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    THE ASSOCIATION BETWEEN FEEDING HABITS, NUTRITIONAL PARAMETERS AND QUALITY OF SLEEP IN HEMODIALYSIS PATIENTS
    (Oxford Univ Press, 2013) Kose, Esra; Turgutalp, Kenan; Kiykim, Ahmet; Celik, Fatma; Oguz, Ebru Gok
    [Abstract Not Available]
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    The Association Between Feeding Habits, Nutritional Parameters and Quality of Sleep in Hemodialysis Patients
    (Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2014) Kose, Esra; Turgutalp, Kenan; Kiykim, Ahmet; Celik, Fatma
    OBJECTIVE: Poor sleep and sleep-related breathing disorders are common in hemodialysis (HD) patients. However, it is not well known whether there is a relation between nutritional habit and quality of sleep. The aim of this study was to investigate the relation between quality of sleep and nutritional characteristics. MATERIAL and METHODS: The study population included 84 HD patients. Data were collected with the questionnaire developed by the researchers and included questions about socio-demographic features, biochemical findings, and anthropometric data. RESULTS: The quality of sleep was poor in 51.2% of the patients. These patients were relatively older than the patients with good quality of sleep (44.0 +/- 13.0 and 37.4 +/- 11.8 year respectively, p<0.001). The patients with the good quality of sleep consumed significantly more meat-offal-cheese-egg (p<0.01) and fruit (p<0.05). The patients with the poor quality of sleep had significantly lower albumin (p<0.01), pre-albumin (p=0.02) and total lymphocyte counts (p=0.02). The patients who more frequently had gastrointestinal complaints (especially abdominal discomfort and flatulence) had the poor quality of sleep. CONCLUSION: There are some associations between sleep quality and nutritional aspects. Nutritional habits should be evaluated in HD patients having poor sleep quality.
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    THE EFFECT OF GLOMERULAR C3 DEPOSITION ON RENAL OUTCOME IN PATIENTS WITH MEMBRANOUS NEPHROPATHY: DATA OF THE TSN-GOLD STUDY
    (Oxford Univ Press, 2023) Gursu, Meltem; Ceheci, Egemen; Turkmen, Aydin; Dervisoglu, Erkan; Sezen, Mehnet; Turgutalp, Kenan; Sahin, Gulizar Manga
    [Abstract Not Available]
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    Epidemiological features of primary glomerular disease in Turkey: a multicenter study by the Turkish Society of Nephrology Glomerular Diseases Working Group
    (BioMed Central Ltd, 2020) Türkmen, Aydın; Şumnu, Abdullah; Cebeci, Egemen; Yazıcı, Halil; Eren, Necmi; Seyahi, Nurhan; Dilek, Kamil; Dede, Fatih; Derici, Ülver Boztepe; Ünsal, Abdülkadir; Şahin, Garip; Sipahioǧlu, Murat Hayri; Gok, Mahmut; Tatar, Erhan; Dursun, Belda; Sıpahı, Savaş; Yılmaz, Mürvet; Süleymanlar, Gültekin; Ulu, Sena Memnune; Güngör, Özkan; Kutlay, Sim; Bahçebaşı, Zerrin Bicik; Şahin, Ídris; Kurultak, İlhan; Türkmen, Kültigin; Yılmaz, Zülfikar; Kazancıoğlu, Rümeyza Turan; Çavdar, Caner; Candan, Ferhan; Aydın, Zeki; Oygar, Düriye Deren; Gul, Cuma Bulent; Arici, Mustafa; Paydaş, Saime; Taymez, Dilek Güven; Küçük, Mehmet; Trablus, Sinan; Turgutalp, Kenan; Koç, Leyla; Sezer, Siren; Duranay, Murat; Bardak, Simge; Altıntepe, Lütfullah; Arikan, Izzet Hakki; Azak, Alper; Odabaş, Ali Rıza; Şahin, Gülizar Manga; Ozturk, Savas
    Abstract Background: The largest data on the epidemiology of primary glomerular diseases (PGDs) are obtained from the databases of countries or centers. Here, we present the extended results of the Primary Glomerular Diseases Study of the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) Working Group. Methods: Data of patients who underwent renal biopsy and received the diagnosis of PGD were recorded in the database prepared for the study. A total of 4399 patients from 47 centers were evaluated between May 2009 and May 2019. The data obtained at the time of kidney biopsy were analyzed. After the exclusion of patients without light microscopy and immunofluorescence microscopy findings, a total of 3875 patients were included in the study. Results: The mean age was 41.5 ± 14.9 years. 1690 patients were female (43.6%) and 2185 (56.3%) were male. Nephrotic syndrome was the most common biopsy indication (51.7%). This was followed by asymptomatic urinary abnormalities (18.3%) and nephritic syndrome (17.8%). The most common PGD was IgA nephropathy (25.7%) followed by membranous nephropathy (25.6%) and focal segmental glomerulosclerosis (21.9%). The mean total number of glomeruli per biopsy was 17 ± 10. The mean baseline systolic blood pressure was 130 ± 20 mmHg and diastolic blood pressure was 81 ± 12 mmHg. The median proteinuria, serum creatinine, estimated GFR, and mean albumin values were 3300 (IQR: 1467–6307) mg/day, 1.0 (IQR: 0.7–1.6) mg/dL, 82.9 (IQR: 47.0–113.0) mL/min and 3.2 ± 0.9 g/dL, respectively. Conclusions: The distribution of PGDs in Turkey has become similar to that in other European countries. IgA nephropathy diagnosed via renal biopsy has become more prevalent compared to membranous nephropathy. Keywords: Epidemiology, Glomerulonephritis, Kidney biopsy, Primary glomerular diseases; the Turkish Society of Nephrology glomerular diseases (TSN-GOLD) working group, Turkish Society of Nephrology
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    The frequency of osteoporosis in hemodialysis and continuous ambulatory peritoneal dialysis patients according to PTH levels after active vitamin D therapy during the two years period
    (2010) Yılmaz, Mehmet Emin; Kara, İsmail Hamdi; Kadiroğlu, Ali Kemal; Turgutalp, Kenan; Kayabaşı, Hasan; Yılmaz, Zülfikar; Şit, Dede
    Amaç: Osteoporoz; düşük kemik kitlesi, kemikte mikroyapısal dejenerasyon ve yüksek fraktür riskiyle karakterize bir iskelet hastalığıdır. Bu çalışmada amacımız iki yıllık periodda vitamin D tedavisinden sonra Paratiroid hormone düzeyine göre hemodiyaliz ve devamlı ayaktan periton diyaliz tedavisi gören hastalarda osteoporoz sıklığını tespit etmektir. Materyal ve metod: Dicle Üniversitesi Tıp Fakültesi Hastanesi Diyaliz Merkezinde diyaliz tedavisi gören 18 HD hastası (12 erkek, 6 kadın) ve 12 SAPD hastası (8 erkek, 4, kadın) çalışmaya alındı. Hastalar aktif vitamin D tedavisi öncesi ve sonrası sol topuk kantitatif ultrasonografi ile ölçülen kemik mineral dansitesiyle değerlendirildi. Biyokimyasal analizler için kan örnekleri aktif vitamin D tedavisi öncesi ve sonrasında 12 saatlik açlık periodundan sonra alındı.Bulgular: Tedavi sonunda kemik mineral dansitesinin T ve Z skorları ile ALP, PTH değeri 120 -250 pg/ml olan grupla birlikte PTH değeri 250 pg/ml’den fazla olanlarda da yüksek bulundu. Bu değerler PTH değeri 120 pg/ml’nin altında olanlarda düşük bulundu. Başlangıç Osteoporoz oranı; PTH değeri < 120 pg/ml olanlarda % 23, 120 -250 pg/ml olanlarda % 20 ve 250 pg/ml’den büyük olanlarda ise % 20 olarak saptandı. Tedavi sonrasında sırasıyla % 30, % 0 ve % 20 olduğu görüldü. Sonuç: Tedavi öncesi T skor değerinde her üç grup arasında istatistiksel farklılık yoktu. Tedaviden sonra, anlamlı istatistiksel farklılık saptandı. Özellikle tedavi sonrası PTH değeri 120 – 250 pg/ml olan ikinci grupta T skoru daha iyi bulundu.
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    IMMUNOSUPPRESSIVE TREATMENT RESULTS IN PATIENTS WITH PRIMARY IGA NEPHROPATHY IN TURKIYE: A NATIONWIDE STUDY
    (Oxford Univ Press, 2023) Oruc, Aysegul; Sumnu, Abdullah; Turkmen, Aydin; Basturk, Taner; Cebeci, Egemen; Turgutalp, Kenan; Cetinkaya, Hakki
    [Abstract Not Available]
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    Immunosuppressive treatment results in patients with primary IgA nephropathy in Turkiye; the data from TSN-GOLD working group
    (Taylor & Francis Ltd, 2024) Oruc, Aysegul; Sumnu, Abdullah; Turkmen, Aydin; Basturk, Taner; Cebeci, Egemen; Turgutalp, Kenan; Cetinkaya, Hakki
    BackgroundImmunoglobulin A (IgA) nephropathy (IgAN) treatment consists of maximal supportive care and, for high-risk individuals, immunosuppressive treatment (IST). There are conflicting results regarding IST. Therefore, we aimed to investigate IST results among IgAN patients in Turkiye.MethodThe data of 1656 IgAN patients in the Primary Glomerular Diseases Study of the Turkish Society of Nephrology Glomerular Diseases Study Group were analyzed. A total of 408 primary IgAN patients treated with IST (65.4% male, mean age 38.4 +/- 12.5 years, follow-up 30 (3-218) months) were included and divided into two groups according to treatment protocols (isolated corticosteroid [CS] 70.6% and combined IST 29.4%). Treatment responses, associated factors were analyzed.ResultsRemission (66.7% partial, 33.7% complete) was achieved in 74.7% of patients. Baseline systolic blood pressure, mean arterial pressure, and proteinuria levels were lower in responsives. Remission was achieved at significantly higher rates in the CS group (78% vs. 66.7%, p = 0.016). Partial remission was the prominent remission type. The remission rate was significantly higher among patients with segmental sclerosis compared to those without (60.4% vs. 49%, p = 0.047). In the multivariate analysis, MEST-C S1 (HR 1.43, 95% CI 1.08-1.89, p = 0.013), MEST-C T1 (HR 0.68, 95% CI 0.51-0.91, p = 0.008) and combined IST (HR 0.66, 95% CI 0.49-0.91, p = 0.009) were found to be significant regarding remission.ConclusionCS can significantly improve remission in high-risk Turkish IgAN patients, despite the reliance on non-quantitative endpoints for favorable renal outcomes. Key predictors of remission include baseline proteinuria and specific histological markers. It is crucial to carefully weigh the risks and benefits of immunosuppressive therapy for these patients.
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    IS THE SEVERITY OF GLOMERULAR IGG STAINING IN PATIENT WITH IGA NEPHROPATHY USEFUL FOR PREDICTING POOR RENAL PROGNOSIS? THE DATA FROM TSN-GOLD WORKING GROUP
    (Oxford Univ Press, 2020) Turgutalp, Kenan; Cebeci, Egemen; Turkmen, Aydin; Derici, Ulver; Seyahi, Nurhan; Eren, Necmi; Dede, Fatih
    [Abstract Not Available]
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    Kronik hemodializ ve sürekli ayaktan periton diyalizi programında olan hastaların osteoporoz risk faktörlerinin değerlendirilmesi
    (2016) Turgutalp, Kenan; Yılmaz, M. Emin
    Osteoporoz; düşük kemik kitlesi ve kemiğin mikroy apışında bozulma ile birlikte kırık riskinin de eşlik ettiği bir iskelet bozukluğudur. Bu çalışmada HD ve SAPD programında olan kronik böbrek yetmezlikli hastalarda osteoporozun araştırılması planlanmıştır. Çalışmaya Dicle Üniversitesi Tıp Fakültesi Diyaliz Merkezinde tedavi görmekte olan, 12'si erkek, 6'sı kadın olmak üzere 18 HD hastası ve 8'i erkek, 4'ü kadın olmak üzere 12 SAPD hastası alındı. Sol topuk kantitatif ultrasonuyla (TKU) tüm hastaların KMD'si, T ve Z skoru ölçüldü ve yaş, cins, kilo, BMI'leri hesaplandı Eş zamanlı olarak PTH, fosfat, total kalsiyum, CaxP düzeyleri çalışıldı. 2 yıl sonra aynı ölçümler aynı yöntemle tekrar edildi. Çalışmamızda HD ve SAPD hastalarında ortalama KMD değerleri karşılaştırıldığında ilk ölçümde sırasıyla 0.44±0.12, 0.55±0.14 olarak bulundu (p=0.021). Yapılan ikinci ölçümde ise HD ve SAPD hastalarının KMD değerleri karşılaştırıldığında sırasıyla 0.44±0.13, 0.51±0.15 olarak bulundu ve aralarında istatistiksel olarak anlamlı fark yoktu (p=0.223). HD ve SAPD hastalarının ilk ölçümde ortalama PTH değerleri sırasıyla 238.9±279.6, 410.7±367.7 olarak bulundu (p=0.157). İkinci ölçümde yapılan karşılaştırmada HD hastalarının ortalama PTH değeri SAPD hastalarına göre daha düşük bulundu (sırasıyla 397.2±30 1.1, 71 8.9±567.1) (p=0.052). İlk ölçümlerde HD hastalarının T ve Z skoru ortalama değeri SAPD hastalarına göre daha düşüktü fakat istatistiksel olarak anlamlı değildi (p=0,08, 63 p=0,196). İkinci yapılan ölçümlerde HD ve SAPD hastalarının ortalama T ve Z skoru arasında istatistiksel olarak anlamlı fark bulunamadı (p=0,657, p=0,302). Sonuç olarak; hem HD hem de SAPD hastalarında osteoporoz saptandı ve osteoporozun oluşum sıklığı açısından aralarında fark tespit edilmedi. Diyaliz hastalarında ROD çok sık karşılaşılan bir problemdir. Hiperfosfatemi hiperparatiroidizmin oluşumunda risk faktörüdür. Diyaliz hastalarında yüksek turnoverli kemik hastalığının meydana gelmesine engel olmak için daha sıkı bir fosfat kontrolü sağlanmalı, hastaların diyet alışkanlıkları değiştirilmelidir.
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    THE LONGITUDINAL EVOLUTION OF COVID-19 OUTCOMES AMONG HEMODIALYSIS PATIENTS: A NATIONWIDE MULTICENTRE CONTROLLED STUDY
    (Oxford Univ Press, 2022) Ozturk, Savas; Turgutalp, Kenan; Arici, Mustafa; Gorgulu, Numan; Tonbul, Halil Zeki; Eren, Necmi; Gencer, Vedat
    [Abstract Not Available]
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    The Longitudinal Evolution of Post-COVID-19 Outcomes Among Hemodialysis Patients in Turkey
    (Elsevier Science Inc, 2022) Ozturk, Savas; Turgutalp, Kenan; Arici, Mustafa; Gorgulu, Numan; Tonbul, Halil Zeki; Eren, Necmi; Gencer, Vedat
    Introduction: Hemodialysis (HD) patients have increased risk for short-term adverse outcomes of COVID-19. However, complications and survival at the post-COVID-19 period have not been published extensively.Methods: We conducted a national, multicenter observational study that included adult maintenance HD patients recovered from confirmed COVID-19. A control HD group without COVID-19 was selected from patients in the same center. We investigated the characteristics and outcomes in the follow-up of HD patients and compare them with the non-COVID-19 group.Results: A total of 1223 patients (635 patients in COVID-19 group, 588 patients in non-COVID-19 group) from 47 centers were included in the study. The patients' baseline and HD characteristics were almost similar. The 28th-day mortality and mortality between 28th day and 90th day were higher in the COVID-19 group than non-COVID-19 group (19 [3.0%] patients vs. none [0%]; 15 [2.4%] patients vs. 4 [0.7%] patients, respectively). The presence of respiratory symptoms, rehospitalization, need for home oxygen therapy, lower respiratory tract infection, and arteriovenous (AV) fistula thrombosis was significantly higher in the COVID-19 group in both the first 28 days and between 28 and 90 days. In the multivariable analysis, age (odds ratio [OR] [95% CI]: 1.029 [1.004-1.056]), group (COVID-19 group vs. non-COVID-19 group) (OR [95% CI]: 7.258 [2.538-20.751]), and vascular access type (tunneled catheter/AV fistula) (OR [95% CI]: 2.512 [1.249-5.051]) were found as independent parameters related to 90-day mortality.Conclusion: In the post-COVID-19 period, maintenance HD patients who have had COVID-19 have increased rehospitalization, respiratory problems, vascular access problems, and high mortality compared with the non-COVID-19 HD patients.
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    QUS measurements in dialysis patients
    (Medi+World Int, 2005) Kara, Ismail Hamdi; Yilmaz, Mehmet Emin; Turgutalp, Kenan; Tuzcu, Alparslan; Kadiroglu, Ali Kemal
    Background: It was aimed to evaluate the bone measurements by quantitative heel ultrasound (QUS) in patients undergoing chronic haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD), and healthy controls. It was also aimed to investigate the relationship between weight, body mass index (BMI), smoking and parathyroid hormone (PTH) with QUS parameters. Method: Present study included 25 patients on chronic HD (Group 1), 16 patients treated by CAPD (Group 2) and 32 controls (Group 3). QUS (Hologic, Sahara bone sonometer) measured broadband ultrasound attenuation (BUA; dB/Mhz), quantitative ultrasound index (QUI; g/cm(2)), speed of sound (SOS; m/s). The WHO (1997) classification of BMI was used for weight classification. The smoking criterion was defined as smoker and non-smoker. Results: Mean age of cases was 40.2 +/- 15.5, 36.0 +/- 9.9 and 36.6 +/- 12.4 years, in groups 1, 2 and 3 (p>0.05), and mean dialysis duration time was 31.8 +/- 12.6 and 42.8 +/- 12.8 months, in groups 1 and 2 (p=0.015). Depending on the QUS parameters, both osteoporosis and osteop zenia were diagnosed in five (56%) of women and in 11 (69%) of men in HD vs in two (33%) of women and in four (40%) of men in CAPD, respectively (p=0.584). QUS measurements were not correlated with serum PTH and BMI in both HD and CAPD groups, respectively. In HD group, we found SOS to be lower ( 1526 +/- 27 vs. 1548 +/- 19 m/s, p=0.016) in smokers compared to non- smokers. There were negative correlations between smoking and QUS parameters ( r=-0.34; p=0.044). Conclusion: Our findings suggest that there is an unfavorable influence of HD and smoking on bone mineralization compared to CAPD.
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    The relationship between glomerular IgG staining and poor prognostic findings in patients with IgA nephropathy: the data from TSN-GOLD working group
    (BioMed Central Ltd, 2021) Turgutalp, Kenan; Cebeci, Egemen; Türkmen, Aydın; Derici, Ülver Boztepe; Seyahi, Nurhan; Eren, Necmi; Dede, Fatih; Güllülü, Mustafa; Baştürk, Taner; Şahin, Gülizar Manga; Yılmaz, Mürvet; Sipahi, Savaş; Şahin, Garip; Ulu, Sena Memnune; Tatar, Erhan; Gündogdu, Ali; Kazancıoğlu, Rümeyza Turan; Sevinç, Can; Güngör, Özkan; Şahin, İdris; Kutlay, Sim; Kurultak, İlhan; Aydın, Zeki; Altun, Bülent; Dursun, Belda; Yılmaz, Zülfükar; Uzun, Özcan; Süleymanlar, Gültekin; Candan, Ferhan; Sezer, Siren; Tanburoğlu, Derya Basak; Bicik, Zerrin; Taymez, Dilek Güven; Akcali, Esra; Oygar, Düriye Deren; İstemihan, Zülal; Bardak, Simge; Bardak, Simge; Akçay, Ömer Faruk; Dincer, Mevlüt Tamer; Dervişoğlu, Erkan; Yenigün, Ezgi Çoşkun; Türkmen, Kültigin; Özturk, Savaş
    Background: Galactose-deficient IgA1 (Gd-IgA1) has an increased tendency to form immunocomplexes with IgG in the serum, contributing to IgAN pathogenesis by accumulating in the glomerular mesangium. Several studies showed that glomerular IgG deposition in IgAN is an important cause of mesangial proliferation and glomerular damage. This study aims to determine the association of the positivity of IgG and the intensity of IgG staining with a poor renal prognosis. Methods: A total of 943 IgAN patients were included in the study. Glomerular IgG staining negative and positive patients were compared using Oxford classification scores, histopathological evaluations, proteinuria, eGFR, albumin, blood pressures. IgG positive patients were classified as (+), (++), (+++) based on their staining intensity, and the association with the prognostic criteria was also evaluated. Results: 81% (n = 764) of the patients were detected as IgG negative, while 19% (n = 179) were positive. Age, gender, body mass index, blood pressure, proteinuria, eGFR, uric acid values were similar in IgG positive and negative patients who underwent biopsy (p > 0.05). Intensity of glomerular IgG positivity was not found to be associated with diastolic and systolic blood pressure, urea, uric acid, age, eGFR, albumin, proteinuria (p > 0.05 for all, r = − 0.084, r = − 0.102, r = − 0.006, r = 0.062, r = 0.014, r = − 0.044, r = − 0.061, r = − 0.066, r = 0.150, respectively). There was no difference for histopathological findings between IgG (+), IgG (++), IgG (+++) groups (for all, p > 0.05). Conclusion: Glomerular IgG negativity and positivity detected by routine IFM in IgAN patients is not associated with poor renal prognostic risk factors.
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    THE RELATIONSHIP BETWEEN SEVERITY OF INTERSTITIAL FIBROSIS AND ANEMIA IN PATIENT WITH PRIMARY GLOMERULONEPHRITIS: THE DATA FROM TSN-GOLD WORKING GROUP
    (Oxford Univ Press, 2020) Cebeci, Egemen; Turgutalp, Kenan; Ozturk, Savas; Ozluk, Yasemin; Bek, Sibel Gokcay; Sumnu, Abdullah; Seyahi, Nurhan
    [Abstract Not Available]