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1.
Ther Apher Dial ; 28(2): 284-296, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37932586

RESUMO

INTRODUCTION: We aimed to evaluate the relationship between the hand fine motor skills of peritoneal dialysis (PD) practitioners and PD-related peritonitis. METHODS: This multicenter prospective observational study was conducted with 120 incident PD patients. Patients were divided into two groups who had PD-related peritonitis within the first year as Group 1, and those who did not as Group 2. Hand fine motor skills were evaluated by Nine-Hole Peg Test (NHPT) and Nut Screwing Test (NST). RESULTS: Initial NHPT (28.5 ± 6.0 s vs. 25.8 ± 5.0 s, p = 0.011) and NST (82.3 (61.5-102.8) s versus 65.3 (52.3-88.5) s p = 0.023) scores were significantly higher in Group 1 than Group 2. In multivariate logistic regression analysis, NHPT, Body Mass Index, Mini-Mental Test, self PD practitioner, and catheter complications were found to be independent variables in predicting PD-related peritonitis. CONCLUSION: Decreased hand fine motor skills of PD patients is a risk factor for peritonitis.


Assuntos
Diálise Peritoneal , Peritonite , Humanos , Destreza Motora , Diálise Peritoneal/efeitos adversos , Fatores de Risco , Peritonite/epidemiologia , Peritonite/etiologia , Estudos Retrospectivos
2.
Clin Kidney J ; 15(5): 999-1006, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35498893

RESUMO

Background: In this study, we evaluated 3-month clinical outcomes of kidney transplant recipients (KTR) recovering from COVID-19 and compared them with a control group. Method: The primary endpoint was death in the third month. Secondary endpoints were ongoing respiratory symptoms, need for home oxygen therapy, rehospitalization for any reason, lower respiratory tract infection, urinary tract infection, biopsy-proven acute rejection, venous/arterial thromboembolic event, cytomegalovirus (CMV) infection/disease and BK viruria/viremia at 3 months. Results: A total of 944 KTR from 29 different centers were included in this study (523 patients in the COVID-19 group; 421 patients in the control group). The mean age was 46 ± 12 years (interquartile range 37-55) and 532 (56.4%) of them were male. Total number of deaths was 8 [7 (1.3%) in COVID-19 group, 1 (0.2%) in control group; P = 0.082]. The proportion of patients with ongoing respiratory symptoms [43 (8.2%) versus 4 (1.0%); P < 0.001] was statistically significantly higher in the COVID-19 group compared with the control group. There was no significant difference between the two groups in terms of other secondary endpoints. Conclusion: The prevalence of ongoing respiratory symptoms increased in the first 3 months post-COVID in KTRs who have recovered from COVID-19, but mortality was not significantly different.

3.
Turk J Med Sci ; 51(5): 2607-2615, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34289653

RESUMO

BACKGROUND: Vascular calcifications (VCs), recognized risk factor for increased mortality, are highly prevalent in hemodialysis (HD) patients. We aimed to investigate the relation between VC and warfarin use with plain radiography. METHODS: VCs were assessed using Adragao (radial and digital) and Kauppila (aortic) scores in 76 HD patients from six centers. Out of a total 711 HD patients, there were 32 (4.5%) who had been treated with warfarin for at least 1 year, and we included 44 control patients. RESULTS: Of the patients, 47% were females, the mean age was 66 ± 9 years, 23% were diabetics, the mean dialysis vintage was 68 ± 38 months. In warfarin group, median Kauppila score was higher than in control group [11 vs 6.5, (25%-75% percentile, 5 vs. 15), p = 0.032] and the percentage of the patients with a Kauppila score of >6 was higher, as well (76.6% vs. 50%; p = 0.029). Median Adragao score was not significantly different between the two groups [7 vs. 6, (%25,%75 percentile 6 vs. 8), p = 0.17]. Logistic regression analysis revealed that warfarin treatment was independently associated with Kauppila scores of >6 (OR 3.60, 95% CI 1.18-10.9, p = 0.024). DISCUSSION: In this study, we found that warfarin is associated to vascular calcifications, especially in aorta of HD patients.


Assuntos
Aorta Abdominal , Calcificação Vascular , Feminino , Humanos , Pessoa de Meia-Idade , Idoso , Masculino , Aorta Abdominal/diagnóstico por imagem , Varfarina/efeitos adversos , Estudos de Casos e Controles , Calcificação Vascular/diagnóstico por imagem , Calcificação Vascular/epidemiologia , Diálise Renal/efeitos adversos
5.
Clin Kidney J ; 13(1): 123-124, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32082563

RESUMO

Tacrolimus has been used in pregnant organ recipients for >20 years, and the relationship between fetal complications and the amount of tacrolimus crossing the placenta is still controversial. We report the case of a kidney transplant recipient who used tacrolimus and gave birth to an offspring that developed, shortly after birth, an acute kidney injury caused by tacrolimus exposure, which was detected by measuring tacrolimus levels in the umbilical vein, as well as in maternal blood. Even if whole-blood levels of tacrolimus are within the therapeutic range throughout pregnancy, the amount of tacrolimus could reach toxic levels.

6.
Balkan Med J ; 37(3): 138-143, 2020 04 10.
Artigo em Inglês | MEDLINE | ID: mdl-31970974

RESUMO

Background: Cell-free DNA, which may be considered as "liquid" biopsy, may serve as a diagnostic and prognostic marker not only in hematological malignancies but in solid tumors as well. Aims: To investigate the prognostic role of pre-transplant cell-free DNA levels in allogeneic hematopoietic stem cell transplant recipients. Study Design: Retrospective cohort study. Methods: A total of 177 allogeneic hematopoietic stem cell transplant recipients [median age: 36 (16-66) years; male/female: 111/66] with an initial diagnosis of acute leukemia were included in the study. Cell-free DNA was extracted from pre-transplant serum samples by using the MagNA Pure Compact Nucleic Acid Isolation Kit I with the MagNA Pure Compact instrument (Roche Diagnostics, Penzberg, Germany). Results: A positive correlation was demonstrated between cell-free DNA and age (p=0.018; r=0.177). Pre-transplant cell-free DNA levels were lower in bcr-abl (+) patients (p=0.001), while an adverse correlation was indicated between cell-free DNA and bcr-abl levels (p=0.001; r=−0.531). Acute lymphoblastic leukemia patients with bcr-abl positivity (p=0.001) or abnormal cytogenetics (p=0.038) represented significantly lower pre-transplant cell-free DNA levels. Cell-free DNA levels were lower in patients who developed sinusoidal obstruction syndrome (p=0.035). In terms of long-term complications, acute myeloid leukemia patients who experienced post-transplant relapse had significantly lower pre-transplant cell-free DNA levels (p=0.024). Overall survival was not statistically different between high- and low- cell-free DNA groups (45.2% vs 22.5; p=0.821). Conclusion: In general, low serum levels of pre-transplant çell-free DNA seem to be associated with transplant-related morbidities and may be considered an adverse prognostic factor for allogeneic hematopoietic stem cell transplant recipients.


Assuntos
Ácidos Nucleicos Livres/análise , Rejeição de Enxerto/diagnóstico , Leucemia/cirurgia , Transplante de Células-Tronco/normas , Adulto , Idoso , Ácidos Nucleicos Livres/sangue , Feminino , Alemanha , Rejeição de Enxerto/epidemiologia , Humanos , Leucemia/complicações , Leucemia/fisiopatologia , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Recidiva , Estudos Retrospectivos , Transplante de Células-Tronco/métodos , Transplante de Células-Tronco/estatística & dados numéricos
7.
Transplant Proc ; 51(7): 2289-2291, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31400971

RESUMO

INTRODUCTION: Amyloid A amyloidosis is most commonly caused by familial Mediterranean fever (FMF) in Turkey. Amyloidosis secondary to FMF is an important cause of end-stage renal failure, and kidney transplantation (KT) in these cases can be complicated, with long-term results oftentimes inferior compared with organ transplant in patients without FMF. The present study aims to show the long-term results of patients with secondary amyloidosis caused by FMF undergoing KT . METHODS: We enrolled 27 patients with a history of FMF amyloidosis undergoing KT and a control group of 614 patients undergoing KT between 2005 and 2018 at Ankara University Medical School. All data were recorded retrospectively from patients files. RESULTS: Twenty-two patients (81.5%) were treated with triple immunosuppressive therapy consisting of mycophenolate mofetil, tacrolimus, and a steroid; 5 patients (18.5%) were treated with tacrolimus, azathioprine, and prednisolone. Acute cellular rejection was seen in 3 patients (11.1%), and acute cellular- and antibody-mediated rejection occurred in 1 patient (3.7%). During the follow-up period, graft loss due to acute cellular rejection was observed in only 1 patient. One patient was lost to follow-up.


Assuntos
Amiloidose/etiologia , Febre Familiar do Mediterrâneo/complicações , Rejeição de Enxerto/epidemiologia , Falência Renal Crônica/cirurgia , Transplante de Rim/efeitos adversos , Adulto , Feminino , Rejeição de Enxerto/etiologia , Humanos , Falência Renal Crônica/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Turquia
8.
Transplant Proc ; 51(7): 2292-2294, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31400972

RESUMO

Familial Mediterranean fever (FMF) is an important and preventable cause of chronic kidney disease due to secondary amyloidosis. Although colchicine is the first-line therapy in patients with FMF with 60% to 65% complete remission rates, 5% to 10% of patients are colchicine-resistant and 5% to 10% of them are intolerant to the therapy. Anti-interleukin-1 agents, such as anakinra and canakinumab, are safe and efficient therapeutic options in patients with colchicine resistance or intolerance. However, the data on management of these targeted agents is limited in recipients of kidney transplant (RKT). In this case series, we aim to share our experience on canakinumab therapy of 4 RKTs with FMF-related amyloidosis, who were followed up in our clinic between 2010 and 2017. All of the 4 patients with end-stage renal disease were colchicine- resistant and on other alternative therapies, which provided poor disease control. For efficient control of secondary amyloidosis, canakinumab therapy was initiated in 1 of the patients before the renal transplant, and for the remaining patients after renal transplant. Any serious adverse effect, development of proteinuria, or graft dysfunction has not been observed in any of the patients. Under the canakinumab treatment, complete clinical responses, prevent typical familial Mediterranean fever attacks with fever and arthritis and abdominal pain, normalized serum amyloid A and C-reactive protein levels were achieved in all patients. Canakinumab treatment is a safe and effective therapeutic option for RKTs with FMF who are resistant or intolerant to colchicine and anakinra.


Assuntos
Amiloidose/tratamento farmacológico , Anticorpos Monoclonais Humanizados/uso terapêutico , Febre Familiar do Mediterrâneo/tratamento farmacológico , Falência Renal Crônica/tratamento farmacológico , Transplante de Rim , Adulto , Amiloidose/complicações , Amiloidose/cirurgia , Febre Familiar do Mediterrâneo/complicações , Febre Familiar do Mediterrâneo/cirurgia , Feminino , Humanos , Proteína Antagonista do Receptor de Interleucina 1/uso terapêutico , Falência Renal Crônica/etiologia , Falência Renal Crônica/cirurgia , Masculino , Período Pós-Operatório , Resultado do Tratamento
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