Search

Amaç: Tüm dünyada olduğu gibi ülkemizde de yaşlı nüfusun artışıyla hemodiyaliz tedavisi alan yaşlı hasta sayısı artmaktadır. Yaşlı hemodiyaliz hastalarında beslenme sorunları mortalite ve morbiditeyi arttırdığı için erken dönemde tanı konulması ve tedaviye başlanması büyük öneme sahiptir. Bu çalışma hemodiyaliz tedavisi alan yaşlı hastalarda yetersiz beslenme prevalansını belirlemek ve Mini Nütrisyonel DeğerlendirmeKısa Formu ile vücut kütle indeksinin beslenme yetersizliği olan hastalardaki etkinliğini değerlendirmek amacıyla yapıldı. Gereç ve Yöntem: Bu kesitsel çalışmaya 65 yaş ve üstü, 66’sı (69,24±5,68) erkek ve 57’si (71.01±7.50) kadın toplam 123 hasta dahil edildi. Hastalara ait antropometrik, klinik ve laboratuvar verilere tıbbi dosyalardan ulaşıldı. Hastalar Mini Nütrisyonel Değerlendirme-Kısa Formu ve vücut kütle indeksi ile değerlendirildi. Bulgular: Mini Nütrisyonel Değerlendirme-Kısa Formuna göre 44 (%35,7) hastada malnütrisyon, 53 (%43,1) hasta malnütrisyon, yönünden riskli, 26 (%21,2) hasta normal beslenme durumu olarak değerlendirildi. Her üç grup arasında vücut ağırlığı ve vücut kitle indeksi açısından istatistiksel olarak anlamlı fark saptandı (sırasıyla; p

Introduction: Hemodialysis (HD) patients have increased risk for short-term adverse outcomes of COVID-19. However, complications and survival at the post-COVID-19 period have not been published extensively.Methods: We conducted a national, multicenter observational study that included adult maintenance HD patients recovered from confirmed COVID-19. A control HD group without COVID-19 was selected from patients in the same center. We investigated the characteristics and outcomes in the follow-up of HD patients and compare them with the non-COVID-19 group.Results: A total of 1223 patients (635 patients in COVID-19 group, 588 patients in non-COVID-19 group) from 47 centers were included in the study. The patients' baseline and HD characteristics were almost similar. The 28th-day mortality and mortality between 28th day and 90th day were higher in the COVID-19 group than non-COVID-19 group (19 [3.0%] patients vs. none [0%]; 15 [2.4%] patients vs. 4 [0.7%] patients, respectively). The presence of respiratory symptoms, rehospitalization, need for home oxygen therapy, lower respiratory tract infection, and arteriovenous (AV) fistula thrombosis was significantly higher in the COVID-19 group in both the first 28 days and between 28 and 90 days. In the multivariable analysis, age (odds ratio [OR] [95% CI]: 1.029 [1.004-1.056]), group (COVID-19 group vs. non-COVID-19 group) (OR [95% CI]: 7.258 [2.538-20.751]), and vascular access type (tunneled catheter/AV fistula) (OR [95% CI]: 2.512 [1.249-5.051]) were found as independent parameters related to 90-day mortality.Conclusion: In the post-COVID-19 period, maintenance HD patients who have had COVID-19 have increased rehospitalization, respiratory problems, vascular access problems, and high mortality compared with the non-COVID-19 HD patients.

Objective Older adults with co‐morbidities have been reported to be at higher risk for adverse outcomes of coronavirus disease 2019 (COVID‐19). The characteristics of COVID‐19 in older patients and its clinical outcomes in different kidney disease groups are not well known. Methods Data were retrieved from a national multicentric database supported by Turkish Society of Nephrology, which consists of retrospectively collected data between 17 April 2020 and 31 December 2020. Hospitalised patients aged 18 years or older with confirmed COVID‐19 diagnosis suffering from stage 3‐5 chronic kidney disease (CKD) or on maintenance haemodialysis (HD) treatment were included in the database. Non‐uraemic hospitalised patients with COVID‐19 were also included as the control group. Results We included 879 patients [388 (44.1%) female, median age: 63 (IQR: 50‐73) years]. The percentage of older patients in the CKD group was 68.8% (n = 188/273), in the HD group was 49.0% (n = 150/306) and in the control group was 30.4% (n = 70/300). Co‐morbidities were higher in the CKD and HD groups. The rate of presentation with severe‐critical disease was higher in the older CKD and HD groups (43.6%, 55.3% and 16.1%, respectively). Among older patients, the intensive care unit (ICU) admission rate was significantly higher in the CKD and HD groups than in the control group (38.8%, 37.3% and 15.7%, respectively). In‐hospital mortality or death and/or ICU admission rates in the older group were significantly higher in the CKD (29.3% and 39.4%) and HD groups (26.7% and 30.1%) compared with the control group (8.6% and 17.1%). In the multivariate analysis, in‐hospital mortality rates in CKD and HD groups were higher than control group [hazard ratio (HR): 4.33 (95% confidence interval [CI]: 1.53‐12.26) and HR: 3.09 (95% CI: 1.04‐9.17), respectively]. Conclusion Among older COVID‐19 patients, in‐hospital mortality is significantly higher in those with stage 3‐5 CKD and on maintenance HD than older patients without CKD regardless of demographic characteristics, co‐morbidities, clinical and laboratory data on admission.