Fakülteler / Faculties
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Item Hypoalbuminemia, Poor Calcium-Phosphorus Control and High Transporter Peritoneal Characteristics - Three Important 10-Year Survival Predictors for Peritoneal Dialysis Patients(2014) Tutal, Emre; Bal, Zeynep; Sezer, Siren; Uyar, Mehtap Erkmen; 0000-0002-7326-8388; IAO-2608-2023; AAZ-5795-2021; JYQ-2550-2024OBJECTIVE: Peritoneal transport characteristic is a potential survival predictor. In this study we evaluated the effect of transport characteristics on 10 year patient survival and compared its' impact with other possible survival predictors. MATERIAL and METHODS: We included 75 CAPD patients who were followed in our center for at least 10 years after initiation of PD. Based on the standard peritoneal equilibration test, PD patients were divided into two transporter groups: Low / Low average (n: 27) and High / High Average (n: 48). Clinical and demographic data were collected from patient charts and impact of transporter characteristics and some other well-known survival predictors were studied. RESULTS: 10 year PD survival rates were significantly lower in H/HA group (p: 0.001). Atherosclerosis-related mortality rate was significantly higher in H/HA group (45.9% vs. 7.6%, p: 0.043). Hypoalbuminemia, increased CaxP, chronic inflammation, H/HA transport status were independent predictors of PD and patient survival. Further analysis revealed that hypoalbuminemia (p: 0.0001) and increased CaxP levels (p: 0.0001) were the main predictors. CONCLUSION: This study suggests that peritoneal transport status is an important survival predictor. However keeping the calcium and phosphorus levels in recommended ranges, and improving nutritional status still have more importance for lowering mortality rates of PD patients.Item Endothelial Nitric Oxide Synthase Polymorphism Influences Renal Allograft Outcome(2014) Uyar, Murathan; Sezer, Siren; Ozdemir, Fatma Nurhan; Kulah, Eyup; Arat, Zubeyde; Atac, Fatma Belgin; Haberal, Mehmet; https://orcid.org/0000-0002-7326-8388; https://orcid.org/0000-0002-5682-0943; https://orcid.org/0000-0001-6041-4254; https://orcid.org/0000-0001-6868-2165; https://orcid.org/0000-0002-3462-7632; 24372826; AAK-5313-2021; JYQ-2550-2024; AAK-1697-2021; AAJ-5764-2021; ABG-9966-2020; AAJ-8097-2021BackgroundAtherosclerotic lesions within the graft are considered to be a major cause of interstitial fibrosis/tubular atrophy (IF/TA). We evaluated the factors that influence the development of IF/TA and three- and five-yr graft survival including nitric oxide synthase (eNOS) and angiotensin II type 1 and type 2 receptor gene polymorphism. MethodsSeventy-one male and 35 female patients (age: 34.911.2yr) who underwent living-related renal transplantation were included. Angiotensin type 1 and type 2 receptor gene polymorphisms and eNOS intron 4 gene polymorphism were analyzed. The pre- and post-transplant laboratory data, patient characteristics, acute rejection episodes, and presence of IF/TA were evaluated. ResultsPatients with the bb allele of eNOS gene had a lower prevalence of post-transplant third year (12.6% and 38.5%, p=0.005) and fifth year IF/TA (46.6% and 82.3%, p=0.02) and a lower incidence of five-yr graft failure (35.4% and 55.6%, p<0.005). The eNOS gene polymorphism was independent and was the most prominent factor associated with third and fifth year IF/TA (p=0.01, RR: 29.72, and p=0.03, RR: 4.1, respectively). No significant relationship existed when angiotensin II gene polymorphisms were considered. ConclusionsWe concluded that recipient eNOS gene polymorphism can predict IF/TA, and the presence of the bb allele is associated with better graft outcome.Item Free Triiodothyronine in Hemodialysis Patients Link With Malnutrition and Inflammation(2014) Yavuz, Demet; Sezer, Siren; Yavuz, Rahman; Canoz, Mujdat Batur; Altinoglu, Alpaslan; Elsurer, Rengin; Arat, Zubeyde; Ozdemir, Fatma Nurhan; https://orcid.org/0000-0002-4082-6320; https://orcid.org/0000-0002-7326-8388; https://orcid.org/0000-0002-5682-0943; 24878944; ABG-9980-2021; JYQ-2550-2024; AAK-1697-2021Introduction. Free triiodothyronine (FT3) is a marker of comorbidity in end-stage renal disease and in many acute and chronic diseases. There is lack of data about the link between FT3 levels and malnutrition and inflammation in hemodialysis patients. The objective of the present study was to investigate the link between FT3 and malnutrition and inflammation in hemodialysis patients. Materials and Methods. A total of 84 patients were included in the study (38 men and 46 women; mean age, 56.2 +/- 14.8 years; hemodialysis duration, 95.72 +/- 10.35 months). Serum FT3, free thyroxin, and thyroid-stimulating hormone concentrations were determined. Demographic data and laboratory values were evaluated. Patients' comorbidity status was determined using the Charlson Comorbidity Index (CCI), and malnutrition-inflammation status was determined by Malnutrition-Inflammation Score (MIS). Results. Serum FT3 concentration inversely correlated with age (r = -0.328, P =.002), CCI (r = -0.591, P < .001), C-reactive protein (r = -0.299, P =.01), and MIS (r = -0.671, P < .001), and positively correlated with serum albumin (r = 0.389, P < .001). In multivariate linear regression analysis, FT3 was independently associated with MIS (beta, -0.14; 95% confidence interval, -0.175 to 0.063, P = .003), adjusted for CCI, C-reactive protein level, serum albumin level, and MIS. Conclusions. The results of this study indicate that FT3 is negatively correlated with inflammatory markers, namely C-reactive protein, and it is independently related with MIS in hemodialysis patients. Therefore, we suggest that FT3 can be accepted as an inflammatory marker in hemodialysis patients.Item Increased Frequency of Gallbladder Stone and Related Parameters in Hemodialysis Patients(2014) Genctoy, Gultekin; Ayidaga, Sevgul; Ergun, Tarkan; Lakadamyali, Hatice; Erbayrak, Mustafa; Sezer, Siren; https://orcid.org/0000-0002-5145-2280; https://orcid.org/0000-0002-6165-2569; https://orcid.org/0000-0002-7326-8388; 24918131; AAJ-5551-2021; JVN-6452-2024; JYQ-2550-2024Background/Aims: The prevalence of gallbladder stone (GBS) is shown to be increased in some studies in patients with chronic kidney disease (CKD). Nevertheless, some other studies did not confirm these findings. The controversial results about the prevalence of GBS in hemodialysis (HD) patients demand new studies to search GBS prevalence and associating risk factors in HD patients. In the present study, we aimed to investigate GBS prevalence and risk factors in our HD patients. Materials and Methods: A total of 104 HD and 149 control patients were involved. Complete physical examinations, including measurements of dry body weight and height, were done. Abdominal ultrasonography was conducted by the same experienced radiologist. Blood samples were drawn via venipuncture from the study participants after they had fasted overnight just before a midweek hemodialysis session for laboratory examinations. Results: The prevalence of GBS in HD patients was 34.6 % (36/104), and that was significantly higher than that of control group 12.9% (17/149; p=0.0001). In all study participants (HD patients and control group), patients with GBS were older than patients with no GBS (63.2 +/- 14.2 vs 53.7 +/- 16.7; p=0.0001). However, in HD patients, mean age was similar in patients with GBS and no GBS (64.3 +/- 13.8 vs 60.1 +/- 16.6; p>0.05). Patients with GBS had a higher prevalence of units of blood transfusions than patients with no GBS in hemodialysis patients (2.0 +/- 2.9 vs 0.9 +/- 1.3; p=0.047) Conclusion: The present study showed an increased prevalence of GBS in HD patients compared to healthy controls. The number of blood transfusions and autonomic neuropathy may be responsible for the increased prevalence of GBS in HD patients.Item Differential Influence of Vitamin D Analogs on Left Ventricular Mass Index in Maintenance Hemodialysis Patients(2014) Sezer, Siren; Tutal, Emre; Bal, Zeynep; Uyar, Mehtap Erkmen; Bal, Ugur; Cakir, Ulkem; Acar, Nurhan Ozdemir; Haberal, Mehmet; https://orcid.org/0000-0002-7326-8388; https://orcid.org/0000-0002-9446-2518; https://orcid.org/0000-0002-3462-7632; 24619898; JYQ-2550-2024; AAZ-5795-2021; AAK-4322-2021; AAJ-8097-2021Purpose: Secondary hyperparathyroidism (SHPT) is a common feature in maintenance hemodialysis (MHD) patients. Inadequate treatment of SHPT has been associated with cardiovascular complications, and vitamin D therapy might influence the development of cardiovascular diseases. In the present study, we aimed to evaluate the effects of intravenous paricalcitol and calcitriol treatments on left ventricular mass index changes in MHD patients. Methods: We conducted an observational study with a 12-month follow-up duration to compare the outcomes of intravenous paricalcitol and calcitriol treatments in MHD patients. Eighty patients with moderate to severe SHPT were enrolled in the study. All the patients had normalized total serum Ca concentration <10.5 mg/dL, serum calcium-phosphorus product (Ca x P) <75, and parathyroid hormone level (PTH) level >= 300 pg/mL at the begining of the follow-up period. Results: The patients were divided into a paricalcitol group (n = 40) and a calcitriol group (n = 40). The demographic, clinical, and biochemical characteristics of the patients were similar at baseline. We observed significantly superior control of SHPT; lesser frequency of hypercalcemia and hyperphosphatemia, and Ca x P level elevations; and interruption of vitamin D treatment in the paricalcitol group. Moreover, we found no significant change in left ventricular mass index in the paricalcitol group, but found a significantly increased left ventricular mass index in the calcitriol group during the follow-up period (from 136.6 +/- 35.2 g/m(2) to 132.9 +/- 40.4 g/m(2) vs. from 137.2 +/- 30.1 g/m(2) to 149.4 +/- 31.0 g/m(2); p<0.044). Conclusion: We observed that, compared with calcitriol therapy, paricalcitol therapy reduced the PTH concentrations more effectively without causing hypercalcemia and hyperphosphatemia and might have a substantial beneficial effect on the development of left ventricular hypertrophy.Item Hyperproteinuria As A Cardiovasculary Risk Factor in Renal Transplant Recipients(2014) Guliyev, Orhan; Uyar, Mehtap Erkmen; Sezer, Siren; Bal, Zeynep; Colak, Turan; Demirci, Bahar Gurlek; Acar, Nurhan Ozdemir; Haberal, Mehmet; https://orcid.org/0000-0002-7326-8388; https://orcid.org/0000-0002-8372-7840; https://orcid.org/0000-0002-3462-7632; JYQ-2550-2024; AAZ-5795-2021; AAJ-8554-2021; AAJ-8097-2021Item Bone Loss Is Associated with Graft Dysfunction at the Time of First Year of Kidney Transplantation: A Cross-Sectional Study(2014) Sezer, Siren; Demirci, Bahar Gurlek; Tutal, Emre; Guliyev, Orhan; Sayin, Cihat Burak; Acar, Fatma Nurhan Ozdemir; Haberal, Mehmet; https://orcid.org/0000-0002-7326-8388; https://orcid.org/0000-0001-8287-6572; https://orcid.org/0000-0002-5682-0943; https://orcid.org/0000-0002-3462-7632; J-3707-2015; AAK-1697-2021; AAJ-8097-2021Item Relationship Between Inflammation, Sex Hormone Profile and Sexual Dysfunction in Female Patients Receiving Different Types of Renal Replacement Therapy(2014) Altunoglu, Alpaslan; Yavuz, Demet; Canoz, Mujdat Batur; Yavuz, Rahman; Karakas, Latife Atasoy; Bayraktar, Nilufer; Colak, Turan; Sezer, Siren; Ozdemir, Fatma Nurhan; Haberal, Mehmet; https://orcid.org/0000-0002-4082-6320; https://orcid.org/0000-0001-7369-5470; https://orcid.org/0000-0002-7886-3688; https://orcid.org/0000-0002-8372-7840; https://orcid.org/0000-0002-7326-8388; https://orcid.org/0000-0002-5682-0943; https://orcid.org/0000-0002-3462-7632; ABG-9980-2021; AEY-5060-2022; Y-8758-2018; AAJ-8554-2021; JYQ-2550-2024; AAK-1697-2021; AAJ-8097-2021Item Oxidative Stress in Maintenance Hemodialysis Patients(2014) Uyar, Mehtap Erkmen; Bal, Zeynep; Bayraktar, Nilufer; Demirci, Bahar Gurlek; Sayin, Burak; Sezer, Siren; https://orcid.org/0000-0002-7886-3688; https://orcid.org/0000-0001-8287-6572; https://orcid.org/0000-0002-7326-8388; IAO-2608-2023; AAZ-5795-2021; Y-8758-2018; J-3707-2015; JYQ-2550-2024Item Relationship Between Proteinuria and Pulsewave Velocity in Patients with Stage 1-4 Chronic Kidney Disease(2014) Uyar, Mehtap Erkmen; Tutal, Emre; Bal, Zeynep; Guliyev, Orhan; Sezer, Siren; https://orcid.org/0000-0002-7326-8388; IAO-2608-2023; AAZ-5795-2021; JYQ-2550-2024