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Hyperbaric-oxygen treatment: An adjunctive therapy in acute renal failure due to crush injury

Natural Science 2012年第8期4卷 699-704页

作者： rumeyza kazancioglu Cenk Gulgun Salih Aydin Nilgun Aysuna Semra Bozfakioglu Mehmet S Sever Bezmialem Vakif University Faculty of Medicine Department of Nephrology Istanbul Turkey Istanbul University Istanbul Medical Faculty Department of Nephrology Istanbul Turkey Istanbul University Istanbul Medical Faculty Department of Undersea and Hyperbaric Medicine Istanbul Turkey

Objective: Major seismic events leave their survivors trapped under the rubble leading to extensive muscle damage and its devastating sequale of hemodynamic and metabolic disturbances and acute renal failure. Hypoxemia aggravated during each hemodialysis (HD) session is important in acute renal failure patients with massive tissue injury. We retrospectively analyzed the adjunctive role of hyperbaric-oxygen (HBO) therapy in patients treated with HD for acute renal failure due to crush injury in terms of dialysis duration. Patients and methods: 16 patients admitted after the Marmara earthquake to Istanbul Faculty of Medicine were treated with HBO. Only 8 (2M, 6F, mean age: 24.8 + 7.3 years) of them had required HD treatment. 29 (16M, 13F, mean age: 34.6 + 12.9 years) crush syndrome patients treated with HD but not with HBO were taken as controls and the clinical and laboratory data of the two groups were compared. Results: The mean duration time under the rubble for the HBO group was 9.4 + 3.2 hours. Mainly lower extremity fasciotomies were performed at 15.6 + 14.8 hours after extrication. There were no amputations in this group. There were three amputations in the control group. The mean number of HD sessions was 9.2 + 6.7/patient for 10.9+9.6 days until renal functions recovered and the patients had 27.4 + 15.6 HBO sessions until the recovery of their lesions. There were no correlations between the number of HBO sessions and any laboratory parameter nor the number of HD sessions. There was no statistical difference in the need for HD between the HBO and control group. Conclusions: Our results could not demonstrate any beneficial effect of HBO treatment in terms of HD duration;however, the valuable contribution of the HBO treatment was to increase the salvage of crushed limbs.

关键词： Hyperbaric Oxygen Treatment Crush Injury Hemodialysis

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Skin disorders in peritoneal dialysis patients:An underdiagnosed subject

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World Journal of Nephrology 2016年第4期5卷 372-377页

作者： Meltem Gursu Sami Uzun Derya Topcuoglu Leyli Kadriye Koc Lamiye Yucel Abdullah Sumnu Egemen Cebeci Oktay Ozkan Ahmet Behlul Leyla Koc Savas Ozturk rumeyza kazancioglu Department of Nephrology Bezmialem Vakif University Medical Faculty34093 IstanbulTurkey Department of Nephrology Haseki Training and Research Hospital34093 IstanbulTurkey Department of Dermatology Haseki Training and Research Hospital34093 IstanbulTurkey

AIM： To examine all skin changes in peritoneal dialysis （PD） patients followed up in our ***： Patients on PD program for at least three months without any known chronic skin disease were included in the study. Patients with already diagnosed skin disease, those who have systemic diseases that may cause skin lesions, patients with malignancies and those who did not give informed consent were excluded from the study. All patients were examined by the same predetermined dermatologist with all fndings recorded. The demographic, clinical and laboratory data including measures of dialysis adequacy of patients were recorded also. Statistical Package for Social Sciences （SPSS） for Windows 16.0 standard version was used for statistical ***： Among the patients followed up in our PD unit, those without exclusion criteria who gave informed consent, 38 patients were included in the study with male/female ratio and mean age of 26/12 and 50.3 ± 13.7 years, respectively. The duration of CKD was 7.86 ± 4.16 years and the mean PD duration was 47.1 ± 29.6 mo. Primary kidney disease was diabetic nephropathy in 11, nephrosclerosis in six, uropathologies in four, chronic glomerulonephritis in three, chronic pyelonephritis in three, autosomal dominant polycystic kidney disease in three patients while cause was unknown in eight patients. All patients except for one patient had at least one skin lesion. Loss of lunula, onychomycosis and tinea pedis are the most frequent skin disorders recorded in the study group. Diabetic patients had tinea pedis more frequently （ P = 0.045）. No relationship of skin findings was detected with primary renal diseases, comorbidities and medications that the patients were ***： Skin abnormalities are common in in PD patients. The most frequent skin pathologies are onychomycosis and tinea pedis which must not be overlooked.

关键词： Skin Peritoneal dialysis Onychomycosis Tinea pedis Xeroderma

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