Prevalence and Associates of Frailty Status in Different Stages of Chronic Kidney Disease: A Cross-Sectional Study.

OBJECTIVES: Frailty is a state of homeostenosis associated with adverse outcomes. Chronic kidney disease (CKD) increases considerably by aging and shares the common risk factors with frailty. We aimed to examine the prevalence and independent associates of frailty status in CKD patients. DESIGN: In this single-centre, cross-sectional study, we used the five-item Fatigue, Resistance, Ambulation, Illnesses and Loss of Weight (FRAIL) scale to evaluate frailty. A binary logistic regression analysis model including the parameters found to have relationship with frailty in univariate analyses was used to detect independent associates of frailty status. Odds ratio (OR) and 95% confidence interval (CI) were given. PARTICIPANTS: Study included 148 patients aged 18-80. Sixty (60) patients were end stage renal disease (ESRD) patients on maintenance hemodialysis (HD) (at least for 3 months) and 88 were stage 3-4 CKD patients. Thirty-seven (37) patients (42%) were eGFR G3a, 31 patients (35.3%) were eGFR G3b and 20 patients (22.7%) were eGFR G4 in stage 3-4 CKD patients. MEASUREMENTS: Demographics, etiology of CKD, comorbidities, regular drugs, dialysis-related and laboratory data were recorded. FRAIL scale was scored as follows; 0=robust, 1-2=prefrail, and ≥3= frail. The frailty status was compared between frail+prefrail group vs robust (non-frail) group. RESULTS: The prevalences of prefrailty and frailty were 68.3% and 3.3% in HD group and 53.4% and zero in stage 3-4 CKD group, respectively (p = 0.025). In the multivariate logistic regression analysis, being in HD group (OR=3.87, 95% CI= 1.06-14.19, p=0.04), older age (OR=1.09, 95% CI= 1.04-1.13) and female sex (OR=9.13, 95%CI= 2.82-29.46) were independent risk factors for frailty (p<0.001, for both). CONCLUSION: Prefrailty and frailty are quite common among HD and CKD stage 3-4 patients. Being an HD patient is an independent risk factor for non-robust (frail or prefrail) status. Our findings point out a remarkably high prevalence of frailty severity (prefrailty/frailty) phenotype among patients with advanced CKD stages.

Zingiberene attenuates hydrogen peroxide-induced toxicity in neuronal cells.

In this experimental design, we explored the neuroprotective potential of zingiberene (ZGB), a monocyclic sesquiterpene, in hydrogen peroxide (H2O2)-induced toxicity in newborn rat cerebral cortex cell cultures for the first time. The rats were exposed to H2O2 for 6 h to determine the oxidative stress levels. To evaluate cell viability, both 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyltetrazolium bromide and lactate dehydrogenase assays were carried out. Total antioxidant capacity (TAC) and total oxidative stress (TOS) parameters were used to evaluate oxidative changes. Besides determining 8-hydroxy-2-deoxyguanosine (8-OH-dG) levels in vitro, single-cell gel electrophoresis was also performed to measure the resistance of neuronal DNA to H2O2- exposed rats. Our results showed that survival and TAC levels of the cells decreased, while TOS, 8-OH-dG levels and the mean values of the total scores of cells showing DNA damage increased in the H2O2 alone-treated cultures. But pretreatment of ZGB suppressed the cytotoxicity, genotoxicity and oxidative stress that were increased by H2O2. Based on these observations, it is suggested that the sesquiterpene ZGB can be used as a novel and natural potential therapeutic in counteracting oxidative damages in the field of neurodegenerative disorders.

Attitude and approach of people who live in southeastern Anatolia region on tissue and organ transplantation.

OBJECTIVE: The purpose of this study was to determine the attitudes and the approach of the people living in the southeastern anatolia region and the impact of the lack of education on them. MEASUREMENTS: We used questionnaires consisting of 15 questions that were given to 145 people to be completed in 2 hours. The questionnaire assessed their knowledge, attitudes, and awareness of organ donation. RESULTS: We asked whether they were well-informed about organ donation; 50% did not feel well-informed. CONCLUSIONS: These data confirm the great lack of knowledge about organ donation in the southeastern anatolia region.

Adenosine deaminase, 5'-nucleotidase, guanase and cytidine deaminase activities in gastric tissues from patients with gastric cancer.

The activities of some of the enzymes participating in nucleotide metabolism were measured in cancerous and noncancerous gastric tissues from patients with gastric cancer. The enzyme activities measured were found to be higher in the cancerous tissues than in the non-cancerous tissues. Adenosine deaminase (ADA), 5'-nucleotidase (5'-NT), guanase (GUA) and cytidine deaminase (CD) activities in the cancerous tissues were 56.0 +/- 24.0, 45.0 +/- 20.0, 0.34 +/- 0.16 and 4.65 +/- 2.04, respectively. The activities in non-cancerous tissues were 13.2 +/- 6.0, 19.8 +/- 8.3, 0.12 +/- 0.06 and 1.65 +/- 0.8, respectively. Cancerous tissues consisted of 7 gastric tissues with Grade I-II and 8 tissues with Grade III-IV adeno cancer. Non-cancerous adjacent tissues were obtained from the same patients with Grade I-II cancer. There were no meaningful differences between enzyme activities of the gastric tissues with Grade I-II and Grade III-IV cancer. Enzyme activity ratios indicates that ADA activity increased by the highest amount relative to other enzyme activities in the cancerous tissues. In the correlation analysis, we found positive correlations between some of the enzyme activities in the cancerous tissues. Results suggest that increased activities of these enzymes might play a part in the accelerated nucleotide metabolism in the cancerous gastric tissues.