Background: Here we aimed to investigate the predictors of catheter-related bloodstream infections (CRBSI) in patients with acute kidney injury or chronic kidney disease who required renal replacement therapy through a non-tunneled hemodialysis catheter. Methods: A total of 111 patients who received non-tunneled hemodialysis catheters were retrospectively evaluated. Patients were divided into two groups; those who developed CRBSI and those who did not. Patient’s demographic data, laboratory results at admission, information regarding catheter infections, and culture results were obtained from electronic medical records. Results: The mean age of the patients was 64 ± 16 years, and 51 of them were male. CRBSI occurred in 14 patients (12.6%). Admission serum albumin level (OR: 0.119, 95% CI: 0.019–0.756, p = 0.024), admission mean platelet volume (OR: 2.207, 95% CI: 1.188–4.100, p = 0.012) and catheter duration (OR: 1.580, 95% CI: 1.210–2.064, p = 0.001) were independent predictors for the CRBSI development. ROC curve analysis demonstrated that a catheter duration of 22 days was predictive for presence of CRBSI (78% sensitivity, 76% specificity, AUC: 0.825, 95% CI: 0.724–0.925, p < 0.001). Conclusions: Prolonged catheter duration, low serum albumin, and high mean platelet volume independently predict the development of CRBSI in patients undergoing hemodialysis for acute kidney injury or chronic kidney disease.

This study aims to evaluate the association between prognostic nutritional index (PNI) and contrast-induced nephropathy (CIN).Material and methods: A total of 251 patients who were at high risk for contrast nephropathy were included in the study. The patients were grouped according to their PNI score (PNI score <45 or PNI score ≥45). CIN was defined as a 25% relative increase, or 0.5 mg/dL absolute increase in serum creatinine level above baseline within 72 hours of contrast exposure, in the absence of an alternative explanation.Results: Two groups were assigned according to the PNI score. The first group consists of 111 patients (PNI<45) and the second group has 140 patients (PNI≥45). CIN developed in 162 (%64.8) patients. C-reactive protein was higher in the low-PNI group. Also, the patients with the low-PNI group had lower ejection fraction, lower serum albumin levels, and lower hemoglobin levels. CIN, postprocedure renal replacement therapy requirement and in-hospital mortality were higher in the low PNI group. Multivariable logistic regression analysis revealed that advanced age (p=0.012, [OR] = 1.044 [1.009-1.079]), low baseline GFR (p=0.033, [OR]= 1.022 [1.002-1.043]), high amount of contrast media (p=0.022, [OR]= 1.017 [1.002-1.031]), and low PNI score (p=0.033 , [OR]= 2.069 [1.060-4.039]) were independent predictors of CIN.Conclusion: Our study demonstrated that the PNI score was an independent risk factor for the development of CIN.

Objective: Hemodialysis is a treatment modality for patients, in which physical and psychological stress factors are together. Intense anxiety and stress caused by treatment are very favorable for alexithymic feelings. Hemodialysis patients undergo continuous biochemical changes hemodynamically. Our aim in this study was to investigate the relationship between biochemical parameters; we use in hemodialysis patients' follow-up and alexithymic emotions and stress factors.Methods: Fifty-one patients who received hemodialysis treatment due to end-stage renal failure in Bilecik Province in 2019 were included in the study. Routine biochemical follow-up data of patients, hemodialysis stressor scale, and Toronto alexithymia scale (TAS) were used in the study. The statistical significance level was determined as p<0.05 between routinely monitored hemodialysis parameters and scales. Results:It was observed that 58.8% of the patients included in the study were alexithymic. The mean hemodialysis stressor was 86.6, and the mean TAS was 62.76. The high levels of stress and alexithymic emotion scales in hemodialysis patients were noted. A significant relationship was found between inlet creatinine, urea reduction ratio, Kt/V, dry weight, albumin, output urea, and calcium between the hemodialysis stress scale and TAS subgroups. Conclusion:Psychiatric evaluation should be routine in the follow-up of hemodialysis patients, and the monthly psychologist/psychiatric examination, which was abolished with the last regulation change, should be restarted. It is also essential to increase the awareness of health-care professionals working in the dialysis unit about coping with stress and stressful patient management.

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