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Öğe THE ASSOCIATION BETWEEN HRQOL, OTHER FACTORS AND MORTALITY IN PD PATIENTS WHO WERE FOLLOWED FOR 7 YEARS(Oxford Univ Press, 2013) Guney, Ibrahim; Turkmen, Kultigin; Yazici, Raziye; Aslan, Sevket; Altintepe, Lutfullah; Yeksan, Mehdi[Abstract Not Availabe]Öğe The association of decreased testosterone with atherosclerosis and inflammation in male predialysis patients with chronic kidney disease(Elsevier, 2020) Aydemir, Harun; Guney, Ibrahim; Duran, Cevdet; Gencer, Vedat; Akbayrak, Sahabettin; Kurku, Huseyin; Akgul, Yavuz Sultan SelimPurpose: To investigate the frequency of hypogonadism and its relationship to inflammation and carotid intima-media thickness (CIMT) in male patients with predialysis chronic kidney disease (CKD). Methods: A total of 105 patients with CKD, 55 (52.4%) as stage 3, 33 (31.4%) as stage 4 and 17 (16.2%) as stage 5, were enrolled into the study. Total testosterone (TT) and free testosterone (FT), interleukin 6 (IL-6), C-reactive protein (CRP) levels, and CIMT were measured. Results: According to TT and FT, hypogonadism was detected in 18 (17.1%) and 22 (20.9%) patients, respectively. There was no difference in terms of TT and FT, CIMT, CRP and IL-6 between the stages of CKD. According to TT, the patients with hypogonadism had significantly higher CRP and high-density lipoprotein cholesterol (HDL-cholesterol) levels (p=0.004 and p=0.005, respectively). There was no significant difference in other parameters. According to FT, the patients with hypogonadism had significantly higher CRP (p=0.017), and TT were negatively correlated with body mass index (BMI), waist circumference (WC), hip circumference, and CRP levels. FT was negatively correlated with age, waist circumference, systolic blood pressure, diastolic blood pressure (DBP) and CRP. Conclusions: The frequency of hypogonadism was found around 17-21% among the patients with CKD. Despite similar IL-6 and CIMT levels, CRP was found to be higher in the patients with hypogonadism. We consider that further studies with larger populations are needed to elucidate the entity. (C) 2020 Sociedad Espanola de Arteriosclerosis. Published by Elsevier Espana, S.L.U. All rights reserved.Öğe DETERMINATION OF RELIABILITY OF SOME TESTS IN EVALUATING AV FISTUL FLOW RATE IN HEMODIALYSIS PATIENTS(Oxford Univ Press, 2013) Yavuz, Yasemin Coskun; Selcuk, Nedim Yilmaz; Guney, Ibrahim; Altintepe, Lutfullah[Abstract Not Availabe]Öğe Does the serum uric acid level have any relation to arterial stiffness or blood pressure in adults with congenital renal agenesis and/or hypoplasia?(Taylor & Francis Inc, 2017) Yazici, Raziye; Guney, Ibrahim; Altintepe, Lutfullah; Yazici, MehmetBackground: The relationship between serum uric acid and arterial stiffness or blood pressure is not clear. The serum uric acid level and its association with cardiovascular risk is not well known in patients with reduced renal mass. We aimed to investigate the relation between serum uric acid levels and arterial stiffness and also blood pressure in patients with congenital renal agenesis and/or hypoplasia. Material and Methods: In this single center, cross-sectional study, a total of 55 patients (39 (% 70.9) with unilateral small kidney and 16 (% 29.1) with renal agenesis) were included. The median age was 35 (21-50) years. The study population was divided into tertiles of serumuric acid (according to 2.40-3.96, 3.97-5.10, and 5.11-9.80mg/dl cut-off values of serum uric acid levels). Official and 24-h ambulatory non-invasive blood pressures of all patients were measured. The arterial stiffness was assessed by pulse wave velocity (PWV). Results: PWV values were increased from first to third tertile (5.5 +/- 0.6, 5.7 +/- 0.8, 6.1 +/- 0.7, respectively), but this gradual increase between tertiles did not reach significance. Linear regression analyses showed a positive correlation between serum uric acid levels and PWV (beta = 0.40, p = 0.010), but no correlation was found between uric acid and daytime systolic blood pressure (beta = 0.24, p = 0.345). Conclusion: In congenital renal agenesis/hypoplasia, the serumuric acid level was positively correlated with arterial stiffness, but there was no correlation with blood pressure.Öğe HEALTH RELATED QUALITY OF LIFE, SLEEP QUALITY AND DEPRESSION IN ELDERLY HEMODIALYSIS PATIENTS(Oxford Univ Press, 2012) Turkmen, Kultigin; Guney, Ibrahim; Turgut, Faruk; Altintepe, Lutfullah; Tonbul, Halil Zeki; Abdel-Rahman, Emaad[Abstract Not Availabe]Öğe Health-related quality of life, depression and mortality in peritoneal dialysis patients in Turkey: seven-year experience of a center(Informa Healthcare, 2014) Turkmen, Kultigin; Guney, Ibrahim; Yazici, Raziye; Arslan, Sevket; Altintepe, Lutfullah; Yeksan, MehdiIntroduction: Impairment of health-related quality of life (HRQoL) and being in a depressive mood were found to be associated with increased mortality in peritoneal dialysis (PD) patients. We aimed to investigate the association between HRQoL, depression, other factors and mortality in PD patients. Materials and methods: Totally 171 PD patients were included and followed for 7 years in this prospective study. Results: Of 171 PD patients, 45 (26.3%) deceased, 18 (10.5%) maintained on PD, 87 (50.9%) shifted to hemodialysis (HD) and 21 (12.3%) underwent transplantation. The most common cause of death was cardiovascular disease (32, 71.1%) followed by infection (6, 13.3%), cerebrovascular accident (5, 11.2%). The etiology of patients who shifted to HD was PD failure (41, 47.1%), peritonitis (33, 37.9%), leakage (6, 6.9%), catheter dysfunction (3, 3.4%), self willingness (4, 4.6%). Non-survivors were older than survivors (56.6 +/- 15.0 vs. 43.6 +/- 14.6, p = 0.003). There were also statistically significant difference in terms of albumin, residual urine, presence of diabetes and co-morbidity. When the groups were compared regarding HRQoL scores, non-survivors had lower physical functioning (p<0.001), role-physical (p = 0.0045), general health (p = 0.004), role-emotional (p = 0.011), physical component scale (PCS) (p = 0.004), mental component scale (MCS) (p = 0.029). Age, presence of residual urine, diabetes, albumin, PCS and MCS were entered in regression analysis. Decrease of 1 g/dL of albumin and being diabetic were found to be the independent predictors of mortality. Conclusions: Diabetes and hypoalbuminemia but not HRQOL scores were associated with higher mortality in PD patients after 7 years of following period.Öğe Individualized hemodialysis: Is similar hemodialysis adequacy possible using less water?(Tubitak Scientific & Technological Research Council Turkey, 2023) Aktas, Ali; Ozer, Hakan; Baloglu, Ismail; Tonbul, Halil Zeki; Guney, Ibrahim; Selcuk, Nedim YilmazBackground and aim: There are over 60,000 hemodialysis (HD) patients in Turkiye, and the number of patients is increasing yearly. Dialysate flow rate (Qd) is a factor in HD adequacy. Approximately 150 L of water are consumed per session to prepare the dialysate. We aimed to investigate whether HD effectiveness can be achieved at a low Qd in different patient groups for the purpose of saving water. Materials and methods: This prospective study included 81 HD patients from 2 centers. The patients underwent an aggregate total of 486 HD sessions, including 3 sessions at a Qd of 500 mL/min and 3 sessions at a Qd of 300 mL/min for each patient. We used online Kt/V readings recorded at the end of each dialysis session to compare the effectiveness of these 2 types of HD session performed at a different Qd. Results: The online Kt/V readings were similar between the standard (500) and low (300) Qd HD (1.51 +/- 0.41 and 1.49 +/- 0.44, respectively, p = 0.069). In the subgroup analyses, men had higher online Kt/V values at the standard Qd compared to the low Qd (1.35 +/- 0.30 and 1.30 +/- 0.32, respectively, p = 0.019), but the Kt/V values were not different for women. While the low Qd did not reduce online Kt/V in patients using small surface area dialysis membranes (1.75 +/- 0.35 for 300 Qd and 1.75 +/- 0.32 for 500 Qd, p = 0.931), it was associated with reduced online Kt/V in patients using large surface area dialysis membranes (1.12 +/- 0.25 for 300 Qd and 1.17 +/- 0.24 for 500 Qd, p = 0.006). The low Qd did not result in differences in online Kt/V among low-weight patients. However, online Kt/V values were better with the standard Qd in patients weighing 65 kg and above. Conclusion: In our study, dialysis adequacy at a reduced dialysate flow was not inferior for women, patients with low body weight, or patients using small surface area membranes. Individualized HD at a reduced Qd of 300 mL/min in eligible patients can save 48 L of water per HD session and an average of 7500 L of water per year.Öğe Irritable bowel syndrome frequency and related factors in hemodialysis patients(Wiley, 2020) Ozkul, Durmus; Guney, Ibrahim; Sackan, Fatih; Yavuz, Yasemin Coskun; Yilmaz, Nedim; Tonbul, Halil Z.Introduction Irritable bowel syndrome (IBS) is a functional bowel disease that is common in society, does not threaten life, impairs quality of life, and causes serious economic losses. Gastrointestinal system complaints and especially IBS are common in patients with chronic kidney disease. It has also been shown that psychiatric diseases are more common in patients with IBS. In this study, we aimed to determine the frequency of IBS in hemodialysis patients and to investigate the factors associated with IBS. Methods In this cross-sectional study, the questionnaire prepared to evaluate depression, anxiety, and abdominal pain was administered face-to-face to 686 patients by the same researcher in seven dialysis centers; 404 patients without exclusion criteria were included in the study. The diagnosis of IBS was made according to Rome IV criteria. A multivariate logistic regression model was used to identify factors that are significantly related to IBS. Findings In 69 (17.1%) of the patients included in the study, symptoms were consistent with IBS. Binominal logistic regression analysis was performed to evaluate the effect of age, dialysis duration, diabetes, proton pump inhibitor, non-steroidal anti-inflammatory drugs, calcium acetate use, Hamilton depression and anxiety scores associated with IBS in the presence of IBS of the participants. The logistic regression model was statistically significant, chi(2) (3) = 69.748, P < 0.001. Independent risk factors for IBS in hemodialysis patients were determined as anxiety, long-term dialysis treatment, and using calcium acetate as a phosphorus binder. Discussion In hemodialysis patients, IBS occurs approximately twice as often as in a healthy population. Independent risk factors for IBS in hemodialysis patients are anxiety, long-term dialysis treatment, and using calcium acetate as a phosphorus binder.Öğe Masked hypertension in renal transplant recipients(Taylor & Francis Ltd, 2014) Kayrak, Mehmet; Gul, Enes Elvin; Kaya, Coskun; Solak, Yalcin; Turkmen, Kultigin; Yazici, Raziye; Guney, IbrahimPurpose: Arterial hypertension is a risk factor affecting graft function in renal transplant recipients (RTRs). In pediatric RTRs, high prevalence of masked and nocturnal hypertension was reported. Most of the RTRs had a history of hypertension and some of them were normotensive at outpatient visits whereas home blood pressure (BP) levels were higher. Masked hypertension (MHT) is defined as a normal office BP but an elevated ambulatory BP. Previous reports have demonstrated the detrimental role of MHT in clinical outcomes in hypertensive patients. However, the true prevalence of MHT in RTRs is yet to be defined. Methods: A total of 113 RTRs (mean age 44 +/- 16 years, 72 males, 41 females) with normal office BP (< 140/90 mmHg) were enrolled to the study from the outpatient renal transplantation clinic. Ambulatory BP monitoring (ABPM) was performed in all participants for a 24-h period. Average daytime BP values above 135 mmHg systolic and 85 mmHg diastolic were defined as MHT. Results: The prevalence of MHT in our cohort was 39% (n = 45). Fasting glucose and C-reactive protein levels were higher in patients with MHT compared with normal BP group (p = 0.02 and p = 0.04, respectively). RTRs with deceased donor type had higher prevalence of MHT than RTRs with living donor (40% vs 19%, p = 0.003). In multivariate analysis, deceased donor type could predict the MHT independent of age, gender, office systolic BP level, diabetes mellitus, serum creatinine, C-reactive protein, and glucose levels (OR = 3.62, 95% CI 1.16-11.31, p = 0.03). Conclusion: We demonstrated an increased prevalence of MHT in a typical renal transplant cohort. In addition, transplantation from a deceased donor may be a predictor of MHT. The prevalence of MHT may help to explain high rate of cardiovascular events in RTRs. Therefore, routine application of ABPM in RTRs may be plausible, particularly in RTRs with deceased donor type.Öğe Non-Caseating Granulamatus Nephritis: Rare Sign of Sarcoidosis(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2016) Gencer, Vedat; Guney, Ibrahim; Yazici, Raziye; Esen, Hasan; Aslan, Uysaler; Bolukbas, OzdenSarcoidosis is chronic multisystem granulomatous disease. It can rarely cause renal structural and functional damage. Renal impairment is mostly due to the calcium metabolism and associated with hypercalciuria, nephrolithiasis and nephrocalcinosis. Non-caseating granulomatous nephritis can also be seen in few patients. We diagnosed non-caseating granulomatous nephritis with renal biopsy in a 50-year-old female pulmonary sarcoidosis case. Steroid treatment was immediately started and there was a significant decrease in proteinuria and creatinine after a month. Proteinuria and serum creatinine increase are important in patients with sarcoidosis and treatment must be started immediately to prevent end-stage renal failure.Öğe PERI-AORTIC FAT TISSUE AND MALNUTRITION-INFLAMMATION-ATHEROSCLEROSIS/CALCIFICATION SYNDROME IN END-STAGE RENAL DISEASE PATIENTS(Oxford Univ Press, 2012) Turkmen, Kultigin; Kayikcioglu, Hatice; Guney, Ibrahim; Altintepe, Lutfullah; Ozbek, Orhan; Tonbul, Halil Zeki[Abstract Not Availabe]Öğe Predictive Value of Atrial Electromechanical Delay on Long-Term Cardiovascular Outcomes in Hemodialysis Patients(Karger, 2015) Turkmen, Kultigin; Demirtas, Event; Topal, Ergun; Gaipov, Abduzhappar; Kocyigit, Ismail; Orscelik, Ozcan; Guney, IbrahimBackground: Atrial electromechanical delay (AEMD) times were considered independent predictors of cardiovascular morbidity among the general population. We aimed at evaluating AEMD times and other risk factors associated with 2-year combined cardiovascular (CV) events in HD patients. Material and Methods: Sixty hemodialysis (HD) and 44 healthy individuals were enrolled in this prospective study. Echocardiography was performed before the mid-week dialysis session for HD patients. Data were expressed as mean SD. Spearman test was used to assess linear associations. Survival was examined with the Kaplan-Meier method. Multivariate Cox regression analysis was used to determine the predictors of combined CV events in this cohort. Results: At the beginning of the study, left intra-atrial-AEMD times were significantly longer in HD patients compared to the left intra-atrial-AEMD times in healthy individuals. After 24 months, 41 patients were still on HD treatment and 19 (31.6%) had died. Serum triglyceride, total cholesterol and albumin were found to be higher and C-reactive protein (CRP) levels, left intra-atrial EMD time (LIAT) and interatrial EMD times were found to be lower in survived HD patients. With the cut-off median values of 3.5 g/dl for albumin, 0.87 mg/dl for CRP, 157 mg/dl for total cholesterol and 151 mg/dl for triglyceride, the Kaplan-Meier curves demonstrated significant differences in terms of all-cause mortality. We also demonstrated the Kaplan-Meier survival curves of HD patients according to tertile values of LIAT. Cox regression analysis revealed that increased CRP and higher LIAT were found to be independent predictors of combined CV events. Conclusions: Increased LIAT and inflammation were found to be closely associated with 2 years combined CV events and all-cause mortality in HD patients. (C) 2015 S. Karger AG, BaselÖğe The Relationship between Bone Mineral Densitometry and Visceral Adiposity Index in Postmenopausal Women(Georg Thieme Verlag Kg, 2023) Elmas, Halis; Duran, Cevdet; Can, Mustafa; Tolu, Ismet; Guney, IbrahimObjective It was aimed to compare visceral adiposity index (VAI) levels in patients with normal bone mineral density (BMD), osteopenia, and osteoporosis.Methods One hundred twenty postmenopausal women (40 with normal BMD, 40 with osteopenia, and 40 with osteoporosis) between the ages of 50 to 70 years were included in the study. For females, the VAI was calculated using the formula (waist circumference [WC]/[36.58 + (1.89 x body mass index (BMI))]) x (1.52/High-density lipoprotein [HDL]-cholesterol [mmol/L]) x (triglyceride [TG]/0.81 [mmol/L]).Results The time of menopause from the beginning was similar in all groups. Waist circumference was found to be higher in those with normal BMD than in the osteopenic and osteoporotic groups ( p = 0.018 and p < 0.001, respectively), and it was also higher in the osteopenic group than in the osteoporotic group ( p = 0.003). Height and body weight, BMI, blood pressure, insulin, glucose, HDL-cholesterol, and homeostasis model assessment-insulin resistance (HOMA-IR) levels were similar in all groups. Triglyceride levels were found to be higher in the normal BMD group, compared with the osteoporotic group ( p = 0.005). The level of VAI was detected as higher in those with normal BMD, compared with the women with osteoporosis ( p = 0.002). Additionally, the correlation analysis showed a positive correlation between dual-energy X-ray absorptiometry (DXA) spine T -scores, WC, VAI, and a negative correlation between DXA spine T -scores and age.Conclusion In our study, we found higher VAI levels in those with normal BMD, compared with women with osteoporosis. We consider that further studies with a larger sample size will be beneficial in elucidating the entity.Öğe The relationship between glomerular filtration rate, and metabolic and inflammatory parameters in obese and non-obese patients with polycystic ovary syndrome(Elsevier, 2020) Can, Mustafa; Duran, Cevdet; Guney, Ibrahim; Elmas, Halis; Ayhan, Mehmet; Erdem, Said SamiAim: To investigate the relationship between glomerular filtration rates (GFR), and homeostasis model assesment of insulin resistance (HOMA-IR), C-reactive protein (CRP) and neutrophil to lymphocyte ratio (NLR) in patients with polycystic ovary syndrome (PCOS). Material and methods: Thirty-one overweight and obese PCOS patients with body mass index (BMI) >= 25 kg/m(2) and 25 non-obese PCOS patients with BMI < 25 kg/m(2) were included into patients' group, while 23 overweight and obese, and 25 non-obese age-and BMI-matched healthy individuals (aged between 18 and 40 years), were enrolled as controls. Levels of serum creatinine, glucose, insulin, CRP, and complete blood count were measured. eGFR, HOMA-IR and NLR were also calculated. Results: In PCOS group, HOMA-IR (p=0.001), CRP (p=0.025) and waist hip ratio (WHR) (p=0.011) were higher than controls. In obese PCOS sub-group, HOMA-IR (p=0.004) and WHR (p=0.002) were higher than obese controls. In non-obese PCOS sub-group, HOMA-IR (p=0.001) were higher than non-obese controls. In obese PCOS sub-group; HOMA-IR (p = 0.001) and CRP (p=0.001) levels were significantly higher than non-obese PCOS sub-group. In terms of other parameters, no significant difference was found between the groups. The analysis showed a negative correlation between GFR, and BMI and HOMA-IR in PCOS group, between GFR, WHR and insulin levels in obese PCOS sub-group, and between BMI, and HOMA-IR and NLR in non-obese PCOS sub-group. Conclusion: Although HOMA-IR and CRP were higher in PCOS group, there was no difference in NLR and GFR levels between those with PCOS and controls. (C) 2020 Sociedad Espanola de Arteriosclerosis. Published by Elsevier Espana, S.L.U. All rights reserved.Öğe Relationship between Plasma Pentraxin-3, Neutrophil-to-Lymphocyte Ratio, and Atherosclerosis in Renal Transplant Patients(Karger, 2012) Turkmen, Kultigin; Erdur, Fatih Mehmet; Guney, Ibrahim; Ozbiner, Huseyin; Toker, Aysun; Gaipov, Abduzhappar; Ozbek, OrhanBackground/Aims: Atherosclerosis and inflammation are the most important risk factors in the pathogenesis of cardiovascular diseases (CVD) in patients with end-stage renal disease (ESRD). Pentraxin-3 (PTX-3) was shown to predict inflammation and atherosclerosis in ESRD patients. However, the role of renal transplantation (Rtx) in terms of atherogenesis is still unclear. We aimed to investigate the relationship between PTX-3, neutrophil-to-lymphocyte ratio (NLR), and carotid intima-media thickness (CIMT) in Rtx patients and healthy controls. Methods: This was a cross-sectional study involving 29 Rtx patients (12 females, 40.1 +/- 11.9 years) without overt CVD and 19 healthy subjects (9 females, 36.9 +/- 8.9 years), testing the relationship between CIMT, assessed by ultrasonography, and selected biomarkers. Results: CIMT, PTX-3, and high-sensitivity C-reactive protein (hs-CRP) levels of Rtx patients were found to be significantly higher compared to healthy subjects. CIMT was positively correlated with age, creatinine, uric acid, triglyceride, PTX-3, hs-CRP, and NLR, and negatively correlated with estimated glomerular filtration rate in all participants. In Rtx patients, CIMT was positively correlated with age, BMI, serum phosphorus, low-density lipoprotein, and hs-CRP. The multivariate analysis revealed that hs-CRP was found to be an independent variable of CIMT in Rtx patients. Conclusion: Our data showed that inflammation and atherosclerosis persist in Rtx patients. Serum hs-CRP might be a useful marker to assess these parameters in this population. Copyright (C) 2012 S. Karger AG, BaselÖğe TECHNICAL SURVIVAL IN PERITONEAL DIALYSIS PATIENTS: QUALITY OF LIFE AND OTHER RELATED FACTORS(Oxford Univ Press, 2013) Guney, Ibrahim; Turkmen, Kultigin; Yazici, Raziye; Arslan, Sevket; Altintepe, Lutfullah; Yeksan, Mehdi[Abstract Not Availabe]
