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Öğe Arm circumference: Its importance for dialysis patients in the obesity era(2013) Akpolat T.; Kaya C.; Utaş C.; Arinsoy T.; Taşkapan H.; Erdem E.; Yilmaz M.E.; Ataman R.; Bozfakioglu S.; Özener C.; Karayaylali I.; Kazancioglu R.; Çamsari T.; Yavuz M.; Ersoy F.; Duman S.; Ateş K.Purpose: The purposes of this study were to investigate the association between arm circumference and body mass index (BMI) and to discuss problems, mainly arm circumference and cuff size mismatch, that could affect the reliability of home blood pressure monitoring (HBPM) among peritoneal dialysis (PD) and hemodialysis (HD) patients. Methods: 525 PD and 502 HD patients from 16 centers were included in the study. A two-part questionnaire was used to gather information from the participants. Arm circumferences were categorized into four groups according to the British Hypertension Society cuff size recommendations. Results: Mean BMI and arm circumference of all participants were 25.0 kg/m2 and 27.6 cm, respectively. There was a significant correlation between BMI and arm circumference. The mean BMI and arm circumference values were higher in PD patients than in HD patients. Requirement of a large-sized adult cuff was more common among PD patients compared to HD patients (14 % vs 8 %, p = 0.002). Conclusions: Since HBPM is a useful tool for clinicians to improve BP control, nephrologists should be aware of the problems related to HBPM in dialysis patients and take an active role to increase the reliability of HBPM. © 2012 Springer Science+Business Media, B.V.Öğe Body pain during daily activities in patients on peritoneal dialysis(2005) Taskapan H.; Ersoy F.F.; Passadakis P.; Tam P.; Memmos D.; Katopodis K.; Özener Ç.; Akçiçek F.; Çamsari T.; Ates K.; Ataman R.; Vlachojannis J.G.; Dombros N.; Utas C.; Akpolat T.; Bozfakioglu S.; Wu G.G.; Karayaylali I.; Arinsoy T.; Stathakis Ch.; Yavuz M.; Tsakiris D.; Dimitriades A.; Yilmaz M.E.; Gültekin M.; Polat N.; Oreopoulos D.G.Objective. To review the prevalence of body pain during daily activities in patients on peritoneal dialysis (PD) and to correlate it with various demographic and renal osteodystrophy markers such as calcium (Ca), phosphorus (P), intact parathyroid hormone (iPTH), and vitamin D 3 levels. Methods. A cross-sectional study was conducted involving 530 chronic PD patients (44.3% female, 55.6% male) from 24 centers in Canada, Greece, and Turkey. Pain severity scoring during daily activities was performed using the pain scoring table of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results. The overall prevalence of pain was 52.9% (61.3% in females and 49.5% in males, p < 0.05). Morning stiffness was reported by 23.6% of the patients, and diminished range of movement by 20%. The mean age, weight, and body mass index were higher in patients with pain than in those without (p < 0.05). There was no statistically significant difference between patients with pain and those without pain with respect to their mean serum iPTH, Ca, P, Ca x P, ionized Ca, or bone alkaline phosphatase levels (p > 0.05). Mean serum 25-hydroxyvitamin D 3 [25(OH)D 3] levels were lower in patients with pain compared to those without pain (p < 0.05). Conclusions. A high percentage of the PD patients (53%) had body pain; iPTH levels and other biochemical parameters of renal osteodystrophy were not different between those with and without pain. Patients with pain had lower 25(OH)D 3 levels than did those without. Factors such as age, gender, obesity, and metabolic factors may interact to cause varying degrees of articular/bone pain in patients on PD. Since vitamin D deficiency aggravates the signs and symptoms of joint disease such as pain and stiffness, one should attempt to correct levels of 25(OH)D 3, as well as 1,25(OH) 2D 3 levels, in these patients.Öğe A retrospective analysis for aetiology and clinical findings of 287 secondary amyloidosis cases in Turkey(2002) Tuglular S.; Yalcinkaya F.; Paydas S.; Oner A.; Utas C.; Bozfakioglu S.; Ataman R.; Akpolat T.; Ok E.; Sen S.; Düsünsel R.; Evrenkaya R.; Akoglu E.Background. Secondary amyloidosis is the most frequent of the various types of systemic amyloidosis, the epidemiology of which is not yet fully known. The aim of our study was to evaluate retrospectively the collective data for the aetiological distribution, clinical findings and approaches to the management of secondary amyloidosis in Turkey. Methods. Data from a simple questionnaire addressing aetiology, and demographic and clinical characteristics of patients with biopsy-proven secondary amyloidosis was retrospectively analysed. Eleven nephrology clinics contributed data for this study. Results. The 11 contributing centres provided a total of 287 cases (102 female, 185 male). The aetiological distribution was as follows: familial Mediterranean fever (FMF) 64%, tuberculosis 10%, bronchiectasis and chronic obstructive lung disease 6%, rheumatoid arthritis 4%, spondylarthropathy 3%, chronic osteomyelitis 2%, miscellaneous 4%, unknown 7%. Oedema accompanied by proteinuria was present in 88% of the cases, hepatomegaly in 17%, and splenomegaly in 11%. The mean systolic and diastolic blood pressures were 115 ± 26 and 73 ± 15 mmHg respectively. The family history was positive in 16%; 73% of the cases were on colchicine treatment when the questionnaire was administered. Thirty-eight per cent of the cases had progressed to ESRD and were on renal replacement therapy. Conclusions. FMF is the leading cause of secondary amyloidosis in Turkey, followed by tuberculosis. Oedema accompanied by proteinuria is the most prominent presenting finding, and hypotension seems to be common among these patients.Öğe Severe vitamind D deficiency in chronic renal failure patients on peritoneal dialysis(2006) Taskapan H.; Ersoy F.F.; Passadakis P.S.; Tam P.; Memmos D.E.; Katopodis K.P.; Ozener C.; Akcicek F.; Camsari T.; Ates K.; Ataman R.; Vlachojannis J.G.; Dombros N.A.; Utas C.; Akpolat T.; Bozfakioglu S.; Wu G.; Karayaylali I.; Arinsoy T.; Stathakis C.P.; Yavuz M.; Tsakiris D.J.; Dimitriades A.D.; Yilmaz M.E.; Gültekin M.; Oreopoulos D.G.The aim of this study was to evaluate the prevalence of vitamin D deficiency in chronic renal failure (CRF) patients on peritoneal dialysis (PD) and to correlate the findings with various demographic and renal osteodystrophy markers. Method: This cross-sectional, multicenter study was carried out in 273 PD patients with a mean age of 61.7 ± 10.9 years and mean duration of PD 3.3 ± 2.2 years. It included 123 female and 150 male patients from 20 centers in Greece and Turkey, countries that are on the same latitude, namely, 36 - 42° north. We measured 25(OH)D3 and 1.25(OH)2D3 levels and some other clinical and laboratory indices of bone mineral metabolism. Results: Of these 273 patients 92% (251 patients) had vitamin D deficiency i.e. serum 25(OH)D3 levels less than 15 ng/ml, 119 (43.6%) had severe vitamin D deficiency i.e. serum 25(OH)D3 levels, less than 5 ng/ml, 132 (48.4%) had moderate vitamin D deficiency i.e. serum 25(OH)D3 levels, 5 - 15 ng/ml, 12 (4.4%) vitamin D insufficiency i.e. serum 25(OH)D3 levels 15 - 30 ng/ml and only 10 (3.6%) had adequate vitamin D stores. We found no correlation between 25(OH)D3 levels and PTH, serum albumin, bone alkaline phosphatase, P, and Ca × P. In multiple regression analyses, the independent predictors of 25(OH)D3 were age, presence of diabetes (DM-CRF), levels of serum calcium and serum 1.25(OH)2D3. Conclusion: We found a high prevalence (92%) of vitamin D deficiency in these 273 PD patients, nearly one half of whom had severe vitamin D deficiency. Vitamin D deficiency is more common in DM-CRF patients than in non-DM-CRF patients. Our findings suggest that these patients should be considered for vitamin D supplementation. © 2006 Dustri-Verlag Dr. K. Feistle.
