Browsing by Author "Sezer, S."

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Alkaline Phosphatase a New Marker for Graft Outcome and High Pulse Wave Velocity in Renal Transplant Recipients
(2017) Sezer, S.; Tutal, E.; Bal, Z.; Demirci, B.; Haberal, M.; 0000-0002-3462-7632; AAZ-5795-2021; AAJ-8097-2021
Bioimpedance Analysis Reveals Graft Function in Renal Transplant Recipients
(2014) Sezer, S.; Demirci, B.; Guliyev, O.; Colak, T.; Sayin, C.; Haberal, M.; https://orcid.org/0000-0002-7326-8388; https://orcid.org/0000-0002-8372-7840; https://orcid.org/0000-0002-3462-7632; JYQ-2550-2024; AAJ-8554-2021; AAJ-8097-2021
Elevated FGF-23 Level Could Predict Progressive Arterial Stiffening and Graft Loss in Kidney Transplant Recipients
(2014) Sezer, S.; Bal, Z.; Uyar, M. Erkmen; Guliyev, O.; Erdemir, B.; Colak, T.; Haberal, M.; https://orcid.org/0000-0002-8372-7840; https://orcid.org/0000-0002-3462-7632; AAJ-8554-2021; AAJ-8097-2021
Factors influencing hemoglobin variability and its association with mortality in hemodialysis patients
(2018) Bal, Z.; Demirci, B.G.; Karakose, S.; Tutal, E.; Uyar, M.E.; Acar, N.O.; Sezer, S.; 29805324
Purpose. We aimed to investigate the factors influencing hemoglobin variability with inflammatory and nutritional parameters and its associations with all-cause mortality among hemodialysis patients. Methods. One hundred and sixty-nine patients during the entire 12 months were enrolled into the study. Fasting plasma glucose, creatinine, calcium, phosphorus, alkaline phosphatase, parathyroid hormone (PTH), C-reactive protein (CRP), serum iron, serum iron-binding capacity, and transferrin saturation were analyzed. We defined six groups: low, target range, high, low-Amplitude fluctuation with low hemoglobin levels, low-Amplitude fluctuation with high hemoglobin levels, and high-Amplitude fluctuation. Body mass index (BMI), malnutrition-inflammation score (MIS), and Charlson Comorbidity Index were evaluated. Results. Hemoglobin variability was significantly correlated with age, platelet count, and number of hospitalization instances and inversely correlated with erythropoietin dose per body surface area. The coefficient of variation of hemoglobin showed a correlation with MIS and ferritin. The absolute level of hemoglobin showed a negative correlation between PTH, CRP, MIS, number of hospitalization instances and a positive correlation with albumin and BMI. High, low, and target-range groups showed survival advantage compared to the other three groups. In regression analysis, age, CRP levels, MIS, and BMI were the predictors of mortality. Conclusion. Inflammation and duration of anemia were the major predictors of hemoglobin variability. High-Amplitude fluctuation predicts high mortality; on the contrary low-Amplitude fluctuations is related to better survival. MIS was independently associated with mortality. This trial is registered with NCT03454906. © 2018 Zeynep Bal et al.
Fibroblast Growth Factor 23/Klotho Axis Is a Risk Factor for Kidney Transplant Loss
(2014) Sezer, S.; Bal, Z.; Uyar, M. Erkmen; Ozdemir, H.; Guliyev, O.; Yildirim, S.; Tutal, E.; Haberal, M.; https://orcid.org/0000-0002-7528-3557; https://orcid.org/0000-0002-5735-4315; https://orcid.org/0000-0002-3462-7632; AAZ-5795-2021; X-8540-2019; AAF-4610-2019; AAJ-8097-2021
Fibromyalgia and Its Clinical Relevance in Renal Transplant Recipients
(2014) Uyar, M. Erkmen; Sezer, S.; Bal, Z.; Guliyev, O.; Tutal, E.; Demirci, B. Gurlek; Haberal, M.; https://orcid.org/0000-0002-3462-7632; AAZ-5795-2021; AAJ-8097-2021
Graft Function and Arterial Stiffness: Can Bioimpedance Analysis Be Useful in Renal Transplant Recipients?
(2015) Sezer, S.; Demirci, B. Gurlek; Guliyev, O.; Sayin, C. B.; Colak, T.; Acar, F. N. Ozdemir; Haberal, M.; 0000-0002-5682-0943; 0000-0002-8372-7840; 0000-0002-3462-7632; 26036549; AAK-1697-2021; AAJ-8554-2021; AAJ-8097-2021
Objective. We aimed to determine the total body water (TBW) by means of bioimpedance analysis (BIA) and to analyze the association of TBW, graft function, and arterial stiffness by means of pulse-wave velocity (PWV) and echocardiographic measurements in renal transplant (RT) recipients. Methods. Eighty-two RT recipients (mean age, 38.7 +/- 11.5 y; 58 male) who were using >= 1 antihypertensive treatment were enrolled in the study. Biochemical parameters, 24-hour urinary protein loss, estimated glomerular filtration rate (eGFR), transthoracic echocardiography, bioimpedance analysis according to systolic blood pressure, TBW, lean tissue index (LTI), extracellular water (ECW), intracellular water (ICW), lean tissue mass (LTM), phase angle (Phi50) levels, and renal resistive index (RRI) were evaluated. Results. TBW and ECVV were significantly correlated with systolic blood pressure. Urinary protein loss, pulmonary artery pressure, frequency of overhydration, systolic blood pressure, TBW, LTI, ECW, ICVV, LTM, and Phi50 values were significantly higher in patients with estimated glomerular filtration rate (eGFR) 15-49 mL/min but similar in patients with eGFR 50-70 mL/min. Conclusions. Hypertensive RT recipients have increased TBW, LTI, ICW, FTI, LTM, and Phi50 values. Graft function is positively correlated with systolic blood pressure and BIA parameters. Therefore, hypertensive RT recipients should be closely followed with the use of BIA for an early diagnosis of loss of graft function.
High Grade Proteinuria as a Cardiovascular Risk Factor in Renal Transplant Recipients
(2015) Guliyev, O.; Sayin, B.; Uyar, M. E.; Genctoy, A.; Sezer, S.; Bal, Z.; Demirci, B. G.; Haberal, M.; 0000-0001-8287-6572; 0000-0002-3462-7632; 0000-0002-5145-2280; 26036546; J-3707-2015; AAJ-8097-2021; AAZ-5795-2021; IAO-2608-2023; AAJ-5551-2021
Background. Proteinuria is a marker of graft damage and is closely associated with a higher risk of morbidity, mortality, and cardiovascular disease in kidney transplant recipients (KTRs). Arterial stiffness is a well-known predictor of vascular calcification and systemic arteriosclerosis. In our study, we aimed to investigate. the association between proteinuria and graft/patient survival and to determine whether proteinuria may be a predictor for cardiovascular disease in our KTR population. Methods. Ninety KTRs (31 women; age, 38.7 +/- 11 years, with 45.9 +/- 9.6 months post-transplantation period) with normal graft functions in the 3 to 5 years of the post-transplantation period were enrolled. All patients were evaluated for their standard clinical (age, sex, and duration of hemodialysis) parameters. High-grade proteinuria was defined as proteinuria >500 mg/day in the 24-hour urine collection. All patients were evaluated by means of pulse-wave velocity (PWV) measurement at the initiation of the study. Results. Patients were divided into 2 groups: group 1 (high-grade proteinuria) patients with >= 500 mg/24 hours (n = 30) and group 2 (low-grade proteinuria) patients with <500 mg/24 hours (n = 60). High-grade proteinuria was correlated with higher PWV measurements and lower estimated glomerular filtration levels. Proteinuria appears to precede the elevation of serum creatinine and thus may be a useful marker of renal injury and may also be a contributing factor on deterioration of the graft. Conclusions. High-grade (>500 mg/day) proteinuria in KTRs is strongly associated with poor graft survival and increased risk of cardiovascular events. In our study, we proved the significant difference between high-grade and low-grade proteinuric patients, and we suggest 500 mg/day as the threshold of proteinuria in KTR population.
Hyperuricemia as a Cardiovascular Risk Factor in Renal Transplant Recipients
(2014) Uyar, M. Erkmen; Sezer, S.; Bal, Z.; Guliyev, O.; Colak, T.; Demirci, B. Gurlek; Haberal, M.; https://orcid.org/0000-0002-8372-7840; https://orcid.org/0000-0002-3462-7632; AAZ-5795-2021; AAJ-8554-2021; AAJ-8097-2021
Hyperuricemia Takes a Toll in Graft Function, Left Ventricular Diameters and Arterial Stiffness in Renal Transplant Recipients
(2015) Demirci, B. Gurlek; Sezer, S.; Oygur, C.; Bal, Z.; Tutal, E.; Haberal, M.; 0000-0002-3462-7632; AAZ-5795-2021; AAJ-8097-2021
Hyperviscosity in Renal Transplant Recipients
(2015) Tutal, E.; Uyar, M. Erkmen; Uyanik, S.; Bal, Z.; Guliyev, O.; Toprak, S. K.; Ilhan, O.; Sezer, S.; Haberal, M.; 0000-0002-3462-7632; 0000-0001-7717-5827; 26036545; AAJ-8097-2021; H-9131-2012; IAO-2608-2023; AAZ-5795-2021; ABC-8182-2021
Objective. The resistance of blood to flow is called plasma viscosity. Increased blood viscosity has been described in patients with coronary and peripheral arterial disease. In this study, we evaluated the influence of clinical and laboratory findings on plasma viscosity in renal transplant recipients. Methods. Eighty-one kidney transplant recipients (37.8 +/- 11.3 years old, 50.38 +/- 16.8 months post-transplantation period, 27 female) with normal graft functions were enrolled. The biochemical and clinical parameters in the 1st year after transplantation were retrospectively recorded, and graft function was evaluated by means of the yearly decline in eGFR. Plasma viscosity was measured and searched for the association with cross-sectionally analyzed cardiovascular parameters including body composition analyses, ambulatory blood pressure monitoring (ABPM) data, and pulse-wave velocity. Results. Patients were divided into 2 groups according to the median value of serum viscosity. Patients with high viscosity had higher serum low-density lipoprotein (P = .042) and C-reactive protein (P = .046) levels than lower viscosity group. In ABPM, daytime (P = .047) and office systolic (P = .046) blood pressure levels and left ventricular mass index (LVMI; P = .012) were significantly higher in patients with hyperviscosity. Patients with high viscosity had higher hip circumference (P = .038) and fat mass (P = .048). Estimated glomerular filtration rate decline was significantly higher in high-viscosity patients than in patients with low viscosity levels (12.9% vs 17.2%; P = .001) at 2 years' follow-up. Conclusions. We suggest that the hyperviscous state of the renal transplant recipients may arise from the inflammatory state, hypertension, and increased fat mass and increased LVMI. Hyperviscosity is also closely related to renal allograft dysfunction.
Hyperviscosity in Renal Transplantation Recipients
(2014) Tutal, E.; Uyar, M. Erkmen; Uyanik, S.; Bal, Z.; Guliyev, O.; Toprak, S.; Ilhan, O.; Sezer, S.; Haberal, M.; https://orcid.org/0000-0001-7717-5827; https://orcid.org/0000-0002-7326-8388; https://orcid.org/0000-0002-3462-7632; AAZ-5795-2021; H-9131-2012; JYQ-2550-2024; AAJ-8097-2021
Impact of Cytomegalovirus on Angiogenesis in Renal Allografts and Its Association with Interstitial Fibrosis and Graft Survival
(2014) Ozdemir, B. H.; Ozdemir, F. N.; Sezer, S.; Baskin, E.; Haberal, M.; https://orcid.org/0000-0002-7528-3557; https://orcid.org/0000-0002-5682-0943; https://orcid.org/0000-0003-4361-8508; https://orcid.org/0000-0002-3462-7632; X-8540-2019; AAK-1697-2021; B-5785-2018; AAJ-8097-2021
Impact of Proton Pomp Inhibitors on Hypomagnesemia and Arterial Stiffness in Renal Transplant Recipients
(2015) Sezer, S.; Demirci, B. Gurlek; Uyar, M. Erkmen; Uyanik, S.; Haberal, M.; 0000-0002-3462-7632; AAJ-8097-2021; IAO-2608-2023
Is There a Link Between Proteinuria and Increased FGF-23 Levels in Renal Transplant Patients
(2016) Tutal, E.; Sezer, S.; Bal, Z.; Demirci, B.; Haberal, M.; 0000-0002-3462-7632; AAZ-5795-2021; AAJ-8097-2021
Non-Dipping Hypertension in Renal Transplant Recipients
(2014) Sezer, S.; Uyar, M. Erkmen; Bal, Z.; Guliyev, O.; Sayin, B.; Colak, T.; Haberal, M.; https://orcid.org/0000-0001-8287-6572; https://orcid.org/0000-0002-8372-7840; https://orcid.org/0000-0002-3462-7632; AAZ-5795-2021; J-3707-2015; AAJ-8554-2021; AAJ-8097-2021
Post-Transplant C-Reactive Protein Predicts Arterial Stiffness and Graft Function in Renal Transplant Recipients
(2015) Demirci, B. Gurlek; Sezer, S.; Colak, T.; Sayin, C. B.; Tutal, E.; Haberal, M.; 0000-0002-8372-7840; 0000-0002-3462-7632; 26036547; AAJ-8554-2021; AAJ-8097-2021
Background. The aim of this study was to evaluate the renal and cardiovascular outcomes of post-transplant c-reactive protein (CRP) levels. Methods. One hundred fifty renal transplant recipients (113 men; median age, 38.9 10.8 years) were cross-sectionally analyzed. Mean pre-transplant and post-transplant CRP levels were analyzed by the 1st, 3rd, 6th, 12th, and 24th months of transplantation. Patients were divided into 3 groups according to mean post-transplantation CRP levels: group 1 (CRP >20 mg/L and fluctuating levels; n = 34), group 2 (CRP, 6-20 mg/L; n = 40), and group 3 (CRP <6 mg/L; n = 76). Arterial stiffness was measured by means of carotid femoral pulse-wave velocity (PWv) by use of the SphygmoCor system. Results. Patients in group 1 had significantly lower estimated glomerular filtration rate (eGFR) (P = .000) and left ventricular systolic function and higher duration of dialysis before transplantation, pulse-wave velocity (PWv), proteinuria, and left ventricular mass index when compared with the other two groups. In regression analysis, eGFR and PWv were detected as the predictors of post-transplantation CRP levels. Conclusions. Fluctuating and high stable (>20 mg/L) post-transplant CRP levels predict eGFR, proteinuria, left ventricular mass index, and PWv after transplantation. Thus, CRP levels may be a useful marker to anticipate graft survival and cardiovascular morbidity in renal transplant recipients.
Post-transplantation Anemia Predicts Cardiovascular Morbidity and Poor Graft Function in Kidney Transplant Recipients
(2015) Demirci, B. Gurlek; Sezer, S.; Sayin, C. B.; Tulal, E.; Uyar, M. E.; Acar, F. N. Ozdemir; Haberal, M.; 0000-0002-3462-7632; 0000-0002-5682-0943; 26036548; IAO-2608-2023; AAJ-8097-2021; AAK-1697-2021
Objective. We aimed to investigate whether low post-transplantation-period hemoglobin levels are predictive of cardiovascular morbidity in terms of left ventricular (LV) hypertrophy and vascular stiffness and to determine the contributing factors of post-transplantation anemia in kidney transplant (KT) recipients. Methods. One hundred fifty (mean age, 38.9 +/- 10.8 y; 113 male) KT recipients with functioning grafts were enrolled in the study. All subjects underwent clinical and laboratory evaluations (24-hour urinary protein loss, complete blood count) and transthoracic echocardiography to assess LV systolic function. Arterial stiffness was measured by means of carotid-femoral pulse-wave velocity (PWV). Mean hemoglobin levels were analyzed at the 1st, 6th, 12th, and 24th months after transplantation. Patients were divided into 2 groups according to presence of anemia: patients with anemia (group 1; n = 120) and normal (group 2; n = 30). Results. PWV values (6.8 +/- 1.9 m/s vs 6.4 +/- 1.1 m/s in groups 1 and 2, respectively; P = .002) and LV mass index (LVMI; 252.1 +/- 93.7 g/m(2) vs 161.2 +/- 38.5 g/m(2) groups 1 and 2, respectively; P = .001) were significantly higher in group 1. Estimated glomerular filtration rate and (64 +/- 28.5 m/min vs 77.8 +/- 30 m/min in groups 1 and 2, respectively; P = .001) LV systolic function (57.2 +/- 5.8% vs 77.8 +/- 30% in groups 1 and 2, respectively; P < .005) were significantly lower in group 1. In regression analysis, LV systolic function and LVMI were predictors of post-transplantation hemoglobin levels. Conclusions. Post-transplantation anemia contributes to cardiovascular morbidity by deteriorating LV function and increasing PWV and is therefore associated with poor prognosis for graft survival. Early correction of post-transplantation anemia, especially with the use of erythropoietin, may be beneficial for both graft and recipient survivals.
Pulmonary Hypertension Is Closely Related to Arterial Stiffness in Renal Transplant Patients
(2015) Bal, Z.; Sezer, S.; Uyar, M. E.; Bal, U.; Kulah, E.; Guliyev, O.; Tutal, E.; Haberal, M.; 0000-0002-3462-7632; 0000-0002-9446-2518; 0000-0001-6041-4254; 26036550; AAJ-8097-2021; IAO-2608-2023; AAK-4322-2021; AAZ-5795-2021; AAJ-5764-2021
Introduction and Aims. Pulmonary hypertension (PH) is an independent predictor of increased mortality in patients on dialysis and those undergoing renal transplantation. We investigated PH and its association with vascular calcification and endothelial dysfunction in renal transplant patients. Methods. The records of 300 consecutive patients who underwent renal transplant in our center between 2005 to 2012 were evaluated. PH was defined as systolic pulmonary artery pressure (sPAP) >= 35 mm Hg. Demographic information, clinical characteristics, pulse wave velocity (PWv), and renal recessive indices (RRI) were collected and compared among patients with and without PH. Results. Eight patients in PH group (age 36 [19] years) and 87 subjects in nPH group (age 35 [9] years) were evaluated. Demographic and clinical characteristics and laboratory data of the 2 groups were similar. Additionally, sPAP was positively correlated with PWv (r = 0.263, P = .01). In multivariate analyses, RRI (P = .004), serum CRP (P = .025), and PWv (P = .001) were associated with pulmonary artery pressure. Conclusion. PH is significantly associated with arterial stiffness in renal transplant recipients who have a high risk for cardiovascular disease. Considering the common prevalence of cardiovascular diseases, including PH, we suggested that all patients with renal transplantation should be evaluated for regular echocardiographic examination in clinical practice.
Pulmonary Hypertension Is Closely Related With Arterial Stiffness in Patients With Renal Transplantation
(2014) Bal, Z.; Sezer, S.; Uyar, M. Erkmen; Bal, U.; Guliyev, O.; Demirci, B. Gurlek; Tutal, E.; Haberal, M.; https://orcid.org/0000-0002-9446-2518; https://orcid.org/0000-0002-3462-7632; AAZ-5795-2021; AAK-4322-2021; AAJ-8097-2021