Yazar "Dayanan, Ramazan" seçeneğine göre listele

Listeleniyor 1 - 3 / 3
  • [ N/A ]
    Öğe
    A Case of Severe Hypernatremia and Rhabdomyolysis Treated by Hemodialysis without Sequelae
    (Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2016) Yaprak, Mustafa; Turgut, Faruk; Sunger, Osman; Dayanan, Ramazan; Sikgenc, Mehmet Mahfuz; Akin, Selcuk; Degirmen, Elif
    Hypernatremia is defined as plasma sodium concentration above 145 mEq/L. While severe symptoms are generally seen in case of plasma sodium concentration of 158 mEq/L, higher levels above 180 mEq/L are associated with a high mortality rate. Herein, a case of severe hypernatremia with a sodium level of 189 mEq/L and rhabdomyolysis treated by hemodialysis was presented. A 24-year-old woman was brought to the emergency department because of impaired general condition and confusion. She had a history of tuberculosis meningitis 1.5 years ago and left hemiplegia. Urea, creatinine, sodium, LDH and CK were 95 mg/dL, 2.6 mg/dL, 189 mEq/L, 1630 U/L, and 12601 U/L, respectively. The patient was diagnosed with hypernatremia, rhabdomyolysis and acute renal failure. Hemodialysis was performed because of anuria, increased urea and creatinine levels and metabolic acidosis. On the 5th day, the sodium level was reduced to 140 mEq/L. She was discharged from hospital uneventfully after the acute renal failure improved. In conclusion, both hypernatremia itself and its quick correction carry a risk of high mortality and morbidity. Therefore, in patients with chronic hypernatremia and need of dialysis, dialysate sodium should be lower than 10 mEq/L of serum sodium level, and if this is impossible, the duration of dialysis and blood flow rate should be reduced.
  • Küçük Resim
    Öğe
    Platelet-to-lymphocyte ratio predicts mortality better than neutrophil-to-lymphocyte ratio in hemodialysis patients
    (Springer, 2016) Yaprak, Mustafa; Turan, Mehmet Nuri; Dayanan, Ramazan; Akin, Selcuk; Degirmen, Elif; Yildirim, Mustafa; Turgut, Faruk
    Purpose Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were established showing the poor prognosis in some diseases, such as cardiovascular diseases and malignancies. The risk of mortality in patients with end-stage renal disease (ESRD) was higher than normal population. In this study, we aimed to investigate the relationship between NLR, PLR, and all-cause mortality in prevalent hemodialysis (HD) patients. Methods Eighty patients were enrolled in study. NLR and PLR obtained by dividing absolute neutrophil to absolute lymphocyte count and absolute platelet count to absolute lymphocyte count, respectively. The patients were followed prospectively for 24 months. The primary end point was all-cause mortality. Results Mean levels of neutrophil, lymphocyte, and platelet were 3904 +/- 1543/mm(3), 1442 +/- 494/mm(3), 174 +/- 56 x 10(3)/mm(3), respectively. Twenty-one patients died before the follow-up at 24 months. Median NLR and PLR were 2.52 and 130.4, respectively. All-cause mortality was higher in patients with high NLR group compared to the patients with low NLR group (18.8 vs. 7.5 %, p = 0.031) and in patients with higher PLR group compared to patients with lower PLR group (18.8 vs. 7.5 %, p = 0.022). Following adjusted Cox regression analysis, the association of mortality and high NLR was lost (p = 0.54), but the significance of the association of high PLR and mortality increased (p = 0.013). Conclusion Although both NLR and PLR were associated with all-cause mortality in prevalent HD patients, only PLR could independently predict all-cause mortality in these populations.
  • Küçük Resim
    Öğe
    Role of ultrasonographic chronic kidney disease score in the assessment of chronic kidney disease
    (Springer, 2017) Yaprak, Mustafa; Cakir, Ozgur; Turan, Mehmet Nuri; Dayanan, Ramazan; Akin, Selcuk; Degirmen, Elif; Yildirim, Mustafa
    Ultrasonography (US) is an inexpensive, noninvasive and easy imaging procedure to comment on the kidney disease. Data are limited about the relation between estimated glomerular filtration rate (e-GFR) and all 3 renal US parameters, including kidney length, parenchymal thickness and parenchymal echogenicity, in chronic kidney disease (CKD). In this study, we aimed to investigate the association between e-GFR and ultrasonographic CKD score calculated via these ultrasonographic parameters. One hundred and twenty patients with stage 1-5 CKD were enrolled in this study. The glomerular filtration rate was estimated by the Chronic Kidney Disease Epidemiology Collaboration equation. US was performed by the same radiologist who was blinded to patients' histories and laboratory results. US parameters including kidney length, parenchymal thickness and parenchymal echogenicity were obtained from both kidneys. All 3 parameters were scored for each kidney, separately. The sum of the average scores of these parameters was used to calculate ultrasonographic CKD score. The mean age of patients was 63.34 +/- 14.19 years. Mean kidney length, parenchymal thickness, ultrasonographic CKD score and median parenchymal echogenicity were found as 96.2 +/- 12.3, 10.97 +/- 2.59 mm, 6.28 +/- 2.52 and 1.0 (0-3.5), respectively. e-GFR was positively correlated with kidney length (r = 0.343, p < 0.001), parenchymal thickness (r = 0.37, p < 0.001) and negatively correlated with CKD score (r = -0.587, p < 0.001) and parenchymal echogenicity (r = -0.683, p < 0.001). Receiver operating characteristic curve analysis for distinction of e-GFR lower than 60 mL/min showed that the ultrasonographic CKD score higher than 4.75 was the best parameter with the sensitivity of 81% and positive predictivity of 92% (AUC, 0.829; 95% CI, 0.74-0.92; p < 0.001). We found correlation between e-GFR and ultrasonographic CKD score via using all ultrasonographic parameters. Also, our study showed that ultrasonographic CKD score can be useful for distinction of CKD stage 3-5 from stage 1 and 2. We suggested that the ultrasonographic CKD score provided more objective data in the assessment of CKD.