Browsing by Author "Eldem, Olcay"

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    Periaortic Fat Tissue: A Predictor of Cardiac Valvular Calcification, Malnutrition, Inflammation, and Atherosclerosis Components in Hemodialysis Patients
    (2015) Genctoy, Gultekin; Eldem, Olcay; Ergun, Tarkan; Arikan, Serap; 0000-0002-5145-2280; 0000-0001-5752-3812; 25940595; AAJ-5551-2021; AAM-4084-2021; AAJ-1289-2021
    Cardiac valvular calcification (CVC) in end-stage renal disease is shown to be a component of malnutrition, inflammation, atherosclerosis, calcification (MIAC) syndrome. Thoracic periaortic fat tissue (T-PAFT) is shown to be increased in patients with end-stage renal disease (ESRD), and has positive correlation with MIAC. Negative correlation between CVC and vitamin D is shown in hemodialysis (HD) patients. In this study, we investigated a relationship between body composition, T-PAFT, metabolic and inflammatory parameters, and CVC in HD patients. Seventy-six HD patients (49M) were included. CVC is defined as bright echoes of >1mm on one or more cusps on echocardiography. Results were expressed as the number of calcified valves (0,1,2). Calcium, phosphorus, parathyroid hormone (PTH), C-reactive protein (CRP), albumin and 25-hydroxy vitamin D levels were studied from predialysis blood samples. T-PAFT was calculated using a method with manual definition of borders on images from multislice computed tomography. Basal metabolic rate, muscle mass, total and truncal fat mass were measured by bioimpedance analysis. There were 65.8% of patients who had CVC. Patients with CVC were older (63.5 +/- 14.6 +/- 17, P=0.02). T-PAFT (1599 +/- 596, 739.7 +/- 179mm(2), P=0.001) and CRP (15.8 +/- 11; 11.1 +/- 13.2mg/dL; P=0.04) were higher in the group with CVC. T-PAFT had positive correlations with CRP, MIAC, body mass index (BMI) and number of calcified valves, negative correlation with left ventricular ejection fraction, and no correlation with albumin, calcium, phosphorus, and PTH. The logistic regression analysis revealed that T-PAFT was a significant predictor of CVC. In this study, T-PAFT showed a positive correlation with inflammation, CVC, and MIAC score in HD patients. T-PAFT was a significant predictor of CVC.
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    Pulmonary hypertension associates with malnutrition and body composition hemodialysis patients
    (2015) Genctoy, Gultekin; Arikan, Serap; Eldem, Olcay; 25410114
    Background/Aim: The prevalence of pulmonary hypertension (PH) is reported between 17 and 56% in hemodialysis (HD) patients. Pathogenesis of PH in HD patients is still unclear. Malnutrition associating impaired pulmonary function tests in HD patients previously reported. Present study aimed to investigate an association between PH and nutrition and inflammation HD patients. Patients/Methods: Total 179 HD patients (109 M, 70 F) were included. Pulmonary artery pressure (PAP) and ejection fraction (EF) percentage was determined by echocardiography after a midweek HD session. Bioimpedance analyses were performed after dialysis. Percent body fat mass truncal fat (%), total body water (%), body-mass index was determined. Serum 25-OH vitamin D, albumin, lipid parameters, C-reactive protein (CRP), calcium, phosphorus, parathyroid hormone, ferritin levels, and hemogram were studied. Results: Pulmonary hypertension (PAP >35 mmHg) was found in 48 (26.8%) of 179 patients studied. Body-mass index (BMI) was negatively correlated with PAP (r = -0.34; p = 0.02). HD vintage, prevalence of diabetes, sex, type of vascular access were not different between patients with PH and without PH. Patients with PH were older (68.1 +/- 14.4; 61.3 +/- 14.7; p = 0.005). Percent body fat (19.8 +/- 8.1% vs. 28.1 +/- 10%; p = 0.001), albumin (3.4 +/- 0.5 g/dl vs. 3.9 +/- 3.3 g/dl; p = 0.0001), truncal fat (16.8 +/- 10.7 vs. 26.4 +/- 10.5; p = 0.001), triglyceride (147.9 +/- 88.5 vs. 182.1 +/- 97.7 mg/dl; p = 0.03), and total cholesterol (146.9 +/- 34.5 vs. 169.5 +/- 43 mg/dl; p = 0.004) levels were significantly lower in patients with PH than with no PH. Logistic regression analysis revealed that increased percent body fat, albumin, and total cholesterol associate with a decreased risk of PH. Conclusion: Present study demonstrated a significant association between malnutrition and PH in HD patients. Those results should be confirmed by further prospective studies including cytokine levels and spirometric measurements.