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Background: In February 2023, Türkiye experienced 2 significant earthquakes, measuring 7.4 and 7.3 on the Richter scale and impacting 11 provinces. This study was performed to investigate the experiences of patients undergoing hemodialysis treatment in earthquake-affected areas who were relocated to alternative centers, with a focus on assessing the medical challenges that emerged thereafter. Methods: This study included 181 hemodialysis patients (71 females, 110 males) from 11 earthquake-affected provinces who were transferred to different dialysis centers because of infrastructure and superstructure damage at their original treatment facilities. Results: The predominant reason for relocation was damage to personal residences, reported by 77.4% of patients. Notably, 59.4% resumed hemodialysis with a delay of at least 1 day. Emergency complications were observed in 24.6% of patients, with hypervolemia (11.7%) being the most common. At the time of reporting, 23.1% of patients continued treat ment at the relocated centers, while 78.8% expressed intent to return to their original facilities. Importantly, only 1 patient was reported to have died during the study period, highlighting the overall resilience of this population. Conclusion: Hemodialysis patients are particularly vulnerable to the impacts of earthquake-related disruptions. Dialysis centers in high-risk regions must adhere to construction standards that ensure operational resilience. Additionally, priori tizing the transfer and medical coordination of hemodialysis patients during disasters is essential to maintaining continuity of care and minimizing health risks. Cite this article as: Tuğcu M, Keleş M, Duranay M, et al. Post-earthquake realities: A study on the challenges of relocated hemodialysis patients following the Kahramanmaraş earthquake. Turk J Nephrol. 2025;34(4):289-296.

Background: This study investigated the relationship between erythrocyte membrane fatty acids, omega-3 index, and zinc protoporphyrin (ZnPP) levels in hemodialysis (HD) patients across hemoglobin-defined anemia severities. Methods: This prospective cross-sectional study included 117 chronic HD patients and 28 healthy controls. ZnPP was measured by high-performance liquid chromatography, and erythrocyte membrane fatty acids by gas chromatography–mass spectrometry. Results: HD patients showed a significantly lower omega-3 index than controls (p < 0.0001), although it did not differ across hemoglobin-defined groups (p = 0.589). Palmitic and erucic acid were higher, whereas oleic acid was lower, in patients with lower hemoglobin. In unadjusted analyses, hemoglobin correlated inversely with palmitic acid (r = −0.220, p = 0.017) and erucic acid (r = −0.183, p = 0.048), whereas the positive association with oleic acid (r = 0.451, p < 0.0001) remained significant after false discovery rate (FDR) correction. ZnPP increased as hemoglobin decreased (p = 0.013) and was negatively associated with hemoglobin (r = −0.406, p < 0.0001). Conclusions: HD patients with lower hemoglobin showed altered erythrocyte membrane fatty acid composition; among fatty acids, only the oleic acid–hemoglobin association remained significant after FDR correction. ZnPP rose as hemoglobin declined and was independently inversely associated with hemoglobin after multivariable adjustment (β = −0.051, p < 0.0001), independent of any dichotomous reference definition, supporting ZnPP as a continuous marker of anemia severity and iron-restricted erythropoiesis in HD patients.

Amaç: Böbrek yetmezliğinde artmış inflamasyon söz konusudur. Serum ferritini bir akut faz reaktanıdır. Sistemik immün inflamasyon indeksi, kardiyovaskuler hastalıklarda ve kanserlerde prognostic önemi olduğu gösterilen, nötrofil, lenfosit ve trombosit sayılarından hesaplanan yeni bir belirteçtir. Bu çalışma, sistemik immün inflamasyon indeksinin diyaliz hastalarının mortalite riskini belirlemede kullanılabilirliğini ve mortalite ile ferritin düzeyleri arasındaki ilişkiyi belirlemeyi amaçlamaktadır. Gereç ve Yöntemler: Çalışmaya 84 hemodiyaliz ve periton diyaliz hastası alındı. Hastaların bazal demografik, klinik ve laboratuvar verileri, tıbbi kayıtlardan elde edildi. Mutlak nötrofil lenfosit oranının, mutlak platelet ile çarpımı ile sistemik immün inflamasyon indeksi elde edildi. Sonuç: Hastaların ortalama yaşı 51.3 ± 20.1olup, ortalama takip süreleri 60 (6 ~ 85) aydı. Takip süresince hastaların 45(%53) ü öldü. Hastalar medyan ferritin düzeyine göre analiz edildi. Kaplan-Meier analizine göre ferritinin yüksek olduğu grupta mortalitenin daha yüksek olduğu saptandı (log-rank test, P = 0.029). Yine hastalar medyan sistemik immün inflamasyon indeksine göre analiz edildi. Kaplan-Meier analizine göre sitemik immün inflamasyon indeksinin yüksek olduğu grupta daha yüksek mortalite oranları saptandı (log-rank test, P = 0.029). Çok değişkenli regresyon analizinde yaş (HR 1.060, P=0.00), Kt/V (HR 0.161, P=0.014), CRP (HR1.001, P=0.0429) ve Sistemik immün inflamasyon indeksi (HR 1.001, P=0.00) ve ferritin (HR) 1.001, P=0.013) tüm nedenlere bağlı ölümlerin en önemli belirleyicileriydi. Tartışma: Yeni bir inflamatuar belirteç olan Sistemik immün inflamasyon indeks ve ferritin, diyaliz hastalarında tüm nedenlere bağlı ölümlerle ilişkilidir. Diyaliz hastalarında inflamasyonun Sistemik immün inflamasyon indeks ve ferritin düzeyleri ile takip edilebileceğini düşünüyoruz.

Background: Subclinical hypothyroidism (SCH) is a term to define a mild and early thyroid deficiency. Some reports claim SCH has an association with increased cardiovascular disease (CVD), especially in individuals 4 mIU/L TSH levels were labelled for SCH group. Both groups were evaluated for MPV, lipid profiles and epidemiological features. Results: SCH group had higher levels of MPV, total cholesterol (TC) and LDL cholesterol (LDL-C) levels (P