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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
    (Acta Medica Mediterranea, 2013) Yilmaz Z.; Yildirim Y.; Zaydin F.Y.; Aydin E.; Kadiroglu A.K.; Yilmaz M.E.
    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 1>% 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 1 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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    Evaluation of the antioxidant and renoprotective effects of ellagic acid on ischemia / reperfusion induced nephropathy in rats
    (Acta Medica Mediterranea, 2014) Yildirimi Y.; Aba Adıyaman, Özlem; Yilmaz Z.; Kadiroglu A.K.; Yilmaz M.E.; Gül M.; Ketani A.
    Aims: Renal ischemia-reperfusion (I/R) injury is one of the important cause of acute kidney injury (AKI). Reactive oxygen species and inflammatory cytokines play major role in the pathogenesis of IR injury. Ellagic acid (EA), a phenolic compound, have shown to exert antioxidants, anti-inflammatory, anticarcinogenic, antihyperlipidemic effects. We aim to evaluate, the effect of EA on renal I/R induced nephropathy in rats. Materials and methods: Twenty-eight male Sprague-Dawley rats were divided into four groups; control, control + EA, I/R, and EA+I/R. EA (85 mg/kg, perorally) was administered 30 min prior to the ischemia. Rats were unilaterally nephrectomized and subjected to 45 min of renal pedicle occlusion followed by 60 min of reperfusion. Both groups were subsequently studied by renal function tests, oxidant and antioxidant parameters, and kidney histology. Results: Serum/kidney TAC, NO and paraoxonase levels were significantly higher, while serum urea and creatinine, serum/kidney MDA and TOS were significantly lower in EA+I/R group compared to I/R group (p<0.05). Histopathologic examination revealed that the severity of damage was significantly lower in the EA+I/R group compared to the I/R alone group. Conclusion: Administration of EA appears to have beneficial effects on I/R induced renal injury by reducing oxidative stress, thus preventing histological injuries and bringing about an improvement in renal function.
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    Relationship between fluid status as assessed by bioimpedance analysis and NT-pro BNP, blood pressure and left ventricular mass index in hemodialysis patients
    (Societa Editrice Universo, 2014) Yilmaz Z.; Yildirim Y.; Aydin F.Y.; Aydin E.; Kadiroglu A.K.; Yilmaz M.E.; Ulgen M.S.
    Aims: Maintenance of fluid status within an optimal range and accurate assessment of dry weight (DW) is essential in patients on intermittent haemodialysis (HD) treatment. In this study, we aimed to investigate the association of fluid status measured by bioimpedance analysis (BIA) with N-terminal pro-B natriuretic peptide (NT-proBNP), blood pressure and left ventricular mass index (LVMI) in hemodialysis patients. Materials and Methods: A total of 45 hemodialysis patients were enrolled in the study. N-terminal pro-B natriuretic peptide (NT-proBNP) was measured by immunoassay. Blood pressure (BP) was recorded. Echocardiographic examinations were performed in all patients. Multifrequency bioimpedance analysis was used to assess pre- and post-dialysis fluid status. Overhydration/ extracellular water (OH/ECW) ratio was used as fluid status index and OH/ECW ratio >0.15 was defined as clinical overhydration. Patients were divided into two groups; overhydrated (OH/ECW>0.15) and non-overhydrated (OH/ECW?0.15). Results: OH/ECW, systolic blood pressure (SBP), diastolic blood pressure (DBP), LVMI and NT-proBNP levels were significanly reduced after hemodialysis session. The presence of overhydration was more frequent in pre-HD patients compared to post-HD patients (31.1% vs 13.3%, p=0.004). OH/ECW was positively correlated with pre-and post-HD SBP, DBP, LVMI and NT-proBNP (p<0.05). Overhydrated patients had significantly higher values of pre-HD and post-HD SBP, DBP, LVMI and NT-proBNP compared to non-overhydrated patients. In addition, SBP, DBP, LVMI and NT-proBNP levels were significantly reduced after hemodialysis in both overhydrated and non- overhydrated patients group. Conclusions: This study revealed that OH/ECW ratio was significantly associated with SBP, DBP, LVMI and NT-proBNP. © Società Editrice Universo (SEU).
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    Venlafaxine HCl in the treatment of painful peripheral uremic neuropathy: A case report
    (2006) Kadiroglu A.K.; Sit D.; Kayabasi H.; Yilmaz E.; Isikoglu B.
    Background: It is well known that uremia may lead symmetric sensorimotor polyneuropathy that tends to affect the lower limbs compared to upper limbs. It typically involves the legs than the arms. Clinical manifestations include paresthesia, painful dysesthesia, weakness in the legs and arms. The traditional tricyclic antidepressants (TCA) are commonly used in the treatment of painful peripheral polyneuropathy. Venlafaxine is a serotonin-noradrenaline reuptake inhibitor that may have analgesic effect on painful peripheral polyneuropathy. Case Report: Venlafaxine extended release capsule (Effexor 75mg XR, Wyeth) was administered to a 49 years old female patient who has been under hemodialysis therapy for 7 years. She complained of bilateral numbness, pain, pin-pricking and burning in her feet that increasing in the evening. She was also suffered from insomnia for two months. The patient's symptoms were resolved in two weeks after beginning to the therapy but the intensity of pain continued minimaly and the patients demonstrated effective improvements at her insomnia in this period. Venlafaxine was well tolerated and there were no side effects such as nasuea, elevated blood pressure and dizziness. Conclusions: Venlafaxine relieved the symptoms of the uremic polyneuropathy and it was effective in insomnia.