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    The comparison of four different dialysates on QT dispersion and arrhythmias in hemodialysis patients
    (2012) Türkmen K.; Mil S.; Solak Y.; Türk S.
    OBJECTIVES: Sudden cardiac death (SCD) is common in patients with end-stage renal disease receiving hemodialysis. SCD may be caused by electrolyte imbalance or malignant arrhythmias in hemodialysis patients. We aimed to evaluate the effects of four different dialysates on QT dispersion and arrhythmia. MATERIAL and METHODS: Twenty-one patients receiving hemodialysis were enrolled. Four different dialysates were used and twelve-lead ECG measurements were recorded to determine QTc and QTc dispersion. Holter ECG was performed to assess arrhythmia. RESULTS: In group 1 (1.0 K +, 1.5 Ca++), predialytic and postdialytic QTc dispersion measurements were 52.3±11.7 and 59.2± 13.1 msec respectively and this is statistically significant (p=0.007). In group 2 (2.0 K +, 1.5 Ca++), group 3 (1.0K +, 1.75Ca++), and in group 4 (2.0 K +, 1.75Ca++), QTc dispersion measurements were 53.5±14.4 and 53.2± 15.0 msec, 53.5±14.4 and 53.2±15.0 msec, 50.8±12.0 and 52.2±13.3 msec, 51.3±12.2 and 52.1±12.3 msec, respectively, and these were not statistically significant. CONCLUSION: In group 1, patients had higher QTc dispersion. There was no statistically significant difference regarding QTc dispersion among the four groups. We also could not find an increased rate of arrhythmias in the groups. These results suggest that there may be other causative risk factors that can affect QT dispersion and arrhythmias in hemodialysis patients.
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    A retrospective analysis of five year data of end-stage renal disease patients: A single center experience
    (2011) Türkmen K.; Tunç A.; Solak Y.; Türk S.
    OBJECTIVES: CKD is a worldwide threat to public health. Approximately 1.8 million people are currently being treated with renal replacement therapy including hemodialysis, peritoneal dialysis and transplantation. The etiology and factors affecting the progression of chronic kidney disease to endstage renal disease (ESRD) differ in industrialized and underdeveloped countries. STUDY DESIGN: The aim of the study was to investigate the etiologies of ESRD, factors affecting progression to ESRD and mortality rates of patients between 2000-2004, in Konya, a city in the Middle Anatolian region of Turkey. MATERIAL and METHODS: We included 417 end-stage renal disease patients (207 female and 210 male) between 16-90 years old receiving RRT for the first time in the study. CKD was diagnosed by GFR measurement that was calculated by MDRD formula. Co-morbidity was expressed using Wright-Khan index. RESULTS: We showed that there was an increased rate of diabetic nephropathy between 2003 and 2004. The increased rate of diabetic nephropathy was found to be statistically significant in the last two years (p<0.005). There was also significant negative correlation between mortality and diastolic BP (r: -0.143, p: 0.05) and the education level of the patients (r: -0.159, p: 0.0002). There was a positive correlation between mortality and serum urea levels (r: 0.193, p: 0.0001), HD through a catheter for the first time (r: 0.140, p: 0.0006), and receiving HD by a continuous RRT modality (r: 0.163, p: 0.0001). CONCLISION: Our study showed that advanced age, increased mean arterial BP before the first RRT, having CVD or DM as an etiology of ESRD, increased erythrocyte sedimentation rate (ESR), decreased serum albumin levels and the presence of co-morbid diseases were the main factors that affected survival of the patients.
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    Study of Elements, Antioxidants and Lipid Peroxidation in Hemodialysis Patients
    (2006) Menevşe E.; Sivrikaya A.; Karagözoğlu E.; Tiftik A. M.; Türk S.
    Background: During hemodialysis, most of the elements must be kept in a rather narrow physiological range, otherwise life-threatening events may occur. Furthermore, lipid peroxidation in patients may be partly due to the trace element disturbances. It has been mentioned that there are relations between deficiency in trace elements and antioxidant levels. The present study aimed to determine whether there were differences between hemodialysis patients and a healthy group according to selenium, aluminium, malondialdehyde (MDA), reduced form of glutathione (GSH) and superoxide dismutase (SOD) levels. Methods: The study included 47 hemodialysis patients (hemodialysis group). Blood samples were taken before (pre-hemodialysis) and after (post-hemodialysis) hemodialysis session. The control group included 23 healthy volunteers. Results: The aluminium, MDA, and SOD levels were lower and reduced form of GSH levels were higher in the control group when compared with the pre-hemodialysis group. MDA and SOD levels were higher in the posthemodialysis group than in the control group. GSH levels were lower and aluminium levels higher in the preversus the post-hemodialysis group. Conclusions: In order to evaluate the data of antioxidant and oxidant levels, hemodialysis patients are subjected to oxidative stress. Moreover, the study shows that analyzing levels of aluminium may be useful in hemodialysis patients in evaluating elements status.