No abstract

The prevalence of end-stage renal disease (ESRD) is increasing in the world [1,2]. Peritoneal dialysis (PD) has been an alternative treatment to hemodialysis (HD) for patients with ESRD since 1976 [3,4]. PD is a homebased treatment with many advantages; preservation of residual renal function (RRF), hemodynamic stability, better quality of life and cost savings [5][6][7][8]. Survival rates with PD are better than those with HD after 3 years from initiation [5,8,9]. Despite the advantages of PD in quality of life compared with haemodialysis, the prevalence of PD decreases gradually [10,11]. In our country too, total number of PD patients is gradually decreasing over the years [12].Prevalent PD patients in our country as of the end of 2007 were 5307 patients and this number decreased to 3346 at the end of 2017, according to the Turkish Kidney Registry System Reports [12,13]. The long-term benefits of PD are still controversial [5]. Therefore, this study aimed to report a single-center experience and long-term clinical outcomes of PD over a 9-year period. Materials and methods ParticipantsThis study was approved by Baskent University Institutional Review Board (Project no: KA19/196) and supported by Başkent University Research Fund. This was a retrospective cohort study. All patients who were initiated on PD at Başkent University Adana Dr. Turgut Noyan Training and Research Hospital, in Turkey, from January 2011 to May 2019, were included. The patients who were younger than 18 years and the patients with a PD history of less than 3 months were excluded from our analysis. The follow-up of the patients was reviewed until death, renal transplantation, transferred to HD or the end of the study in May 2019. Clinical proceduresA double-cuffed Curl Tenckhoff catheter (ArgyleTM Peritoneal Dialysis Catheter Kit, Curl Catch, 2 Cuff, 62 cm) was inserted in all patients in our centre using the laparoscopy technique by general surgeons. After a break period, patients and their caregivers underwent a standard Background/aim: The aim of this study was to evaluate the clinical outcomes and identify the predictors of mortality in peritoneal dialysis patients. Materials and methods:Medical records of all incident peritoneal dialysis (PD) patients followed up between January 2011 and May 2019 were reviewed retrospectively. All patients were followed up until death, renal transplantation, transfer to haemodialysis or the end of the study.Results: A total of 242 patients were included in the study. The incidence of peritonitis was 0.18 (ranging from 0 to 14.9) episodes per patient year. Death occurred in 28% (n: 68) of cases. Age, diabetes mellitus, malignancy and refractory heart failure were independent risk factors for all-cause mortality according to multivariate analysis. The presence of comorbid disease and diabetes mellitus and patients aged > 65 years were associated with increased risk of mortality and decreased patient survival. Peritonitis history was associated with increased risk of mortality. Between peritonitis and perito...

Worldwide, chronic kidney disease (CKD) is reported to occur in more than 10% of the general population (Fugl-Meyer, Nilsson,

BackgroundThis study reports findings in subjects who underwent brain imaging for any reason, and examined factors influencing cerebrovascular events (CVEs) in hemodialysis (HD) patients.MethodsWe reviewed the files of patients on HD between January 2015 and January 2018. A total of 432 patients who underwent HD for at least 5 months by the January 2015 and who were older than 18 years were included in the study; 264 had been examined by cerebral computed tomography or magnetic resonance imaging examination within the 3 years. Cerebrovascular pathology was detected in 139 of 264 patients.ResultsOf the 139 patients, 65 (24.62%) had ischemic lesions, 25 (9.47%) had hemorrhagic lesions, and 49 (18.56%) had cerebral small vessel disease (CSVD). We compared recorded data and later clinical findings between patients with and those without CVEs. The cause of end-stage renal disease was diabetes in 58.5% of patients with ischemic lesions, 52% in those with hemorrhagic lesions, and 55% in those with CSVD (P < 0.05). Patients with cerebrovascular ischemia were older (P = 0.0001) and had lower serum creatinine (sCr) (P = 0.0001) and higher serum C-reactive protein (CRP) (P = 0.002) levels than normal subjects. Hemorrhagic patients were older (P = 0.003) and had lower sCr (P = 0.003) and serum predialysis potassium (P = 0.003) and parathyroid hormone (PTH) (P = 0.004) levels than normal subjects. Patients with CSVD were older (P < 0.0001) and had lower sCr (P < 0.0001), phosphorus (P < 0.007), and PTH (P < 0.013) and higher CRP (P < 0.002) levels than normal subjects.ConclusionsHD patients with CVEs are older and typically have diabetes mellitus and lower sCr levels.

Introduction Hepatitis C virus (HCV) infection is associated with increased mortality and morbidity in kidney transplant patients. The ability to establish a sustained viral response before renal transplant is important for these patients. Direct‐acting antiviral agents can increase the sustained viral response in most patients with HCV infection. In this case series, we aimed to determine the efficacy and safety of a combined therapy of ombitasvir, paritaprevir, ritonavir, and dasabuvir with or without ribavirin in patients with HCV genotype 1 infection without cirrhosis and on hemodialysis who were awaiting deceased‐donor kidney transplant. Methods Our study included eight male and two female HCV ribonucleic acid (RNA)‐positive hemodialysis patients (mean age 50.7 ± 15 years, mean hemodialysis duration 14 ± 5.5 years, mean HCV duration 18 ± 3.7 years). Findings Three patients with genotype 1a received oral therapy with 12.5 mg ombitasvir, 150 mg paritaprevir, 7 5 mg ritonavir, and 250 mg dasabuvir plus 200 mg ribavirin for 12 weeks. Seven patients with genotype 1b received 12.5 mg ombitasvir, 150 mg paritaprevir, 75 mg ritonavir, and 250 mg dasabuvir without ribavirin treatment for 12 weeks. The sustained virologic response rate was 100% at 12 weeks after completion of antiviral treatment in both treatment groups. No serious adverse effects were observed in either treatment group. Five patients had constitutional symptoms such as nausea, anorexia, and fatigue. During the treatment period, hemoglobin, white cell blood count, thrombocyte, and ferritin levels were similar to pretreatment levels. Treatment did not affect weekly erythropoietin and monthly intravenous iron treatment doses. Discussion Direct‐acting antiviral agents are safe and effective for generating a sustained viral response in HCV genotype 1‐infected hemodialysis patients on kidney wait lists.