Browsing by Author "Uyar, M. E."

Now showing 1 - 4 of 4

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.
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.
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.