178 results on '"Kultigin, Turkmen"'
Search Results
102. SP214EVALUATION OF LONG TERM THİRST DUE TO RAMADAN FASTİNG İN TERMS OF ACUTE KİDNEY İNJURY
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F. Mehmet Erdur, H. Zeki Tonbul, Ismail Baloglu, N. Yılmaz Selçuk, Fatih Pektas, and Kultigin Turkmen
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Transplantation ,medicine.medical_specialty ,Creatinine ,Urine volume ,business.industry ,Acute kidney injury ,medicine.disease ,Thirst ,Term (time) ,chemistry.chemical_compound ,chemistry ,Nephrology ,medicine ,medicine.symptom ,Intensive care medicine ,business - Published
- 2017
103. Health-related qualıty of lıfe, sleep qualıty, and depressıon in peritoneal dialysis and hemodıalysıs patıents
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Yalcin Solak, Kultigin Turkmen, Ibrahim Guney, Lutfullah Altintepe, Mehdi Yeksan, Raziye Yazici, and Halil Zeki Tonbul
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medicine.medical_specialty ,Cross-sectional study ,business.industry ,medicine.medical_treatment ,Beck Depression Inventory ,Hematology ,humanities ,Peritoneal dialysis ,Quality of life ,Nephrology ,Internal medicine ,medicine ,Physical therapy ,Hemodialysis ,Renal replacement therapy ,business ,Depression (differential diagnoses) ,Dialysis - Abstract
Health-related quality of life (HRQoL) and sleep quality (SQ) were impaired in patients with end-stage renal disease (ESRD). The impairment of both HRQoL and SQ and being in a depressive mood were found to be associated with increased morbidity and mortality in dialysis patients. We aimed to investigate the association between SQ, HRQoL, and depression, and to define independent predictors of SQ and depression in peritoneal dialysis (PD) and hemodialysis (HD) patients. Ninety HD patients (41 females, 49 males with mean age 50 ± 15.7 years) and 64 PD patients (27 females, 37 males with mean age 52.4 ± 15.3 years) receiving renal replacement therapy for at least 3 months were screened for the assessment of SQ, HRQoL, and depression in this cross-sectional study. A modified postsleep inventory, Short Form of Medical Outcomes Study (SF-36) and Beck depression inventory (BDI) were applied to all patients for evaluating SQ, HRQoL, and depression, respectively. HD and PD patients had similar total SQ scores. Physical and mental component scale of HRQoL were found to be significantly higher in HD patients (p < 0.001). PD patients were found to be much more in depressive mood when compared with HD patients (p < 0.001). Independent predictors of depression in patients were mental component scale of HRQoL, gender (being female), and dialysis modality (being PD patient). Physical component scale was also found to be an independent predictor of SQ. This study showed that despite similar SQ scores between two groups, HD patients had better HRQoL and less depression than PD patients.
- Published
- 2011
104. Predictors of Kidney Dimensions Measured by Multi-detector Computed Tomography (MDCT) in 930 Middle-Aged and Elderly Patients
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Ibrahim Guler, Kultigin Turkmen, Seda Ozbek, Zeynep Biyik, Suleyman Turk, Yalcin Solak, Alaaddin Nayman, Huseyin Ozbiner, Cigdem Samur, and Orhan Ozbek
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Male ,medicine.medical_specialty ,Renal function ,Kidney ,urologic and male genital diseases ,Critical Care and Intensive Care Medicine ,Logistic regression ,Diabetes mellitus ,Multidetector Computed Tomography ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Aged ,Aged, 80 and over ,business.industry ,Organ Size ,General Medicine ,Middle Aged ,medicine.disease ,Sagittal plane ,medicine.anatomical_structure ,Nephrology ,Coronal plane ,Renal physiology ,Female ,Radiology ,business ,Glomerular Filtration Rate - Abstract
A few studies investigated renal size using computed tomography (CT) in middle-aged and elderly patients while taking renal function into account. Thus, we aimed to assess kidney dimensions and their predictors in patients without known renal disease by multi-detector computed tomography (MDCT).This is a 6-month-long prospective observational study. Estimated glomerular filtration rate (eGFR) was calculated with Cockcroft-Gault (CG) and modification of diet in renal disease (MDRD) formulas. Pole-to-pole kidney length (R1) was determined from coronal and sagittal oblique images. Kidney length (R2), width (R3), and parenchymal thickness were measured in axial slices.The data of the 930 patients were included in this study. CG-eGFR was more closely correlated with R1, R2, and R3 than MDRD-eGFR. CG-eGFR, female gender, and presence of diabetes mellitus were independent predictors of R1 size in logistic regression analyses.Kidney sizes diminish with advancing age. CG-eGFR shows a better correlation with kidney dimensions compared with MDRD. Overall, age was a stronger determinant of eGFR than renal dimensions.
- Published
- 2011
105. A Retrospective Analysis of Five Year Data of End-Stage Renal Disease Patients: A Single Center Experience
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Yalcin Solak, Ahmet Tunc, Kultigin Turkmen, and Suleyman Turk
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medicine.medical_specialty ,business.industry ,Urology ,Diastole ,Significant negative correlation ,Single Center ,medicine.disease ,Serum urea ,End stage renal disease ,Diabetic nephropathy ,Catheter ,medicine ,Retrospective analysis ,Surgery ,business - Abstract
RESulTS: We showed that there was an increased rate of diabetic nephropathy between 2003 and 2004. The increased rate of diabetic nephropathy was found to be statistically significant in the last two years (p
- Published
- 2011
106. Aspergillus thyroiditis in a renal transplant recipient mimicking subacute thyroiditis
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Kultigin Turkmen, Suleyman Turk, Orhan Ozbek, S. Erekul, Yalcin Solak, Huseyin Atalay, and A. Nar
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Voriconazole ,endocrine system ,Transplantation ,Aspergillus ,Pathology ,medicine.medical_specialty ,endocrine system diseases ,biology ,business.industry ,Thyroid ,medicine.disease ,biology.organism_classification ,Thyroiditis ,chemistry.chemical_compound ,Infectious Diseases ,medicine.anatomical_structure ,chemistry ,Renal transplant ,medicine ,Caspofungin ,business ,Subacute thyroiditis ,medicine.drug - Abstract
Fungal pathogens are increasingly encountered after renal transplantation. Aspergillus causes significant morbidity and mortality in transplant patients. Fungal thyroiditis is a rare occurrence owing to unique features of the thyroid gland. Most cases are caused by Aspergillus species and have been described in immunocompromised patients. Presentation may be identical with that of subacute thyroiditis, in which hyperthyroidism features and painful thyroid are the prominent findings. Diagnosis can be ascertained by fine-needle aspiration of thyroid showing branching hyphae of Aspergillus. We describe a renal transplant patient who developed Aspergillus thyroiditis as part of a disseminated infection successfully treated with voriconazole.
- Published
- 2010
107. Vascular Calcifi cation in Chronic Kidney Disease
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Kultigin Turkmen and Halil Zeki Tonbul
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Pathology ,medicine.medical_specialty ,business.industry ,Urology ,Medicine ,Surgery ,business ,medicine.disease ,Kidney disease - Published
- 2010
108. Assessment of Adrenal Functions in Patients with Autosomal Dominant Polycystic Kidney Disease
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Tevfik Ecder, Kultigin Turkmen, Nadir Alpay, Mukremin Uysal, B. Cekrezi, Bora Uslu, Fatih Tufan, Rian Disci, and Nese Ozbey
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Adult ,Male ,endocrine system ,medicine.medical_specialty ,Hydrocortisone ,Endocrinology, Diabetes and Metabolism ,Autosomal dominant polycystic kidney disease ,Renal function ,Flank Pain ,Adrenocorticotropic hormone ,urologic and male genital diseases ,Nephropathy ,chemistry.chemical_compound ,Basal (phylogenetics) ,Endocrinology ,Dehydroepiandrosterone sulfate ,Adrenocorticotropic Hormone ,Internal medicine ,Adrenal Glands ,Internal Medicine ,medicine ,Humans ,Pain Measurement ,Sex Characteristics ,Dehydroepiandrosterone Sulfate ,business.industry ,Adrenal cortex ,Dehydroepiandrosterone ,Organ Size ,General Medicine ,Middle Aged ,Polycystic Kidney, Autosomal Dominant ,medicine.disease ,Zona Reticularis ,medicine.anatomical_structure ,chemistry ,Female ,Zona Fasciculata ,business ,Algorithms ,hormones, hormone substitutes, and hormone antagonists ,Glomerular Filtration Rate ,Kidney disease - Abstract
Background Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease and extrarenal manifestations may be observed in many organ systems. Hypothalamus-pituitary-adrenal axis was not evaluated extensively in patients with ADPKD. We aimed to evaluate this axis in these patients. Methods Twenty two patients with ADPKD and 27 healthy subjects were enrolled. Basal dehydroepiandrosterone sulfate (DHEAS) levels and cortisol and DHEA responses to low dose short adrenocorticotropin stimulation test were assessed. Correlation analyses of these parameters with glomerular filtration rates (GFR), renal volumes and pain characteristics in patients with ADPKD were performed. Results Patients with ADPKD had higher basal cortisol levels (12.1 ± 3.4 vs. 9.6 ± 4.3 μg/dL, p=0.033), and higher basal cortisol/DHEAS ratios (0.073 ± 0.05 vs. 0.045 ± 0.02, p=0.015) compared to controls. None of the subjects had inadequate response to adrenocorticotropin stimulation. Patients with ADPKD had lower delta cortisol (absolute increase between peak and basal) levels (10.3 ± 2.8 vs. 12.6 ± 4.2 μg/dL, p=0.026) compared to controls. Subgroup analysis showed that significant differences existed only between female patients and female controls. There was no significant correlation between cortisol levels and renal volumes or GFR. A significant correlation was found only between delta cortisol and pain frequency in female patients. Conclusions Patients with ADPKD had higher basal cortisol levels, higher basal cortisol/DHEAS ratios and lower delta cortisol levels compared to controls, indicating promptly stimulated zona fasciculata function. Further studies are needed to confirm these results and to investigate possible underlying mechanisms.
- Published
- 2010
109. Coronary Flow Velocity Reserve and Carotid Intima Media Thickness in Patients with Autosomal Dominant Polycystic Kidney Disease
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Mukremin Uysal, Huseyin Oflaz, Tevfik Ecder, Bora Uslu, Kultigin Turkmen, Ali Elitok, Erdem Kasikcioglu, Fatih Tufan, Sabahat Alisir, Arif Oguzhan Cimen, and Sule Namli
- Subjects
Adult ,Male ,medicine.medical_specialty ,Epidemiology ,Autosomal dominant polycystic kidney disease ,Diastole ,Renal function ,Critical Care and Intensive Care Medicine ,Coronary circulation ,Coronary Circulation ,Internal medicine ,medicine ,Humans ,Endothelial dysfunction ,Transplantation ,business.industry ,Middle Aged ,Atherosclerosis ,Polycystic Kidney, Autosomal Dominant ,medicine.disease ,Coronary Vessels ,Coronary arteries ,Dipyridamole ,Carotid Arteries ,Kidney Tubules ,medicine.anatomical_structure ,Intima-media thickness ,Nephrology ,Clinical Nephrology ,Case-Control Studies ,Cardiology ,Female ,Tunica Intima ,Tunica Media ,business ,Blood Flow Velocity ,Echocardiography, Stress ,medicine.drug - Abstract
Cardiovascular problems are a major cause of morbidity and mortality in patients with autosomal dominant polycystic kidney disease. Endothelial dysfunction, an early and reversible feature in the pathogenesis of atherosclerosis, is associated with increased vascular smooth muscle tone, arterial stiffening, and increased intima-media thickness. Coronary flow velocity reserve is a noninvasive test showing endothelial function of epicardial coronary arteries and coronary microcirculatory function. The aim of the study was to investigate the carotid intima-media thickness and coronary flow velocity reserve in patients with autosomal dominant polycystic kidney disease.Thirty normotensive patients with autosomal dominant polycystic kidney disease (10 male, 20 female) with well-preserved renal function and 30 healthy subjects (12 male, 18 female) were included in the study. Coronary flow velocity reserve was measured at baseline and after dipyridamole infusion by echocardiography. Coronary flow velocity reserve was calculated as the ratio of hyperemic to baseline diastolic peak velocities.Carotid intima-media thickness was significantly higher in patients than in control subjects (0.80 +/- 0.29 versus 0.54 +/- 0.14 mm, respectively; P0.001). Moreover, coronary flow velocity reserve was significantly lower in patients than in control subjects (1.84 +/- 0.39 versus 2.65 +/- 0.68, respectively; P0.001).Normotensive patients with autosomal dominant polycystic kidney disease with well-preserved renal function have significantly increased carotid intima-media thickness and significantly decreased coronary flow velocity reserve compared with healthy subjects. These findings suggest that atherosclerosis starts at an early stage in the course of their disease in patients with autosomal dominant polycystic kidney disease.
- Published
- 2008
110. The Relationship between Oxidative Stress and Coronary Artery Calcification in Patients Undergoing Peritoneal Dialysis or Hemodialysis
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Orhan Ozbek, Suleyman Turk, Fatih Mehmet Erdur, Kultigin Turkmen, Aysun Toker, Fatih Ozcicek, Hatice Kayikcioglu, and Halil Zeki Tonbul
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Hemodiyaliz,periton diyalizi,oksidatif stres,vasküler kalsifikasyonu ,medicine.medical_specialty ,Hemodialysis,peritoneal dialysis,oxidative stress,vascular calcification ,business.industry ,medicine.medical_treatment ,Nitrotyrosine ,nutritional and metabolic diseases ,Multi slice ,General Medicine ,medicine.disease_cause ,Peritoneal dialysis ,chemistry.chemical_compound ,chemistry ,Internal medicine ,Coronary artery calcification ,cardiovascular system ,medicine ,Cardiology ,In patient ,cardiovascular diseases ,Hemodialysis ,business ,Vascular calcification ,Oxidative stress - Abstract
Vascular calcification and increased oxidative stress are commonly seen in patients with end-stage renal disease (ESRD). Nitrotyrosine is one of the end products of nitric oxide metabolism and is accepted as an indicator of oxidative stress. Nitrotyrosine levels have been found to be high in ESRD patients. The aim of our study is to investigate the relation between coronary artery calcification and oxidative stress in peritoneal dialysis (PD) and hemodialysis (HD) patients. 46 PD and 34 HD patients are included in the study. Coronary artery calcification scoring (CACS) is made by multi slice computed tomography. Patients are divided into 4 groups according to their CACS values as Group 1 (CACS: 0), Group 2 (CACS:1-99), Group 3 (CACS:100-399) and Group 4 (CACS: ≥400). Serum nitrotyrosine levels were measured. Nitrotyrosine levels were significantly increased in HD patients compared to PD patients. Nitrotyrosine levels were found to be elevated in accordance with increased CACS in PD patients. However, we could not find this relationship in HD patients. There might be an important relationship between CACS and oxidative stress in PD patients., Son dönem böbrek yetersizliği (SDBY) gelişen hastalarda vasküler kalsifikasyon (VK) ve oksidatif stres yaygın olarak gözlenmektedir. SDBY’li hastalarda oksidatif stres belirteci olan nitrotirozin düzeyinin yüksek olduğu tespit edilmiştir. Çalışmamızın amacı periton diyaliz (PD) ve hemodiyaliz (HD) hastalarında koroner arter kalsifikasyonu ile oksidatif stres arasındaki ilişkiyi incelemektir. Çalışmamıza 46 PD ve 34 HD hastası alınmıştır. Hastalara multi slice bilgisayarlı tomografi ile koroner arter kalsiyum skorlaması (KAKS) yapıldı. KAKS değerlerine göre hastalar Grup 1 (KAKS 0), Grup 2 , Grup 3 ve Grup 4 (KAKS: ≥400) olmak üzere 4 gruba ayrıldı. Serumda nitrotirozin düzeyleri ölçüldü. PD hastalarıyla kıyaslandığında, HD hastalarının nitrotirozin düzeyi anlamlı olarak yüksekti. PD ve HD hastaları KAKS göre gruplara ayrıldığında PD hastalarında KAKS arttığında nitrotirozin düzeyi de anlamlı olarak artmaktaydı, halbuki bu ilişki HD hastalarında tespit edilemedi.PD hastalarında KAKS ile oksidatif stres arasında anlamlı bir ilişki mevcuttur
- Published
- 2015
111. 5-Fluorouracil Induced Acute Coronary Syndrome: Case Report
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Aysu Timuroglu, Levent Demirtas, Adalet Ozcicek, Emin Murat Akbas, Ufuk Kuyrukluyildiz, Kultigin Turkmen, Zafer Kucuksu, and Fatih Ozcicek
- Subjects
medicine.medical_specialty ,Acute coronary syndrome ,Fluorouracil ,business.industry ,Internal medicine ,medicine ,medicine.disease ,business ,Gastroenterology ,medicine.drug - Published
- 2015
112. The Relationship Between Osteoprotegerin/RANKL Axis and Arterial Stiffness in Osteopenic/Osteoporotic Renal Transplantation Recipients
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Eray Eroglu, Ender Dogan, Kultigin Turkmen, Cigdem Karakukcu, Ozkan Gungor, Ozcan Orscelik, Ali Dogan, Bulent Tokgoz, Ismail Kocyigit, Aydin Unal, Oktay Oymak, and Murat Hayri Sipahioglu
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musculoskeletal diseases ,medicine.medical_specialty ,biology ,business.industry ,Urology ,medicine.disease ,Transplantation ,Osteoprotegerin ,RANKL ,biology.protein ,Arterial stiffness ,Medicine ,Surgery ,business - Abstract
OBJECTIVE: Cardiovascular diseases are the main reason of death in patients with renal transplantation (Rtx). Osteoprotegerin (OPG) is produced by osteoblasts and is linked to increased cardiovascular risk in Rtx. OPG acts as a decoy receptor binding receptor activator of nuclear factor kappa-B ligand (RANKL) and this interaction plays a role in bone resorption and vascular function. This study aimed to investigate the relation between OPG, RANKL, osteoporosis and arterial stiffness in Rtx patients.
- Published
- 2014
113. SP566THE RELATIONSHIP BETWEEN CORONARY ARTERY CALCIUM SCORES AND LEFT ATRIUM SIZE IN HEMODIALYSIS PATIENTS
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N. Yılmaz Selçuk, Kultigin Turkmen, Ismail Baloglu, and H. Zeki Tonbul
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Transplantation ,Coronary artery calcium ,medicine.medical_specialty ,medicine.anatomical_structure ,Nephrology ,business.industry ,medicine.medical_treatment ,Internal medicine ,Left atrium ,medicine ,Cardiology ,Hemodialysis ,business - Published
- 2017
114. Utility of Double Filtration Plasmapheresis in Acute Antibody Mediated Renal Allograft Rejection: Report of Three Cases
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Mehdi Yeksan, Kultigin Turkmen, Melih Anil, Huseyin Atalay, Ilker Polat, Zeynep Biyik, and Yalcin Solak
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medicine.medical_specialty ,biology ,business.industry ,Urology ,medicine.medical_treatment ,Autoantibody ,medicine.disease ,Double filtration plasmapheresis ,Extracorporeal ,ABO blood group system ,medicine ,biology.protein ,Renal allograft ,Surgery ,Plasmapheresis ,Antibody ,business ,Kidney transplantation - Abstract
Plasmapheresis is an extracorporeal procedure, which is often employed to rapidly lower circulating titers of autoantibodies, immune complexes or toxins. There are two types of plasmapheresis namely, regular plasmapheresis (RPP) by centrifugation and membrane fi ltration, and double fi ltration plasmapheresis (DFPP) which is a special form of membrane fi ltration in which two membranes called as plasma separator and plasma fractionator are employed to fi lter macromolecules more selectively. DFPP have several advantages over RP. Despite widespread utilization of DFPP in the setting of ABO blood group incompatible kidney transplantation, there is no report regarding DFPP in patients with antibody mediated acute renal allograft rejection who are good candidates for benefi cial effects of DFPP. Here we report three renal transplant recipients in whom DFPP was applied as a component of anti-rejection treatment regimen.
- Published
- 2011
115. Community-acquired carbapenem-resistant Acinetobacter baumannii urinary tract infection just after marriage in a renal transplant recipient
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Zeynep Biyik, Nejdet Genc, Mehdi Yeksan, Kultigin Turkmen, Huseyin Atalay, and Yalcin Solak
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Transplantation ,medicine.medical_specialty ,biology ,business.industry ,Urinary system ,medicine.medical_treatment ,Immunosuppression ,Patient survival ,biochemical phenomena, metabolism, and nutrition ,urologic and male genital diseases ,bacterial infections and mycoses ,medicine.disease ,biology.organism_classification ,Comorbidity ,female genital diseases and pregnancy complications ,Acinetobacter baumannii ,surgical procedures, operative ,Infectious Diseases ,Renal transplant ,Internal medicine ,medicine ,Intensive care medicine ,Carbapenem resistant Acinetobacter baumannii ,business ,Kidney transplantation - Abstract
Urinary tract infection (UTI) is common in renal transplant recipients and may worsen allograft and patient survival. Many risk factors such as age, female gender, immunosuppression, comorbidity, deceased-donor kidney transplantation, and uretheral catheterization are involved in development of UTI. Acinetobacter baumannii has rarely been reported as a causative agent for development of UTI. Here, we present an unusual case of a renal transplant recipient who developed community-acquired carbapenem-resistent A. baumannii UTI.
- Published
- 2011
116. The Relationship between Serum Oxalic Acid, Central Hemodynamic Parameters and Colonization by Oxalobacter formigenes in Hemodialysis Patients
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Baris, Gulhan, Kultigin, Turkmen, Merve, Aydin, Murat, Gunay, Aytekin, Cıkman, and Murat, Kara
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Original Paper - Abstract
Elevated pulse wave velocity (PWV) and central aortic blood pressures are independent predictors of increased cardiovascular morbidity and mortality in hemodialysis (HD) patients. Oxalic acid is a uremic retention molecule that is extensively studied in the pathogenesis of calcium oxalate stones. Oxalobacter formigenes, a member of the colon microbiota, has important roles in oxalate homeostasis. Data regarding the colonization by and the exact role of O. formigenes in the pathogenesis of oxalic acid metabolism in HD patients are scant. Hence, we aimed to determine the relationship between fecal O. formigenes colonization, serum oxalic acid and hemodynamic parameters in HD patients with regard to the colo-reno-cardiac axis.Fifty HD patients were enrolled in this study. PWV and central aortic systolic (cASBP) and diastolic blood pressures (cADBP) were measured with a Mobil-O-Graph (I.E.M. GmbH, Stolberg, Germany). Serum oxalic acid levels were assessed by ELISA, and fecal O. formigenes DNA levels were isolated and measured by real-time PCR.Isolation of fecal O. formigenes was found in only 2 HD patients. One of them had 113,609 copies/ml, the other one had 1,056 copies/ml. Serum oxalic acid levels were found to be positively correlated with PWV (r = 0.29, p = 0.03), cASBP (r = 0.33, p = 0.001) and cADBP (r = 0.42, p = 0.002) and negatively correlated with LDL (r = -0.30, p = 0.03). In multivariate linear regression analysis, PWV was independently predicted by oxalic acid, glucose and triglyceride.This is the first study that demonstrates the absence of O. formigenes as well as a relation between serum oxalic acid and cASBP, cADBP and PWV in HD patients. Replacement of O. formigenes with pre- and probiotics might decrease serum oxalic acid levels and improve cardiovascular outcomes in HD patients.
- Published
- 2014
117. The Relationship Between Serum Zinc Levels and Tumor Markers in Hemodialysis Patients
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Kultigin Turkmen, Suleyman Turk, and Tevfik Ecder
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education.field_of_study ,medicine.medical_specialty ,Hemodiyaliz,çinko,tümör belirteçleri ,biology ,Serum zinc ,Hemodialysis,zinc,tumor markers ,Beta-2 microglobulin ,business.industry ,Incidence (epidemiology) ,medicine.medical_treatment ,Significant difference ,Population ,General Medicine ,Gastroenterology ,Endocrinology ,Antigen ,Internal medicine ,biology.protein ,Medicine ,Hemodialysis ,business ,education ,ATP synthase alpha/beta subunits - Abstract
The incidence of neoplasia is increased in end-stage renal disease (ESRD) patients. Zinc (Zn) deficiency is associated with neoplasia and also commonly seen in ESRD patients. However, the data regarding the relationship between Zn levels and tumor markers is scant in this population. We aimed to investigate the relationship between Zn levels and tumor markers in hemodialysis patients. Twenty-six hemodialysis patients (11 male, 15 female, mean age 41.6±14.3 years) and 11 healthy subjects (6 male and 5 female, mean age 38.7±7.2 years) were included. Serum Alpha fetoprotein (AFP), carcinoembriyonic antigen (CEA), CA 19-9, CA 15-5, CA 125, beta subunit of human corionic gonadotrophin (β-HCG) and beta-2 microglobulin (β2M) and Zn levels were measured. Data were analysed by Student’s t test. Serum Zinc levels were significantly lower in ESRD patients (group 1) compared to healthy subjects (group 2) (p, Son dönem böbrek yetersizliği (SDBY) bulunan hastalarda neoplazi insidansı artmıştır. Çinko (Zn) eksikliği neoplazi gelişimi ile ilişkilidir ve bu durum SDBY hastalarında sıklıkla görülmektedir. Bununla birlikte bu populasyonda serum Zn düzeyleri ile tumor belirteçleri arasındaki ilişki bilinmemektedir. Çalışmamızda hemodiyaliz hastalarında serum Zn düzeyleri ile tümör belirteçleri arasındaki ilişkiyi araştırmayı hedefledik. Çalışmaya 26 hemodiyaliz hastası (11 erkek, 15 kadın, yaş ortalaması 41.6±14.3 yıl) ve 11 sağlıklı birey (6 erkek, 5 kadın, yaş ortalaması 38.7±7.2) dahil edildi. Serum alfa fetoprotein (AFP), karsinoembriyonik antijen (CEA), CA 19-9, CA 15-5, CA 125, beta HCG, beta-2 mikroglobulin (β2M) ve Zn değerleri ölçüldü. Veriler Student t test ile analiz edildi. Serum Zn düzeyleri SDBY hastalarında (grup 1) sağlıklı bireylere (grup 2) oranla anlamlı olarak düşük saptandı (p
- Published
- 2014
118. INVESTIGATION LEVEL OF GLUCOSE-6-PHOSPHATE DEHYDROGENASE, 6-PHOSPHOGLUCONATE DEHYDROGENASE, GLUTATHIONE REDUCTASE IN BLOOD OF IRON DEFICIENCY ANEMIA PATIENTS
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Mehmet Aktas, Fatih Ozcicek, Taha Abdulkadir Coban, Kultigin Turkmen, and Murat Cankaya
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medicine.medical_specialty ,business.industry ,Glutathione reductase ,General Medicine ,medicine.disease ,chemistry.chemical_compound ,Endocrinology ,6-Phosphogluconate dehydrogenase ,chemistry ,Iron-deficiency anemia ,Internal medicine ,medicine ,Glucose-6-phosphate dehydrogenase ,business - Published
- 2014
119. Predictors of epicardial adipose tissue in patients with type 2 diabetes mellitus
- Author
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Hikmet Hamur, Levent Demirtas, Eftal Murat Bakirci, Kultigin Turkmen, Adalet Ozcicek, Emin Murat Akbas, Fatih Ozcicek, and Ufuk Kuyrukluyildiz
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medicine.medical_specialty ,Waist ,Endocrinology, Diabetes and Metabolism ,Population ,Adipose tissue ,Gastroenterology ,chemistry.chemical_compound ,Diabetes mellitus ,High-density lipoprotein ,Internal medicine ,Epicardial adipose tissue ,Internal Medicine ,medicine ,Neutrophil to lymphocyte ratio ,education ,Neutrophil-to-lymphocyte ratio ,education.field_of_study ,business.industry ,Research ,Atherogenic index of plasma ,Type 2 Diabetes Mellitus ,Platelet-to-lymphocyte ratio ,medicine.disease ,Endocrinology ,chemistry ,Waist circumference ,business ,Body mass index - Abstract
Background Epicardial adipose tissue (EAT), visceral fat depot of the heart, was found to be associated with coronary artery disease in cardiac and non-cardiac patients. Platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) were introduced as potential markers to determine inflammation in various disorders. Recently, atherogenic index of plasma (AIP) was found to be closely associated with atherosclerosis in general population. Waist circumference is commonly used to assess the risk factors in various metabolic disorders. There has been a well known relation between inflammation and peripheral adipose tissue in diabetes mellitus. However, the data regarding EAT and inflammation is scant in this population. Hence, we aimed to determine the relationship between PLR, NLR, AIP, waist circumference and EAT in diabetic patients. Methods This was a cross-sectional study involving 156 patients with type 2 diabetes mellitus (87 females, 69 males; mean age, 53.62 ± 9.33 years) and 50 control subjects (35 females, 15 males; mean age, 51.06 ± 8.74 years). EAT was measured by using a trans-thoracic echocardiogram. Atherogenic index of plasma was calculated as the logarithmically transformed ratio of the serum triglyceride to high density lipoprotein (HDL)cholesterol. NLR and PLR were calculated as the ratio of the neutrophils and platelets to lymphocytes, respectively. Results Waist circumference, PLR, NLR, AIP and EAT measurements were significantly higher in diabetic patients when compared to control subjects. When diabetic patients were separated into two groups according to their median value of EAT (Group 1, EAT
- Published
- 2014
120. The investigation of plasma glucose-6-phosphate dehydrogenase, 6-phoshogluconate dehydrogenase, glutathione reductase in premenauposal patients with iron deficiency anemia
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Ozcicek, Fatih, Aktas, Mehmet, Kultigin Turkmen, Coban, T. Abdulkadir, Cankaya, Murat, and EBYÜ, Tıp Fakültesi
- Subjects
kineret ,apoptosis ,IL-1ß ,ovary ,rat ,ischemia ,reperfusion - Abstract
AIM: To investigate the effect of Kineret® on ischemia reperfusion (IR) injury in rat ovaries. METHODS: Rats were divided into four groups: ovarian IR (IRG); 50 mg/kg Kineret® + ovarian IR (KIR-50); 100 mg/kg Kineret® + ovarian IR (KIR-100); and sham operation (SOC). KIR-50 (n = 10) and KIR-100 (n = 10) groups received an intraperitoneal injection of Kineret® at doses of 50 and 100 mg/kg, respectively. IRG and SOC (n = 10) rat groups were given distilled water as solvent using the same method. The results were compared between the groups. RESULTS: In rats in which IR occurred, oxidant parameters, such as malondialdehyde (MDA) and myeloperoxidase (MPO), were increased, the level of proinflammatory interleukin 1 beta (IL-1β) was elevated and total glutathione (tGSH) as an antioxidant was decreased in the ovarian tissues. Administration of Kineret® at a dose of 100 mg/kg inhibited the increase of MDA, MOP and IL-1β and a decrease in tGSH caused by IR more significantly than administration of Kineret® at a dose of 50 mg/kg. In addition, 100 mg/kg Kineret® significantly decreased severe hemorrhage, degeneration and inflammatory signs in the follicular cells, caused by IR. Kineret® at 100 mg/kg markedly ameliorated increased apoptosis in ovarian tissue with IR more significantly than 50 mg/kg kineret. CONCLUSION: Our findings indicate that Kineret® might be useful in clinical practice for the treatment of damage that may occur as a result of ovarian torsion.
- Published
- 2014
121. Successful Peritoneal Dialysis in a Hemophilia a Patient with Factor VIII Inhibitor
- Author
-
Yalcin Solak, Suleyman Turk, Kultigin Turkmen, and Huseyin Atalay
- Subjects
medicine.medical_specialty ,Gastrointestinal bleeding ,business.industry ,medicine.medical_treatment ,General Medicine ,Bethesda unit ,medicine.disease ,Prothrombin complex concentrate ,Gastroenterology ,Uremia ,Peritoneal dialysis ,Nephrology ,hemic and lymphatic diseases ,Internal medicine ,medicine ,Renal replacement therapy ,Hemodialysis ,business ,medicine.drug ,Kidney disease - Abstract
Chronic kidney disease and need for renal replacement therapy in hemophiliacs are relatively rare occurrences. Successful hemodialysis and peritoneal dialysis applications have been reported in the literature. We report a difficult-to-manage patient with hemophilia A plus factor VIII inhibitor who presented with gastrointestinal bleeding complicated by uremia. We admitted this hemophilia A patient with gastrointestinal bleeding who did not take regular factor infusions. He also had chronic kidney disease due to urinary stone disease. Since uremia might have contributed to bleeding, we chose hemodialysis along with factor VIII supplementation. His factor VIII and factor VIII inhibitor levels were 4% and 5 Bethesda units respectively. In order to bypass the inhibitor, we applied factor VIIA and prothrombin complex concentrate. After cessation of the hemorrhage, we placed a Tenckhoff catheter under prothrombin complex concentrate infusion. We did not observe any perioperative complication. To our knowledge, this is the first report of successful peritoneal dialysis in a hemophilia A patient who had factor VIII inhibitors.
- Published
- 2010
122. A hepatitis C-positive patient with new onset of nephrotic syndrome and systemic amyloidosis secondary to common variable immunodeficiency
- Author
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Melih Anil, Huseyin Atalay, Halil Zeki Tonbul, Hasan Esen, Kultigin Turkmen, Yalcin Solak, and Selçuk Üniversitesi
- Subjects
Adult ,Giardiasis ,Male ,Nephrotic Syndrome ,Serum albumin ,lcsh:Medicine ,Case Report ,Angiotensin-Converting Enzyme Inhibitors ,Losartan ,Hypogammaglobulinemia ,chemistry.chemical_compound ,Anti-Infective Agents ,Ramipril ,Agammaglobulinemia ,Ciprofloxacin ,medicine ,Humans ,Immunologic Factors ,Creatinine ,Proteinuria ,biology ,business.industry ,Amyloidosis ,Common variable immunodeficiency ,lcsh:R ,Immunoglobulins, Intravenous ,General Medicine ,Hepatitis C ,Hepatitis C Antibodies ,medicine.disease ,Common Variable Immunodeficiency ,chemistry ,Immunology ,biology.protein ,medicine.symptom ,business ,Angiotensin II Type 1 Receptor Blockers ,Nephrotic syndrome - Abstract
WOS: 000284158800011, PubMed: 20697163, Common variable immunodeficiency (CVID) is a heterogenous group of predominantly antibody deficiency disorders that make up the greatest proportion of patients with symptomatic primary hypogam maglobulinemia The rare coincidence of amyloidosis and hypogamma globulinemia has been reported previously Contrary to the usual insidious slowly progressive disease following hepatitis C infection a rapidly progressive cirrhotic form can develop in hypogammaglobulinemic patients We report a HCV positive patient with a new onset of nephrotic syndrome and systemic amyloidosis secondary to CVID Blood analyses showed serum creatininne of 1 8 mg/dL and serum albumin of 3 1 gm/dL 24 h urinary protein was 11 800 mg/day Serum immunoglobulin levels were IgG 340 mg/dL IgM 18 mg/dL IgA 11 mg/dL Duodenal biopsy revealed AA type amvloidosis with potassium permanganite and Congo red staining After a month of antiprotemuric therapy the proteinurin was reduced to 3350 mg/day
- Published
- 2010
123. An Update on Coronary Artery Disease and Chronic Kidney Disease
- Author
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Adrian Covic, Baris Afsar, Mehmet Kanbay, and Kultigin Turkmen
- Subjects
medicine.medical_specialty ,education.field_of_study ,Pathology ,Proteinuria ,business.industry ,Population ,Review Article ,lcsh:Diseases of the genitourinary system. Urology ,lcsh:RC870-923 ,medicine.disease ,Coronary artery disease ,Malnutrition ,Nephrology ,Internal medicine ,Diabetes mellitus ,medicine ,Cardiology ,cardiovascular diseases ,Endothelial dysfunction ,medicine.symptom ,Risk factor ,business ,education ,Kidney disease - Abstract
Despite the improvements in diagnostic tools and medical applications, cardiovascular diseases (CVD), especially coronary artery disease (CAD), remain the most common cause of morbidity and mortality in patients with chronic kidney disease (CKD). The main factors for the heightened risk in this population, beside advanced age and a high proportion of diabetes and hypertension, are malnutrition, chronic inflammation, accelerated atherosclerosis, endothelial dysfunction, coronary artery calcification, left ventricular structural and functional abnormalities, and bone mineral disorders. Chronic kidney disease is now recognized as an independent risk factor for CAD. In community-based studies, decreased glomerular filtration rate (GFR) and proteinuria were both found to be independently associated with CAD. This paper will discuss classical and recent epidemiologic, pathophysiologic, and clinical aspects of CAD in CKD patients.
- Published
- 2013
124. SP432PREDICTORS OF ATRIAL CONDUCTION DELAY IN HEMODIALYSIS AND PERITONEAL DIALYSIS PATIENTS: THE ROLE OF INFLAMMATION
- Author
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Ibrahim Guney, Kultigin Turkmen, Levent Demirtas, Eftal Murat Bakirci, Ozcan Orscelik, Mutlu Buyuklu, Ismail Kocyigit, and Emin Murat Akbas
- Subjects
Transplantation ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Conduction Phenomenon ,Inflammation ,Peritoneal dialysis ,Atrial conduction ,medicine.anatomical_structure ,Nephrology ,Internal medicine ,Cardiac conduction ,medicine ,Cardiology ,Social role ,Hemodialysis ,medicine.symptom ,Atrium (heart) ,business - Published
- 2015
125. FP631PREDICTORS OF LEFT ATRIAL MECHANICAL FUNCTIONS IN END STAGE RENAL DISEASE PATIENTS
- Author
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Kultigin Turkmen, Levent Demirtas, Mutlu Buyuklu, Ismail Kocyıgıt, and Ozcan Orscelik
- Subjects
Transplantation ,medicine.medical_specialty ,Nephrology ,Left atrial ,business.industry ,Internal medicine ,medicine ,Cardiology ,business ,End stage renal disease - Published
- 2015
126. FP760THE RESULTS OF THE QUESTIONNAIRE SURVEY OF QUALITY IN HEMODIALYSIS
- Author
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Halil Zeki Tonbul, Aslıhan Alhan, Kultigin Turkmen, and San A
- Subjects
Transplantation ,medicine.medical_specialty ,Nephrology ,business.industry ,medicine.medical_treatment ,media_common.quotation_subject ,Family medicine ,medicine ,Questionnaire ,Quality (business) ,Hemodialysis ,business ,media_common - Published
- 2015
127. Platelet-to-Lymphocyte Ratio: One of the novel and valuable platelet indices in hemodialysis patients
- Author
-
Kultigin Turkmen
- Subjects
Blood Platelets ,Inflammation ,Male ,medicine.medical_specialty ,Platelet indices ,business.industry ,Neutrophils ,medicine.medical_treatment ,Lymphocyte ,MEDLINE ,Hematology ,medicine.anatomical_structure ,Nephrology ,Renal Dialysis ,medicine ,Humans ,Kidney Failure, Chronic ,Platelet ,Female ,Hemodialysis ,Lymphocytes ,Intensive care medicine ,business - Published
- 2013
128. The relationship between atherogenic index of plasma and epicardial adipose tissue in hemodialysis and peritoneal dialysis patients
- Author
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Kultigin Turkmen, Adalet Ozcicek, Huseyin Ozbiner, Fatih Ozcicek, Halil Zeki Tonbul, Hikmet Hamur, Orhan Ozbek, Emin Murat Akbas, and Mehmet Fatih Erdur
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Population ,Critical Care and Intensive Care Medicine ,Gastroenterology ,Peritoneal dialysis ,End stage renal disease ,Diabetic nephropathy ,Coronary artery disease ,Hypertensive Nephropathy ,Internal medicine ,Medicine ,Humans ,education ,Triglycerides ,Adiposity ,education.field_of_study ,business.industry ,Cholesterol, HDL ,General Medicine ,Middle Aged ,medicine.disease ,Radiography ,Cross-Sectional Studies ,Adipose Tissue ,Nephrology ,Case-Control Studies ,Cardiology ,Kidney Failure, Chronic ,Female ,Hemodialysis ,business ,Dyslipidemia - Abstract
Epicardial adipose tissue (EAT) is the true visceral fat depot of the heart. The relationship between coronary artery disease and EAT was shown in end-stage renal disease (ESRD) patients. One of the established risk factor in this population is dyslipidemia. We aimed to determine the relationship between atherogenic index of plasma (AIP) and EAT in ESRD patients.This was a cross-sectional study involving 76 ESRD patients receiving PD or HD for ≥6 months and 42 healthy subjects. EAT was measured by using an electrocardiogram-gated 64-multidetector computed tomography (MDCT). Atherogenic index of plasma was calculated as the logarithmically transformed ratio of the serum trigliseride to HDL-cholesterol.The etiology of ESRD patients was diabetic nephropathy (n = 16), chronic glomerulonephritis (n = 10), hypertensive nephropathy (n = 23), polycystic kidney disease (n = 7), nephrolithiasis (n = 5) and unknown (n = 15). There were no differences with respect to the following variables between ESRD patients and healthy subjects: age; sex; BMI; predialysis levels of DBP; serum levels of albumin, HDL-cholesterol and hemoglobin. However, ESRD patients had higher serum levels of trigliseride, hs-CRP and AIP when compared to healthy subjects. There was a statistically significant relationship between EAT, BMI and AIP in ESRD patients (r = 0.42, p 0.001 and r = 0.25, p = 0.028, respectively). The stepwise linear regression analysis revealed that age, as well as BMI were independent predictors of EAT.We found a relationship between EAT as defined by MDCT and AIP in ESRD patients. Further clinical and experimental studies are needed.
- Published
- 2013
129. Masked hypertension in renal transplant recipients
- Author
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Coskun Kaya, Ibrahim Guney, Suleyman Turk, Raziye Yazici, Kurtulus Ozdemir, Yalcin Solak, Enes Elvin Gul, Lutfullah Altintepe, Kultigin Turkmen, Mehmet Kayrak, and Ondokuz Mayıs Üniversitesi
- Subjects
Adult ,Male ,medicine.medical_specialty ,Ambulatory blood pressure ,Diastole ,renal transplant recipients ,Cohort Studies ,Risk Factors ,Internal medicine ,Masked Hypertension ,Internal Medicine ,medicine ,Prevalence ,Humans ,masked hypertension ,Risk factor ,business.industry ,General Medicine ,Blood Pressure Monitoring, Ambulatory ,Kidney Transplantation ,Surgery ,Transplantation ,ambulatory blood pressure monitoring ,Blood pressure ,Ambulatory ,Female ,Cardiology and Cardiovascular Medicine ,business ,Cohort study - Abstract
WOS: 000331906400006 PubMed: 23721572 Purpose: Arterial hypertension is a risk factor affecting graft function in renal transplant recipients (RTRs). In pediatric RTRs, high prevalence of masked and nocturnal hypertension was reported. Most of the RTRs had a history of hypertension and some of them were normotensive at outpatient visits whereas home blood pressure (BP) levels were higher. Masked hypertension (MHT) is defined as a normal office BP but an elevated ambulatory BP. Previous reports have demonstrated the detrimental role of MHT in clinical outcomes in hypertensive patients. However, the true prevalence of MHT in RTRs is yet to be defined. Methods: A total of 113 RTRs (mean age 44 +/- 16 years, 72 males, 41 females) with normal office BP (< 140/90 mmHg) were enrolled to the study from the outpatient renal transplantation clinic. Ambulatory BP monitoring (ABPM) was performed in all participants for a 24-h period. Average daytime BP values above 135 mmHg systolic and 85 mmHg diastolic were defined as MHT. Results: The prevalence of MHT in our cohort was 39% (n = 45). Fasting glucose and C-reactive protein levels were higher in patients with MHT compared with normal BP group (p = 0.02 and p = 0.04, respectively). RTRs with deceased donor type had higher prevalence of MHT than RTRs with living donor (40% vs 19%, p = 0.003). In multivariate analysis, deceased donor type could predict the MHT independent of age, gender, office systolic BP level, diabetes mellitus, serum creatinine, C-reactive protein, and glucose levels (OR = 3.62, 95% CI 1.16-11.31, p = 0.03). Conclusion: We demonstrated an increased prevalence of MHT in a typical renal transplant cohort. In addition, transplantation from a deceased donor may be a predictor of MHT. The prevalence of MHT may help to explain high rate of cardiovascular events in RTRs. Therefore, routine application of ABPM in RTRs may be plausible, particularly in RTRs with deceased donor type.
- Published
- 2013
130. Risk factors that can affect the progression of chronic kidney disease in patients with poststreptecoccal glomerulonephritis history
- Author
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Fatih Mehmet Erdur, Kultigin Turkmen, and Adem Kucuk
- Subjects
Male ,medicine.medical_specialty ,Pathology ,Native Hawaiian or Other Pacific Islander ,Mild proteinuria ,Renal function ,Scabies ,Glomerulonephritis ,Internal medicine ,Streptococcal Infections ,medicine ,Humans ,Proteinuria ,business.industry ,Retrospective cohort study ,Skin Diseases, Bacterial ,medicine.disease ,Nephrology ,Microalbuminuria ,Female ,Kidney Diseases ,medicine.symptom ,business ,Tubulointerstitial Disease ,Kidney disease - Abstract
To the Editor: Recently, Hoy et al.1 suggested that patients who had a history of poststreptecoccal glomerulonephritis (PSGN) might have the tendency to develop chronic kidney disease in the following years. The study was designed as a retrospective cohort study. Of the 177 PSGN patients, 36 of them were between 10 and 19 years old, 74 of them were between 20 and 29 years old, and 70 of them were between 30 and 39 years old. According to the results of this study, there is an increased risk of albumin/creatinine ratio and decrements of glomerular filtration rate of patients who had history of PSGN. However, in the study-setting part of the article, the data about the history of PSGN patients regarding chronic diseases such as tubulointerstitial disease, vesicoureteral reflux, and hemolytic uremic syndrome (HUS), etc., which could cause microalbuminuria and increased albumin/creatinine ratio, were not detailed by the authors. Sharma et al.2 showed that chronic kidney disease is more commonly seen in patients with diarrhea-positive HUS. Acute interstitial nephritis is also associated with mild proteinuria in children.3 Therefore, the data about patients’ history should be detailed in the article, including the diseases-causing proteinuria, as an exclusion criterion. In addition, as the present study did not include a control group comprising healthy subjects to compare the results, this issue should be mentioned as a limitation of this study.
- Published
- 2013
131. PERI-AORTIC FAT TISSUE THICKNESS IN PERITONEAL DIALYSIS PATIENTS
- Author
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Mehmet Kayrak, Orhan Ozbek, Kultigin Turkmen, Ibrahim Guler, Cigdem Samur, Halil Zeki Tonbul, and Selçuk Üniversitesi
- Subjects
Male ,Pathology ,medicine.medical_specialty ,medicine.medical_treatment ,Adipose tissue ,Aorta, Thoracic ,Comorbidity ,Intra-Abdominal Fat ,Peri-aortic ,Peritoneal dialysis ,Electrocardiography ,Predictive Value of Tests ,medicine.artery ,Multidetector Computed Tomography ,Image Processing, Computer-Assisted ,Humans ,Medicine ,Thoracic aorta ,Visceral fat ,Aged ,business.industry ,Calcinosis ,Original Articles ,General Medicine ,respiratory system ,Middle Aged ,epicardial adipose tissue ,coronary artery calcification ,respiratory tract diseases ,Cross-Sectional Studies ,Peri-aortic fat tissue ,Cardiovascular Diseases ,Nephrology ,Coronary artery calcification ,Epicardial adipose tissue ,thoracic aortic calcification ,Kidney Failure, Chronic ,Female ,business ,Pericardium ,Peritoneal Dialysis - Abstract
WOS: 000318850200013, PubMed: 22753454, Background: Thoracic peri-aortic fat tissue (PFT) and epicardial adipose tissue (EAT) are metabolically active visceral fat deposits surrounding the thoracic aorta and the heart, respectively. Various studies have demonstrated a positive predictive value of both PFT and EAT for coronary artery disease in the general population. In the present study, we aimed to investigate PFT thickness and the independent predictors of PFT in peritoneal dialysis (PD) patients. Methods: Our cross-sectional study enrolled 35 PD patients (10 women, 25 men) and 30 age-and-sex-matched healthy subjects (15 women, 15 men). We measured PFT, thoracic artery calcification (TAC), EAT, and coronary artery calcification (CAC) by electrocardiogram-gated 64-multi-detector computed tomography. Results: The measured PFT, EAT, CAC, and TAC were significantly higher in the PD group than in the healthy subjects (p < 0.05 each). In the PD group, PFT and TAC were significantly correlated (r = 0.33, p = 0.007). Also, PFT measurements were positively correlated with EAT and total CAC in the PD and the control group alike (r = 0.58, p = 0.001 and r = 0.54, p = 0.01 respectively). A stepwise linear regression analysis revealed that age, duration of hypertension, and being a PD patient were independent predictors of PFT. Conclusions: Measured PFT was higher in PD patients than in healthy subjects and, in the PD population, was also shown to be related to calcification scores and EAT., Scientific Investigation and Project Foundation of Selcuk University Meram School of MedicineSelcuk University, This study was supported by the Scientific Investigation and Project Foundation of Selcuk University Meram School of Medicine.
- Published
- 2013
132. An exceedingly rare localization of a brown tumor in a hemodialysis patient
- Author
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Ali, Karagoz, Kultigin, Turkmen, Raziye, Yazici, Sevket, Arslan, Suleyman, Baktık, Meryem Ilkay Eren, Karanis, Lutfullah, Altintepe, and Ibrahim, Guney
- Subjects
Adult ,Parathyroid Glands ,Sacrum ,Renal Dialysis ,Humans ,Kidney Failure, Chronic ,Osteoclasts ,Bone Neoplasms ,Female ,Hyperparathyroidism, Secondary ,Bone and Bones - Abstract
Brown tumor, which is seen in the context of hyperparathyroidism, is defined as a uremic bone disease characterized by increased osteoclastic activity and fibroblastic proliferation in the involved bone. In chronic renal failure, there is an excessive parathyroid hormone secretion due to hypocalcemia, hyperphosphatemia, and vitamin D deficiency. Brown tumor of the femur, facial bones, mandible, sternum, ribs, and pelvis are rare, whereas, it rarely involves sacrum. Here, we presented a brown tumor of the sacrum that developed secondary to parathyroid hyperplasia in a patient receiving hemodialysis.
- Published
- 2012
133. Relationship between Plasma Pentraxin-3, Neutrophil-to-Lymphocyte Ratio, and Atherosclerosis in Renal Transplant Patients
- Author
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Suleyman Turk, Orhan Ozbek, Kultigin Turkmen, Halil Zeki Tonbul, Abduzhappar Gaipov, Fatih Mehmet Erdur, Huseyin Ozbiner, Mehdi Yeksan, Aysun Toker, and Ibrahim Guney
- Subjects
education.field_of_study ,medicine.medical_specialty ,Creatinine ,Original Paper ,business.industry ,Urology ,Population ,Renal function ,Inflammation ,Gastroenterology ,Transplantation ,chemistry.chemical_compound ,chemistry ,Internal medicine ,Immunology ,medicine ,Uric acid ,cardiovascular diseases ,medicine.symptom ,Neutrophil to lymphocyte ratio ,Cardiology and Cardiovascular Medicine ,education ,business ,Lipoprotein - Abstract
Background/Aims: Atherosclerosis and inflammation are the most important risk factors in the pathogenesis of cardiovascular diseases (CVD) in patients with end-stage renal disease (ESRD). Pentraxin-3 (PTX-3) was shown to predict inflammation and atherosclerosis in ESRD patients. However, the role of renal transplantation (Rtx) in terms of atherogenesis is still unclear. We aimed to investigate the relationship between PTX-3, neutrophil-to-lymphocyte ratio (NLR), and carotid intima-media thickness (CIMT) in Rtx patients and healthy controls. Methods: This was a cross-sectional study involving 29 Rtx patients (12 females, 40.1 ± 11.9 years) without overt CVD and 19 healthy subjects (9 females, 36.9 ± 8.9 years), testing the relationship between CIMT, assessed by ultrasonography, and selected biomarkers. Results: CIMT, PTX-3, and high-sensitivity C-reactive protein (hs-CRP) levels of Rtx patients were found to be significantly higher compared to healthy subjects. CIMT was positively correlated with age, creatinine, uric acid, triglyceride, PTX-3, hs-CRP, and NLR, and negatively correlated with estimated glomerular filtration rate in all participants. In Rtx patients, CIMT was positively correlated with age, BMI, serum phosphorus, low-density lipoprotein, and hs-CRP. The multivariate analysis revealed that hs-CRP was found to be an independent variable of CIMT in Rtx patients. Conclusion: Our data showed that inflammation and atherosclerosis persist in Rtx patients. Serum hs-CRP might be a useful marker to assess these parameters in this population.
- Published
- 2012
134. Sleep quality, depression, and quality of life in elderly hemodialysis patients
- Author
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Halil Zeki Tonbul, Faruk Turgut, Fatih Mehmet Erdur, Kultigin Turkmen, Lutfullah Altintepe, Abduzhappar Gaipov, Ibrahim Guney, Mustafa Saglam, and Emaad M. Abdel-Rahman
- Subjects
Gerontology ,medicine.medical_specialty ,Beck Depression Inventory ,medicine.medical_treatment ,Population ,International Journal of Nephrology and Renovascular Disease ,poor sleep quality ,End stage renal disease ,Quality of life ,Internal medicine ,Medicine ,education ,Depression (differential diagnoses) ,Original Research ,Post-Sleep Inventory ,education.field_of_study ,end-stage renal disease ,business.industry ,Incidence (epidemiology) ,humanities ,health-related quality of life ,Nephrology ,Test score ,Hemodialysis ,business - Abstract
Kultigin Turkmen,1 Fatih Mehmet Erdur,1 Ibrahim Guney,2 Abduzhappar Gaipov,1 Faruk Turgut,3 Lutfullah Altintepe,2 Mustafa Saglam,1 Halil Zeki Tonbul,1 Emaad M Abdel-Rahman41Division of Nephrology, Meram School of Medicine, Necmettin Erbakan University, Meram, Konya, Turkey; 2Division of Nephrology, Meram Research and Training Hospital, Meram, Konya, Turkey; 3Division of Nephrology, Iskenderun State Hospital, Iskenderun, Hatay, Turkey; 4Division of Nephrology, University of Virginia Health System, Charlottesville, VA, USAObjective: Both the incidence and the prevalence of end-stage renal disease (ESRD) in elderly patients are increasing worldwide. Elderly ESRD patients have been found to be more prone to depression than the general population. There are many studies that have addressed the relationship between sleep quality (SQ), depression, and health related quality of life (HRQoL) in ESRD patients, but previous studies have not confirmed the association in elderly hemodialysis (HD) patients. Therefore, the aim of the present study was to demonstrate this relationship in elderly HD patients.Patients and methods: Sixty-three elderly HD patients (32 females and 31 males aged between 65 and 89 years) were included in this cross-sectional study. A modified Post-Sleep Inventory (PSI), the Medical Outcomes Study 36-item short form health survey, and the Beck Depression Inventory (BDI) were applied.Results: The prevalence of poor sleepers (those with a PSI total sleep score [PSI-4 score] of 4 or higher) was 71% (45/63), and the prevalence of depression was 25% (16/63). Of the 45 poor sleepers, 15 had depression, defined as a BDI score of 17 or higher. Poor sleepers had a significantly higher rate of diabetes mellitus (P = 0.03), significantly higher total BDI scores, and lower Physical Component Scale scores (ie, lower HRQoL) than good sleepers. The PSI-4 score correlated negatively with Physical Component Scale (r = −0.500, P < 0.001) and Mental Component Scale scores (r = −0.527, P < 0.001) and it correlated positively with the BDI score (r = 0.606, P < 0.001). In multivariate analysis, independent variables of PSI-4 score were BDI score (beta value [β] = 0.350, P < 0.001), Mental Component Scale score (β = −0.291, P < 0.001), and age (β = 0.114, P = 0.035).Conclusion: Poor SQ is a very common issue and is associated with both depression and lower HRQoL in elderly HD patients.Keywords: health-related quality of life, end-stage renal disease, poor sleep quality, Post-Sleep Inventory, Beck Depression Inventory
- Published
- 2012
135. Brucella peritonitis in peritoneal dialysis: a case report and review of the literature
- Author
-
Zeynep Biyik, Suleyman Turk, Kultigin Turkmen, Sinan Demircioğlu, Ilker Polat, Nejdet Genc, and Yalcin Solak
- Subjects
Male ,Systemic disease ,medicine.medical_specialty ,medicine.medical_treatment ,Peritonitis ,Brucella ,Review ,Brucellosis ,Peritoneal dialysis ,Peritoneal Dialysis, Continuous Ambulatory ,Internal medicine ,Ascites ,medicine ,Humans ,Zoonotic Infection ,biology ,business.industry ,Continuous ambulatory peritoneal dialysis ,General Medicine ,Middle Aged ,medicine.disease ,biology.organism_classification ,Nephrology ,Kidney Failure, Chronic ,medicine.symptom ,business - Abstract
Brucellosis is a zoonotic infection that humans contract usually by ingestion of unpasteurized milk and milk products or by direct contact with raw infected animal products. Infection is endemic in many countries, including Turkey. Being a systemic disease, brucellosis may affect almost any part of the body. The peritoneum is a site rarely involved in brucellosis. Most peritonitis episodes involving Brucella species have been spontaneous cases reported in cirrhotic patients with ascites. To our knowledge, the literature contains only 5 cases of Brucella peritonitis related to continuous ambulatory peritoneal dialysis. Here, we report Brucella peritonitis in a continuous ambulatory peritoneal dialysis patient, and we discuss the relevant literature.
- Published
- 2012
136. Effects of secondary amyloidosis on arteriovenous hemodialysis fistula outcomes and intradialytic hypotension: a case-control study
- Author
-
Yalcin, Solak, Memduh, Caymaz, Halil Zeki, Tonbul, Orhan, Ozbek, Kultigin, Turkmen, and Niyazi, Gormus
- Subjects
Adult ,Male ,Arteriovenous Shunt, Surgical ,Treatment Outcome ,Renal Dialysis ,Risk Factors ,Case-Control Studies ,Humans ,Kidney Failure, Chronic ,Female ,Amyloidosis ,Hypotension - Abstract
Amyloid fibrils can affect vascular structure through deposition and by causing nitric oxide depletion and increase of asymmetric dimethyl arginine. Patients with amyloidosis are prone to development of hypotension. Hypotension may also affect the maturation of arteriovenous fistula (AVF) and may set the stage for formation of thrombosis and fistula failure. Thus, we aimed to evaluate effects of secondary amyloidosis on AVF outcomes and intradialytic hypotension. This is a case-control study which included 20 hemodialysis patients with amyloidosis and 20 hemodialysis patients without amyloidosis as control group. All patients underwent Doppler ultrasound of AVF. A thorough fistula history and baseline laboratory values along with episodes of intradialytic hypotension and blood pressure measurements were recorded. There was no difference between the groups regarding age, gender, body mass index, presence of comorbidities, hypertension, and drug use. Systolic and diastolic blood pressures were similar (119 ± 28/75 ± 17 and 120 ± 14/75 ± 10 mmHg for patients with and without amyloidosis, respectively). Intradialytic hypotension episodes were also similar. Patients with amyloidosis had significantly lower serum albumin and higher C-reactive protein values compared to control hemodialysis patients. AVF sites and total number of created fistulas were similar in both groups. Flow rates of current functional AVFs were not different between the groups (1084 ± 875 and 845 ± 466 mL/minute for patients with and without amyloidosis, respectively, p:0.67). Patency duration of first AVF was not different between the groups. Clinical fistula outcomes and rate of intradialytic hypotension episodes were not significantly different between patients with and without secondary systemic amyloidosis.
- Published
- 2012
137. The Relationship between Epicardial Adipose Tissue and Coronary Artery Calcification in Peritoneal Dialysis Patients
- Author
-
Melih Anil, Hatice Kayikcioglu, Mehmet Kayrak, Alaaddin Nayman, Orhan Ozbek, Yalcin Solak, Halil Zeki Tonbul, Huseyin Babur, Kultigin Turkmen, and Selçuk Üniversitesi
- Subjects
medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Peritoneal dialysis ,Coronary artery calcification ,Disease ,Left ventricular hypertrophy ,End stage renal disease ,Pathogenesis ,Coronary artery disease ,End-stage renal disease ,Internal medicine ,Epicardial adipose tissue ,medicine ,cardiovascular diseases ,Endothelial dysfunction ,Original Paper ,business.industry ,nutritional and metabolic diseases ,medicine.disease ,medicine.anatomical_structure ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
WOS: 000312167700006, PubMed: 22493602, Background: Atherosclerosis, endothelial dysfunction, coronary artery calcification (CAC), and left ventricular hypertrophy are the most commonly encountered risk factors in the pathogenesis of cardiovascular disease in end-stage renal disease patients. Epicardial adipose tissue (EAT) is the true visceral fat depot of the heart. The relationship between coronary artery disease and EAT has been shown in healthy subjects and patients with a high risk of coronary artery disease. In the present study, we aimed to investigate the relationship between EAT and CAC in peritoneal dialysis (PD) patients. Patients and Methods: Forty-five PD patients (18 females, 27 males, with a mean age of 50.6 +/- 15 years) and 25 healthy subjects (12 females, 13 males, with a mean age of 52.4 +/- 10.7 years) were enrolled in the study. EAT and CAC score (CACS) measurements were performed by a multidetector computed tomography scanner. Results: EAT of the PD patients was significantly higher than that of the healthy subjects (p = 0.02). When patients were divided into two subgroups (group 1: CACS 10, n = 25), EAT was also significantly higher in group 2 patients than in group 1 patients and healthy subjects. Age and EAT were also found to be correlated with CACS >= 10. Conclusion: There is a relationship between the anatomic assessment of coronary artery lesions by multidetector computed tomography and EAT in PD patients. This relationship might be attributed to increased inflammation and proinflammatory cytokines in uremic patients. copyright (C) 2012 S. Karger AG, Basel
- Published
- 2012
138. Efficacy and tolerability of intravenous paricalcitol in calcitriol-resistant hemodialysis patients with secondary hyperparathyroidism: 12-month prospective study
- Author
-
Lutfullah Altintepe, Huseyin Atalay, Kultigin Turkmen, Yalcin Solak, and Halil Zeki Tonbul
- Subjects
Paricalcitol ,Adult ,Male ,medicine.medical_specialty ,Time Factors ,Calcitriol ,Adolescent ,medicine.medical_treatment ,Urology ,Drug Resistance ,Critical Care and Intensive Care Medicine ,Hyperphosphatemia ,Young Adult ,Renal Dialysis ,Medicine ,Humans ,Prospective Studies ,Aged ,Aged, 80 and over ,Hyperparathyroidism ,Bone Density Conservation Agents ,Dose-Response Relationship, Drug ,business.industry ,General Medicine ,Drug Tolerance ,Middle Aged ,medicine.disease ,Surgery ,Discontinuation ,Treatment Outcome ,Tolerability ,Nephrology ,Parathyroid Hormone ,Ergocalciferols ,Injections, Intravenous ,Kidney Failure, Chronic ,Secondary hyperparathyroidism ,Female ,Hyperparathyroidism, Secondary ,Hemodialysis ,business ,medicine.drug ,Follow-Up Studies - Abstract
Rationale/objectives: Data are limited regarding the use of paricalcitol in calcitriol-resistant patients with secondary hyperparathyroidism (SHPT). We aimed to evaluate the effects of paricalcitol in calcitriol-resistant hemodialysis patients with SHPT. Methods: This is a 12-month, open-label, prospective study. Forty patients with calcitriol-resistant and/or calcitriol-intolerant SHPT were included. After a washout period, all patients converted to paricalcitol with a 1:3 conversion ratio. Serum calcium and phosphorus were monitored monthly, while serum intact parathyroid hormone (iPTH) once in every 3 months. Paricalcitol dose was reduced or discontinued in case of hypercalcemia and/or hyperphosphatemia. Pre- and posttreatment electrolyte and iPTH values were compared with Student’s t-test and Wilcoxon signed-rank test, respectively. Main findings: Forty patients completed the study. Mean initiation dose of paricalcitol was 23 ± 7 µg/week. Mean serum calcium was 8.9 ± 0.8 mg/dL at baseline and 9.4 ± 0.7 mg/dL at study end (p = 0.07). Mean monthly serum phosphorus levels stayed stable. Paricalcitol was effective in reducing iPTH levels when compared with pretreatment values (747.9 ± 497.2 pg/mL, 307.3 ± 417.1 pg/mL, respectively; p < 0.001). Thirty-two patients had to discontinue intravenous (IV) paricalcitol at some time during their treatment. Main reasons for discontinuation were as follows: hyperphosphatemia (58%), hypercalcemia (25%), and iPTH < 150 pg/mL (17%). Principle conclusions: Paricalcitol was found to be effective in reducing iPTH levels in calcitriol-resistant patients with SHPT despite relatively frequent drug discontinuation rates.
- Published
- 2012
139. The relationship between neutrophil-to-lymphocyte ratio and inflammation in end-stage renal disease patients
- Author
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Kultigin Turkmen, Ibrahim Guney, Halil Zeki Tonbul, and Fatma Humeyra Yerlikaya
- Subjects
Male ,medicine.medical_specialty ,Neutrophils ,medicine.medical_treatment ,Population ,Inflammation ,Critical Care and Intensive Care Medicine ,Systemic inflammation ,Gastroenterology ,End stage renal disease ,Peritoneal dialysis ,Coronary artery disease ,Leukocyte Count ,Internal medicine ,medicine ,Humans ,Lymphocytes ,Neutrophil to lymphocyte ratio ,education ,education.field_of_study ,business.industry ,fungi ,General Medicine ,Middle Aged ,medicine.disease ,Cross-Sectional Studies ,Nephrology ,Immunology ,Kidney Failure, Chronic ,Female ,Hemodialysis ,medicine.symptom ,business - Abstract
Patients with end-stage renal disease (ESRD) have elevated serum levels of inflammatory mediators including C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin (IL)-6. Systemic inflammation was found to be correlated with coronary artery disease (CAD) in this population. Neutrophil-to-lymphocyte ratio (NLR) was introduced as a potential marker to determine inflammation in cardiac and non-cardiac disorders. Data regarding NLR and its association with inflammation are lacking. We aimed to determine the relationship between NLR and inflammation in ESRD patients.This was a cross-sectional study involving 61 ESRD patients (25 females and 36 males; mean age: 48.3 ± 14.5 years) receiving peritoneal dialysis (PD) or hemodialysis (HD) for ≥6 months in the Dialysis Unit of Selcuk University. NLR, CRP, TNF-α, and IL-6 levels were measured.NLR, serum CRP, IL-6, and TNF-α levels were significantly higher in PD patients when compared with HD patients. ESRD patients with NLR ≥ 3.5 had significantly higher TNF-α levels when compared with patients with NLR3.5. In the bivariate correlation analysis, NLR was positively correlated with TNF-α in this population.Simple calculation of NLR can predict inflammation in ESRD patients.
- Published
- 2011
140. Health-related qualıty of lıfe, sleep qualıty, and depressıon in peritoneal dialysis and hemodıalysıs patıents
- Author
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Kultigin, Turkmen, Raziye, Yazici, Yalcin, Solak, Ibrahim, Guney, Lutfullah, Altintepe, Mehdi, Yeksan, and Halil Zeki, Tonbul
- Subjects
Male ,Sleep Wake Disorders ,Cross-Sectional Studies ,Depression ,Renal Dialysis ,Quality of Life ,Humans ,Kidney Failure, Chronic ,Female ,Middle Aged ,Sleep ,Peritoneal Dialysis - Abstract
Health-related quality of life (HRQoL) and sleep quality (SQ) were impaired in patients with end-stage renal disease (ESRD). The impairment of both HRQoL and SQ and being in a depressive mood were found to be associated with increased morbidity and mortality in dialysis patients. We aimed to investigate the association between SQ, HRQoL, and depression, and to define independent predictors of SQ and depression in peritoneal dialysis (PD) and hemodialysis (HD) patients. Ninety HD patients (41 females, 49 males with mean age 50 ± 15.7 years) and 64 PD patients (27 females, 37 males with mean age 52.4 ± 15.3 years) receiving renal replacement therapy for at least 3 months were screened for the assessment of SQ, HRQoL, and depression in this cross-sectional study. A modified postsleep inventory, Short Form of Medical Outcomes Study (SF-36) and Beck depression inventory (BDI) were applied to all patients for evaluating SQ, HRQoL, and depression, respectively. HD and PD patients had similar total SQ scores. Physical and mental component scale of HRQoL were found to be significantly higher in HD patients (p0.001). PD patients were found to be much more in depressive mood when compared with HD patients (p0.001). Independent predictors of depression in patients were mental component scale of HRQoL, gender (being female), and dialysis modality (being PD patient). Physical component scale was also found to be an independent predictor of SQ. This study showed that despite similar SQ scores between two groups, HD patients had better HRQoL and less depression than PD patients.
- Published
- 2011
141. IL-33 Exacerbates Acute Kidney Injury
- Author
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Quocan Nguyen, Aysun Toker, Ali Akcay, Charles L. Edelstein, Ana Andres Hernando, Zhibin He, Alkesh Jani, Kultigin Turkmen, Christopher Altmann, Danica Galešić Ljubanović, Arijana Pačić, Dong Won Lee, and Sarah Faubel
- Subjects
CD4-Positive T-Lymphocytes ,Male ,medicine.medical_specialty ,Chemokine CXCL1 ,Kidney Glomerulus ,Inflammation ,Antineoplastic Agents ,urologic and male genital diseases ,Proinflammatory cytokine ,chemistry.chemical_compound ,Mice ,Internal medicine ,medicine ,Animals ,Acute tubular necrosis ,Creatinine ,Kidney ,business.industry ,urogenital system ,Interleukins ,Acute kidney injury ,acute kidney injury ,IL-33 ,cisplatin ,Endothelial Cells ,General Medicine ,Acute Kidney Injury ,Kidney Tubular Necrosis, Acute ,medicine.disease ,Flow Cytometry ,Interleukin-33 ,CXCL1 ,Interleukin 33 ,Mice, Inbred C57BL ,Disease Models, Animal ,Endocrinology ,medicine.anatomical_structure ,Basic Research ,chemistry ,Nephrology ,Immunology ,medicine.symptom ,Cisplatin ,business - Abstract
Inflammation contributes to the pathogenesis of acute kidney injury (AKI). IL-33 is a proinflammatory cytokine, but its role in AKI is unknown. Here we observed increased protein expression of full-length IL-33 in the kidney following induction of AKI with cisplatin. To determine whether IL-33 promotes injury, we administered soluble ST2 (sST2), a fusion protein that neutralizes IL-33 activity by acting as a decoy receptor. Compared with cisplatin-induced AKI in untreated mice, mice treated with sST2 had fewer CD4 T cells infiltrate the kidney, lower serum creatinine, and reduced acute tubular necrosis (ATN) and apoptosis. In contrast, administration of recombinant IL-33 (rIL-33) exacerbated cisplatin-induced AKI, measured by an increase in CD4 T cell infiltration, serum creatinine, ATN, and apoptosis ; this did not occur in CD4-deficient mice, suggesting that CD4 T cells mediate the injurious effect of IL-33. Wildtype mice that received cisplatin and rIL-33 also had higher levels of the proinflammatory chemokine CXCL1, which CD T cells produce, in the kidney compared with CD4-deficient mice. Mice deficient in the CXCL1 receptor also had lower serum creatinine, ATN, and apoptosis than wildtype mice following cisplatin-induced AKI. Taken together, IL-33 promotes AKI through CD4 T cell-mediated production of CXCL1. These data suggest that inhibiting IL-33 or CXCL1 may have therapeutic potential in AKI.
- Published
- 2011
142. Epicardial adipose tissue and coronary artery calcification in diabetic and nondiabetic end-stage renal disease patients
- Author
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Zeynep Biyik, Hatice Kayikcioglu, Kultigin Turkmen, Halil Zeki Tonbul, Mehmet Kayrak, and Orhan Ozbek
- Subjects
Male ,medicine.medical_specialty ,Adipose tissue ,Disease ,Coronary Artery Disease ,Critical Care and Intensive Care Medicine ,Left ventricular hypertrophy ,End stage renal disease ,Coronary artery disease ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,Diabetic Nephropathies ,Endothelial dysfunction ,Vascular Calcification ,Retrospective Studies ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Cross-Sectional Studies ,Adipose Tissue ,Nephrology ,Cardiology ,Kidney Failure, Chronic ,Female ,business ,Body mass index ,Pericardium - Abstract
Atherosclerosis, coronary artery calcification, diabetes mellitus, inflammation, endothelial dysfunction, and left ventricular hypertrophy are the most commonly encountered risk factors in the pathogenesis of cardiovascular disease in end-stage renal disease (ESRD) patients. Epicardial adipose tissue (EAT) is the true visceral fat depot of the heart. The relationship between coronary artery disease (CAD) and EAT was shown in healthy subjects and patients with high risk of CAD. To date, there is not enough data about EAT in diabetic and nondiabetic ESRD patients. Therefore, we aimed to investigate the EAT and coronary artery calcification score (CACS) in diabetic and nondiabetic ESRD patients and healthy subjects.Sixty ESRD patients (17 diabetic, 43 nondiabetic ESRD patients) and 20 healthy subjects were enrolled in the study. EAT and CACS were performed by a 64-slice multidetector computed tomography scanner.There were no differences in age, gender, body mass index, predialysis systolic and diastolic blood pressure levels, biochemical parameters including serum low-density lipoprotein and high-density lipoprotein cholesterol, triglycerides, and C-reactive protein between healthy subjects, diabetic, and nondiabetic ESRD patients. Total CACSs and EAT measurements were significantly higher in diabetic ESRD patients when compared with nondiabetic ESRD patients and healthy subjects. There was statistically significant relationship between EAT and CACS in ESRD patients (p0.0001, r = 0.48).In conclusion, we found a significant increase in terms of EAT and CACS in diabetic ESRD patients when compared with nondiabetic ESRD patients and healthy subjects.
- Published
- 2011
143. The relationship between epicardial adipose tissue and malnutrition, inflammation, atherosclerosis/calcification syndrome in ESRD patients
- Author
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Kultigin Turkmen, Mehmet Kayrak, Orhan Ozbek, Halil Zeki Tonbul, Yalcin Solak, Cigdem Samur, Melih Anil, Hatice Kayikcioglu, and Selçuk Üniversitesi
- Subjects
Male ,Turkey ,Epidemiology ,Adipose tissue ,Coronary Artery Disease ,Critical Care and Intensive Care Medicine ,Gastroenterology ,Coronary artery disease ,Risk Factors ,Endothelial dysfunction ,biology ,Calcinosis ,Syndrome ,Middle Aged ,C-Reactive Protein ,Adipose Tissue ,Nephrology ,Female ,Inflammation Mediators ,Pericardium ,Adult ,medicine.medical_specialty ,Nutritional Status ,Risk Assessment ,Internal medicine ,medicine ,Humans ,Serum Albumin ,Inflammation ,Transplantation ,Analysis of Variance ,Chi-Square Distribution ,business.industry ,C-reactive protein ,Malnutrition ,Case-control study ,Original Articles ,medicine.disease ,Atherosclerosis ,Endocrinology ,Cross-Sectional Studies ,Case-Control Studies ,biology.protein ,Linear Models ,Kidney Failure, Chronic ,business ,Tomography, X-Ray Computed ,Body mass index ,Biomarkers ,Calcification - Abstract
WOS: 000293721400019, PubMed: 21757644, Background and objectives Malnutrition, inflammation, atherosclerosis/calcification (MIAC) and endothelial dysfunction are the most commonly encountered risk factors in the pathogenesis of cardiovascular disease in ESRD patients. Epicardial adipose tissue (EAT) is the true visceral fat depot of the heart. The relationship between CAD and EAT was shown in patients with high risk of coronary artery disease. In this study, we aimed to investigate the relationship between EAT and MIAC syndrome in ESRD patients. Design, setting, participants, & measurements Eighty ESRD patients and 27 healthy subjects enrolled in this cross-sectional study. EAT and coronary artery calcification score were measured by a multidetector computed tomography (MDCT) scanner. Patients with serum albumin 10 ng/dl (normal range, 0-5 ng/dl) had inflammation; and those with CACS >10 had atheroscleosis/calcification. Results Total CACS and EAT measurements were significantly higher in ESRD patients when compared with healthy subjects. There was a statistically significant relationship between EAT and CACS in ESRD patients (r = 0.48). EAT measurements were higher in PD patients than HD patients. Twenty-four of the patients had no component, 31 had one component, 17 had two components, and nine had all of the MIAC components. EAT was found to be significantly increased when the presence of MIAC components increased. EAT was positively correlated with age, body mass index, and presence of MIAC. These parameters were also found as independent predictors of increased EAT. Conclusions We found a relationship between EAT and components of MTAC syndrome in ESRD patients. J Am Soc Nephrol 6: 1920-1925, 2011. doi: 10.2215/CJN.00890111, Scientific Investigation and Project Foundation of Selcuk University Meram School of MedicineSelcuk University, This study was supported by the Scientific Investigation and Project Foundation of Selcuk University Meram School of Medicine.
- Published
- 2011
144. Falls in elderly hemodialysis patients
- Author
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Rasheed A. Balogun, Kultigin Turkmen, Faruk Turgut, and Emaad M. Abdel-Rahman
- Subjects
medicine.medical_specialty ,Population ,Psychological intervention ,Poison control ,Disease ,Occupational safety and health ,Renal Dialysis ,Risk Factors ,Injury prevention ,Epidemiology ,medicine ,Humans ,Intensive care medicine ,education ,Aged ,Aged, 80 and over ,education.field_of_study ,business.industry ,Age Factors ,General Medicine ,Prognosis ,Falling (accident) ,Physical therapy ,Kidney Failure, Chronic ,Accidental Falls ,medicine.symptom ,business - Abstract
The elderly, (age ≥ 65 years) hemodialysis (HD) patient population is growing rapidly across the world. The risk of accidental falls is very high in this patient population due to multiple factors which include aging, underlying renal disease and adverse events associated with HD treatments. Falls, the most common cause of fatal injury among elderly, not only increase morbidity and mortality, but also increase costs to the health system. Prediction of falls and interventions to prevent or minimize fall risk and associated complications will be a major step in helping these patients as well as decreasing financial and social burdens. Thus, it is vital to learn how to approach this important problem. In this review, we will summarize the epidemiology, risk factors, pathophysiology and complications of falls in elderly HD patients. We will also focus on available methods to assess and predict the patients at higher risk of falling and will provide recommendations for interventions to reduce the occurrence of falls in this population.
- Published
- 2011
145. Ambulatory blood pressure monitoring: from old concepts to novel insights
- Author
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Tevfik Ecder, Kultigin Turkmen, Adrian Covic, and Mehmet Kanbay
- Subjects
Nephrology ,medicine.medical_specialty ,Ambulatory blood pressure ,business.industry ,Urology ,Blood Pressure ,Blood Pressure Monitoring, Ambulatory ,Masked Hypertension ,Blood pressure ,Predictive Value of Tests ,Predictive value of tests ,Internal medicine ,Ambulatory ,Hypertension ,medicine ,Humans ,In patient ,Renal Insufficiency, Chronic ,Intensive care medicine ,business ,Cardiovascular mortality - Abstract
Ambulatory blood pressure monitoring (ABPM) is an out-of-office technique for the assessment of 24-h blood pressure measurements. ABPM is indicated to diagnose many conditions, including white-coat hypertension, resistant hypertension, episodic hypertension, nocturnal hypertension, autonomic dysfunction, hypotension secondary to excessive usage of antihypertensive medication, and masked hypertension. ABPM gives a better prediction of clinical outcomes in patients with hypertension and cardiovascular diseases when compared to office blood pressure measurements. Recently, several new indices have been introduced with the aim of predicting various clinical end-points in several patient populations. In this review, we aimed to determine the clinical utility of 24-h ABPM and its potential implications for the management of hypertension in patients with a high risk of cardiovascular mortality and morbidity, as well as various novel indices that can predict clinical end-points in different patient populations.
- Published
- 2011
146. Comparison of adverse-event profiles of intravenous low-molecular-weight iron dextran and iron sucrose in peritoneal dialysis patients
- Author
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Suleyman Turk, Kultigin Turkmen, Ibrahim Guney, Emine Kaya, Huseyin Atalay, and Yalcin Solak
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Critical Care and Intensive Care Medicine ,Iron sucrose ,Gastroenterology ,Ferric Compounds ,Peritoneal dialysis ,chemistry.chemical_compound ,Glucaric Acid ,Dosing schedules ,Internal medicine ,medicine ,Iron dextran ,Humans ,Adverse effect ,Infusions, Intravenous ,Aged ,Ferric Oxide, Saccharated ,business.industry ,Low molecular weight iron ,Anemia ,Dextrans ,General Medicine ,Middle Aged ,Surgery ,Dextran ,chemistry ,Nephrology ,Hematinics ,Kidney Failure, Chronic ,Female ,Hemodialysis ,business ,Peritoneal Dialysis ,medicine.drug - Abstract
Both erythropoiesis-stimulating agents and iron treatments are underutilized in peritoneal dialysis (PD) patients. Studies to evaluate safety profiles of various intravenous iron preparations are limited in PD patients compared to hemodialysis. No study in the literature compared safety of low-molecular-weight iron dextran (LMW-ID) with that of iron sucrose in PD patients. We aimed to compare adverse-effect profiles of LMW-ID and iron sucrose with varying dosing schedules in PD patients with a hope to foster use of parenteral iron solutions in PD patients.We retrospectively reviewed patient charts and included patients who were administered iron sucrose or LMW-ID parenterally. Sociodemographic characteristics, clinical features, and pertinent laboratory data were collected. Adverse events which were deemed to be related to infusion of parenteral iron were recorded. We double-checked both physician records and nursing documents for observed adverse events.A total of 167 chronic PD patients were included in the study, and 92 patients were administered LMW-ID, whereas 75 patients were administered iron sucrose. Only one adverse event occurred in a patient who was administered 500 mg iron sucrose in a single infusion.This study showed the comparable safety of LMW-ID in varying doses over that of iron sucrose in PD patients.
- Published
- 2011
147. Fetuin-A, inflammation, and coronary artery calcification in hemodialysis patients
- Author
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Mukremin Uysal, Alaattin Yildiz, Abdulkadir Unsal, Kultigin Turkmen, Numan Gorgulu, Tamer Sakaci, Abdullah Ozkok, and Selçuk Üniversitesi
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Inflammation ,Internal medicine ,medicine ,cardiovascular diseases ,Vascular calcification ,Dialysis ,Cardiovascular mortality ,hemodialysis ,business.industry ,nutritional and metabolic diseases ,Mean age ,Fetuin ,Fetuin-A ,Nephrology ,inflammation ,vascular calcification ,Coronary artery calcification ,Cardiology ,cardiovascular system ,population characteristics ,Original Article ,Hemodialysis ,medicine.symptom ,business - Abstract
Hemodialysis patients have extremely increased cardiovascular mortality. Vascular calcification, inflammation, and low serum fetuin-A levels are implicated for increased mortality. In this study, relationship between coronary artery calcification, inflammation, and serum fetuin-A levels were investigated. Seventy-eight hemodialysis patients (38 male, 40 female, mean age: 52±14.5 years) were included. All patients were on dialysis for more than 6 months. Coronary artery calcium scores (CACS) are determined by electron-beam computed tomography. Serum CRP, IL-1?, IL-6, TNF-?, and serum fetuin-A levels were measured. Mean CACS value was 488.5±94.5. Serum fetuin-A levels were negatively correlated with CACS (r. -0.30, P=0.009). Patients are divided into two groups according to total CACS value; group 1 (CACS
- Published
- 2011
148. Perfusion storage reduces apoptosis in a porcine kidney model of donation after cardiac death
- Author
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Kameswaran Ravichandran, Arijana Pačić, Alkesh Jani, Jessica Martin, Kultigin Turkmen, Li Lu, Charles L. Edelstein, Danica Galešić Ljubanović, and Michael A. Zimmerman
- Subjects
Male ,Programmed cell death ,Pathology ,medicine.medical_specialty ,Adenosine ,Allopurinol ,Urinary system ,Organ Preservation Solutions ,Sus scrofa ,bcl-X Protein ,Apoptosis ,Kidney ,Andrology ,Raffinose ,Animals ,Humans ,Insulin ,Medicine ,Viaspan ,Warm Ischemia ,Transplantation ,business.industry ,Cold Ischemia ,Kidney metabolism ,Organ Preservation ,Hypoxia-Inducible Factor 1, alpha Subunit ,Glutathione ,Kidney Transplantation ,Tissue Donors ,Death ,Perfusion ,medicine.anatomical_structure ,Caspases ,Models, Animal ,Circulatory system ,Tissue and Organ Harvesting ,cardiac death ,kidney transplantation ,cold ischemia ,delayed graft function ,business - Abstract
Background Donation after cardiac death (DCD) kidneys suffer a high incidence of delayed graft function attributable to warm ischemia and cold ischemia (CI). Neither the mechanism of injury nor type of cell death has been described. Clinical studies suggest that perfusion storage (PS) of DCD kidneys may reduce injury although the mechanism of protection is unknown. In a porcine model of DCD, we hypothesized that DCD kidneys have increased caspase-1 due to warm ischemia (WI) and increased caspase-3 and apoptosis due to CI. Methods Male Yorkshire pigs subjected to cardiac death were perfused with cold University of Wisconsin solution. The perfused kidneys were removed and stored in cold University of Wisconsin solution for 24 hr. Kidney biopsies were obtained before cardiac death and at 0 and 24 hr of CI. Results There was an increase in caspase-1 activity due to WI before cold preservation. CI was associated with a massive increase in apoptosis, caspase-3/7 activity, and caspase-3 protein expression. Next, we hypothesized that PS would protect against apoptosis. We compared DCD kidneys subjected to static versus PS for 24 hr. PS significantly reduced proximal tubular apoptosis and was associated with increased B-cell lymphoma-extra large, and hypoxia-inducible transcription factor-1α. Conclusions These findings suggest that in DCD kidneys, WI preferentially activates caspase-1, whereas CI activates caspase-3 and causes apoptosis. PS may protect DCD kidneys through activation of antiapoptotic pathways involving B-cell lymphoma-extra large and hypoxia-inducible transcription factor-1α.
- Published
- 2011
149. Apoptosis and autophagy in cold preservation ischemia
- Author
-
Quocan Nguyen, Charles L. Edelstein, Arijana Pačić, Kultigin Turkmen, Sarah Faubel, Alkesh Jani, Kameswaran Ravichandran, Jessica Martin, Ali Akcay, and Danica Galešić Ljubanović
- Subjects
Male ,Programmed cell death ,cold ischemia ,delayed graft function ,apoptosis ,autophagy ,Cell ,Apoptosis ,Biology ,Green fluorescent protein ,Mice ,chemistry.chemical_compound ,Ischemia ,Autophagy ,medicine ,Animals ,Viaspan ,Transplantation ,Caspase 3 ,Bafilomycin ,Organ Preservation ,Cold Temperature ,Mice, Inbred C57BL ,medicine.anatomical_structure ,chemistry ,Immunology ,Cancer research ,biological phenomena, cell phenomena, and immunity ,Flux (metabolism) - Abstract
Background. Prolonged cold ischemia (CI) is a risk factor for the development of delayed graft function that predicts reduced 5-year kidney transplant survival. CI results in caspase-3 activation, tubular injury, and apoptosis. Autophagy, a highly conserved pathway that permits recycling of nutrients within the cell during stress, is linked to apoptosis. We hypothesized that CI during kidney preservation would induce autophagy. We sought to determine apoptosis and autophagic flux in CI. Methods. Autophagic flux and apoptosis were examined in kidneys of wild-type and green fluorescent protein (GFP)-microtubule-associated protein1 light chain 3 (LC3) transgenic mice that were subjected to 48 hr of CI. Autophagic flux was determined by performing experiments with and without bafilomycin A1. Results. CI alone significantly increased the number of apoptotic cells/hpf, caspase-3/7 activity, and protein expression of autophagy markers LC3 II and autophagy-related protein 5. To determine the effect of inhibiting autophagic flux on apoptosis, kidneys of wild-type and GFP-LC3 transgenic mice were subjected to 48 hr of CI in the presence of lysosomal inhibitor bafilomycin A1. The combination of CI and bafilomycin A1 suppressed autophagic flux and significantly reduced the number of apoptotic cells/hpf, caspase-3/7 activity, LC3 II (both by immunoblot and in GFP-LC3 transgenic mice), and autophagy-related protein 5 protein expression. Conclusion. In summary, we have shown that autophagy and autophagic flux are reduced in cold ischemic kidneys treated with bafilomycin A1. Reduced autophagy and autophagic flux were associated with a significant reduction in apoptotic cell death, which may provide a therapeutic rationale for including bafilomycin A1 in University of Wisconsin solution during organ preservation.
- Published
- 2011
150. Acute renal failure secondary to malignant hypertension induced thrombotic microangiopathy
- Author
-
Kultigin, Turkmen, Yalcin, Solak, Hasan, Esen, and Halil Z, Tonbul
- Subjects
Hypertension, Malignant ,Male ,Thrombotic Microangiopathies ,Humans ,Acute Kidney Injury ,Aged - Published
- 2010
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