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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 Adipocyte volumes and levels of adipokines in diabetes and obesity(Elsevier Sci Ltd, 2008) Gokalp, Deniz; Bahceci, Mithat; Ozmen, Sehmus; Arikan, Senay; Tuzcu, Alpaslan; Danis, RamazanAim: Obesity is a major risk factor for insulin resistance, type 2 diabetes, heart disease, and many other chronic diseases. The factors regulating cytokine production seem to have a role on the determination of adipocyte volume. We aimed to investigate the association of plasma adiponectin and resistin concentrations with adipocyte volumes in obese, diabetic, obese-diabetic and control groups. Methods: Plasma adiponectin, resistin and lipid levels and adipocyte volumes were investigated in obese, non-diabetic, non-obese diabetic, obese diabetic and control groups consisting 100 subjects who planned to undergo elective surgery. Differences in clinical or laboratory parameters among groups were compared by using one-way ANOVA test. Chi-square test was used for comparing the frequencies. Results: The lipid values in all three groups were higher than the control group. A negative correlation was found between adiponectine levels and adipocyte volumes. When adipocyte volumes were compared with other groups, adipocyte volumes were significantly higher in the obese diabetic group (p = 0.000). The adipocyte volumes in the obese group were determined to be higher than the control group. Conclusions: Although a positive correlation was found between adipocyte volumes and adiponectin in literature, adiponectin concentrations in our study were lower. These conditions can be explained by the effect of insulin resistance on the adiponectin levels in obese diabetic groups. Moreover, adiponectin levels are mostly associated with subcutaneous adipose tissue which may have been less. Resistin levels may play an important role in the development of obesity, insulin resistance and diabetes. (C) 2008 Diabetes India. Published by Elsevier Ltd. All rights reserved.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 case of essential mixed cryoglobulinemia and associated acquired von-Willebrand disease treated with rituximab(Springer, 2009) Pasa, Semir; Altintas, Abdullah; Cil, Timucin; Danis, Ramazan; Ayyildiz, Orhan; Muftuoglu, EkremCurrent treatment options of essential mixed cryoglobulinemia (EMC); include immunosuppressive approaches, such as corticosteroids, cyclophosphamide, plasma exchange, other cytotoxic drugs in moderate to severe manifestations. Some controlled studies have been carried out to assess the efficacy of anti-CD20 monoclonal antibody, rituximab in patients with hepatitis C (HCV) related cryoglobulinemia (CG) and in patients with autoimmune disorders. Recent trials and some case reports demonstrate a beneficial role for rituximab in HCV related mixed CG. Although, the published evidence for treatment of EMC with rituximab is restricted to case reports, which have shown positive results. Several diseases include lymphoproliferative and myeloproliferative disorders, solid tumors, immunological disorders, cardiovascular disorders and some drugs associated with acquired von Willebrand disease (avWD). CG, which is a kind of immune complex disease, may be related with development of autoantibodies to various autoantigens. In this present case report, we showed the efficacy of rituximab in a 21-year-old female patient, suffered from neuropathy and arthralgia related with EMC, and developed avWD, presented with mucosal bleeding associated with CG. von Willebrand factor activity of our patient also increased with controlling the underlying disease, EMC by rituximab. This case demonstrate that rituximab may be an effective treatment option in EMC and avWD mainly related to CG.Öğe A Case of Sheehan's Syndrome Admitting With Severe Hyponatremia(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2005) Danis, Ramazan; Ozmen, Sehmus; Parmaksiz, Ergun; Ozmen, Cihan Akgul; Yazanel, OrhanPostpartum necrosis of pituitary gland is one of the most common reasons of hypopituitarism. It is most commonly due to massive bleeding before or during delivery. Nonspecific symptoms like fatigue and weakness may confuse and delay the diagnosis. Patients with Sheehan's syndrome may rarely present with hyponatremia signs. A 55-year-old woman admitted to our nephrology department with stupor, severe hyponatremia (100 mEq/L), and hypoglycemia (56 mg/L). The diagnosis of Sheehan's syndrome was based on medical history, laboratory and radiological imaging findings. The patient's clinical picture improved dramatically after hormone and sodium replacement therapy. Sheehan's syndrome must be in differential diagnosis of old women with hyponatremia and it must be known that hyponatremia in those patients may be severe.Öğe Does adding misoprostol to standard intravenous proton pump inhibitor protocol improve the outcome of aspirin/NSAID-induced upper gastrointestinal bleeding?(Springer, 2007) Yilmaz, Serif; Bayan, Kadim; Dursun, Mehmet; Canoruc, Fikri; Kilinc, Nihal; Tuzun, Yekta; Danis, RamazanAspirin and nonsteroidal anti-inflammatory drug (NSAID)-induced gastrointestinal bleeding is recognized as an important health problem. We performed a single-center randomized clinical trial to compare the effect of high-dose intravenous proton pump inhibitor (omeprazole) alone (group 1) with omeprazole in combination with a low-dose prostaglandin analog (misoprostol; group 2) on clinical outcomes in patients with aspirin/NSAID-induced upper gastrointestinal bleeding. Additionally, we evaluated the contribution of Helicobacter pylori eradication therapy on the late consequences. Patients were recruited to the study if they had upper gastrointestinal bleeding with history of taking aspirin or other NSAIDs within the week before the onset of bleeding. All were evaluated in terms of probable risk factors. After the standard treatment protocol, patients with histologically proven H pylori infection were prescribed a triple eradication therapy for 14 days. The primary end points were recurrent bleeding, surgery requirement, and death rates before discharge and at the end of follow-up period. This study lasted for 2 years. A total of 249 patients with upper gastrointestinal bleeding were admitted, and 49.7% of these patients were users of aspirin/NSAIDs. There were 67 patients in group 1 and 56 in group 2. The distributions for gender, age, comorbidity, H pylori infection, and high-risk ulcer rate were similar in both groups. Among aspirin/NSAID users, endoscopy revealed duodenal ulcer in 47 (38.2%), gastric ulcer in 10 (8.1%), and erosive gastropathy in 33 (26.8%). The overall rebleeding occurred in 12.2%, death in 2.4% of the patients. The in-hospital death (P=.414), rebleeding (P=.925), and surgery (P=.547) rates were similar in both treatment groups. After the follow-up period of 3 months, overall rebleeding occurred in 4.1%, and death in 4.8% of the patients. The overall mortality rate was highest in those > 65 years old, who were chronic low-dose aspirin users with comorbidity. One died of transfusion-related graft-versus-host disease. In this pilot study, we indicated that adding misoprostol (600 mu g/day) to standardized proton pump inhibitor treatment did not improve or change the rebleeding or mortality rates of patients with upper gastrointestinal bleeding related to aspirin/NSAID use. Other prospective studies on higher doses of misoprostol are needed to establish the coeffect. One should bear in mind that all blood products must be irradiated before transfused to the host.Öğe The effects of nonsteroidal anti-inflammatory drugs on platelet function and severity of upper gastrointestinal haemorrhage(Springer, 2009) Pasa, Semir; Bayan, Kadim; Kucukoner, Mehmet; Tuzun, Yekta; Altintas, Abdullah; Cil, Timucin; Danis, RamazanNonsteroidal anti-inflammatory drugs (NSAIDs) cause gastrointestinal (GI) damage primarily due to the inhibition of prostaglandin synthesis in gastric mucosa, which is an important factor in mucosa protection. Platelets are a cardinal feature of vascular repair. A variety of angiogenic stimulators are stored in platelets and are released during clotting at the wound. When there is a defect in any of these functions and/or platelet number, haemostasis is usually impaired and there may be an associated increased risk and severity of bleeding. While the mechanism of mucosal injury and bleeding are well documented with the use of NSAIDs, very little is known about the platelet function abnormalities and their effects on severity of upper GI bleedings. We performed a prospective analysis of 49 patients who had a history of NSAIDs use to investigate the association between the platelet function impairment associated with NSAIDs and severity of upper GI haemorrhages. Thirty-six of 49 patients (73.5%) had deteriorated platelet function. Mean severity score of patients with deteriorated platelet functions was 3.39, and that of patients with normal platelet functions was 2.46. Mean severity score was statistically significantly higher in patients with deteriorated platelet functions. In conclusion, impaired platelet functions associated with NSAIDs may cause more severe upper GI bleeding. Clinicians should be alert for GI complications especially in older patients and in those with a history of ulcer bleeding.Öğe The efficacy of rituximab in patients with splenectomized refractory chronic idiopathic thrombocythopenic purpura(Springer, 2009) Pasa, Semir; Altintas, Abdullah; Cil, Timucin; Danis, Ramazan; Ayyildiz, OrhanThe most difficult problem a physician encounters is the management of patients with idiopathic thrombocytopenic purpura (ITP), who has persistent severe thrombocytopenia after failure of initial treatment with glucocorticoids and splenectomy. Most of the patients refractory to corticosteroids and splenectomy will become refractory to other available agents, such as intravenous immunoglobulin (IVIg), danazol or chemotherapy. In this study, we investigated the effect of rituximab on 17 splenectomized refractory chronic ITP patients. Here, we showed that the anti-CD20 antibody, rituximab, induces a clinically significant response in severe chronic ITP patients, who are unresponsive to other therapeutic options. After sixth month, 10 out of 14 responders were still maintaining their durable and significant platelet responses (platelet counts > 50 x 10(9)/l), without requirement to any other ITP medication. Therefore, we suggest that, rituximab is an effective treatment option in splenectomized refractory or relapsed ITP patients. Rituximab was well tolerated without severe side effects.Öğe Familial Mediterranean fever gene mutations in the Southeastern region of Turkey and their phenotypical features(Taylor & Francis Ltd, 2008) Pasa, Semir; Altintas, Abdullah; Devecioglu, Bilge; Cil, Timucin; Danis, Ramazan; Isi, Hilmi; Bayan, KadimFamilial Mediterranean fever (FMF) is an autosomal recessive disease characterized by recurrent inflammatory attacks of serosal membranes. Several studies have focused on the differences between frequency of the mutations and their phenotypical manifestations. The aim of this study was to evaluate whether or not this phenotypical variation is associated with the existence of particular mutations. Twelve MEFV(Mediterranean fever) gene mutations were investigated in 119 patients suffering from FMF. Heterozygote M694V(21/119), heterozygote E148Q(21/119), homozygote M694V(17/119) and heterozygote V726A(12/119) mutations were the most common mutations. Patients were grouped according to the presence of the M694V mutation: group I was M694V/M694V, group II was M694V/others, and group III was other/other. Mean severity scores for the groups were 13.94 +/- 4.10, 10.79 +/- 3.01 and 8.31 +/- 2.26, respectively. There were statistically significant differences between the mean severity scores of groups I and II(p = 0.029), groups I and III(p < 0.0001), and groups II and III(p < 0.0001). Diagnosis of amyloidosis was established in four(23%) patients of group I, and three(8%) patients of group II, but in none of the patients in group III. There was also a statistically significant difference between groups I and III(p = 0.046), but not between groups II and III(p = 0.083) and groups I and II(p = 0.317) in terms of amyloidosis development. In conclusion, we found a higher disease severity score and higher prevalence of amyloidosis in FMF patients who were M694V mutation carriers. Many ethnic groups live in Anatolia and more ethnic origin-based studies are needed to determine the real effect of these mutations on disease severity and amyloidosis.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 Hyperthyroidism may affect serum N-terminal pro-B-type natriuretic peptide levels independently of cardiac dysfunction(Wiley, 2007) Arikan, Senay; Tuzcu, Alpaslan; Gokalp, Deniz; Bahceci, Mithat; Danis, RamazanBackground It is known that NT-proBNP levels increase in cardiac failure. However, NT-proBNP levels in different thyroid states are still unclear. We aimed to evaluate serum NT-proBNP levels in both hyperthyroid and hypothyroid patients without cardiac insufficiency. Subjects and methods Thirty-six patients with hyperthyroidism (42.9 +/- 16.7 years), 25 patients with hypothyroidism (35.4 +/- 13.9 years) and 34 age-matched euthyroid subjects (41.4 +/- 13.8 years) were included in the study. After anthropometric evaluations, body fat analyses were determined by bioelectrical impedance. Electrocardiography and echocardiography were used in cardiac evaluations. Serum NT-proBNP was measured by immunoassay. Results Mean serum NT-proBNP levels in hyperthyroid patients were higher than in both control subjects (13.65 +/- 13.02 vs. 6.50 +/- 4.83 pmol/l, P = 0.002) and hypothyroid patients (13.65 +/- 13.02 vs. 5.98 +/- 5.08 pmol/l, P = 0.003). However, mean serum NT-proBNP levels in hypothyroid patients were not different from those in control subjects. There was a positive correlation between serum NT-proBNP and thyroid hormones (NT-proBNP and FT3: r = 0.324, P = 0.001; NT-proBNP and FT4: r = 0.269, P = 0.009, respectively). Serum NT-proBNP levels were positively correlated with left ventricle end-diastolic diameters (r = 0.232, P = 0.04), interventricular septum thickness (r = 0.315, P = 0.006), and negatively correlated with left ventricular ejection fraction (r = -0.238, P = 0.04). Conclusions Serum NT-proBNP levels may increase in hyperthyroidism independently of cardiac insufficiency. Therefore, hyperthyroidism may lead to cardiac ultrastructural changes undetermined by conventional echocardiography and these changes may be responsible for elevation of NT-proBNP levels. In contrast to decreased thyroid hormones, excess thyroid hormones may have a more pronounced effect on serum NT-proBNP levels.Öğe Incidence of Tuberculosis Disease and Latent Tuberculosis Infection in Patients with End Stage Renal Disease in an Endemic Region(Taylor & Francis Ltd, 2010) Ates, Gungor; Yildiz, Tekin; Danis, Ramazan; Akyildiz, Levent; Erturk, Baykal; Beyazit, Huseyin; Topcu, FusunAim. Patients in chronic renal failure suffer impaired cellular immunity and have an increased risk of tuberculosis (TB). Our aim in this multicenter study was to determine the incidence of TB and to evaluate latent tuberculosis infection (LTBI) in hemodialysis patients. Methods. We retrospectively evaluated the frequency of TB in 779 dialysis patients at 13 hemodialysis centers in five different cities in Southeast Turkey. The tuberculin skin test (TST) was conducted in 733 patients to detect LTBI. Results. The mean age of the patients was 51.2 +/- 15.9 years; 398 (51.1%) of the patients were female, and 53.9% of patients had a BCG scar. The mean dialysis duration time was 35.1 +/- 33.4 months. TB was diagnosed in 34 cases. The incidence rate of TB in patients undergoing hemodialysis was 3.1%. Ten patients had a history of TB before beginning hemodialysis, and 24 patients had a history of TB after beginning hemodialysis. A diagnosis of TB was made based on clinical data in eight patients and microbiologically or pathologically in 26 patients. The median time between the initiation of dialysis to the diagnosis of TB was 11 months. Extrapulmonary TB occurred in 45.8% of cases, and the most common site of involvement was the lymph nodes. The TST was positive in 61.8% of TB patients and in 37.5% of those with no history of TB. Conclusions. The incidence of TB is high in hemodialysis patients, and they should be evaluated periodically to exclude insidious infection and reduce morbidity and mortality.Öğe MICROCHIMERISM, A DILEMMA IN CURRENT MEDICINE(Nobel Ilac, 2006) Ozmen, Sehmus; Danis, Ramazan; Altintas, Abdullah; Bayan, Kadim; Yilmaz, SerifMicrochimerism refers to presence of a small number of cells or DNA of one individual harbored in another individual. Many studies indicate that cell trafficking occurs between the fetus and mother during pregnancy and between others after organ transplantation or blood transfusions. These cells or DNA can persist in recipient?s blood or tissues for decades, creating a state of physiologic microchimerism. In several recent studies, microchimerism has been shown to have potential roles in pathogenesis of different diseases. However, due to the fact that microchimerism has also been found in healthy individuals and in organs affected by non-autoimmune conditions, an alternative hypothesis has been suggested in which microchimeric cells are associated with the healing process of a tissue injury as opposed to causing disease. As a conclusion of this review of recent studies, we can say that microchimerism studies yielded more questions than answers.Öğe Predictive value of serum NT-proBNP levels in type 2 diabetic people with diabetic nephropathy(Elsevier Ireland Ltd, 2012) Danis, Ramazan; Ozmen, Sehmus; Arikan, Senay; Gokalp, Deniz; Alyan, OmerObjective: The serum N-terminal fragment of pro brain natriuretic peptide (NT-proBNP) level in type 2 diabetic subjects with or without diabetic nephropathy (DN) is still unclear. We aimed to evaluate the relationship between serum NT-proBNP levels and different stages of diabetic nephropathy, and identify probable factors predicting serum NT-proBNP level. Subjects and methods: This cross-sectional study included 20 normoalbuminuric (Group-I), 28 microalbuminuric (Group-II), 20 macroalbuminuric type 2 diabetic patients (Group-III), and 20 healthy volunteers (Group-IV). Serum NT-proBNP levels were measured with highly sensitive and specific immunoassay. Results: Mean NT-proBNP levels were 32 +/- 55, 91 +/- 95, 331 +/- 297, 42 +/- 34 pg/ml for Groups I-IV, respectively. When patients with LVH were excluded, mean logNT-proBNP was still significantly higher in Group-III than all other groups. The three diabetic groups were similar in age, BMI, HbA1c, fasting serum glucose, and GFR. In a multivariate linear regression model, adjusting for factors significantly correlated with NT-proBNP levels, the patient group, presence of LVH, and hemoglobin remained as an independent predictor of serum NT-proBNP. These variables explained 68% of the variability of NT-proBNP (adjusted R-2 = 0.683). Conclusions: Mean serum NT-proBNP level of macroalbuminuric diabetic patients was higher than normoalbuminuric and microalbuminuric diabetic patients, and healthy control subjects even after exclusion of LVH. NT-proBNP may be a useful and predictive marker of diabetic nephropathy. (C) 2011 Elsevier Ireland Ltd. All rights reserved.Öğe Pregnancy-related atypical hemolytic uremic syndrome with renal, cardiac and obstetric complications and a satisfactory recovery: a case report(Taylor & Francis Ltd, 2021) Gunay, Emrah; Ozan, Mahsum; Kaya, Seyhmus; Ocal, Ece; Kutlu, Zeynep; Senol, Ayhan; Danis, Ramazan[Abstract Not Available]Öğe Prothrombin Time, Activated Thromboplastin Time, Fibrinogen and D-Dimer Levels and von-Willebrand Activity of Patients with Sheehan's Syndrome and the Effect of Hormone Replacement Therapy on These Factors(Akad Doktorlar Yayinevi, 2010) Pasa, Semir; Altintas, Abdullah; Tumer, Cemil; Demircin, Mustafa; Cil, Timucin; Bayan, Kadim; Danis, RamazanIncreased mortality due to atherosclerotic cardiovascular disease has been described in adult patients with hypopituitarism, although the precise underlying mechanisms remain undetermined. Various abnormalities of coagulation and fibrinolysis occur in patients with thyroid diseases. Conversely, there are conflicting reports concerning the effects of growth hormone replacement on coagulation and fibrinolytic pathways in hypopituitary adults, and there is no existing data on the effects of hypocortisolism on thrombotic and fibrinolytic systems. The same controversial data were also obtained in studies which evaluate the effects of estrogen replacement therapy on cardiovascular events in post-menopausal women. The aim of this study was to investigate the effects of Sheehan's syndrome (SS), which is a common cause of hypopituitarism, on haemostatic factors and to assess the effects of L-thyroxin, prednisolone and conjugated estrogen / medroxyprogesterone acetate replacement on these factors. Prothrombin time (PT), activated thromboplastin time (aPTT), fibrinogen and D-dimer levels, and von-Willebrand factor (vWF) activity were compared among 32 patients with SS and 35 control subjects (CS) with similar age. A shorter PT and aPTT, higher fibrinogen and d-dimer levels, and similar vWF activity were determined in patients with SS as compared with CS. In addition, it was determined that hormone replacement treatment did not have a significant effect on coagulation parameters except the fibrinogen and d-dimer levels.Öğe The Retrospective Analysis of 84 Patients With Nephrotic Sydrome(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2005) Danis, Ramazan; Ozmen, Sehmus; Parmaksiz, Ergun; Yazanel, OrhanThe frequency of histologic types of glomerulonephritis vary depending on ethnicity and geographic location. Characteristics of 84 patients with nephrotic syndrome admitted to Dicle University Faculty of Medicine were retrospectively analysed. The mean age of 41 female and 43 male patients was 35.0 years. Forty-seven patients (78.3%) had primary glomerulonephritis and the remaining 13 patients (21.7%) had secondary glomerulonephritis. The basal mean values of patients with NS were as follows: serum creatinine 1.68 mg/dl, serum urea 64.5 mg/dl, renal protein loss 5.7 gr/day, and creatinine clearence 65 ml/min. MPGN and MGN were the most common GN types in biopsies performed with a NS indication. In our study, MPGN, a decreasing type in developed countries, and MGN, the most common type worldwide were at top. Although MPGN is decreasing in western countries it is still common in different regions of our country and is the most common GN type in our region.Öğe Rhabdomyolysis-Induced Acute Renal Failure Following Fenofibrate Therapy: A Case Report and Literature Review(Hindawi Ltd, 2010) Danis, Ramazan; Akbulut, Sami; Ozmen, Sehmus; Arikan, SenayFenofibrate, a fibric acid derivative, is used to treat diabetic dyslipidemia, hypertriglyceridemia, and combined hyperlipidemia, administered alone or in combination with statins. Rhabdomyolysis is defined as a pathological condition involving skeletalmuscle cell damage leading to the release of toxic intracellular material into circulation. Its major causes include muscle compression or overexertion; trauma; ischemia; toxins; cocaine, alcohol, and drug use; metabolic disorders; infections. However, rhabdomyolysis associated with fenofibrate is extremely rare. Herein we report a 45-year-old female patient who was referred to our department because of generalizedmuscle pain, fatigue, weakness, and oliguria over the preceding 3 weeks. On the basis of the pathogenesis and clinical and laboratory examinations, a diagnosis of acute renal failure secondary to fenofibrate-induced rhabdomyolysis wasmade. Weekly followups for patients who are administered fenofibrate are the most important way to prevent possible complications.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.
