Hemodializ ünitesinde HCV antikorları prevalansı

Non-A, non-B hepatit virüsleri, hemodializ hastalarındaki hepa- titlerin en büyük sebebi gibi görünmekte olup, yüksek kronikleşme oranıyla uzun süre yaşayan hemodializ ve transplantasyon hastalarında ciddi tehdit yaratmaktadırlar. Non-A, non-

Pretransplant anti-HCV nedenli karaciğer hastalığı

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The contribution of thyroid dysfunction on cardiovascular disease in patients with chronic kidney disease

WOS: 000314785400004PubMed ID: 23206977Accelerated atherosclerosis and arterial stiffness are the two leading causes of increased cardiovascular disease in patients with chronic kidney disease. Dysfunctional thyroid hormone metabolism has been suggested to play a role in atherosclerosis and arterial stiffness. Changes in cardiac contractility and output, myocardial oxygen demand, systemic and peripheral vascular resistance, blood pressure and lipid profile, increased inflammatory burden and endothelial dysfunction may be responsible for thyroid hormone-related cardiovascular disease. This article focuses on the mechanistic insights of this association and provides a concise review of the current literature. (C) 2012 Elsevier Ireland Ltd. All rights reserved

Kronik hemodiyaliz hastalarında arteriyal sertliğin değerlendirilmesi ve ilişkili risk faktörleri

Aim: Pulse wave velocity (PWV) and augmentation index (AI) are indicators of arterial stiffness and non invasive methods of detecting the severity of vascular injury. This study included large sample size and evaluated PWV and AI in chronic hemodialysis (HD) patients to detect the related risk factors. Method: 881 patients on chronic HD program (44% females) were included in this study. PWV and AI of the patients measured by single operator using pulse wave analysis device (Sphygmocor). Pulse wave was measured from carotid-radial distance. Aortic AI was obtained from aortic pulse wave forms derived from radial artery .for all patients, left ventricular geometry was evaluated by echocardiography and volume status was evaluated by bioimpedence device. Results: The average PWV in patient group was 10.0;plusmn; 2.5 m/s, average AI was 27;plusmn;11%. AI -HR75, the heart rate corrected form at 75 beat/minute of AI was found to be 29;plusmn;11%. PWV and AI were found above limit value in 29% and 67% of the patients respectively. A positive relation was found between PWV and AI. when patients with high and normal AI were compared, albumin values were lower while average blood pressure values, cardiothoracic ratio(CTR) were higher and ejection time longer in patients with high AI. AI had a negative relation with height and weight. AI 75 was also negatively related to height and weight. In patients with high AI75 more patients had left ventricular hypertrofy (LVH). Male patients percentage and average blood pressure was higher in patients with high PWV. In the analysis of PWV of the subgroup (n:408 patients), evident interdialytic weight increase was present in the group with PWV of ;amp;#8805; 11.5 m/ sc compared to the group of ;lt; 8.5 m/sc. Conclusion: measures that can be used to evaluate vascular stiffness like PWV and AI are related to average arterial blood pressure, cardiothoracic ratio, hypoalbuminemia, interdialytic weight increase. We think that the relation between these parameters and cardiovascular morbidity and mortality will become clear in the follow up of our hemodialysis patients.Amaç: Arteryel sertliğin göstergelerinden olan nabız dalga hızı (NDH) ve artırma göstergesi (AG), vasküler hasarın şiddetini belirlemede kullanılan invaziv olmayan yöntemlerdir. Geniş hasta sayısı içeren bu çalışmada, kronik HD hastalarında NDH ve AG değerlendirilerek, ilişkili olduğu risk faktörlerinin belirlenmesi amaçlandı. Yöntem: Kronik HD programında olan toplam 881 hasta (%44’ü kadın) çalışmaya dahil edildi. Hastaların NDH ve AG ölçümleri nabız dalga analizi cihazı (Sphygmocor) kullanılarak, tek operatör tarafından yapıldı. NDH analizi karotid-radyal mesafeden ölçüldü. Aortik AG radyal arterden derive edilen aortik nabız dalga formlarından elde edildi. Tüm hastaların ekokardiyografi ile sol ventrikül geometrisi ve bioimpedens cihazıyla volüm durumu değerlendirildi. Bulgular: Hasta grubunun ortalama NDH değeri 10.0 ±2.5 m/s, ortalama AG % 27±11 idi. AG’nin kalp hızı ile düzeltilmiş şekli olan AG -KH75 ise %29±11 olarak saptandı. NDH hastaların %29’da, AG ise %67’de sınır değerin üstünde bulundu. AG ve NDH arasında pozitif ilişki saptandı. AG yüksek ve normal olan hastalar karşılaştırıldığında; AG yüksek olan grupta, albumin değerleri daha düşük, ortalama kan basıncı değerleri, kardiyotorasik oranları (KTO) daha yüksek ve ejeksiyon süreleri daha uzun saptandı. AG boy ve kilo negatif ilişkili idi. AG 75 kilo ve boy ile negatif ilişkiliydi. AG 75 yüksek olanlarda, sol ventrikül hipertrofili (LVH ) hasta oranı daha çoktu. NDH değeri yüksek olan grupta erkek hasta oranı ve ortalama kan basıncı değerleri yüksek bulundu. Alt grup analizinde (n:408 hasta) NDH değeri ? 11. 5 m/sn olan grupta, 8. 5 m/sn olana göre belirgin artmış interdiyalitik ağırlık artışı vardı. Sonuç: Hemodiyaliz hastalarında, NDH ve AG gibi damar sertliğinin göstergesi olabilecek ölçümler, ortalama arter kan basıncı, kardiyotorasik oran, hipoalbuminemi, interdiyalitik ağırlık artışı ile ilişkiliydi. Bu parametrelerin kardiyovasküler morbidite ve mortalite ile ilişkisi hemodiyaliz hasta topluluğumuzun takipleri sırasında açıklık kazacağını düşünüyoruz

Acute glomerulonephritis and myocarditis due to Coxsackie B

A young boy, who suffered from a febrile upper respiratory tract infection 10 days before admission, had symptoms of acute glomerulonephritis with decreased urine volume, swelling of the feet and dyspnea. Renal biopsy showed diffuse cellular proliferation of the glomeruli compatible with healing acute post infectious glomerulonephritis. The normal values ofASO tit¬ter and C degree suggested that the glomerulonephritis was non-streptococcal in origin. Although the symptoms of congestion has improved rapidly with therapy, the echocardiographic findings such as global hypokinesia, low ejection fraction and dilation of the right atrium, ST-T wave changes in the electrocardiography and elevated serum levels of CPK showed coexistence of myocarditis. Tests for neutralization showed a recent Coxsackie B2 or B3 virus infection.A young boy, who suffered from a febrile upper respiratory tract infection 10 days before admission, had symptoms of acute glomerulonephritis with decreased urine volume, swelling of the feet and dyspnea. Renal biopsy showed diffuse cellular proliferation of the glomeruli compatible with healing acute post infectious glomerulonephritis. The normal values ofASO tit¬ter and C degree suggested that the glomerulonephritis was non-streptococcal in origin. Although the symptoms of congestion has improved rapidly with therapy, the echocardiographic findings such as global hypokinesia, low ejection fraction and dilation of the right atrium, ST-T wave changes in the electrocardiography and elevated serum levels of CPK showed coexistence of myocarditis. Tests for neutralization showed a recent Coxsackie B2 or B3 virus infection