular mortality in hemodialysis (HD) patients. Herein, we aimed to investigate the relationships between adipocytokines, inflammation and serum and anthropometric markers of PEW syndrome in HD patients

Pregnancy and its outcomes in hemodialysis patients in Turkey

Background/aim: This study aimed to investigate pregnancy frequency and evaluate the factors affecting live births in hemodialysis (HD) patients. Materials and methods: Female HD patients whose pregnancy was retrospectively reported between January 1, 2014, and December 31, 2019. The duration of HD, primary disease, and the information on whether the pregnancy resulted in abortion, stillbirth, or live birth, whether the HD duration was prolonged after diagnosing the pregnancy and whether it accompanied preeclampsia were recorded. Results: In this study, we reached 9038 HD female patients' data in the study. A total of 235 pregnancies were detected in 145 patients. The mean age was 35.42 (35 +/- 7.4) years. The mean age at first gestation was 30.8 +/- 6.5 years. The average birth week was 32 (28 -36) weeks. A total of 53.8% (no = 78) of the patients had live birth, 51.7% (no = 70) had at least one abortion in the first 20 weeks, and 13.1% (no = 19) had at least one stillbirth after 20 weeks. The rate of patients' increased numbers of dialysis sessions during pregnancy was 71.7%. The abortion rate was 22.4% in those with increased HD sessions, whereas 79.3% in those not increased HD sessions (p < 0.001). Live birth frequency was 67.2% in the increased HD sessions group and 3.4% in those who did not differ in HD sessions (p < 0.001). Conclusion: For the first time, we reported pregnancy outcomes in HD female patients, covering all regions of Turkey. It has been observed that; increasing the number of HD sessions in dialysis patients will decrease fetal and maternal complications and increase live birth rates