Browsing by Author "Hasbal, Nuri Baris"

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COVID-19: a novel menace for the practice of nephrology and how to manage it with minor devastation?
(2020) Ulu, Sena; Gungor, Ozkan; Gok Oguz, Ebru; Hasbal, Nuri Baris; Turgut, Didem; Arici, Mustafa; 0000-0001-7474-5927; 32713282; AAI-9418-2021
Coronavirus disease 19 (COVID-19) became a nightmare for the world since December 2019. Although the disease affects people at any age; elderly patients and those with comorbidities were more affected. Everyday nephrologists see patients with hypertension, chronic kidney disease, maintenance dialysis treatment or kidney transplant who are also high-risk groups for the COVID-19. Beyond that, COVID-19 or severe acute respiratory syndrome (SARS) due to infection may directly affect kidney functions. This broad spectrum of COVID-19 influence on kidney patients and kidney functions obviously necessitate an up to date management policy for nephrological care. This review overviews and purifies recently published literature in a question to answer format for the practicing nephrologists that will often encounter COVID-19 and kidney related cases during the pandemic times
Do Hemodialysis Patients Need Immune Boosting with Vitamin, Mineral, and Probiotic Supplementation during COVID-19 Pandemic?
(2021) Gungor, Ozkan; Ulu, Sena; Hasbal, Nuri Baris; Onan, Engin; Turgut, Didem; Arici, Mustafa
Coronavirus disease 2019 (COVID-19) has been accepted as a global pandemic, and poses a greater risk to the elderly and those with comorbidities. Comorbid diseases (particularly end-stage kidney disease with hemodialysis) and impaired immunity place patients in the high-risk group for COVID-19. In recent studies, it was also mentioned that exaggerated inflammation and a cytokine storm were the underlying causes related to the high mortality in COVID-19 patients. Currently, treatment modalities to balance the immune system of such vulnerable patient groups are essential, to protect them from the disease. Several vitamins (like vitamins C, D, and E), trace elements like zinc, and probiotics have been proposed as immune boosters to protect and combat infectious conditions. It is well known that these vitamins and elements are insufficient in hemodialysis patients. In this review, we aimed to evaluate the immune-boosting mechanisms of vitamins C, D, E, zinc, and probiotics, the studies related to their beneficial effects against infections, and their possible benefits for hemodialysis patients during the COVID-19 pandemic.
Effect of Calcineurin Inhibitors and Mammalian Target of Rapamycin Inhibitors on the Course of COVID-19 in Kidney Transplant Recipients
(2021) Hasbal, Nuri Baris; Turgut, Didem; Oguz, Ebru Gok; Ulu, Sena; Gungor, Ozkan; 0000-0001-7474-5927; 33707409; AAI-9418-2021
Coronavirus disease 19 (COVID-19) has been an ongoing pandemic since December 2019. Unfortunately, kidney transplant recipients are a high-risk group during the disease course, and scientific data are still limited in this patient group. Beyond the dosage of immunosuppressive drugs, pharmacological immunosuppression may also alter the infection response in the COVID-19 course. The effects of immunosuppressive agents on the development and process of infection should not be decided only by determining how potent they are and how much they suppress the immune system; it is also thought that the direct effect of the virus, increased oxidative stress, and cytokine storm play a role in the pathogenesis of COVID-19 disease. There are data about immunosuppressive drugs like calcineurin inhibitors (CNI) or mammalian target of rapamycin inhibitors (mTORi) therapy related to their beneficial effects during any infection course. Limited data suggest that the use of CNI or mTORi may have beneficial effects on the process. In this hypothetical review, the probable impacts of CNI and mTORi on the pathogenesis of the COVID-19 were investigated.
Plasma Exchange in the Treatment of Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis: A Retrospective Analysis
(2022) Oguz, Ebru Gok; Paydas, Saime; Hasbal, Nuri Baris; Turgut, Didem; Sahin, Hatice; Kaya, Bulent; Bahcebasi, Zerrin Bicik; Yadigar, Serap; Gok, Serdal; Ayli, Mehmet Deniz
Objective: Immunosuppressive therapy in anti-neutrophil cytoplasmic antibody-associated vasculitis is indispensable for patient and kidney survival. There is a controversy about whether the risks of plasma exchange treatment override the probability of kidney-related outcomes. Hence, the question arises in which conditions the plasma exchange will be required? In this study, we aimed to evaluate the effect of plasma exchange adding to immunosuppressive therapy in anti-neutrophil cytoplasmic antibody-associated vasculitis patients. Methods: We retrospectively analyzed 57 patients with biopsy-proven anti-neutrophil cytoplasmic antibody-associated vasculitis. We grouped patients according to treatment options with or without plasma exchange. We investigated the 1-year and 5-year patients and kidney outcomes. Results: Thirty-six (63.2%) of 57 patients were treated with plasma exchange besides the routine immunosuppressive treatment. Sixteen (44.5%) of 36 patients were with active pulmonary hemorrhage and the remaining 20 (55.5%) were with vasculitic pulmonary involvement. The survival rate was 80.7% and 68.8% in the first and fifth year, respectively. In the multivariate Cox regression analysis model, risk factors affecting patient survival were age >50 years (hazard ratio = 17.11 P =.034), pulmonary involvement (hazard ratio = 13.25, P =.02), positive perinuclear anti-neutrophil cytoplasmic antibody-associated vasculitis (hazard ratio = 5.93, P =.036), and lower albumin level (hazard ratio = 0.18, P =.014). It is found that C-reactive protein level and plasma exchange did not relate to better patient and kidney outcomes (P >.05). Conclusions: In anti-neutrophil cytoplasmic antibody-associated vasculitis, although pulmonary hemorrhage and pulmonary involvement are serious complications, plasma exchange did not provide additional benefit to standard treatment.