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Öğe The association of demographic, clinical, and thrombophilic factors with the failure of arteriovenous fistula among hemodialysis patients(Saudi Med J, 2008) Kadiroglu, Ali K.; Sit, Dede; Kayabasi, Hasan; Yilmaz, Zulfukar; Yilmaz, EminObjective: To evaluate the association of demographic, clinical, and thrombophilic factors with the failure of arteriovenous fistula (AVF) among patients undergoing chronic hemodialysis. Methods: Sixty-two (33 males, 29 females) patients undergoing chronic hemodialysis were included in the study in March 2005 at the Hemodialysis Center of the Medicine Faculty at Dicle University, Diyarbakir, Turkey. The patients were divided into 2 groups according to whether they needed (group II) or do not need (group 1) more than one fistula placed. Results: Female gender, longer vintage of hemodialysis, frequent intradialytic hypotensive episodes, elevated levels of phosporous, calcium-phosporous product (Cap), and intact parathormone (iPTH), and left ventricle hypertrophy were more likely in group 2. Conclusion: Arteriovenous fistula loss, and recurrent requirement of AVF constitution increase with hemodialysis vintage. We believe that female gender, frequent intradialytic hypotensive episodes, elevated serum levels of phosporous, iPTH, and high Cap products are risk factors related to the failure of AVF among hemodialysis patients.Öğe THE ASSOCIATION OF RELATIVE HYDRATION STATUS WITH NT-PROBNP, IVC INDEX AND BLOOD PRESSURE IN NEWLY DIAGNOSED STAGE 5 CHRONIC KIDNEY DISEASE(Carbone Editore, 2013) Yilmaz, Zulfukar; Yildirim, Yasar; Aydin, Fatma Yilmaz; Aydin, Emre; Kadiroglu, Ali Kemal; Yilmaz, Mehmet EminIntroduction: 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 >% 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 I 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 AN ATYPICAL LOCALISATION OF TUBERCULOSIS INFECTION IN PATIENTS UNDERGOING HAEMODIALYSIS: A CASE REPORT(Wiley, 2010) Kayabasi, Hasan; Sit, Dede; Kadiroglu, Ali Kemal; Yilmaz, Zulfukar; Bukte, YasarSpinal tuberculosis (TB) is a rare skeletal system localisation of TB in haemodialysis patients. In this paper, a case of Pott's disease with a psoas muscle abscess is reported. The patient had been on the dialysis programme for five years and was complaining of back pain, weight loss and weakness, which were investigated. A thoracolumbar magnetic resonance imaging showed multiple paravertebral abscesses invading the psoas muscle. TB diagnosis was made by microbiological analysis of specimen, which was obtained by fine needle aspiration under computerised tomography guidance.Öğe Can Paricalcitol Increase the Effectiveness of N-Acetylcysteine in Contrast Induced Acute Kidney Prophylaxis in Rats? A Biochemical and Histopathological Study(Soc Chilena Anatomia, 2022) Yildirim, Yasar; Bahadir, Veysi; Aydin, Emre; Aydin, Fatma Yilmaz; Yilmaz, Zulfukar; Ketani, Aydin; Kaplan, Ibrahim& nbsp;N-Acetylcysteine (NAC) is used for contrast induced acut kidney injury (CI-AKI) prophylaxis because of its antioxidant effects. Paricalcitol, which has reno-protective effects, is likely to provide a more effective prophylaxis when added to NAC treatment. The study was designed based on this hypothesis. The study was organised to include 4 groups each consisting of 7 rats. Group 1 was the control group, and Group 2 included rats with CI-AKI. Rats in Group 3 were administered NAC at a dose of 100 mg/kg via oral gavage once a day for 5 days. Rats in group 4 were administered paricalcitol at a dose of 0.4 mcg/kg once a day for 5 days in addition to NAC. CI-AKI was induced after the treatments in both groups. The study was terminated on the sixth day. Samples were collected from the rats & rsquo; sera and kidney tissues to study oxidant and antioxidant parameters; kidney function tests were also studied. There were significant differences between the contrast nephropathy group (Group 2) and NAC and NAC+paricalcitol groups with respect to serum urea and creatinine levels. When the same groups were compared regarding oxidant (TOS-MDA) and antioxidant (TAC-Paraoxonase) parameters, we observed that the oxidant parameters increased in serum and kidney tissue samples with NAC use, and that effect was strengthened by the addition of paricalcitol to NAC treatment. However, despite increased antioxidant effectiveness, we observed no decrease in urea and creatinine levels when paricalcitol was added for CI-AKI in rats. There was no significant difference between Group 3 and Group 4. Paricalcitol provides a more potent antioxidant effect in both serum and kidney tissue samples when added to NAC treatment in rats with CI-AKI. Despite increased antioxidant parameters, however, paricalcitol does not provide a significant decrease in urea and creatinine levels.Öğe Could the appropriate anti-diabetic therapy be mixed insulin in dialysis patients?(Springer India, 2021) Demircan, Vehbi; Yildirim, Yasar; Aydin, Emre; Kara, Ali Veysel; Aydin, Fatma Yilmaz; Yilmaz, Zulfukar; Kadiroglu, Ali KemalBackground A good glycemic regulation should be provided to reduce mortality and morbidity in patients with end-stage renal failure due to diabetes mellitus. However, the use of insulin therapies in patients with renal failure is troublesome due to the increased rate of side effects. In our study, we investigated the frequency of hypoglycemia and its symptoms in patient groups receiving intensive and mixed insulin therapies. Materials and methods This prospective study included 89 hemodialysis patients with DM-related stage 5 chronic kidney disease who were followed up in a nephrology clinic of a university hospital between January 2013 and August 2015. Our study group was divided into two groups as those receiving intensive insulin therapy and mixed insulin therapy. Group 1 and group 2 consisted of 46 patients and 43 patients, respectively. Hypoglycemia (glucose < 70 mg/dl) was investigated in patients with HbA1c levels that decreased below 7% after treatment, and the symptoms were evaluated according to the hypoglycemic scale. The results between the groups were evaluated using chi-square and Student's t test Results A total of 89 patients were included in the study. HbA1c was 6.83% in the group receiving intensive insulin therapy and 6.95% in the group receiving mixed insulin therapy (p > 0.05). Hypoglycemia was detected in 27 patients (58.7%) in the intensive insulin therapy group and 14 patients (32.6%) in the mixed insulin therapy group. There was a significant level of hypoglycemia in the group receiving intensive insulin therapy (p < 0.05). In our study, the group receiving intensive insulin therapy had higher frequency and severity of common hypoglycemia symptoms such as confusion, sweating, weakness, dysphasia, palpitations, blurred vision, and feeling hungry. Conclusion There was a higher frequency of hypoglycemia under intensive insulin therapy in patients undergoing dialysis due to chronic kidney failure, which suggests that mixed insulin therapy is the ideal treatment to avoid hypoglycemia in this group of patients.Öğe EFFECT OF RED CELL DISTRIBUTION WIDTH ON ACUTE KIDNEY INJURY IN PATIENTS WITH METASTATIC LUNG CANCER RDW IN LUNG CANCER PATIENTS WITH KIDNEY INJURY(Carbone Editore, 2019) Aydin, Fatma Yilmaz; Aydin, Emre; Yildirim, Yasar; Yilmaz, Zulfukar; Kara, Ali Veysel; Yilmaz, Sureyya; Kaplan, Muhammet AliIntroduction: Lung cancer is a common malignity with high mortality rate. One of the main reason which affects mortality is acute kidney injury (AKI). Therefore, early diagnosis of AKI is of essential. In our study, we investigated the effects of Red Cell Distribution Width (RDW) on acute kidney injury development in metastatic acute lung cancer patients. Material and methods : The present study was conducted 143 patients with lung malignity at Stage 4 followed up Faculty of Medicine, Dicle University, between 2010- 2015. The study was carried out retrospectively. Creatinine levels, RDW, hemoglobin, Mean Corpuscular Volume ( MCV), C Reaktive protein (CRP), albumin levels as of admission to the intensive care unit (ICU) and after 48 hours, length of stay in ICU and results were recorded. The patients were divided in two groups as RDW > 16,8 and <= 16,8. The groups were examined in terms of acute kidney injury development, mortality and length of stay in intensive care. Results: The study population consists of 122 male (85.3%) and 21 female (14.7%) patients. The average RDW values of the patients is 16.53 +/- 1.91 and RDW >16,8 in 43.4%. AKI development was identified in 60.1% of the patients. The mean age, serum creatinine, AKI and CRP, mortality values were significantly higher and serum albumin, length of stay in intensive care (day) were significantly lower in RDW> 16.8 patient group compared to RDW <= 16.8 patient group. Conclusion: The present study showed that RDW is closely associated with acute kidney injury in advanced lung cancer patients.Öğe Eivaluation of the Nutritional Status and Anthropometric Measurements in Continuous Ambulatory Peritoneal Dialysis (CAPD) Patients According to the Anemia Status(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2007) Kadiroglu, Ali Kemal; Sit, Dede; Kayabasi, Hasan; Yilmaz, Zulfukar; Yilmaz, M. EminNutritional biochemical markers such as serum albumin and anthropometric measurements such as BMI are valid and useful tools in assessing the nutritional status in dialysis. Forty-two patients on CAPD therapy were enrolled in the study. Anemic patients and patients who were al target hematocrit levels were evaluated by nutritional parameters and anthropometry. Gender, age, duration of CAPD, dialysis adequacy, educational and economic status had significant affect on BMI and serum albumin. There were positive significant correlations between hematocrit levels and BMI (r=0.331, p=0.0032), and FM (r=.0.383, p=0.012), and MAMC (r=0.365, p=0.017I and serum albumin levels (r=0.416. p=0.006). Achieving target hematocrit levels may improve BMI and MAMC, but not biochemical parameters.Öğe The evaluation incidence and risk factors of mortality among patients with end stage renal disease in Southeast Turkey(Taylor & Francis Ltd, 2008) Sit, Dede; Kadiroglu, Ali Kemal; Kayabasi, Hasan; Kara, Ismail Hamdi; Yilmaz, Zulfukar; Yilmaz, M. EminAim. End stage renal disease (ESRD) presents with higher morbidity and mortality with respect to the general population. In recent study, the causes of mortality and associated risk factors in ESRD have been evaluated. Materials and Methods. In this study, 1538 patients diagnosed with ESRD in 10-year period were evaluated retrospectively. The patients were divided as dead (group 1) and alive (group 2). The patients' demographic features, causes of death, comorbidity at hospitalization, hematological and biochemical analyses, creatinine clearance at the beginning of hospitalization, daily urine volume, blood gas results, CRP value as inflammatory marker, ejection fraction, interventricular septum diameter, left ventricle posterior wall end-diastolic diameter, and left atrium diameter determined with echocardiography were recorded. Results. Mortality ratio of ESRD patients in a 10-year period was 14.1%. While the general mean age of all patients was 54.7 +/- 16.6 and male/female ratio was 781/757, these ratios were 66.3 +/- 21.8 and 114/103 in Group 1 and 52.8 +/- 21.7 and 667/654 in Group 2. One or more comorbid pathologies were present in 82.9% of Group 1. The most common cause of mortality was cardiovascular diseases (CVD), and the most common cause of comorbidity was infections. Older age, anemia, absence of residual renal function, hypoalbuminemia, inflammation, impaired Ca and P metabolism, and left ventricular hypertrophy were significantly higher in Group 1 than in Group 2. Conclusion. CVD are the most important preventable causes of morbidity and mortality in all stages of chronic kidney disease. Taking precaution against CVD and the associated complications will provide a positive contribution in reducing morbidity and mortality among ESRD patients.Öğe Evaluation of Anthropometric and Metabolic Parameters in Obstructive Sleep Apnea(Hindawi Ltd, 2015) Yildirim, Yasar; Yilmaz, Sureyya; Guven, Mehmet; Kilinc, Faruk; Kara, Ali Veysel; Yilmaz, Zulfukar; Kirbas, GokhanAims. Sleep disorders have recently become a significant public health problem worldwide and have deleterious health consequences. Obstructive sleep apnea (OSA) is the most common type of sleep-related breathing disorders. We aimed to evaluate anthropometric measurements, glucose metabolism, and cortisol levels in patients with obstructive sleep apnea (OSA). Materials and Methods. A total of 50 patients with a body mass index >= 30 and major OSA symptoms were included in this study. Anthropometric measurements of the patients were recorded and blood samples were drawn for laboratory analysis. A 24-hour urine sample was also collected from each subject for measurement of 24-hour cortisol excretion. Patients were divided equally into 2 groups according to polysomnography results: control group with an apnea-hypopnea index (AHI) <5 (n = 25) and OSA group with an AHI = 5 (n = 25). Results. Neck and waist circumference, fasting plasma glucose, HbA1c, late-night serum cortisol, morning serum cortisol after 1 mg dexamethasone suppression test, and 24-hour urinary cortisol levels were significantly higher in OSA patients compared to control subjects. Newly diagnosed DM was more frequent in patients with OSA than control subjects (32% versus 8%, p = 0.034). There was a significant positive correlation between AHI and neck circumference, glucose, and latenight serum cortisol. Conclusions. Our study indicates that increased waist and neck circumferences constitute a risk for OSA regardless of obesity status. In addition, OSA has adverse effects on endocrine function and glucose metabolism.Öğe Evaluation of fluid status related parameters in hemodialysis and peritoneal dialysis patients: Clinical usefulness of bioimpedance analysis(Elsevier Urban & Partner Sp. Z O O, 2014) Yilmaz, Zulfukar; Yildirim, Yasar; Aydin, Fatma Yilmaz; Aydin, Emre; Kadiroglu, Ali Kemal; Yilmaz, Mehmet Emin; Acet, HalitBackground and objective: Fluid overload is a common and serious problem that leads to severe complications in dialysis patients. We aimed to compare hydration status as measured with bioimpedance analysis (BIA) method in hemodialysis (HD) and peritoneal dialysis (PD) patients, as well as investigating the association between blood pressure, left ventricular mass index (LVMI) and hydration status. Materials and methods: We examined 43 HD and 33 PD patients. Blood pressure was recorded. In each group, echocardiographic examinations were performed on all patients. Hydration status was assessed using multifrequency bioelectrical impedance analysis. Overhydration was defined as an overhydration (OH)/extracellular water (ECW) ratio of >0.15. Results: The OH/ECW ratio was significantly higher in PD patients compared to post-HD patients. Overhydration was statistically more frequent in PD than in post-HD patients (30.3% vs. 11.6%, P = 0.043). Systolic blood pressure (SBP) in both post-HD and PD groups, and LVMI in the PD group were found to be significantly higher in overhydrated patients than non-overhydrated patients. In multiple linear regression analyses, increased OH/ECW ratio was independently associated with higher SBP and LVMI. Conclusions: Fluid overload may be an even more prevalent and serious problem in PD patients. Overhydration is closely associated with increased blood pressure and LVMI. OH/ECW ratio, a derived parameter of fluid load measured by BIA, was a significant and independent determinant of SBP and LVMI. (C) 2014 Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.Öğe EVALUATION OF THE ANTIOXIDANT AND RENOPROTECTIVE EFFECTS OF ELLAGIC ACID ON ISCHEMIA/REPERFUSION INDUCED NEPHROPATHY IN RATS(Oxford Univ Press, 2014) Yildirim, Yas Ar; Aba, Ozlem; Yilmaz, Zulfukar; Kadiroglu, Ali Kemal; Yilmaz, Mehmet Emin; Gul, Mesut; Ketani, Aydin[Abstract Not Available]Öğe EVALUATION OF THE ANTIOXIDANT AND RENOPROTECTIVE EFFECTS OF ELLAGIC ACID ON ISCHEMIA/REPERFUSION INDUCED NEPHROPATHY IN RATS(Carbone Editore, 2014) Yildirimi, Yasar; Adiyaman, Ozlem Aba; Yilmaz, Zulfukar; Kadiroglu, Al Kemal; Yilmaz, Mehmet Emin; Gul, Mesut; Ketani, AydinAims: Renal ischemia-reperfusion (I/R) injury is one of the important cause of acute kidney injury (AKI). Reactive oxygen species and inflammatory cytokines play major role in the pathogenesis of IR injury. Ellagic acid (EA), a phenolic compound, have shown to exert antioxidants, anti-inflammatory, anticarcinogenic, antihyperlipidemic effects. We aim to evaluate, the effect of EA on renal I/R induced nephropathy in rats. Materials and methods: Twenty-eight male Sprague-Dawley rats were divided into four groups; control, control + EA, I/R, and EA+I/R. EA (85 mg/kg, perorally) was administered 30 min prior to the ischemia. Rats were unilaterally nephrectomized and subjected to 45 min of renal pedicle occlusion followed by 60 min of reperfusion. Both groups were subsequently studied by renal function tests, oxidant and antioxidant parameters, and kidney histology. Results: Serum/kidney TAC, NO and paraoxonase levels were significantly higher, while serum urea and creatinine, serum/kidney MDA and TOS were significantly lower in EA+I/R group compared to I/R group (p<0.05). Histopathologic examination revealed that the severity of damage was significantly lower in the EA+I/R group compared to the I/R alone group. Conclusion: Administration of EA appears to have beneficial effects on I/R induced renal injury by reducing oxidative stress, thus preventing histological injuries and bringing about an improvement in renal function.Öğe Evaluation of the Frequency of QTc Dispersion and Its Relationship with Clinical and Laboratory Parameters in Dialysis Patients(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2013) Yilmaz, Zulfukar; Yildirim, Yasar; Yilmaz Aydin, Fatma; Aydin, Emre; Kadiroglu, Ali Kemal; Yilmaz, Mehmet Emin; Kayabasi, HasanOBJECTIVE: QTc dispersion is defined as the difference between the maximal and minimal correct QT interval on standard 12-lead ECG. Increased QTc dispersion has been reported in ESRD patients. In our study, we aimed to evaluate the frequency of QTc dispersion and its relationship between clinical and laboratory parameters in patients on regular dialysis programme. MATERIAL and METHODS: Sixty patients underwent dialysis ( 30 HD, 30 CAPD) and another 30 healthy subjects were enrolled into the study. The standard 12 lead ECGs were performed and QTcd was measured from all dialysis patients and control subjects. Blood samples were collected for the measurement of laboratory parameters. RESULTS: Dialysis patients showed significantly higher QTcd than control subjects (55.75 +/- 36.48 versus 28.73 +/- 28.27; p=0.001). Patients with QTcd > 50 ms had significantly higher SBP, urea and ferritin levels, but significantly lower iron binding capacity and calcium levels compared those with QTcd <= 50 ms(p<0.05). Positive correlations were found between QTcd and urea, ferritin and SBP levels, and inverse correlations with iron binding capacity level (p<0.05). CONCLUSION: The frequency of QTc dispersion was 40% among the dialysis patients. Although serum calcium was significantly lower in patients who had QTcd > 50 ms than QTcd <= 50 ms (p<0.05), there was no significant correlation between QTcd and calcium.Öğe Evaluation of volume overload by bioelectrical impedance analysis, NT-proBNP and inferior vena cava diameter in patients with stage 3&4 and 5 chronic kidney disease(Taylor & Francis Ltd, 2014) Yilmaz, Zulfukar; Yildirim, Yasar; Oto, Ferhat; Aydin, Fatma Yilmaz; Aydin, Emre; Kadiroglu, Ali Kemal; Yilmaz, Mehmet EminBackground: Determination of fluid overload is important in chronic kidney disease. Early diagnosis and treatment of volume overload may decrease morbidity and mortality. We aimed to determine body composition by using bioelectrical impedance analysis, and studying other clinical characteristics, inferior vena cava diameter, and N-terminal pro-B natriuretic peptide associated with hydration status in chronic kidney disease Stages 3&4 and 5 in patients not undergoing dialysis. Method: We examined 62 patients with Stages 3&4 and 68 patients with Stage 5 chronic kidney disease. Plasma NT-proBNP was measured and analyzed after log transformation. Inferior vena cave diameter was measured with echocardiography and indexed for body surface area. Hydration status was assessed using multi-frequency bioelectrical impedance analysis. Overhydration was defined as overhydration/extracellular water >0.15. Results: Overhydration was more frequent in Stage 5 than in Stages 3&4 patients. Systolic and diastolic blood pressure, inferior vena cava index, and log NT-proBNP were higher in overhydrated compared to non-overhydrated patients. A significant positive correlation existed between overhydration/extracellular water and log NT-proBNP, systolic and diastolic blood pressures, and inferior vena cava index. In multiple linear regression analysis, the variables associated with hydration status were male sex, extracellular water/total body water, and extracellular water/intracellular water (greater overhydration), while serum albumin levels had a negative association with overhydration. Conclusion: Overhydration is more prevalent in Stage 5 chronic kidney disease patients than in Stages 3&4 patients. Bioelectrical impedance analysis, inferior vena cava diameter, and NT-proBNP analysis in chronic kidney disease are useful methods to determine the volume overload.Öğe FACTORS ASSOCIATED WITH MORTALITY AMONG TUBERCULOSIS PATIENTS IN SOUTHEAST TURKEY(Carbone Editore, 2015) Yilmaz, Sureyya; Taylan, Mahsuk; Sen, Hadice Selimoglu; Abakay, Ozlem; Demir, Melike; Kaya, Halide; Yilmaz, ZulfukarIntroduction: Tuberculosis (TB) is a disease caused by bacillus mycobacterium tuberculosis. Tuberculosis is a preventable and treatable disease that, despite the rapid advances in active therapy, continues to cause global mortality. In this study, we investigated the risk factors associated with mortality in patients undergoing treatment for TB. Materials and methods: Records of 2,450 tuberculosis patients who were followed-up with in tuberculosis dispensaries in the city of Diyarbakir, southeast Turkey, between January 2005 and December 2011 were reviewed retrospectively. Case definitions and treatment outcomes were classified according to WHO criteria. Results: Of the 2,450 registered TB patients, 1,339 were male (54.7%) and 1,111 were female (45.3%). Their mean age was 32.15 +/- 17.87 years, and 51 (2.1%) of them died. Mortality rates were higher in pulmonary TB (PTB) patients, males, relapse patients, category 2 patients, those >65 years old, TB meningitis patients, and patients who self-administered their therapy. According to Kaplan-Meier analysis, the mortality rates were significantly higher in patients aged >65 years, in those with Category II and in those TB meningitis. The significant independent risk factors for mortality during anti-TB treatment were advanced age, TB meningitis and gastrointestinal TB. Conclusion: Mortality was increased in the elderly, males, those with relapse, and in category II and extrapulmonary TB patients. Based on these data, we suggest that tuberculosis control programs should pay more attention to the high-risk groups determined in the current and previous studies. Treatment regimens for these risk groups should be considered for revision.Öğe The Frequency Of Metabolic Syndrome in Patients on Continuous Ambulatory Peritoneal Dialysis and the Association of Developing Metabolic Syndrome With Dialysis Duration(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2011) Kayabasi, Hasan; Yilmaz, Zulfukar; Yildirim, Idris; Yildirim, Yasar; Kadiroglu, Ali Kemal; Yilmaz, M. EminOBJECTIVE: To evaluate the characteristics of patients with metabolic syndrome, and the association of developing MS with peritoneal dialysis duration among patients undergoing continuous ambulatory peritoneal dialysis. MATERIAL and METHODS: Fifty-eight nondiabetic CAPD patients were evaluated. Biochemical parameters, blood pressure, length, weight, waist circumference, and body mass indexes were recorded. MS was determined using NCP-ATP III criteria. The patients were divided into 3 groups according to dialysis duration (Group 1: <= 60 months, Group 2: 61-120 months, Group 3: >= 121 months) and the frequency of MS was compared. RESULTS: Twenty-four of 58 patients were male, and MS was present in 22 (37.9%) patients. 14 (82.4%) of 22 patients with MS were female, (p=0.544). There was a statistically significant difference between patients with and without MS regarding age, BMI, waist circumference, PD duration, and triglyceride levels (p<0.05). 55% (n=32) of the patients were in group 1, 34.5% (n=20) in group 2, and 10.5% (n=6) in group 3 (p=0.092). The frequency of MS decreased with prolongation of dialysis duration (50% in group 1, 20% in group 2, and 33,3% in group 3) (p<0.001). CONCLUSION: The frequency of MS among our CAPD patients was 37.9% and it decreased with prolongation of dialysis duration. This result may suggest that alterations in metabolic state, and abandoning glucose-based PD solutions may improve MS criteria.Öğe LATE-BREAKING ABSTRACT: The effect of volume overload on pulmonary hypertension in hemodialysis patients(European Respiratory Soc Journals Ltd, 2015) Yilmaz, Sureyya; Yildirim, Yasar; Taylan, Mahsuk; Demir, Melike; Yilmaz, Zulfukar; Kara, Aliveysel; Aydin, Fatma[Abstract Not Available]Öğe Parameters of oxidative stress and echocardiographic indexes in patients on dialysis therapy(Taylor & Francis Ltd, 2010) Kayabasi, Hasan; Sit, Dede; Atay, A. Engin; Yilmaz, Zulfukar; Kadiroglu, Ali Kemal; Yilmaz, M. EminAim: Quantity of oxidative stress (OS) is enhanced in every stage of chronic renal failure (CRF). OS and its effects on echocardiographic indexes in patients on hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) were evaluated. Materials and methods: Thirty-nine patients on CAPD, 32 patients on HD, and 30 healthy individuals with similar demographic features were included. Patients with diabetes mellitus and chronic inflammatory diseases were excluded. Blood samples were collected to examine hematological and biochemical parameters and levels of malonyldialdehyde (MDA), glutathione peroxidase (GSH-px), and superoxide dismutase (SOD) after a 12-hour fasting period in the middle of dialysis week. OS parameters were compared with ejection fraction (EF), interventricular septum diameter (IVSd), left ventricular posterior wall diameter (LVPWd), and left atrium diameter (LAd) determined in M-mod echocardiographic examination. Results: No significant difference was observed between MDA and GSH-px levels of patients and control group; however, SOD levels of patients group were significantly lower (p < 0.0001). SOD levels of patients on HD were lower than that of patients on CAPD (p = 0.039). Negative correlation was detected between MDA and EF (r = -0.380, p = 0.001); SOD has negative correlation with systolic blood pressure (r = -0.265, p = 0.011), diastolic blood pressure (r = -0.230, p = 0.028), phosphorus (r = -0.327, p = 0.001), intact parathyroid hormone (iPTH) (r = -0.259, p = 0.013), C-reactive protein (CRP) (r = -0.235, p = 0.024), fibrinogen (r = -0.342, p = 0.001), and total cholesterol (r = -0.249, p = 0.017); and positive correlation with hemoglobin (r = 0.414, p < 0.001) and albumin (r = 0.367, p < 0.001). MDA was independently related with age (beta = -0.258, p = 0.035), male gender (beta = -0.312, p = 0.004), and EF (beta = -0.461, p < 0.001). No correlation was determined between antioxidants and cardiac indexes. Conclusion: SOD levels decreased significantly especially in patients on HD, and it was observed that lower levels of SOD would lead to OS in patients on HD and CAPD when compared to healthy individuals; MDA levels were independently influenced from EF.Öğe PRETREATMENT WITH PARICALCITOL ATTENUATES OXIDATIVE STRESS IN RENAL ISCHEMIA REPERFUSION INDUCED NEPHROPATY IN RATS(Oxford Univ Press, 2016) Yildirim, Yasar; Yilmaz, Zulfukar; Kadiroglu, Ali K.; Kara, Ali V.; Bahadir, Veysi; Aydin, Emre; Aydin, Fatma Y.[Abstract Not Available]Öğe Pretreatment with Paricalcitol Attenuates Oxidative Stress in Renal lschemia Reperfusion-Induced Nephropathy in Rats(Sci Printers & Publ Inc, 2020) Aydin, Fatma Yilmaz; Yilmaz, Zulfukar; Yildirim, Yasar; Aydin, Emre; Ketani, Aydin; Bahadir, Veysi; Kaplan, IbrahimOBJECTIVE: 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 mu g/kg paricalcitol was administered to rats once a day for 5 consecutive days in the paricalcitol and paricalcitol+1/R groups. After right nephrectomy, rats were exposed to ischemia/ reperfusion on day 6 in the paricalcitol+1/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 +1/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 histopathologii.
