Browsing by Author "Tutal, E."

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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
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
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
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
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.
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
Relations Among Hyperuricemia, Inflammation, Oxidative Stress and Arterial Stiffness in Renal Transplant Recipients
(2015) Demirci, B. Gurlek; Sezer, S.; Uyar, M. Erkmen; Bal, Z.; Tutal, E.; Acar, F. Ozdemir; Haberal, M.; 0000-0002-3462-7632; AAJ-8097-2021; IAO-2608-2023; AAZ-5795-2021
Sagittal Abdominal Diameter as an Anthropometric Measure of Cardiovascular and Graft Loss Risk in Renal Transplant Recipients
(2015) Bal, Z.; Uyar, M. E.; Tutal, E.; Guliyev, O.; Colak, T.; Sezer, S.; Haberal, M.; 0000-0002-3462-7632; 0000-0002-8372-7840; 26036544; IAO-2608-2023; AAJ-8097-2021; AAZ-5795-2021; AAJ-8554-2021
Background. Sagittal abdominal diameter (SAD) has been presented as a stronger prognostic factor for all-cause and cardiovascular mortality in the general population. The aim of this study was to evaluate the relationship between SAD and its associated parameters in renal transplant recipients. Methods. One hundred eighty-one renal transplant recipients were enrolled in the study. All patients were evaluated according to standard clinical and biochemical parameters. Anthropometric measurements were performed for all patients. Pulse-wave velocity (PWV) was determined from pressure tracing over carotid and femoral arteries with the use of the Sphygmocor system. Results. Patients were divided into 2 groups according to SAD measurements. Group 1 (n = 127) was defined as SAD <24.3 cm, and group 2 (n = 54) was defined as SAD > 24.3 cm. Patients in group 2 had significantly higher triglycerides, C-reactive protein (CRP), uric acid, systolic blood pressure, PWV, and body mass index measurements compared with group 1 (P < .05 for all). In group 2, estimated glomerular filtration rate (eGFR) was significantly lower than group 1 (P = .022). SAD had positive correlation with PWV, systolic and diastolic blood pressure, body mass index, triglycerides, fasting glucose, CRP, and uric acid (P < .05 for all). On stepwise linear regression analyses, proteinuria (P = .005), SAD (P = .001), and CRP (P = .015) independently predicted the degree of percentage change of eGFR. Conclusions. Considering the significant association of visceral fat with inflammation and cardiovascular disease, estimating visceral fat by means of SAD could be a useful tool to stratify cardiovascular risk as well as graft function in renal transplant recipients.
Treatments Against Renin-Angiotensin-Aldosterone System Could Influence FGF23 and Klotho Levels in Renal Transplant Recipients
(2016) Sezer, S.; Tutal, E.; Bal, Z.; Uyar, M.; Haberal, M.; 0000-0002-3462-7632; IAO-2608-2023; AAJ-8097-2021; AAZ-5795-2021