Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item 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-8107-2021Nephrotic 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.Item 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-5716-2021Systemic 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.Item 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-4517-2015OBJECTIVE: 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.Item Risk Factors of Cerebrovascular Events in Hemodialysis Patients. Prospective Case Control Study(2018) Ozelsancak, Ruya; Micozkadioglu, Hasan; Torun, Dilek; 0000-0002-0788-8319; 0000-0002-6267-3695; 0000-0001-5142-5672; AAD-5716-2021; AAD-9111-2021; AAE-7608-2021Item The Higher Mortality Is Associated with Heart Valve Disease in End Stage Kidney Disease; A Single Center Experience(2018) Ozelsancak, Ruya; Tekkarismaz, Nihan; Torun, Dilek; Micozkadioglu, Hasan; 0000-0002-6267-3695; 0000-0001-7631-7395; 0000-0001-5142-5672; 0000-0002-0788-8319; AAD-9111-2021; AAD-9088-2021; AAE-7608-2021; AAD-5716-2021Item Relationship Between Malnutrition Inflammation Score, Overhydration and Arterial Stiffness in Hemodialysis Patients(2016) Bal, Zeynep; Tutal, Emre; Ozelsancak, Ruya; Genctoy, Gultekin; Demirci, Bahar Gurlek; Sezer, Siren; https://orcid.org/0000-0002-0788-8319; https://orcid.org/0000-0002-5145-2280; AAZ-5795-2021; AAD-5716-2021; AAJ-5551-2021Item Age Related Differences in The Hydration, Nutritional Status and Arterial Stiffness in Maintenance Hemodialysis Patients(2016) Bal, Zeynep; Ozelsancak, Ruya; Genctoy, Gultekin; Kal, Oznur; Tutal, Emre; Sezer, Siren; https://orcid.org/0000-0002-0788-8319; https://orcid.org/0000-0002-5145-2280; https://orcid.org/0000-0002-7751-4961; AAZ-5795-2021; AAD-5716-2021; AAJ-5551-2021; AAJ-7586-2021Item What is the Level of Awareness About the Foods Containing Inorganic Phosphorus in Patients with Chronic Renal Failure(2017) Tekkarismaz, Nihan; Torun, Dilek; Ozelsancak, Ruya; 0000-0001-7631-7395; 0000-0002-6267-3695; 0000-0002-0788-8319; AAD-9088-2021; AAD-9111-2021; AAD-5716-2021Item Fibromyalgia Syndrome in Turkish Hemodialysis Patients(2016) Leblebici, Berrin; Ozelsancak, Ruya; Yilmaz, Emine Ece; Doruk, Pinar; https://orcid.org/0000-0002-6241-268X; https://orcid.org/0000-0002-0788-8319; https://orcid.org/0000-0002-8602-6038; https://orcid.org/0000-0002-3528-3712; 26198740; AAM-3220-2021; AAD-5716-2021; AAA-8043-2021The aim of our study was to evaluate the frequency of fibromyalgia syndrome (FMS) in hemodialysis (HD) patients and to assess whether this syndrome is associated with gender, age, duration of HD, or various laboratory parameters. This study was composed of 221 chronic HD patients (99 females and 122 males), and we recorded each participant's age, gender, causes of kidney failure, HD duration, education level, and symptoms related to FMS, which was diagnosed according to the 2010 American College of Rheumatology criteria. We documented the laboratory parameters for all patients. In addition, patients with FMS filled out the Fibromyalgia Impact Questionnaire. Twenty-two patients met the diagnostic criteria for FMS (9%), and there were no statistically significant differences related to age, gender, or HD duration between FMS and non-FMS groups (P>0.05). In addition, the education levels were lower in patients diagnosed with FMS (P<0.05), and there were statistically significant differences related to sleep disturbance, fatigue, and cognitive symptoms between the two groups (P<0.05) as well. However, their laboratory parameters were similar (P>0.05). There was a higher prevalence of FMS in HD patients than in the general population. Sleep disturbances, fatigue, education level, and cognitive symptoms were associated with FMS, but there was no correlation between the laboratory parameters and this condition.Item The Effect of Hemodialysis on Balance Measurements and Risk of Fall(2016) Erken, Ertugrul; Ozelsancak, Ruya; Sahin, Safak; Yilmaz, Emine Ece; Torun, Dilek; Leblebici, Berrin; Kuyucu, Yunus Emre; Sezer, Siren; https://orcid.org/0000-0002-0788-8319; https://orcid.org/0000-0002-6267-3695; 27497737; AAD-5716-2021; AAD-9111-2021Patients with end-stage renal disease (ESRD) have increased risk of falls and fall-related complications. Other than aging and factors related to chronic kidney disease, treatment of hemodialysis may also contribute to this increased risk. The aim of this study was to demonstrate the impairment of balance after a session of hemodialysis with a quantitative assessment and reveal an increased fall risk that would possibly be related to treatment of hemodialysis for patients on maintenance hemodialysis. Fifty-six patients with ESRD on chronic hemodialysis program and 53 healthy individuals were involved in this study. Fall Index percentages were calculated, and fall risk categories were determined for all patients and healthy controls using Tetrax posturography device (Sunlight Medical Ltd Israel). The patient group was evaluated twice for balance, before and after a routine session of hemodialysis. Fall Index scores of healthy controls were lower than that of ESRD patients (p = 0.001). In the patient group, we found the mean Fall Index to be significantly higher at the post-dialysis assessment compared to the pre-dialysis assessment (p = 0.003). The number of patients with high risk of falling also increased at the post-dialysis assessment yet the difference did not reach significance. Fall Index was correlated with the increase in age only at the pre-dialysis balance measurement (p = 0.038). Patients with better dialysis adequacy had significantly lower Fall Index scores than the others at the pre-dialysis balance measurement (p = 0.004). The difference was not significant at the post-dialysis measurement. In the current study, we evaluated the balance of ESRD patients before and after a routine session of hemodialysis treatment. This is the first study to investigate the effect of hemodialysis on balance, using an electronic posturographic balance system. We found the Fall Index score to be significantly higher after hemodialysis, indicating a negative effect of hemodialysis on postural stability. As expected, our data showed an increased Fall Index score correlated with the increase in age both in ESRD patients and in healthy controls. However, the correlation with age was not observed for the patient group at the post-dialysis balance measurement. We might conceive that young patients with ESRD are also prone to fall risk after a session of hemodialysis. Methods that provide quantitative assessment for fall risk could be rather beneficial for high-risk populations such as patients on maintenance hemodialysis.
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