Browsing by Author "Karaca, C."

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Emergency Vs. Planned Hemodialysis Initiation: Effects on Vascular Access and Treatment Practices
(Yuzuncu Yil Universitesi Tip Fakultesi, 2025) Turgut, T.; Karaca, C.
Hemodialysis (HD) is commonly used for end-stage renal disease, but there is a rising trend in initiating HD as an emergency rather than a planned procedure. This study investigates the clinical effects of emergency versus programmed HD initiation. This retrospective study analyzed patients starting their first HD between January 2021 and December 2023. Data on laboratory parameters, vascular access, and medications were collected. Patients were divided into emergency and programmed HD initiation groups and compared. The study included 136 patients (mean age 59.6 years). Emergency HD patients were more likely to use non-tunneled central venous catheters (CVCs) and had lower eGFR levels compared to those with programmed HD (102 [99%] vs. 5 [15.2%]; p<0.001 and 7.8 ± 3.3 mL/min/1.73 m² vs. 9.4 ± 2.7 mL/min/1.73 m²; p=0.010). While hemoglobin levels were lower in the emergency group (9.3 ± 2.0 g/dL vs. 9.9 ± 1.5 g/dL; p=0.156), the difference was not significant. IV iron and ESA use was significantly lower in the emergency group (28 [27.2%] vs. 22 [66.7%]; p<0.001 and 11 [10.7%] vs. 8 [25%]; p=0.045). Emergency HD initiation is linked to increased use of non-tunneled CVCs, lower eGFR, and reduced use of IV iron and ESA. Improved planning and early intervention are needed for better patient outcomes. © 2025, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Impact of Altitude on Anemia, Erythropoietin-Stimulating Agent, and İntravenous Iron Requirement in Hemodialysis Patients
(Yuzuncu Yil Universitesi Tip Fakultesi, 2023) Karaca, C.; Alagoz, S.; Alan, A.M.; Keskin, B.N.A.; Usakli, S.; Kantarci, M.; Trabulus, S.
Anemia is an important cause of morbidity and mortality in chronic kidney disease (CKD). Previous studies have shown the curative effects of altitude on anemia in hemodialysis (HD) and non-hemodialysis CKD. This study examined the effect of altitude on erythropoietin stimulating agent (ESA), İntravenous (IV) iron requirement in HD patients. This retrospective observational study was conducted between January and June 2023. The study group was divided into two groups according to altitude: HD patients living in Van Province (1,730 meters, 5,765 feet) in the high-altitude group (HAG) and HD patients living in Istanbul Province (sea level) in the low-altitude group (LAG). In addition to hemoglobin (Hgb) and ferritin levels, ESA and IV iron doses were recorded at monthly visits for six months. These values of the HAG and LAG were compared. A total of 184 patients were included in the study (HAG: 108 patients and LAG: 79 patients). HD patients living at high altitudes had statistically significantly higher Hgb and ferritin values compared to low altitudes (HAG: 11.5 g/dL, 749 pg/L vs. LAG: 11.3 g/dL; 543 pg/L; p=0.04, p< 0.001, respectively). In addition, ESA (HAG: 53 IU/kg/week, 12000 IU/month vs. LAG: 100.6 IU/kg/week, 24000 IU/month; p<0.001) and IV iron (HAG: 208.3±151 mg/month vs. LAG:364.9±300.8 mg/month; p=0.002) dose was significantly lower. HD patients living at high altitude needed lower doses of ESA and IV iron to reach hig her Hgb values than patients living at lower altitude. © 2023, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.