Hakan Akdam, Alper Alp, Ozgul Ozbek, Umut Cakiroglu, Yavuz Yenicerioglu and Harun Akar
Introduction. The Peritoneal Equilibration Test (PET) is employed to assess peritoneal membrane transport function. The purpose of the test is to determine the optimal peritoneal dialysis regimen. The performance of the test, which is conducted over 4 hours, is time consuming both for the nurses and the patient. There have been studies to validate an approved short version of the original PET protocol, and all have yielded different results. We evaluated the concordance between the 1-hour, 2-hour and 4-hour (classical) test results of the fast PET.
Methods. The study included 32 patients (20 males and 12 females). The patients underwent the 4-hour fast PET test, and the dialysate-to-plasma ratio of creatinine concentration (D/Pcrea) was determined. The standard deviation was added to or subtracted from the mean D/Pcrea ratios at hours 1, 2, and 4 to determine transport groups.
Results. The mean age of the patients was 51.4±16.7 years. Mean D/Pcrea ratios at hours 1, 2, and 4 were 0.41±0.07, 0.54±0.10, and 0.69+0.12, respectively. There was a strong correlation between the 4-hour D/Pcrea ratio and 1-hour (r=0.756, p<0.001) and 2-hour (r=0.867, p<0.001) D/Pcrea ratios. Seventeen patients (53%) were in the same transport group at hours 1, 2, and 4. Eighteen patients (56%) at 1 hour and 24 patients (75%) at 2 hours fell into the same transport group at 4 hours. The patients that fell into different transport groups at different time points showed a shift to a lower or higher transport group.
Conclusions. Two-hour fast PET gives promising results for clinical assessment purposes.
Fatma Kubra Sayin, Sadik Buyukbas, M. Kemal Basarali, Harun Alp, Hatice Toy and Veli Ugurcu
Silybum marianum extract (SME) has been used for centuries as a natural remedy for diseases of liver and biliary tract. Lately, it has been promoted as a nutritional supplement for beneficial effects on some risk factors of diabetes and hyperlipidemia. In this study we aimed to determine the effects of SME on high-fat diet (HFD) induced metabolic disorders. Male Sprague Dawley rats were fed HFD for 11 weeks to induce obesity. SME was given to animals for two different durations, for 11 weeks or for 7 weeks. The results showed significant increase in plasma transaminases, total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), leptin, high sensitive C-reactive protein (hsCRP), glucose and insulin along with significant increase in body mass index (BMI) and liver weights in rats fed the HFD diet compared to rats fed with standard rat diet. SME supplementation for different durations raised improvement in the HFD-induced metabolic disorders such as insulin resistance, hyperlipidemia and hepatopathy at different degrees. Our study concludes that SME can be well considered as an effective supplement to improve insulin and leptin sensitivity and hyperlipidemia and to suppress body weight gain.
Alper Alp, Hakan Akdam, Ibrahim Meteoglu, Emel Ceylan, Arzu Cengiz, Fusun Taskin, Harun Akar and Yavuz Yenicerioglu
Sarcoidosis is a multisystem, immune-mediated, granulomatous disease. Clinical presentation of this disease may vary; in majority of cases (~90%) thoracic involvement is the leading sign. Although renal involvement is thought to be uncommon in sarcoidosis this entity may not be so rare. Hypercalcemia seems to be the most likely cause of sarcoidosis-associated renal disease, it can even cause acute renal failure in 1-2% of sarciodosis patients. Immediate treatment is appropriate whenever organ function is threatened or when symptoms are severe. We present a case of sarcoidosis with hypercalcemia excluding other clinical conditions, which may potentially confuse the diagnosis.
Aysegul Kahraman, Hakan Akdam, Alper Alp, Mustafa Ahmet Huyut, Cagdas Akgullu, Tuba Balaban, Fadime Dinleyen, Aynur Topcu, Husniye Gelmez, Nevin Atakan, Harun Akar and Yavuz Yenicerioglu
Introduction. The amount of interdialytic weight gain (IDWG) considering body weight is of great importance in hemodialysis patients. In general practice, patients are asked to get standard weight between two hemodialysis sessions. However, it should be individualized considering patient’s weight. We aimed to determine the association between the IDWG and the nutritional parameters, cardiovascular risk factors, and quality of life.
Methods. Thrity-two patients receiving hemodialysis at least for one year were enrolled into the study. Patients were monitored for 12 consecutive hemodialysis sessions; and the arithmetic mean of IDWG was calculated. IDWG% was calculated in accordance with patients’ dry weight. Data of patients with IDWG<3% (Group I) and IDWG≥3 (Group II) were compared. Sociodemographic variables, laboratory, anthropometric measurements, blood pressure, left ventricular mass index, Subjective Global Assessment Scale and SF-36 Quality of Life Scale were applied to evaluate the patients.
Results. 59.4% (n=19) and 40.6% (n=13) of patients were included in Group I and Group II, respectively. In Group II, albumin (p=0.02), potassium (p=0.02), phosphorus (p=0.04), nPCR (p=0.03), physical function (p=0.04), role limitations caused by physical problems (p=0.04), general health (p=0.03), physical quality of life (p=0.04) scores were significantly higher. A significant correlation was detected between IDWG and physical and mental quality of life, total score SF-36, albumin, total protein and the potassium values.
Conclusions. Patients with an IDWG ≥ 3% have better nutritional parameters and quality of life scales. The limiting of IDWG to 1-2 kg, ingoring patient weight may give rise to malnutrition and a reduced quality of life.