Browsing by Author "Bozfakioğlu, Semra"
Now showing 1 - 5 of 5
- Results Per Page
- Sort Options
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 Renal replacement therapies in the aftermath of the catastrophic Marmara earthquake(Blackwell Publishing, 2002-12) Sever, Mehmet Şükrü; Erek, Ekrem; Vanholder, Raymond; Yürügen, Birsen; Gülçin, Kantarcı; Hülya, Ergin; Bozfakioğlu, Semra; Dalmak, S.; Tülbek, M. Yaşar; Kiper, Halil; Lameire, N.; Yavuz, Mahmut; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Nefroloji Bilim Dalı.Background. Renal replacement therapy is of vital importance in the treatment of crush syndrome victims, who are frequently encountered after catastrophic earthquakes. The Marmara earthquake, which struck Northwestern Turkey in August 1999, was characterized by 477 victims who needed dialysis. Method. Within the first week of the disaster, questionnaires containing 63 clinical and laboratory variables were sent to 35 reference hospitals that treated the victims. Information considering the features of dialyses obtained through these questionnaires was submitted to analysis. Results. Overall, 639 casualties with renal complications were registered, 477 of whom (mean age 32.3 +/- 13.7 years, 269 male) needed dialysis. Among these, 452 were treated by a single dialysis modality (437 intermittent hemodialysis, 11 continuous renal replacement therapy and 4 peritoneal dialysis), while 25 victims needed more than one type of dialysis. In total, 5137 hemodialysis sessions were performed (mean 11.1 +/- 8.0 sessions per patient) and mean duration of hemodialysis support was 13.4 +/-9.0 days; this duration was shorter in the non-survivors (7.0 +/-8.7 vs. 10.0 +/- 9.8 days, P = 0.005). Thirty-four victims who underwent continuous renal replacement therapy had higher mortality rates (41.2 vs. 13.7%, P < 0.0001). Only eight victims were treated by peritoneal dialysis, four of whom also required hemodialysis or continuous renal replacement therapy. The mortality rate in the dialyzed victims was 17.2%, a significantly higher figure compared to the mortality rate of the non-dialyzed patients with renal problems (9.3%; P = 0.015). Conclusion. Substantial amounts of dialysis support may be necessary for treating the victims of mass disasters complicated with crush syndrome. Dialyzed patients are characterized by higher rates of morbidity and mortality.Item Severe vitamin D deficiency in chronic renal failure patients on peritoneal dialysis(Dustri-Verlag Dr Karl Feistle, 2006) Taşkapan, Hülya; Ersoy, F. Fevzi; Passadakis, Ploumis; Tam, Paul; Memmos, Dimitrios; Katopodis, K. P.; Özener, Çetin; Akçiçek, Fehmi; Çamsarı, Taner; Ateş, Keven; Ataman, Muveddet Rezzan; Vlachojannis, J. G.; Dombros, N.; Utas, Cengiz; Akpolat, T.; Bozfakioğlu, Semra; Wu, G.; Karayaylalı, İbrahim; Arınsoy, Turgay; Stathakis, C.; Tsakiris, Dimitrios A.; Dimitriades, A. D.; Yılmaz, Muzaffer; Gültekin, Meral; Oreopoulos, D.G.; Yavuz, Mahmut; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Nefroloji Bilim Dalı.; 7006244754The aim of this study was to evaluate the prevalence of vitamin D deficiency in chronic renal failure (CRF) patients on peritoneal dialysis (PD) and to correlate the findings with various demographic and renal osteodystrophy markers. Method: This cross-sectional, multicenter study was carried out in 273 PD patients with a mean age of 61.7 +/- 10.9 years and mean duration of PD 3.3 +/- 2.2 years. It included 123 female and 150 male patients from 20 centers in Greece and Turkey, countries that are on the same latitude, namely, 36 - 42 degrees north. We measured 25(OH)D-3 and 1.25(OH)(2)D-3 levels and some other clinical and laboratory indices of bone mineral metabolism. Results: Of these 273 patients 92% (251 patients) had vitamin D deficiency i.e. serum 25(OH)D-3 levels less than 15 ng/ml, 119 (43.6%) had severe vitamin D deficiency i.e. serum 25(OH)D-3 levels, less than 5 ng/ml, 132 (48.4%) had moderate vitamin D deficiency i.e. serum 25(OH)D3 levels, 5 - 15 ng/ml, 12 (4.4%) vitamin D insufficiency i.e. serum 25(OH)D3 levels 15 - 30 ng/ml and only 10 (3.6%) had adequate vitamin D stores. We found no correlation between 25(OH)D-3 levels and PTH, serum albumin, bone alkaline phosphatase, P, and Ca x P. In multiple regression analyses, the independent predictors of 25(OH)D-3 were age, presence of diabetes (DM-CRF), levels of serum calcium and serum 1.25(OH)(2)D-3- Conclusion: We found a high prevalence (92%) of vitamin D deficiency in these 273 PD patients, nearly one half of whom had severe vitamin D deficiency. Vitamin D deficiency is more common in DM-CRF patients than in non-DM-CRF patients. Our findings suggest that these patients should be considered for vitamin D supplementation.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.