Browsing by Author "Huddam, Bulent"

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    Böbrek nakli yapılan hastalarda hiperürisemi ve gut hastalığı sıklığı
    (Tıp Araştırmaları Dergisi 2006 4 (2):7-10, 2006) Kanbay, Mehmet; Usluoğulları, Alper; Huddam, Bulent; Çolak, Turan; Akcay, Ali; Kart-Köseoğlu, Hamide; Yücel, Eftal; Haberal, Mehmet
    Amaç: Böbrek nakli sonrası hiperürisemi sık görülmesine rağmen gut hastalığı nadirdir. Ancak bu konu ile ilgili böbrek nakli yapılmış Türk hasta grubunda yayınlanmış makale mevcut değildir. Bu çalışmanın amacı böbrek nakli yapılmış hastalarda hiperürisemi ve gut hastalığı görülme sıklığını belir-lemektir. Gereç ve Yöntem: Başkent Üniversitesi Hastanesi Transplantasyon Ünitesinde 2000 ve 2002 yılları arasında böbrek nakli yapılmış 155 hasta (E/K, 119/36; ortalama yaş 34,7±9,7 yıl) retrospektif olarak araştırıldı. Çalışmaya en az 2 yıl süresince normal böbrek fonksiyonlarına sahip olan hastalar dahil edildi. Hastaların nakil olduktan sonra rutin poliklinik kontrollerindeki laboratuvar değerleri kayıt edildi. Ayrıca hastaların demografik özellikleri ve kullandığı ilaçlar kayıt edildi. Serum ürik asid seviyesi kadınlarda 6 mg/dl erkeklerde 7 mg/dl üzerinde ise hiperürisemi olarak kabul edildi. Klinik olarak gut hastalığı hiperürisemi ile birlikte gut artritinin ve tofüsün olmasıyla tanımlandı. Bulgular: Hiperürisemi 95 hastada, gut hastalığı ise 13 hastada saptandı. Serum ürik asid seviyelerinin hastaların yaşından, cinsiyetinden, donörün canlı veya kadavra olmasından ve aldıkları ilaç rejimin-den bağımsız olduğu saptandı. Sonuç: Böbrek transplantasyonu yapılan hastalarda hiperürisemi yaygın olarak görülmesine rağmen gut hastalığı bu hasta grubunda nadirdir. Aim: Although the prevalence of hyperuricemia is high after renal transplantation, investigation has shown that gout occurs rarely in these patients. The present study was designed to investigate the preva-lence of hyperuricemia and gout in renal transplant patients. Materials and methods: The records of 155 patients (M/F, 119/36, mean age 34.7 9.7 years) who under-went renal transplantation in between 2000 and 2002 were retrospectively reevaluated. Patients with at least 2 years stable graft survival duration were included. For each individual, mean value of serum uric acid levels that were repeated in each routine visits approximately every 6 months in transplanta-tion outpatient clinic were used. Patient demograph-ics, immunosuppressive drug regimens and other medications were also recorded. Hyperuricemia was defined as serum uric acid level of >6 mg/dl in females and 7 mg/dl in males. Clinical gout was defined as hyperuricemia with gouty arthritis and tophi. Results: Hyperuricemia and gout were seen in 95 patients, and 13 patients, respectively. Mean serum uric acid levels were found to be independent from patients' age, sex, donor type, and immunosuppres-sive drug regimen. Conclusion: Our study confirmed that although hyperuricemia is a common complication in renal transplant recipients, gout is not seen often in these populations.
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    The Use of Mycophenolate Mofetil in Experimental Encapsulating Peritoneal Sclerosis
    (2015) Huddam, Bulent; Basaran, Murat; Kocak, Gulay; Azak, Alper; Yalcin, Funda; Reyhan, Nihan Haberal; Duranay, Murat; 0000-0001-9852-9911; 26159779; AAK-4587-2021
    Encapsulated peritoneal sclerosis (EPS) is a rare complication of long-term peritoneal dialysis usually associated with the inadequacy and early termination of dialysis modality. Adequate treatment of peritoneal fibrosis has not been achieved by medical intervention so far. Mycophenolate mofetil (MMF), which inhibits inosine monophosphate dehydrogenase reversibly and highly selectively, is the most widely used drug for maintenance immunosupression in renal transplantation. Recent studies have shown that MMF has also antifibrotic effects. In this study, we evaluated the effects of MMF on EPS model in rats based on antifibrotic effects. Twenty-four Wistar albino rat have been randomly divided into four groups. Group I (control group) received isotonic saline intraperitoneally (i.p) 2 ml/day for (0-3rd weeks). Group II (chlorhexidine (CG) group) received CG 2 ml/day i.p. for (0-3rd weeks). Group III (chlorhexidine + MMF group) received CG (2 ml/day) i.p. for (0-3rd weeks) plus MMF 30 mg/kg/day peroral (4th-6th weeks). Group IV (resting group) received CG 2 ml/day) i.p. (0-3rd weeks) plus peritoneal resting without any treatment (4th-6th weeks) At the end of the sixth weeks, all of the rats were killed. All of the groups were analyzed in terms of peritoneal thickness, degree of inflammation, vasculopathy, neovascularization and fibrosis. Also, the parietal peritoneal tissue samples were evaluated for matrix metalloproteinase 2 (MMP-2) by using the immunohistochemical analysis. When the CG group was compared with the MMF group, the medication resulted in a statistically significant reduction in peritoneal thickness, inflammation and fibrosis score (53.23 +/- A 16.24 vs. 17.22 +/- A 3.62, 1 +/- A 1.225 vs. 1 +/- A 0, 1.6 +/- A 0.548 vs. 0.2 +/- A 0.447, respectively, all p < 0.05). In the resting group, no beneficial effects on morphological abnormality of the peritoneum were observed as compared with MMF group. However, according to immunohistochemical analysis of the expression of MMP-2 on peritoneal samples, the highest expression of MMP-2 was observed in the MMF group. MMF was effective for the treatment of encapsulating peritoneal fibrosis in our rat model. Most recently, MMF may be first choice for EPS due to antifibrotic effect.