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GÜRSU, MELTEM

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MELTEM
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  • PublicationOpen Access
    Volume status in patients on peritoneal dialysis: the role of apelin and bio-impedance spectroscopy
    (2012-01-01T00:00:00Z) Kazancioglu, RÜMEYZA; Gursu, MELTEM; KARADAG, S; TATLI, E; AYDIN, Z; UZUN, S; SUMNU, A; CEBECI, E; OZTURK, S; KAZANCIOĞLU, RÜMEYZA; GÜRSU, MELTEM
    One of the main factors determining the survival of peritoneal dialysis (PD) patients is volume status. We aimed to investigate hydration status of PD patients by bio-impedance spectroscopy (BIS) and echocardiography and to study the relation of them with apelin, which has effects related with volume status like vasodilation, positive inotropism, and inhibition of ADH release and RAS antagonism. Chronic PD patients without active cardiac disease or clinically prominent hypervolemia were included. Besides the demographic, clinical, and laboratory data, BIS and echocardiographic findings together with apelin levels were recorded. The study included 21 patients. Of them, eight patients were euvolemic, one patient was hypovolemic, and others have some degree of overhydration (1.1-6.8 L) with BIS, although all were euvolemic clinically. Mean apelin level was 1.49 +/- 0.49 ng/mL. Apelin level was positively correlated with ejection fraction and negatively with total body water (TBW), intracellular and extracellular water, lean tissue mass, and left atrium diameter. On linear regression model, TBW was the major determinant of apelin. Although apelin is expected to increase in hypervolemic patients, the negative correlation with body water in this study may be related with yet unknown role of apelin in dialyzed patients. They may have important roles in volume status in future.
  • PublicationOpen Access
    Is pentraxin-3 stronger than C-reactive protein to determine inflammation in peritoneal dialysis patients?
    (2012-01-01) Gursu, MELTEM; OZTURK, S.; AYDIN, Z.; KARADAG, S.; DOVENTAS, Y.; KOLDAS, M.; UZUN, S.; SUMNU, A.; KAZANCIOĞLU, RÜMEYZA; GÜRSU, MELTEM; KAZANCIOĞLU, RÜMEYZA
    Pentraxin-3 (PTX-3) is the prototype of long pentraxins and is produced by many tissues and organs including vascular endothelial cells in response to pro-inflammatory signals. It is thought to be an independent indicator of disease activity. We analyzed the correlation of PTX-3 with other markers of inflammation in peritoneal dialysis (PD) patients. Non-diabetic patients on chronic PD program who meet the dialysis adequacy criteria and who had no active infectious/inflammatory disease were included. Demographic and clinical parameters were recorded as well as hsCRP, fibrinogen, interleukin-6 (IL-6) and PTX-3 levels; and the correlation between them were studied. Twenty-five patients (mean age: 45.7 +/- 12.5 years; female/male ratio: 16/9) were included. Mean PTX-3 level was 2.16 +/- 2.76ng/ml. PTX-3 was found to be correlated positively with only IL-6 among inflammatory markers (r=0.827; p<0.001) but not with hsCRP. With linear regression model, IL-6 was the only independent determinant of PTX-3 levels. PTX-3 may be a more valuable marker of inflammation than CRP in patients on PD.