Tıp Fakültesi / Faculty of Medicine

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Author: search.filters.author.Sezer, S.Subject: search.filters.subject.RISK

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    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.
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    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.