D Vitamini, Kalsiyum & Mineral Metabolizması, D Vitaminin İskelet Dışı Etkileri ve Kronik Böbrek Yetmezliğinde Nütrisyonel D Vitamini Kullanımı

Background/aim: Deficient levels of vitamin D are an important factor in the pathogenesis of some neurodegenerative diseases. The aim of this study is to determine the relationship between vitamin D deficiency and depression status and sleep disorders of patients on dialysis. Materials and methods: In this cross-sectional study, 121 hemodialysis patients were enrolled. All patients had been on hemodialysis for at least six months at the time of the study. Sleep quality and depression status were measured by using specific inventories. All the patients filled out Pittsburg Sleep Quality Index (PSQI) and Beck Depression Inventory (BDI), and gave blood samples. Vitamin D levels were measured for 121 patients, and statistical analysis was done by using SPSS. Results: Regression analyses demonstrated that low levels of 25(OH)D and high BDI score were independent risk factors for poor sleep quality [ORs were 0.668 (0.566-0.789), 1.080 (1.001-1.164), and 1.080 (1.001-1.164), respectively]. Conclusion: Our results suggest that deficiency of 25(OH)D is an important independent risk factor for poor sleep quality in hemodialysis patients.

Amaç:. Bu çalışmada varyant B.1.1.7 pozitif ve negatif SARS-CoV-2 enfeksiyonu olan hastalarda akut böbrek hasarı gelişimi ve mortalite oranlarının karşılaştırılması amaçlanmıştır. Materyal ve Metod: Çalışmaya varyant B.1.1.7 negatif 92 (grup I) ve 57 varyant B.1.1.7 pozitif 57 (grup II) SARS-CoV-2 hastası dahil edildi. Her hastanın demografik verileri, komorbiditeleri, yoğun bakım yatış gün sayıları, invaziv mekanik ventilatör ihtiyacı, mekanik ventilatör gün sayısı, akut böbrek yetmezliği gelişip gelişmediği, gelişti ise kaçıncı günde akut böbrek yetmezliği geliştiği ve tedavinin sonlanım şekilleri kaydedildi. Bulgular: Grup II hastalara 17/57 (29.8%) grup I hastalara 31/92 (33.7%) göre daha fazla oranda akut böbrek hasarı gelişti (p=0.04). Grup I’de 46/92 (50 %) grup II’de 38/57 (66.7%) hasta hasta invaziv mekanik ventilasyon desteğine alındı (p <0.05). Akut böbrek hasarı gelişmeyen hastaların mortalite oranı grup II’de 22/40 (55%) grup I’e 19/61 (31.2%) göre daha yüksekti (p<0.05). Sonuç: Varyant B.1.1.7 enfeksiyonu olan hastalarda akut böbrek hasarı gelişiminin diğer grup hastalara göre daha az olduğu saptanmıştır. Varyant B.1.1.7 enfeksiyonundaki mortalite artışının akut böbrek hasarı gelişiminden bağımsız olarak gerçekleştiğini düşündürmektedir.

Introduction: Depression and sleep disturbance are prevalent comorbidities in hemodialysis patients. This study aimed to investigate the relationship between depressive mood, sleep disturbance, and the fear of COVID-19 Scale in hemodialysis patients during the pandemic process. Material and Method: 116 hemodialysis patients followed up in our clinic and volunteered were included in the study. The socio-demographic characteristics of the patients and the laboratory test results studied in their routine follow-ups were obtained from the file records. Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and the Fear of COVID-19 Scale (FCV-19S) were applied through face-to-face interviews. Results: 116 patients (70 males, 46 females) with a hemodialysis duration of 40 months (13-295) and age of 60.2±13.3 years were included in the study. The patients were divided into two groups according to their PSQI score as good sleeper (PSQI ≤ 5, n=66) and poor sleeper (PSQI >5, n=50). When evaluated by gender 28 (56%) female patients were in the poor sleeper group (p=0.002). Dialysis time was longer, BDI score and FCV-19 scale were higher in the poor sleeper group than the good sleeper group. PSQI score was positively correlated with dialysis time (r=0.259 p=0.005), BDI score (r=0.279 p=0.002), and FCV-19 scale (r=0.304 p=0.001). In the Multiple Logistic Regression analysis established to evaluate the risk factors affecting sleep quality, BDI was determined as an independent risk factor for poor sleep (OR: 1.084, 95%CI [1.021-1.152], p=0.008). Subjects were divided into two groups according to their BDI scores as those with depressive mood (BDI score ≥ 17, n=47) (40.5%) and those without (BDI score < 17, n=69) (59.5%). Thirty-two of the cases with depressive mood were women (68.1%) (p