The Research of Sleep Disorders and Their Effects on Quality of Life in Patients with Chronic Renal Failure and Renal Transplant

Objective End stage renal insufficiency (ESRI) is defined as the irreversible loss of renal functions. In its treatment is used hemodialisis, peritoneal dialisis or renal transplantation. Sleep disorders cause excesive daytime sleepiness, mental problems, dysfunction in general health and functions; and therefore affect the quality of life in patients with ESRI. In this study is evaluated the relationship between sleep quality and the qulity of life in patients with hemodialisis, peritoneal dialisis and renal transplantation. Materials and Methods A total of 117 patients being treated in Uludağ University Faculty of Medicine Dialisis Unit between years 2011-2012 were enrolled. Pittsburg Sleep Quality Index (PSQI) were used to determine sleep quality of patients, and Epworth Sleepiness Scale (EUS) and Rolls Royce Quality of Life Scale were used. Results In PSQI, poor sleep quality was observed in 81.5% of patients with hemodialisis, which was 80.8% in patients with renal transplantation and 82% in patients with peritoneal dialisis. In Rolls-Royce Quality of life scale, general health, physical symptoms and activities were higher in patients with renal transplantation, and sleep disorders were higher in patients with hemodialisis. Conclusion Chronic renal insufficiency is a very common condition. Sleep disorders in these patients may affect self-care and show a negative influence on the quality of life. Fort his reason, sleep disorders should be questioned and treated in these chronically ill patients with ESRI

Case reports of hyperthyroidism after kidney transplantation: a review of literature

Different disturbances of thyroid hormones in the absence of concurrent thyroid disease have been reported in patients on maintenance hemodialysis. After a successful kidney transplant, thyroid hormone metabolism normalizes. Although increased frequency of goiter and thyroid adenomas have been observed, hyperthyroidism is very rare. Herein, we report two kidney transplant recipients under immunosuppressive therapy that presents with hyperthyroidism. [Med-Science 2017; 6(2.000): 361-4

The Effect of Trandolapril on Insulin Resistance is Determined by the Degree of Baseline Resistance Level

Insulin resistance (IR) is the core problem in type 2 diabetes mellitus that may lead to cardiovascular morbidity and mortality. Hypertension commonly accompanies type 2 diabetes. Antihypertensive agents improving IR may reduce the risk of cardiovascular diseases. This study was conducted to assess the effect of trandolapril on IR, glucose and lipid metabolisms in hypertensive subjects with different degrees of IR and investigate the importance of IR level in angiotensin converting enzyme inhibitor response. The subjects were nondiabetic and type 2 diabetic hypertensive patients treated with trandolapril for 12 weeks. Blood pressures (BP) and metabolic parameters were measured in all patients at baseline and after 12 weeks of trandolapril treatment and compared. Trandolapril reduced BP similarly in nondiabetic and diabetic patients. Homeostasis model assessment insulin resistance (HOMA-IR), serum glucose and hemoglobin A1C (A1C) in diabetic patients were higher than nondiabetics. HOMA-IR (from 9.0  1.0 to 6.6  0.7, p4.67 responded better. In conclusion, trandolapril improved insulin sensitivity better in type 2 diabetic hypertensive patients with higher degree of IR compared with the ones with low grade IR, being independent of its hemodynamic action. [Med-Science 2014; 3(2.000): 1140-54

Medicine Science 2014;3(2):1140-54 Trandolapril and insulin resistance Original Investigation The Effect of Trandolapril on Insulin Resistance is Determined by the Degree of Baseline Resistance Level Trandolapril and insulin resistance Original Investigat

Abstract Insulin resistance (IR) i

Losartan and QT Dispersion in Hypertensive Patients on Maintenance Hemodialysis

QT and corrected QT (QTc) intervals and their increased dispersions (QTd, QTcd) have been linked to the occurrence of arrhythmias in hemodialysis (HD) patients. This study was performed to determine the effects of the angiotensin II receptor blocker losartan on these parameters in HD patients. Our cohort comprised 24 dialysis patients and 14 healthy controls. 15 dialysis patients were treated for 16 weeks with losartan (HD losartan group) but not 9 patients (HD control group). Blood pressures (BP) and electrocardiogram-derived data (Sokolow-Lyon and Cornell voltages, QT, QTd, QTc and QTcd) were measured in all patients. At the beginning of the study, there were no differences in patient characteristics among the 3 groups. Baseline maximum QTc, QTd, QTcd and Socolow-Lyon and Cornell voltages and BPs of the healthy group were lower than those of HD groups. While these parameters were similar in the dialysis groups, only BPs in losartan group were higher. After 16 weeks, BPs, Socolow-Lyon and Cornell voltages values in losartan group significantly decreased but not in the HD control group. Whereas maximum QT and QTc, QTd, QTcd, heart rate and QRS interval did not change in the HD groups. Electrocardiographic LVH of 2 patients improved in the losartan group. Losartan reduced BP and electrocardiographic LVH was improved in HD patients without affecting QTd and QTcd during the 16-week study period. [Med-Science 2014; 3(4.000): 1627-38

Comparison of different sexual dysfunction scales in females patients on renal replacement therapy

Bu çalışma, 28-31, Mayıs 2015 tarihlerinde London[İngiltere]’de düzenlenen 52. Congress of the European-Renal-Association-European-Dialysis-and-Transplant-Assocation Kongresi‘nde bildiri olarak sunulmuştur.European Renal Assoc;European Dialysis & Transplant Asso

Effect of parathyroidectomy timing in kidney transplant recipients on graft function

Objectives: Persistent hyperparathyroidism can have a deleterious effect on graft function in kidney transplant recipients, although serum calcium, phosphorus, and parathyroid hormone levels tend to normalize after successful transplant. Parathyroidectomy can result in sustained amelioration of persistent hyperparathyroidism despite graft failure risk and unfavorable graft outcomes. Data on this issue are limited and conflicting. Here, we evaluated the effects of parathyroidectomy on graft function in kidney transplant recipients.Materials and Methods: This retrospective study included 249 adult kidney transplant recipients (121 deceased-donor/128 living-donor; 142 males/107 females; mean age of 39.3 +/- 11.6 y; mean follow-up of 46.5 +/- 23.5 mo). Participants were grouped as those without (n = 222), those with pretransplant (n = 12), and those with posttransplant (n = 15) parathyroidectomy. Graft outcomes and serum calcium, phosphorus, and parathyroid hormone levels were studied.Results: Serum calcium levels at baseline and at 1, 3, 6, and 12 months and parathyroid hormone levels at baseline and at 6 and 12 months were higher and serum phosphorus levels at 3, 6, and 12 months were lower in the posttransplant parathyroidectomy group versus the other groups (P .05).Conclusions: Parathyroidectomy resulted in sustained decreased levels of serum calcium and parathyroid hormone. We observed no graft failure risk associated with parathyroidectomy in our study. Parathyroidectomy before transplant is advantageous with better graft function

The effect of calcineurin inhibitors on anthropometric measurements in kidney transplant recipients

Background This study was designed to investigate the effect of calcineurin inhibitors (CNIs), cyclosporine (CsA), and tacrolimus (Tac) on anthropometrics in kidney transplant recipients. Methods 111 of 128 adult kidney transplant recipients who received post-transplant CNIs were included in this retrospective study. Anthropometrics were recorded in the pre-transplant and post-transplant 4-year follow-up periods (1(st), 3(rd), 6(th), 12(th), 24(th), 36(th) and 48(th) months). Results Compared to pre-transplant values, significant increases in body weight and body mass index (between 3(rd) and 48(th) months), waist and hip circumferences (between 1(st) and 48(th) months), waist-to-hip ratio (between 1(st) and 3(rd) or 6(th) months) and neck circumference (between 1(st) and 12(th) or 24(th) months) were observed in both CsA and Tac groups. A significant increase was noted in post-transplant body fat percentage values for the 3(rd) to 24(th) months in the CsA group, whereas for the 24(th) to 48(th) months in both CsA and Tac groups. Hip circumferences percentage changes from the pre-transplant period to the 1(st), 12(th) and 24(th) months were significantly higher in CsA than in the Tac group. At each time point, there was no significant difference in percentage changes for other anthropometric parameters between the CsA and Tac groups. De novo diabetes mellitus developed in 8.3% of the CsA group and 19.1% of the Tac group. Conclusions After a successful kidney transplant, anthropometric measurements increase in most recipients. Although the effect of calcineurin inhibitor type on weight gain is unclear, a regression analysis showed that CNI type was not a risk factor for the development of obesity in the 48(th) month. However, it is helpful to be cautious about its dyslipidemic effect in patients using CsA and the potential hazards of using Tac in patients with a diabetic predisposition

A Rare Cause of Primary Hyperparathyroidism Presented with Giant Adenoma, Multiple Brown Tumors And End Stage Renal Failure

Single gland adenoma is the most common cause of primary hyperparathyroidism (PHPT). Although PHPT is generally an asymptomatic disease detected by an incidental finding of hypercalcemia, overt skeletal disease, renal failure and huge adenoma that cause local pressure can be seen seldomly in neglected cases. We report a case of a parathyroid adenoma weighing 116 g (normal weight 25 - 40 mgs)causing multiple brown tumors, renal failure and refractory anemia. [Med-Science 2014; 3(2.000): 1262-8