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Objective: The most important factor in facing the pandemic is to ensure the physical and mental health status of the healthcare workers. Studies have found serious stressors experienced by the hemodialysis incharge-nurses but report less burnout than the other nurses. Determining the mental distress of the hemodialysis incharge-nurses during the pandemic is important in determining the necessary precautions. The objective of this study is to determine the psychological complaints of the hemodialysis incharge-nurses during the pandemic. Methods: The participants of the study are hemodialysis incharge-nurses who work in different provinces of Turkey. The data of the study were collected from April to June 2020. Beck Anxiety Inventory was used to measure the frequency of anxiety symptoms experienced by the individuals. Beck Depression Inventory was used to measure the behavioral manifestations of depression. Maslach Burnout Inventory was used to measure burnout in the workplace. The Perceived Trauma Coping Scale was used to evaluate the perception of coping-up with a traumatic life. Results: In our study, we found Beck Anxiety Inventory mean score was 13.42 +/- 11.28, Beck Depression Inventory mean score was 11.88 +/- 9.57, Maslach emotional exhaustion mean score was 15.74 +/- 8.19, Maslach depersonalization mean score was 4.96 +/- 3.70, and Maslach personal failure mean score was 8.95 +/- 4.50, respectively. Finally, the mean Perceived Trauma Coping Scale trauma score was 63.05 +/- 12.78, the mean Perceived Trauma Coping Scale future score was 36.34 +/- 8.65, and the mean Perceived Trauma Coping Scale elasticity score was 71.94 +/- 17.67, respectively. Conclusion: The findings of the study show the importance of the improvements to be made in reducing the depression and burnout levels of the nurses.

Hypogonadism in male patients with chronic renal failure and diabetes mellitus has been known separately; up to now, the effect of these two diseases together on testosterone deficiency and the impact of testosterone deficiency on metabolic values have not been known precisely, therefore in this study we aimed to investigate testosterone deficiency in patients with diabetes mellitus and chronic renal failure. Eighty-seven chronic renal failure patients and 45 control patients who were followed at endocrinology and nephrology clinics were included in the study. After exclusion criteria, the patients were divided into two groups according to diabetes mellitus status. Groups were compared according to testosterone levels. Testosterone deficiency and good groups were compared to blood glucose, Hba1c, and lipid profile levels. The mean age of 87 CRF patients and 45 people in the control group were similar (59.85 ± 9.99 and 56.67 ± 8.56, respectively, p= 0.16). Testosterone deficiency was 24.1% (21/87) in CRF group and 8.8% (4/45) in control group (p= 0.04). The total testosterone levels were notably lower in the diabetic-CRF patients, 3.44 ± 1.3 vs. 4.26 ± 1.46 mg/dl (p= 0.02). The testosterone deficient CRF group had higher blood glucose and HbA1c according to the testosterone sufficient group. (161.20 ± 61.24 mg/dl vs 133.25 ± 59.87 mg/dl blood glucose, p= 0.04 and 7.54 ± 1.46 vs 6.79 ± 1.14 % HbA1c, p= 0.04). Serum triglyceride and LDL levels did not significantly change between groups (p= 0.20 and 0.76, respectively). Testosterone deficiency in male CRF patients is not uncommon. Male patients with both T2DM and CRF have more common testosterone deficiency. In testosterone-sufficient patients, blood glucose regulation was better. Therefore, in these patients, it may be helpful not to neglect testosterone deficiency, which affects gonadal function, body metabolism, and cardiac and skeletal health.

Introduction: There are many differences between hemodialysis (HD) and peritoneal dialysis (PD) treatments, including their impact on the psychological status of the patients. In this study, our aim was to compare the psychological statuses of HD and PD patients during the social isolation period due to the COVID-19 pandemic. Methods: We conducted this cross-sectional study on adult HD and PD patients when the curfew measures were in effect. We used an electronic form composed of 3 sections to collect data. In the first section, we collected data on the demographics and clinical and laboratory parameters of the patients. The second and third sections consisted of the Hospital Anxiety and Depression Scale (HADS) and the Impact of Event Scale-Revised (IES-R) questionnaires, respectively. Results: The HD (n = 116) and PD (n = 130) groups were similar regarding age and sex, and they had similar HADS anxiety scores. HADS depression scores were higher in PD patients (p = 0.052). IES-R scores were significantly higher in PD patients in comparison to HD patients (p = 0.001). Frequencies of abnormal HADS-anxiety (p = 0.035) and severe psychological impact (p = 0.001) were significantly higher in PD patients. Discussion/Conclusion: During the social isolation period due to the COVID-19 pandemic, HD patients had better mood profiles than PD patients. A more stable daily routine, an uninterrupted face-to-face contact with health-care workers, and social support among patients in the in-center dialysis environment might be the cause of the favorable mood status. PD patients might need additional psychological support during those periods.

This study evaluated the effectiveness of prognostic nutritional index (PNI) in predicting contrast induced nephropathy (CIN) in patients with acute coronary syndrome (ACS). This study included 925 ACS patients (mean age 62.5 ± 12.4 years, 73.5% male); 604 were diagnosed as unstable angina pectoris/non–ST-elevation myocardial infarction (USAP/NSTEMI) and 321 as ST-elevation myocardial infarction (STEMI). The PNI formula was: 10 × serum albumin (g/dL) + .005 × total lymphocyte count (/mm3). The patients were divided into two groups: CIN (n = 232) and non-CIN (n = 693). Patients without CIN had a significantly lower PNI than patients with CIN (44.3 ± 6.9 vs 54.7 ± 7.4; P < .001). In the receiver operating characteristic (ROC) curve analysis, the cut-off value for PNI of 48.6 has 80% specificity and 81% sensitivity in predicting CIN (area under the ROC curve (AUC): .87, 95% CI [.84–.89]). PNI

Abnormalities of trace elements have previously been linked to inflammatory processes in hemodialysis (HD) patients. We aimed to establish the trace element status of maintenance HD patients, to investigate the relationship between coronary artery calcification scores (CACs) and whole blood levels of trace elements.Patients undergoing HD in three times a week for 6 months and age-and sex-matched controls were included from October 2015 to June 2016. Data were collected from patient files. All subjects' whole blood levels of trace elements were measured by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). CACs for patients were assessed by multi-detector computed tomography.The 35 patients (male, 60%) with a mean age of 45.7 ± 10.4 years and 35 controls were included. HD patients showed significantly lower levels of selenium and uranium and higher cadmium (Cd), cobalt, lithium, manganese, nickel, lead, platinum, tin, strontium, and thallium levels compared to controls. Coronary artery calcification (CAC) was present in 21 patients (60%), and median CACs were 14.2 (IQR 0-149). Patients with CACs median were significantly older, had a higher prevalence of hypertension and lower ALP levels than patients with CACs ≤ median. No significant differences in whole blood levels of trace elements were found between patients with CACs median and patients with CACs ≤ median. A near significance was noted in median whole blood levels of Cd between these groups (P = 0.096). According to multivariate analysis, age was the only independent determinant for CAC development.Age is independently associated with coronary vascular calcification. High Cd levels might play a role in CAC development in HD patients.

The aim of the study was to evaluate the clinical features of the patients on hemodialysis with COVID-19 and determine the prognostic factors. In this single center prospective study, a total of 58 chronic renal failure patients on hemodialysis and diagnosed COVID-19 infection were enrolled in the study. The patients were divided into two groups according to their need for intensive care unit referral. Demographic features of the patients, clinical manifestations, laboratory data, treatments, and clinical outcome were evaluated. The mean age of 58 HD patients was 63.2±13.8 (30-93) years and female-male ratio was 0.34. SARS-CoV2-PCR positivity rate was 32.8%. 85.2% of patients (n=46) had bilateral lesions and 14.8% (n=8) had unilateral one lesion in chest CT. The most common symptoms were fatigue (in 44 patients, 80%) and dyspnea (in 31 patients, 56.4%). The most common comorbidity was HT (in 37 patients, 67.3%). The patients who need intensive care and died were older (p=0.015). We observed lower platelet and eosinophil counts, potassium levels, higher AST, troponin and CRP levels in the group of patients who need intensive care and died than the group who survived (p=0.043, p=0.005, p=0.033, p=0.007, p=0,001, p

WOS: 000461206800006, Objective: Bioimpedance spectroscopy (BIS) can be used to determine hypervolemia and malnutrition in chronic hemodialysis (HD) patients. In this prospective observational study, we investigated the survival predictability of impedance ratio (IR) calculated by BIS in HD patients (Clinical Trials Gov Identifier: NCT01468363). Materials and Methods: A total of 430 chronic HD patients, out of 500 prevalent chronic HD patients from the city of Zonguldak who met the inclusion criteria, were included in the study. With a mean follow-up of 32.2 +/- 14.4 months, BIS was performed in all patients. The IR percentage (IR%) was calculated by dividing the resistance values using the 200 kHz and 5 kHz impulses. Student's t-test, Cox regression analysis, and Kaplan-Meier survival analysis were performed, and a p

Background To evaluate osteoprotegerin (OPG) levels in relation to cardiovascular (CV) risk factors in patients with chronic kidney disease (CKD) on different regimens of renal replacement therapy. Methods A total of 143 patients with CKD and 30 healthy controls were included in this study and divided into five categories, including predialysis patients with chronic renal failure (preD; n = 36), chronic peritoneal dialysis patients (PD; n = 36), hemodialysis patients (HD; n = 35), renal transplant patients (RT; n = 36), and controls (n = 30). Data on demographics, concomitant diseases and CV risk factors, serum OPG levels, and correlates of serum OPG levels were determined. Results Serum OPG (pmol/l) levels were significantly higher in HD (P

High serum phosphorus (P) levels in chronic renal failure (CRF) lead to parathyroid hormone (PTH) resistance of skeletal system. Serum calcitriol level increases and calcium (Ca) reabsorbtion from intestine decreases. Because of these abnormalities calcifications occur in soft tissues and perivascular tissues. Cardiovascular complications occur and high CaxP product levels seen in laboratory results. Our aim was to find out the critical level of CaxP product in different treatment groups of patients with CRF. CRF patients who did not require dialysis before (preD, N=36), chronic renal disease patients on peritoneal dialysis (PD, N=36), chronic renal disease patients receiving hemodialysis treatment (HD, N=35), renal transplant patients (Tx, N=36), and healthy individuals (N=30) evaluated for the study. Total of 173 patients (77 male, 96 female) included to the study. Patients body mass indexes calculated. Blood levels of PTH, Ca, P and cystatin C (CysC) levels were measured (Siemens Healthcare Diagnostics, USA). Kolmogorov-Smirnov test is used to check the normality of data among groups. One Way Analysis of Variance is used for normally distributed groups. For non-normally distributed data, Kruskal Wallis Analysis of Variance is used for comparison of groups. Associations between categorical variables are assessed using the cross-tables and Chi-squared tests. The Receiver operating characteristics (ROC) analysis is used to measure the performance of biochemical parameters in detecting kidney dysfunction. Greater than 1mg/dL CysC levels accepted as renal dysfunction. The cut-off value for CaxP product was obtained as 37.535. Area under the ROC curve was 0.678 (p=0.002), the sensitivity and specificity were 0.573 and 0.800, respectively. Median value of all groups for CaxP was found as 37.730; very near the cut-off value (37.535). There was a significant difference in CysC levels between the two groups of dialysis according to cut-off value of 37.535. (p

Objective: Body composition analysis is useful technique for assessing hydration, nutritional status and predicting clinical outcomes. Bioimpedance analysis (BIA) is a cheap and noninvasive tool for monitoring body composition but needs some improvements regarding measurement methods. We aimed to find out if body position has an effect on the BIA results. Material and Methods: Personal characteristics including age, gender, height, weight and blood pressure were recorded. Hydration and nutritional status measured by body composition monitor in supine and standing positions consequently for each individual. Results: Two hundred and one populations from various region in Turkey, 61% (n: 123) male, mean age was 46.3±12 years (18-76) of age, participated in this crossectional study. From supine to standing positions overhydration and extracellular water (ECW) were increased from 0.04±1.08 and 17.69±2.92 to 0.46±1.05 L and 17.84±2.90 L while intracellular water (ICW) decreased from 22.55±4.35 to 22.04±4.28 L significantly. Systolic and diastolic blood pressures were 131.3±18.1 and 75.1±12 decreased to 127.0±16.0 and 72.2±9.0 mmHg in supine to standing positions (p> 0.05). Conclusion: Supine and standing positions could affect the volume parameters of BIA due to shift of ECW and ICW by gravity but nutritional parameters also changes significantly. Protocols should be re evaluated in order to get more accurate results in bioimpedance measurements.

AIM: To evaluate the clinical outcome, identify predictors of patient and technique survival in our peritoneal dialysis (PD) patients in the western region of Turkey. METHODS: We included all patients who initiated therapy between 2001 and 2010. Socio-demographic characteristics such as who helped to administer the PD as well as conditions under which PD was chosen by patients were investigated from patients' files. Hemodialysis (HD) history and duration, additional systemic diseases, and end-stage renal disease etiologies of all patients were recorded. Clinical data such as blood pressure, amount of ultrafiltration, and laboratory parameters were evaluated before initiation of PD and during the last monitoring period. Infectious complications and their incidences were investigated. Patient and technique survival were investigated for every patient. RESULTS: 322 patients started PD treatment during the study period. 23 patients were excluded. Data from the remaining 299 patients (167 female, mean follow-up time 38.5 ± 26.8 months, mean age 44.7 ± 15.9 years) were evaluated retrospectively. It was determined that 87.3% of the patients made their PD exchanges without help from anyone. 79.9% of patients chose PD as their personal preference. 48 patients had HD history before PD. Peritonitis incidences and catheter exit site/tunnel infection attacks were 27 ± 23 and 32.3 ± 24.9 patient-months, respectively. During the follow-up period, 199 patients (80 patients transferred to HD, 78 patients died and, 41 patients had transplantation) were withdrawn from PD. The most frequent causes of death were cardiovascular events and peritonitis and/or sepsis, whereas most frequent causes of transfer to HD were peritonitis and/or sepsis. Mean survival time was 49.9 ± 2.6 months. The estimation of survival rate was 85.2%, 66.5% and 45.3% at 1, 3, and 5 years, respectively. Preference for PD (RR: 4.77, p < 0.001), presence of HD history (RR: 2.08, p = 0.04), presence of diabetes mellitus (RR: 2.13, p = 0.01), low pretreatment serum albumin (RR: 0.32, p < 0.001), and low serum parathormone levels at last visit (RR: 0.99, p = 0.04) were predictors of mortality. Mean technique survival duration was 48.5 ± 2.4 months. The estimation of technique survival by Kaplan-Meier analyses was 92%, 67% and 43% at 1, 3, and 5 years, respectively. Technique survival was associated with preference for PD (RR: 0.45, p < 0.001), presence of diabetes mellitus (RR: 1.92, p = 0.003), and pretreatment serum albumin levels (RR: 0.58, p = 0.003). CONCLUSION: Patient survival in the presented institute is similar to that reported in Western countries. Compulsory choice of PD, presence of HD history, presence of diabetes, low pretreatment serum albuminm, and low serum parathormone levels at last visit were the strongest predictors of death. Risk factors for technique failure were compulsory choice of PD, presence of diabetes, low pretreatment serum albumin.

Introduction: Overhydration is the main contributory factor of left ventricular hypertrophy and closely associated with cardiovascular events in end stage renal disease (ESRD) patients. The aim of this prospective-study was to investigate the impact of strict salt and volume control on hypertension and cardiac condition in ESRD patients. Methods: A total of 12 peritoneal dialysis (PD) and 15 prevalent hemodialysis (HD) patients were enrolled. All patients either PD or HD were allocated to intervention of strict salt restriction according to basal hydration state of empty abdomen in PD and midweek predialysis HD which were estimated by body composition monitor (BCM) and echocardiography. Results: Mean ages were 48.3±16.7 years for PD, and 48.8±18 for HD patients. Extracellular water/height was 10.04±2.70 and 10.39±1.53L/m in PD and HD groups. Systolic blood pressures decreased in PD and HD from 133.1±28 and 147.3±28.5 to 114.8±16.5 and 119.3±12.1mmHg, respectively, (p0.05). LVMI and LAI were not increased in both groups. Conclusion: Strict salt and volume control in ESRD patients after assessment of hydration status with either using BCM or echocardiography provides better management of volume control leading to more precise cardiovascular protection. © 2013 Informa Healthcare USA, Inc.

Introduction. Continuous ambulatory peritoneal dialysis (CAPD) is widely accepted for the management of end-stage renal disease (ESRD). Although not as widely used as hemodialysis, CAPD has clear advantages, especially those related to patient satisfaction and simplicity. Peritoneal dialysis (PD) catheter insertion can be accomplished by several different techniques. In this study, we aimed to evaluate our results obtained with peritoneal dialysis catheter placement by combination of pelvic fixation plus preperitoneal tunneling. Material and Methods. Laparoscopic peritoneal catheter implantation by combining preperitoneal tunneling and pelvic fixation methods was performed in 82 consecutive patients with end-stage renal disease. Sex, age, primary disease etiology, complications, mean duration of surgery, mean duration of hospital stay, morbidity, mortality, and catheter survival rates and surgical technique used were assessed. Analysis of catheter survival was performed using the Kaplan-Meier method. Results. Mean follow-up period was 28.35 ± 14.5 months (range of 13–44 months). Mean operative time was 28 ± 6 minutes, and mean duration of hospital stay was 3 ± 1 days. There were no conversions from laparoscopy to other insertion methods. None of the patients developed serious complications during surgery or the postoperative period. No infections of the exit site or subcutaneous tunnel, hemorrhagic complications, abdominal wall hernias, or extrusion of the superficial catheter cuff was detected. No mortality occurred in this series of patients. Catheter survival was found to be 92% at 3 years followup. Conclusions. During one-year followup, we had seven patients of migrated catheters due to separation of pelvic fixation suture from peritoneal surface, but they were reimplanted and fixated again laparoscopically with success. Over a three-year followup period, catheter survival was found to be 92%. In the literature, similar catheter survival rates without combination of the two techniques are reported. As a conclusion, although laparoscopic placement of PD catheters avoids many perioperative and early complications, as well as increasing catheter free survival period and quality of life, our results comparing to other studies in the literature indicate that different laparoscopic placement methods are still in debate, and further studies are necessary to make a more accurate decision.

WOS: 000393291900012 OBJECTIVE: Cinacalcet reduces parathyroid hormone levels by increasing the sensitivity of the parathyroid gland to calcium. in this study, we firstly aimed to evaluate the efficacy of cinacalcet in Turkish hemodialysis patients. MATERIAL and METHODS: 4483 hemodialysis patients were screened and 469 patients who had used cinacalcet were included in the study. the patients were divided into 4 groups according to drug usage durations (Group 1: 3 months, Group 2: 6 months, Group 3: 9 months and Group 4: 12 months). the patients' Parathormone, Ca, P and CaxP levels at the 3rd, 6th, 9th and 12th months were compared to the start of treatment and previous months. RESULTS: the levels of Parathormone, Ca, P and CaxP significantly decreased compared to their initial levels in all groups (from 1412 pg/ml to 1222 pg/mL for Parathormone, p< 0,001) in the 3rd month. However, this reduction was not continued in the subsequent months (Parathormone: 1381 pg/ml for the 12th month). CONCLUSION: Cinacalcet may not provide adequate benefit in control of hyperparathyroidism in Turkish hemodialysis patient population.

Background: Depression is a co-morbidity whose identifi cation and intervention can be vital in chronic kidney failure. Case report: 36-yearold male patient was brought to ER with palpitation. He had been diagnosed with chronic kidney failure for 9 months and on dialysis for 6 months. Physical examination showed 220/minutes HR and ECG tachycardia with high T waves, broad QRS and P wave, prolonged PR distance which were consistent with severe hyperkalemia. His K level was 9.55 mEq/L and received an emergency dialysis. Control ECG was normal and K level was 4.86 mEq/L. The reason for fatal increase in K level was overconsumption of apricots. He didn’t follow his diet although warned at dialysis sessions. He was given education about his diet again. The following day, his K level was 7.48 mEq/L and received another emergency dialysis. He’d been eating grapes aware of the consequences. The patient was on dialysis in 3 months after his diagnosis and lost his job because of his dialysis sessions and was still unemployed. He had socioeconomical problems and learned that overconsumption of fruits could kill him. In the light of those fi ndings; he was considered to have major depression with suicidal ideation and was emergently referred to a psychiatry clinic for observation and treatment. Conclusion: Chronic kidney failure consists many physical and psychological problems. Dialysis patients depend on machines, invasive procedures and health workers, generally cannot keep a full time job. There is also a serious food and drink restriction. Thus; depression is common and there is a higher suicide rate. Still; depression is underdiagnosed and undertreated in dialysis patients. To check dialysis patients for depression signs and start therapy if needed will improve the quality of life and prevent possible suicide attempts. PS 0536 Nephrology

WOS: 000340761700001, PubMed ID: 25177700, Objectives. Hypertension and hypervolemia relationship was proven among renal disease, although it is not known in normal population. Present study determines the fluid distribution defects in relation to blood pressure. Material and Methods. In a population-based survey in Turkey demographics, height, weight, blood pressure, urine analysis, and serum creatinine measurements were recorded. Bioimpedance measured with the Body Composition Monitor. Results. Total 2034 population of 71.6% male, mean age 47 +/- 12.6 (18-89) years, systolic blood pressure (SBP) 134.7 +/- 20, diastolic blood pressure 77.9 +/- 11.6 mmHg. Body mass index (BMI) was 28.5 +/- 4.5 (15.8-50.6) kg/m(2); overhydration was 0.05 +/- 1.05 L. There was a correlation between extracellular water (ECW)/height and SBP (r = 0.21, P < 0.001). Receiver operating characteristic (ROC) curve with the performance of 0.60 (P < 0.001) that showed cut-off value of ECW/height was 10.06 L/m, with the 69% sensitivity and 45% specificity for SBP: 140 mmHg values. Risk factors for high SBP were increase of ECW/Height, age, BMI and presence of diabetes. ECW/height, SBP, and fat tissue index (FTI) increased in BMI categories (low, normal, and obese) and in diabetics. SBP and FTI were lower in smokers. Conclusions. High blood pressure may be accompanied by increased extracellular volume indices. In the future volume status assessment could be of use in evaluating the effectiveness of pharmacological intervention in the treatment of hypertension.

To investigate the effects of ESRD etiologies on mortality in peritoneal dialysis patients.We included patients who initiated therapy between 2001-2011 and classified them according to etiologies including amyloidosis, diabetes mellitus, chronic glomerulonephritis and polycistic renal disease. Socio-demographic data, clinical courses and infectious complications were compared between groups, and the reasons for peritoneal dialysis withdrawal were recorded. Patient and technique survival analysis were performed.354 patients were included to the study. Thereafter, 154 patients were excluded. Totally, 29 patients with AA-amyloidosis (mean age 37.9±16.4 years, follow-up time 21.7±20.2 months), 78 patients with diabetes mellitus (mean age 56.9±13.6 years, follow-up time 35±28.6 months), 68 patients with chronic glomerulonephritis (mean age 37.2±12 years, follow-up time 47.7±29.9 months), 29 patients with polycystic renal disease (mean age 35.6±13.8 years, follow-up time 45.4±36.8 months) were evaluated. Albumin level was lower in patients with amyloidosis at initiation and the end of study (for both p0.001). Incidence of peritonitis and catheter exit site/tunnel infection attacks were higher in patients with amyloidosis (p=0.002 and 0.018 respectively). There was statistical difference among groups with respect to the last status of patients (p0.001). Deaths were frequent in amyloidotic and diabetic patients. The majority of deaths were due to peritonitis and/or sepsis and, cardiovascular reasons. The mortality rate was found higher in patients with amyloidosis (log rank=0.005), especially at first 2-3 years. Presence of anyone helping to administer peritoneal dialysis (OR:6.244, p=0,025), initial serum albumin level (OR:0.352, p=0,034) and presence of catheter exit site/tunnel infection(OR:0.250, p=0,015) were independent predictors of patient survival.Renal failure etiology has effects on peritoneal dialysis patients' survival. Patients with amyloidosis have the worst survival. Because of loss of PD survival advantage seen in first years of therapy in patients with amyloidosis, peritoneal dialysis may not be suitable as first choice therapy in this group.

The aim of this study is to investigate the mortality and the factors which may affect it in patients who were transferred to peritoneal dialysis (PD) from hemodialysis (HD), compared to patients assigned to PD as first-line therapy.A total of 322 patients treated with PD between 2001 and 2010 were evaluated retrospectively. Twenty three patients were excluded and the data of remaining 299 patients (167F, mean follow up time 38.5±26.8 months, mean age 44.7±15.9 years) were evaluated. Patients were separated into two groups according to their HD history. Group 1 and group 2 consisted of patients with (n=48) and without (n=251) a history of prior HD, respectively. Socio-demographic characteristics such as who helped administer the PD and the preference of patients (compulsory vs their preference) were obtained from the patient records. The clinical data obtained during the last clinical evaluation before the initiation of PD (blood pressure, daily urine volumes, daily ultrafiltration amounts and laboratory parameters) were recorded. Additional systemic diseases and information about the etiologies of the end stage renal disease (ESRD) of all patients were recorded. Frequencies of the infectious complications were recorded. Patient and technique survival were investigated and compared between groups.In group 1, the patients were older and had less urine amounts (p=0.028 and 0.041 respectively). Thirty five patients (70%) and 25 patients (9.3%) have been transferred to PD due to vascular problems in group 1 and 2, respectively (p0.001). In group 1, 37 (74%) patients were carrying out PD treatment by themselves, compared to 222 (88.4%) patients in group 2 (p=0.016). Incidences of peritonitis and catheter exit site/tunnel infection attacks were found 24.9±26.8 and 27.2±26.5 patient-months in group 1, and 27.4±22.4 and 33.4±24.5 patient-months in group 2, respectively (p=0.50 and 0.12). In group 1, twenty three patients have death and 2 patients have discontinued the treatment due to transplantation. In group 2, 174 patients have discontinued the treatment (55 patients have died, 80 patients have been switched to hemodialysis and 39 patients have received renal transplantation). There were significant differences between groups according to the last condition (p0.001). Mean patient survival were found 22.9±4.2 and 55.5±2.8 patient-months in group 1 and group 2, respectively. The patient survival rates by Kaplan-Meier analysis were 50%, 40.9%, 27.3% and 9.1% at 1, 2, 3, and 4 years in group 1 and 90.9%, 81.6%, 73.9%, 64.9% and 53.1% at 1, 2, 3, 4 and 5 years in group 2, respectively. The mortality rate is higher in patients who have undergone HD before PD compared without HD history (log rank:0.001). In the Cox proportional hazards model analysis, preference of PD (RR: 7.72, p0.001), presence of diabetes (RR: 2.26, p=0.01), pretreatment serum albumin level (RR: 0.37, p0.001) and catheter exit size infection attacks (RR:0.34, p=0.01) were identified as predictors of mortality.Our data show that mortality in patients transferred to PD from HD was higher than in patients undergoing PD as first-line therapy. Compulsory choice such as vascular access problems and social factors were the most important causes of increasing mortality in patients transferred to PD from HD.

The analysis of body composition gained much more interest with the use of non-invasive practical method of bioimpedance. This technique uses electrical properties of materials like body cells. Cel...