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    Post-Earthquake Realities: A Study on the Challenges of Relocated Hemodialysis Patients Following the Kahramanmaras Earthquake
    (Aves, 2025) Tugcu, Murat; Keles, Mustafa; Duranay, Murat; Huddam, Bulent; Yazici, Raziye; Ayar, Yavuz; Guzel, Fatma Betul
    On February 2023 T & uuml;rkiye experienced siniicant rtas ri.Background: In February 2023, T & uuml;rkiye experienced 2 significant earthquakes, measuring 7 .4 and 7.3 on the Richter scale and impacting 11 provinces. This study was performed to investigate the experiences of patients undergoing hemodialysis ftreatment in earthquake-affected areas who were relocated to alternative centers, with a focus on assessing the medical tchallenges that emerged thereafter. Methods: This study included 181 hemodialysis patients (71 females, 110 males) from 11 earthquake-affected provinces fwho were transferred to different dialysis centers because of infrastructure and superstructure damage at their original treatment facilities. Results: The predominant reason for relocation was damage to personal residences, reported by 77.4% of patients. Notably, 59.4% resumed hemodialysis with a delay of at least 1 day. Emergency complications were observed in 24.6% of patients, with hypervolemia (11.7%) being the most common. At the time of reporting, 23.1% of patients continued treatment at the relocated centers, while 78.8% expressed intent to return to their original facilities. Importantly, only 1 patient was reported to have died during the study period, highlighting the overall resilience of this population. Conclusion: Hemodialysis patients are particularly vulnerable to the impacts of earthquake-related disruptions. Dialysis centers in high-risk regions must adhere to construction standards that ensure operational resilience. Additionally, prioritizing the transfer and medical coordination of hemodialysis patients during disasters is essential to maintaining continuity of care and minimizing health risks.
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    The effects of tacrolimus and mycophenolate mofetil on regression of encapsulating peritoneal sclerosis in a rat model
    (Asoc Regional Dialisis Trasplantes Renales, 2021) Huddam, Bulent; Sasmaz, Simge; Haberal, Nihan; Azak, Alper; Genek, Dilek Gibyeli; Kocak, Gulay; Karakus, Volkan
    Objective: Encapsulating peritoneal sclerosis (EPS) is a rare, but potentially fatal complication of peritoneal dialysis. Currently, treatment of peritoneal fibrosis is not fully possible yet. In this study, we aimed to demonstrate the effects of tacrolimus therapy on peritoneal fibrosis and inflammation when administered alone or with mycophenolate mofetil (MMF) in the EPS model induced in rats. Methods: Thirty six Wistar albino rats were separated into six equal groups. Group I was the control group. Group II-VI were administered intraperitoneal chlorhexidine (CH) for induced EPS model in rats. Group II, IV, V, VI were administered isotonic liquid, tacrolimus, tacrolimus and concurrently with CH, tacrolimus and MMF together, respectively. Group III was not administered any drug. All peritoneal samples were stained immunohistochemically with matrix metalloproteinase-2 (MMP-2) antibody. Thickness of peritoneal fibrosis, subserosal large collagen fibers, subserosal fibroblast proliferation and subserosal fibrotic matrix deposition were evaluated. Results: Comparing the experimentally induced EPS groups, the best histopathological results and the largest staining with MMP-2 were achieved in Group VI. Furthermore, in all treatment groups (IV, V, VI) more staining with MMP-2 was detected compared to non-treatment groups (I, II, III) but no statistically significant differences were found among all groups. A statistically significant remission was observed in all histopathological parameters, primarily peritoneal thickness in rats that were administered MMF with tacrolimus, compared to rats which were administered tacrolimus only. Conclusion: Concurrent use of tacrolimus and MMF in the treatment of EPS may be a promising approach.