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    The effects of Losartan on oxidative stress and inflammation in non-diabetic patients undergoing chronic hemodialysis
    (Verduci Publisher, 2013) Kayabasi, H.; Yilmaz, Z.; Sit, D.; Kadiroglu, A. K.; Yilmaz, E.
    INTRODUCTION: We aimed to evaluate the effects of Losartan, an angiotensin receptor blocker, on serum inflammatory markers, plasma thiol groups, and oxidative stres indexes among patients undergoing hemodialysis (HD) treatment. PATIENTS AND METHODS: Fiftytwo end-stage renal disease (ESRD) patients undergoing chronic HD programme for at least 12 months, and thirty age and gender matched healthy volunteers were enrolled into this prospective clinical trial. Plasma levels of thiol groups (SH), total antioxidant capacitiy (TAC), and total oxidant status (TOS) were studied. Oxidative stress index (OSI) was calculated by TOS/TAC. Firstly results of patients were compared with healthy subjects and then patients were treated by Losartan 50-100 mg and followed up for three months. RESULTS: Among patients, SH Groups, TAC, TOS, and OSI were statistically higher than controls. Also the inflammatory markers were significantly higher in patients than controls and albumin was lower among patients. At the end of the 3 months among all patients the mean value of TAC was increased to 1.7 +/- 0.4 micromol Trolox Eqv./L. from 1.4 +/- 0.2, and SH groups to 0.33 +/- 0.02 mmol/L from 0.22 +/- 0.01, (p < 0.001) while TOS decreased to 7.2 +/- 1.1 micromol H2O2 Eqv./L from 9.5 +/- 4.5, and OSI decreased to 5.0 +/- 0.8 from 7.1 +/- 3.2 (p < 0.001). CONCLUSIONS: Losartan was effective in controlling blood pressure, and decreasing OSI, a marker of elevated oxidative stress, and increasing plasma levels of SH groups, an antioxidant, in ESRD patients undergoing hemodialysis. So, it may not be only a hypotensive drug, but also improves OS, particularly in patients with ESRD.
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    Fungal peritonitis in peritoneal dialysis: a 10 year retrospective analysis in a single center
    (Verduci Publisher, 2012) Basturk, T.; Koc, Y.; Unsal, A.; Ahbap, E.; Sakaci, T.; Yildiz, I.; Kayabasi, H.
    INTRODUCTION: Fungal peritonitis (FP) is a rare but serious complication in patients undergoing peritoneal dialysis (PD), and is associated with higher morbidity, mortality. We aimed to analyze the predisposing factors, etiological agents, outcome and treatment of FP in patients with PD. METHODOLOGY: We evaluated retrospectively all PD patients PD center between 2001 and 2011. Sixteen patients with FP were included into the study. RESULTS: The clinical records of 16 patients with FP among 355 patients were reviewed for the clinical and laboratory data. Among 506 episodes of PD-related peritonitis in 10 years, we identified 16 episodes of FP. Median PD duration was 36.7 +/- 22.2 months. In 87.5% of patients had one or more previous episode of bacterial peritonitis that were treated with multipl broad-spectrum antibiotics. FP was primary infection in five patients, whereas eleven patients experienced FP during the course of treatment of bacterial peritonitis. Six patients died due to the fungal infection whereas others were transferred to haemodialysis. CONCLUSIONS: Treatment of bacterial peritonitis with broad spectrum antibiotics was an important risk factor predisposing to the development of FR The catheter removal and initiation of antifungal therapy as soon as possible are obligatory in episode of FP because it is responsible from high mortality rate.