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    DETERMINATION OF VOLUME OVERLOAD BY BIOELECTRICAL IMPEDANCE ANALYSIS AND NT-PROBNP IN DIABETIC PRE-DIALYSIS PATIENTS
    (Editura Acad Romane, 2016) Yildirim, Y.; Kara, A. V.; Kilinc, F.; Aydin, F.; Aydin, E.; Yilmaz, Z.; Kadiroglu, A. K.
    Introduction. Diabetic chronic kidney disease has more fatal clinical progresses and this situation can be related to volume overload, which is seen more commonly in diabetic chronic kidney disease patients than in non-diabetic chronic kidney disease patients. Therefore, we examined the effect of diabetes mellitus on volume overload in newly diagnosed stage 5 chronic kidney disease patients whose volume overloads were not showing signs of improvement from renal replacement therapy. Method. One hundred and five patients (46 diabetic, 59 non-diabetic) with end-stage chronic kidney disease, who had glomerular filtration rate (GFR) under 15 mL/min for at least three months were enrolled in this prospective study. We determined the body volume overload and configuration using a bioimpedance device. NT-proBNP levels were recorded. Results. There was a statistically significant difference between diabetic and non-diabetic groups according to overhydration (OH, p=0.003), extracellular water (ECW, p=0.045), intracellular water (ICW, p<0.001) and OH/ECW (p=0.003). In addition, there was a statistically significant difference between groups in terms of N-terminal Pro-brain Natriuretic Peptide (NT-proBNP levels, p=0.008). Discussion. We compared diabetic and non diabetic end-stage chronic kidney disease patients who were not in renal replacement therapy yet. We found more volume overload and extracellular fluid volume in the diabetic group.
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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.