Browsing by Author "Yildiz, Ismail"

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The Association of Upper Extremity Deep Vein Thrombosis and Homozygosity for the MTHFR 1298A-C Mutation in a Young Women with Membranoproliferative Glomerulonephritis
(2014) Yildiz, Ismail; Torun, Dilek; Ozelsancak, Ruya; Ozkan, Ugur; Canpolat, Tuba; 0000-0002-6267-3695; 0000-0002-0788-8319; AAD-9111-2021; AAD-5716-2021; AAK-8107-2021
Nephrotic syndrome increases the tendency to thromboembolic complications in both adults and children. Changes in the plasma concentrations of many proteins concerned with regulation of clotting and fibrinolytic systems, hyperviscosity, dehydration, corticosteroid and diuretic therapy may also contribute to thromboembolism. In addition, some of the genetic disorders also increase tendency to thromboembolic events. One of these disorders is methylene tetrahydrofolate reductase (MTHFR) A1298C mutation, which may cause hyperhomocysteinemia and thrombotic events when the folate level is low. A 26-year-old female was admitted to hospital with upper extremity deep vein thrombosis and nephrotic range proteinuria. On her renal biopsy, membranoproliferative glomerulonephritis (MPGN) was found. The other causes of thrombosis were excluded and homozygosity for the MTHFR A1298C mutation was determined. The levels of homocysteine and folic acid were normal. We report a first case of MPGN together with homozygosity for MTHFR 1298C mutation in adult nephrotic syndrome, complicated with unusual upper extremity venous thrombosis.
The Effect of Serum Mannose-Binding Lectin Levels on Dialysis-Related Peritonitis and Catheter-Related Bacteremia
(2015) Erken, Ertugrul; Torun, Dilek; Sezgin, Nurzen; Micozkadioglu, Hasan; Zumrutdal, Aysegul; Ozelsancak, Ruya; Yildiz, Ismail; 0000-0002-6267-3695; 0000-0002-0788-8319; 0000-0001-5142-5672; 0000-0002-7054-1203; AAD-9111-2021; AAD-5716-2021; AAE-7608-2021; P-4517-2015
OBJECTIVE: Mannose-binding lectin (MBL) takes part in innate immunity through opsonisation and complement activation. Deficiency of MBL is associated with some infections and autoimmune disorders. This study focused on functional MBL deficiency and its effects on dialysis-related peritonitis and catheter-related bacteremia in patients with end stage renal disease. MATERIAL and METHODS: The study included 51 patients on chronic peritoneal dialysis (PD) program and 31 under maintenance hemodialysis (HD) who had tunneled/cuffed hemodialysis catheters (total 82). Serum MBL level measurements were performed by ELISA technique. RESULTS: The mean value for serum MBL in patient groups of PD, HD, and healthy controls were 2536.5 ng/ml, 2088.7 ng/ml, 1924 ng/ml respectively. Difference of MBL level was not significant among groups. Serum MBL value was negatively correlated to the number of peritonitis episodes in PD group (p=0.019). Deficiency of MBL was not associated with high incidence of peritonitis. Surveillance of catheter associated blood stream infection for tunneled/cuffed hemodialysis catheters was 2.07 episodes/1000 catheter days. An association with MBL deficiency and incidence of catheter-related bacteremia was not observed. CONCLUSION: Serum MBL value was negatively correlated to the number of peritonitis episodes but an expected association of MBL deficiency with high incidence of dialysis-related peritonitis and catheter-related bacteremia was not found. New studies with greater sample size might probably indicate the potential effect of MBL deficiency on dialysis-related peritonitis.
The Effects of Cinacalcet Treatment on Bone Mineral Metabolism, Anemia Parameters, Left Ventricular Mass Index and Parathyroid Gland Volume in Hemodialysis Patients with Severe Secondary Hyperparathyroidism
(2016) Torun, Dilek; Yildiz, Ismail; Micozkadioglu, Hasan; Nursal, Gul Nihal; Yiğit, Fatma; Ozelsancak, Ruya; 26787561
The aim of this study was to investigate the effects of cinacalcet therapy on anemia parameters, bone mineral metabolism, left ventricular mass index (LVMI) and parathyroid gland volume in hemodialysis (HD) patients with secondary hyperparathyroidism. Twenty-five HD patients (M/F: 11/14, mean age: 45.2 +/- 17.9 years, mean HD duration: 96.4 +/- 32.7 months) were included in this prospective pilot study. The indication to start calcimimetic therapy was persistent serum levels of parathyroid hormone (PTH) > 1000 pg/mL, refractory to intravenous (i.v.) vitamin D and phosphate-binding therapy. The initial and one-year results of adjusted serum calcium (Ca+2), phosphate (P), Ca x P product, PTH, hemoglobin (Hb) and ferritin levels, transferrin saturation index (TSAT), median weekly erythropoietin (EPO) dose, LVMI, and parathyroid volume by parathyroid ultrasonography were determined. There were no differences between pre-and posttreatment levels of serum Ca+2 (P = 0.853), P (P = 0.447), Ca x P product (P = 0.587), PTH (P = 0.273), ferritin (P = 0.153) and TSAT (P = 0.104). After 1 year of calcimimetic therapy, the Hb levels were significantly higher than the initial levels (P = 0.048). The weekly dose of EPO decreased with no statistical significance. The dose of cinacalcet was increased from 32.4 +/- 12.0 to 60.0 +/- 24.4 mg/day (P = 0.01). There were no differences between the pre-and post-treatment results regarding weekly vitamin D dose, parenteral iron dose, LVMI and parathyroid volume. The results of our study suggest that cinacalcet therapy might have an additional benefit in the control anemia in HD patients.
Termination of Hemodialysis Treatment on the 5th Month of Mycophenolate Mofetil in Type 4 Lupus Nephritis with Serious Renal Failure: A Case Report
(2015) Torun, Dilek; Micozkadioglu, Hasan; Ozelsancak, Ruya; Yildiz, Ismail; 0000-0002-6267-3695; 0000-0001-5142-5672; 0000-0002-0788-8319; AAD-9111-2021; AAE-7608-2021; AAD-5716-2021
Systemic lupus erythematosus (SLE) is a chronic, occasionally life-threatening, multisystem disorder, and renal involvement is one of the most common and most serious complications of SLE. Among the various histological types of lupus nephritis, diffuse proliferative nephritis carries the worst prognosis. A 28-year-old woman was admitted to Baskent University Adana Hospital with the complaints of dyspnea, chest pain, and fatigue. The patient had active lupus manifestations including generalized pleural and pericardial effusion, hypoalbuminemia, anemia, leucopenia, hypocomplementemia, markedly elevated ANA, acute kidney injury, and uncontrolled hypertension. Renal biopsy had been performed at another institute and shown type 4 lupus nephritis. She had been managed with methylprednisolone and cyclophosphamide (CYP) for 6 months. We started immunosuppressive therapy with intravenous methylprednisolone (1 gr/day) for 3 days as an induction therapy. The treatment was continued with oral methylprednisolone 0.5 mg/kg/day and mycophenolate mofetil (MMF) 1 gr/day. Hemodialysis (HD) therapy was initiated because of progressive renal failure and hypervolemia during the clinical course. Despite the improvement in her general condition, the patient underwent HD treatment three times a week for 5 months. On the fifth month of MMF therapy the renal function and diuresis were progressively improved and HD treatment was terminated. Management with MMF may be effective for remission of lupus nephritis in patients who are nonresponders to initial CYC therapy.