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    A case of peritoneal dialysis in which SARS-CoV-2 was diagnosed by sudden hearing loss
    (Taylor & Francis, 2021) Günay, Emrah; Kozan, Günay; Yüksel, Enver; Mızraklı, Ayser; Aslan, Özgür; Kavak, Şeyhmus; Kaya, Şafak; Yılmaz, Zülfükar
    Sudden hearing loss in cases of SARS-CoV-2 is rare, and it is even less common as a first symptom. For the first time in the literature, we present a case of SARS-CoV-2 accompanied by bilateral sudden hearing loss in a peritoneal dialysis patient.
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    Prognostic significance of controlling nutritional status (CONUT) score in hemodialysis patients
    (MediHealth Academy Yayıncılık, 2022) Aydın, Fatma Yılmaz; Yüksel, Enver; Aydın, Emre
    Introduction: Malnutrition is a common and important problem in HD Hemodialysis (HD) patients. Malnutrition occurs due to various factors increases the risk of morbidity and mortality in HD patients. The Controlling Nutritional Status (CONUT) score has been designed to assess the nutritional status in patients. In addition, the relationship between the CONUT score and mortality has been investigated. We aimed to investigate the effectiveness of the CONUT score in predicting mortality in HD patients. Material and Method: The data of 110 patients who started HD between 2017-2021 were analyzed retrospectively. From the laboratory parameters were evaluated before starting the first hemodialysis treatment. The CONUT score was calculated based on lymphocyte count, total cholesterol levels, and serum albumin levels. The patients were divided into two groups as CONUT score ?4 and CONUT score ?5. The groups were compared regarding these parameters. Results: The data of 110 hemodialysis patients were analyzed. 58 (52.7%) of these patients were male. The mean age of the patients was 53.18±17.10 years. There were 49 (44.5%) patients with a CONUT score of ?4 and 61 (55.5%) patients with a CONUT score of ?5. 35 patients (13.9%) died. Among 35 all-cause deaths, 4 (11.4%) were occurred in the low CONUT group, and 31 (88.6%) were occurred in the high CONUT group (p
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    Relationship between epicardial adipose tissue and body composition as determined by multi-frequency bioelectrical impedance analysis in patients with stage 5 chronic kidney disease
    (International Scientific Information, Inc., 2020) Yılmaz, Zülfükar; İnce, Hasan; Aydın, Emre E.; Yıldırım, Yaşar; Aydın, Fatma Yılmaz; Yüksel, Enver; Karabulut, Aziz; Dursun, Lezgin; Kadiroǧlu, Ali Kemal; Yılmaz, Mehmet Emin
    Background: The main cause of mortality among chronic kidney disease (CKD) patients is cardiovascular disease (CVD). Epicardial adipose tissue (EAT) is considered to be novel cardiovascular risk factor. We assessed EAT in non-dialyzed stage 5 CKD patients and explored the association of EAT with body composition as determined by multi-frequency BIA. Material/Methods: The present included 70 stage 5 CKD patients who had not undergone dialysis and 40 healthy control subjects. EAT thickness was assessed by echocardiography. Hydration status and body composition were evaluated by multi-frequency bioelectrical impedance analysis. Results: Stage 5 CKD patients had significantly higher EAT thickness than healthy subjects (6.56±1.18 vs. 4.05±1.45, p<0.001). Fat tissue mass, systolic blood pressure (SBP), age, fat tissue index, and body mass index were positively correlated with EAT thickness in the CKD patient group (p<0.05). Lean tissue mass, lean tissue index (LTI), and high-density lipoprotein (HDL) were negatively correlated with EAT thickness in the CKD patient group (p<0.05). Stepwise multiple regression analysis showed that age, SBP, and LTI were independently associated with EAT thickness in CKD patients. Conclusions: We found significantly higher EAT thickness in stage 5 CKD patients who were not on dialysis compared to healthy controls. EAT was significantly associated with age, SBP, and LTI in CKD patients. Interventions to reduce the risk factors associated with EAT thickness might protect against CVD disease in CKD patients.
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    The relationship between serum vitamin D levels and health-related quality of life in peritoneal dialysis patients
    (Springer, 2022) Yüksel, Enver; Aydın Emre
    Introduction We aimed to investigate the relationship between Vitamin D level and quality of life in patients undergoing peritoneal dialysis as renal replacement therapy. Methods 50 peritoneal dialysis patients aged between 18 and 73 years were included in this study. KDQOL-36 questionnaire was applied to rate the quality of life of the patients. This questionnaire consisted of 36 questions divided into five subscales. The patients were divided into two groups according to serum vitamin D levels. Patients with a serum 25(OH) D level < 20 ng/mL were identified as vitamin D deficiency group and those with a serum 25(OH)D level >= 20 ng/mL were identified as normal vitamin D group. Results The patients had a mean age of 41.16 +/- 16.05 years, 56% of them were females. The mean 25(OH) D levels of patients with 25 (OH) D levels < 20 ng/mL and those with >= 20 ng/mL were 10.50 +/- 4.62 ng/mL and 25.55 +/- 4.11 ng/mL, respectively. We found that all subscales of KDQOL-36 were lower with statistically significance in the group with Vitamin D (Vit-D) deficiency. Hemoglobin level was detected as independent risk factor for Symptom and problem list subscales and SF-12 physical component summary subscale (PCS) (P = 0.029, P = 0.047). Vit-D deficiency was detected as independent risk factors for kidney disease burden subscale and PCS (P = 0.035, P = 0.019). Hypertension was detected as independent risk factor for kidney disease burden subscale (P = 0.015). Conclusion Our study is the first to investigate the relationship between serum Vit-D level and quality of life by KDQOL-36 scale in peritoneal dialysis patients. We revealed that patients with low Vit-D levels had worse quality of life in all subscales.
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    The Role of monocyte to high-density lipoprotein cholesterol ratio in predicting the severity of proteinuria and renal dysfunction in primary nephrotic syndrome
    (Cureus Inc., 2021) Aydın, Fatma Yılmaz; Eynel, Eren; Oruç, İdris; İnce, Hasan; Yüksel, Enver; Aydın, Emre
    Introduction: Monocyte to high-density lipoprotein (HDL) cholesterol ratio (MHR) has emerged as a novel marker of endothelial injury, inflammation, and oxidative stress. This study aimed to investigate the effect of MHR on primary nephrotic syndrome (NS) and its relationship with the severity of proteinuria. Methods: This study enrolled 161 patients newly diagnosed with primary NS and 100 healthy individuals. Demographic characteristics of the patients, primary NS diagnosis, basal laboratory parameters, the amount of 24-hour urinary protein excretion, and MHR were recorded. The groups were compared regarding these parameters. Results: MHR was significantly higher in patients with primary NS compared with the healthy group (12.89 +/- 4.86 and 9.71 +/- 2.30, respectively; p < 0.001). There was no difference between the groups in terms of age and sex. The amount of protein in the 24-hour urine in patients with a diagnosis of primary NS was 6.91 +/- 3.73 g/day. The correlation analysis showed a positive correlation between MHR and the amount of proteinuria (r = 0.519, p < 0.001) and creatinine level (r = 0.167, p = 0.034). The multivariate regression analysis found that the severity of proteinuria was independently correlated to MHR (p < 0.001). According to the receiver operating characteristic curve analysis, the optimal cut-off level for MHR in NS was 10.08 (area under the curve of 0.704, sensitivity of 68%, and a specificity of 62%). Conclusion: Our study is the first to compare the severity of proteinuria and renal functions with MHR in patients with primary NS. We believe that MHR can be used as a biomarker to determine inflammation, endothelial injury, and the level of oxidative stress, and may be useful to predict prognosis in patients with primary NS.
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    Urinary tract infection in kidney transplant recipients: The predictors and two-year outcomes
    (Dicle Üniversitesi Tıp Fakültesi, 2022) Yüksel, Enver; Akkoç, Hasan
    Background: Urinary tract infection (UTI) is the most common infection in kidney transplant recipients (KTR). Our aim in this study is to determine the prevalence, risk factors, and causative microorganisms of UTI. In addition, to compare the kidney functions of the patients in the 2nd year who developed and did not develop UTI after transplantation. Method: Two hundred sixteen patients underwent kidney transplantation in our center between July 2012 and March 2020. A total of 206 patients with 267 episodes of UTI were included in the study. The impacts of catheterization, hemodialysis duration, gender, posttransplant prolonged hospital stay on UTI development, and UTI on two-year allograft functions, were evaluated. Results: The mean age of the study patients was 34.5±12.7, and 43.7% of them were women. At least one UTI attack developed in 38.8% (80/206) of the KTR. Thirty-one KTR developed recurrent UTI (R-UTI). UTI incidence was found 38.8% in our cohort. Female gender, posttransplant prolonged hospital stay, presence of prolonged double-j stent and foley catheter durations were found associated with UTI development. (p<0.001, p<0.001, p<0.001, p<0.001, respectively). The mean estimated glomerular filtration rate eGFR in KTR with UTI at 2-year post-transplant was significantly lower than KTR without UTI (71.2±29.2 vs 82.4±23.9; p=0.006). Low eGFR was more prominent among the KTR with R-UTI (69.9±31.6). Escherichia coli and Klebsiella pneumonia were the most frequently isolated microorganisms in our cohort. Conclusions: This study demonstrated UTI may have an adverse impact on allograft function in KTR, especially in KTR with R-UTI.