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    THE ASSOCIATION OF RELATIVE HYDRATION STATUS WITH NT-PROBNP, IVC INDEX AND BLOOD PRESSURE IN NEWLY DIAGNOSED STAGE 5 CHRONIC KIDNEY DISEASE
    (Carbone Editore, 2013) Yilmaz, Zulfukar; Yildirim, Yasar; Aydin, Fatma Yilmaz; Aydin, Emre; Kadiroglu, Ali Kemal; Yilmaz, Mehmet Emin
    Introduction: Accurate and sensitive methods are very important for the assessment of volume status in chronic kidney disease (CKD). Bioelectrical impedance analysis (BIA) is a simple, non-invasive and promising method to assess volume status in patients with CKD. Objective: The aim of this study was to evaluate the association between BIA derived relative hydration status (RHS) and clinical findings and other markers of volume status in patients who were newly diagnosed with stage 5 CKD. Patients and method: Totally 85 patients who were newly diagnosed with stage 5 CKD and have not received any renal replacement therapy were enrolled in this study. Hydration status was assessed by multi-frequency BIA device (Body Composition Monitor, Fresenius). Relative hydration status was defined as the overhydration (OH) to extracellular water (ECW) ratio and clinical overhydration was considered as an overhydration-to-extracellular water ratio of >% 15. The patient population was divided into 2 groups; group 1: RHS >% 15, group 2: RHS <= %15. Inferior vena cava (IVC) diameter was measured by echocardiography and indexed for body surface area as IVC index (mm/m2). NT-proBNP was measured by immunoassay. Results: Among subjects, 57.6% of the patients had RHS >% 15. Systolic blood pressure (SBP), diastolic blood pressure (DBP), proteinuria, OH. ECW, IVC index, and NT-proBNP were significantly higher, while serum albumin and residual urine were significantly lower in group I than group 2 (p<0.05). There was a significant positive correlation between RHS and SBP, DBP, proteinuria. OH, ECW, NT-proBNP and IVC index and a negative correlation with albumin and residual urine (p<0.05). Conclusions: RHS may be an important measuring parameter of volume overload in patients with CKD. RHS is correlated with NT-proBNP, blood pressure and IVC index.
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    AN ATYPICAL LOCALISATION OF TUBERCULOSIS INFECTION IN PATIENTS UNDERGOING HAEMODIALYSIS: A CASE REPORT
    (Wiley, 2010) Kayabasi, Hasan; Sit, Dede; Kadiroglu, Ali Kemal; Yilmaz, Zulfukar; Bukte, Yasar
    Spinal tuberculosis (TB) is a rare skeletal system localisation of TB in haemodialysis patients. In this paper, a case of Pott's disease with a psoas muscle abscess is reported. The patient had been on the dialysis programme for five years and was complaining of back pain, weight loss and weakness, which were investigated. A thoracolumbar magnetic resonance imaging showed multiple paravertebral abscesses invading the psoas muscle. TB diagnosis was made by microbiological analysis of specimen, which was obtained by fine needle aspiration under computerised tomography guidance.
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    Bacteremia caused by Stenotrophomonas maltophilia in a dialysis patient with a long-term central venous catheter
    (Univ Chicago Press, 2006) Kara, Ismail Hamdi; Yilmaz, Mehmet Emin; Sit, Dede; Kadiroglu, Ali Kemal; Koekoglu, Oemer Faruk
    [Abstract Not Available]
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    Carpal Tunnel Syndrome Based on Accumulation of ?2 Microglobulin With Vascular Steal Syndrome: A Case Report
    (Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2006) Kadiroglu, Ali Kemal; Sit, Dede; Kayabasi, Hasan; Yilmaz, M. Emin; Isikoglu, Bunyamin
    Rheumatologic and osteoarticular syndromes occur frequently in chronic haemodialysis patients. The number and severity of these complications increase with the time on hemodialysis (HD). Beta-2 microglobulin accumulates in the soft tissue in HD patients due to its low level of clearance. Carpal tunnel syndrome (CTS) is one of the clinical expressions of this accumulation. Early diagnosis and treatment of CTS is important, since being late may lead to permanent defect and/or resistant symptoms.
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    A Case With Pancytopenia Due to Hemodialysis Inadequacy (Case Report)
    (Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2005) Sit, Dede; Kadiroglu, Ali Kemal; Yilmaz, M. Emin; Ayyildiz, M. Orhan; Isikoglu, Bunyamin
    Hemodialysis inadequacy affects not only morbidity and mortality of the dialysis patients, but it can also reduce the effectivity of therapies such as rHuEPO. Hemodialysis inadequacy and erythropoietin ineffectivity are the essential problems of the physicians who deal with patients who have end stage renal failure, and they reduce treatment success. We report a rarely seen case who has pancytopenia because of hemodialysis inadequacy and/or rHuEPO ineffectivity.
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    Comparison of the effects of Losartan and Nebivolol on oxidative stress in patients with end stage renal disease
    (Oxford Univ Press, 2007) Kayabasi, Hasan; Kadiroglu, Ali Kemal; Sit, Dede; Selek, Sahabettin; Yilmaz, M. Emin
    [Abstract Not Available]
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    Could the appropriate anti-diabetic therapy be mixed insulin in dialysis patients?
    (Springer India, 2021) Demircan, Vehbi; Yildirim, Yasar; Aydin, Emre; Kara, Ali Veysel; Aydin, Fatma Yilmaz; Yilmaz, Zulfukar; Kadiroglu, Ali Kemal
    Background A good glycemic regulation should be provided to reduce mortality and morbidity in patients with end-stage renal failure due to diabetes mellitus. However, the use of insulin therapies in patients with renal failure is troublesome due to the increased rate of side effects. In our study, we investigated the frequency of hypoglycemia and its symptoms in patient groups receiving intensive and mixed insulin therapies. Materials and methods This prospective study included 89 hemodialysis patients with DM-related stage 5 chronic kidney disease who were followed up in a nephrology clinic of a university hospital between January 2013 and August 2015. Our study group was divided into two groups as those receiving intensive insulin therapy and mixed insulin therapy. Group 1 and group 2 consisted of 46 patients and 43 patients, respectively. Hypoglycemia (glucose < 70 mg/dl) was investigated in patients with HbA1c levels that decreased below 7% after treatment, and the symptoms were evaluated according to the hypoglycemic scale. The results between the groups were evaluated using chi-square and Student's t test Results A total of 89 patients were included in the study. HbA1c was 6.83% in the group receiving intensive insulin therapy and 6.95% in the group receiving mixed insulin therapy (p > 0.05). Hypoglycemia was detected in 27 patients (58.7%) in the intensive insulin therapy group and 14 patients (32.6%) in the mixed insulin therapy group. There was a significant level of hypoglycemia in the group receiving intensive insulin therapy (p < 0.05). In our study, the group receiving intensive insulin therapy had higher frequency and severity of common hypoglycemia symptoms such as confusion, sweating, weakness, dysphasia, palpitations, blurred vision, and feeling hungry. Conclusion There was a higher frequency of hypoglycemia under intensive insulin therapy in patients undergoing dialysis due to chronic kidney failure, which suggests that mixed insulin therapy is the ideal treatment to avoid hypoglycemia in this group of patients.
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    Delirium With a Single Dosage of Acyclovir in a Continuous Ambulatory Peritoneal Dialysis Patient: Case Report
    (Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2007) Kayabasi, Hasan; Kadiroglu, Ali Kemal; Kara, Ismail Hamdi; Sit, Dede; Yilmaz, M. Emin
    Valacyclovir is an effective oral agent for the treatment of herpes virus infection, however, the pharmacokinetics of the drug are altered in renal failure. It is increasingly recognized that dose adjustment of oral valacyclovir in renal failure is necessary to avoid neurotoxicity. We studied this drug in a continuous ambulatory peritoneal dialysis (CAPD) and immunocompromised patient. She developed neurotoxicity with an adjustment dosage of valacyclovir for a cutaneous zoster infection. The elimination half-time (15 h) was similar to that reported for end-stage renal disease patients, while the steady-state volume of distribution (85 l) and the area under the curve concentration (127 mg/l.h) were greater. The mean CAPD dialysance was only 5.27 ml/min with less than 1% of an administered dose being recovered in the 24-hour dialysate. 48 h after interrupting treatment, she recovered normal neurological status and 500 mg of valacyclovir every 2 days was effective and well tolerated.
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    Diagnosis and Treatment in Chronic Kidney Disease and Evalution of Cardiovascular Disease and Associated Risk Factors
    (Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2008) Kadiroglu, Ali Kemal; Sit, Dede; Yilmaz, M. Emin
    Today, chronic kidney disease (CKD) is a world-wide public health problem. Losing kidney function and occurance of cardiovascular disease (CVD) are inevitablely the main clinical outcomes. Increasing evidence suggested that the adverse outcomes of CKD can be prevented or delayed through early detection and treatment. CKD and hypertension are often present together and hypertension is both a cause and a complication of CKD and is a risk factor for progression of kidney disease and for CVD. The goals of antihypertensive therapy in CKD are to lower blood pressure, reduce the risk of CVD, slow progression of CKD and prevent the complications of decreased GFR. A clinical action plan should be developed for each patient, based on the stage of CKD and follow-up intervals for monitoring the patients should be determined by clinical condition.
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    The effect of inflammatory reactions on antibody unresponsiveness to hepatitis B vaccine in hemodialysis patients
    (Briefland, 2007) Sit, Dede; Kadiroglu, Ali Kemal; Kayabasi, Hasan; Yilmaz, Zuelfuekar; Yilmaz, Mehmet Emin
    Background and Aims: In this study, the effect of infections and inflammation developed during hepatitis B vaccination program on antibody response in hemodialysis (HD) patients was evaluated. Methods: In total, 94 patients who had hepatitis B surface antigen (HBsAg) (-), antibody to hepatitis B surface (antiHBs) (-), antibody against hepatitis B core immunoglobulin G (antiHBclgG) (-) (Group A) and who were previously vaccinated but having antibody titer levels lower than 10 mIU/mL (Group B), on maintenance HD program were included in this study. In group A, 40 mu g intramuscular vaccine on 0, 1, 2 and 6 months and in group B, 40 mu g of intramuscular booster dose vaccine were administered. Antibody titer of 10 mIU/mL was considered as positive. Group A was then divided into two subgroups with respect to antibody response (Group A1 and Group A2). Results: Eighty-one patients completed the study (Group A; n=64, mean age=42.3 +/- 11.4 years; Group B: n=17, mean age=53.6 +/- 10.6 years). In Group A, antibody response was positive in 82.8% (Group A1), negative in 17.2% (Group A2) and it was positive in 100% of Group B. Inflammatory parameters, nutritional and demographic features were found similarly in all groups. Throughout the study, infections developed most frequently in Group A. Conclusions: We concluded that acute infections and inflammations developed in patients vaccinated according to vaccination schedule recommended for HBV prophylaxis during HD treatment does not affect antibody response and acute phase reactants are not indicators for negative antibody response.
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    The effect of venlafaxine HCl on painful peripheral diabetic neuropathy in patients with type 2 diabetes mellitus
    (Elsevier Science Inc, 2008) Kadiroglu, Ali Kemal; Sit, Dede; Kayabasi, Hasan; Tuzcu, Alpaslan Kemal; Tasdemir, Nebahat; Yilmaz, M. Emin
    Objective: The objective of this study was to evaluate the efficacy of venlafaxine HCl in the symptomatic treatment of painful peripheral diabetic neuropathy (PPDN) among patients with type 2 diabetes mellitus (DM). Design: This study was designed as a prospective, randomized, and controlled trial. Setting: This study was conducted at the Dicle University Medical Faculty (Diyarbakir, Turkey). Patients: Sixty type 2 DM outpatients (47 females and 13 males) with PPDN who had a minimum visual analog scale (VAS) score of 40 mm were enrolled in this study. Interventions: Patients randomized to the treatment group (n=30) received venlafaxine HCl, whereas those randomized to the control group (n=30) received a combination of vitamins B-1 and B-6 tablets. Measures: Severity of pain was measured by VAS, Short-Form McGill Pain Questionnaire, and numerical analog scale scores at admission and at the second, fourth, and eighth weeks of the study. Polyneuropathy was supported by electromyelography. Outcome: In the treatment group, severity of pain was measured as 70.0+/-13.0 in the VAS, as 24.9+/-6.2 in the Short-Form McGill Pain Questionnaire, and as 7.2+/-1.1 in the numerical analog scale. In the control group, it was measured as 73.0+/-8.0 in the VAS, as 26.8+/-6.2 in the Short-Form McGill Pain Questionnaire, and as 7.4+/-0.8 in the numerical analog scale (P>.05). Results: The most common form of PPDN was distal symmetrical sensorimotor polyneuropathy in both groups (46.8% vs. 50.0%). At the end of the study, there was a significant difference in severity of pain between the groups. In the treatment group, scores were 8.5+/-5.2 and 3.1+/-1.6 in the Short-Form McGill Pain Questionnaire and numerical analog scale, respectively; in the control group, these were 20.5+/-7.0 and 5.5+/-1.6, respectively (P<.001). Conclusions: Venlafaxine HCl is a safe and well-tolerable analgesic drug in the symptomatic treatment of PPDN; however, it has minimal adverse effects. It showed its efficacy markedly in the second week of therapy. (C) 2008 Elsevier Inc. All rights reserved.
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    The effects of losartan on the oxidative stress index and thiols in patients undergoing dialysis treatment
    (Oxford Univ Press, 2007) Kadiroglu, Ali Kemal; Kayabasi, Hasan; Sit, Dede; Kara, I. Hamdi; Yilmaz, M. Emin
    [Abstract Not Available]
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    The effects of nebivolol on serum levels of malonyldialdehyde and paraoxonase in patients with end stage renal disease
    (Oxford Univ Press, 2007) Sit, Dede; Kayabasi, Hasan; Kadiroglu, Ali Kemal; Yilmaz, Zulfikar; Yilmaz, M. Emin
    [Abstract Not Available]
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    Eivaluation of the Nutritional Status and Anthropometric Measurements in Continuous Ambulatory Peritoneal Dialysis (CAPD) Patients According to the Anemia Status
    (Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2007) Kadiroglu, Ali Kemal; Sit, Dede; Kayabasi, Hasan; Yilmaz, Zulfukar; Yilmaz, M. Emin
    Nutritional biochemical markers such as serum albumin and anthropometric measurements such as BMI are valid and useful tools in assessing the nutritional status in dialysis. Forty-two patients on CAPD therapy were enrolled in the study. Anemic patients and patients who were al target hematocrit levels were evaluated by nutritional parameters and anthropometry. Gender, age, duration of CAPD, dialysis adequacy, educational and economic status had significant affect on BMI and serum albumin. There were positive significant correlations between hematocrit levels and BMI (r=0.331, p=0.0032), and FM (r=.0.383, p=0.012), and MAMC (r=0.365, p=0.017I and serum albumin levels (r=0.416. p=0.006). Achieving target hematocrit levels may improve BMI and MAMC, but not biochemical parameters.
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    The evaluation incidence and risk factors of mortality among patients with end stage renal disease in Southeast Turkey
    (Taylor & Francis Ltd, 2008) Sit, Dede; Kadiroglu, Ali Kemal; Kayabasi, Hasan; Kara, Ismail Hamdi; Yilmaz, Zulfukar; Yilmaz, M. Emin
    Aim. End stage renal disease (ESRD) presents with higher morbidity and mortality with respect to the general population. In recent study, the causes of mortality and associated risk factors in ESRD have been evaluated. Materials and Methods. In this study, 1538 patients diagnosed with ESRD in 10-year period were evaluated retrospectively. The patients were divided as dead (group 1) and alive (group 2). The patients' demographic features, causes of death, comorbidity at hospitalization, hematological and biochemical analyses, creatinine clearance at the beginning of hospitalization, daily urine volume, blood gas results, CRP value as inflammatory marker, ejection fraction, interventricular septum diameter, left ventricle posterior wall end-diastolic diameter, and left atrium diameter determined with echocardiography were recorded. Results. Mortality ratio of ESRD patients in a 10-year period was 14.1%. While the general mean age of all patients was 54.7 +/- 16.6 and male/female ratio was 781/757, these ratios were 66.3 +/- 21.8 and 114/103 in Group 1 and 52.8 +/- 21.7 and 667/654 in Group 2. One or more comorbid pathologies were present in 82.9% of Group 1. The most common cause of mortality was cardiovascular diseases (CVD), and the most common cause of comorbidity was infections. Older age, anemia, absence of residual renal function, hypoalbuminemia, inflammation, impaired Ca and P metabolism, and left ventricular hypertrophy were significantly higher in Group 1 than in Group 2. Conclusion. CVD are the most important preventable causes of morbidity and mortality in all stages of chronic kidney disease. Taking precaution against CVD and the associated complications will provide a positive contribution in reducing morbidity and mortality among ESRD patients.
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    The evaluation of effects of demographic features, biochemical parameters, and cytokines on clinical outcomes in patients with acute renal failure
    (Taylor & Francis Ltd, 2007) Kadiroglu, Ali Kemal; Sit, Dede; Atay, A. Engin; Kayabasi, Hasan; Altintas, Abdullah; Yilmaz, M. Emin
    Aim. To evaluate the effects of cytokines, biochemical parameters and demographic features on clinical outcomes of acute renal failure (ARF). Patients and Methods. 59 patients with acute renal failure (28 men, 31 women) were enrolled to the study. Cytokines, biochemical parameters, and complete blood count were measured. Patients were divided into two groups: as survivors (group 1, n = 46) and nonsurvivors (group 2, n = 13). Results. Mean age of patients were 52.3 +/- 17.9 years. 46 patients survived (77.9%) and 13 patients died (22. 1 %). There was a statistically significant relationship between IL-2R, IL-6, and TNF-oc levels and mortality rates (p = 0.004, p = 0.016, p = 0.020, respectively) and between TC levels and mortality rates (p = 0.041). In multivariable logistic regression analysis, the effects of proinflammatory cytokines (IL- I beta, IL-2R, IL-6, TNF alpha, CRP, and ESR) on the clinical outcomes in ARF was observed to be statistically significant (r = 0.341, p = 0.005). Conclusion. We realized that in totally demographic features (male gender, advanced age, poor nutritional status), biochemical parameters (TC, albumin, and hemoglobin) and cytokine levels (IL-2R, IL-6, TNF-oc), CRP and ESR may be predictive factors for mortality in patients with ARF.
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    Evaluation of fluid status related parameters in hemodialysis and peritoneal dialysis patients: Clinical usefulness of bioimpedance analysis
    (Elsevier Urban & Partner Sp. Z O O, 2014) Yilmaz, Zulfukar; Yildirim, Yasar; Aydin, Fatma Yilmaz; Aydin, Emre; Kadiroglu, Ali Kemal; Yilmaz, Mehmet Emin; Acet, Halit
    Background and objective: Fluid overload is a common and serious problem that leads to severe complications in dialysis patients. We aimed to compare hydration status as measured with bioimpedance analysis (BIA) method in hemodialysis (HD) and peritoneal dialysis (PD) patients, as well as investigating the association between blood pressure, left ventricular mass index (LVMI) and hydration status. Materials and methods: We examined 43 HD and 33 PD patients. Blood pressure was recorded. In each group, echocardiographic examinations were performed on all patients. Hydration status was assessed using multifrequency bioelectrical impedance analysis. Overhydration was defined as an overhydration (OH)/extracellular water (ECW) ratio of >0.15. Results: The OH/ECW ratio was significantly higher in PD patients compared to post-HD patients. Overhydration was statistically more frequent in PD than in post-HD patients (30.3% vs. 11.6%, P = 0.043). Systolic blood pressure (SBP) in both post-HD and PD groups, and LVMI in the PD group were found to be significantly higher in overhydrated patients than non-overhydrated patients. In multiple linear regression analyses, increased OH/ECW ratio was independently associated with higher SBP and LVMI. Conclusions: Fluid overload may be an even more prevalent and serious problem in PD patients. Overhydration is closely associated with increased blood pressure and LVMI. OH/ECW ratio, a derived parameter of fluid load measured by BIA, was a significant and independent determinant of SBP and LVMI. (C) 2014 Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.
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    Evaluation of inflammatory and hematological parameters in patients diagnosed with COVID-19
    (J Infection Developing Countries, 2022) Mermutluoglu, Cigdem; Dursun, Recep; Aktar, Fesih; Dayan, Saim; Celen, Mustafa Kemal; Kadiroglu, Ali Kemal; Inci, Erdal
    Introduction: This study aims to research the effects of hematological and inflammatory parameters on the prognosis of COVID-19 disease and Methodology: One hundred and eighty-six patients with COVID-19 and a control group consisting of 187 healthy individuals were included in the study. Hematological variables and inflammatory parameters of the patients were recorded on the first and the fifth days of hospitalization. Results: White blood cell count, lymphocyte count, and platelet count were statistically lower, and mean platelet volume (MPV), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) levels were higher in the patient group compared to the control group. It was observed that the neutrophil count and MPV level were lower, and the platelet count and ferritin level were statistically higher on the fifth day of follow-up compared to the admission day. In contrast, there was a significantly positive correlation between the duration of hospitalization and the fifth day D-dimer (r = 0.546, p < 0.001) and ferritin (r = 0.568, p < 0.001); in addition, there was a negative correlation between the duration of hospitalization and admission day lymphocyte count and the fifth-day lymphocyte count. Conclusions: Increased levels of ferritin and D-dimer, and decreased count of lymphocytes are among the important factors affecting the duration of hospitalization for COVID-19 patients. Furthermore, we think that neutrophil count and MPV levels are low, and platelet count and ferritin levels are high during the disease. Therefore, these parameters can be used as prognostic indicators of the disease.
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    EVALUATION OF THE ANTIOXIDANT AND RENOPROTECTIVE EFFECTS OF ELLAGIC ACID ON ISCHEMIA/REPERFUSION INDUCED NEPHROPATHY IN RATS
    (Oxford Univ Press, 2014) Yildirim, Yas Ar; Aba, Ozlem; Yilmaz, Zulfukar; Kadiroglu, Ali Kemal; Yilmaz, Mehmet Emin; Gul, Mesut; Ketani, Aydin
    [Abstract Not Available]
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    The Evaluation of the Association Between Serum Cholesterol Levels with Nutritional Parameters and Anthropometric Measures in Non-Diabetic Continuous Ambulatory Peritoneal Dialysis Patients
    (Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2009) Sit, Dede; Kayabasi, Hasan; Kadiroglu, Ali Kemal; Yilmaz, M. Emin
    We evaluated the association of serum cholesterol levels with nutritional parameters and anthropometric measurements in non-diabetic patients undergoing continuous ambulatory peritoneal dialysis (CAPD) treatment. Thirty-nine (21 males, 18 females) patients were enrolled into the study. The patients were divided into two groups as group 1 (n=20, serum cholesterol >= 200 mg/dl), and group 2 (n=19, serum cholesterol < 200 mg/dl.) according to serum cholesterol levels. A positive correlation was found between serum levels of cholesterol and prealbumin (r=0.428, p=0.007), transferrin (r=0.322, p=0.046), triglyceride (r=0.537, p=0.001), LDLC (r=0.739, p<0.001), and HDL-C (r=0.454, p=0.004), and between BMI and FM (r=0.851, p<0.001), FFM (r=0.503, p=0.001), TBW (r=0.522, p=0.001) and MAMC (r=0.849, p<0.001). BIA in group 1 was higher than group 2 (p = 0.007). No statistical relation was found between serum cholesterol, and the anthropometric measurements. In conclusion, we found a positive correlation between serum cholesterol levels and prealbumin and transferrin but not in anthropometric measurements in CAPD patients. Further, large scale studies are needed to conclude an absolute judgement.