Fakülteler / Faculties
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Item Comparison of Glomerular Filtration Rate Measurements with Two Plasma and Single Plasma Sample Methods in Renal Transplant Cases with Stable Renal Graft Functions(2015) Oner, Ali Ozan; Aydin, Funda; Ipekci, Tumay; Sipahi, Murat; Suleymanlar, Gultekin; Gungor, Firat; 0000-0002-2755-0526; 25643901; AAB-2986-2020This study was planned to determine the efficacies of single plasma sample methods (SPSMs) in indicating glomerular filtration rate (GFR) by taking two plasma sample method (TPSM) as reference in the determination of the GFR in cases with clinically stable renal transplantation. Ninety-six renal transplantation cases (33 female, 63 male; age interval 18-67, mean age 37.46 +/- A 11.81 years) progressing stably clinically and as laboratory, with minimum 6 months after transplantation were included in the study. The GFR values of the cases were measured with SPSM and TPSM. It is observed that all SPSMs have a strong correlation with TPSM. Highest correlation was observed between Groth&Aasted SPSM and TPSM GFR (intraclass correlation coefficient: 0.965). In the analyses performed by using the Bland-Altman analysis, GFR values calculated by all SPSMs were concordant to the TPSM which is the gold standard method in 95 % confidence interval (average +/- A 1.96 standard deviation) and were within the clinically acceptable limits. The narrowest concordance interval was obtained between Groth&Aasted Tc-99 m DTPA SPSM and Tc-99 m DTPA TPSM..Besides, we have obtained the minimum bias and precision value by the Groth&Aasted method. As a result; we can see that all the SPSMs give reliable results in measuring GFR in cases with renal transplantation; besides, we suggest Groth&Aasted method as the first option.Item Effect of The Timing of Dialysis Initiation on Left Ventricular Hypertrophy and Inflammation in Pediatric Patients(2017) Bakkaloglu, Sevcan A.; Kandur, Yasar; Serdaroglu, Erkin; Noyan, Aytul; Bayazit, Aysun Karabay; Sever, Lale; Ozlu, Sare Gulfem; Ozcelik, Gul; Dursun, Ismail; Alparslan, Caner; 2-s2.0-85017214984; AAD-5713-2021Background The optimal time for dialysis initiation in adults and children with chronic kidney disease remains unclear. The aim of this study was to evaluate the impact of dialysis timing on different outcome parameters, in particular left ventricular (LV) morphology and inflammation, in pediatric patients receiving peritoneal dialysis and hemodialysis. Methods The medical records of pediatric dialysis patients who were followed-up in nine pediatric nephrology centers in Turkey between 2008 and 2013 were retrospectively reviewed. In addition to demographic data, we retrieved anthropometric measurements, data on dialysis treatment modalities, routine biochemical parameters, complete blood count, serum ferritin, parathormone, C-reactive protein (CRP), and albumin levels, as well as echocardiographic data and hospitalization records. The patients were divided into two groups based on their estimated glomerular filtration rate (eGFR) levels at dialysis initiation, namely, an early-start group, characterized by an eGFR of > 10 ml/min/1.73 m(2), and a late-start group, with an eGFR of < 7 ml/min/1.73 m(2). The collected data were compared between these groups. Results A total of 245 pediatric dialysis patients (mean age +/- standard deviation 12.3 +/- 5.1 years, range 0.5-21 years) were enrolled in this study. Echocardiographic data were available for 137 patients, and the mean LV mass index (LVMI) was 58 +/- 31 (range 21-215) g/m(2.7). The LVMI was 75 +/- 30 g/ m(2.7)(n = 81) and 34 +/- 6 g/m(2.7)(n = 56) in patients with or without LV hypertrophy (LVH) (p < 0.001). Early-start (eGFR > 10 ml/min/1.73 m(2)) versus late-start dialysis (eGFR < 7 ml/ min/1.73 m(2)) groups did not significantly differ in LVMI and LVH status (p > 0.05) nor in number of hospitalizations. Serum albumin levels were significantly higher in the earlydialysis group compared with the late-dialysis group (3.3 +/- 0.7 vs. 3.1 +/- 0.7 g/dl, respectively; p < 0.05). The early-start group had relatively higher time-averaged albumin levels (3.2 +/- 0.5 vs. 3.1 +/- 0.5 g/dl; p = > 0.05) and relatively lower CRP levels (3.64 +/- 2.00 vs. 4.37 +/- 3.28 mg/L, p > 0.05) than the late-start group, but these differences did not reach statistical significance. Conclusion Although early dialysis initiation did not have a significant effect on important clinical outcome parameters, including LVH, inflammatory state, and hospitalization, in our pediatric dialysis patients, this area of study deserves further attention.Item FGF23, NGAL, and Endostatin: the Predictors of Allograft Function in Renal Transplant Recipients(2018) Demirci, Bahar Gurlek; Sezer, Siren; Yildirim, Saliha Uyanik; Erdogan, Meltem Kaynar; Tutal, Emre; Ozdemir, Ozlem; Orazbayev, Gani; Haberal, Mehmet; 0000-0002-3462-7632; 29528011; AAJ-8097-2021Objectives: Increased circulating levels of fibroblast growth factor 23, neutrophil gelatinase-associated lipocalin, and endostatin are independent risk factors for cardiovascular disease. Here, we evaluated correlations among these parameters and graft dysfunction and their relation with arterial stiffness. Materials and Methods: This prospective study included 73 maintenance kidney transplant patients with stable allograft function who had received the transplant at least 36 months previously. We calculated the estimated glomerular filtration rate (eGFR). Pulse-wave velocity was determined. Serum levels of fibroblast growth factor 23, neutrophil gelatinase-associated lipocalin, and endostatin were measured by enzyme-linked immunosorbent assay. Results: Demographic characteristics and pulse-wave velocity values were similar in groups 1 and 2 (GFR < 60 and > 60 mL/min, respectively). Mean levels of fibroblast growth factor 23 (P = .036), neutrophil gelatinase-associated lipocalin (P = .018), and endostatin were significantly higher in group 1. Fibroblast growth factor 23 was negatively correlated with eGFR (r = -0.267, P = .023) and positively correlated with neutrophil gelatinase-associated lipocalin (r = 0.258, P = .036) and endostatin (r = 0.321, P = .006). Serum endostatin levels were positively correlated with pulse-wave velocity (r = 0.276, P = .019). In linear regression analysis, eGFR was detected as the unique predictor of neutrophil gelatinase-associated lipocalin (P = .001). In addition, each 1 mL/min decrease in eGFR resulted in a 0.281 pg/mL increase in fibroblast growth factor 23 (P = .023) and a 0.04 ng/mL increase in neutrophil gelatinase-associated lipocalin (P = .007); each 1 cm/s increase in pulse-wave velocity resulted in a 3648.7 U/L increase of endostatin (P = .019). Conclusions: All 3 parameters were associated with loss of graft function in kidney transplant recipients. Moreover, endostatin can be used as an independent predictor for cardiovascular morbidity in this population.