Fakülteler / Faculties
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Item Biomonitoring of Oxidative-Stress-Related Genotoxic Damage in Patients with End-Stage Renal Disease(TOXICS, 2024-02-09) Yuzbasioglu, Yucel; Hazar, Merve; Dilsiz, Sevtap Aydin; Yucel, Cigdem; Bulut, Mesudiye; Cetinkaya, Serdar; Erdem, OnurChronic kidney disease (CKD), a common progressive renal failure characterized by the permanent loss of functional nephrons can rapidly progress to end-stage renal disease, which is known to be an irreversible renal failure. In the therapy of ESRD, there are controversial suggestions about the use of regular dialysis, since it is claimed to increase oxidative stress, which may increase mortality in patients. In ESRD, oxidative-stress-related DNA damage is expected to occur, along with increased inflammation. Many factors, including heavy metals, have been suggested to exacerbate the damage in kidneys; therefore, it is important to reveal the relationship between these factors in ESRD patients. There are very few studies showing the role of oxidative-stress-related genotoxic events in the progression of ESRD patients. Within the scope of this study, genotoxic damage was evaluated using the comet assay and 8-OHdG measurement in patients with ESRD who were undergoing hemodialysis. The biochemical changes, the levels of heavy metals (aluminum, arsenic, cadmium, lead, and mercury) in the blood, and the oxidative biomarkers, including superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and malondialdehyde (MDA) levels were evaluated, and their relationship with genotoxic damages was revealed. Genotoxicity, oxidative stress, and heavy-metal levels, except mercury, increased significantly in all renal patients. DNA damage, 8OHdG, and MDA significantly increased, and GSH significantly decreased in patients undergoing dialysis, compared with those not having dialysis. The duration and the severity of disease was positively correlated with increased aluminum levels and moderate positively correlated with increased DNA damage and cadmium levels. In conclusion, this study revealed that the oxidative-stress-related DNA damage, and also the levels of Al and Cd, increased in ESRD patients. It is assumed that these changes may play an important role in the progression of renal damage. Approaches for reducing oxidative-stress-related DNA damage and heavy-metal load in ESRD patients are recommended.Item Graft Function and Arterial Stiffness: Can Bioimpedance Analysis Be Useful in Renal Transplant Recipients?(2015) Sezer, S.; Demirci, B. Gurlek; Guliyev, O.; Sayin, C. B.; Colak, T.; Acar, F. N. Ozdemir; Haberal, M.; 0000-0002-5682-0943; 0000-0002-8372-7840; 0000-0002-3462-7632; 26036549; AAK-1697-2021; AAJ-8554-2021; AAJ-8097-2021Objective. We aimed to determine the total body water (TBW) by means of bioimpedance analysis (BIA) and to analyze the association of TBW, graft function, and arterial stiffness by means of pulse-wave velocity (PWV) and echocardiographic measurements in renal transplant (RT) recipients. Methods. Eighty-two RT recipients (mean age, 38.7 +/- 11.5 y; 58 male) who were using >= 1 antihypertensive treatment were enrolled in the study. Biochemical parameters, 24-hour urinary protein loss, estimated glomerular filtration rate (eGFR), transthoracic echocardiography, bioimpedance analysis according to systolic blood pressure, TBW, lean tissue index (LTI), extracellular water (ECW), intracellular water (ICW), lean tissue mass (LTM), phase angle (Phi50) levels, and renal resistive index (RRI) were evaluated. Results. TBW and ECVV were significantly correlated with systolic blood pressure. Urinary protein loss, pulmonary artery pressure, frequency of overhydration, systolic blood pressure, TBW, LTI, ECW, ICVV, LTM, and Phi50 values were significantly higher in patients with estimated glomerular filtration rate (eGFR) 15-49 mL/min but similar in patients with eGFR 50-70 mL/min. Conclusions. Hypertensive RT recipients have increased TBW, LTI, ICW, FTI, LTM, and Phi50 values. Graft function is positively correlated with systolic blood pressure and BIA parameters. Therefore, hypertensive RT recipients should be closely followed with the use of BIA for an early diagnosis of loss of graft function.Item 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-8097-2021Background. 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.Item Effect of Post-Transplant Cardiac Angiographic Procedures on Post-Transplant Renal Function(2022) Keskin, Suzan; Ciftci, Orcun; Soy, Ebru Ayvazoglu; Muderrisoglu, Haldun; Haberal, Mehmet; 0000-0002-0993-9917; 0000-0002-3462-7632; 35918191; AAC-5566-2019; AAJ-8097-2021Background. Cardiac interventions often are performed before and after renal transplant for coronary artery disease. The aim of this study was to investigate whether post-transplant cardiac coronary procedures affect post-transplant renal function. Method. We retrospectively included renal transplant recipients who underwent renal transplant procedures at Baskent University between April 28, 1997 and January 20, 2020. We analyzed the effect of cardiac catheterization in renal transplant recipients between 6 and 12 months post-transplant with post-transplant renal function assessed by glomerular filtration rate (GFR). We compared the effect of the type of coronary intervention on GFR change in group 1, whereby group 1 was divided into 2 subgroups (coronary artery bypass grafting [CABG] and stenting). Group 1 included patients who underwent cardiac intervention, whereas group 2 included those who had not undergone cardiac intervention. Results. In all, 108 patients underwent coronary angiography; 45 (41.7%) had normal coronaries or minimal coronary artery disease (CAD); 37 (34.3%) underwent stent implantation; 26 (24.1%) underwent CABG. The mean post- transplantation GFR of all patients after cardiac catheterization was 84.26+25.91 (mL/min/1.73 m(2)). The final, after 12 months mean GFR of all patients was 69.55+27.05. The final GFR was significantly lower than the initial post-renal GFR value in patients who underwent cardiac intervention but not in non-intervened patients. Conclusion. Invasive cardiac revascularization procedures showed a negative effect on posttransplant renal function in renal transplant recipients. All renal transplant recipients who underwent cardiac intervention survived the intervention, and there was no mortality. The reason for this outcome was assumed to be because of the short follow-up period.Item The Effect of Renal Transplantation on Cardiac Functions(2020) Yilmaz, Kerem Can; Akgun, Arzu Neslihan; Keskin, Suzan; Ciftci, Orcun; Moray, Gokhan; Muderrisoglu, Haldun; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0001-8926-9142; 33229768; AAJ-8097-2021; W-5233-2018; AAJ-1331-2021Chronic renal failure is a well-known risk factor for cardiovascular poor outcome. Despite advances in dialysis and renal transplantation, these patients still have high cardiovascular morbidity and mortality. The aim of our study was to evaluate the changes in blood parameters and echocardiographic parameters of patients undergoing renal transplantation in our center. One hundred and eighty-three patients who underwent renal transplantation between September 2012 and January 2016 were included in the study. Pre- and postoperative hemoglobin values, lipid profiles, ejection fractions, presence of left ventricular hypertrophy, presence of diastolic dysfunction, and valve pathologies were retrospectively scanned. Data were obtained from all patients in terms of blood parameters, but we compared 92 patients' echocardiographic data because of lack of both pre- and postoperative echocardiography records. In our study, 124 patients (67.8%) were male, and the mean age was 42.6 +/- 14.4 years. Hemoglobin levels (11.2 +/- 1.98, 12.7 +/- 2.2 mg/dL, P <0.001) and high-density lipoprotein (HDL) values (37.6 +/- 10.5, 46.6 +/- 13.6 mg/dL, P <0.001) were found to be different significantly. In echocardiographic evaluation, there was no difference between pre- and postoperative ejection fractions in 92 patients. However, patients with preoperative ejection fraction <50% had a significant increase in postoperative ejection fraction (40.1 +/- 6.2, 48.4% +/- 9.4%, P = 0.012). Renal transplantation can improve left ventricle ejection fraction in patients with basal ejection fraction less than 50% and also provide a significant increase in hemoglobin and HDL levels in all patients. This suggests that renal transplantation may reverse the process for dilated cardiomyopathy and may improve cardiac function in patients with low ejection fraction. However, transplantation should be performed as early as possible in these patients.Item Dietary Fiber Intake: Its Relation With Glycation End Products and Arterial Stiffness in End-Stage Renal Disease Patients(2019) Demirci, Bahar Gurlek; Tutal, Emre; Eminsoy, Irem O.; Kulah, Eyup; Sezer, Siren; 30314838; AAB-3881-2021Objective: We aimed to analyze the relationship between the effect of total dietary fiber intake on C-reactive protein (CRP) and on oxidative stress parameters such as serum advanced glycation end products (AGEs), superoxide dysmutase (SOD), malondialdehyde, and arterial stiffness by pulse wave velocity (PWv) in maintanace hemodialysis (MHD) patients. Methods: Among 650 MHD patients, 128 were selected according to inclusion criteria. The dietary survey was performed with a 3-day dietary history. Dietary fiber level was adjusted for total energy intake by the residual method. Patients were stratified by quartiles of adjusted dietary fiber (ADF) level as group 1 (n = 32) (ADF: <8.86 g/day), group 2 (n = 35) (ADF: 8.86-12.50 g/day), group 3 (n = 31) (ADF: 12.51-15.90 g/day), and group 4 (n = 30) (ADF: >= 15.91 g/day). Monthly assessed biochemical parameters including serum hemoglobin, albumin, CRP, calcium, phosphorus, and lipid profile levels were recorded. Serum AGEs, SOD, and malondialdehyde levels were determined by ELISA method. The PWv was determined from pressure tracing over carotid and femoral arteries. Results: Patients in group 3 and 4 had significantly lower CRP and AGE than those in group 1 and 2. Mean serum SOD level and PWv were significantly higher in group 4. In regression analysis, ADF intake was the unique predictor for both AGE (r(2) = 0.164, P = 0.017) and CRP levels (r(2) = 0.238, P = 0.01). Conclusion: Present data show that dietary fiber intake is independently correlated with inflammation and oxidative stress. In addition, decreased fiber intake results in impaired arterial stiffness. Thus, adequate fiber intake could prevent cardiovascular events and inflammatory processes in patients undergoing MHD. (C) 2018 by the National Kidney Foundation, Inc. All rights reserved.Item Parathyroid Hormone Levels in the Prediction of Ischemic Stroke Risk(2017) Dener, Sefik; Celik, Guner; Dogan, Ali; Ozturk, Serefnur; Kulaksizoglu, Sevsen; Ekmekci, Hakan; 0000-0002-7613-2240; 28115793; AAI-8932-2021Objective. It was examined whether PTH and 25-dihydroxyvitamin D(25(OH)D) levels, together or separately, are indicators of the risk of stroke. Materials and Methods. This prospective study was performed at two centers. In the study, 100 patients diagnosed with acute ischemic stroke and 100 control individuals in the same age range were examined. In addition to neurological examination, cranial imaging, extensive routine blood chemistry, PTH, and 25(OH) D levels were evaluated in all cases. Stroke risk factors were determined. Logistic regression was used for statistical analysis. Results. A total of 60 patients and 79 control individuals were included in the study. Different estimation models were designed in order to examine the relationship between PTH and 25(OH) D levels with stroke. According to modeling results, it was determined that the most effective predictor for risk of stroke was 25(OH) D levels, followed by hypertension and PTH levels, respectively. Conclusion. PTH and 25(OH) D levels together can make important contributions to determination of stroke risk, and further investigations are needed to understand this relationship more fully.