Person: GÜRSU, MELTEM
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Publication Open 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, SEMRAIntroduction: 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.Publication Open 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, RÜMEYZAPeritonitis 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.Publication Open 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, RÜMEYZAIntroduction 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.Publication Open 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, RÜMEYZAWhile 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.Publication Open 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, RÜMEYZABackgrounds & 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.Publication Open Access Placement of hemodialysis catheters with a technical, functional, and anatomical viewpoint.(2012-01-01T00:00:00Z) AYDIN, Z; Gursu, MELTEM; UZUN, S; KARADAG, S; TATLI, E; SUMNU, A; OZTURK, S; Kazancioglu, RÜMEYZA; GÜRSU, MELTEM; KAZANCIOĞLU, RÜMEYZAPublication Open Access Correlation of Body Composition Analysis with Anthropometric Measurements in Peritoneal Dialysis Patients(2022-01-01T00:00:00Z) ARTAN, AYŞE SERRA; GÜRSU, Meltem; ELÇİOĞLU, Ömer Celal; YABACI TAK, AYŞEGÜL; KAZANCIOĞLU, Rümeyza; ARTAN, AYŞE SERRA; GÜRSU, MELTEM; ELÇİOĞLU, ÖMER CELAL; YABACI TAK, AYŞEGÜL; KAZANCIOĞLU, RÜMEYZAObjective: 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.Publication Open Access Use of Herbal Products in Type 2 Diabetic Patients(2015-09-01) OZTURK, Savas; gündoğdu, Yaprak Pelin; Gursu, MELTEM; yamak, Mehmet; OZKAN, Oktay; şar, Fuat; yenigün, Mustafa; Kazancioglu, RÜMEYZA; GÜRSU, MELTEM; KAZANCIOĞLU, RÜMEYZAAim: Use of herbal products is relatively common among general population. We aimed to study the use of herbal products for any reason in patients with type 2 diabetes mellitus (DM).Publication Open 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, MELTEMOne 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.Publication Open Access Evaluation of Kidney Function in Patients on Chemotherapy(2021-04-01T00:00:00Z) Haziyev, Elgun; GÜRSU, Meltem; ŞEKER, Mesut; ELÇİOĞLU, Ömer Celal; ARTAN, AYŞE SERRA; ALİYEV, Altay; TÜRK, HACI MEHMET; DEMİR, Tarık; TOPRAK, ALİ; KAZANCIOĞLU, Rümeyza; GÜRSU, MELTEM; ŞEKER, MESUT; ELÇİOĞLU, ÖMER CELAL; ARTAN, AYŞE SERRA; ALİYEV, ALTAY; TÜRK, HACI MEHMET; DEMİR, TARıK; TOPRAK, ALİ; KAZANCIOĞLU, RÜMEYZAObjective: We aimed to study whether long-term kidney function would be affected by different chemotherapy regimens in patients with malignancy.