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    MALNUTRITION, INFLAMMATION, AND ATHEROSCLEROSIS SYNDROME COMPONENTS PREDICTS POOR CARDIOVASCULAR OUTCOMES IN PATIENTS WITH STAGE 3-5 CHRONIC KIDNEY DISEASE
    (Oxford Univ Press, 2012) Solak, Yalcin; Yilmaz, Mahmut Ilker; Caglar, Kayser; Saglam, Mutlu; Yaman, Halil; Sonmez, Alper; Unal, Hilmi Umut
    [Abstract Not Availabe]
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    PLATELET TO LYMPHOCYTE RATIO INDEPENDENTLY PREDICTS CARDIOVASCULAR EVENTS IN PATIENTS WITH CHRONIC KIDNEY DISEASE
    (Oxford Univ Press, 2012) Yilmaz, Mahmut Ilker; Solak, Yalcin; Saglam, Mutlu; Yaman, Halil; Unal, Hilmi Umut; Gok, Mahmut; Cetinkaya, Hakki
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    RED CELL DISTRIBUTION WIDTH INDEPENDENTLY PREDICTS CARDIOVASCULAR EVENTS IN PATIENTS WITH CHRONIC KIDNEY DISEASE
    (Oxford Univ Press, 2012) Solak, Yalcin; Yilmaz, Mahmut Ilker; Caglar, Kayser; Saglam, Mutlu; Yaman, Halil; Unal, Hilmi Umut; Gok, Mahmut
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    Serum neutrophil gelatinase-associated lipocalin is associated with cardiovascular events in patients with chronic kidney disease
    (Springer, 2015) Solak, Yalcin; Yilmaz, Mahmut Ilker; Siriopol, Dimitrie; Saglam, Mutlu; Unal, Hilmi Umut; Yaman, Halil; Gok, Mahmut
    Background Neutrophil gelatinase-associated lipocalin (NGAL) is a member of the lipocalin family best known as a novel and early marker of acute kidney injury (AKI). Recent data suggest that NGQueryAL is not only a marker of AKI, but also an important player in the vascular remodeling, atherosclerotic plaque stability and thrombus formation. We conducted this study to investigate the association of serum NGAL levels with fatal and composite (fatal and non-fatal) cardiovascular events (CVE) in a cohort of patients with stage 1-5 CKD. Methods This was an observational cohort study in which serum NGAL was obtained from 298 CKD (stages 1-5) patients. Fatal and composite CVE were recorded for a median 41 months. We examined alteration of serum NGAL through CKD groups as well as association with inflammatory markers. We also performed a Cox regression analysis to determine the association of NGAL with predefined clinical outcomes. Results The median value of NGAL was 50.5 ng/mL (IR 47.6-54.9 ng/mL), and higher NGAL values were recorded in diabetic patients. In a multiple linear regression model, including all univariate associates of NGAL, only log eGFR, log hs-CRP and log HDL cholesterol maintained an independent association with log NGAL. During the observational period, 30 patients died due to cardiovascular causes and 69 non-fatal CVE were registered. In the fully adjusted model, we observed a 2.08-fold increase in the risk of fatal CVE and a 1.50-fold increase in the risk of fatal and non-fatal CVE for each increment of 1 SD in log NGAL values. Conclusions This is the first study that shows that serum NGAL is associated with cardiovascular events (fatal and non-fatal) in patients with CKD, independently of traditional risk factors, renal function and inflammation.
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    Serum Uric Acid Independently Predicts Cardiovascular Events in Advanced Nephropathy
    (Karger, 2012) Kanbay, Mehmet; Yilmaz, Mahmut Ilker; Sonmez, Alper; Solak, Yalcin; Saglam, Mutlu; Cakir, Erdinc; Unal, Hilmi Umut
    Background: Chronic kidney disease (CKD) is associated with increased risk for cardiovascular (CV) disease and is also associated with elevated uric acid, which is emerging as a nontraditional CV risk factor. We therefore evaluated uric acid as a risk factor for CV disease in subjects presenting to nephrologists with CKD who were not on medications known to alter endothelial function. Methods: 303 subjects with stage 3-5 CKD were followed for a mean of 39 months (range 6-46) and assessed for fatal and nonfatal CV events. Hyperuricemia was defined as uric acid >6.0 mg/dl for women and >7.0 mg/dl for men. In addition to other CV risk factors, endothelial function (flow-mediated dilatation), inflammatory markers (hsCRP), and insulin resistance (HOMA index and fasting insulin levels) were included in the analysis. We evaluated the association between uric acid and flow-mediated dilatation with linear regression. The impact of uric acid on composite CV events was assessed with Cox regression analysis. Results: Of a total of 303 patients, 89 had normouricemia and 214 had hyperuricemia. Both fatal (32 of 214 vs. 1 of 89 subjects) and combined fatal and nonfatal (100 of 214 vs. 13 of 89 subjects) CV events were more common in subjects with hyperuricemia compared with normal uric acid levels, and this was independent of estimated glomerular filtration rate, traditional CV risk factors including diabetes, hypertension and BMI, and nontraditional risk factors (hsCRP and endothelial function). The 46-month survival rate was 98.7% in the group with low uric acid compared to 85.8% in patients with high uric acid (p = 0.002). Conclusions: Hyperuricemia is an independent risk factor for CV events in subjects presenting with CKD who are not on medications known to alter endothelial function. Copyright (C) 2012 S. Karger AG, Basel