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    The effect of Ramadan fasting on kidney function in patients with chronic kidney disease
    (Springer, 2020) Baloglu, Ismail; Turkmen, Kultigin; Kocyigit, Ismail; Altunoren, Orcun; Demirtas, Levent; Zararsiz, Gokmen; Eroglu, Eray
    Purpose Because of the increase in globalization, clinicians all over the world are confronted the questions about safety of Ramadan fasting. However, there is no clear information about whether there is an obstacle for fasting patients with chronic disease. Hence, in the present study, we aimed to investigate the effects of Ramadan fasting on kidney and the factors affecting this relationship in patients with chronic kidney disease. Methods This study involving 117 patients [36 females, 81 males; mean age, 60 (46.0-70.0) years] with stage 2-3 chronic kidney and fasting. Patients were evaluated every 10 days for acute kidney injury (AKI) in Ramadan month. And, patients with acute kidney injury and patients without AKI were grouped. Results When the patients were evaluated for AKI, we observed that in 27 patients had acute kidney injury. While patients without AKI fasted for more days (p < 0.001), urea levels and frequency of hypertension were higher in the group with AKI (p = 0.019;p = 0.025 respectively). We also performed univariate and multiple binary logistic regression analysis to identify the risk factors of AKI. Hypertension and number of fasting day were found to be predictive of AKI (p = 0.02;p < 0.001 respectively). Conclusions We found a significant relationship between hypertension, the number of fasting days and acute kidney injury. Patients with chronic kidney damage and hypertension should be evaluated more carefully, informed about the importance of hydration after fasting and should be followed frequently for AKI.
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    The Relationship Between Osteoprotegerin/RANKL Axis and Arterial Stiffness in Osteopenic/Osteoporotic Renal Transplantation Recipients
    (Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2015) Kocyigit, Ismail; Turkmen, Kultigin; Dogan, Ender; Gungor, Ozkan; Orscelik, Ozcan; Karakukcu, Cigdem; Eroglu, Eray
    OBJECTIVE: Cardiovascular diseases are the main reason of death in patients with renal transplantation (Rtx). Osteoprotegerin (OPG) is produced by osteoblasts and is linked to increased cardiovascular risk in Rtx. OPG acts as a decoy receptor binding receptor activator of nuclear factor kappa-B ligand (RANKL) and this interaction plays a role in bone resorption and vascular function. This study aimed to investigate the relation between OPG, RANKL, osteoporosis and arterial stiffness in Rtx patients. MATERIAL and METHODS: This cross-sectional study included 80 adult Rtx recipients. Femoral neck mineral density was obtained by dual-energy X-ray absorptiometry. Serum OPG and RANKL were measured by the ELISA method. Pulse-wave analysis was measured in the carotid and femoral arteries using a pulse wave velocity (PWV) machine. RESULTS: Patients were divided into two groups as normal (n:24) and osteopenia/osteoporosis group (n: 56). Body mass index was significantly lower in the osteopenic/osteoporotic group compared to the normal group. Pulse wave velocity was positively correlated with age (r:0.204,p:0.072), osteoprotegerin (r:0.219,p:0.052), calcium x phosphate product (r:0.605,p:<0.001), and systolic blood pressure (r:0.198,p:0.058) and negatively correlated with RANKL (r:-0.261,p:0.020) and creatinine clearance (r:-0.220,p:0.051). PWV was independently predicted by calcium x phosphate product but not creatinine clearance, RANKL, osteoprotegerin and systolic blood pressure. CONCLUSION: In our study, serum calcium x phosphate product but not OPG and RANKL levels were found to be the main predictor of arterial stiffness in Rtx patients.