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Öğe 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.Öğe Evaluation of the characteristics of patients with acute drug poisoning and clinical outcomes in a university hospital in region of southeastern Anatolia(2013) Kadiroğlu A.K.; Yilmaz Z.; Yildirim Y.; Ebik B.; Yildirim S.; Oto F.; Ulucan F.Introduction: Cases of intoxication is an important part of the patients admitted to General Internal Medicine Intensive Care Unit. The aim of this study is to present the features of patients admitted to our General Internal Medicine Intensive Care Unit with acute drug intoxication and clinical outcomes. Material and method: The data of patients with acute drug intoxication admitted to our General Internal Medicine Intensive Care Unit between June 2010 and December 2012 were analysed retrospectively. The patients' age, gender, etiology, comorbid conditions, blood pressure, arterial blood gases, hematological and biochemical parameters, treatments and clinical outcomes were evaluated. Results: 81.4% of patients were female, 18.6% were male. The mean age of the patient was 30.23 ± 15.44 years. Multi-drug poisoning (51.2%)was the most common cause among the drug poisoning. 32.5% of the patients had comorbid conditions. The most common comorbid was psychosis among the disease. Only one patient hospitalized with organophosphate intoxication was need for mechanical ventilation due to extremely secretion. Hemodialysis therapy was performed 2 times in one patient with valproic acid intoxication. Conclusion: The cases of multi-drug intoxications (51.2%) were found to be more in patients with acute drug intoxication hospitalized into the General Internal Medicine Intensive Care unit. 16.2% of our patients hospitalized with drug intoxication had psychosis.Öğe Insulin regulates plasma ghrelin concentrations in streptozotocin-induced diabetic rats(University of Dicle, 2014) Tasdemir E.; Obay B.D.; Bilgin H.M.; Sermet A.; Yildirim Y.; Kocyigit Y.Ghrelin, an orexigenic peptide produced in the stomach has shown to elicit peripheral actions including regulation of pancreatic ß-cell function. The aim of the study is to clarify the regulation of plasma ghrelin concentrations by insulin in streptozotocin (STZ) induced diabetic rats. Adult male Wistar rats were divided into control and three experimental groups as each group had 7 rats (n=28). To investigate the role of ghrelin in the hyperphagic response to uncontrolled diabetes, experimental groups of rats were injected once daily for 7 days with either STZ (70 mg/kg i.p.) or insulin subcutaneously (5-7 U). Plasma insulin, ghrelin and glucose concentrations were measured. STZ-induced diabetic rats were markedly hyperphagic as accompanied by hyperglycemia. Treatment of diabetic rats with insulin reversed these changes. STZ- induced diabetic rats had higher plasma ghrelin concentrations than control rats. Ghrelin levels were attenuated by the subcutaneous injection of insulin (5-7 U over 7 days). Insulin treatment also partially reversed hyperphagia observed in STZ- induced diabetic rats and there was a decrease in plasma ghrelin concentrations compared with STZ-INS pair fed rat. The results indicate that insulin treatment reverses elevated plasma ghrelin concentrations in STZ- induced diabetic rats suggesting the pathophysiological significance of ghrelin in diabetes.Öğe Pretreatment with paricalcitol attenuates oxidative stress in renal ischemia reperfusion-induced nephropathy in rats(Science Printers and Publishers Inc., 2020) Aydin F.Y.; Yilmaz Z.; Yildirim Y.; Aydin E.; Ketani A.; Bahadir V.; Brahim Kaplan I.OBJECTIVE: To investigate whether paricalcitol could ameliorate kidney injury due to ischemia reperfusion (I/R) in an experimental study. STUDY DESIGN: Rats were divided into 4 groups: control, paricalcitol, I/R, and paricalcitol+I/R, each containing 7 animals. Intraperitoneal 0.3 ?g/kg paricalcitol was administered to rats once a day for 5 consecutive days in the paricalcitol and paricalcitol+I/R groups. After right nephrectomy, rats were exposed to ischemia/ reperfusion on day 6 in the paricalcitol+I/R and I/R groups. Oxidant and antioxidant parameters, kidney function tests, and histology were investigated. RESULTS: Serum urea and creatinine levels exhibited a significant decrease in rats treated with paricalcitol before I/R as compared to rats exposed just to I/R. In a comparison of the paricalcitol+I/R group with the I/R group, serum total oxidant status (TOS) levels decreased significantly; serum total antioxidant capacity (TAC) and nitric oxide levels, however, increased significantly with paricalcitol administration. Malondialdehyde and TOS levels of kidney tissue were significantly lower, whereas TAC and paraoxonase levels were higher in the paricalcitol+I/R group than in the I/R group. Renal tissue injury scores were found to be significantly higher in the I/R group than in the paricalcitol+I/R group. CONCLUSION: Pretreatment with paricalcitol was detected to be renoprotective by decreasing renal injury related with renal I/R, which was assessed by improved renal function and histopathology. © Science Printers and Publishers, Inc.Öğe 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).
