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    Continuous renal replacement therapy after cardiac surgery in patients with acute renal failure
    (2013) Guclu O.; Yavuz C.; Gurkan S.C.; Yuksel V.; Demirtas S.; Caliskan A.; Gur O.
    Aim Acute renal failure is an important adverse effect of cardiopulmonary bypass that can result in high mortality or morbidity rates. It can be treated with continuous renal replacement therapy after cardiac surgery. The purpose of this study was to determine the factors associated with the mortality and incidence of acute renal failure in patients of post cardiac surgery. Methods Patients (1564) who underwent cardiac surgery between January 2007 and January 2012 and treated with continuous renal replacement therapy were included (N=40). Patients with previous renal disorders were excluded. A retrospective analysis was carried out. Results Overall, continuous renal replacement therapy was used in 40 (2.6%) patients. The mean age was 62.7±11 years. Mean duration of cardiopulmonary bypass was 166±80 min, and aorta cross-clamping time was 97±35 min. The patients' mean pretherapy creatinine level and mean creatinine level before hospital discharge were 3.3±1.1 mg/dL and 1.1±0.4 mg/dl, respectively. Thirty-day mortality was 35%. Only 6 patients required long-term renal replacement therapy. Conclusion Acute renal failure requiring hemodialysis after cardiac surgery is associated with higher mortality and morbidity and prolonged hospital stay. Early renal recovery with continuous renal replacement therapy seems to offer an evident survival benefit. Continuous renal replacement therapy may represent an important therapy and reduce mortality rates. We believe that these rates might decrease even more with detailed preoperative evaluation and meticulous postoperative care with collaborative management.
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    Evaluating the anti-angiogenic properties of iloprost and dipyridamole in the chick embryo chorioallantoic membrane model
    (Scientific Publishers of India, 2014) Guclu O.; Karahan O.; Yazici S.; Caliskan A.; Demirtas S.; Yavuz C.; Muratoglu A.
    Dipyridamole is an antithrombotic agent that is widely used in the treatment of many vascular disorders. Also, the prostacyclin analogue iloprost has been utilized to salvage limbs in patients with severe limb ischemia. In this study we investigated whether dipyridamole and iloprost have anti-angiogenic properties and their anti-angiogenic properties were compared to bevacizumab, a known inhibitor of angiogenesis, using the in vivo chick chorioallantoic membrane animal model. Agar pellets were prepared with three different drug concentrations at 10-6 M, 10-5 M, and 10-4 M. For each drug concentration twenty fertilized eggs were used. The entire experiment was performed in duplicate. Blood vessel density and loss were examined and scored under a stereoscopic microscope. For the 10-4 M, 10-5 M and 10-6 M concentrations, the anti-angiogenic scores of iloprost were 0.2, 0.1 and 0.05, respectively. In the same order, the anti-angiogenic scores for dipyridamole were 0.2, 0.3 and 0.8. The anti-angiogenic scores for bevacizumab were significantly higher than dipyridamole and iloprost over all concentrations (p<0.05). There were no significant differences found between the anti-angiogenic scores for iloprost and dipyridamole for all concentrations (p>0.05). Iloprost demonstrated no anti-angiogenic properties in the chorioallantoic membrane animal model, while dipyridamole did exhibit very weak anti-angiogenic activity only at very high doses of 10-4 M. These results reveal that both agents can be prescribed safely for the treatment of medical conditions that require angiogenesis to facilitate healing.