77 results on '"Halil Zeki, Tonbul"'
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2. Can Resistance Be Resolved with Lanthanum Carbonate in the Treatment of Hyperphosphatemia? A Multicenter Experience
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Halil Zeki Tonbul, Ismail Baloğlu, Hakan Özer, Oktay Oymak, Lutfullah Altıntepe, and Fettah Fevzi Ersoy
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Internal medicine ,RC31-1245 ,Pediatrics ,RJ1-570 - Published
- 2023
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3. Retrospective Evaluation of Therapeutic Plasma Exchange in Nephrology Clinic: A Single-Center Experience
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Hatice Ozge Serin, Ismail Baloğlu, Halil Zeki Tonbul, Kültigin Türkmen, and Nedim Yılmaz Selçuk
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Internal medicine ,RC31-1245 ,Pediatrics ,RJ1-570 - Published
- 2023
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4. Acute kidney injury in Turkey: epidemiological characteristics, etiology, clinical course, and prognosis
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Meltem Gursu, Itir Yegenaga, Serhan Tuglular, Belda Dursun, Sibel Gokcay Bek, Simge Bardak, Engin Onan, Serap Demir, Ulver Derici, Ayhan Dogukan, Mustafa Sevinc, Ismail Kocyigit, Eda Altun, Ali Burak Haras, Mehmet Riza Altiparmak, and Halil Zeki Tonbul
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Acute kidney injury ,Etiology ,Kidney replacement therapy ,Survival ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background This study aimed to evaluate the etiologies, comorbidities, and outcomes of acute kidney injury (AKI) in Turkey and determine any potential differences among different geographical parts of the country. Methods This prospective observational study was conducted by the Acute Kidney Injury Working Group of the Turkish Society of Nephrology. Demographical and clinical data of patients with AKI at the time of diagnosis and at the 1st week and 1st, 3rd, and 6th months of diagnosis were evaluated to determine patient and renal survival and factors associated with patient prognosis. Results A total of 776 patients were included (54.7% male, median age: 67 years). Prerenal etiologies, including dehydration, heart failure, and sepsis, were more frequent than other etiologies. 58.9% of the patients had at least one renal etiology, with nephrotoxic agent exposure as the most common etiology. The etiologic factors were mostly similar throughout the country. 33.6% of the patients needed kidney replacement therapy. At the 6th month of diagnosis, 29.5% of the patients had complete recovery; 34.1% had partial recovery; 9.5% developed end-stage kidney disease; and 24.1% died. The mortality rate was higher in the patients from the Eastern Anatolian region; those admitted to the intensive care unit; those with prerenal, renal, and postrenal etiologies together, stage 3 AKI, sepsis, cirrhosis, heart failure, and malignancy; those who need kidney replacement therapy; and those without chronic kidney disease than in the other patients. Conclusion Physicians managing patients with AKI should be alert against dehydration, heart failure, sepsis, and nephrotoxic agent exposure. Understanding the characteristics and outcomes of patients with AKI in their countries would help prevent AKI and improve treatment strategies.
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- 2022
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5. COVID-19 Infection in Peritoneal Dialysis Patients: A Comparative Outcome Study with Patients on Hemodialysis and Patients without Kidney Disease
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Rümeyza Kazancıoğlu, Savaş Öztürk, Kenan Turgutalp, Meltem Gürsu, Mustafa Arıcı, Ayşegül Oruç, Elbis Ahbap, Sibel Gökçay Bek, Erkan Şengül, Melike Betül Öğütmen, Dilek Gibyeli Genek, Mehmet Deniz Aylı, Yavuz Ayar, Engin Onan, Serhat Karadağ, Ebru Aşıcıoğlu, Halil Yazıcı, Mehmet Rıza Altıparmak, Bülent Tokgöz, Ali Rıza Odabaş, Halil Zeki Tonbul, Siren Sezer, Alaattin Yıldız, and Kenan Ateş
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Internal medicine ,RC31-1245 ,Pediatrics ,RJ1-570 - Published
- 2022
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6. Predicting the outcome of COVID-19 infection in kidney transplant recipients
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Ozgur Akin Oto, Savas Ozturk, Kenan Turgutalp, Mustafa Arici, Nadir Alpay, Ozgur Merhametsiz, Savas Sipahi, Melike Betul Ogutmen, Berna Yelken, Mehmet Riza Altiparmak, Numan Gorgulu, Erhan Tatar, Oktay Ozkan, Yavuz Ayar, Zeki Aydin, Hamad Dheir, Abdullah Ozkok, Seda Safak, Mehmet Emin Demir, Ali Riza Odabas, Bulent Tokgoz, Halil Zeki Tonbul, Siren Sezer, Kenan Ates, and Alaattin Yildiz
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Kidney transplantation ,COVID-19 ,Registry ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background We aimed to present the demographic characteristics, clinical presentation, and outcomes of our multicenter cohort of adult KTx recipients with COVID-19. Methods We conducted a multicenter, retrospective study using data of patients hospitalized for COVID-19 collected from 34 centers in Turkey. Demographic characteristics, clinical findings, laboratory parameters (hemogram, CRP, AST, ALT, LDH, and ferritin) at admission and follow-up, and treatment strategies were reviewed. Predictors of poor clinical outcomes were analyzed. The primary outcomes were in-hospital mortality and the need for ICU admission. The secondary outcome was composite in-hospital mortality and/or ICU admission. Results One hundred nine patients (male/female: 63/46, mean age: 48.4 ± 12.4 years) were included in the study. Acute kidney injury (AKI) developed in 46 (42.2%) patients, and 4 (3.7%) of the patients required renal replacement therapy (RRT). A total of 22 (20.2%) patients were admitted in the ICU, and 19 (17.4%) patients required invasive mechanical ventilation. 14 (12.8%) of the patients died. Patients who were admitted in the ICU were significantly older (age over 60 years) (38.1% vs 14.9%, p = 0.016). 23 (21.1%) patients reached to composite outcome and these patients were significantly older (age over 60 years) (39.1% vs. 13.9%; p = 0.004), and had lower serum albumin (3.4 g/dl [2.9–3.8] vs. 3.8 g/dl [3.5–4.1], p = 0.002), higher serum ferritin (679 μg/L [184–2260] vs. 331 μg/L [128–839], p = 0.048), and lower lymphocyte counts (700/μl [460–950] vs. 860 /μl [545–1385], p = 0.018). Multivariable analysis identified presence of ischemic heart disease and initial serum creatinine levels as independent risk factors for mortality, whereas age over 60 years and initial serum creatinine levels were independently associated with ICU admission. On analysis for predicting secondary outcome, age above 60 and initial lymphocyte count were found to be independent variables in multivariable analysis. Conclusion Over the age of 60, ischemic heart disease, lymphopenia, poor graft function were independent risk factors for severe COVID-19 in this patient group. Whereas presence of ischemic heart disease and poor graft function were independently associated with mortality.
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- 2021
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7. Determinants of mortality in a large group of hemodialysis patients hospitalized for COVID-19
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Kenan Turgutalp, Savas Ozturk, Mustafa Arici, Necmi Eren, Numan Gorgulu, Mahmut Islam, Sami Uzun, Tamer Sakaci, Zeki Aydin, Erkan Sengul, Bulent Demirelli, Yavuz Ayar, Mehmet Riza Altiparmak, Savas Sipahi, Ilay Berke Mentes, Tuba Elif Ozler, Ebru Gok Oguz, Bulent Huddam, Ender Hur, Rumeyza Kazancioglu, Ozkan Gungor, Bulent Tokgoz, Halil Zeki Tonbul, Alaattin Yildiz, Siren Sezer, Ali Riza Odabas, and Kenan Ates
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Hemodialysis ,COVID-19 ,Radiological manifestations ,Mortality ,Clinical findings ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background Maintenance hemodialysis (MHD) patients are at increased risk for coronavirus disease 2019 (COVID-19). The aim of this study was to describe clinical, laboratory, and radiologic characteristics and determinants of mortality in a large group of MHD patients hospitalized for COVID-19. Methods This multicenter, retrospective, observational study collected data from 47 nephrology clinics in Turkey. Baseline clinical, laboratory and radiological characteristics, and COVID-19 treatments during hospitalization, need for intensive care and mechanical ventilation were recorded. The main study outcome was in-hospital mortality and the determinants were analyzed by Cox regression survival analysis. Results Of 567 MHD patients, 93 (16.3%) patients died, 134 (23.6%) patients admitted to intensive care unit (ICU) and 91 of the ones in ICU (67.9%) needed mechanical ventilation. Patients who died were older (median age, 66 [57–74] vs. 63 [52–71] years, p = 0.019), had more congestive heart failure (34.9% versus 20.7%, p = 0.004) and chronic obstructive pulmonary disease (23.6% versus 12.7%, p = 0.008) compared to the discharged patients. Most patients (89.6%) had radiological manifestations compatible with COVID-19 pulmonary involvement. Median platelet (166 × 103 per mm3 versus 192 × 103 per mm3, p = 0.011) and lymphocyte (800 per mm3 versus 1000 per mm3, p
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- 2021
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8. Are Kidney Donor Risk Index/Kidney Donor Profile Index Scores Predictor of Future Graft Function?
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Ismail Baloglu, Halil Zeki Tonbul, Kultigin Turkmen, Nedim Yilmaz Selcuk, and Mehmet Sinan Iyisoy
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Medicine - Abstract
Kidney donor profile index (KDPI) is a method developed to assess donor kidney quality for cadaveric transplants. We investigated the relationship between kidney donor risk index (KDRI) and KDPI scores of cadaveric transplants in the last five years in our clinic and current graft conditions. Forty people (12 females, 28 males; mean age, 46.35 + 8.94 years), who underwent cadaveric transplantation between January 2013 and March 2018, were participated in this study. At the same time, the KPDI and KDRI scores of the donor’s kidneys were calculated and then compared with that of the recipients’ data. The mean KDRI value of donors was 1.11 ± 0.33 and the median KDPI value was 60.50%. KDRI/KDPI scores were found to be high in women (P = 0.021) and, when the posttransplant findings of the recipients were evaluated by bivariate correlation analysis KDRI/KDPI scores were positively correlated with the day when creatinine (Cr) values started to fall off spontaneously (r = 0.457, P = 0.003). It was observed that recipients who were transplanted from the donors with high KDRI/KDPI scores had higher Cr levels (P
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- 2021
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9. Factors Affecting Kidney Functions in One-Year Follow-up After COVID-19 in Kidney Transplant Patients
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Hakan OZER, İsmail BALOĞLU, Yasin ÖZTÜRK, Fethi YÖNET, Halil Zeki TONBUL, Nedim Yılmaz SELCUK, and Kültigin TÜRKMEN
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General Earth and Planetary Sciences ,General Environmental Science - Abstract
Background Coronavirus disease (COVID-19) is more severe, and mortality is higher in kidney transplantation (KTx) patients; it is still unclear how renal functions progress and the conditions affecting renal functions in the post-COVID-19 period. We aimed to investigate the changes in kidney functions and the factors affecting this change after COVID-19. Material and Methods Forty-one kidney transplantation patients who were hospitalised for COVID-19 were included in this retrospective study. The patient's personal information, examination, and treatment information regarding their hospitalisation and follow-ups were obtained from the hospital system. Results Patients with elevated serum creatinine in the first year post-COVID had higher baseline proteinuria and systemic immune inflammation index (SII). Proteinuria increased more in patients with a long transplantation period, hypertension, high basal creatinine, and SII. Also, proteinuria was higher in patients who developed AKI during the COVID period. In addition, baseline SII was an independent predictor of the change in serum creatinine and proteinuria. Conclusions We found that patients with signs of increased inflammation, such as high SII were more fragile regarding renal functions. Therefore, the post-COVID-19 follow-up process of KTx patients with COVID-19 should be individualised.
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- 2023
10. The Prevalence of Fabry Disease in Patients with Chronic Kidney Disease in Turkey: The TURKFAB Study
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Kultigin Turkmen, Aydın Guclu, Garip Sahin, Ismail Kocyigit, Levent Demirtas, Fatih Mehmet Erdur, Erkan Sengül, Oktay Ozkan, Habib Emre, Faruk Turgut, Hilmi Unal, Murat Karaman, Cengiz Acıkel, Hasan Esen, Ebru Balli, Gulfidan Bıtırgen, Halil Zeki Tonbul, Mahmut Ilker Yılmaz, and Alberto Ortiz
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Chronic kidney disease ,Fabry disease ,Agalsidase therapy ,Screening ,ERBP ,Dermatology ,RL1-803 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Background/Aims: Fabry disease is a treatable cause of chronic kidney disease (CKD) characterized by a genetic deficiency of α-galactosidase A. European Renal Best Practice (ERBP) recommends screening for Fabry disease in CKD patients. However, this is based on expert opinion and there are no reports of the prevalence of Fabry disease in stage 1-5 CKD. Hence, we investigated the prevalence of Fabry disease in CKD patients not receiving renal replacement therapy. Methods: This prospective study assessed α-galactosidase activity in dried blood spots in 313 stage 1-5 CKD patients, 167 males, between ages of 18-70 years whose etiology of CKD was unknown and were not receiving renal replacement therapy. The diagnosis was confirmed by GLA gene mutation analysis. Results: Three (all males) of 313 CKD patients (0.95%) were diagnosed of Fabry disease, for a prevalence in males of 1.80%. Family screening identified 8 aditional Fabry patients with CKD. Of a total of 11 Fabry patients, 7 were male and started enzyme replacement therapy and 4 were female. The most frequent manifestations in male patients were fatigue (100%), tinnitus, vertigo, acroparesthesia, hypohidrosis, cornea verticillata and angiokeratoma (all 85%), heat intolerance (71%), and abdominal pain (57%). The most frequent manifestations in female patients were fatigue and cornea verticillata (50%), and tinnitus, vertigo and angiokeratoma (25%). Three patients had severe episodic abdominal pain attacks and proteinuria, and were misdiagnosed as familial Mediterranean fever. Conclusions: The prevalence of Fabry disease in selected CKD patients is in the range found among renal replacement therapy patients, but the disease is diagnosed at an earlier, treatable stage. These data support the ERBP recommendation to screen for Fabry disease in patients with CKD of unknown origin.
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- 2016
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11. MO166: The Longitudinal Evolution of Covid-19 Outcomes Among Hemodialysis Patients: A Nationwide Multicentre Controlled Study
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Savas Ozturk, Kenan Turgutalp, Mustafa Arici, Numan Gorgulu, Halil Zeki Tonbul, Necmi Eren, Vedat Gencer, Deniz Ayli, Irem Pembegul, Murside Esra Dolarslan, Zeynep Ural, Hulya Colak, Tuba Elif Ozler, Ozgur Can, Mehmet Emin Demir, Orcun Altunoren, Bulent Huddam, Kursad Onec, Bülent Demirelli, Zeki Aydin, Eda Altun, Selma Alagoz, Yavuz Ayar, Zeynep Ebru Eser, Bayram Berktaş, Zulfukar Yilmaz, Eser Uslu Ates, Enver Yuksel, Gizem Kumru Sahin, Merve Aktar, Egemen Cebeci, Belda Dursun, Sibel Yucel Kocak, Abdulmecit Yildiz, Sinan Kazan, Mahmut Gok, Sengul Erkan, Murat Tugcu, Ramazan Ozturk, Serdar Kahvecioglu, Ekrem Kara, Bulent Kaya, Garip Sahin, Tamer Sakaci, Savas Sipahi, Ilhan Kurultak, Beyza Algül Durak, Mehmet Riza Altiparmak, Sabahat Alisir Ecder, Serhat Karadag, Mevlut Tamer Dincer, Hakan Ozer, Sibel Bek, Sena Ulu, Ozkan Gungor, Elif Ari Bakir, Ali Riza Odabas, Nurhan Seyahi, Alaattin Yildiz, and Kenan Ateş
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Transplantation ,Nephrology - Abstract
BACKGROUND AND AIMS Haemodialysis (HD) patients are at increased risk for adverse short-term consequences of COVID-19. In this study, we investigated the characteristics of chronic HD patients in the post-COVID-19 period and compared them with the control group. METHOD We conducted a national multicentre observational study involving adult chronic HD patients recovering from COVID-19. The control HD group was selected from patients with similar characteristics who did not have COVID-19 in the same center. SARS-CoV-2 RT-PCR negative patients and patients in the active period of COVID-19 were not included. RESULTS A total of 1223 patients (635 COVID-19 groups, 588 control groups) were included in the study from the data collected from 47 centres between 21 April 2021 and 11 June 2021. The patients' baseline demographics, comorbidities, medications, HD characteristics and basic laboratory tests were quite similar between the groups (Table 1). 28th-day mortality and between 28th day and 90th day mortality were higher in the COVID-19 group than in the control group [19 (3.0%) patients and 0 (0%) patients; 15 (2.4%) patients and 4 (0.7%) patients, respectively]. Presence of respiratory symptoms, rehospitalization, need for home oxygen therapy, lower respiratory tract infection and A-V fistula thrombosis were significantly higher in the COVID-19 group in the first 28 days of illness and between 28 and 90 days. Mortality was significantly associated with preexisting COVID-19, age, current smoking, use of tunneled HD catheter, persistence of respiratory symptoms, rehospitalization, need for home oxygen support, presence of lower respiratory tract infection within 28 days and persistence of respiratory symptoms. CONCLUSION In the post-COVID-19 period, mortality, rehospitalization, respiratory problems and vascular access problems are higher in maintenance HD patients who have had COVID-19 compared to control HD patients. Table 2. Comparative presentation of patients data on the 28th day and between 28 and 90 day COVID-19 groupN = 635 Control groupN = 588 28th-day results, n(%) Death* 19(3.0) 0(0) Any respiratory symptoms* 152(23.9) 11(1.9) Rehospitalization for any reason* 52(8.2) 24(4.1) Need for home oxygen support * 26(4.1) 2(0.3) Lower respiratory tract infection* 65(10.2) 8(1.4) AV fistula thrombosis* 13(2.0) 2(0.3) Other thromboembolic events * 15(2.4) 4(0.7) Need for HD catheter placement* 21(3.3) 9(1.5) 28th day-90. day resultsa n(%) N:616 N:588 Death* 15(2.4) 4(0.7) Any respiratory symptoms* 45(7.3) 10(1.7) Rehospitalization for any reason* 44(7.1) 18(3.1) Need for home oxygen support* 12(1.9) 2(0.3) AV fistula thrombosis* 9(1.5) 1(0.2) Other thromboembolic events* 9(1.5) 2(0.3) Need for HD catheter placement 13(2.1) 10(1.7) HD: haemodialysis, AV: arteriovenous. *P
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- 2022
12. Irritable bowel syndrome frequency and related factors in hemodialysis patients
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Halil Zeki Tonbul, Fatih Sackan, Nedim Yilmaz Selcuk, Yasemin Coşkun Yavuz, Ibrahim Guney, and Durmus Ozkul
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Male ,medicine.medical_specialty ,Abdominal pain ,medicine.drug_class ,medicine.medical_treatment ,030232 urology & nephrology ,Proton-pump inhibitor ,030204 cardiovascular system & hematology ,Irritable Bowel Syndrome ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Renal Dialysis ,Risk Factors ,Internal medicine ,medicine ,Humans ,Irritable bowel syndrome ,Dialysis ,business.industry ,Hematology ,Middle Aged ,medicine.disease ,Cross-Sectional Studies ,Nephrology ,Quality of Life ,Anxiety ,Female ,Hemodialysis ,medicine.symptom ,business ,Kidney disease - Abstract
INTRODUCTION Irritable bowel syndrome (IBS) is a functional bowel disease that is common in society, does not threaten life, impairs quality of life, and causes serious economic losses. Gastrointestinal system complaints and especially IBS are common in patients with chronic kidney disease. It has also been shown that psychiatric diseases are more common in patients with IBS. In this study, we aimed to determine the frequency of IBS in hemodialysis patients and to investigate the factors associated with IBS. METHODS In this cross-sectional study, the questionnaire prepared to evaluate depression, anxiety, and abdominal pain was administered face-to-face to 686 patients by the same researcher in seven dialysis centers; 404 patients without exclusion criteria were included in the study. The diagnosis of IBS was made according to Rome IV criteria. A multivariate logistic regression model was used to identify factors that are significantly related to IBS. FINDINGS In 69 (17.1%) of the patients included in the study, symptoms were consistent with IBS. Binominal logistic regression analysis was performed to evaluate the effect of age, dialysis duration, diabetes, proton pump inhibitor, non-steroidal anti-inflammatory drugs, calcium acetate use, Hamilton depression and anxiety scores associated with IBS in the presence of IBS of the participants. The logistic regression model was statistically significant, χ2 (3) = 69.748, P
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- 2020
13. Evaluation of Long-Term Thirst due to Ramadan Fasting in Terms of Acute Kidney Injury
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Ismail Baloglu, Kultigin Turkmen, Fatih Pektas, Halil Zeki Tonbul, and Nedim Yilmaz Selcuk
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Transplantation ,Nephrology ,business.industry ,Anesthesia ,medicine ,Acute kidney injury ,Surgery ,medicine.symptom ,business ,medicine.disease ,Thirst ,Term (time) - Published
- 2020
14. BK Virus Nephropathy in Renal Transplantation: Case Series and Review of the Literature
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Kultigin Turkmen, Nedim Yilmaz Selcuk, Haci Hasan Esen, Halil Zeki Tonbul, and Ismail Baloglu
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Transplantation ,medicine.medical_specialty ,BK virus nephropathy ,Nephrology ,business.industry ,Urology ,Medicine ,Surgery ,business - Published
- 2020
15. The Longitudinal Evolution of Post-COVID-19 Outcomes Among Hemodialysis Patients in Turkey
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Savas Ozturk, Kenan Turgutalp, Mustafa Arici, Numan Gorgulu, Halil Zeki Tonbul, Necmi Eren, Vedat Gencer, Mehmet Deniz Ayli, Irem Pembegul, Murside Esra Dolarslan, Zeynep Ural, Hulya Colak, Tuba Elif Ozler, Ozgur Can, Mehmet Emin Demir, Orcun Altunoren, Bulent Huddam, Kursad Onec, Bulent Demirelli, Zeki Aydin, Eda Altun, Selma Alagoz, Yavuz Ayar, Zeynep Ebru Eser, Bayram Berktas, Zulfukar Yilmaz, Eser Uslu Ates, Enver Yuksel, Gizem Kumru Sahin, Merve Aktar, Egemen Cebeci, Belda Dursun, Sibel Yucel Kocak, Abdulmecit Yildiz, Sinan Kazan, Mahmut Gok, Erkan Sengul, Murat Tugcu, Ramazan Ozturk, Serdar Kahvecioglu, Ekrem Kara, Bulent Kaya, Garip Sahin, Tamer Sakaci, Savas Sipahi, Ilhan Kurultak, Beyza Algul Durak, Mehmet Riza Altiparmak, Sabahat Alisir Ecder, Serhat Karadag, Mevlut Tamer Dincer, Hakan Ozer, Sibel Gokcay Bek, Memnune Sena Ulu, Ozkan Gungor, Elif Ari Bakir, Ali Riza Odabas, Nurhan Seyahi, Alaattin Yildiz, Kenan Ates, Pembegül, İrem, MÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Huddam, Bülent, RTEÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, and Kara, Ekrem
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Mortality-Rates ,hemodialysis ,Nephrology ,Hemodialysis ,Nationwide study ,outcome ,COVID-19 ,OVID-19 ,nationwide study ,Transplant ,Outcome - Abstract
Introduction: Hemodialysis (HD) patients have increased risk for short-term adverse outcomes of COVID-19. However, complications and survival at the post-COVID-19 period have not been published extensively.Methods: We conducted a national, multicenter observational study that included adult maintenance HD patients recovered from confirmed COVID-19. A control HD group without COVID-19 was selected from patients in the same center. We investigated the characteristics and outcomes in the follow-up of HD patients and compare them with the non-COVID-19 group.Results: A total of 1223 patients (635 patients in COVID-19 group, 588 patients in non-COVID-19 group) from 47 centers were included in the study. The patients' baseline and HD characteristics were almost similar. The 28th-day mortality and mortality between 28th day and 90th day were higher in the COVID-19 group than non-COVID-19 group (19 [3.0%] patients vs. none [0%]; 15 [2.4%] patients vs. 4 [0.7%] patients, respectively). The presence of respiratory symptoms, rehospitalization, need for home oxygen therapy, lower respiratory tract infection, and arteriovenous (AV) fistula thrombosis was significantly higher in the COVID-19 group in both the first 28 days and between 28 and 90 days. In the multivariable analysis, age (odds ratio [OR] [95% CI]: 1.029 [1.004-1.056]), group (COVID-19 group vs. non-COVID-19 group) (OR [95% CI]: 7.258 [2.538-20.751]), and vascular access type (tunneled catheter/AV fistula) (OR [95% CI]: 2.512 [1.249-5.051]) were found as independent parameters related to 90-day mortality.Conclusion: In the post-COVID-19 period, maintenance HD patients who have had COVID-19 have increased rehospitalization, respiratory problems, vascular access problems, and high mortality compared with the non-COVID-19 HD patients.
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- 2022
16. Characteristics and outcomes of hospitalised older patients with chronic kidney disease and COVID‐19: A multicenter nationwide controlled study
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Numan Gorgulu, Ekrem Kara, Bulent Tokgoz, Dilek Guven Taymez, Halil Zeki Tonbul, Ender Hur, Murside Esra Dolarslan, İrem Pembegül, Mustafa Arici, Zubeyde Serhan Tuglular, İdris Şahin, Mahmud Islam, Alaattin Yildiz, Gülizar Şahin, Taner Basturk, Kenan Ates, Mehmet Riza Altiparmak, Zeki Aydin, Mahmut Gok, Hamad Dheir, Zeki Soypacaci, Serhat Karadag, Siren Sezer, Necmi Eren, Kenan Turgutalp, Garip Sahin, Ali Riza Odabas, Serkan Bakirdogen, Barış Döner, Mehmet Deniz Ayli, Tuba Elif Ozler, Melike Betul Ogutmen, Savas Ozturk, Erkan Sengul, RTEÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Kara, Ekrem, Pembegül, İrem, Ozturk, Savas, Turgutalp, Kenan, Arici, Mustafa, Gok, Mahmut, Islam, Mahmud, Altiparmak, Mehmet Riza, Aydin, Zeki, Doner, Baris, Eren, Necmi, Sengul, Erkan, Karadag, Serhat, Ozler, Tuba Elif, Dheir, Hamad, Pembegul, Irem, Taymez, Dilek Guven, Sahin, Garip, Bakirdogen, Serkan, Dolarslan, Murside Esra, Soypacaci, Zeki, Hur, Ender, Basturk, Taner, Ogutmen, Melike Betul, Gorgulu, Numan, Sahin, Idris, Ayli, Mehmet Deniz, Tuglular, Zubeyde Serhan, Sahin, Gulizar, Tokgoz, Bulent, Tonbul, Halil Zeki, Yildiz, Alaattin, Sezer, Siren, Odabas, Ali Riza, and Ates, Kenan
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Nephrology ,HEMODIALYSIS ,medicine.medical_treatment ,kidney disease ,Renal-diasease ,030204 cardiovascular system & hematology ,law.invention ,0302 clinical medicine ,COVID-19 Testing ,law ,Risk Factors ,INFECTION ,030212 general & internal medicine ,POPULATION ,RISK ,Mortality rate ,Hazard ratio ,DEATH ,General Medicine ,Middle Aged ,Intensive care unit ,Original Papers ,Death ,Hospitalization ,Hemodialysis ,Female ,Covid-19 ,Infection ,Risk ,medicine.medical_specialty ,Population ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,Mortality ,Renal Insufficiency, Chronic ,Aged ,Retrospective Studies ,Original Paper ,business.industry ,SARS-CoV-2 ,MORTALITY ,COVID-19 ,Retrospective cohort study ,medicine.disease ,Confidence interval ,RENAL-DISEASE ,business ,Renal-Disease ,Kidney disease - Abstract
Objective Older adults with co‐morbidities have been reported to be at higher risk for adverse outcomes of coronavirus disease 2019 (COVID‐19). The characteristics of COVID‐19 in older patients and its clinical outcomes in different kidney disease groups are not well known. Methods Data were retrieved from a national multicentric database supported by Turkish Society of Nephrology, which consists of retrospectively collected data between 17 April 2020 and 31 December 2020. Hospitalised patients aged 18 years or older with confirmed COVID‐19 diagnosis suffering from stage 3‐5 chronic kidney disease (CKD) or on maintenance haemodialysis (HD) treatment were included in the database. Non‐uraemic hospitalised patients with COVID‐19 were also included as the control group. Results We included 879 patients [388 (44.1%) female, median age: 63 (IQR: 50‐73) years]. The percentage of older patients in the CKD group was 68.8% (n = 188/273), in the HD group was 49.0% (n = 150/306) and in the control group was 30.4% (n = 70/300). Co‐morbidities were higher in the CKD and HD groups. The rate of presentation with severe‐critical disease was higher in the older CKD and HD groups (43.6%, 55.3% and 16.1%, respectively). Among older patients, the intensive care unit (ICU) admission rate was significantly higher in the CKD and HD groups than in the control group (38.8%, 37.3% and 15.7%, respectively). In‐hospital mortality or death and/or ICU admission rates in the older group were significantly higher in the CKD (29.3% and 39.4%) and HD groups (26.7% and 30.1%) compared with the control group (8.6% and 17.1%). In the multivariate analysis, in‐hospital mortality rates in CKD and HD groups were higher than control group [hazard ratio (HR): 4.33 (95% confidence interval [CI]: 1.53‐12.26) and HR: 3.09 (95% CI: 1.04‐9.17), respectively]. Conclusion Among older COVID‐19 patients, in‐hospital mortality is significantly higher in those with stage 3‐5 CKD and on maintenance HD than older patients without CKD regardless of demographic characteristics, co‐morbidities, clinical and laboratory data on admission.
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- 2021
17. Evaluation of Hemodialysis Adequacy: Correlation between Kt/Vurea and Other Methods
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N. Yılmaz Selçuk, Kultigin Turkmen, Ismail Baloglu, Halil Zeki Tonbul, and Hatice Evran
- Subjects
Correlation ,Transplantation ,medicine.medical_specialty ,Nephrology ,business.industry ,medicine.medical_treatment ,medicine ,Urology ,Surgery ,Hemodialysis ,business ,Kt vurea - Published
- 2019
18. The Relationship Between Visceral Adiposity Index and Epicardial Adipose Tissue in Patients with Type 2 Diabetes Mellitus
- Author
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Kultigin Turkmen, Emin Murat Akbas, Ismail Baloglu, Hikmet Hamur, Sinan Iyısoy, Halil Zeki Tonbul, Nedim Yilmaz Selcuk, Adalet Ozcicek, and EBYÜ, Tıp Fakültesi
- Subjects
Adult ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Type 2 diabetes ,Intra-Abdominal Fat ,030204 cardiovascular system & hematology ,Coronary artery disease ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Endocrinology ,High-density lipoprotein ,Diabetes mellitus ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Adiposity ,Aged ,Triglyceride ,business.industry ,Type 2 Diabetes Mellitus ,General Medicine ,Middle Aged ,epicardial adipose tissue ,medicine.disease ,visceral adiposity index ,Cross-Sectional Studies ,Diabetes Mellitus, Type 2 ,chemistry ,Echocardiography ,diabetes mellitus ,Uric acid ,Female ,business ,Pericardium ,Body mass index - Abstract
Introduction and aim Cardiovascular diseases remain the most common cause of morbidity and mortality in patients with diabetes. 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. Increased visceral adiposity is associated with proinflammatory activity, impaired insulin sensitivity, increased risk of atherosclerosis and high mortality. In the present study we aimed to investigate the relationship between EAT and visceral adiposity index (VAI) in patients with diabetes. Methods This was a cross-sectional study involving 128 patients with type 2 diabetes mellitus (73 females, 55 males; mean age, 54.09+±+9.17 years) and 32 control subjects (23 females, 9 males; mean age, 50.09+±+7.81 years). EAT was measured by using a trans-thoracic echocardiograph. Parameters such as waist circumference (WC), body mass index (BMI), triglyceride and high density lipoprotein (HDL) cholesterol were used to calculate VAI. Result EAT and VAI measurements were significantly higher in patients with diabetes when compared to control subjects. In the bivariate correlation analysis, VAI was positively correlated with uric acid level (r=0.214, p=0.015), white blood cell count (r= 0.262, p=0.003), platelet count (r=0.223, p=0.011) and total cholesterol levels (r= 0.363, p Conclusion Simple calculation of VAI was found to be associated with increased EAT in patients with type 2 diabetes.
- Published
- 2019
19. The relationship between FGF23 and anemia in HD and renal transplant patients
- Author
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Yasin Ozturk, Kultigin Turkmen, Ismail Baloglu, Halil Zeki Tonbul, Hakan Ozer, and Mehmet Fatih Erdur
- Subjects
Nephrology ,Adult ,Male ,medicine.medical_specialty ,Anemia ,Urology ,medicine.medical_treatment ,Iron ,Gastroenterology ,Hemoglobins ,Total iron-binding capacity ,Renal Dialysis ,Internal medicine ,medicine ,Humans ,Aged ,medicine.diagnostic_test ,biology ,Transferrin saturation ,business.industry ,Middle Aged ,medicine.disease ,Kidney Transplantation ,Ferritin ,Transplantation ,stomatognathic diseases ,Fibroblast Growth Factor-23 ,Cross-Sectional Studies ,Ferritins ,biology.protein ,Female ,Hemoglobin ,Hemodialysis ,business - Abstract
Recent studies claim that FGF23 is also associated with anemia and inflammation. In this study, the relationship between FGF23 and anemia in hemodialysis (HD) and renal transplantation patients (RTx patients) patients was investigated. This was a cross-sectional study involving 40 RTx patients (13 females, 27 males; mean age, 45.93 ± 12.49 years) who had transplantation at least 6 months before, 25 HD patients (12 females, 13 males; mean age, 54.72 ± 15.5 years), and 20 healthy control subjects (13 females, 7 males; mean age, 36.7 ± 9.38 years). FGF23 was studied using Elisa method. Parameters such as iron, ferritin, total iron binding capacity, and transferrin saturation were assessed. FGF23 level was significantly higher in HD patients when compared with the RTx patients and control groups. In the bivariate correlation analysis, hemoglobin was positively correlated with albumin (r = 0.681, p = 0.000), ferritin (r = 0.446, p = 0.043), and negatively correlated with CRP (r = − 0.476, p = 0.016) and FGF23 (r = 0.493, p = 0.043). FGF23 was found to be an independent predictor of decreased hemoglobin in HD patients. In addition, this association was observed to disappear after transplantation. While FGF23 is closely related to hemoglobin levels in HD patients, we have shown that this relationship disappears after transplantation.
- Published
- 2021
20. Impact of hospital-acquired acute kidney injury on Covid-19 outcomes in patients with and without chronic kidney disease: a multicenter retrospective cohort study
- Author
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Ali Riza Odabas, Savas Sipahi, Serkan Bakirdogen, Egemen Cebeci, Numan Gorgulu, Feyza Bora, Yavuz Ayar, Zeki Aydin, Zeki Soypacaci, Ekrem Kara, Mustafa Arici, Kenan Turgutalp, Hakki Çetinkaya, Erkan Sengul, Halil Zeki Tonbul, Mahmud Islam, Ozkan Gungor, İdris Şahin, Alaattin Yildiz, Kenan Ates, Mehmet Riza Altiparmak, Tuba Elif Ozler, Melike Betul Ogutmen, Savas Ozturk, Siren Sezer, Murside Esra Dolarslan, Nurhan Seyahi, Bulent Tokgoz, RTEÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, and Kara, Ekrem
- Subjects
Male ,medicine.medical_specialty ,Population ,urologic and male genital diseases ,Article ,law.invention ,Aki ,law ,Risk Factors ,Internal medicine ,medicine ,Humans ,Hospital Mortality ,Renal Insufficiency, Chronic ,education ,Survival rate ,Pandemics ,Aged ,Retrospective Studies ,education.field_of_study ,business.industry ,SARS-CoV-2 ,urogenital system ,Incidence (epidemiology) ,Mortality rate ,Incidence ,Acute kidney injury ,COVID-19 ,Retrospective cohort study ,General Medicine ,Acute Kidney Injury ,Middle Aged ,medicine.disease ,Intensive care unit ,mortality ,female genital diseases and pregnancy complications ,Survival Rate ,Intensive Care Units ,Female ,business ,Covid-19 ,chronic kidney disease ,Kidney disease ,hospitalization - Abstract
Background/aim: Hospital-acquired acute kidney injury (HA-AKI) may commonly develop in Covid-19 patients and is expected to have higher mortality. There is little comparative data investigating the effect of HA-AKI on mortality of chronic kidney disease (CKD) patients and a control group of general population suffering from Covid-19. Materials and methods: HA-AKI development was assessed in a group of stage 3-5 CKD patients and control group without CKD among adult patients hospitalized for Covid-19. The role of AKI development on the outcome (in-hospital mortality and admission to the intensive care unit [ICU]) of patients with and without CKD was compared. Results: Among 621 hospitalized patients (age 60 [IQR: 47-73]), women: 44.1%), AKI developed in 32.5% of the patients, as stage 1 in 84.2%, stage 2 in 8.4%, and stage 3 in 7.4%. AKI developed in 48.0 % of CKD patients, whereas it developed in 17.6% of patients without CKD. CKD patients with HA-AKI had the highest mortality rate of 41.1% compared to 14.3% of patients with HA-AKI but no CKD (p < 0.001). However, patients with AKI+non-CKD had similar rates of ICU admission, mechanical ventilation, and death rate to patients with CKD without AKI. Adjusted mortality risks of the AKI+non-CKD group (HR: 9.0, 95% CI: 1.9-44.2) and AKI+CKD group (HR: 7.9, 95% CI: 1.9-33.3) were significantly higher than that of the non-AKI+non-CKD group. Conclusion: AKI frequently develops in hospitalized patients due to Covid-19 and is associated with high mortality. HA-AKI has worse outcomes whether it develops in patients with or without CKD, but the worst outcome was seen in AKI+CKD patients. Turkish Society of Nephrology for the organization We thank Turkish Society of Nephrology for the organization and funding of the study. We also would like to express our gratitude to the patients whose records were used in this study, without which this research would not be possible.
- Published
- 2021
21. Predicting the outcome of COVID-19 infection in kidney transplant recipients
- Author
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Mustafa Arici, Erhan Tatar, Ozgur Merhametsiz, Kenan Turgutalp, Hamad Dheir, Numan Gorgulu, Nadir Alpay, Seda Safak, Oktay Ozkan, Kenan Ates, Savas Sipahi, Ozgur Akin Oto, Mehmet Riza Altiparmak, Halil Zeki Tonbul, Berna Yelken, Bulent Tokgoz, Mehmet Emin Demir, Zeki Aydin, Abdullah Ozkok, Alaattin Yildiz, Ali Riza Odabas, Siren Sezer, Melike Betul Ogutmen, Savas Ozturk, Yavuz Ayar, Yelken, Berna, Oto, Özgür Akın, Öztürk, Savaş, Turgutalp, Kenan, Arıcı, Mustafa, Alpay, Nadir, Merhametsiz, Özgür, Sipahi, Savaş, Öğütmen, Melike Betül, Altıparmak, Mehmet Rıza, Görgülü, Numan, Tatar, Erhan, Özkan, Oktay, Ayar, Yavuz, Aydın, Zeki, Dheir, Hamad, Özkök, Abdullah, Şafak, Seda, Demir, Mehmet Emin, Odabaş, Ali Rıza, Tokgöz, Bülent, Tonbul, Halil Zeki, Sezer, Siren, Ateş, Kenan, Yıldız, Alaattin, and Koç University Hospital
- Subjects
Male ,Nephrology ,Turkey ,medicine.medical_treatment ,Myocardial Ischemia ,030204 cardiovascular system & hematology ,lcsh:RC870-923 ,Kidney transplantation ,chemistry.chemical_compound ,0302 clinical medicine ,Risk Factors ,Urology ,Hospital Mortality ,030212 general & internal medicine ,Graft Survival ,Age Factors ,Acute kidney injury ,Acute Kidney Injury ,Middle Aged ,Renal Replacement Therapy ,Treatment Outcome ,Creatinine ,Cohort ,Female ,Research Article ,Adult ,medicine.medical_specialty ,Registry ,Critical Care ,COVID-19 ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,Lymphocyte Count ,Renal replacement therapy ,Serum Albumin ,Retrospective Studies ,Mechanical ventilation ,SARS-CoV-2 ,business.industry ,Retrospective cohort study ,Length of Stay ,lcsh:Diseases of the genitourinary system. Urology ,medicine.disease ,Respiration, Artificial ,Transplant Recipients ,chemistry ,business - Abstract
Background: we aimed to present the demographic characteristics, clinical presentation, and outcomes of our multicenter cohort of adult KTx recipients with COVID-19.Methods: we conducted a multicenter, retrospective study using data of patients hospitalized for COVID-19 collected from 34 centers in Turkey. Demographic characteristics, clinical findings, laboratory parameters (hemogram, CRP, AST, ALT, LDH, and ferritin) at admission and follow-up, and treatment strategies were reviewed. Predictors of poor clinical outcomes were analyzed. The primary outcomes were in-hospital mortality and the need for ICU admission. The secondary outcome was composite in-hospital mortality and/or ICU admission.Results: one hundred nine patients (male/female: 63/46, mean age: 48.412.4years) were included in the study. Acute kidney injury (AKI) developed in 46 (42.2%) patients, and 4 (3.7%) of the patients required renal replacement therapy (RRT). A total of 22 (20.2%) patients were admitted in the ICU, and 19 (17.4%) patients required invasive mechanical ventilation. 14 (12.8%) of the patients died. Patients who were admitted in the ICU were significantly older (age over 60 years) (38.1% vs 14.9%, p=0.016). 23 (21.1%) patients reached to composite outcome and these patients were significantly older (age over 60years) (39.1% vs. 13.9%; p=0.004), and had lower serum albumin (3.4g/dl [2.9-3.8] vs. 3.8g/dl [3.5-4.1], p=0.002), higher serum ferritin (679 mu g/L [184-2260] vs. 331 mu g/L [128-839], p=0.048), and lower lymphocyte counts (700/mu l [460-950] vs. 860 /mu l [545-1385], p=0.018). Multivariable analysis identified presence of ischemic heart disease and initial serum creatinine levels as independent risk factors for mortality, whereas age over 60 years and initial serum creatinine levels were independently associated with ICU admission. On analysis for predicting secondary outcome, age above 60 and initial lymphocyte count were found to be independent variables in multivariable analysis. Conclusion: over the age of 60, ischemic heart disease, lymphopenia, poor graft function were independent risk factors for severe COVID-19 in this patient group. Whereas presence of ischemic heart disease and poor graft function were independently associated with mortality., NA
- Published
- 2021
22. Determinants of mortality in a large group of hemodialysis patients hospitalized for COVID-19
- Author
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Ali Riza Odabas, Tuba Elif Ozler, Savas Ozturk, Ozkan Gungor, Yavuz Ayar, Ebru Gok Oguz, Bulent Tokgoz, Kenan Turgutalp, Mahmut Islam, Ilay Berke Mentes, Halil Zeki Tonbul, Rumeyza Kazancioglu, Ender Hur, Zeki Aydin, Bulent Demirelli, Erkan Sengul, Mustafa Arici, Numan Gorgulu, Tamer Sakaci, Bülent Huddam, Alaattin Yildiz, Kenan Ates, Mehmet Riza Altiparmak, Savas Sipahi, Necmi Eren, Siren Sezer, Sami Uzun, İÜC, Cerrahpaşa Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Altiparmak, Mehmet Riza, and KAZANCIOĞLU, Rümeyza
- Subjects
Male ,medicine.medical_specialty ,Critical Care ,Turkey ,medicine.medical_treatment ,Clinical findings ,Radiological manifestations ,lcsh:RC870-923 ,law.invention ,Pulmonary Disease, Chronic Obstructive ,law ,Renal Dialysis ,Risk Factors ,Intensive care ,Internal medicine ,medicine ,Humans ,Hemodialysis ,COVID-19 ,Mortality ,Hospital Mortality ,Pandemics ,Survival analysis ,Aged ,Retrospective Studies ,Mechanical ventilation ,Heart Failure ,business.industry ,SARS-CoV-2 ,Mortality rate ,Retrospective cohort study ,Middle Aged ,medicine.disease ,lcsh:Diseases of the genitourinary system. Urology ,Intensive care unit ,Respiration, Artificial ,Hospitalization ,Radiography ,Nephrology ,Heart failure ,Kidney Failure, Chronic ,Female ,business ,Research Article - Abstract
Background Maintenance hemodialysis (MHD) patients are at increased risk for coronavirus disease 2019 (COVID-19). The aim of this study was to describe clinical, laboratory, and radiologic characteristics and determinants of mortality in a large group of MHD patients hospitalized for COVID-19. Methods This multicenter, retrospective, observational study collected data from 47 nephrology clinics in Turkey. Baseline clinical, laboratory and radiological characteristics, and COVID-19 treatments during hospitalization, need for intensive care and mechanical ventilation were recorded. The main study outcome was in-hospital mortality and the determinants were analyzed by Cox regression survival analysis. Results Of 567 MHD patients, 93 (16.3%) patients died, 134 (23.6%) patients admitted to intensive care unit (ICU) and 91 of the ones in ICU (67.9%) needed mechanical ventilation. Patients who died were older (median age, 66 [57–74] vs. 63 [52–71] years, p = 0.019), had more congestive heart failure (34.9% versus 20.7%, p = 0.004) and chronic obstructive pulmonary disease (23.6% versus 12.7%, p = 0.008) compared to the discharged patients. Most patients (89.6%) had radiological manifestations compatible with COVID-19 pulmonary involvement. Median platelet (166 × 103 per mm3 versus 192 × 103 per mm3, p = 0.011) and lymphocyte (800 per mm3 versus 1000 per mm3, p p = 0.001) on admission were lower in patients who died. Age (HR: 1.022 [95% CI, 1.003–1.041], p = 0.025), severe-critical disease clinical presentation at the time of diagnosis (HR: 6.223 [95% CI, 2.168–17.863], p p = 0.009), ferritin levels on admission (HR; 1.057 [95% CI, 1.006–1.111], p = 0.028), elevation of aspartate aminotransferase (AST) (HR; 3.909 [95% CI, 2.143–7.132], p 3 per mm3) during hospitalization (HR; 1.864 [95% CI, 1.025–3.390], p = 0.041) were risk factors for mortality. Conclusion Hospitalized MHD patients with COVID-19 had a high mortality rate. Older age, presence of heart failure, clinical severity of the disease at presentation, ferritin level on admission, decrease in platelet count and increase in AST level during hospitalization may be used to predict the mortality risk of these patients.
- Published
- 2021
23. P0290THERAPEUTIC PLASMAPHERESIS EXPERIENCE DUE TO NEPHROLOGICAL INDICATIONS
- Author
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Ismail Baloglu, Kultigin Turkmen, Halil Zeki Tonbul, Nedim Yilmaz Selcuk, and Hatice Ozge Serin
- Subjects
Transplantation ,medicine.medical_specialty ,Nephrology ,business.industry ,medicine.medical_treatment ,Medicine ,Plasmapheresis ,business ,Intensive care medicine - Abstract
Background and Aims Therapeutic plasma exchange (PEX) has an increasingly long list of indications in recent years, in addition to immunosuppressive therapies in many life-threatening immune activations, it provides significant improvements in mortality and morbidity. In this study, we aimed to investigate the laboratory and clinical effects of PEX performed with nephrologic indication in our clinic. Method The records of 67 patients (36 females, 31 males; mean age, 45.7±15.8 years) who underwent PEX with nephrological indication between 2012 and 2017 in our clinic were retrospectively reviewed. Characteristics of the patients such as, indications of PEX, laboratory values and number of PEX sessions were recorded. In addition, clinical responses were also evaluated. Results When a total 398 PEX sessions were examined, the most common indication (40.3%) was acute humoral rejection after renal transplantation, followed by granulomatosis with polyangiitis (19.4%) and thrombotic microangiopathy (9%), respectively. The average of the PEX sessions was 5.94. There was a statistically significant increase in the bicarbonate value when the arterial blood gas of the patients was evaluated after PEX (p=0.002). However, no significant difference was observed in the pH and ionized calcium values (p=0.135, p=0.969, respectively) (Table 1). When all the patients were evaluated, there was no significant change in hemoglobin values (p=0.174), but platelet values decreased significantly (p=0.011) after PEX. However, when the patient group admitted with thrombotic microangiopathy was examined, it was observed that platelet count increased and LDH level decreased significantly (p=0.063, p=0.028, respectively). When the serum creatinine values of all patients were evaluated, a significant decrease was observed in the serum creatinine values after PEX (p=0.001). In addition, after 2 years following PEX treatment, 70.1% of patients were still alive and 12.5% of patients undergoing PEX for acute humoral rejection were undergoing on hemodialysis treatment. Conclusion According to the results of our study, patients should be followed up especially for acid-base and electrolyte changes after PEX. In addition, therapeutic PEX might be effective in terms of improving morbidity and 2 year-mortality of these patients.
- Published
- 2020
24. A Rare Cause of Hyperkalemia: Adrenal Insufficiency Due to Bilateral Adrenal Lymphoma
- Author
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Nedim Yilmaz Selcuk, Halil Zeki Tonbul, Kultigin Turkmen, Ismail Baloglu, Pembe Oltulu, and Suleyman Baktik
- Subjects
Transplantation ,medicine.medical_specialty ,Hyperkalemia ,business.industry ,medicine.disease ,Gastroenterology ,Nephrology ,Internal medicine ,Adrenal lymphoma ,medicine ,Adrenal insufficiency ,Surgery ,medicine.symptom ,business - Published
- 2019
25. Hemodiyaliz Hastalarında İki Farklı Bikarbonat İçerikli Diyalizat Kullanımının Asidoz Kontrolüne Etkisi
- Author
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Türkmen Kültigin, Ismail Baloglu, Nedim Yilmaz Selcuk, Halil Zeki Tonbul, Kültigin Türkmen: 0000-0002-1667-7716, Nedim Yılmaz Selçuk: 0000-0003-0836-7993, İsmail Baloğlu: 0000-0002-8751-5490, and Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü İç Hastalıkları Anabilim Dalı
- Subjects
Gynecology ,medicine.medical_specialty ,business.industry ,Urology ,Medicine ,Surgery ,business - Abstract
AMAÇ: Hemodiyaliz hastalarında kronik bir metabolik asidoz eğilimi söz konusudur. Yüksek olgu sayılı çalışmalarda diyaliz öncesi serum bikarbonat konsantrasyonu ile mortalite arasında ilişki saptanmıştır. Çalışmamızda 32 ve 36 mmol/L bikarbonat içerikli diyaliz solüsyonu kullanımının asidoz kontrolüne etkisi araştırıldı.GErEÇ ve YÖnTEMLEr: Bir merkezde haftada üç kez hemodiyalize giren 91 (43E,48K) hastaya ilk altı ay 32 mmol/L diyalizat, ikinci altı ayda aynı hastalara 36 mmol/L bikarbonat diyalizat kullanılmaya başlandı ve diyaliz öncesi ve sonrası plazma bikarbonat düzeyleri karşılaştırıldı. BULGULAr: İlk altı ayda ortalama bikarbonat düzeyi 20,552,55 mmol/L olup sadece 30 hastada bikarbonat düzeyi 22 mmol/L ve üzerindeydi. İkinci altı aylık dönemde ise ortalama bikarbonat düzeyi 23,593,3 mmol/L olup hedef düzeylerdeydi. Ancak 19 hastada diyaliz sonu ortalama bikarbonat düzeyi 30 mmol/L'nin üzerinde bulundu. Prediyaliz asidozu olan hastaların ortalama interdiyalitik kilo artışı 2,80,5 kg olup, asidozu olmayan gruptan daha yüksekti (p0,05). Prediyaliz üre, Kt/V, albumin, potasyum ve CRP düzeyleri bakımından iki periyot arasında anlamlı farklılık yoktu. SOnUÇ: 36 mmol/L bikarbonat içeren diyaliz solüsyonu kullanımı ile asidoz kontrolü daha iyi yapılmakta ancak hastaların yaklaşık yüzde yirmisinde diyaliz sonunda ciddi metabolik alkaloz gelişmektedir. Bu durum aritmiyi tetikleyebilir. Bu nedenle aritmisi olan veya metabolik alkaloza eğilimi olan hastalarda yüksek bikarbonatlı solüsyon kullanımında bikarbonat içeriğinin ayarlanmasının gerektiğini düşünmekteyiz., OBJECTIVE: In hemodialysis patients; there is a continuing tendency to metabolic acidosis. In studies, the relationship between serum bicarbonate concentration and dialysis mortality has been determined. In our study, the effect of 32 and 36 mmol/L bicarbonate-containing dialysis solution on acidosis control was investigated. MATErıAL and METHODS: In a hemodialysis clinic, a 32 mmol/L bicarbonate-containing dialysate was used in the first six months and a 36 mmol/L bicarbonate-containing dialysate was used in the second six months. The study was performed on 91 (43M/48F) patients. Plasma bicarbonate levels before and after dialysis were compared. rESULTS: In the first period, only 30 patients' bicarbonate levels were 22 mmol/L or more. In the second period, the mean bicarbonate level was 23.59±3.3 mmol/L. However, the level of bicarbonate after dialysis was above 30 mmol/L in 19 patients. In patients with predialysis acidosis, the interdialytic mean weight gain was higher than in the group without acidosis (p>0.05). There were no significant differences between the two periods in terms of predialysis urea, Kt/V, albumin, potassium and CRP levels.CONClUSION: Acidosis control is better with the use of a dialysis solution containing 36 mmol/L bicarbonate. But at the end of dialysis, severe metabolic alkalosis developed on approximately twenty percent of patients. This situation can trigger arrhythmia. We therefore think that it is necessary to adjust the machine bicarbonate in the use of high bicarbonate solution in patients with arrhythmia or alkalosis tendency.
- Published
- 2017
26. The Prevalence of Fabry Disease in Patients with Chronic Kidney Disease in Turkey: The TURKFAB Study
- Author
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Erkan Sengul, Halil Zeki Tonbul, Levent Demirtas, Alberto Ortiz, Kultigin Turkmen, Hasan Esen, Aydın Güçlü, Oktay Ozkan, Cengiz Han Açikel, Mahmut Ilker Yilmaz, Fatih Mehmet Erdur, Habib Emre, Garip Sahin, Ismail Kocyigit, Ebru Balli, Gulfidan Bıtırgen, Hilmi Umut Unal, Faruk Turgut, Murat Karaman, and Kırşehir Ahi Evran Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri, Nefroloji ABD
- Subjects
Adult ,Male ,0301 basic medicine ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Pathology ,medicine.medical_specialty ,Adolescent ,Turkey ,DNA Mutational Analysis ,MEDLINE ,lcsh:RC870-923 ,urologic and male genital diseases ,03 medical and health sciences ,Chronic kidney disease ,Internal medicine ,Prevalence ,lcsh:Dermatology ,medicine ,Humans ,Mass Screening ,In patient ,Prospective Studies ,Renal Insufficiency, Chronic ,Prospective cohort study ,Mass screening ,Aged ,Fabry disease ,Alpha-galactosidase ,biology ,business.industry ,General Medicine ,Middle Aged ,lcsh:RL1-803 ,lcsh:Diseases of the genitourinary system. Urology ,medicine.disease ,030104 developmental biology ,lcsh:RC666-701 ,Nephrology ,alpha-Galactosidase ,ERBP ,Screening ,biology.protein ,Female ,Agalsidase therapy ,Cardiology and Cardiovascular Medicine ,business ,Kidney disease - Abstract
WOS: 000392937800028 PubMed ID: 28006774 Background/Aims: Fabry disease is a treatable cause of chronic kidney disease (CKD) characterized by a genetic deficiency of a-galactosidase A. European Renal Best Practice (ERBP) recommends screening for Fabry disease in CKD patients. However, this is based on expert opinion and there are no reports of the prevalence of Fabry disease in stage 1-5 CKD. Hence, we investigated the prevalence of Fabry disease in CKD patients not receiving renal replacement therapy. Methods: This prospective study assessed a-galactosidase activity in dried blood spots in 313 stage 1-5 CKD patients, 167 males, between ages of 18-70 years whose etiology of CKD was unknown and were not receiving renal replacement therapy. The diagnosis was confirmed by GLA gene mutation analysis. Results: Three (all males) of 313 CKD patients (0.95%) were diagnosed of Fabry disease, for a prevalence in males of 1.80%. Family screening identified 8 aditional Fabry patients with CKD. Of a total of 11 Fabry patients, 7 were male and started enzyme replacement therapy and 4 were female. The most frequent manifestations in male patients were fatigue (100%), tinnitus, vertigo, acroparesthesia, hypohidrosis, cornea verticillata and angiokeratoma (all 85%), heat intolerance (71%), and abdominal pain (57%). The most frequent manifestations in female patients were fatigue and cornea verticillata (50%), and tinnitus, vertigo and angiokeratoma (25%). Three patients had severe episodic abdominal pain attacks and proteinuria, and were misdiagnosed as familial Mediterranean fever. Conclusions: The prevalence of Fa bry disease in selected CKD patients is in the range found among renal replacement therapy patients, but the disease is diagnosed at an earlier, treatable stage. These data support the ERBP recommendation to screen for Fabry disease in patients with CKD of unknown origin. (C) 2016 The Author(s) Published by S. Karger AG, Basel Sanofi Genzyme Corporation; Intensificacion ISCIII and REDINREN [RD012/0021] We are indebted to our patients and their families for volunteering to contribute their medical information to the physicians who are dedicated to their care. This work was supported by grants from Sanofi Genzyme Corporation. The lead investigator had full access to all data in the study. All investigators take responsibility for the accuracy of the individual data that they entered in the system provided by FMF Arthritis Vasculitis and Orphan disease Research (FAVOR). AO was supported by Intensificacion ISCIII and REDINREN RD012/0021.
- Published
- 2016
27. Sekonder Hipertansiyonun Nadir Bir Nedeni; Fabry Hastalığı
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Nedim Yilmaz Selcuk, Kultigin Turkmen, İsmail Baloğlu, and Halil Zeki Tonbul
- Subjects
business.industry ,Urology ,Medicine ,Surgery ,business ,Nuclear medicine - Published
- 2018
28. Serum neutrophil gelatinase-associated lipocalin is associated with cardiovascular events in patients with chronic kidney disease
- Author
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Suleyman Turk, Ali Osman Yildirim, Mahmut Gok, Halil Zeki Tonbul, Halil Yaman, Tayfun Eyileten, Abduzhappar Gaipov, Mahmut Ilker Yilmaz, Adrian Covic, Sebahattin Sari, Dimitrie Siriopol, Yalcin Solak, Hilmi Umut Unal, Mutlu Saglam, Hakki Cetinkaya, and Mehmet Kanbay
- Subjects
Adult ,Male ,Nephrology ,medicine.medical_specialty ,Urology ,Myocardial Infarction ,Renal function ,Coronary Disease ,Gastroenterology ,Peripheral Arterial Disease ,Lipocalin-2 ,Proto-Oncogene Proteins ,Internal medicine ,Diabetes mellitus ,Diabetes Mellitus ,Prevalence ,medicine ,Humans ,Prospective Studies ,Myocardial infarction ,Renal Insufficiency, Chronic ,Prospective cohort study ,Proportional Hazards Models ,biology ,business.industry ,Cholesterol, HDL ,C-reactive protein ,Acute kidney injury ,Middle Aged ,medicine.disease ,Lipocalins ,Stroke ,C-Reactive Protein ,Death, Sudden, Cardiac ,ROC Curve ,Cardiovascular Diseases ,Area Under Curve ,Immunology ,Linear Models ,biology.protein ,Female ,business ,Acute-Phase Proteins ,Glomerular Filtration Rate ,Kidney disease - Abstract
Neutrophil gelatinase-associated lipocalin (NGAL) is a member of the lipocalin family best known as a novel and early marker of acute kidney injury (AKI). Recent data suggest that NGQueryAL is not only a marker of AKI, but also an important player in the vascular remodeling, atherosclerotic plaque stability and thrombus formation. We conducted this study to investigate the association of serum NGAL levels with fatal and composite (fatal and non-fatal) cardiovascular events (CVE) in a cohort of patients with stage 1–5 CKD. This was an observational cohort study in which serum NGAL was obtained from 298 CKD (stages 1–5) patients. Fatal and composite CVE were recorded for a median 41 months. We examined alteration of serum NGAL through CKD groups as well as association with inflammatory markers. We also performed a Cox regression analysis to determine the association of NGAL with predefined clinical outcomes. The median value of NGAL was 50.5 ng/mL (IR 47.6–54.9 ng/mL), and higher NGAL values were recorded in diabetic patients. In a multiple linear regression model, including all univariate associates of NGAL, only log eGFR, log hs-CRP and log HDL cholesterol maintained an independent association with log NGAL. During the observational period, 30 patients died due to cardiovascular causes and 69 non-fatal CVE were registered. In the fully adjusted model, we observed a 2.08-fold increase in the risk of fatal CVE and a 1.50-fold increase in the risk of fatal and non-fatal CVE for each increment of 1 SD in log NGAL values. This is the first study that shows that serum NGAL is associated with cardiovascular events (fatal and non-fatal) in patients with CKD, independently of traditional risk factors, renal function and inflammation.
- Published
- 2015
29. Serum uric acid may predict development of progressive acute kidney injury after open heart surgery
- Author
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Yalcin Solak, Melih Anil, Aysun Toker, Halil Zeki Tonbul, Humeyra Cicekler, Kultigin Turkmen, Zeynep Biyik, Suleyman Turk, Alper Kilicaslan, Mehdi Yeksan, Ahmet Nihat Baysal, Abduzhappar Gaipov, Niyazi Gormus, and Fatih Mehmet Erdur
- Subjects
Adult ,Male ,medicine.medical_specialty ,Turkey ,Urine ,Lipocalin ,urologic and male genital diseases ,Critical Care and Intensive Care Medicine ,chemistry.chemical_compound ,Postoperative Complications ,Lipocalin-2 ,Predictive Value of Tests ,Proto-Oncogene Proteins ,Humans ,Medicine ,Prospective Studies ,Cardiac Surgical Procedures ,Aged ,Creatinine ,urogenital system ,business.industry ,Serum uric acid ,Acute kidney injury ,General Medicine ,Acute Kidney Injury ,Middle Aged ,Prognosis ,medicine.disease ,Lipocalins ,female genital diseases and pregnancy complications ,Uric Acid ,Cardiac surgery ,Surgery ,chemistry ,Nephrology ,Disease Progression ,Uric acid ,Female ,business ,Complication ,Biomarkers ,Acute-Phase Proteins - Abstract
Acute kidney injury (AKI) is a common complication of cardiac surgery developing in 25-35% cases. Recently, neutrophil gelatinase-associated lipocalin (NGAL) was shown to predict AKI development earlier than serum creatinine. Some studies demonstrated the predictive role of post-operative serum uric acid (SUA) as an early marker of AKI. We aimed to study the role of serum and urine NGAL as well as SUA to predict progression of AKI.This is a prospective observational study of patients undergoing cardiac surgery. Blood and urine samples for measurement of uric acid, serum and urine NGAL levels were collected prior to cardiac surgery (0 h), and in the time course at 2nd and 24th hours after surgery. Patients who developed AKI were divided into two subgroups as progressing and non-progressing AKI.Sixty patients (42 males, 18 females) were included. After cardiac surgery, 40 patients developed AKI, 20 of whom non-progressing AKI, and 20 progressing AKI. All of the markers significantly increased in AKI patients. A receiver operator characteristics (ROC) curve analysis showed higher predictive ability of SUA for progressing AKI compared with serum and urine NGAL. When compared markers obtained at the second hour after surgery, UA had significantly large AUC than NGAL to predict AKI developed at 24 and 48 h, particularly in patients, who require renal replacement therapy (RRT).Uric acid seems to predict the progression of AKI and RRT requirement in patients underwent cardiac surgery better than NGAL.
- Published
- 2014
30. The 2-year follow-up results of lyso-GB3 levels in patients with Fabry disease
- Author
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Kultigin Turkmen, Ismail Baloglu, Nedim Yilmaz Selcuk, and Halil Zeki Tonbul
- Subjects
medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,Urology ,Follow up results ,Lyso gb3 ,medicine.disease ,Biochemistry ,Fabry disease ,Endocrinology ,Genetics ,Medicine ,In patient ,business ,Molecular Biology - Published
- 2018
31. The relationship between neutrophil-to-lymphocyte ratio and vascular calcification in end-stage renal disease patients
- Author
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Kultigin Turkmen, Fatih Mehmet Erdur, Emin Murat Akbas, Halil Zeki Tonbul, Adalet Ozcicek, and Fatih Ozcicek
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,fungi ,Inflammation ,Hematology ,Disease ,Stepwise regression ,medicine.disease ,End stage renal disease ,Surgery ,Peritoneal dialysis ,Nephrology ,Internal medicine ,cardiovascular system ,medicine ,Cardiology ,cardiovascular diseases ,Hemodialysis ,Neutrophil to lymphocyte ratio ,medicine.symptom ,business ,Calcification - Abstract
Chronic inflammation was found to be correlated with coronary (CAC) and thoracic peri-aortic calcification (TAC) in end-stage renal disease (ESRD) patients. Neutrophil-to-lymphocyte ratio (NLR) was introduced as a potential marker to determine inflammation in cardiac and noncardiac disorders. Data regarding NLR and its association with TAC and CAC are lacking. We aimed to determine the relationship between NLR and vascular calcification in ESRD patients. This was a cross-sectional study involving 56 ESRD patients (22 females, 34 males; mean age, 49.9 ± 14.2 years) receiving peritoneal dialysis or hemodialysis for ≥6 months in the Dialysis Unit of Necmettin Erbakan University. TAC and CAC scores were measured by using an electrocardiogram-gated 64-multidetector computed tomography. NLR was calculated as the ratio of the neutrophils and lymphocytes. There was a statistically significant correlation between NLR, TACS and CACS in ESRD patients (r = 0.43, P = 0.001 and r = 0.30, P = 0.02, respectively). The stepwise linear regression analysis revealed that age, as well as NLR were independent predictors of TACS. However, increased age was the only independent predictor of CACS according to linear regression analysis. Simple calculation of NLR can predict vascular calcification in ESRD patients.
- Published
- 2013
32. Renal Transplant Results of the Organ Transplant Center of Meram Medical School between 2003-2011
- Author
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Mehdi Yeksan, Ahmet Tekin, Suleyman Turk, Şakir Tavli, Abduzhappar Gaipov, Kultigin Turkmen, Halil Zeki Tonbul, Nedim Yilmaz Selcuk, Bayram Çolak, Mehmet Erikoglu, and Fatih Mehmet Erdur
- Subjects
Creatinine ,medicine.medical_specialty ,business.industry ,medicine.drug_class ,Urology ,medicine.medical_treatment ,Medical record ,medicine.disease ,Tacrolimus ,Delayed Graft Function ,Surgery ,Transplantation ,chemistry.chemical_compound ,chemistry ,Chronic allograft nephropathy ,Medicine ,Corticosteroid ,business ,Dialysis - Abstract
OBJECTiVE: Renal transplantation (RTx) is the best therapeutic modality for end-stage renal disease patients. We report 8 years single-centre experience on cadaveric and living donor RTx in terms of demographic features along with graft functions, posttransplant medical complications, patients-graft survivals. maTERial and mETHOdS: We enrolled 66 RTx (female/male: 36/30) patients including 40 cadaveric and 26 living donors. At admission age, gender, causes of renal failure, dialysis typeduration, type of RTx, induction and maintenance immunosuppressive modalities, rejection episodes, biochemistry-hemogram parameters at 1, 6, 12, 24 and 60 months after transplantation and medical complications were obtained from the medical records. RESulTS: Mean recipient age was 41±11.6 years. Mean transplant duration was 32.2±31.4 months, and the mean creatinine values was 1.4±0.9 mg/dl. The most commonly used immunosuppressive protocol was corticosteroid+tacrolimus+mycophenolate mofetil. Delayed graft function, chronic allograft nephropathy and acute rejection were observed in 27.3%, 25.7% and 13.6% of patients, respectively. 1and 5-year patient survival rates were 100% and 100% for living donor patients and doi: 10.5262/tndt.2013.1001.05 Yazisma Adresi: Kultigin TURKmEn Erzincan Universitesi Mengucek Gazi Egitim ve Arastirma Hastanesi, Nefroloji Bolumu, Erzincan, Turkiye Phone : +90 446 212 21 12 E-mail : mdkt2010@yahoo.com Gelis Tarihi : 01.07.2012 Kabul Tarihi : 03.08.2012
- Published
- 2013
33. Assessment of abdominal aortic calcification at different stages of chronic kidney disease
- Author
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Nedim Yilmaz Selcuk, Halil Zeki Tonbul, Melih Anil, Mehmet Uyar, and Zeynep Biyik
- Subjects
Nephrology ,Adult ,Male ,medicine.medical_specialty ,Turkey ,Urology ,medicine.medical_treatment ,Radiography ,030232 urology & nephrology ,Aortic Diseases ,Disease ,030204 cardiovascular system & hematology ,Severity of Illness Index ,03 medical and health sciences ,0302 clinical medicine ,Lumbar ,Renal Dialysis ,Risk Factors ,medicine.artery ,Internal medicine ,medicine ,Prevalence ,Humans ,Aorta, Abdominal ,Renal Insufficiency, Chronic ,Vascular Calcification ,Aged ,Aorta ,business.industry ,Abdominal aorta ,Middle Aged ,medicine.disease ,Cross-Sectional Studies ,Cardiology ,Female ,Hemodialysis ,Radiology ,business ,Kidney disease - Abstract
Vascular calcifications that may cause cardiovascular disease are highly prevalent in chronic kidney disease (CKD). In this study, we aimed to determine abdominal aorta calcifications (AAC) in predialysis and hemodialysis patients by lateral lumbar radiography and to investigate factors that were associated with the calcifications.Two hundred and fifty-nine adult chronic hemodialysis patients, 300 predialysis CKD patients and 60 healthy subjects with normal kidney function as a control group were enrolled in the study. Lateral lumbar radiography was used to measure AAC. Calcified deposits of the abdominal aorta wall at the level of the first through fourth lumbar vertebrae were graded by a 24-point scoring system.AAC prevalence (AAC score ≥1) was significantly different in hemodialysis, predialysis and control groups (71.8, 45.7 and 33.3 %, respectively; p 0.001). AAC prevalence in CKD stages 1, 2, 3, 4 and 5 predialysis patients was 26.6, 43.3, 40, 58.3 and 55 %, respectively. AAC scores of the hemodialysis group were higher than of the predialysis group (p 0.001) and the control group (p 0.001). AAC scores of the predialysis group were not higher than of the control group (p = 0.314). AAC scores of the hemodialysis group were significantly higher than of the control group (p 0.001) and stage 1 (p 0.001), stage 2 (p = 0.001) and stage 3 predialysis groups (p = 0.002). Age (p 0.001), presence of diabetes mellitus (p 0.001) and serum phosphorus levels (p = 0.011) were found to be independent predictors of calcification in the hemodialysis group. Age (p 0.001), serum phosphorus levels (p = 0.007) and history of cardiovascular disease (p = 0.014) were found to be independent predictors of calcification in the predialysis group.Abdominal aortic calcification is highly prevalent in the hemodialysis population. Strict phosphorus control should be implemented to the predialysis and hemodialysis patients.
- Published
- 2016
34. Peri-aortic fat tissue and malnutrition–inflammation–atherosclerosis/calcification syndrome in end-stage renal disease patients
- Author
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Abduzhappar Gaipov, Halil Zeki Tonbul, Suleyman Turk, Hatice Kayikcioglu, Adrian Covic, Ibrahim Guney, Fatih Mehmet Erdur, Orhan Ozbek, Lutfullah Altintepe, Mümtaz Yilmaz, Kultigin Turkmen, and Mehmet Kanbay
- Subjects
Male ,Nephrology ,medicine.medical_specialty ,Pathology ,Turkey ,Urology ,medicine.medical_treatment ,Population ,Aortic Diseases ,Gastroenterology ,End stage renal disease ,Peritoneal dialysis ,chemistry.chemical_compound ,Renal Dialysis ,Risk Factors ,Internal medicine ,medicine.artery ,Multidetector Computed Tomography ,medicine ,Humans ,education ,Retrospective Studies ,Inflammation ,Aorta ,education.field_of_study ,business.industry ,Incidence ,Malnutrition ,Calcinosis ,Middle Aged ,respiratory system ,Atherosclerosis ,medicine.disease ,respiratory tract diseases ,C-Reactive Protein ,Cross-Sectional Studies ,Adipose Tissue ,chemistry ,Kidney Failure, Chronic ,Uric acid ,Female ,Hemodialysis ,business ,Follow-Up Studies ,Calcification - Abstract
Thoracic peri-aortic fat tissue (PFT) is considered as a metabolically active organ in atherosclerosis. Malnutrition, inflammation and atherosclerosis/calcification (MIAC) are the most commonly encountered risk factors of cardiovascular disease in end-stage renal disease (ESRD) patients. Calcification of the aorta was found to be an important cardiovascular risk marker predicting future events, morbidity and mortality in this population. We aimed to investigate the relationship between PFT, MIAC syndrome and thoracic aortic calcification (TAC) in ESRD patients.Seventy-nine ESRD patients receiving hemodialysis (HD) or peritoneal dialysis (PD) and 20 control subjects were enrolled in this cross-sectional study. PFT and TAC were assessed using a 64-MDCT scanner. Patients with serum albumin3.5 g/dL were defined as patients with malnutrition; those with serum C-reactive protein level10 mg/L had inflammation, and those with coronary artery calcification score (CACS)10 had atherosclerosis/calcification.TAC and PFT were significantly higher in ESRD patients compared with control subjects. There was a statistically significant relationship between PFT and TAC in ESRD patients (r = 0.458, p0.0001). PFT was found to be significantly increased when the MIAC components increased. PFT was positively associated with age, BMI, uric acid, hemoglobin and CAC. The multivariate analysis revealed that age and uric acid were independent predictors of increased PFT. Twenty-four (30.4 %) patients had none, 30 (37.9 %) had one component, 17 (21.5 %) had two components, and 8 (10.2 %) had all MIAC components. PFT was highest among patients having all three components (28.6 cm(3)) and lowest among those who do not have the MIAC syndrome (8.54 cm(3)). TAC was highest among patients having all three components (179.2 HU) and lowest among those who do not have the MIAC syndrome (0 HU).We found a relationship between PFT and MIAC syndrome in ESRD patients.
- Published
- 2012
35. The Relationship Between Bone Mineral Densitometry and Vascular Calcification in Peritoneal Dialysis Patients
- Author
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Orhan Ozbek, Kultigin Turkmen, Fatih Mehmet Erdur, Halil Zeki Tonbul, Hatice Kayikcioglu, and Mustafa Saglam
- Subjects
medicine.medical_specialty ,Bone mineral densitometry ,business.industry ,Urology ,medicine.medical_treatment ,Significant difference ,nutritional and metabolic diseases ,Multi slice ,Peritoneal dialysis ,Coronary artery calcification ,Medicine ,Surgery ,Femur ,In patient ,business ,Vascular calcification - Abstract
ObJEcTIVE: Vascular calcification (VC) and disturbed bone mineral metabolism (BMM) are commonly seen in patients with end-stage renal disease (ESRD). Fetuin-A has been found to be significantly low in ESRD patients. The aim of our study was to investigate the relation between coronary artery calcification, BMM and fetuin-A in peritoneal dialysis (PD) patients. MATERIAl and METHODS: 46 PD (M/F=28/18) patients were included in the study. Coronary artery calcification scoring (CACS) was performed by multi slice computed tomography. The patients were divided into 4 groups according to their CACS values as Group 1 (CACS: 0), Group 2 (CACS:199), Group 3 (CACS:100-399) and Group 4 (CACS: ≥400). Serum levels of fetuin-A were measured. Bone mineral densitometry was measured by dual energy X-ray absorptiometer (DEXA). RESUlTS: There was a statistically significant difference difference between CACS and femur T scores in PD patients. Femur T scores were found to be decreased while CACS values are increased. We could not find any differences in terms of CACS when we separated patients according to T scores greater or lower than -2. Osteopenic patients were found to be older and they also had low fetuin-A levels. cOnclUSIOn: We found an important relationship between CACS and bone mineralization in PD patients. KEy wORDS: Peritoneal dialysis, Vascular calcification, Bone mineral densitometry doi: 10.5262/tndt.2012.1003.07 Yazisma Adresi: Kultigin Turkmen Selcuk Universitesi Meram Tip Fakultesi, Nefroloji Bilim Dali, Konya, Turkiye Gsm : 0 538 492 78 77 E-posta : mdkt2010@yahoo.com Gelis Tarihi : 22.12.2011 Kabul Tarihi : 13.01.2012
- Published
- 2012
36. Plasma 9-cis,11-trans ve 10-trans, 12-cis Conjugated Linoleic Acid Isomers Levels in Continuous Ambulatory Peritoneal Dialysis Patients
- Author
-
Sevil Kurban, Halil Zeki Tonbul, Fatma Humeyra Yerlikaya, and Idris Mehmetoglu
- Subjects
chemistry.chemical_classification ,medicine.medical_specialty ,business.industry ,Urology ,medicine.medical_treatment ,Linoleic acid ,Conjugated linoleic acid ,Continuous ambulatory peritoneal dialysis ,Peritoneal dialysis ,End stage renal disease ,Transplantation ,chemistry.chemical_compound ,Endocrinology ,Essential fatty acid ,chemistry ,Internal medicine ,medicine ,Surgery ,business ,Dialysis - Abstract
ObJectIVe: Peritoneal dialysis is a renal replacement therapy in patients with end stage renal disease. Conjugated linoleic acid (CLA) refers to a class of positional and geometric conjugated isomers of the omega-6 essential fatty acid, linoleic acid. This study aimed to investigate biologically active isomers of CLA (10-trans, 12-cis CLA and -9-cis,11-trans CLA) and the relationship between these fatty acids and weight, body mass index (BMI), C-reactive protein (CRP) and parathyroid hormone (PTH) in continuous ambulatory peritoneal dialysis patients (CAPD) and healthy subjects. MAterIAl and MetHODS: This study was performed on 51 (21M, 30F) CAPD patients at least 6 months under dialysis, aged 20-75 years and 45 (25M, 20F) healthy control subjects aged 20-60 years. Plasma 10-trans, 12-cis CLA (t10,c12 CLA) and 9-cis,11-trans CLA (c9,t11 CLA) levels were measured by GS-MS technique. reSultS: t10,c12 and c9,t11 isomers of CLA levels of the CAPD patients were as follows: 11.84 ± 5.3 and 8.34 ± 4.4 mg/L respectively. The same parameters of the controls were as follows: 12.88 ± 4.1 and 9.20 ± 4.5 mg/L, respectively. The differences between plasma CLA isomers levels of CAPD doi: 10.5262/tndt.2012.1003.08 Yazisma Adresi: Fatma Humeyra YerlikAYA Necmettin Erbakan Universitesi, Meram Tip Fakultesi, Biyokimya Anabilim Dali, Konya, Turkiye Gsm : 0 505 466 42 31 E-posta : fhumeyray@hotmail.com Gelis Tarihi : 21.10.2011 Kabul Tarihi : 27.11.2011 Yerlikaya FH ve ark: Surekli Ayaktan Periton Diyalizi Hastalarinda Plazma 9-cis, 11-trans ve 10-trans, 12-cis Konjuge Linoleik Asit Izomerleri Duzeyleri 248 turk nefroloji Diyaliz ve transplantasyon Dergisi Turkish Nephrology, Dialysis and Transplantation Journal Turk Neph Dial Transpl 2012; 21 (3): 247-252 periton diyalizi (SAPD) hastalarinda ve saglikli kisilerde bu yag asit duzeylerini karsilastiran ve vucut kitle indeksi (VKI), C-reaktif protein (CRP) ve PTH ile iliskisini arastiran herhangi bir calismaya rastlanilmamistir. Biz bu calismada, SAPD hastalarinda ve saglikli kisilerde plazma c9,t11 KLA ve t10,c12 KLA izomerleri duzeylerini ve bu yag asitleri ile kilo, VKI, CRP, PTH arasindaki iliskiyi arastirmayi amacladik.
- Published
- 2012
37. Relationship Between Fetuin-A, Inflammation, Coronary Artery Calcification in Hemodialysis and Peritoneal Dialysis Patients
- Author
-
Kultigin Turkmen, Aysun Toker, Orhan Ozbek, Fatma Humeyra Yerlikaya, Hatice Kayikcioglu, Halil Zeki Tonbul, and Abduzhappar Gaipov
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,medicine.medical_treatment ,Inflammation ,Disease ,urologic and male genital diseases ,Fetuin ,Peritoneal dialysis ,Coronary artery calcification ,Internal medicine ,Cardiology ,Medicine ,Surgery ,In patient ,Hemodialysis ,medicine.symptom ,business ,Vascular calcification - Abstract
OBJeCTIve: Vascular calcification is commonly seen in patients with end-stage renal disease (ESRD). Fetuin-A has been found to be a vascular calcification inhibitor and its level is significantly low in ESRD patients. The aim of our study was to investigate the relation between coronary artery calcification, inflammation and fetuin-A levels in peritoneal dialysis (PD) and hemodialysis (HD) patients.
- Published
- 2012
38. Paid Living-Unrelated Renal Transplantation Abroad: Too Much Unknown
- Author
-
Kultigin Turkmen, Mehmet Erikoğlu, Ibrahim Guney, Halil Zeki Tonbul, Suleyman Turk, and Yalcin Solak
- Subjects
Deceased donor kidney ,Age and gender ,Transplantation ,Pediatrics ,medicine.medical_specialty ,surgical procedures, operative ,business.industry ,Urology ,medicine ,Surgery ,Disease ,business - Abstract
ObjecTIve: Despite the unethical characteristic and unfavorable consequences, paid livingunrelated renal transplantation is still considered as an option for end-stage renal disease patients. This study aimed to compare the medical and surgical complications along with allograft functions of PLURT patients with age and gender matched transplant recipients who received a living or deceased donor kidney at our center.
- Published
- 2012
39. Clinical Nephrology - Epidemiology I
- Author
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Edward R Smith, Harin Rhee, Luciano De Paola, Martin L Ford, Piergiorgio Messa, Evgenios Dafnis, Knud Rasmusen, Spencer Andrew, Chi-Chih Hung, Yalcin Solak, Lison Dominique, Hilmi Umut Unal, Paul Mitchell, Kunihiro Yamagata, Konstantinos Sombolos, Luigi Russo, Zeynep Biyik, Eva Maria Wiberg, Takayuki Hamano, Ryohei Yamamoto, Sebastjan Bevc, Chakravarthi Rajkumar, Masahiro Kikuya, Chao-Yu Guo, Zdravko Kraev, Anna Koteva, Masaaki Nakayama, Fabio Manfredini, Haruhisa Hoshi, Vassilios Vargiemezis, Takuo Hirose, Sang Heon Song, Yasuyuki Nagasawa, Laurie A. Tomlinson, Francesco Rapisarda, Mani Khorsand Askari, Rajiv Agarwal, Chun-Yu Yen, Ragai Fouda, Davide Bolignano, Hung-Chen Chen, Pavlos Nikolaidis, Yoshifumi Ubara, Miroslav Tisljar, Mutlu Saglam, Chang Seong Kim, Luca De Nicola, Kayser Caglar, Adamasco Cupisti, Tsuyoshi Watanabe, Luigi Catizone, Anatoliy Gozhenko, Boletis John, Antonio Bellasi, Kouji Arase, Biagio Di Iorio, Silvio V. Bertoli, Hsiao-Han Wang, Atsuhiro Kanno, Georgi Mihaylov, Sankar D. Navaneethan, Alberto Forteza, D'haese Patrick, Hambach Ramona, Hoda Shabpirai, Mei-Li Yang, Jasenka Crnjakovic Palmovic, Taku Obara, Breda Pečovnik Balon, Soo Wan Kim, Manuel-Y.-Keenoy Begona, Edgar Almeida, Marinella Ruospo, Kunitoshi Iseki, Daniel Robinson, Jie Jin Wang, António Sampaio, Antonio Barillà, Letizia Gargano, Renato Rapanà, Danica Galešić Ljubanović, Graziella D'Arrigo, Stefania Rastelli, Jacobs Jeffrey, Ivica Horvatić, Dominique Charmot, Catarina Teixeira, Soo-Bong Lee, Seong Kwon Ma, Jose Cortina, Carmine Zoccali, Manuel Praga, Azusa Hara, Chikako Nakano, Sheren Salah, Kentaro Tanaka, Toshiki Moriyama, Francesca Mallamaci, Van Sprundel Marc, Stephan B. Felix, Matthias Hellberg, Stela Bulimbasic, Tsuneo Konta, Konstantinos Siamopoulos, Petar Shikov, Saeid Abdi, Eduardo Gutiérrez, Arturo Evangelista, Peter Höglund, Luigi Lombardi, Nikan Zerafatjou, Mohammed Salem, Ole Simonsen, Dina Alsayed, Enrique Morales, Yutaka Imai, Wei-Ming Wang, Suetonia C. Palmer, Hassan Ghasemi, Violeta Sánchez, Hiroshi Tsuji, Samuel Iff, Henry Völzke, Il Young Kim, Kazuhisa Amaka, Mariacristina Vecchio, Kazuhiko Tsuruya, Naohiko Fujii, Marcello Tonelli, Shiho Terata, Dimitrios Vlahakos, Ihor Mysula, Wong Germaine, Benjamin Dvorsak, Mahmut Ilker Yilmaz, Halil Yaman, Mário Raimundo, Jeong Woo Park, Giorgia De Berardis, Alessandro Zuccalà, Eun Hui Bae, Naomi Clyne, Friedlinde Ernst, Michihiro Satoh, Takanao Hashimoto, Isao Matsui, Gaetano Lucisano, Christos Argyropoulos, Kazunori Inoue, Te-Hui Kuo, Joon Seok Choi, Sebastiano Cutrupi, Hiroshi Satoh, Ryusuke Inoue, Hirohito Metoki, Giovanni Tripepi, Giovanni F.M. Strippoli, Halil Zeki Tonbul, Ming-Fei Liu, Francis B. Gabbai, Miguel Leal, François Guido, Tina Stropnik Galuf, Jonathan C. Craig, Akihiro Shimomura, Ulrich John, Dong Won Lee, Vincenzo Bellizzi, Ihm-Soo Kwak, Lawrence P. McMahon, Radovan Hojs, M. Paz Sanz, Valeria Saglimbene, Belén Redal-Baigorri, Eun-Young Seong, Stephen G Holt, Robert Ekart, Dawlat Belal, Raab Michael, Yasser M Abdelhamid, Hideaki Yoshida, Takayoshi Ohkubo, Roberto Minutolo, Konstantinos Xynos, Graziella Bonanno, Shigeko Hara, Carmela Marino, Christian Schwahn, Kazuhito Totsune, Shang-Jyh Hwang, Patrizia Pizzini, James G. Heaf, Hakki Cetinkaya, Carlota Lavinas, Martina Ferreira, Daniele Ciurlino, Wei-Hung Lin, Fabrizio Fabrizi, Hamdy Ahmed, Fabio Pellegrini, Antonio Costa, Andrea Pota, Yukiko Ohmoto, Abduzhappar Gaipov, Nina Hojs, Reza Afshar, Felice Nappi, Hiromi Rakugi, Ming-Cheng Wang, Kei Asayama, Christos Iatrou, Krešimir Galešić, Yoshitsugu Obi, Borka Bozic, Stefan Krivoshiev, Oleksandr Susla, Cecília Teixeira, Droste Jos, Ali Davati, Domenico Russo, Yoshitaka Isaka, Suleyman Turk, Inês Henriques, Koichi Asahi, Toshihiro Ishigami, Maurizio Postorino, Giuseppe Conte, Cristina Nogueira, Satoshi Mikami, Jasna Bacalja, Mahmut Gok, Deng-Chi Yang, Sylvia Stracke, Rosenbaum David, Giorgio Fuiano, Shouichi Fujimoto, De Schryver Antoon, Dimitrios Tsakiris, Raquel Bellot, Hiroshi Sato, and Pasquale Fatuzzo
- Subjects
Transplantation ,medicine.medical_specialty ,Nephrology ,business.industry ,Epidemiology ,medicine ,Clinical nephrology ,Intensive care medicine ,business - Published
- 2012
40. Effects of secondary amyloidosis on arteriovenous hemodialysis fistula outcomes and intradialytic hypotension: A case-control study
- Author
-
Niyazi Gormus, Halil Zeki Tonbul, Yalcin Solak, Kultigin Turkmen, Memduh Caymaz, and Orhan Ozbek
- Subjects
medicine.medical_specialty ,business.industry ,Fistula ,medicine.medical_treatment ,Amyloidosis ,Diastole ,Arteriovenous fistula ,Hematology ,medicine.disease ,Thrombosis ,Surgery ,Blood pressure ,Nephrology ,Internal medicine ,medicine ,Cardiology ,Secondary systemic amyloidosis ,Hemodialysis ,business - 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
41. Health-related qualıty of lıfe, sleep qualıty, and depressıon in peritoneal dialysis and hemodıalysıs patıents
- Author
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Yalcin Solak, Kultigin Turkmen, Ibrahim Guney, Lutfullah Altintepe, Mehdi Yeksan, Raziye Yazici, and Halil Zeki Tonbul
- Subjects
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
42. Vascular Calcifi cation in Chronic Kidney Disease
- Author
-
Kultigin Turkmen and Halil Zeki Tonbul
- Subjects
Pathology ,medicine.medical_specialty ,business.industry ,Urology ,Medicine ,Surgery ,business ,medicine.disease ,Kidney disease - Published
- 2010
43. The Relationship between Oxidative Stress and Coronary Artery Calcification in Patients Undergoing Peritoneal Dialysis or Hemodialysis
- Author
-
Orhan Ozbek, Suleyman Turk, Fatih Mehmet Erdur, Kultigin Turkmen, Aysun Toker, Fatih Ozcicek, Hatice Kayikcioglu, and Halil Zeki Tonbul
- Subjects
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
44. Dyslipidemia in Dialysis
- Author
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Yalcin Solak and Halil Zeki Tonbul
- Subjects
medicine.medical_specialty ,education.field_of_study ,Statin ,medicine.diagnostic_test ,business.industry ,medicine.drug_class ,medicine.medical_treatment ,Population ,medicine.disease ,Peritoneal dialysis ,Internal medicine ,medicine ,Hemodialysis ,business ,education ,Lipid profile ,Dyslipidemia ,Dialysis ,Cause of death - Abstract
Cardiovascular (CV) disease is the leading cause of death in dialysis patients. Traditional CV risk factors aggregate in this population as well as an abundance of novel risk factors unique to dialysis population. Dyslipidemia is related to increased CV risk in the general population. However, recent randomized trials showed no clear benefit of treating dyslipidemia in hemodialysis patients with a statin. Several hypotheses have been put forward to account for these discouraging results, including differences in atherosclerotic plaque composition, qualitative and quantitative changes in lipid profiles of hemodialysis patients, and increased frequency of sudden deaths in this population, among others. Dialysis mode, namely HD or peritoneal dialysis (PD), also lead to some particular changes in the lipid and lipoprotein profiles. PD patients generally have a more atherogenic lipid profile compared with their HD counterparts. Modifications in some parameters of HD or PD along with pharmacologic therapy, mainly statins, constitute the current therapeutic armamentarium against dyslipidemia in dialysis patients. Future randomized controlled trials taking into account the particular characteristics of dialysis dyslipidemia are needed for evidence-based answers in this currently controversial topic.
- Published
- 2014
45. Cost of Paid Transplantation Abroad: Possible Donor-Origin Early Multiple Myeloma in a Renal Transplant Recipient Treated Using Bortezomib
- Author
-
Melih Anil, Yalcin Solak, Halil Zeki Tonbul, Huseyin Atalay, and I. Aydogdu
- Subjects
Male ,Oncology ,medicine.medical_specialty ,Population ,immune system diseases ,hemic and lymphatic diseases ,Internal medicine ,medicine ,Humans ,education ,Dexamethasone ,Multiple myeloma ,Transplantation ,education.field_of_study ,Bortezomib ,business.industry ,Cancer ,Middle Aged ,medicine.disease ,Kidney Transplantation ,Lymphoproliferative Disorders ,Tissue Donors ,Surgery ,Lymphoma ,surgical procedures, operative ,Proteasome inhibitor ,Egypt ,Multiple Myeloma ,business ,medicine.drug - Abstract
The incidence of cancer is greater in transplant recipients compared with the general population. Posttransplantation lymphoproliferative disorder (PTLD) is the second most common cancer in these patients. Non-Hodgkin lymphoma is most commonly observed, and multiple myeloma (PTLD-MM) accounts for less than 4% of PTLDs. Most reported PTLD-MM is of recipient origin, and to date, few cases of donor-origin PTLD-MM have been reported. Bortezomib is a protease inhibitor that has been used successfully to treat multiple myeloma. Herein, we describe the case of a patient in whom multiple myeloma developed shortly after paid living-unrelated renal transplantation performed abroad (in Egypt). The patient had no apparent risk factors for PTLD-MM. Thus, it was supposed that PTLD-MM was of donor origin, considering its early development, lack of recipient risk factors, and no available donor medical status. To our knowledge, this report is the first to describe the use of bortezomib in this setting. Although bortezomib plus dexamethasone therapy resulted in hematologic remission, the patient remained dialysis-dependent.
- Published
- 2010
46. A hepatitis C-positive patient with new onset of nephrotic syndrome and systemic amyloidosis secondary to common variable immunodeficiency
- Author
-
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
47. FREQUENCY AND OUTCOME OF PATIENTS WITH ACUTE RENAL FAILURE HAVE MORE CAUSES THAN ONE IN ETIOLOGY
- Author
-
N. Yilmaz Selçuk, Nedim Yilmaz Selçuk, Ali Riza Odabas, Ramazan Çetinkaya, Halil Zeki Tonbul, and Ayla San
- Subjects
Adult ,Male ,medicine.medical_specialty ,Kidney Function Tests ,Critical Care and Intensive Care Medicine ,Gastroenterology ,Renal Dialysis ,Risk Factors ,Oliguria ,Internal medicine ,Epidemiology ,medicine ,Humans ,Prospective Studies ,Aged ,Chi-Square Distribution ,business.industry ,Septic shock ,Incidence ,Incidence (epidemiology) ,General Medicine ,Acute Kidney Injury ,Middle Aged ,Prognosis ,medicine.disease ,Survival Analysis ,Surgery ,Diarrhea ,Nephrology ,Etiology ,Female ,Anuria ,medicine.symptom ,business ,Kidney disease - Abstract
In literature, there was little data about frequency and outcome of ARF with two or more causes in etiology. Therefore, the aim of this study was to search this issue. This series included 339 patients with ARF from Jan 1,1987 to Jan 1,1999. Fourty-six (30 males) of all patients (13.5%) had two or more causes in etiology of ARF. Of these patients, causes were prerenal and renal in 26 (56%), prerenal, renal and postrenal in 12 (26%), renal and postrenal in 4 (9%), and prerenal and postrenal in 4 (9%). The most frequent cause is diarrhea and vomiting in prerenal, gentamycin usage in renal and prostate hypertrophy in postrenal. Of these patients, there was oliguria in 32 (70%), anuria in 8 (17%) and non-oliguria in 6 (13%). Treatment modalities of patients was only medical in 19 (41%), dialysis in addition to medical therapy in 27 (59%). In spite of treatment, 5 (10.8) of patients with two or more causes in etiology died. Causes of death were uremic coma in 2, cardiac disorders in 2 and septic shock in 1. Three (11.2%) of other patients with one cause died. Mortality rates were not different (chi2: 0.0298, p0.5). Cortical necrosis was diagnosed in one patient with multiple etiology and 2 of other patients. Finally, frequency of ARF with two or more etiologic causes was 13.5%, and most frequent causes were hypovolemia and nephrotoxic drugs. Outcome of these patients was similar to other patients with one cause.
- Published
- 2000
48. OUTCOME OF PREGNANCIES WITH HELLP SYNDROME COMPLICATED BY ACUTE RENAL FAILURE (1989–1999)
- Author
-
Nedim Yilmaz Selcuk, Ramazan Cetinkaya, Ali Riza Odabas, San A, and Halil Zeki Tonbul
- Subjects
Adult ,HELLP Syndrome ,Pediatrics ,medicine.medical_specialty ,Adolescent ,HELLP syndrome ,Pregnancy, High-Risk ,medicine.medical_treatment ,Comorbidity ,Critical Care and Intensive Care Medicine ,Severity of Illness Index ,Statistics, Nonparametric ,symbols.namesake ,Pregnancy ,Renal Dialysis ,Infant Mortality ,Prevalence ,Humans ,Medicine ,reproductive and urinary physiology ,Dialysis ,Fisher's exact test ,Probability ,Coma ,Eclampsia ,business.industry ,Stupor ,Infant, Newborn ,Pregnancy Outcome ,General Medicine ,Acute Kidney Injury ,medicine.disease ,Surgery ,Pregnancy Complications ,Maternal Mortality ,Nephrology ,symbols ,Female ,medicine.symptom ,business ,Complication - Abstract
HELLP syndrome, a syndrome of hemolysis, elevated liver enzymes and low platelets may occur in pregnancy with pre-eclampsia/eclampsia, and its a significant complication is acute renal failure (ARF). The aim of study was to determine frequency and outcome of HELLP syndrome complicated by ARF. Thirty-nine patients with pregnancy-related ARF were treated between Jan 1, 1989 and Jan 1, 1999. In these patients, the most frequent causes were HELLP syndrome (n = 14; 36%), postpartum hemorrhage (n = 10; 26%), pre-eclampsia/eclampsia (n = 6; 15%) and abruptio placenta (n = 4; 10%). Seven of the patients with HELLP syndrome had impairment of consciousness during hospitalization. Of these patients, coma in 5, stupor in 1, confusion in 1 were diagnosed. Twelve of the patients with HELLP syndrome and 14 of the other patients were treated by dialysis. Mann-Whitney U test and chi2 test(corrected by Yates and Fisher exact) were used for statistical analysis. Although serious clinical findings, with supportive treatment, 12 patients with HELLP syndrome and 21 other patients were fully recovered. One patient both with and without HELLP syndrome could not recovered due to diffuse cortical necrosis. Moreover, one patient with HELLP syndrome and 3 other patients were died. Mortality rate of the patients with HELLP syndrome was not found different from those of the other patients (p = 0.544). The causes of death were cerebral hemorrhage in patient with HELLP syndrome and disseminated intravascular coagulation (n = 1), cerebral emboli (n = 1), adult respiratory distress syndrome (n = 1). Fetal death occurred in 4 patients with HELLP syndrome (28.5%) and 7 other patients (28%), and rates were similar (p0.5). Finally, HELLP syndrome was the most frequent cause leading to ARF in pregnancy and their prognosis was not different from those of the other patients.
- Published
- 2000
49. SP217IMPACT OF ON-PUMP CIRCULATION ON HEMOTOLOGIC PARAMETERS OF PATIENTS WITH ACUTE KIDNEY INJURY AFTER OPEN HEART SURGERY
- Author
-
Alper Kilicaslan, Mukhit Dossov, Ramazan Ucar, Yalcin Solak, Niyazi Gormus, Suleyman Turk, Mehmet Kayrak, Abduzhappar Gaipov, Halil Zeki Tonbul, and Fatih Pektas
- Subjects
Transplantation ,medicine.medical_specialty ,Nephrology ,business.industry ,Internal medicine ,medicine ,Acute kidney injury ,Cardiology ,Circulation (currency) ,medicine.disease ,business ,Surgery - Published
- 2015
50. FP760THE RESULTS OF THE QUESTIONNAIRE SURVEY OF QUALITY IN HEMODIALYSIS
- Author
-
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
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