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Öğe Course of Encephalopathy in a Cirrhotic Dialysis Patient Treated Sequentially with Peritoneal and Hemodialysis(Hindawi Ltd, 2015) Koz, Suleyman; Sahin, Idris; Terzi, Zafer; Koz, Sema TulayEnd-stage kidney disease and advanced cirrhosis are sometimes seen concomitantly. There is no consensus on dialysis modality in terms of determining the optimal way of treating these patients. It has been suggested that peritoneal dialysis is a better choice for these patients, but efficacy of hemodialysis in stable cirrhotic patients has not been evaluated sufficiently. We report a case with advanced cirrhosis and end-stage kidney disease who was faced with hepatic encephalopathy episodes up on starting renal replacement therapy. The case is also interesting in that it reveals effects of hemodialysis and peritoneal dialysis on hepatic encephalopathy episodes and quality of life of the patient.Öğe Dispeptik semptomları olan ve helicobakter pylori pozitif saptanan hastalarda helicobakter pylori eradikasyonun dispeptik semptomlar üzerine etkilerinin araştırılması(İnönü Üniversitesi, 2011) Terzi, ZaferDispepsi, kelime anlamı olarak sindirim güçlüğünü ifade etmekle birlikte, epigastrik bölgede olan farklı semptomları bir başlık altında incelemek için hekimler tarafından kullanılan bir terimdir. H. pylori infeksiyonu, dünyada en yaygın GİS infeksiyonudur. Epidemiyolojik çalışmalar, genel olarak H. pylori infeksiyonu için en önemli risk faktörünün sosyoekonomik şartlar olduğunu göstermektedir. Dispepsi etyopatogenezinde öne sürülen birçok mekanizma olup hangisinin daha etkili olduğu tartışmalıdır. Dispepside Helicobakter Pylori'nin rölü de tartışma konusudur. Çalışmamızda dispeptik semptomları olan ve Helikobakter Pylori pozitif saptanan hastalarda Helikobakter Pylori eradikasyonun dispeptik semptomlar üzerine etkilerinin araştırılması amaçlanmıştır. Çalışmaya dahil edilen hastalara Modifiye Glasow Dispepsi Ciddiyet Skorlaması kullanılarak dispepsi şiddeti belirlendi. H. pylori pozitif olan hastalara eradikasyon tedavisi verildi . H. pylori negatif olan hastalara PPI kullanması önerildi. Hastalar tedavi sonrası dispepsi şiddetinin değerlendirilmesi için polikliniğimize davet edildi. Modifiye Glasow Dispepsi Ciddiyet Skorlaması kullanılarak tedavi sonrası dispepsi şiddeti belirlendi. Çalışma kriterlere uyan ve tedaviyi tamamlayıp kontrollere gelen toplam 137 hastada gerçekleştirildi. Hastalarının 75'i (% 54,7) kadın, 62'si (% 45,3) erkek cinsiyette olup hastalarımızın % 62'sinde (85 hasta) H.pylori pozitifliği saptanırken % 38'inde (52 hasta) H.pylori negatif idi. H.pylori pozitif ve negatif olan hastalardaki Modifiye Glasow Dispepsi Ciddiyet Skorlaması ile belirlenen tedavi sonrası total skorlardaki azalmalar karşılaştırıldığında her iki grupta da istatistiksel olarak anlamlı farklılık saptanmamıştır ( p= 0,667 )Öğe Elimination of NTproBNP in peritoneal dialysis patients Does peritoneal membrane type make a difference in plasma level and elimination of NTproBNP?(Dustri-Verlag Dr Karl Feistle, 2016) Koz, Suleyman; Sahin, Idris; Temel, Ismail; Koz, Sema T.; Terzi, ZaferBackground: Brain natriuretic peptide and its derivative peptide NTproBNP are utilized to exclude cardiac diseases, and predicting risk of mortality in dialysis patients. Our aim was to evaluate both elimination of NTproBNP through dialysate and a possible relationship between plasma and/or dialysate NTproBNP level and membrane transport status of peritoneal dialysis patients. Methods: 57 plasma (P) and dialysate (D) samples of 44 peritoneal dialysis (PD) patients were analyzed for NTproBNP. Modified peritoneal equilibration test (PET) results and other variables were obtained from the charts. Results: Median (IQR) NTproBNP concentrations (pg/mL x 1,000) in P and D were 3.3 (1 - 13) and 0.5 (0.2 - 3.6), respectively. There was a linear correlation between P-NTproBNP and D-NTproBNP (r = 0.928, p = 0.0001; regression equation was y = 0.897(*)x -0.28). Mean P/D-NTproBNP ratio was 5.5 +/- 0.5. Median P and D-NTproBNP levels by the membrane transport status were aligned as high (H) > high average (HA) > low average (LA), and the difference between H and LA was statistically significant (p < 0.001). Mean arterial pressure (MAP), residual Kt/V and dialysate/plasma ratio of crearinine (D/P Cr) were significant predictors of D-NTproBNP; whereas only MAP and residual Kt/V were significant predictors of P-NTproBNP in multiple regression analysis. Both P-and D-NTproBNP have significant and similar size of correlations with MAP, albumin, D/P Cr ratio, and Na. Conclusions: D-NTproBNP level is similar to 1/5 of P-NTproBNP, and the issue of relationship between membrane transport status and natriuretic peptide levels needs more work.Öğe Estimated Dialysate Magnesium Clearance in Peritoneal Dialysis Patients(Wiley-Blackwell, 2015) Koz, Suleyman; Sahin, Idris; Koz, Sema Tulay; Terzi, Zafer; Ataman, Engin; Akkus, Hadi[Abstract Not Available]Öğe Features of Hemodialysis in Cirrhotic Patients: Single Center Experience(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2015) Koz, Suleyman; Sahin, Idris; Terzi, Zafer; Koz, Sema TulayOBJECTIVE: End-stage kidney disease and advanced cirrhosis are sometimes seen concomitantly. Our purpose was to compare hemodialysis (HD) sessions in critically ill cirrhotic patients from ICU versus stable cirrhotic patients from outpatient clinic, and observe endurance of both stable and acutely ill cirrhotic patients to intermittent HD. MATERIAL and METHODS: All of the Child-Pugh class B or C cirrhotic patients requiring renal replacement therapy during a period of three years were included in the study. If hypotension, arrhythmia, bleeding, or any other health problems were present during dialysis, the dialysis session was regarded as a troubled session. RESULTS: There were two groups of patients. All of the stable patients lived more than three months, whereas all patients in the ICU group died within a month. Mean ultrafiltration volume per session was 1786 +/- 210 ml in ICU and 1616 +/- 266 ml in stable patients (p>0.05). The number of the troubled sessions was 24 in ICU and 1 in stable patients (p<0.0001). Bleeding was a problem in a minority of the patients. CONCLUSION: Intermittent HD may be an acceptable choice for stable cirrhotic dialysis patients. Hypotension is a frequent complication of intermittent HD in ICU patients.
