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    The Osteoporotic Effect of Arteriovenous Fistula on the lpsilateral Upper Extremity in Hemodialysis Patients
    (Galenos Yayincilik, 2013) Bakan, Betul; Kalender, Ali Murat; Ozer, Ali; Sucakli, Mustafa Haki; Ozkan, Fuat; Dogan, Ekrem
    Objective: Hemodialysis requires an arteriovenous fistula (AVF), the presence of which may influence the structure of nearby bone. This study analyzed the effect of AVF on ipsilateral upper extremity bone mineral density (BMD), as measured by phalangeal radiographic absorptiometry (RA). Materials and Methods: In this cross-sectional study, phalangeal BMD was measured in both arms by RA in a convenience sample of end-stage renal disease (ESRD) patients with a forearm AVF Patients were excluded if the patient had pathology which might affect distal arm circulation. BMD values (g/cm(2)) from forearms with AVF were compared with values from forearms without AVF Predialysis values of complete blood count, calcium, phosphorus, alkaline phosphatase, parathyroid hormone, urea, creatinine, potassium, albumin, total cholesterol, HDL cholesterol, and LDL cholesterol were determined in all patients; dialysis adequacy values were also calculated. Results: One hundred and sixteen patients agreed to participate in the study. Thirty-three patients were excluded, thus, data were analyzed from 83 patients (59% male, 41% female, mean hemodialysis time: 156 +/- 6 months, mean age: 53 +/- 16 years). AVFs were located in the nondominant hand in all patients. Phalangeal BMD in forearms with AVF (0.28 +/- 0.05 g/cm(2), range: 0.14-0.40) was significantly lower than that in the contralateral forearm (0.30 +/- 0.04 g/cm2, range: 0.79-0.40, p<0.05). Conclusion: In ESRD patients on hemodialysis, BMD is lower in the ipsilateral-to-AVF hand compared to the contralateral-to-AVF hand. In these patients, further investigations should be made to ascertain the ability of BMD assessment in determining fracture risk and to prompt physicians to initiate treatments which will preserve BMD and reduce fractures.
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    Temperament and Character Profiles of End Stage Renal Disease Patients Undergoing Hemodialysis and Peritoneal Dialysis
    (Kure Iletisim Grubu A S, 2011) Orhan, Fatma Ozlem; Ozer, Ali; Sayarlioglu, Hayriye; Dogan, Ekrem; Altunoren, Ozlem; Akman, Oguz; Karaaslan, Mehmet Fatih
    Temperament and character profiles of end stage renal disease patients undergoing hemodialysis and peritoneal dialysis The aim of this study was to evaluate the temperament and character profiles of end stage renal disease patients (ESRD) undergoing hemodialysis and peritoneal dialysis and to compare the results with those of healthy controls. The study population consisted of 39 hemodialysis patients (24 female, 15 male), 30 peritoneal dialysis patients (16 female, 14 male), and 39 age and gender-matched healthy control subjects (24 female, 15 male). All participants were instructed to complete a self-administered 240-item temperament and character inventory (TCI) and the Hospital Anxiety and Depression Scale (HADS). Novelty Seeking and Self-Directedness scores were significantly lower in patients. There was no difference between hemodialysis and peritoneal dialysis patients regarding depression and anxiety scores. There were no significant correlations between TCI scores and laboratory variables. Studies in this area may lead to the development of specific and focused interventions for temperament and character profiles in HD and PD patients. We suggest that evaluation and treatment of ESRD patients should also include psychosomatic approaches in clinical practice.