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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 antioxidant and renoprotective effects of ellagic acid on ischemia / reperfusion induced nephropathy in rats(Acta Medica Mediterranea, 2014) Yildirimi Y.; Aba Adıyaman, Özlem; Yilmaz Z.; Kadiroglu A.K.; Yilmaz M.E.; Gül M.; Ketani A.Aims: 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 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 Factors associated with mortality among tuberculosis patients in southeast Turkey(A. CARBONE Editore, 2015) Yilmaz S.; Taylan M.; Sen H.S.; Abakay O.; Demir M.; Kaya H.; Yilmaz Z.Introduction: 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 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).
