Browsing by Author "Ataman, Rezzan"
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Publication Arm circumference: Its importance for dialysis patients in the obesity era(Springer, 2013-08-01) Akpolat, Tekin; Kaya, Coskun; Utaş, Cengiz; Arınsoy, Turgay; Taskapan, Hulya; Erdem, Emre; Yılmaz, M. Emin; Ataman, Rezzan; Bozfakioglu, Semra; Özener, Cetin; Karayaylalı, İbrahim; Kazancıoğlu, Rumeyza; Camsarı, Taner; Ersoy, Fevzi; Duman, Soner; Ateş, Kenan; Yavuz, Mahmut; YAVUZ, MAHMUT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.The purposes of this study were to investigate the association between arm circumference and body mass index (BMI) and to discuss problems, mainly arm circumference and cuff size mismatch, that could affect the reliability of home blood pressure monitoring (HBPM) among peritoneal dialysis (PD) and hemodialysis (HD) patients.525 PD and 502 HD patients from 16 centers were included in the study. A two-part questionnaire was used to gather information from the participants. Arm circumferences were categorized into four groups according to the British Hypertension Society cuff size recommendations.Mean BMI and arm circumference of all participants were 25.0 kg/m(2) and 27.6 cm, respectively. There was a significant correlation between BMI and arm circumference. The mean BMI and arm circumference values were higher in PD patients than in HD patients. Requirement of a large-sized adult cuff was more common among PD patients compared to HD patients (14 % vs 8 %, p = 0.002).Since HBPM is a useful tool for clinicians to improve BP control, nephrologists should be aware of the problems related to HBPM in dialysis patients and take an active role to increase the reliability of HBPM.Item Body pain during daily activities in patients on peritoneal dialysis(Wiley-Blackwell, 2005-02) Taşkapan, Hülya; Ersoy, Fettah Fevzi; Passadakis, Ploumis S.; Tam, Paul Y. W.; Memmos, Dimitrios E.; Katopodis, Konstantinos P.; Özener, Çetin Islak; Akçiçek, Fehmi; Çamsarı, Taner; Ateş, Kenan Bahri; Ataman, Rezzan; Vlachojannis, John George; Dombros, Nicholas V.; Utaş, Cengiz; Akpolat, Tekin; Bozfakioǧlu, Semra; Wu, George G.; Karayaylali, İbrahim; Arınsoy, Turgay; Stathakis, Charalambos P.; Yavuz, Mahmut; Tsakiris, Dimitrios J.; Dimitriades, Athanasios C.; Yılmaz, Mehmet Emin; Gültekin, Meral; Polat, Nese; Oreopoulos, Dimitrios George; Yavuz, M.; Uludağ Üniversitesi.; 7006244754Objective. To review the prevalence of body pain during daily activities in patients on peritoneal dialysis (PD) and to correlate it with various demographic and renal osteodystrophy markers such as calcium (Ca), phosphorus (P), intact parathyroid hormone (iPTH), and vitamin D-3 levels. Methods. A cross-sectional study was conducted involving 530 chronic PD patients (44.3 % female, 55.6 % male) from 24 centers in Canada, Greece, and Turkey. Pain severity scoring during daily activities was performed using the pain scoring table of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results. The overall prevalence of pain was 52.9 % (61.3 % in females and 49.5 % in males, p < 0.05). Morning stiffness was reported by 23.6 % of the patients, and diminished range of movement by 20 %. The mean age, weight, and body mass index were higher in patients with pain than in those without (p < 0.05). There was no statistically significant difference between patients with pain and those without pain with respect to their mean serum iPTH, Ca, P, Ca x P, ionized Ca, or bone alkaline phosphatase levels (p > 0.05). Mean serum 25-hydroxyvitamin D-3 [25(OH)D-3] levels were lower in patients with pain compared to those without pain (p < 0.05). Conclusions. A high percentage of the PD patients (53 %) had body pain; iPTH levels and other biochemical parameters of renal osteodystrophy were not different between those with and without pain. Patients with pain had lower 25(OH)D-3 levels than did those without. Factors such as age, gender, obesity, and metabolic factors may interact to cause varying degrees of articular/bone pain in patients on PD. Since vitamin D deficiency aggravates the signs and symptoms of joint disease such as pain and stiffness, one should attempt to correct levels of 25(OH)D-3, as well as 1,25(OH)(2)D-3 levels, in these patients.Item Bone mineral density and its correlation with clinical and laboratory factors in chronic peritoneal dialysis patients(Sprınger Japan KK, 2006) Ersoy, Fettah Fevzi; Passadakis, Stauros Ploumis; Tam, Paul; Memmos, Evaggelos Dimitros; Katopodis, Pericles Konstantinos; Çetin Özener, Çetin Özener; Fehmi Akçiçek, Fehmi Akçiçek; Çamsarı, Taner; Ateş, Kenan; Stathakis, Panagiotis Charalampos; Arınsoy, Turgay; Karayaylalı, İbrahim; Wu, George; Bozfakıoğlu, Semra; Akpolat, Tekin; Utaş, Cengiz; Dombros, Athanasios Nicholas; Vlachojannis, John George; Ataman, Rezzan; Yardımsever, Mehmet; Karayalçın, Binnur; Gültekin, Meral; Yılmaz, Mehmet Emin; Dimitriades, Chrysostomos Athanasios; Tsakiris, John Dimitrios; Yavuz, Mahmut; Uludağ Üniversitesi/Tıp Fakültesi.; 7006244754The aim of this study was to assess the clinical and laboratory correlations of bone mineral density (BMD) measurements among a large population of patients on chronic peritoneal dialysis (PD). This cross-sectional, multicenter study was carried out in 292 PD patients with a mean age of 56 +/- 16 years and mean duration of PD 3.1 +/- 2.1 years. Altogether, 129 female and 163 male patients from 24 centers in Canada, Greece, and Turkey were included in the study. BMD findings, obtained by dual-energy X-ray absorptiometry (DEXA) and some other major clinical and laboratory indices of bone mineral deposition as well as uremic osteodystrophy were investigated. In the 292 patients included in the study, the mean lumbar spine T-score was -1.04 +/- 1.68, the lumbar spine Z-score was -0.31 +/- 1.68, the femoral neck T-score was -1.38 +/- 1.39, and the femoral neck Z score was -0.66 +/- 1.23. According to the WHO criteria based on lumbar spine T-scores, 19.2% of 292 patients were osteoporotic, 36.3% had osteopenia, and 44.4% had lumbar spine T-scores within the normal range. In the femoral neck area, the prevalence of osteoporosis was slightly higher (26%). The prevalence of osteoporosis was 23.3% in female patients and 16.6% in male patients with no statistically significant difference between the sexes. Agreements of lumbar spine and femoral neck T-scores for the diagnosis of osteoporosis were 66.7% and 27.3% and 83.3% for osteopenia and normal BMD values, respectively. Among the clinical and laboratory parameters we investigated in this study, the body mass index (BMI) (P < 0.001), daily urine output, and urea clearance time x dialysis time/volume (Kt/V) (P < 0.05) were statistically significantly positive and Ca x PO4 had a negative correlation (P < 0.05) with the lumbar spine T scores. Femoral neck T scores were also positively correlated with BMI, daily urine output, and KT/V; and they were negatively correlated with age. Intact parathyroid hormone levels did not correlate with any of the BMD parameters. Femoral neck Z scores were correlated with BMI (P < 0.001), and ionized calcium (P < 0.05) positively and negatively with age, total alkaline phosphatase (P < 0.05), and Ca x P (P < 0.01). The overall prevalence of fractures since the initiation of PD was 10%. Our results indicated that, considering their DEXA-based BMD values, 55% of chronic PD patients have subnormal bone mass-19% within the osteoporotic range and 36% within the osteopenic range. Our findings also indicate that low body weight is the most important risk factor for osteoporosis in chronic PD patients. An insufficient dialysis dose (expressed as KT/V) and older age may also be important risk factors for osteoporosis of PD patients.Item The prevalence and clinical features of Tuberculous Peritonitis in CAPD patients in Turkey, report of ten cases from multi-centers(Taylor and Francis, 2003) Karayaylalı, İbrahim; Seyrek, Neslihan; Akpolat, Tekin; Ateş, Kenan; Özener, Çetin; Yılmaz, Mehmet Emin; Utaş, Cengiz; Akçiçek, Fehmi; Arınsoy, Turgay; Ataman, Rezzan; Bozfakioğlu, Semra; Çamsarı, Taner; Ersoy, Fevzi; Yavuz, Mahmut; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Bilim Dalı.; 7006244754Objective. To determine the rate, risk factors and outcome of Tuberculous Peritonitis (TBP) in patients treated with continuous ambulatory peritoneal dialysis (CAPD) in our units. Design. Retrospectively, we reviewed the medical data of all CAPD patients from 12 centers for TBP, covering the period between 1986 and December 2002. Setting. All patients were from 12 renal clinics at tertiary-care university hospitals. Results. Ten cases of TBP were identified among the CAPD patients in our centers. There were five male and five female patients with a mean age of 37.2 years. None of the patients had tuberculosis history, 6 patients had predominance of PNL. One patient had coincidental bacterial peritonitis. Two patients were successfully treated without the removal of the Tenckhoff catheter. Conclusion. TBP in CAPD patients is a very rare complication. In contrast to predominance of lymphocytes in nonuremic patients with tuberculous peritonitis, CAPD patients with tuberculous peritonitis may have predominance of PNL on examination of the peritoneal fluid. Since TBP has high morbidity and mortality, early diagnosis and treatment of disease are extremely important for improving outcome.Item The rate, risk factors, and outcome of fungal peritonitis in CAPD patients: Experience in Turkey(Sage Publications, 2000) Taşkapan, Hülya; Özener, Çetin; Ateş, Kenan; Akçiçek, Fehmi; Yılmaz, Muzaffer; Ataman, Rezzan; Bozfakioğlu, Semra; Camsarı, Taner; Ersoy, F. Fevzi; Karayaylalı, İbrahim; Akpolat, T.; Utaş, Cengiz; Yavuz, Mahmut; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.Continuous ambulatory peritoneal dialysis (CAPD) is an increasingly popular replacement therapy for patients with end-stage renal disease (ESRD). However, peritonitis continues to be a frequent complication of CAPD. Pathogenic bacteria and a small number of fungi cause the majority of cases of peritonitis. In most series, about 2% – 10% of CAPD-related peritonitis episodes have a fungal etiology. About 80% – 90% of fungal peritonitis (FP) episodes are caused by yeasts of the Candida species, less frequently by a variety of other yeasts and filamentous fungi. Fungal peritonitis is often a major cause of treatment failure in patients on CAPD and carries high risk of morbidity and mortality. The risk factors that predispose to the development of FP and regimens for FP treatment are not clear. In an attempt to identify the rate and risk factors for FP, and to examine outcome in relation to treatment strategies, we reviewed our experience with FP in this multicenter study.Item What is the optimal dwell time for maximizing ultrafiltration with icodextrin exchange in automated peritoneal dialysis patients?(Sage Publications, 2006) Jeloka, Tarun K.; Ersoy, Fevzi F.; Sahu, Krishna M.; Camsari, aner; Utaş, Cengiz; Bozfakioğlu, Semra; Özener, Çetin; Ateş, Kenan; Ataman, Rezzan; Akçiçek, Fehmi; Akpolat, Tekin; Karayaylalı, İbrahim; Arınsoy, Turgay; Mehmet, Emin Yılmaz; Süleymanlar, Gültekin; Burdzy, Dorothy; Oreopoulos, Dimitrios G.; Yavuz, Mahmut; Uludağ Üniversitesi/Tıp Fakültesi.; 7006244754Background: Icodextrin is increasingly being used in automated peritoneal dialysis (APD) for the tong dwell exchange to maintain adequate ultrafiltration (UF). However, the UF reported in the literature varies with different dwelt times: from 200 to 500 mL with 12 - 15 hour dwells. In order to maximize UF, it is important to know the relationship between dwell time and UF when using icodextrin in APD patients. With this knowledge, decisions can be made with respect to dwelt period, and adjustments to the dialysis prescription can be made accordingly. Methods: We prospectively studied this relationship in 36 patients from Canada and Turkey. All patients did the icodextrin day exchange manually after disconnecting themselves from overnight cycler dialysis. Dwell period was increased by 1 hour every week, from 10 to 14 hours. Ultrafiltration was noted for each icodextrin exchange. Mean UF for each week (i.e., dwell period) was compared by repeated measures ANOVA. Results: We found no difference in mean UF with increasing dwelt time: 351.73 +/- 250.59 mL at 10 hours versus 371.75 +/- 258.25 mL at 14 hours (p = 0.83). We also compared mean UF between different subgroups and found that mates (p = 0.02 vs females) and high transporters (p = 0.04 vs low) had higher mean UF. Further analysis of maximal UF showed no correlation to age, sex, diabetic status, transport category, creatinine clearance, Kt/V, duration on peritoneal dialysis, or duration of icodextrin use. Conclusion: Icodextrin-related UF in APD patients is not related to demographic factors and does not increase significantly beyond 10 hours.