Browsing by Author "Ozlu, Sare Gulfem"

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Clinical Course Of Adolescent Onset Atypıcal Hemolytic Uremic Syndrome: A Study Of Turkish Ahus Registry
(2022) Celegen, Kubra; Gulhan, Bora; Fidan, Kibriya; Yuksel, Selcuk; Yilmaz, Neslihan; Yilmaz, Aysun Caltik; Kilic, Beltinge Demircioglu; Gokce, Ibrahim; Tufan, Asli Kavaz; Kalyoncu, Mukaddes; Nalcacioglu, Hulya; Ozlu, Sare Gulfem; Sukur, Eda Didem Kurt; Canpolat, Nur; Bayazit, Aysun K.; Koyun, Mustafa; Tabel, Yilmaz; Tulpar, Sebahat; Celakil, Mehtap; Bek, Kenan; Zeybek, Cengiz; Duzova, Ali; Ozcakar, Zeynep Birsin; Topaloglu, Rezan; Soylemezoglu, Oguz; Ozaltin, Fatih
Could Plasma Based Therapies Still Be Considered in Selected Cases with Atypical Hemolytic Uremic Syndrome?
(2021) Ozlu, Sare Gulfem; Gulhan, Bora; Aydog, Ozlem; Atayar, Emine; Delibas, Ali; Parmaksiz, Gonul; Ozdogan, Elif Bahat; Comak, Elif; Tasdemir, Mehmet; Acar, Banu; Ozcakar, Zeynep Birsin; Topaloglu, Rezan; Soylemezoglu, Oguz; Ozaltin, Fatih; 35023648
Background. Atypical hemolytic uremic syndrome (aHUS) occurs due to defective regulation of the alternative complement pathway (ACP) on vascular endothelial cells. Plasma based therapy (PT) was the mainstay of the treatment for aHUS for many years until the introduction of therapies targeting blockage of the complement system. The aim of this study was to evaluate patients with aHUS who had been treated with plasma based therapies alone. Methods. The outcomes of seven genetically confirmed aHUS patients (2 girls, 5 males) were evaluated by means of clinical presentation, response to plasma therapy, course of the disease during the follow-up period and last status. Results. The median age of the patients at admission was 6.7 years (IQR 0.7-7.8). Three patients received plasma exchange therapy and the other four patients were treated with plasma infusions. One patient was lost to follow-up after one year; the median duration of follow-up for other patients was 3.7 years (IQR 2.7-6.5). During the follow up, two patients from our historical records when complement blocking therapies had not been in clinical use yet in Turkey, underwent kidney transplantation. One transplant patient experienced an acute rejection episode without graft loss. The remaining five patients had a glomerular filtration rate of more than 90 ml/min./1.73 m(2) at the last visit. Conclusion. Although we had a relatively small patient population, our findings indicate that PT might still be considered in selected patients particularly in countries where complement blocking therapies are difficult to reach due to their unavailability or costs that are not covered by the health care systems.
Effect of The Timing of Dialysis Initiation on Left Ventricular Hypertrophy and Inflammation in Pediatric Patients
(2017) Bakkaloglu, Sevcan A.; Kandur, Yasar; Serdaroglu, Erkin; Noyan, Aytul; Bayazit, Aysun Karabay; Sever, Lale; Ozlu, Sare Gulfem; Ozcelik, Gul; Dursun, Ismail; Alparslan, Caner; 2-s2.0-85017214984; AAD-5713-2021
Background The optimal time for dialysis initiation in adults and children with chronic kidney disease remains unclear. The aim of this study was to evaluate the impact of dialysis timing on different outcome parameters, in particular left ventricular (LV) morphology and inflammation, in pediatric patients receiving peritoneal dialysis and hemodialysis. Methods The medical records of pediatric dialysis patients who were followed-up in nine pediatric nephrology centers in Turkey between 2008 and 2013 were retrospectively reviewed. In addition to demographic data, we retrieved anthropometric measurements, data on dialysis treatment modalities, routine biochemical parameters, complete blood count, serum ferritin, parathormone, C-reactive protein (CRP), and albumin levels, as well as echocardiographic data and hospitalization records. The patients were divided into two groups based on their estimated glomerular filtration rate (eGFR) levels at dialysis initiation, namely, an early-start group, characterized by an eGFR of > 10 ml/min/1.73 m(2), and a late-start group, with an eGFR of < 7 ml/min/1.73 m(2). The collected data were compared between these groups. Results A total of 245 pediatric dialysis patients (mean age +/- standard deviation 12.3 +/- 5.1 years, range 0.5-21 years) were enrolled in this study. Echocardiographic data were available for 137 patients, and the mean LV mass index (LVMI) was 58 +/- 31 (range 21-215) g/m(2.7). The LVMI was 75 +/- 30 g/ m(2.7)(n = 81) and 34 +/- 6 g/m(2.7)(n = 56) in patients with or without LV hypertrophy (LVH) (p < 0.001). Early-start (eGFR > 10 ml/min/1.73 m(2)) versus late-start dialysis (eGFR < 7 ml/ min/1.73 m(2)) groups did not significantly differ in LVMI and LVH status (p > 0.05) nor in number of hospitalizations. Serum albumin levels were significantly higher in the earlydialysis group compared with the late-dialysis group (3.3 +/- 0.7 vs. 3.1 +/- 0.7 g/dl, respectively; p < 0.05). The early-start group had relatively higher time-averaged albumin levels (3.2 +/- 0.5 vs. 3.1 +/- 0.5 g/dl; p = > 0.05) and relatively lower CRP levels (3.64 +/- 2.00 vs. 4.37 +/- 3.28 mg/L, p > 0.05) than the late-start group, but these differences did not reach statistical significance. Conclusion Although early dialysis initiation did not have a significant effect on important clinical outcome parameters, including LVH, inflammatory state, and hospitalization, in our pediatric dialysis patients, this area of study deserves further attention.
Time-Averaged Hemoglobin Values, Not Hemoglobin Cycling, Have an Impact On Outcomes in Pediatric Dialysis Patients
(2018) Bakkaloglu, Sevcan A.; Kandur, Yasar; Serdaroglu, Erkin; Noyan, Aytul; Bayazit, Aysun Karabay; Tasdemir, Mehmet; Ozlu, Sare Gulfem; Ozcelik, Gul; Dursun, Ismail; Alparslan, Caner; Akcaboy, Meltem; Atikel, Yesim Ozdemir; Parmaksiz, Gonul; Atmis, Bahriye; Sever, Lale; 30105415; AAD-5713-2021
During erythropoietin-stimulating agent (ESA) treatment, hemoglobin (Hb) levels usually fluctuate; this phenomenon is known as "Hb cycling (HC)." In this study, we aimed to evaluate the predictors of HC and its impact on left ventricular hypertrophy (LVH) as a patient-important outcome parameter in pediatric dialysis patients. Records of patients followed up in nine pediatric nephrology centers between 2008 and 2013 were reviewed. More than 1 g/dL decrease or increase in Hb level was considered as HC. Patients were divided into two groups according to 12-month Hb trajectory as rare cycling (RC) (<= 3) and frequent cycling (FC) (> 3 fluctuation) as well as three groups based on T-A-Hb levels: < 10, 10-11, and > 11 g/dL. Two hundred forty-five dialysis (160 peritoneal dialysis (PD) and 85 hemodialysis (HD)) patients aged 12.3 +/- 5.1 (range 0.5-21) years were enrolled in this study. Fifty-two percent of the patients had RC, 45% had FC, and only 3% had no cycling. There were no differences between HC groups with respect to age, dialysis modality, having anemia, hospitalization rate, residual urine volume, and mortality. Although left ventricular mass index (LVMI) tended to be higher in RC than FC group (65 +/- 37 vs 52 +/- 23 g/m(2.7), p = 0.056), prevalence of LVH was not different between the groups (p = 0.920). In regression analysis, FC was not a risk factor for LVH, but low T-A Hb level (< 10 g/dL) was a significant risk for LVH (OR = 0.414, 95% CI 0.177-0.966, p = 0.04). The target Hb levels were more often achieved in PD patients, and the number of deaths was significantly lower in non-anemic patients (Hb level > 11 g/dL). Hb cycling is common among dialysis patients. Severity of anemia rather than its cycling has more significant impact on the prevalence of LVH and on inflammatory state.