The predictors of catheter-related bloodstream infections in patients undergoing hemodialysis: A single center experience.

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.

Predictive value of post-procedural hyponatremia on contrast-induced nephropathy in patients who underwent coronary angiography or percutaneous coronary intervention.

OBJECTIVE: Hyponatremia is a prognostic marker for specific pathologies. However, the association between contrast-induced nephropathy (CIN) and post-procedural hyponatremia has not been explored. Our study aims to evaluate the association between hyponatremia developing after contrast media administration and CIN. MATERIAL AND METHODS: A total number of 236 patients who required nephrology consultation before coronary angiography (CAG) or percutaneous coronary intervention (PCI) because of the high risk for contrast nephropathy, were included. Serum sodium levels were measured at admission and within three consecutive days after contrast media administration. RESULTS: Hyponatremia was observed in 141patients (59.7%) following angiography. CIN was developed in 149 (63.4%) patients. Among the patients who developed hyponatremia, ejection fraction, serum haemoglobin level and serum albumin level were low whereas, contrast media volume and percentage of the diabetes mellitus were higher. Also, length of hospital stay, percentage of CIN, renal replacement requirement and mortality rate were higher in patients with hyponatremia. In univariable analysis to evaluate the risk factors for CIN, being female gender, age, diabetes mellitus, serum albumin concentration, haemoglobin level, contrast media volume and hyponatremia were associated with development of CIN. Multivariable logistic regression analysis revealed that advanced age, serum albumin concentration and hyponatremia were independent predictors of CIN. CONCLUSION: Post-procedural hyponatremia was an independent risk factor for CIN in CAG or PCI patients.

Relationship Between Serum Magnesium Level and Insulin Resistance in Turkey Non-obese Adult Population.

The homeostasis model assessment of insulin resistance (HOMA-IR) is widely used in clinical practice to estimate insulin resistance. In particular, magnesium (Mg) is an extensively studied mineral that has been shown to function in the management of hyperglycemia and insulin resistance (IR) action. The pathophysiology of IR in non-obese patients has not been clearly demonstrated. From this point of view, we aimed to investigate the relationship between serum Mg level and IR in non-obese patients. We analyzed 957 patients who are not obese and estimated glomerular filtration rate (e-GFR) ≥ 60 mL/min/1.73 m2. Patients were divided into two groups, with and without IR. The results of the IR detected group (HOMA-IR ≥ 2.5, n = 544) and the IR undetected group (HOMA-IR < 2.5, n = 413) were compared. The median Mg value of the patients was 1.76 [0.21] mg/dL. A statistically significant difference was observed between the two groups regarding serum Mg levels (p = 0.043). A negative correlation was found between the HOMA-IR index and serum Mg levels among patients (r = - 0.064, p = 0.049). Multivariable logistic regression analysis revealed that serum Mg level (p = 0.039, odds ratio [OR] = 0.770[95%CI: [0.917-0.989]) was independent risk factors for IR. HOMA-IR increases as the Mg level decreases in advanced ages without obesity, especially in men with low e-GFR.