39 research outputs found
Hypovitaminosis D and insulin resistance in peritoneal dialysis patients
No full textAn association between hypovitaminosis D and insulin resistance has been highlighted. Effects of vitamin D are not only mediated via the vitamin D receptors by active vitamin D metabolites, but 25(OH)D(3) also acts through VDR-independent pathways directly. It was reported that acute and chronic intravenous 1,25-dihydroxycholecalciferol therapy corrects insulin resistance in dialysis patients. There are no studies in patients on dialysis which evaluated relationship between 25(OH)D levels and insulin resistance. The aim of this study was to evaluate relationship between serum 25 (OH) D levels and insulin resistance in nondiabetic patients on peritoneal dialysis (PD). We studied 53 nondiabetic patients on PD and in 25 age-, gender- and body mass index-matched healthy controls. Insulin resistance was evaluated by the homeostasis model assessment method (HOMA-IR) using fasting glucose and insulin levels. Vitamin D deficiency was defined if 25(OH)D(3) levels are equal to or less to 15 ng/ml. Mean HOMA-IR index in patients on PD (3.1 +/- A 3.3) was significantly higher than those of controls (1.7 +/- A 1.9) (P 0.05). There was no significant difference between two PD groups according to mean duration of PD, age, gender, PTH, serum calcium, phosphorus, percentage of fat, and body mass index. There was a negative correlation between HOMA-IR index and 25 (OH)D levels in PD patients (r: -0,368, P < 0,05). In multiple regression analyses, the independent predictors of HOMA-IR index were 25(OH)D3 levels, duration of dialysis, and percentage of fat (measured by bioelectrical impedance) in PD patients. Our findings show a negative correlation of 25(OH)D levels with insulin resistance in PD patients. PD patients with hypovitaminosis D are at higher risk of insulin resistance even if they are on treatment with active vitamin D for PTH control. Further studies are required to explore the relation between vitamin D deficiency and insulin resistance in PD patients.Inonu University Medical Research CenterThis study was supported by Inonu University Medical Research Center
25 (OH) Vitamin D in Patients with Chronic Kidney Disease, and Dialysis Patients
No full textIn addition to its role on calcium homeostasis, vitamin D exhibits local (paracrine) effects on cell proliferation differentiation and immune function. Most cells in the body express Vitamin D receptors and 1 alpha-hydroxylase, thereby permitting local production of 1,25 dihydroxycholecalciferol, which has therapeutic implications (paracrine effects). Studies have shown that chronic vitamin D deficiency may have serious adverse consequences such as increased risk of hypertension, multiple sclerosis, rheumatoid arthritis, cancer of the colon, prostate, breast, ovary, and type 1 diabetes. However, information about the effect of vitamin D supplementation and replacement, and cardiometabolic outcomes is very limited. Studies on Vitamin D replacement in patients with chronic kidney disease and dialysis patients are needed
Good response to HBsAg vaccine in dialysis patients is associated with high CD4+/CD8+ ratio
No full textChronic renal failure is accompanied by various abnormalities of innate and acquired, cellular and humoral immunity. We aimed to investigate whether positive Candida skin test results, CD4+ and CD8+, before the first dose of vaccination could be a predictor for antibody response to hepatitis B vaccination and the relation of these parameters with hepatitis B antibody levels 1 month after the last dose of vaccination. The present study was carried out in 57 dialysis patients. All patients received recombinant hepatitis B vaccine (40 mu g) given intramuscularly in the deltoid muscle in a four-dose schedule at 0, 1, 2, and 6 months. Candida skin test and lymphocyte subsets (CD4+ and CD8+) were determined before the first dose of vaccination and 1 month after the fourth inoculation of hepatitis B vaccine. Ten patients (17.5%) were non-responders (HBsAb 100 IU/L), which was determined 1 month after the fourth dose of vaccination. Thirty-nine patients (68.4%) and 44 patients (77.2%) were anergic to Candida skin test before the first dose and 1 month after fourth inoculation of hepatitis B vaccine, respectively. There was no relationship between Candida skin test and response to hepatitis B vaccination. Mean age was lower, and CD4+/CD8+ ratio measured both before and after vaccination was higher in good responders compared with that of weak responders and that of non-responders. Females were better responders than males. High skin test anergy rate and low seroconversion rate after hepatitis B vaccination are important problems in patients on dialysis. Females, younger patients, and patients with higher CD4+/CD8+ ratio have better HBsAb antibody response to hepatitis B vaccination
SP523THE EFFECTS OF MUSCLE STRENGHT AND PHYSICAL FUNCTION ON BALANCE IN PERITONEAL DIALYSIS PATIENTS
No full text
Diabetic nephropathy: diagnosis, prevention and treatment [Diyabetik nefropati: tani, onleme ve tedavisi]
No full textDiabetic Nephropathy (DN) is a microvascular complication seen in both type 1 and 2 Diabetes Mellitus (DM) and worldwide incidince is increasing. Hemodynamic, metabolic and genetic factors are responsible take part in the pathogenesis. First finding is microalbuminuria (30-300 mg/day or 20-200 µ/min.). Screening for microalbuminuria should be performed once a year, starting 5 years after diagnosis in type 1 DM and at diagnosis in type 2 DM patients. Hyperglycemia, hypertension, smoking, high dietary protein, hyperlipidemia, sex, race, obesity and genetic tendency were identified as independent risk factors in the development and progression of DN. Good glycemic control (HbA1c < 7%), treating hypertension (< 130/80 mmHg or < 125/75 mmHg if proteinuria > 1.0 g/day), treating dyslipidemia (LDL cholesterol [Med-Science 2016; 5(4.000): 1068-73
SP709SERUM NT-PROBNP, ACYLGHRELIN, DESACYLGHRELIN, OBESTATIN, AND FATTY ACID BINDING PROTEIN 4 LEVELS IN HEMODIALYSIS PATIENT
No full textExtrapulmonary tuberculosis in ten hemodialysis patients: a single center experience
No full textTuberculosis (TB) infection is increasing all over the world especially among immunocompromised patients including end stage renal disease (ESRD) patients. Symptoms and signs are non-spesific and involvement is generally extra-pulmonary in ESRD patients. We presented ten ESRD patients with TB. Six of our cases presented with TB lymphadenitis, two with Potts disease, one with breast TB and one with lung TB and Wegeners granulomatosis. The diagnosis of TB is based on the finding of an acid fast bacilli-positive smear, positive culture of Mycobacterium tuberculosis, and typical histopathologic findings. Anti-TB therapy with isoniazid, rifampin, pyrazinamide and ethambutol combinations are generally successful. Non- spesific constitutional symptoms and unexplained deterioration of general health in ESRD patients should attract attention of clinicians about TB infections. [Med-Science 2016; 5(4.000): 1016-8
Vitamin D and pro-inflammatory cytokine IFN-γ and the anti-inflammatory cytokines IL-4 and IL-10 in Peritoneal Dialysis Patients
No full textSeveral clinical trials in patients with chronic disease have found that active vitamin D usage lowers pro-inflammatory cytokines. The aim of this study was evaluate whether supplementation of cholecalciferol in peritoneal dialysis patients with vitamin D deficiency would lead any chance in the pro-inflammatory cytokine IFN-γ and the anti-inflammatory cytokines IL-4 and IL-10, and pentraxin 3 and peripheral blood mononuclear cell subpopulations (CD3, CD4, CD8, CD45)and CD4/CD8 ratio. We analyzed fasting blood samples from 31 continuous peritoneal dialysis patients (14 males, 16 females, mean age 48,6±14,8 yrs) for serum 25-hydroxyvitamin D [25(OH)D)] and specific plasma cytokine concentrations (interferon-gamma [IFN-γ], interleukin [IL]-4, and IL-10), pentraxine 3, CD3, CD4, CD8 and CD45 before and after cholecalciferol replacement. Before and after cholecalciferol replacement mean 25 (OH) level was 6,1±2,1 ng/dL and 39,7±10,9 ng/dL respectively (p [Med-Science 2017; 6(3.000): 393-7
