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Now showing 1 - 10 of 24
  • PublicationOpen Access
    Comparative Evaluation of Orthostatic Hypotension in Patients with Diabetic Nephropathy.
    (2021-07-20T00:00:00Z) Aytaş, Gamze; Elçioğlu, Ömer C; Kazancıoğlu, Rümeyza; Gürsu, Meltem; Artan, A Serra; Yabacı, Ayşegül; Soysal, PINAR; Bilgi, Kadir; Özçelik, Semra; KAZANCIOĞLU, RÜMEYZA; ELÇİOĞLU, ÖMER CELAL; GÜRSU, MELTEM; YABACI TAK, AYŞEGÜL; SOYSAL, PINAR; ÖZÇELİK, SEMRA
    Introduction: Orthostatic hypotension (OH) affects 5-20% of the population. Our study investigates the presence of OH in diabetic nephropathy (DNP) patients and the factors affecting OH in comparison with nondiabetic chronic kidney disease (NDCKD) patients. Method: Patients presented to the nephrology clinic, and those who consented were included in the study. DNP was defined by kidney biopsy and/or clinical criteria. NDCKD patients of the same sex, age, and eGFR were matched to DNP patients. Demographic parameters and medications were obtained from the records. OH was determined by Mayo clinic criteria. The same researcher used an electronic device to measure blood pressure (BP). All samples were taken and analyzed the same day for biochemical and hematologic parameters and albuminuria. Results: 112 (51 F, 61 M, mean age: 62.56 ± 9.35 years) DNP and 94 (40 F, 54 M, mean age: 62.23 ± 10.08 years) NDCKD patients were included. There was no significant difference between DNP and NDCKD groups in terms of OH prevalence (70.5 vs. 61.7%, p = 0.181). Male patients had significantly higher OH prevalence than female patients (74.7 vs. 60.0%, p = 0.026). There was no significant difference in change in systolic BP between the groups (24.00 [10.00-32.00] mm Hg vs. 24.00 [13.75-30.25] mm Hg, p = 0.797), but the change in diastolic BP was significantly higher in the DNP group (8.00 [2.00-13.00] mm Hg vs. 6.00 [2.00-9.00] mm Hg, p = 0.025). In the DNP group, patients with OH had significantly higher uric acid levels than those without OH (7.18 ± 1.55 vs. 6.36 ± 1.65 mg/dL, p = 0.017). And, 73.7% of patients on calcium channel blockers developed OH (p = 0.015), and OH developed in 80.6% of 36 patients on alpha-blockers (p = 0.049). Conclusion: OH prevalence is very high in CKD, and etiology of CKD does not have a statistically significant effect on the frequency of OH, despite a difference that could be meaningful clinically. Therefore, patients with CKD are checked for OH, with or without concurrent diabetes mellitus. Evaluation of postural BP changes should be a part of nephrology practice.
  • PublicationOpen Access
    Peritonitis due to Candida Guilliermondii in a Patient on Continuous Ambulatory Peritoneal Dialysis
    (2015-09-01) TATLI, Emel; Gursu, MELTEM; Aydın, Zeki; UZUN, Sami; KARADAG, Serhat; CEBECI, Egemen; PEHLIVANOGLU, Filiz; SAVAS, Ozturk; Kazancioglu, RÜMEYZA; GÜRSU, MELTEM; KAZANCIOĞLU, RÜMEYZA
    Peritonitis still maintains its importance today as the most significant complication affecting mortality and morbidity in peritoneal dialysis (PD) patients. Although peritonitis is bacterial in 80% of cases, increasing rate of fungal peritonitis has been reported by many studies in recent years. While Candida species (mainly C. parapsilosis, C. albicans and C. tropicalis) are responsible for 70% of cases, other species (Trichosporon, Penicillium, Aspergillus and Acremonium) are very rarely seen. C. guilliermondii has been reported as the cause of peritonitis in PD patients in a few cases. Herein, we present a PD patient with peritonitis due to C. guilliermondii. We aimed to emphasize that non-albicans Candida species should be remembered in PD patients with peritonitis.
  • PublicationOpen Access
    Acute kidney injury in Turkey: epidemiological characteristics, etiology, clinical course, and prognosis
    (2022-10-01T00:00:00Z) GÜRSU, Meltem; Yegenaga, Itir; TUĞLULAR, ZÜBEYDE SERHAN; DURSUN, BELDA; GÖKÇAY BEK, SİBEL; Bardak, Simge; ONAN, ENGİN; Demir, Serap; DERİCİ, ÜLVER; DOĞUKAN, AYHAN; Sevinc, Mustafa; KOÇYİĞİT, İSMAİL; Altun, Eda; Haras, Ali Burak; ALTIPARMAK, Mehmet Rıza; TONBUL, HALİL ZEKİ; GÜRSU, MELTEM
    Background: This study aimed to evaluate the etiologies, comorbidities, and outcomes of acute kidney injury (AKI) in Turkey and determine any potential differences among different geographical parts of the country. Methods: This prospective observational study was conducted by the Acute Kidney Injury Working Group of the Turkish Society of Nephrology. Demographical and clinical data of patients with AKI at the time of diagnosis and at the 1st week and 1st, 3rd, and 6th months of diagnosis were evaluated to determine patient and renal survival and factors associated with patient prognosis. Results: A total of 776 patients were included (54.7% male, median age: 67 years). Prerenal etiologies, including dehydration, heart failure, and sepsis, were more frequent than other etiologies. 58.9% of the patients had at least one renal etiology, with nephrotoxic agent exposure as the most common etiology. The etiologic factors were mostly similar throughout the country. 33.6% of the patients needed kidney replacement therapy. At the 6th month of diagnosis, 29.5% of the patients had complete recovery; 34.1% had partial recovery; 9.5% developed end-stage kidney disease; and 24.1% died. The mortality rate was higher in the patients from the Eastern Anatolian region; those admitted to the intensive care unit; those with prerenal, renal, and postrenal etiologies together, stage 3 AKI, sepsis, cirrhosis, heart failure, and malignancy; those who need kidney replacement therapy; and those without chronic kidney disease than in the other patients. Conclusion: Physicians managing patients with AKI should be alert against dehydration, heart failure, sepsis, and nephrotoxic agent exposure. Understanding the characteristics and outcomes of patients with AKI in their countries would help prevent AKI and improve treatment strategies.
  • PublicationOpen Access
    Changes in the inflammatory markers with advancing stages of diabetic nephropathy and the role of pentraxin-3.
  • PublicationOpen Access
    Endothelial Dysfunction and Atherosclerosis in Patients With Autosomal Dominant Polycystic Kidney Disease
    (2021-02-01T00:00:00Z) Büyükbaba, Mitat; Çınar, Ahmet; Tunç, Muhammed; Gürsu, Meltem; Kazancıoğlu, Rümeyza; TUNÇ, MUHAMMED; GÜRSU, MELTEM; KAZANCIOĞLU, RÜMEYZA
    Introduction In this study, we aimed to determine the endothelial dysfunction (ED) and atherosclerosis in patients with autosomal dominant polycystic kidney disease (ADPKD). Materials and methods This study was conducted with 83 subjects (26 male, mean age: 46±11 years) consisted of three groups including ADPKD, hypertension (HT) and healthy control groups. The groups were evaluated in terms of serum endocan and asymmetric dimethylarginine (ADMA) levels, flow-mediated dilatation (FMD), nitroglycerin-mediated dilation (NMD) and carotid intima-media thickness (CIMT). Results Serum endocan and ADMA levels and CIMT were significantly higher while NMD was significantly lower in ADPKD group than control group. FMD and NMD were lower but serum ADMA level was higher in the ADPKD group than HT group; while serum endocan level and CIMT were not significantly different in ADPKD and HT groups. In ADPKD patients, CIMT value and serum endocan and ADMA levels were higher while NMD was lower in patients with eGFR≤60 mL/min/1.73 m2 than patients with eGFR>60 mL/min/1.73 m2. Serum ADMA level was higher and NMD was lower in hypertensive ADPKD patients than non-hypertensive ones. Serum endocan level was higher in ADPKD patients with nephrolithiasis and a negative correlation was detected between serum endocan level and 24-hour urine volume. Conclusions Endothelial dysfunction and atherosclerosis are common conditions in ADPKD patients and it was further reinforced in our study. In order to clarify the relationship between serum endocan level and 24-hour urine volume, which is a remarkable finding in our study, larger studies that including the measurement of urine endocan may be useful.
  • PublicationOpen Access
    COVİD-19 infection in a membranous nephropathy patient treated with rituximab.
    (2020-09-04T00:00:00Z) Elcioglu, Omer Celal; Artan, Ayse Serra; Mirioglu, Safak; Gursu, Meltem; Durdu, Bulent; Koc, Meliha Meric; Okyaltirik, Fatmanur; Gultekin, Mehmet Ali; Kazancioglu, Rümeyza; ELÇİOĞLU, ÖMER CELAL; MİRİOĞLU, ŞAFAK; GÜRSU, MELTEM; DURDU, BÜLENT; MERİÇ KOÇ, MELİHA; OKYALTIRIK, FATMANUR; GÜLTEKİN, MEHMET ALİ; KAZANCIOĞLU, RÜMEYZA
    While COVID-19 pandemic continues to afect our country and most countries in the world, we have to make some changes both in our social life and our approach to healthcare. We have to struggle with the pandemic on one hand and also try to follow up and treat our patients with chronic diseases in the most appropriate way. In this period, one of our group of patients who are challenging us for follow-up and treatment are those who should start or continue to use immunosuppressive therapy. In order to contribute to the accumulation of knowledge in this area, we wanted to report a patient who was followed up with the diagnosis of COVID-19 and had been administered rituximab very recently due to a nephrotic syndrome caused by membranous nephropathy.
  • PublicationOpen Access
    Is handgrip strength and key pinch measurement related with biochemical parameters of nutrition in peritoneal dialysis patients?
    (2015-07-01) YARDIMCI, Bulent; SUMNU, Abdullah; KAYA, Ibrahim; Gursu, MELTEM; Aydın, Zeki; KARADAG, Serhat; UZUN, Sami; tatlı, Emel; OZTURK, Savas; CETINUS, Ercan; Kazancioglu, RÜMEYZA; GÜRSU, MELTEM; KAZANCIOĞLU, RÜMEYZA
    Backgrounds & objective: End-stage renal disease (ESRD) frequently causes Protein Energy Wasting (PEW), which is an important morbidity and mortality factor. Although it is difficult to assess PEW with a reliable method, there are various methods such as Handgrip strength test (HST), serum albumin, cholesterol, etc. HST is a simple and reliable antropometric method which is used for nutritional status and body muscle strength. This study aims to assess the relationship between HST and biochemical markers in evolution of nutritional status of ESRD patients. Methods: This cross-sectional study included 36 consecutive patients, who are on peritoneal dialysis and 36 healthy -control subjects. Jamar-hand dynamometer was used for handgrip strength test; a pinch gauge was used for key pinch. Other antropometric tests included skin fold thicknesses at biceps, triceps, umbilical, suprailiac and subscapular regions; circumferences at waist hip, neck and midarm. Biochemical tests were performed only in Peritoneal Dialysis (PD) group. SPSS for Windows ver. 15.0 was used for statistics. Results: The mean age of patients was 49.3±14.4, and mean age of control group was 43.8±10.6 (p=0.075). In PD group dominant hand dynamometer test 1,2 and 3 results were 19.3±9.3 kg, 25.3±10.8 kg, 25.5± 10.6 kg and; 34.2±10.3 kg, 34.4±9.8 kg, 34.6±10.0 kg for control group (p< 0,001). Right key pinch results were 6.7±1.9 kg for patients; 13.5±4.5 kg for control group (p<0.001). Left key pinch results were 6.8±1.9 kg for patients; 13.2±4.4 kg for control group (p<0.001). There was not any significant relationship concerning handgrip or key pinch tests with biochemical parameters. Conclusion: Handgrip Strength Test and key pinch may be reliable, cheap and easily performed tests for the diagnosis of Protein Energy Wasting in patients on Peritoneal Dialysis.
  • PublicationOpen Access
    Spontanous Rupture of Renal Pelvis Due to Bladder Globe
  • PublicationOpen Access
    Placement of hemodialysis catheters with a technical, functional, and anatomical viewpoint.
  • PublicationOpen Access
    Correlation of Body Composition Analysis with Anthropometric Measurements in Peritoneal Dialysis Patients
    Objective: This study investigates correlations between different methods for diagnosis of protein energy malnutrition (PEM) in peritoneal dialysis patients. Methods: Twenty four patients were included. Patients with amputations, infections, peritonitis, malignancies and PD duration less than three months were excluded. Physical examination findings, laboratory results and anthropometric measurements were recorded. Body composition analysis was performed with multi-frequency bioimpedance analyzer. Dialysis malnutrition score (DMS) was calculated. The correlations of different parameters were searched. Results: Eleven patients were female and 13 patients were male. Mean age was 58.9±12.6 years. Median dialysis duration was 25 (interquartile range: 14) months. Protein percentage was negatively correlated with fat percentage (r=-0.785; p<0.001), triceps skinfold thickness (SFT) (r=-0.641; p<0.001), biceps SFT (r=-0.685; p<0.001), body mass index (BMI) (r=-0.867; p<0.001), mid-arm circumference (r=-0.680; p=0.001). Fat percentage was positively correlated with BMI (r=0.780; p<0.001), biceps SFT (r=0.817; p<0.001), triceps SFT (r=0.901; p<0.001) and mid-arm circumference (r=0.558; p=0.005) Albumin was negatively correlated with DMS (r= -0.439; p=0.032). DMS and albumin were not correlated with bioimpedance and anthropometry Conclusion: Albumin is a marker of PEM in PD patients. Malnutrition scores may be used as adjunct methods. Increase in fat mass and percentage may influence the interpretation of anthropometric measurements.