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Öğe ACCURACY OF URINARY SPOT PROTEIN TO CREATININE RATIO IN PRE-POST TREATMENT OF NEPHRITIS(Oxford Univ Press, 2013) Ozmen, Sehmus; Akin, Davut; Danis, Ramazan; Yilmaz, Mehmet[Abstract Not Available]Öğe Analysis of 152 Patients with Nephrotic Syndrome in the Period between 2001 and 2007(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2008) Akin, Davut; Ozmen, Sehmus; Danis, RamazanThe frequency of glomerulonephritis (GN) may vary depending on developmental areas and geographic location. The characteristics of 152 patients with nephrotic syndrome (NS) admitted to Dicle University School of Medicine between 2001 and 2007 were retrospectively analyzed. Of 152 patients 76 (50%) was female and 76 (50%) was male. The mean age of patients was 36.30 +/- 16.5 years. 106 patients (69.7%) had a histologic diagnosis. The frequencies of primary glomerulonephritis were as followed: membranous GN (MGN) 28%, membranoproliferative GN (MPGN) 24% and focal segmental glomerulosclerosis (FSGS) 22.7%. In conclusion MGN was the most common primer GN type in biopsies performed with an NS indication in our region. In our study, MPGN, a decreasing GN type in developed countries, is still common in our region but has a trend to decrease.Öğe Analysis of Our Cases With End Stage Renal Disease in a Period Between 2001 and 2007(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2007) Danis, Ramazan; Ozmen, Sehmus; Akin, Davut; Bestas, Remzi; Atayan, Yahya; Zulfuogullari, Abbas; Yalcin, SuatThe etiology of end stage rectal disease (ESRD) varies with the country, ethnicity, and sex. Climate conditions, socioeconomic status, cultural and environmental factors may play an important role in etiologic distribution of ESRD. We retrospectively analyzed 535 patients in Dicle University School of Medicine, Department of Nephrology. The patients had a creetinine clearance below 15 ml/min per and did not take any type of renal replacement therapy. Hypertension: diabetes mellitus, and urologic disorders were the most common causes of ESRD. It was striking that urologic disorders constituted 11.1% of ESRD cases as the third must common cause, and 42.3% of these subjects had urolithiasis. No difference regarding sex, hemoglobin. parathyroid hormon, erythrupoietin calcium, phosphorus between subjects within different etiologies. In conclusion, hypertension and diabetes mellitus account for half of the ESRD etiology as expected. But urologic disorders, may be preventable when diagnosed early, are more common than world and Turkey registries. More attention must he provided in diagnosis and treatment of urologic disorders. Comprehensive and efficient schedules targeted to early diagnose and treatment of renal stone disease must be initiated.Öğe A general approach and management in complications of hemodialysis catheters(Ortadogu Ad Pres & Publ Co, 2007) Danis, Ramazan; Oezmen, Sehmus; Akin, Davut; Yazanel, OrhanCentral venous catheters are commonly used vascular access for hemodialysis in renal failure. Semi-rigid double-lumen polyurethane catheters may be considered for short-time use (up to 2-3 weeks). Soft silicone double-lumen or twin-catheters, preferably with subcutaneous tunneling, are highly desirable for prolonged usage. The complications related with catheters may be evaluated under three topics: insertion complications, thrombosis, and infection. Infections is the most common cause of the nosocomial sepsis and the most serious complication in dialysis centers. Catheter dysfunction is one of the common complications. The internal jugular route should be considered for mid-term use in order to facilitate the patient's mobilization and to reduce the risk of infection. The subclavian route should be avoided because of the risk of stenosis and/or thrombosis of the outflow vein. Catheter insertion must be performed by a trained physician with ultrasound guidance. Complications associated with insertion, infection, and thrombosis are a major source of morbidity and mortality in end stage renal disease patients. Diagnosis and management of these complications are discussed in details.Öğe Hyaluronic Acid as a New Biomarker to Differentiate Acute Kidney Injury From Chronic Kidney Disease(Iranian Soc Nephrolgy, 2017) Akin, Davut; Ozmen, Sehmus; Yilmaz, Mehmet EminIntroduction. It may be difficult to differentiate acute kidney injury from chronic kidney disease in patients with no past medical reports of kidney function. This study aimed to investigate the role of serum hyaluronic acid (HA), which is known as a marker of fibrosis, in differential diagnosis of kidney failure. Materials and Methods. A total of 90 patients (52 women and 38 mne) admitted to our renal unit with uremia for the first time were included. Serum HA level was measured. The diagnostic role of the test was investigated using the receiver operator curve curves. Results. The mean age of the patients was 54.6 +/- 17.9 years. The diagnosis was chronic kidney disease (CKD) in 41.1%, acute kidney injury (AKI) in 48.9%, AKI on CKD in 6.7% (3 died without a diagnosis). The mean serum HA was significantly higher in the CKD group (146.1 +/- 119.3 ng/mL) than the AKI group (68.9 +/- 69.1 ng/mL; P < .001). Serum HA significantly correlated with proteinuria (r = 0.717, P < .001) and serum albumin level (r = -0.599, P < .001) in the CKD group only. Serum HA cutoff level of 61 ng/dL had a sensitivity of 82% and specificity of 67% for differential diagnosis of AKI and CKD. Conclusions. Serum HA level may be used as tool to differentiate AKI from CKD. Further larger studies are warranted to clarify the definite the role of this marker.Öğe Investigation of anticardiolipin antibodies in chronic hepatitis B infection together with total anti-delta positivity(Ankara Microbiology Soc, 2008) Mese, Sevim; Oezekinci, Tuncer; Atmaca, Selahattin; Arikan, Eralp; Akin, DavutAnticardiolipin antibodies (ACAs) are formed against phospholipids in various clinical conditions such as autoimmune diseases, malignancy, infectious diseases, alcohol-related and hepatic cirrhosis. The aims of this study were to investigate the presence of ACAs in patients with chronic hepatitis B together with positive total anti-delta antibodies, and to investigate the relationship between age, gender, and some laboratory parameters (ALT, AST, albumin, globulin, platelet number) of patients with chronic hepatitis delta virus (HDV) infection, who were positive or negative for ACAs. A total of 60 patients (43 male, 17 female) with chronic hepatitis D infection [HBsAg positive, HBeAg negative, anti-HBe positive, anti-HBc IgG positive, anti-HBc IgM negative, total anti-delta positive, anti-HCV negative] and 30 patients (21 male, 9 female) without hepatitis D infection [HBsAg positive, HBeAg negative, anti-HBe positive, anti-HBc IgG positive, anti-HBc IgM negative, total anti-delta negative, anti-HCV negative] as control group were included to the study. ACA IgG and IgM were searched by a commercial microELISA kit (Euroimmun, Germany). The statistical evaluation was performed with Pearson's chi-square test, Student's t-test, and Fisher's exact test. Total ACAs positivity rate of 60 patients with chronic HDV infection, was found as 13.3%, in which four of the patients were positive for only ACA IgM, while four was positive for only IgG. Positivity for both ACA IgG and ACA IgM could not be detected in these patients. No patients in the control group had positivity for ACAs (IgG and/or IgM). A statistically significant difference was observed in terms of ACA positivity between patients with and without HDV infection (p<0.05). After all, there was no statistically significant correlation between ACAs positivity and the age, sex, and laboratory parameters of the patients with chronic HIDV infection, except lower serum albumin levels (p=0.004). Although the data of this study revealed a statistically significant positive correlation between chronic HDV infection and anticardiolipin antibodies, it is clear that there is a need for further studies on this subject.Öğe Role of lean body mass for estimation of glomerular filtration rate in patients with chronic kidney disease with various body mass indices(Informa Healthcare, 2009) Ozmen, Sehmus; Kaplan, Mehmet Ali; Kaya, Halil; Akin, Davut; Danis, Ramazan; Kizilkan, Berfin; Yazanel, OrhanObjective. Glomerular filtration rate (GFR) is the main tool used to diagnose, treat and follow up renal diseases. Age, gender, ethnicity and obesity all affect the relationship between serum creatinine, muscle mass/body weight and GFR. This study aimed to investigate the role of lean body mass for GFR estimation in patients with chronic kidney disease (CKD) with various body mass indices. Material and methods. In total, 110 Caucasian adult subjects with CKD referred for GFR measurement by 99mTc-DTPA renography were enrolled in the study. The patients were categorized according to body mass index values: 18.5 kg/m2 (underweight), 18.5-24.9 kg/m2 (normal), 25-29.9 kg/m2 (overweight) and 30 kg/m2 (obese). Lean body mass (LBM) and fat mass were measured by leg-to-leg bioimpedance. Predictive factors were identified by linear regression analysis in each group. Results. GFR measured by DTPA, creatinine clearance, Cockcroft and Gault, and Modification of Diet in Renal Disease (four-variable) equations was 3727, 4230, 4227, and 4935 ml/min/1.73 m2, respectively. The predictive role of 1/SCr, age, serum albumin, amount of proteinuria, LBM and fat mass was investigated all groups. None of the factors was significant in underweight and healthy weight groups except for 1/serum creatinine (SCr). LBM/SCr was an independent predictive factor for both overweight and obese groups. 1/SCr accounted for 96.2% of the variability in measured GFR for underweight subjects but only 58.1% of the variability in GFR of obese subjects. Conclusions. The formulae derived from SCr should be used cautiously in overweight and obese subjects. LBM measured by bioimpedance was an independent predictive factor of GFR in obese/overweight subjects and added clinically important diagnostic value to 1/SCr. It needs to be investigated as a parameter in further studies attempting to develop formulae for estimating GFR in larger obese and overweight populations.Öğe Snakebite-induced acute kidney injury: Data from Southeast Anatolia(Taylor & Francis Inc, 2008) Danis, Ramazan; Ozmen, Sehmus; Celen, Mustafa Kemal; Akin, Davut; Ayaz, Celal; Yazanel, OrhanRenal failure is an important complication of snakebite and a major cause of mortality. We aimed to study the clinical profile of snake envenomation in Southeast Anatolia, Turkey, in an adult population. We retrospectively analyzed the records of 200 snakebite victims from 1998 to 2006 at the Dicle University School of Medicine, Diyarbakir, Turkey. Sixteen patients (8%) developed AKI (acute kidney injury). Of those, 25% required dialysis and 18% died. There was no difference between groups in age, arrival time to hospital, and hospital stay time. Both groups received similar hydration and therapy at admission. Disseminated intravascular coagulation (DIC) was observed in 25% of the AKI group and was significantly higher than the non-AKI group (7.1%; p = 0.014). There was no significant difference regarding hemoglobin, platelet levels, and prothrombin time at admission. The prevalence of thrombocytopenia (<150,000 K/UL ) was 60% in the AKI group and 40% in the non-AKI group (p > 0.05). WBC count was significantly higher in the AKI group than in those without AKI (p = 0.001); serum albumin was significantly lower in the AKI group than in those without AKI (p = 0.013). AKI is an important complication of snakebite that may lead to mortality. Despite some troublesome aspects due to its retrospective design, this is a large series from Southeast Anatolia of Turkey in an adult population. Subjects with high WBC, low albumin, and DIC should be closely followed up for the development of AKI.Öğe Thrombophilias and arteriovenous fistula dysfunction in maintenance hemodialysis(Springer, 2009) Danis, Ramazan; Ozmen, Sehmus; Akin, Davut; Batun, Sabri; Kahvecioglu, Serdar; Altintas, Abdullah; Yilmaz, Mehmet E.Most episodes of fistula thrombosis are consequences of underlying physioanatomic abnormalities. However, some dialysis access thrombosis develops independent from any obvious anatomic cause. We aimed to clarify the role of thrombophilias in primary and secondary AVF failure. One hundred eighty nine arteriovenous fistulas in 116 adults on maintenance hemodialysis were analyzed. All subjects were evaluated for many thrombotic factors. Fistula information was obtained both from the patients' self reports, and from their medical records. Twenty-seven AVFs in 18 cases (14.3%) had pAVFF. The percentage of subjects with a BMI < 20 kg/m(2) was significantly lower than no-pAVFF group (P = 0.03). ATIII levels and albumin values were significantly lower in patients with sAVFF compared to those with no sAVFF. Other parameters were similar. There was no statistically significant difference between pAFFF versus No-pAFFF and sAFFF versus No-sAFFF groups with respect to all mutant alleles count. Routine extended analyses of all thrombophillic factors are not recommended in AVFF.Öğe Thrombosis of temporal artery and renal vein in Kimura disease related nephrotic syndrome(Springer, 2009) Danis, Ramazan; Ozmen, Sehmus; Akin, Davut; Ozekinci, Selver; Altintas, Abdullah; Cil, Timucin; Pasa, SemirKimura disease (KD) is an angiolymphoid proliferative disorder of unknown etiology, occurs mainly in Asian patients, presenting with subcutaneous slowly growing masses, with a predilection for preauricular and submandibular regions. The clinical course of the disease is thought to be benign. Concomitant peripheral blood eosinophilia and elevated serum immunoglobulin E levels are often observed. Main systemic manifestation of the KD is renal involvement. Renal abnormalities, notably proteinuria and nephrotic syndrome have been found to be associated with KD. We report a 42-year-old man with KD and a steroid-sensitive membraneous nephrotic syndrome with bilaterally temporal artery and renal vein thrombosis. This is the first reported case of KD associated nephrotic syndrome complicated with wide arterial and venous thrombosis from Anatolia.Öğe Type 4 Renal Tubular Acidosis in a Patient With Lupus Nephritis(Iranian Soc Nephrolgy, 2014) Akin, Davut; Ozmen, SehmusAlthough renal tubular acidosis (RTA) is a rare complication of systemic lupus erythematosus (SLE), type 4 RTA associated with lupus nephritis is extremely rare. A 20-year-old woman presented with malaise and edema in the lower extremities and face. She had multiple lymphadenopathies. There were 20% eosinophil in blood smear and 32% in bone marrow aspiration. Serology revealed positive antinuclear antibody at 1:1000 titer, positive double-stranded DNA antibodies, and low complements C3 and C4 levels. Urinary sediment was active and urinary protein excretion was 4.8 g/d. The SLE Disease Activity Index score was 23. A high SLE Disease Activity Index scores was proposed as a potential risk factor for type 4 RTA. Type 4 RTA may complicate SLE, and specifically, patients with high SLEDAI scores and lymphadenopathy may pose a high risk. Our patient responded successfully to immunomodulatory therapy.Öğe Ureterosygmoidostomy-associated quadriparesis, non-traumatic rhabdomyolysis, and tetany in an adult(Springer, 2008) Ozmen, Sehmus; Danis, Ramazan; Akin, Davut; Gullu, Nezir; Ozmen, Cihan Akgul; Yazanel, OrhanWe report an adult case of ureterosigmoidostomy-associated quadriparesis, rhabdomyolysis, and tetany which may be the first such case in the literature. A 32-year-old female patient was brought to the emergency room of our hospital, having been unable to walk or use her arms for 24 h. Neurological examination revealed quadriparesis. She had severe hypokalemia (1.27 mmol/l) and metabolic acidosis (pH = 7.05). Creatine kinase value was 2,590 U/l on the third day. She received intensive therapy to correct the hypokalemia and acidosis. On the third day of hospitalization tetany was detected in her upper extremities. The patient regained full muscle power after intravenous potassium chloride, bicarbonate, and calcium replacement therapy.
