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Aydın MF, Yıldız A, Oruç A, Aytaç Vuruşkan B, Akgür S, Ayar Y, Güllülü M, Dilek K, Yavuz M, Ortaç H, Ersoy A. Modified histopathological classification with age-related glomerulosclerosis for predicting kidney survival in ANCA-associated glomerulonephritis. Int Urol Nephrol 2023; 55:741-748. [PMID: 36153782 DOI: 10.1007/s11255-022-03371-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 07/25/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The histopathological classification of ANCA-GN divides patients into four groups based on signs of glomerular injury. However, this classification did not consider age-related glomerulosclerosis. In this study, we aimed to compare the prediction of renal survival between Berden's ANCA-GN histopathological classification and ANCA-GN histopathological classification modified with age-related glomerulosclerosis. METHODS Between January 2004 and December 2019, 65 patients diagnosed with ANCA-GN were enrolled. Demographic, laboratory, and histopathologic findings were retrospectively analyzed. Renal survival analyses were compared according to classical and modified ANCA-GN histopathological classifications. Multivariate Cox regression analysis for the factors affecting renal survival was performed. RESULTS In Berden's ANCA-GN histopathological classification, 15 patients were in the focal group, 21 in the crescentic, 21 in the sclerotic, and 8 in the mixed group. The ANCA-GN histopathological classification model generated statistically significant predictions for renal survival (p = 0.022). When the histopathological classification was modified with age-related glomerulosclerosis, eight of the nine patients previously classified in the sclerotic group were classified in the mixed and one in the crescentic groups. Modification of histopathological classification with age-related glomerulosclerosis increases the statistical significance in renal survival analysis (p = 0.009). The multivariate Cox regression analysis showed that the disease-related global sclerotic glomeruli percentage and serum creatinine level were significant independent factors. CONCLUSION Modification of Berden's ANCA-GN histopathological classification model with age-related glomerulosclerosis may increase the statistical significance of the histopathological classification model.
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Affiliation(s)
- Mehmet Fethullah Aydın
- Division of Nephrology, Faculty of Medicine, Bursa Uludağ University, 16059, Nilüfer, Bursa, Turkey.
| | - Abdülmecit Yıldız
- Division of Nephrology, Faculty of Medicine, Bursa Uludağ University, 16059, Nilüfer, Bursa, Turkey
| | - Ayşegül Oruç
- Division of Nephrology, Faculty of Medicine, Bursa Uludağ University, 16059, Nilüfer, Bursa, Turkey
| | - Berna Aytaç Vuruşkan
- Department of Pathology, Faculty of Medicine, Bursa Uludağ University, 16059, Nilüfer, Bursa, Turkey
| | - Suat Akgür
- Division of Nephrology, Kütahya Health Sciences University Evliya Çelebi Training and Research Hospital, Kütahya, Turkey
| | - Yavuz Ayar
- Division of Nephrology, Bursa City Hospital, Bursa, Turkey
| | - Mustafa Güllülü
- Division of Nephrology, Faculty of Medicine, Bursa Uludağ University, 16059, Nilüfer, Bursa, Turkey
| | - Kamil Dilek
- Division of Nephrology, Faculty of Medicine, Bursa Uludağ University, 16059, Nilüfer, Bursa, Turkey
| | - Mahmut Yavuz
- Division of Nephrology, Faculty of Medicine, Bursa Uludağ University, 16059, Nilüfer, Bursa, Turkey
| | - Hatice Ortaç
- Department of Biostatistics, Faculty of Medicine, Bursa Uludağ University, 16059, Nilüfer, Bursa, Turkey
| | - Alparslan Ersoy
- Division of Nephrology, Faculty of Medicine, Bursa Uludağ University, 16059, Nilüfer, Bursa, Turkey
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Aydın MF, Yıldız A, Oruç A, Sezen M, Dilek K, Güllülü M, Yavuz M, Ersoy A. Relapse of primary membranous nephropathy after inactivated SARS-CoV-2 virus vaccination. Kidney Int 2021; 100:464-465. [PMID: 33992674 PMCID: PMC8116315 DOI: 10.1016/j.kint.2021.05.001] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/06/2021] [Accepted: 05/06/2021] [Indexed: 02/07/2023]
Affiliation(s)
| | - Abdülmecit Yıldız
- Division of Nephrology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Ayşegül Oruç
- Division of Nephrology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Mehmet Sezen
- Division of Nephrology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Kamil Dilek
- Division of Nephrology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Mustafa Güllülü
- Division of Nephrology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Mahmut Yavuz
- Division of Nephrology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Alparslan Ersoy
- Division of Nephrology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
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Oruc A, Yildiz A, Akgur S, Aydin MF, Ersoy A, Yavuz M, Dilek K, Gullulu M. Screening for Fabry Disease in Patients Who Underwent Renal Biopsy and Identification of a Novel Mutation. Turk J Nephrol 2021. [DOI: 10.5152/turkjnephrol.2021.4709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Turkmen A, Sumnu A, Cebeci E, Yazici H, Eren N, Seyahi N, Dilek K, Dede F, Derici Ü, Unsal A, SAHIN G, Sipahioglu M, Gok M, Tatar E, Dursun B, Sipahi S, Yılmaz M, Suleymanlar G, Ulu MS, Gungor O, Kutlay S, Bicik Bahçebaşı Z, Sahin İ, Kurultak I, Turkmen K, Yilmaz Z, Turan Kazancioglu R, Cavdar C, Candan F, Aydin Z, Oygar D, Gul CB, Arici M, Paydas S, Guven Taymez D, Kucuk M, Trablus S, Turgutalp K, Koc L, Sezer S, Duranay M, Bardak S, Altintepe L, Arikan IH, Azak A, Odabas AR, Manga Sahin G, Ozturk S. P0501THE EPIDEMIOLOGICAL FEATURES OF PIRMARY GLOMERULAR DISEASES IN TURKEY: THE MULTICENTER STUDY OF TURKISH SOCIETY OF NEPHROLOGY GLOMERULAR DISEASES (TSN-GOLD) WORKING GROUP. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
The largest data on the epidemiology of primary glomerular diseases (PGD) are obtained from the databases of countries or centers. Here, we presented the extended results of the Primary Glomerular Diseases Study of the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD)Working Group.
Method
The data of patients who underwent renal biopsy and diagnosed as primary glomerular disease were recorded in the database prepared for the study. Between May 2009 and May 2019, a total of 4399 patients from 47 centers were evaluated. Basal data of 3875 patients were analyzed after exclusion of those lacking light microscopy and immunofluorescence findings.
Results
The mean age was 41.5 ± 14.9 years. Of the patients, 1690 were female (43.6%) and 2180 (56.3%) were male. Nephrotic syndrome was the most common biopsy indication (51.7%). This was followed by asymptomatic urinary abnormalities (18.3%) and nephritic syndrome (17.8%). The most common PGH was IgA nephropathy (25.7%), followed by membranous nephropathy (25.6%) and FSGS (21.9%). The mean total number of glomeruli per biopsy was 17 ± 10. Mean baseline systolic blood pressure was 130 ± 20 mmHg and diastolic blood pressure was 81 ± 12 mmHg. Median proteinuria was 3300 (IQR: 1467-6307) mg / day, mean serum creatinine, estimated GFR and albumin values were 1.4 ± 1.5 mg / dl, 80.7 ± 39.1 ml / min and 3.2 ± 0.9 g / dl, respectively.
Conclusion
In Turkey, the incidence of IgA nephropathy patients have become more common than membranous nephropathy among PGD patients diagnosed with renal biopsy.
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Affiliation(s)
- Aydin Turkmen
- Istanbul University, Istanbul Faculty of Medicine, Nephrology, Istanbul, Turkey
| | - Abdullah Sumnu
- Medipol University Medical Faculty, Medipol Mega Hospital, Nephrology, İstanbul, Turkey
| | - Egemen Cebeci
- Haseki Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Halil Yazici
- Istanbul University, Istanbul Faculty of Medicine, Nephrology, Istanbul
| | - Necmi Eren
- Kocaeli University Medical Faculty, Nephrology, Kocaeli, Turkey
| | - Nurhan Seyahi
- Istanbul University, Cerrahpasa Faculty of Medicine, Nephrology, Istanbul, Turkey
| | - Kamil Dilek
- Uludag University, Medical Faculty, Nephrology, Bursa, Turkey
| | - Fatih Dede
- Ankara Numune Training and Research Hospital, Nephrology, Ankara, Turkey
| | - Ülver Derici
- Gazi University Medical Faculty, Nephrology, Ankara, Turkey
| | - Abdulkadir Unsal
- Hamidiye Sisli Etfal Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Garip SAHIN
- Eskisehir Osmangazi University, Medical Faculty, Nephrology, Eskisehir, Turkey
| | - Murat Sipahioglu
- Erciyes University, Medical Faculty, Nephrology, Kayseri, Turkey
| | - Mahmut Gok
- Sultan Abdulhamit Han Research and Training Hospital, Nephrology, Istanbul, Turkey
| | - Erhan Tatar
- Bozyaka Training and Research Hospital, Nephrology, Izmır, Turkey
| | - Belda Dursun
- Pamukkale University, Medical Faculty, Nephrology, Denizli, Turkey
| | - Savaş Sipahi
- Sakarya University, Medical Faculty, Nephrology, Sakarya, Turkey
| | - Mürvet Yılmaz
- Bakirkoy Sadi Konuk Training and Research Hospital, Nephrology, Istanbul, Turkey
| | | | | | - Ozkan Gungor
- Sutcu İmam University, Medical Faculty, Nephrology, Kahramanmaras, Turkey
| | - Sim Kutlay
- Ankara University, Medical Faculty, İbni Sina Hospital, Nephrology, Ankara, Turkey
| | | | - İdris Sahin
- Inonu University, Medical Faculty, Nephrology, Malatya, Turkey
| | - Ilhan Kurultak
- Trakya University, Medical Faculty, Nephrology, Istanbul, Turkey
| | - Kultigin Turkmen
- Necmettin Erbakan University, Meram Medicine Faculty, Nephrology, Konya, Turkey
| | - Zulfikar Yilmaz
- Dicle University, Medical Faculty, Nephrology, Diyarbakir, Turkey
| | | | - Caner Cavdar
- Dokuz Eylul University, Medical Faculty, Nephrology, Izmir, Turkey
| | - Ferhan Candan
- Cumhuriyet University, Medical Faculty, Nephrology, Sivas, Turkey
| | - Zeki Aydin
- Darica Farabi Training and Research Hospital, Nephrology, Kocaeli, Turkey
| | - Deren Oygar
- Burhan Nalbantoglu State Hospital, Nephrology, Lefkosa, Cyprus
| | - Cuma Bulent Gul
- Bursa Yuksek Ihtisas Training and Research Hospital, Nephrology, Bursa, Turkey
| | - Mustafa Arici
- Hacettepe University, Medical Faculty, Nephrology, Ankara, Turkey
| | - Saime Paydas
- Cukurova University, Medical Faculty, Nephrology, Adana, Turkey
| | | | - Mehmet Kucuk
- Okmeydanı Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Sinan Trablus
- Istanbul Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Kenan Turgutalp
- Mersin University, Medical Faculty, Nephrology, Mersin, Turkey
| | - Leyla Koc
- Taksim Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Siren Sezer
- Atilim University, Medicana International Hospital, Nephrology, Ankara, Turkey
| | - Murat Duranay
- Ankara Training and Research Hospital, Nephrology, Ankara, Turkey
| | - Simge Bardak
- Batman State Hospital, Nephrology, Batman, Turkey
| | | | | | - Alper Azak
- Balikesir Training and Research Hospital, Nephrology, Balikesir, Turkey
| | - Ali Riza Odabas
- Medeniyet University Medical School, Goztepe Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Gulizar Manga Sahin
- Sultan Abdulhamit Han Research and Training Hospital, Nephrology, Istanbul, Turkey
| | - Savas Ozturk
- Haseki Training and Research Hospital, Nephrology, Istanbul, Turkey
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Oruc A, Ayar Y, Vuruskan BA, Yildiz A, Aktas N, Yavuz M, Gullulu M, Dilek K, Ersoy A. Hepatotoxicity associated with eculizumab in a patient with atypical hemolytic uremic syndrome. Nefrologia 2017; 38:448-450. [PMID: 29221881 DOI: 10.1016/j.nefro.2017.10.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 10/02/2017] [Accepted: 10/24/2017] [Indexed: 10/18/2022] Open
Affiliation(s)
- Aysegul Oruc
- Department of Internal Medicine, Division of Nephrology, Uludağ University Medical School, Bursa, Turkey.
| | - Yavuz Ayar
- Department of Internal Medicine, Division of Nephrology, Uludağ University Medical School, Bursa, Turkey
| | | | - Abdulmecit Yildiz
- Department of Internal Medicine, Division of Nephrology, Uludağ University Medical School, Bursa, Turkey
| | - Nimet Aktas
- Cekirge State Hospital, Department of Nephrology, Bursa, Turkey
| | - Mahmut Yavuz
- Department of Internal Medicine, Division of Nephrology, Uludağ University Medical School, Bursa, Turkey
| | - Mustafa Gullulu
- Department of Internal Medicine, Division of Nephrology, Uludağ University Medical School, Bursa, Turkey
| | - Kamil Dilek
- Department of Internal Medicine, Division of Nephrology, Uludağ University Medical School, Bursa, Turkey
| | - Alparslan Ersoy
- Department of Internal Medicine, Division of Nephrology, Uludağ University Medical School, Bursa, Turkey
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Öksuz MF, Karkucak M, Görukmez O, Ocakoğlu G, Yıldız A, Ture M, Yakut T, Dilek K. Investigation of MEFV gene polymorphisms (G138G and A165A) in adult patients with familial Mediterranean fever. Rev Bras Reumatol Engl Ed 2017; 57:501-506. [PMID: 29173686 DOI: 10.1016/j.rbre.2016.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Accepted: 09/25/2015] [Indexed: 11/27/2022] Open
Abstract
AIM Various mutations have been identified in the Mediterranean fever (MEFV) gene which is reported to be responsible from Familial Mediterranean fever (FMF). In our study, we aimed to determine the frequency of the MEFV mutations in our region and to investigate the impact of G138G (rs224224, c.414A>G) and A165A (rs224223, c.495C>A) gene polymorphisms on the clinical findings of the disease. METHODS One hundred and sixteen patients diagnosed with FMF and 95 control subjects were included in this study. We used the DNA sequence analysis method to identify the most prevailing 10 mutations located in exon 2 and 10 of MEFV gene. RESULTS As a result of the MEFV mutation analysis, the most common mutation was the M694V mutation allele with a frequency rate of 41.8%. When the patients group and control group were compared in terms of frequency of both polymorphic alleles (G polymorphic allele, observed in G138G and the A polymorphic allele, observed in A165A), the variation was observed to be statistically significant (p<0.001). It was found that the MEFV mutation types have no relation with clinical findings and amyloidosis (p>0.05). CONCLUSIONS To our knowledge, our study is the first study in the Southern Marmara region that reports the frequency of MEFV mutations. Our findings imply that the polymorphisms of G138G and A165A may have an impact on progress of the disease. We think that more studies, having higher number of cases and investigating the polymorphisms of MEFV gene, are needed.
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Affiliation(s)
- Mustafa Ferhat Öksuz
- Uludag University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Bursa, Turkey.
| | - Mutlu Karkucak
- Sakarya University, Education and Research Hospital, Department of Medical Genetics, Sakarya, Turkey
| | - Orhan Görukmez
- Sevket Yilmaz Education and Research Hospital, Department of Medical Genetics, Bursa, Turkey
| | - Gökhan Ocakoğlu
- Uludag University, Faculty of Medicine, Department of Biostatistics, Bursa, Turkey
| | - Abdulmecit Yıldız
- Uludag University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Bursa, Turkey
| | - Mehmet Ture
- Uludag University, Faculty of Medicine, Department of Medical Genetics, Bursa, Turkey
| | - Tahsin Yakut
- Uludag University, Faculty of Medicine, Department of Medical Genetics, Bursa, Turkey
| | - Kamil Dilek
- Uludag University, Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Bursa, Turkey
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Aydin MF, Yildiz A, Oruç A, Aytaç Vuruşkan B, Ayar Y, Güllülü M, Dilek K, Yavuz M, Ersoy A. SP147THE EFFECT OF HISTOPATHOLOGICAL CLASSIFICATION ON PROGNOSIS IN ANCA-ASSOCIATED VASCULITIS − SINGLE CENTRAL EXPERIENCE. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx141.sp147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sağ S, Yeşilbursa D, Yildiz A, Dilek K, Şentürk T, Serdar OA, Aydinlar A. Acute effect of hemodialysis on arterial elasticity. Turk J Med Sci 2015; 45:246-50. [PMID: 25790561 DOI: 10.3906/sag-1311-64] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM Reduced arterial elasticity is an independent predictor of cardiovascular mortality in patients with end-stage renal disease (ESRD). Hemodialysis (HD) treatment per se can bring additional risk factors for vascular disease. Our study was designed to determine whether a single hemodialysis session leads to an acute alteration in parameters of arterial elasticity in ESRD. MATERIALS AND METHODS In this study, 58 patients undergoing chronic hemodialysis and 29 healthy controls were enrolled. Large artery elasticity index (LAEI) and the small artery elasticity index (SAEI) were measured by applanation tonometry. The acute effect of a hemodialysis session on arterial elasticity indices was assessed by comparison of prehemodialysis and posthemodialysis determinations. RESULTS At baseline, LAEI did not differ significantly in patients compared with controls. In contrast, the SAEI was significantly lower in patients (4.1 ± 2.6 mL/mmHg x 100) than in healthy individuals (8.9 ± 3.4 mL/mmHg x 100, P < 0.05). In patients with ESRD, no significant changes in LAEI was observed after HD, but SAEI deteriorated significantly (from 4.1 ± 2.6 mL/mmHg x 100 to 3.4 ± 2.3, P < 0.05). CONCLUSION We conclude that ESRD patients face a significant reduction in SAEI, which is exacerbated by a dialysis procedure.
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Sağ S, Yeşilbursa D, Yıldız A, Dilek K, Sentürk T, Serdar OA, Aydınlar A. Acute Haemodialysis-induced Changes in Tissue Doppler Echocardiography Parameters. Balkan Med J 2014; 31:239-43. [PMID: 25337420 DOI: 10.5152/balkanmedj.2014.13170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 07/23/2014] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Tissue Doppler imaging (TDI) is a method that determines the tissue motion and velocity within the myocardium. AIMS To characterize acute haemodialysis (HD)-induced changes in TDI-derived indices for patients that have end-stage renal disease (ESRD). STUDY DESIGN Cross sectional study. METHODS Conventional echocardiography and TDI methods were applied to study ESRD patients (n=58) before and after HD. Pulmonary venous flow, mitral inflow, and TDI signals of the lateral and septal mitral annulus were examined for the determination of altered left-ventricular diastolic filling parameters. Flow velocities from early- (E) and late-atrial (A) peak transmitral; peak pulmonary vein systolic (S) and diastolic (D); and myocardial peak systolic (Sm) and peak early (Em) and late (Am) diastolic mitral annular velocities were also assessed for changes. RESULTS Transmitral E and A velocities and the E/A ratio decreased significantly after HD (p<0.001). Pulmonary vein S (p<0.001) and D (p<0.001) velocities decreased, and S/D ratios increased significantly (p=0.027). HD led to a reduction in septal Em (p<0.001), lateral Em (p=0.006), and Am (p<0.001) velocities. Contrary to the decreases in Em and Am, the Em/Am ratio remained unchanged. CONCLUSION A single HD session was associated with an acute deterioration in the diastolic parameters. Since the Em/Am ratio remained unchanged, we conclude that this index is a relatively load-independent measure of diastolic function in HD patients.
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Affiliation(s)
- Saim Sağ
- Department of Cardiology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Dilek Yeşilbursa
- Department of Cardiology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Abdulmecit Yıldız
- Department of Nephrology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Kamil Dilek
- Department of Nephrology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Tunay Sentürk
- Department of Cardiology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Osman Akın Serdar
- Department of Cardiology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Ali Aydınlar
- Department of Cardiology, Uludağ University Faculty of Medicine, Bursa, Turkey
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Coskun B, Coskun BN, Atis G, Ergenekon E, Dilek K. Evaluation of sexual function in women with rheumatoid arthritis. Urol J 2014; 10:1081-1087. [PMID: 24469654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/22/2012] [Revised: 01/22/2013] [Accepted: 01/24/2013] [Indexed: 06/03/2023]
Abstract
PURPOSE To evaluate the link between rheumatoid arthritis (RA) and female sexual functioning. MATERIAL AND METHODS A total of 32 women with RA and 20 healthy age matched controls were enrolled in this study. The participations are asked to complete Female Sexual Function Index (FSFI), The Short form 36 (SF-36) Health Survey and Beck Depression Inventory (BDI)questionnaires. RESULTS The groups were comparable in terms of demographic characteristics. The women with RA represented significantly worse sexual functioning in category of desire, arousal, lubrication,orgasm, satisfaction domain and total FSFI score compared with healthy women (P = .0001, P = .0001, P = .0001, P = .0001, P = .022 and P = .0001, respectively). The mean BDI scores for the patients with RA were greater than control group (P = .036). Women with RA also had significantly lower quality of life (QoL) parameters: physical functioning, limitations due to physical health, pain, general health, vitality and limitations due to emotional problems compared with healthy women (P = .0001, P = .0001, P = .028, P = .002, P = .001 and P = .0001, respectively). CONCLUSION The present study shows that a significant percent of patients with RA had sexual dysfunction and also deterioration in QoL.
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Affiliation(s)
| | - Belkis Nihan Coskun
- Department of Internal Medicine, School of Medicine, Uludag University, Bursa, Turkey
| | - Gokhan Atis
- Department of Urology, GöztepeTraining and Research Hospital, Istanbul, Turkey
| | - Erbil Ergenekon
- Department of Urology, ŞişliTraining and Research Hospital,Istanbul, Turkey
| | - Kamil Dilek
- Department of Rheumatology,School of Medicine, Uludag University, Bursa, Turkey
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Dalkilic E, Sahbazlar M, Gullulu M, Yavuz M, Dilek K, Ersoy A, Ozkaya G, Yurtkuran M. The time course of gastric methotrexate intolerance in patients with rheumatoid arthritis and psoriatic arthritis. Mod Rheumatol 2014. [DOI: 10.3109/s10165-012-0685-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Dalkilic E, Bulbul Baskan E, Alkis N, Gullulu M, Yavuz M, Dilek K, Ersoy A, Yurtkuran M. Tumor necrosis factor-alpha antagonist therapy-induced psoriasis in Turkey: analysis of 514 patients. Mod Rheumatol 2014. [DOI: 10.3109/s10165-011-0590-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Dalkilic E, Filiz G, Yavuz M, Dilek K, Ersoy A, Yurtkuran M, Oruc A, Gul CB, Gullulu M. Ki-67 proliferation index in renal biopsy samples of patients with systemic lupus erythematosus and its correlation with clinical findings. Iran J Kidney Dis 2013; 7:198-203. [PMID: 23689151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 10/19/2012] [Accepted: 11/03/2012] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Systemic lupus erythematosus is an autoimmune disease that may affect almost all organ systems. Renal involvement is the most significant prognostic factor. Renal biopsy findings play an important role in treatment decision. Ki-67 is a monoclonal antibody that is only found in proliferative cells. This study aimed to investigate the proliferative activity in renal biopsy specimens of patients with lupus nephritis using the Ki-67 monoclonal antibody, and to compare the proliferative index between different subgroups of patients. MATERIALS AND METHODS Renal biopsy specimens of 29 patients with systemic lupus erythematosus were retrospectively evaluated. Type of lupus nephritis and activity and chronicity indexes were determined. Ki-67 immunostaining was performed. For each patient, 1000 cells were counted and the number of Ki-67 positive cells was determined. The Ki-67 activity index was compared between different subgroups of lupus nephritis and correlated with systemic lupus erythematosus disease activity index, serum creatinine, proteinuria, anticardiolipin antibodies, and complement levels. RESULTS A positive correlation between Ki-67 proliferation index, serum creatinine levels, and systemic lupus erythematosus disease activity index were found. Although conventional activity indexes were low, in 3 of 9 patients with class II lupus nephritis, Ki-67 proliferation indexes were high, indicating proliferation. CONCLUSIONS Ki-67 can be used as a proliferation marker in renal biopsy specimens for patients diagnosed with systemic lupus erythematosus.
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Affiliation(s)
- Ediz Dalkilic
- Division of Rheumatology, Department of Internal Medicine, Uludag University Faculty of Medicine, Bursa, Turkey.
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Bantis C, Heering P, Kouri NM, Siekierka-Harreis M, Stangou M, Schwandt C, Efstratiadis G, Rump LC, Ivens K, Haddiya I, Houssaini Squalli T, Laouad I, Ramdani B, Bayahia R, Dimas GG, Tegos TJ, Spiroglou SG, Pitsalidis CG, Sioulis AS, Karamouzis IM, Savopoulos CG, Karamouzis MI, Orologas AG, Hatzitolios AI, Grekas DM, Maixnerova D, Jancova E, Rychlik I, Rysava R, Merta M, Reiterova J, Kolsky A, Honsova E, Skibova J, Tesar V, Kendi Celebi Z, Calayoglu R, Keven K, Kurultak I, Mescigil P, Erbay B, Karatan O, Duman N, Erturk S, Nergizoglu G, Kutlay S, Sengul S, Ates K, Marino F, Martorano C, Bellantoni M, Tripepi R, Zoccali C, Ishizuka K, Harita Y, Kajiho Y, Tsurumi H, Asano T, Nishiyama K, Sugawara N, Chikamoto H, Akioka Y, Yamaguchi Y, Igarashi T, Hattori M, Bantis C, Heering PJ, Kouri NM, Stangou M, Siekierka-Harreis M, Efstratiadis G, Rump LC, Ivens K, Sahay M, Monova DV, Monov SV, Wang YY, Cheng H, Wang GQ, Dong HR, Chen YP, Wang CJ, Tang YL, Buti E, Dervishi E, Bergesio F, Ghiandai G, Mjeshtri A, Paudice N, Caldini AL, Nozzoli C, Minetti EE, Sun L, Feng J, Yao L, Fan Q, Ma J, Wang L, Kirsanova T, Merkusheva L, Ruinihina N, Kozlovskaya N, Elenshleger G, Turgutalp K, Karabulut U, Ozcan T, Helvaci I, Kiykim A, Kaul A, Bhadhuaria D, sharma R, Prasad N, Gupta A, Clajus C, Schmidt J, Haller H, Kumpers P, David S, Sevillano AM, Molina M, Gutierrez E, Morales E, Gonzalez E, Hernandez E, Praga M, Conde Olasagasti JL, Vozmediano Poyatos C, Illescas ML, Tallon S, Uson Carrasco JJ, Roca Munoz A, Rivera Hernandez F, Ismail G, Jurubita R, Andronesi A, Bobeica R, Zilisteanu D, Rusu E, Achim C, Sevillano AM, Molina M, Gutierrez E, Morales E, Huerta A, Hernandez E, Caro J, Gutierrez-Solis E, Praga M, Pasquariello A, Pasquariello G, Innocenti M, Grassi G, Egidi MF, Ozturk O, Yildiz A, Gul CB, Dilek K, Monov SV, Monova DV, Tylicki L, Jakubowska A, Weber E, Lizakowski S, Swietlik D, Rutkowski B, Postorino A, Costa S, Cristadoro S, Magazzu G, Bellinghieri G, Savica V, Buemi M, Santoro D, Lu Y, Shen P, Li X, Xu Y, Pan X, Wang W, Chen X, Zhang W, Ren H, Chen N, Mitic BP, Cvetkovic T, Vlahovic P, Velickovic Radovanovic R, Stefanovic V, Kostic S, Djordjevic V, Ao Q, Ma Q, Cheng Q, Wang X, Liu S, Zhang R, Ozturk S, Ozmen S, Akin D, Danis R, Yilmaz M, Hajri S, Barbouche S, Okpa H, Oviasu E, Ojogwu L, Fotouhi N, Ghaffari A, Hamzavi F, Nasri H, Ardalan M, Stott A, Ullah A, Anijeet H, Ahmed S, Kohli HS, Rajachandran R, Rathi M, Jha V, Sakhuja V, Yenigun E, Dede F, Turgut D, Koc E, Akoglu H, Piskinpasa S, Ozturk R, Odabas A, Bajcsi D, Abraham G, Kemeny E, Sonkodi S, Legrady P, Letoha A, Constantinou K, Ondrik Z, Ivanyi B, Lucisano G, Comi N, Cianfrone P, Summaria C, Piraina V, Talarico R, Camastra C, Fuiano G, Proletov I, Saganova E, Galkina O, Bogdanova E, Zubina I, Sipovskii V, Smirnov A, Bailly E, Pierre D, Kerdraon R, Grezard O, Gnappi E, Delsante M, Galetti M, Maggiore U, Manenti L, Hasan MJ, Muqueet MA, Mostafi M, Chowdhury I, Haque W, Khan T, Kang YJ, Bae EJ, Cho HS, Chang SH, Park DJ, Li X, Xu G, Lin H, Hu Z, Yu X, Xing C, Mei C, Zuo L, Ni Z, Ding X, Li D, Chen N, Ren H, Shen P, Li X, Pan X, Zhang Q, Feng X, Lin L, Zhang W, Chen N. Clinical nephrology - miscellaneous. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Yücel A, Dilek K, Saba D, Ozçimen AA, Yurtkuran M, Oral HB. Interleukin-2 gene polymorphism in Turkish patients with Behçet's disease and its association with ocular involvement. Int J Immunogenet 2013; 40:349-55. [PMID: 23331481 DOI: 10.1111/iji.12039] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Revised: 10/23/2012] [Accepted: 12/12/2012] [Indexed: 12/14/2022]
Abstract
Behçet's disease (BD) is a chronic immune-mediated systemic disease, characterized by oral and genital lesions and ocular inflammation. Several cytokine genes may play crucial roles in host susceptibility to BD, because the cytokine production capacity varies among individuals and depends on the cytokine gene polymorphisms. The association of the interleukin (IL)-2 gene polymorphisms with the susceptibility to BD was investigated in this study. DNA samples were obtained from a Turkish population of 97 patients with BD and 76 healthy control subjects. Polymorphisms of IL-2 gene at position -330 and +166 were determined using the polymerase chain reaction with sequence-specific primers. In the patients with BD, there was a significantly increased frequency of IL-2 -330 GT genotype. Interestingly, we demonstrated that the frequencies of IL-2 -330 GT and IL-2 + 166 GG genotypes were increased in BD patients with ocular involvement, whilst IL-2 -330 TT genotype was significantly decreased. Also, analysis of allele frequency demonstrated that the presence of G allele at position +166 of IL-2 seems to be a risk factor for ocular involvement. These results reveal that IL-2 -330 GT genotype may be a susceptibility factor for BD, whereas IL-2 -330 TT genotype seems to display a protective association with BD. Additionally, IL-2 gene polymorphisms might be associated with ocular involvement in BD.
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Affiliation(s)
- A Yücel
- Department of Ophthalmology, Uludag University Faculty of Medicine, Bursa, Turkey
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Dalkilic E, Sahbazlar M, Gullulu M, Yavuz M, Dilek K, Ersoy A, Ozkaya G, Yurtkuran M. The time course of gastric methotrexate intolerance in patients with rheumatoid arthritis and psoriatic arthritis. Mod Rheumatol 2012; 23:525-8. [PMID: 22752502 DOI: 10.1007/s10165-012-0685-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 05/28/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study aimed to evaluate the incidence and the time course of methotrexate (MTX)-associated gastric intolerance in patients with rheumatoid arthritis and psoriatic arthritis. METHODS Four hundred twenty subjects undergoing MTX treatment for rheumatoid arthritis (n = 346) and psoriatic arthritis (n = 74) were retrospectively assessed. The incidence and time course of gastric MTX intolerance resulting in treatment discontinuation were investigated. In addition, the relations between gastric intolerance and patient characteristics, including gender, age, diagnosis, and rheumatoid factor (RF) positivity, were examined. RESULTS Overall, oral MTX discontinuation rate due to gastric intolerance was 28.6 %. The time to discontinuation for oral MTX was 8.1 ± 11.5 months on average, with more than half of the discontinuations occurring within the first three months of treatment. Discontinuation was not associated with gender, age, diagnosis, or RF positivity. More than half of the patients that switched to a parenteral treatment regimen (52.6 %, 20/38) could tolerate the agent. CONCLUSIONS Gastric MTX intolerance usually develops within the first year of treatment and presents a major obstacle to long-term treatment retention in patients with rheumatologic disease. However, parenteral MTX appears to be a good alternative for patients intolerant of oral MTX.
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Affiliation(s)
- Ediz Dalkilic
- Division of Rheumatology, Department of Internal Medicine, Uludag Medical Faculty, Uludag University, Bursa, Turkey.
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Dalkilic E, Bulbul Baskan E, Alkis N, Gullulu M, Yavuz M, Dilek K, Ersoy A, Yurtkuran M. Tumor necrosis factor-alpha antagonist therapy-induced psoriasis in Turkey: analysis of 514 patients. Mod Rheumatol 2012; 22:738-42. [PMID: 22350572 DOI: 10.1007/s10165-011-0590-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Accepted: 12/22/2011] [Indexed: 11/26/2022]
Abstract
OBJECTIVES New adverse events are being reported with the increased use of anti-tumor necrosis factor (TNF) α therapy. We studied cases of anti-TNFα-induced psoriasis observed in our pool of 514 patients receiving anti-TNFα treatment in Turkey. METHODS Three rheumatoid arthritis patients and 3 ankylosing spondylitis patients with anti-TNFα-induced psoriasis were included in the study. All patients were examined by a dermatologist, and 3 patients underwent skin biopsy. RESULTS None of the 6 patients had preexisting psoriasis or a familial history of psoriasis. The earliest and latest occurrences of psoriatic lesions were at the 6th week and 44th month of anti-TNFα therapy, respectively. Psoriasis was severe and refractory in two patients (requiring systemic treatment), while it presented as mild in four patients. Anti-TNFα therapy was totally withdrawn in case 1. In case 2, the treatment was halted for 3 months then switched to another TNFα blocker, and case 3 was switched to another anti-TNFα treatment. The treatment was sustained in the other 3 patients (cases 4, 5, and 6). CONCLUSIONS TNFα blockers are very effective agents in the treatment of psoriasis, but it is interesting that the same molecules can, paradoxically, induce psoriasis. The occurrence of anti-TNFα-induced psoriasis in six out of 514 patients suggests that the incidence of this adverse reaction is, in fact, as not low as presumed in the literature. In some cases, a severe course of psoriasis may limit the use of these agents.
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Affiliation(s)
- Ediz Dalkilic
- Division of Rheumatology, Department of Internal Medicine, Uludag Medical Faculty, Uludag University, Bursa, Turkey.
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Oral HB, Dilek K, Özçimen AA, Taşkapılıoğlu Ö, Bingöl Ü, Sarandöl A, Sarıcaoğlu H, Yurtkuran M, Yurtkuran MA. Interleukin-4 Gene Polymorphisms Confer Behçet’s Disease in Turkish Population. Scand J Immunol 2011; 73:594-601. [DOI: 10.1111/j.1365-3083.2011.02532.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Özçimen AA, Dilek K, Bingöl Ü, Sarıcaoğlu H, Sarandöl A, Taşkapılıoğlu Ö, Yurtkuran M, Yurtkuran MA, Oral HB. IL-1 cluster gene polymorphisms in Turkish patients with Behçet’s disease. Int J Immunogenet 2011; 38:295-301. [DOI: 10.1111/j.1744-313x.2011.01006.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Saricaoglu H, Yilmaz M, Karkucak M, Ozturk HZY, Yakut T, Gulten T, Baskan EB, Aydogan K, Dilek K. Investigation of ABCB1 gene polymorphism with colchicine response in Behçet's disease. Genet Mol Res 2011; 10:1-6. [PMID: 21218380 DOI: 10.4238/vol10-1gmr824] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Colchicine is commonly used in the treatment of Behçet's disease. However, some patients are unresponsive to colchicine treatment. Adenosine triphosphate-binding cassette subfamily B member 1 (ABCB1) transports colchicine out of cells. We investigated a possible association of C3435T polymorphism of the ABCB1 (MDR1) gene with colchicine response in patients with Behçet's disease. We randomly selected 97 patients with Behçet's disease, examined ABCB1 (MDR1) gene C3435T polymorphisms, and evaluated patient responses to colchicine. Forty-three patients were colchicine responsive, while the remaining 54 patients were unresponsive. No significant difference was found between genotypic and allelic frequencies of the ABCB1 C3435T polymorphisms in patients with Behçet's disease and healthy volunteers. Also, there was no significant difference among responsive and nonresponsive patients. We concluded that ABCB1 C3435T polymorphism is not associated with a colchicine response in patients with Behçet's disease.
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Affiliation(s)
- H Saricaoglu
- Department of Dermatology, Uludag University, Bursa, Turkey
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Sarandol E, Dirican M, Ocak N, Serdar Z, Sonmezisik F, Dilek K. The effects of vitamin E-coated dialysis membranes on serum paraoxonase activity in hemodialysis patients. J Nephrol 2010; 23:431-437. [PMID: 20301081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2008] [Indexed: 05/29/2023]
Abstract
BACKGROUND Hemodialysis patients are exposed to oxidative stress, which can lead to several complications. We therefore sought to evaluate the effect of using vitamin E-coated dialysis membranes for a period of 3 months on serum paraoxonase activity and oxidative stress markers. METHODS Twenty patients and 25 healthy controls were included in this study. Hemodialysis patients were evaluated before and after 3 months of treatment with vitamin E-coated dialysis membranes. Plasma malondialdehyde (MDA) levels, as well as the oxidizability of red blood cells (RBCs) and apolipoprotein B-containing lipoproteins (expressed as RBC-MDA and DeltaMDA, respectively) were determined in order to investigate the patients' oxidative status. Plasma vitamin E and vitamin C levels, serum total carotenoid levels and paraoxonase activity were measured to investigate the patients' antioxidative defenses. RESULTS After 3 months of treatment with vitamin E-coated membranes, vitamin E levels were significantly increased and the oxidizability of RBCs was significantly reduced in the hemodialysis patients. However, there were not any differences from baseline in serum paraoxonase activity, plasma MDA levels or the oxidizability of apolipoprotein B-containing lipoproteins in these patients. CONCLUSIONS Despite promising improvements in vitamin E levels and the oxidizability of RBCs, the results of this study do not support a satisfactory antioxidative effect of vitamin E-coated dialysis membranes. Further studies are needed to identify antioxidative treatments for hemodialysis patients.
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Affiliation(s)
- Emre Sarandol
- Department of Biochemistry, Medical Faculty, Uludag University, Bursa, Turkey.
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Arabul M, Gullulu M, Yilmaz Y, Eren MA, Baran B, Gul CB, Kocamaz G, Dilek K. Influence of erythropoietin therapy on serum prohepcidin levels in dialysis patients. Med Sci Monit 2009; 15:CR583-CR587. [PMID: 19865058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Anemia is a common finding in dialysis patients. Recent evidence has accrued that hepcidin, an iron regulatory peptide, may play a crucial role in the pathophysiology of this condition. This study investigated the effect of erythropoietin (EPO) therapy on serum levels of prohepcidin, the pro-hormone of hepcidin, in patients with end-stage renal disease (ESRD) undergoing chronic dialysis treatment. MATERIAL/METHODS A total of 40 ESRD patients with renal anemia receiving either hemodialysis or peritoneal dialysis were included in this study. The patients were randomly allocated to EPO (subcutaneous 2000 microg three times weekly) plus parenteral iron (n=23) or parental iron only (n=17). Serum prohepcidin levels were measured before and at the end of the study. RESULTS The two groups were comparable in their demographic and laboratory characteristics. No significant differences were found in hemoglobin, hematocrit, iron store indices, or serum levels of prohepcidin at study entry. Significant increases in both hemoglobin and hematocrit as well as a decrease in serum prohepcidin level were evident in the EPO group at the end of the 6-month follow-up in comparison with their values at study entry compared with the control group (P<0.01). CONCLUSIONS It is concluded that EPO therapy, besides enhancing erythropoiesis, modulates serum prohepcidin levels in dialysis patients.
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Affiliation(s)
- Mahmut Arabul
- Department of Internal Medicine, Uludag University Medical School, Bursa, Turkey
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Gullulu M, Kahvecioglu S, Dirican M, Akdag I, Ocak N, Demircan C, Dilek K, Ersoy A, Yavuz M, Yurtkuran M. Paraoxonase Activity in Glomerulonephritic Patients. Ren Fail 2009; 29:433-9. [PMID: 17497465 DOI: 10.1080/08860220701278216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Cardiovascular disease is the most common cause of morbidity and mortality in patients with chronic renal failure. Glomerulonephritic patients have an increased risk for cardiovascular disease, but its etiology is unclear. It is known that an increase in oxidizability of apolipoprotein B-containing lipoproteins has a key role in the initiation of atherosclerosis, and paraoxonase enzyme activity particularly has a preventive role against atherosclerosis. The aim of the present study was to evaluate the oxidizability of apolipoprotein B-containing lipoproteins, serum, and urinary paraoxonase/arylesterase activities in glomerulonephritis patients who had normal lipid parameters and creatinine levels. METHODS Thirty-two patients with glomerulonephritis and 22 healthy controls were included in this study. A total of 32 patients (including nine with membranous GN, eight with immunoglobulin A nephropathy, eight with mesangial proliferative GN, five with focal-segmental glomerulosclerosis, one with diffuse proliferative GN, and one with minimal chance disease having biopsy proven GN) were enrolled into the study. We compared serum and urinary paraoxonase, arylesterase, serum lipids, urea, creatinine, hemoglobin, total protein and albumin values between groups. RESULTS Serum urea, creatinine, total protein, albumin, uric acid, hemoglobin, and lipid parameters were similar in the glomerulonephritis and control groups (p > 0.05). PON1 activity was significantly lower in GN group than controls, but there was no statistically significant difference on arylesterase activity between groups. Oxidizability of apolipoprotein B-containing lipoproteins was significantly higher in GN group than controls. CONCLUSION Our study shows that the findings of normal serum levels of creatinine, lipids, and proteins increased the oxidizability of apolipoprotein B-containing lipoproteins, and any decrease in PON1 activity in patients diagnosed with GN should be considered important. Hence, the immediate commencement of preventive as well as curative treatment in other to avoid the risk of cardiovascular and renal problems would be a correct approach.
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Affiliation(s)
- Mustafa Gullulu
- Department of Nephrology, University Medical School, Bursa, Turkey.
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Dilek K, Ozçimen AA, Saricaoğlu H, Saba D, Yücel A, Yurtkuran M, Yurtkuran M, Oral HB. Cytokine gene polymorphisms in Behçet's disease and their association with clinical and laboratory findings. Clin Exp Rheumatol 2009; 27:S73-S78. [PMID: 19796538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The association of the cytokine gene polymorphisms with the development of Behçet's Disease (BD) was investigated in this study. DNA samples were obtained from a Turkish population of 97 unrelated patients with BD, and 127 unrelated healthy control subjects.All genotyping (IL-6, IL10, IFN-gamma, TGF-Beta1 and TNF-alpha) experiments were performed using sequence-specific primers PCR. The frequency of TGF-Beta1 codon 25 GG genotype was found significantly lower in BD patients compared to healthy control subjects. The IL-10 -1082 GA genotype was more frequent whereas the AA genotype was less common in the BD group compared to the control group. The association between clinial findings and cytokine gene polymorphisms was further investigated in the patients with BD. The frequency of IFN-gamma AA genotype was lower in the patients with genital ulcer. Additionally, it was found that the frequency of IL-6 -174 GG genotype was lower in the patients with Pathergy positivity. These results suggest that TGF-Beta1 and IL-10 gene polymorphisms may affect host susceptibility to BD. Also, to confirm the biological significance of our results, further studies should be performed on other population groups and in large number of cases.
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Affiliation(s)
- K Dilek
- Department of Nephrology and Rheumatology, Uludag University, Bursa, Turkey
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Arabul M, Gullulu M, Yilmaz Y, Akdag I, Kahvecioglu S, Ali Eren M, Dilek K. Effect of fluvastatin on serum prohepcidin levels in patients with end-stage renal disease. Clin Biochem 2008; 41:1055-8. [DOI: 10.1016/j.clinbiochem.2008.05.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2008] [Revised: 04/21/2008] [Accepted: 05/24/2008] [Indexed: 11/26/2022]
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Sag S, Akturk Y, Yesilbursa D, Dilek K, Serdar O. ARTERIAL ELASTICITY MEASUREMENT IN HEMODIALYSIS PATIENTS AND EARLY EFFECT OF HEMODIALYSIS ON VASCULAR COMPLIANCE. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70645-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Yurtkuran M, Yurtkuran M, Dilek K, Güllülü M, Karakoç Y, Özbek L, Bingöl Ü. A randomized, controlled study of balneotherapy in patients with rheumatoid arthritis. Phys Rehab Kur Med 2008. [DOI: 10.1055/s-2008-1061791] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Dirican M, Sarandol E, Serdar Z, Ocak N, Dilek K. Oxidative status and prevalent cardiovascular disease in patients with chronic renal failure treated by hemodialysis. Clin Nephrol 2007; 68:144-50. [PMID: 17915616 DOI: 10.5414/cnp68144] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Hemodialysis (HD) patients are exposed to oxidative stress which contributes to cardiovascular disease (CVD). The purpose of this study was to investigate the oxidative and antioxidative status in HD patients with (CVD+, n = 38) and without (CVD-, n = 67) prevalent CVD. PATIENTS AND METHODS A total of 105 HD patients and 21 healthy controls were assessed for lipid peroxidation indices (plasma malondialdehyde (MDA)), oxidizability of apolipoprotein B-containing lipoproteins (apo B-deltaMDA) and red blood cells (RBC-MDA) together with various components of the antioxidant system in plasma (paraoxonase/arylesterase activities, total carotenoids, vitamins C and E) and RBC (superoxide dismutase and glutathione peroxidase activities). RESULTS Plasma MDA and RBC-MDA were significantly higher, vitamin C and total carotenoid levels were significantly lower in both CVD+ and CVD- HD groups than in the control group. Plasma MDA levels were significantly higher and serum paraoxonase activity, uric acid and albumin levels were significantly lower in patients with CVD+ HD patients compared to those of the CVD- patients. CONCLUSION This study suggests that the elevated level of plasma MDA and the lower activity of paraoxonase could contribute to the increased incidence of cardiovascular disease in hemodialysis patients.
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Affiliation(s)
- M Dirican
- Department of Biochemistry, Medical Faculty of Uludag University, Bursa, Turkey.
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Kahvecioglu S, Akdag I, Gullulu M, Arabul M, Ersoy A, Dilek K, Yavuz M, Yurtkuran M. Comparison of higher dose of losartan treatment with losartan plus carvedilol and losartan plus ramipril in patients with glomerulonephritis and proteinuria. Ren Fail 2007; 29:169-75. [PMID: 17365932 DOI: 10.1080/08860220601098839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Proteinuria may cause a worsening of accompanying renal disease or even lead to glomerulosclerosis. There is no data about the effect of carvedilol on patients with proteinuric (>0.5 g/day) glomerulonephritis. This study aimed to compare the effects of carvedilol with ramipril and losartan in patients with proteinuric glomerulonephritis. METHODS Twenty-one glomerulonephritis patients were followed for 12 months. Patients were divided into three groups. All patients were treated with losartan 50 mg once daily for two weeks. After two weeks (baseline), patients were given additional medications: 50 mg losartan, 5 mg ramipril, and 25 mg carvedilol were given additionally to the patients in groups 1, 2, and 3 respectively. RESULTS Baseline mean proteinuria values of patients in groups 1, 2 and 3 were 1.6 +/- 1.1 g/day, 2.1 +/- 1.3 g/day, and 1.4 +/- 1.2 g/day, respectively. These values decreased to 0.5 +/- 0.7 g/day, 0.6 +/- 0.7 g/day, and 0.9 +/- 0.9 g/day, respectively, at the end of the 12th month. These results were statistically significant only in group 1 (p = 0.04). The rational variation of proteinuria between the first and 12th month of losartan, ramipril, and carvedilol were -61%, -62%, and -27%, respectively. The decreases in blood pressures between baseline and the first, sixth, and twelfth-month measurements were significant in all groups. CONCLUSIONS Thee results showed that angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (AT1ras) provide marked decreases in proteinuria, making their use indisputable in patients with glomerulonephritis. Carvedilol was not found to be as effective as ACEIs and AT1ras in decreasing proteinuria and preserving renal function.
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Affiliation(s)
- Serdar Kahvecioglu
- Department of Nephrology, Uludag University Medical School, Bursa, Turkey.
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Baskan EB, Yilmaz E, Saricaoglu H, Alkan G, Ercan I, Mistik R, Adim SB, Goral G, Dilek K, Tunali S. Detection of parvovirus B19 DNA in the lesional skin of patients with Behçet's disease. Clin Exp Dermatol 2007; 32:186-90. [PMID: 17250756 DOI: 10.1111/j.1365-2230.2006.02330.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND There is disagreement in the current evidence for viral aetiologies in the pathogenesis of Behçet's disease (BD). OBJECTIVES To investigate the presence of B19 DNA in skin lesions of patients with BD, compare with the skin of healthy controls and evaluate its role in the pathogenesis. METHODS In total, 40 patients diagnosed with BD according to the criteria proposed by the International Study Group for Behçet's Disease and routinely followed up at our centre were enrolled into the study. All the patients selected were in the active phase of disease. Skin and blood samples of patients with BD and of the healthy volunteers were examined for B19 serology, histopathology and genome expression. RESULTS The quantity of B19 DNA in nonulcerative BD lesions of was significantly different from ulcerative lesions in the study group and from the skin of the healthy controls (P < 0.01). For the nonulcerative lesions, real-time PCR analysis for B19 DNA was found to be 64% sensitive (95% CI 42.5-82.0) and 85% specific (95% CI 62.1-96.6) with a cut-off value of > 154 IU/mL (P < 0.001). CONCLUSIONS To the best of our knowledge, this is the first study that provides evidence for a possible causal link between BD and parvovirus B19, and our data suggest the presence of the virus, particularly in intact, nonulcerative skin lesions of BD. Limitations to this study include the limited number of participants, and the fact that the exact source of B19 DNA was undetected.
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Affiliation(s)
- E B Baskan
- Department of Dermatology, Uludag University Medical Faculty, 16059 Gorukle, Bursa, Turkey.
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Kahvecioglu S, Dilek K, Akdag I, Gullulu M, Demircan C, Ersoy A, Yurtkuran M. Effect of indomethacin and selective cyclooxygenase-2 inhibitors on proteinuria and renal function in patients with AA type renal amyloidosis. Nephrology (Carlton) 2006; 11:232-7. [PMID: 16756637 DOI: 10.1111/j.1440-1797.2006.00562.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS Because the cardiovascular system (CVS) side-effects of cyclooxygenase-2 (COX-2) selective inhibitors have recently been questioned, we aimed to compare the renal and haemodynamic effects of cyclooxygenase selective (celecoxib and rofecoxib) and non-selective non-steroidal anti-inflammatory drugs (NSAIDs) (indomethacin) in patients with renal amyloidosis secondary to rheumatological diseases who required anti-inflammatory agents and are taking maximum tolerable dose of angiotensin-converting enzyme inhibitors. METHODS The present study was performed on 11 patients with stable proteinuria who were diagnosed as AA amyloidosis secondary to rheumatological diseases confirmed by renal biopsies. The study had three consecutive stages (celecoxib 200 mg/day; indomethacin 100 mg/day; rofecoxib 25 mg/day.) Each was given for 4 weeks and a wash-out phase of 3 weeks was allowed between consecutive stages. RESULTS Although the decrease of proteinuria in the celecoxib period was higher than in the rofecoxib and indomethacin periods, the difference was not statistically significant. No statistically significant differences were found between serum urea, creatinine, creatinine clearance and urinary sodium excretion. CONCLUSION In this study, no differences were found between indomethacin and the two selective COX-2 inhibitors in respect to proteinuria and renal functions in 11 patients with renal amyloidosis secondary to rheumatological diseases with varying degrees of proteinuria. Routine doses of NSAIDs brought no additional benefit to the ACE inhibitor use in terms of proteinuria and renal functions. The use of selective COX-2 inhibitors should be limited to their anti-inflammatory and analgesic effects in this population.
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Affiliation(s)
- Serdar Kahvecioglu
- Department of Nephrology, Uludag University Medical School, Bursa, Turkey.
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Yurtkuran M, Alp A, Yurtkuran M, Dilek K. A modified yoga-based exercise program in hemodialysis patients: a randomized controlled study. Complement Ther Med 2006; 15:164-71. [PMID: 17709061 DOI: 10.1016/j.ctim.2006.06.008] [Citation(s) in RCA: 128] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2005] [Accepted: 06/09/2006] [Indexed: 01/11/2023] Open
Abstract
AIM To evaluate the effects of a yoga-based exercise program on pain, fatigue, sleep disturbance, and biochemical markers in hemodialysis patients. MATERIALS AND METHODS In 2004 a randomized controlled trial was carried out in the outpatient hemodialysis unit of the Nephrology Department, Uludag University Faculty of Medicine. Clinically stable hemodialysis patients (n=37) were included and followed in two groups: the modified yoga-based exercise group (n=19) and the control group (n=18). Yoga-based exercises were done in groups for 30 min/day twice a week for 3 months. All of the patients in the yoga and control groups were given an active range of motion exercises to do for 10 min at home. The main outcome measures were pain intensity (measured by the visual analogue scale, VAS), fatigue (VAS), sleep disturbance (VAS), and grip strength (mmHg); biochemical variables-- urea, creatinine, calcium, alkaline phosphatase, phosphorus, cholesterol, HDL-cholesterol, triglyceride, erythrocyte, hematocrit--were evaluated. RESULTS After a 12-week intervention, significant improvements were seen in the variables: pain -37%, fatigue -55%, sleep disturbance -25%, grip strength +15%, urea -29%, creatinine -14%, alkaline phosphatase -15%, cholesterol -15%, erythrocyte +11%, and hematocrit count +13%; no side-effects were seen. Improvement of the variables in the yoga-based exercise program was found to be superior to that in the control group for all the variables except calcium, phosphorus, HDL-cholesterol and triglyceride levels. CONCLUSION A simplified yoga-based rehabilitation program is a complementary, safe and effective clinical treatment modality in patients with end-stage renal disease.
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Affiliation(s)
- M Yurtkuran
- Uludag University Medical Faculty, Physical Therapy and Rehabilitation Department, Atatürk Balneotherapy and Rehabilitation Center, PK 16080 Kükürtlü, Bursa, Turkey
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Akdag I, Ersoy A, Kahvecioglu S, Gullulu M, Dilek K. Acute colchicine intoxication during clarithromycin administration in patients with chronic renal failure. J Nephrol 2006; 19:515-7. [PMID: 17048210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Colchicine is an effective antiinflammatory medication. It should be used with great caution, however, in patients requiring dialysis. Coadministration of colchicine and macrolides may impair colchicine elimination, resulting in excess drug exposure and toxicity. We report 2 renal failure cases of colchicine intoxication occurring with the administration of clarithromycin.
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Affiliation(s)
- Ibrahim Akdag
- Department of Nephrology, Uludağ University Medical School, Bursa, Turkey.
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Abstract
BACKGROUND Behçet's disease (BD) is usually diagnosed between the second and fourth decades. Onset after 50 years of age is extremely rare. We aimed to analyze the clinical features of late-onset patients with BD. METHOD The study was conducted from 439 patients diagnosed as BD according to criteria of the International Study Group for BD. Clinical features of patients who were asymptomatic or suffered from only recurrent aphthous stomatitis (RAS) until 50 years of age but fulfilled the diagnostic criteria of BD after this age were reviewed. RESULTS The age-of-onset was more than 50 years in nine patients (1.56%). Two patients developed erythema nodosum, two developed pathergy positivity, one developed papulopustules, pathergy positivity and ocular symptoms, one developed papulopustules and pathergy positivity, one developed ocular symptoms, one developed papulopustules and ocular symptoms, and one developed erythema nodosum and pathergy positivity as well as oral aphthae and genital ulcerations after the age of 50 years. The neurologic system was involved in two patients. Mucocutaneous symptoms of two patients worsened after interruption of therapy. Two patients with neurologic and ocular involvement flared during the follow up. CONCLUSION Since the course of the disease is regarded to be relatively mild in mature patients, it is noteworthy that systemic manifestations such as ocular and neurologic involvement and acute flares developed after the age of 50 years in the limited number of patients with late-onset BD in our series.
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Affiliation(s)
- Hayriye Saricaoglu
- Department of Dermatology, Medical Faculty, University of Uluda, Bursa, Turkey.
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Yurtkuran M, Yurtkuran M, Alp A, Sivrioglu K, Dilek K, Tamgaç F, Alper E, Tunali S, Saricaoğlu H, Nasircilar A. Hand involvement in Behçet's disease. Joint Bone Spine 2006; 73:679-83. [PMID: 16626999 DOI: 10.1016/j.jbspin.2005.11.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2005] [Accepted: 11/04/2005] [Indexed: 11/27/2022]
Abstract
AIMS To study the clinical hand findings in Behçet's disease (BD) and to observe scintigraphic changes of these areas. METHODS Fifty-seven randomly selected BD patients and the patients in the control group (N=40) were evaluated by two blind rheumatologists. The hands were examined for the presence of pain, tenderness, swelling, effusion, erythema, warmth, range of motion and limitation of motion, deformities and muscle atrophy. Then scintigraphic examination of the hands was performed. Control hand scintigrams were obtained from 40 age- and sex-matched patients and were examined by the same two observers. RESULTS Thirty-two of the 57 patients (56.1%) showed Behçet's clinical hand findings. Terminal phalangeal pulp atrophy was observed in 17 (29.81%), rheumatoid-like hand findings were observed in 16 (28.1%), dorsal interosseos atrophy was observed in 12 (20.05%) and erythema over the digits was observed in 12 (20.05%). Twenty-four patients (42.1%) had scintigraphic involvement. The disease duration was observed to be an important factor for hand findings (P=0.040) and scintigraphic involvement (P=0.011). CONCLUSION High prevalence of hand involvement in BD and its relationship with disease duration is demonstrated. Hand involvement tends to be overlooked and careful examination is required in the evaluation of BD. The scintigraphic involvement detected in hands requires special consideration, too.
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Affiliation(s)
- Merih Yurtkuran
- Division of Rheumatology, Atatürk Rehabilitation Center, Uludag University, Kükürtlü C.98, 16080 Bursa, Turkey
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Ersoy A, Kahvecioglu S, Bekar A, Aker S, Akdag I, Dilek K. Primary central nervous system lymphoma in a renal transplant recipient with Bardet-Biedl syndrome. Transplant Proc 2006; 37:4323-5. [PMID: 16387110 DOI: 10.1016/j.transproceed.2005.10.121] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2005] [Indexed: 11/17/2022]
Abstract
Bardet-Biedl syndrome (BBS) is a rare autosomal recessive disorder. End-stage renal failure has been reported as the most frequent cause of death in this disorder. There are few reports of kidney transplantation in these patients. Renal transplant patients are known to be at increased risk for the development of malignancies. Although a few patients with BBS have been described to develop malignant disease, there was no previous association with lymphoma. We report a 20-year-old patient in whom primary central nervous system lymphoma was diagnosed 20 months after renal transplantation.
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Affiliation(s)
- A Ersoy
- Department of Nephrology, Uludağ University Medical School, Bursa, Turkey.
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Ersoy A, Kahvecioglu S, Ersoy C, Akdag I, Yurtsever I, Dilek K. Is glucocorticoid-induced osteonecrosis after kidney transplantation related to osteoporosis? Nephrol Dial Transplant 2005; 21:1452-3. [PMID: 16357048 DOI: 10.1093/ndt/gfi342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ersoy A, Kahvecioglu S, Ersoy C, Cift A, Dilek K. Anemia Due to Losartan in Hypertensive Renal Transplant Recipients Without Posttransplant Erythrocytosis. Transplant Proc 2005; 37:2148-50. [PMID: 15964363 DOI: 10.1016/j.transproceed.2005.03.085] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2004] [Indexed: 11/30/2022]
Abstract
Losartan is a safe, effective long-term treatment for hypertension or posttransplant erythrocytosis (PTE) in renal transplant recipients. There were only a few studies in patients without PTE and their results were different. Starting from week 6 and continuing to the week 12 we observed a decrease in hemoglobin (Hb) and hematocrit (Hct) levels in patients without PTE. Anemia developed in 42.8% of the patients, and Hb levels increased after the withdrawal of losartan treatment. There was a significant decrease in Hct levels beginning from week 3 when compared with the control group. Our study suggests that losartan therapy can decrease Hb beyond its antihypertensive efficacy. Based on the capacity of losartan to decrease Hb and Hct, this drug should be carefully used in patients with preexistent anemia or low Hb levels.
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Affiliation(s)
- A Ersoy
- Department of Nephrology, Uludağ University Medical School, 16059 Gorukle/Bursa, Turkey.
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Kahvecioglu S, Akdag I, Kiyici M, Gullulu M, Yavuz M, Ersoy A, Dilek K, Yurtkuran M. High prevalence of irritable bowel syndrome and upper gastrointestinal symptoms in patients with chronic renal failure. J Nephrol 2005; 18:61-6. [PMID: 15772924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND Gastrointestinal symptoms and psychiatric disorders are common among patients with chronic renal failure since uremia affects all systems as well as the gastrointestinal tract. Irritable bowel syndrome (IBS) is a frequent functional disorder worldwide. We aimed to evaluate the frequency of IBS and upper gastrointestinal symptoms in patients with chronic renal failure (CRF). The relationships between IBS, sex and additional psychiatric disorders in the same patient group were determined and results were compared with controls. METHODS Ninety-three hemodialysis (HD) and 35 peritoneal dialysis (PD) patients and 51 healthy volunteers were enrolled in this cross-sectional study. They completed the questionnaires that were later evaluated to determine the frequency of IBS in HD, PD and control groups; the frequency of depression and anxiety in these three groups and their relationship to sex. Symptoms of upper gastrointestinal system and their relation to sex were also investigated in all groups. RESULTS In this study, we have demonstrated that prevalence of IBS in patients with chronic renal failure on hemodialysis or peritoneal dialysis is higher than the controls though the type of dialysis does not seem to influence the IBS prevalence itself. Epigastric pain was more prevalent in HD patients than PD patients. CONCLUSIONS The present study suggests that though IBS is common in patients with CRF, it is generally underestimated. Type of dialysis does not seem to change the clinical picture much. Accompanying mood disorders must also be taken into consideration.
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Affiliation(s)
- Serdar Kahvecioglu
- Department of Nephrology, Uludag University Medical School, Bursa-Turkey
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Usta M, Kahvecioglu S, Akdag I, Gullulu M, Ozdemir B, Ener B, Ersoy A, Cirak Y, Dilek K, Yavuz M. Aspergillus pneumonia in renal transplant recipients at a medical center in Turkey. Transplant Proc 2004; 36:2703-7. [PMID: 15621129 DOI: 10.1016/j.transproceed.2004.09.056] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Pulmonary aspergillosis is a devastating disease. Early diagnosis allowing early treatment may improve the prognosis. However, this goal remains difficult to achieve. When the diagnosis is confirmed, it is often already too late. Despite antifungal treatment, the mortality rate is high. Patients with immunosuppression show a high mortality rate. We present five patients of ages ranging between 34 and 43 years who displayed aspergillus pneumonia between 1991 and 2000. All patients received cyclosporine, azathioprine, and prednisone for maintenance immunosuppressive therapy. Their ages ranged from 34 to 43 years with the onset of infection between 1 to 25 months posttransplant. In all cases, the infection was localized to the lungs. Standard methods of fungal culture and identification were used. No coinfections with tuberculosis or other fungi or bacteria were identified. Three cases were successfully treated but two patients showed deterioration despite appropriate therapy and died. Among patients with solid organ transplantation, lung, liver, and renal transplant patients are at the highest risk of developing aspergillus lung infections. A high degree of awareness and efforts for early diagnosis and therapy may improve the poor prognosis.
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Affiliation(s)
- M Usta
- Ulu Dag University School of Medicine, Ulu Dag, Turkey
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Dirican M, Akca R, Sarandol E, Dilek K. Serum paraoxonase activity in uremic predialysis and hemodialysis patients. J Nephrol 2004; 17:813-8. [PMID: 15593056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
BACKGROUND Paraoxonase (PON1) is a high-density lipoprotein (HDL)-associated enzyme and has been shown to reduce the susceptibility of low-density lipoprotein (LDL) to lipid peroxidation. This study aimed to investigate the activity and phenotype distribution of serum paraoxonase in uremic patients, and to evaluate the correlations of uremia-associated substances (urea, creatinine (Cr) and uric acid) with paraoxonase activity. METHODS Twenty-eight patients with chronic renal failure (CRF), 44 patients with CRF undergoing hemodialysis (HD) and 26 healthy controls were included in this study. Paraoxon or phenylacetate was used as a substrate for measuring paraoxonase and arylesterase activity, respectively. The double substrate method was used to assign phenotypes. Serum lipid parameters were determined by routine laboratory methods. RESULTS Paraoxonase activity, HDL-cholesterol and apolipoprotein (apo) AI levels were found to be significantly lower in HD patients than in controls. However, HDL-standardized paraoxonase activity (PON activity/HDL) was not different in the HD patients compared to controls. Arylesterase activity was significantly lower in both CRF and HD patients than in controls. Paraoxonase phenotype distribution was not different among the groups according to the double substrate method. Serum paraoxonase and arylesterase activities correlated inversely with serum urea and Cr levels. CONCLUSION Patients on long-term HD have reduced paraoxonase/arylesterase activities and this could be related to reduced HDL-cholesterol and apo AI levels, as well as increased urea and Cr levels in uremia.
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Affiliation(s)
- Melahat Dirican
- Department of Biochemistry, Uludag University Medical Faculty, Bursa, Turkey.
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Ersoy A, Ersoy C, Tekce H, Yavascaoglu I, Dilek K. Diabetic ketoacidosis following development of de novo diabetes in renal transplant recipient associated with tacrolimus. Transplant Proc 2004; 36:1407-10. [PMID: 15251345 DOI: 10.1016/j.transproceed.2004.04.080] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Although drugs used in renal transplant recipients such as steroids, cyclosporine, and particularly, tacrolimus have diabetogenic potential, diabetic ketoacidosis is uncommon. There are few data concerning the long-term follow-up of these patients. Diabetic ketoacidosis occurred in a renal transplant recipient following de novo development associated with tacrolimus.
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Affiliation(s)
- A Ersoy
- Department of Nephrology, Uludag University, Bursa, Turkey.
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Saricaoglu H, Bulbul EB, Cikman ST, Dilek K, Tunali S. Effects of long-term cyclosporine A therapy on renal functions in Behçet's disease. Int J Tissue React 2004; 26:93-6. [PMID: 15648441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Cyclosporin A (CsA), one of the most extensively investigated immunomodulatory agents, is widely used today in the treatment of various immunologically triggered dermatologic disorders. The immunologic basis for the therapeutic action of CsA depends on the suppression of lymphokine production by T cells. Due to its immunologic effects, this drug is also commonly preferred in Behcet's disease, especially with neurologic and ocular involvement. Since the course of this chronic disease presents remissions and exacerbations, drug therapy should be long term. Studies on the safety of long-term use of CsA in dermatologic diseases are limited. In this study, we aimed to evaluate the long-term use of CsA in Beh,et's disease without renal involvement. A total of 19 patients with ocular Beh,et's disease receiving CsA therapy for at least 1 year were included in this retrospective study. Changes in the parameters of renal function (creatinine clearance, creatinine level in serum), other adverse effects and their relation with cumulative CsA dosage were evaluated. The duration of CsA therapy and total dosage were not found to have a significant effect on the parameters of renal function, but, depending on clinical observations, the adverse effects seem to increase in the long term. We conclude that our results on renal function should be supported by renal biopsies.
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Affiliation(s)
- H Saricaoglu
- Deparment of Dermatology, Uludag University Medical Faculty, Bursa, Turkey.
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Kanat O, Evrensel T, Filiz G, Usta M, Baskan E, Dilek K, Manavoglu O. Systemic AA amyloidosis and nephrotic syndrome associated with small cell carcinoma of the bladder. Nephrol Dial Transplant 2003; 18:2453-4. [PMID: 14551390 DOI: 10.1093/ndt/gfg391] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ersoy A, Güllülü M, Usta M, Ozçelik T, Ylmaz E, Uzaslan EK, Vuruskan H, Yavuz M, Oktay B, Dilek K, Yurtkuran M. A renal transplant recipient with pulmonary tuberculosis and visceral leishmaniasis: review of superimposed infections and therapy approaches. Clin Nephrol 2003; 60:289-94. [PMID: 14579946 DOI: 10.5414/cnp60289] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Visceral leishmaniasis (VL) is an acute or subacute disease that is almost invariably fatal if untreated. It is a rare disease in renal transplant recipients and frequently reported together with other infectious agents. A 39-year-old renal transplant patient was admitted to hospital for elective coronary surgery. In the post-operative period, he developed spiking fever and non-productive cough and his general condition deteriorated. While he was taking medication for non-specific pneumonia, a cavitary lesion occurred in his lung, and he had the diagnosis of pulmonary tuberculosis and antituberculous treatment was started. Despite treatment, his fever continued. As the patient developed pancytopenia and splenomegaly, a bone marrow aspiration was done. Evaluation of bone marrow aspirate indicated Leishmania parasites. He was successfully treated with a more intensive liposomal amphotericin (L-AmB). Complete cure was achieved during follow-up period of 10 months without clinical relapse. In the existence of fever and long-standing pancytopenia, VL should be suspected although the patient had another proved infection and did not live or visit an endemic area. L-AmB usage can be safely preferred for treatment of selected renal transplant recipients with VL as first-line therapy.
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Affiliation(s)
- A Ersoy
- Divisions of Nephrology, Uludag School of Medicine, Bursa, Turkey.
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Abstract
PURPOSE To compare systemic arterial blood pressure (BP) and nocturnal hypotension in patients with normal-tension glaucoma (NTG), high-tension glaucoma (HTG), and ocular hypertension. METHODS Systemic BP was recorded by a portable automated BP monitoring device every 20 min during the day and every 30 min at night in patients with NTG (n=18), HTG (n=22), and ocular hypertension (n=19). Mean systolic, diastolic, and mean arterial BPs were calculated for 24 h, during the day and at night. The mean and maximum nocturnal dip rates were determined for each patient. The number of readings that declined below 90 mmHg for systolic BP and below 60 and 50 mm Hg for diastolic BP was recorded for each group. Statistical significance was set at P<0.05. RESULTS Minimum, maximum, and mean values of the systolic, diastolic, and mean arterial BPs were not significantly different among groups. There was no difference among groups in the nocturnal dip percentages of systolic and diastolic BPs. The number of systolic BP readings below 90 mmHg was significantly higher in the NTG group compared with the other groups (P<0.001, chi(2) test). CONCLUSION There may not be any difference among NTG, HTG, and ocular hypertension patients in terms of mean ambulatory BP values. On the other hand, when each individual's ambulatory reading is reviewed, readings may reveal that excessive and repetitive nocturnal drops occur more frequently in some patients with NTG. These hypotensive episodes may be related to the development of glaucomatous damage.
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Affiliation(s)
- B Yazici
- Department of Ophthalmology, Uludag University School of Medicine, Bursa, Turkey.
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Usta M, Dilek K, Ersoy A, Ozdemir B, Mistik R, Vuruskan H, Gullulu M, Yavuz M, Oktay B, Yurtkuran M. Prevalence of transfusion transmitted virus infection and its effect on renal graft survival in renal transplant recipients. Scand J Urol Nephrol 2003; 36:473-7. [PMID: 12623514 DOI: 10.1080/003655902762467657] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Little is known about the prevalence of transfusion transmitted virus (TTV) infection in renal transplant recipients (RTxs) and its effects on allograft survival. We investigated the prevalence of TTV and its effects on liver injury and graft survival in RTxs. MATERIAL AND METHODS The study was performed in 33 consecutive RTxs (8 females, 25 males) and 100 blood donors (35 females, 65 males). A nested polymerase chain reaction was used to detect TTV DNA in serum. Serum creatinine and alanine aminotransferase (ALT) levels and 24-h protein excretion were determined in both TTV-positive and-negative patients. The total number of blood transfusions, the duration of hemodialysis and the total duration after transplantation were recorded in RTxs. In addition, hepatitis B surface antigen (HbsAg), anti-hepatitis C virus (HCV) and hepatitis G virus DNA antibodies were determined in all patients. RESULTS TTV DNA was detected in 51.5% of RTxs and in 7% of the control group and this difference was statistically significant (p < 0.01). In the RTx group, 64.7% of TTV-positive and 56.2% of TTV-negative patients had undergone a previous blood transfusion. However, the blood transfusion replacement rate, total duration of dialysis therapy and posttransplant period did not differ between these two groups. Five (15.1%) patients in the RTx group had abnormal liver function tests (ALT >40 IU/l). Of these patients, 2 were anti-HCV-positive, 1 was HBsAg-positive and anti-HCV- plus TTV DNA-positive and the serologic tests of the remaining 2 patients were all negative. Among the TTV-positive patients, 2 (11.7%) were anti-HCV-positive, 1 (5.8%) was HBsAg-positive and 3 (17.6%) were HGV DNA-positive. The baseline serum creatinine levels did not differ significantly between the TTV-positive and-negative patients, being 1.5 +/- 0.6 and 1.4 +/- 0.6 mg/dl, respectively ( p > 0.05). Two of the TTV-positive patients and 1 of the TTV-negative patients had proteinuria. A 1-year follow-up of TTV-positive and-negative patients demonstrated neither acute nor chronic graft rejection. CONCLUSION In RTxs, TTV infection was more prevalent than in the normal population. In our patients the virus did not have an important effect on renal graft rejection and did not cause liver injury. However, the question of whether TTV infection may affect graft survival requires further long-term investigation in larger groups.
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Affiliation(s)
- Mehmet Usta
- Department of Nephrology, Medical Faculty, Uludağ, Bursa, Turkey
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Dilek K, Usta M, Ersoy A, Ozdemir B, Yavuz M, Güllülü M, Yurtkuran M. Long-term effects of losartan on proteinuria and renal function in patients with renal amyloidosis. Scand J Urol Nephrol 2003; 36:443-6. [PMID: 12623509 DOI: 10.1080/003655902762467602] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To investigate the effect of the angiotensin II receptor antagonist losartan on proteinuria in secondary amyloidosis cases. MATERIAL AND METHODS Sixteen patients with renal biopsy-proven AA amyloidosis with proteinuria were included in the study. All the patients had received colchicine treatment for at least 18 months. The patients were divided into two groups with similar age and gender distributions. Eight patients were given losartan at a dose of 50 mg/day for 12 months and the other 8 patients served as controls. Mean arterial blood pressure, proteinuria, serum albumin level and renal function were determined at the initiation of the study and after 1 and 12 months. RESULTS There were no significant differences in proteinuria, serum albumin level, renal function or mean arterial blood pressure at the initiation of the study. In the losartan group daily proteinuria decreased significantly from 5.2 +/- 0.7 g at the initiation of the study to 3.9 +/- 1.2 g at 1 month and 3.6 +/- 0.8 g at 12 months, while in the control group it changed from 4.6 +/- 1.0 g to 4.7 +/- 1.0 g and 6.1 +/- 1.2 g, respectively. The increment at 12 months was significant. After 12 months of treatment with losartan, proteinuria was significantly lower in comparison to the degree of proteinuria in the control group. Serum albumin level increased significantly in the losartan group but was unchanged in the control group. In the control group, creatinine clearance showed a significant decrease. There was no significant difference in mean arterial blood pressure measurements, serum creatinine levels, total protein, albumin and creatinine clearance levels between the two groups. CONCLUSIONS Losartan seemed to prevent an increase in proteinuria without altering the creatinine clearance level in patients with amyloidosis type AA during a 12-month period. This indicates that losartan may be used to decrease proteinuria in this patient group. However, our results are only preliminary and need to be confirmed by larger studies.
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Affiliation(s)
- Kamil Dilek
- Department of Nephrology, Uludağ, University Medical School, Bursa, Turkey.
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Ersoy A, Yavuz M, Usta M, Ercan I, Aslanhan I, Güllülü M, Kurt E, Emir G, Dilek K, Yurtkuran M. Survival analysis of the factors affecting in mortality in injured patients requiring dialysis due to acute renal failure during the Marmara earthquake: survivors vs non-survivors. Clin Nephrol 2003; 59:334-40. [PMID: 12779094 DOI: 10.5414/cnp59334] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND We reviewed medical records of dialyzed patients admitted to our hospital after the Marmara earthquake and evaluated the factors affecting mortality in survivors and non-survivors according to the survival times. PATIENTS AND METHODS Crush syndrome (CS) was diagnosed in 110 patients. Dialysis treatment was initiated in 60 patients; 21 of all died. The patients were divided into 2 groups which consisted of 39 survivors (Group A, 25 male, 14 female, mean age: 31 +/- 2.2 years) and 21 non-survivors (Group B, 9 male, 12 female, mean age: 27 +/- 3.0 years). Victims treated by any form of renal replacement therapy, including daily or intermittant hemodialysis and/or continuous venovenous hemodiafiltration. Clinical and laboratory findings were recorded regularly. Statistical analysis was performed with Kaplan-Meier method, log rank test and Cox regression analysis for the survival functions. RESULTS APACHE II scores were 13.5 +/- 0.5 for Group A and 13 +/- 0.9 for Group B. Dialysis support was started to patients in Group A in a mean period of 2.8 +/- 0.2 days and in Group B in a mean period of 3.7 +/- 0.6 days after the earthquake (p > 0.05). The most frequent site of trauma was lower extremity (61.5%) and upper + lower extremities (23%) in Group A, and lower extremity (38.1%) and trunk + lower extremity (23.8%) in Group B. The frequencies of abdominal trauma, pelvic fracture and thoracic trauma in Group B were 23.8%, 19% and 14.2%, respectively. Multiple trauma was more frequent in Group B than in Group A (42.8% vs 2.5%). The rates of fasciotomy, amputation and surgery were similar in both groups. The frequency of sepsis was higher in non-survivors. In our center, the overall mortality rate was 8%, mortality rate in CS was 21% and in dialyzed patients it was 35%. Mortality was mainly associated with sepsis. Survival periods (52.3 +/- 4.0 days) in Group A were longer than in Group B (17.3 +/- 2.5 days). With Cox regression analysis, the parameters such as systolic hypotension on admission, female gender, high serum peak creatine kinase (> 20,000 U/l) and multiple trauma including thoracic and abdominal regions, were factors increasing risk of mortality. CONCLUSION As a result, sepsis, multiple trauma and severe crush injury were the main factors increasing mortality risk in dialyzed injuries after the earthquake.
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Affiliation(s)
- A Ersoy
- Department of Nephrology, Uludag University Medical School, Gorukle/Bursa, Turkey.
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Abstract
BACKGROUND Arterial involvement is a rare but serious condition in the course of Behçet's disease. We aimed to assess the results of therapeutic approaches in our patients with arterial lesions caused by Behçet's disease. PATIENTS AND METHODS The records of 534 patients with Behçet's disease between 1987 and 2002 were retrospectively evaluated for the presence of arterial lesions. All patients were followed up regularly at 3 to 6 months intervals. RESULTS Arterial lesions were diagnosed in 21 (3.9%) patients. Eight of these patients had pulmonary artery aneurysms (PAA), and the other 13 patients had non-pulmonary arterial lesions. Urgent surgical intervention was performed in three patients with PAA leading to death in all three. In addition, three other patients died due to massive haemoptysis at home despite to immunosuppressive therapy. Only two out of eight patients with PAA are still alive who were treated with cyclophophamide and corticosteroids. Thirteen operations were performed in 7 out of 13 patients having non-pulmonary arterial lesions. Although ten of the operations were primary operations, three reoperations had to be performed. A stent-graft was applied for the management of an iliac artery aneurysm in one patient. Only one patient died 8 years after the first non-pulmonary arterial involvement following a type IV thoracoabdominal aortic aneurysm repair. Five patients with arterial occlusive lesions were successfully treated by corticosteroids. CONCLUSIONS Pulmonary artery aneurysms in Behçet's disease patients have a poor prognosis despite any form of therapy. High dose corticosteroids alone can be successfully used for isolated non-pulmonary arterial occlusive lesions, unless disabling symptoms occur. Surgery or stent-graft insertion is indicated for non-pulmonary arterial aneurysms because these aneurysms entail high risk of complications.
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Affiliation(s)
- D Saba
- Uludağ University Medical Faculty, Department of Thoracic and Cardiovascular Surgery, Göğüs, Kalp ve Damar Cerrahisi Ana Bilim Dali, Görükle, 16059, Bursa, Turkey.
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