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GÜRSU, MELTEM

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    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.
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    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.
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    PublicationOpen 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, RÜMEYZA
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    PublicationOpen 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, RÜMEYZA
    Aim: 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).
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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.
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    PublicationOpen Access
    A Case of Primary Hypoparathyroidism Presenting with Acute Kidney Injury Secondary to Rhabdomyolysis.
    (2016-01-01) SUMNU, A; AYDIN, Z; GURSU, MELTEM; UZUN, S; KARADAG, S; CEBECI, E; OZTURK, S; Kazancioglu, RÜMEYZA; GÜRSU, MELTEM; KAZANCIOĞLU, RÜMEYZA
    Symmetric calcification of the basal ganglia identified radiographically occurs in a variety of familial and nonfamilial conditions. Primary Familial Brain Calcifications (PFBC), which were known by many names previously, including Fahr disease and striopallidodentate calcinosis, are a genetic disease characterized by various mutations in four separate genes and autosomal dominant inheritance [1–4]. PFBC may present with various psychiatric and neurological symptoms [5]. On the other hand, many secondary causes, either infectious, toxic, or metabolic, have been described to cause symmetrical basal ganglion calcifications and so are in the differential diagnosis of PFBC [6]. Parathyroid diseases such as hypoparathyroidism, pseudohypoparathyroidism, and pseudo-pseudohypoparathyroidism are in the forefront among the metabolic causes. Idiopathic or postsurgical hypoparathyroidism is the most common cause of symmetric calcification of the basal ganglia [7–9]. Herein, a case of primary hypoparathyroidism with severe tetany, rhabdomyolysis, and acute kidney injury (AKI) is presented.
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    PublicationOpen Access
    Hemodialysis Experience of a Large Group of Syrian Refugees in Turkey: All Patients Deserve Effective Treatment
    (2019-01-01) Gursu, MELTEM; ARICI, MUSTAFA; Ates, Kenan; Kazancioglu, RÜMEYZA; Yavas, Pinar Guneser; Öztürk, Murat; ALTUN, BÜLENT; Arinsoy, Turgay; GÜRSU, MELTEM; KAZANCIOĞLU, RÜMEYZA
    Background/Aims: Refugee dialysis is a worldwide growing dilemma with limited experience. This report presents the largest hemodialysis (HD) patient registry data of Syrian refugees in Turkey. Methods: Demographic, clinical, laboratory, and dialysis practice data of 345 Syrian HD patients during one year were collected and analyzed. Results: There were 345 prevalent Syrian HD patients at the end of 2016. Majority of the patients were placed in the Southeast Anatolian Region. The majority of the patients (74.8%) are in the age range of 20-64 years. Dialysis vintage in Turkey is less than 12 months in 20.8% and less than one month in 29.3% of patients. The vascular access was arteriovenous fistula in the majority of patients (72.5%). Kt/V is over 1.7 in 57%, serum albumin is above 35 g/L in 65.8% and hemoglobin level is more than 100 g/L in %65.2 of the patients. The ratio of patients with serum phosphorus level of 1.13-1.77 mmol/L was 56.2%. Twenty Syrian HD patients (14 male, 6 female) died within the year 2016 and annual mortality rate was 5.7%. Conclusion: This study with the largest number of Syrian refugees undergoing maintenance hemodialysis showed good dialysis practices, acceptable values for dialysis adequacy and biochemical parameters along with lower mortality compared to native HD population of Turkey. Longer follow up will enrich the knowledge related to care of refugee population in all over the world.
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    PublicationOpen Access
    New options in the treatment of autosomal dominant polycystic kidney disease.
    (2015-05-01) Kazancioglu, RÜMEYZA; GURSU, MELTEM; KAZANCIOĞLU, RÜMEYZA; GÜRSU, MELTEM
    Autosomal dominant polycystic disease (ADPKD) is one of the most common monogenic disorders, and globally is among the most common hereditary causes of end stage kidney disease. Until recently, the causes of this disease remained obscure. However, in the past decade there have been enormous advances in the understanding of the pathophysiology and genetics of this condition, and recent studies have suggested the possibility of specific treatment for slowing cyst growth. This review will focus on the new options for the control of ADPKD.
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    PublicationOpen Access
    THE RELATIONSHIP BETWEEN SOLUBLE TUMOR NECROSIS FACTOR-LIKE WEAK INDUCER OF APOPTOSIS LEVELS AND CARDIAC FUNCTIONS IN PERITONEAL DIALYSIS PATIENTS
    (2014-09-01) KARADAG, S.; GURSU, MELTEM; SAKIN, A.; ATALAY, E.; BASINOGLU, F.; AYDIN, Z.; UZUN, S.; SUMNU, A.; CEBECI, E.; KOLDAS, M.; OZTURK, S.; Kazancioglu, RÜMEYZA; GÜRSU, MELTEM; KAZANCIOĞLU, RÜMEYZA
    Tumor necrosis factor (TNF)-like weak inducer of apoptosis (sTWEAK) levels has been reported to be decreased in patients on hemodialysis (HD) and patients with heart failure. We aimed to study the relationship between sTWEAK levels and cardiac functions in peritoneal dialysis (PD) patients. This cross-sectional study was carried out on patients on chronic PD programs for more than three months. Patients aged under 18 or over 80 years, patients with overt cardiac disease, overt hypervolemia, active systemic infection, malignancy, peritonitis within the last month were excluded. The patient group was compared with the control group including healthy adults aged 24-61 years. Fifty-two PD patients were included in the study (mean age: 52.7 +/- 15.4 years; female/male ratio: 30/22). The corresponding data of the control group were 41.3 +/- 10.7 years and 17/14. There was no statistically significant difference between demographic parameters of the groups except age. The mean sTWEAK level of the patient and the control groups were similar (564 +/- 17 pcg/ml vs 535 +/- 126 pcg/ml, p=0.419). No correlation was detected between any of the demographic variables and sTWEAK levels. Among the echocardiographic parameters, only ejection fraction was found to be correlated negatively with sTWEAK levels. Patients with ischemic heart disease (THD) and heart failure had significantly higher sTWEAK levels compared with the patients without these diseases. With linear regression analysis, only age and the presence of heart failure were found to be the independent determinants of sTWEAK levels. Level of sTWEAK is significantly high in PD patients with heart failure and IHD. sTWEAK may be a marker of cardiac functions in PD patients.
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    PublicationOpen Access
    The relationship between apelin and cardiac parameters in patients on peritoneal dialysis: is there a new cardiac marker?
    (2014-01-16) KARADAG, Serhat; OZTURK, Savas; Gursu, MELTEM; Gurdal, Ahmet; basınoğlu, Filiz; YIGIT, Servet; Aydın, Zeki; UZUN, Sami; SUMNU, Abdullah; Oflaz, Huseyin; Kazancioglu, RÜMEYZA; GÜRSU, MELTEM; KAZANCIOĞLU, RÜMEYZA
    Background: Many markers have been proposed for CVD risk assessment in dialysis population. Apelin is a peptide that has roles in cardiovascular functions and volume regulation namely vasodilation, decreased blood pressure (BP), positive inotropic effect and inhibition of antidiuretic hormone release. The aim of this study was to examine relationship of apelin levels with echocardiographic findings and laboratory parameters related with cardiovascular function and bone mineral metabolism among peritoneal dialysis (PD) patients.