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KAZANCIOĞLU, RÜMEYZA

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RÜMEYZA
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    PublicationOpen Access
    Effect of transfusion of washed red blood cells on serum potassium level in hemodialysis patients
    (2017-01-01) DEMIRTUNC, Refik; OZENSOY, Ugur; CETINKAYA, Fuat; KAYATAS, Kadir; USTUN, Emel; Kazancioglu, RÜMEYZA; KARATOPRAK, CUMALİ; KARATOPRAK, CUMALİ; KAZANCIOĞLU, RÜMEYZA
    Background/aim: This study aimed to compare washed red blood cell (WRBC) transfusion versus nonwashed RBC (NWRBC) transfusion in terms of posttransfusion potassium levels in dialysis patients on a day when the patient did not receive dialysis. Materials and methods: The patients were randomly assigned into two groups, i.e. those receiving WRBCs (n = 21) and those receiving NWRBCs (n = 17). Both groups received one unit of RBCs. Serum potassium and sodium levels were measured before and at the 1st, 2nd, 3rd, 4th, and 6th hours after transfusion. Results: In the WRBC group, the changes in the serum potassium levels at the 3rd, 4th, and 6th hours after transfusion were significant compared with pretransfusion levels. In the serum potassium levels mean decreases by 0.38 ± 0.57 mEq/L at the 3rd hour (P = 0.006), by 0.32 ± 0.47 mEq/L at the 4th hour (P = 0.005), and by 0.32 ± 0.51 mEq/L at the 6th hour (P = 0.009) after transfusion were significant compared with the pretransfusion levels. Conclusion: Although nonwashed RBC transfusion does not change serum potassium levels, washed RBC transfusion significantly reduces serum potassium levels. Washed RBC transfusion is considered to be safer in hemodialysis patients with hyperkalemia and anemia.
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    PublicationOpen Access
    International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in Eastern and Central Europe
    (2021-05-01T00:00:00Z) Dębska-Ślizień, Alicja; Bello, Aminu K.; Johnson, David W.; Jha, Vivekanand; Harris, David C.H.; Levin, Adeera; Tonelli, Marcello; Saad, Syed; Zaidi, Deenaz; Osman, Mohamed A.; Ye, Feng; Khan, Maryam; Lunney, Meaghan; Okpechi, Ikechi G.; Turan Kazancioglu, Rümeyza; KAZANCIOĞLU, RÜMEYZA
    Provision of adequate kidney care for patients with chronic kidney disease or kidney failure (KF) is costly and requires extensive resources. There is an inequality in the global distribution of wealth and resources needed to provide this care. In this second iteration of the International Society of Nephrology Global Kidney Health Atlas, we present data for countries in Eastern and Central Europe. In the region, the median prevalence of chronic kidney disease was 13.15% and treated KF was 764 per million population, respectively, slightly higher than the global median of 759 per million population. In most countries in the region, over 90% of dialysis patients were on hemodialysis and patients with a functioning graft represented less than one-third of total patients with treated KF. The median annual costs for maintenance hemodialysis were close to the global median, and public funding provided nearly universal coverage of the costs of kidney replacement therapy. Nephrologists were primarily responsible for KF care. All countries had the capacity to provide long-term hemodialysis, and 95% had the capacity to provide peritoneal dialysis. Home hemodialysis was generally not available. Kidney transplantation and conservative care were available across most of the region. Almost all countries had official dialysis and transplantation registries. Eastern and Central Europe is a region with a high burden of chronic kidney disease and variable capacity to deal with it. Insufficient funding and workforce shortages coupled with increasing comorbidities among aging patients and underutilization of cost-effective dialysis therapies such as peritoneal dialysis and kidney transplantation may compromise the quality of care for patients with KF. Some workforce shortages could be addressed by improving the organization of nephrological care in some countries of the region.
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    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.
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    PublicationOpen Access
    Global overview of health systems oversight and financing for kidney care
    (2018-02-01) Bello, Aminu K.; Alrukhaimi, Mona; Ashuntantang, Gloria E.; Bellorin-Font, Ezequiel; Gharbi, Mohammed Benghanem; Braam, Branko; Feehally, John; Harris, David C.; Jha, Vivekanand; Jindal, Kailash; Johnson, David W.; Kalantar-Zadeh, Kamyar; Kazancioglu, RÜMEYZA; Kerr, Peter G.; Lunney, Meaghan; Olanrewaju, Timothy Olusegun; Osman, Mohamed A.; Perl, Jeffrey; Rashid, Harun Ur; Rateb, Ahmed; Rondeau, Eric; Sakajiki, Aminu Muhammad; Samimi, Arian; Sola, Laura; Tchokhonelidze, Irma; Wiebe, Natasha; Yang, Chih-Wei; Ye, Feng; Zemchenkov, Alexander; Zhao, Ming-hui; Levin, Adeera; KAZANCIOĞLU, RÜMEYZA
    Reliable governance and health financing are critical to the abilities of health systems in different countries to sustainably meet the health needs of their peoples, including those with kidney disease. A comprehensive understanding of existing systems and infrastructure is therefore necessary to globally identify gaps in kidney care and prioritize areas for improvement. This multinational, cross-sectional survey, conducted by the ISN as part of the Global Kidney Health Atlas, examined the oversight, financing, and perceived quality of infrastructure for kidney care across the world. Overall, 125 countries, comprising 93% of the world's population, responded to the entire survey, with 122 countries responding to questions pertaining to this domain. National oversight of kidney care was most common in high-income countries while individual hospital oversight was most common in low-income countries. Parts of Africa and the Middle East appeared to have no organized oversight system. The proportion of countries in which health care system coverage for people with kidney disease was publicly funded and free varied for AKI (56%), nondialysis chronic kidney disease (40%), dialysis (63%), and kidney transplantation (57%), but was much less common in lower income countries, particularly Africa and Southeast Asia, which relied more heavily on private funding with out-of-pocket expenses for patients. Early detection and management of kidney disease were least likely to be covered by funding models. The perceived quality of health infrastructure supporting AKI and chronic kidney disease care was rated poor to extremely poor in none of the high-income countries but was rated poor to extremely poor in over 40% of low-income countries, particularly Africa. This study demonstrated significant gaps in oversight, funding, and infrastructure supporting health services caring for patients with kidney disease, especially in low- and middle-income countries.
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    PublicationOpen Access
    Determinants of mortality in a large group of hemodialysis patients hospitalized for COVID-19
    (2021-01-14T00:00:00Z) Turgutalp, Kenan; Ozturk, Savas; Arici, Mustafa; Eren, Necmi; Gorgulu, Numan; Islam, Mahmut; Uzun, Sami; Sakaci, Tamer; Aydin, Zeki; Sengul, Erkan; Demirelli, Bulent; Ayar, Yavuz; Altiparmak, Mehmet Riza; Sipahi, Savas; Mentes, Ilay Berke; Ozler, Tuba Elif; Oguz, Ebru Gok; Huddam, Bulent; Hur, Ender; Kazancioglu, Rümeyza; Gungor, Ozkan; Tokgoz, Bulent; Tonbul, Halil Zeki; Yildiz, Alaattin; Sezer, Siren; Odabas, Ali Riza; Ates, Kenan; KAZANCIOĞLU, RÜMEYZA
    Background Maintenance hemodialysis (MHD) patients are at increased risk for coronavirus disease 2019 (COVID-19). The aim of this study was to describe clinical, laboratory, and radiologic characteristics and determinants of mortality in a large group of MHD patients hospitalized for COVID-19. Methods This multicenter, retrospective, observational study collected data from 47 nephrology clinics in Turkey. Baseline clinical, laboratory and radiological characteristics, and COVID-19 treatments during hospitalization, need for intensive care and mechanical ventilation were recorded. The main study outcome was in-hospital mortality and the determinants were analyzed by Cox regression survival analysis. Results Of 567 MHD patients, 93 (16.3%) patients died, 134 (23.6%) patients admitted to intensive care unit (ICU) and 91 of the ones in ICU (67.9%) needed mechanical ventilation. Patients who died were older (median age, 66 [57–74] vs. 63 [52–71] years, p = 0.019), had more congestive heart failure (34.9% versus 20.7%, p = 0.004) and chronic obstructive pulmonary disease (23.6% versus 12.7%, p = 0.008) compared to the discharged patients. Most patients (89.6%) had radiological manifestations compatible with COVID-19 pulmonary involvement. Median platelet (166 × 103 per mm3 versus 192 × 103 per mm3, p = 0.011) and lymphocyte (800 per mm3 versus 1000 per mm3, p < 0.001) counts and albumin levels (median, 3.2 g/dl versus 3.5 g/dl, p = 0.001) on admission were lower in patients who died. Age (HR: 1.022 [95% CI, 1.003–1.041], p = 0.025), severe-critical disease clinical presentation at the time of diagnosis (HR: 6.223 [95% CI, 2.168–17.863], p < 0.001), presence of congestive heart failure (HR: 2.247 [95% CI, 1.228–4.111], p = 0.009), ferritin levels on admission (HR; 1.057 [95% CI, 1.006–1.111], p = 0.028), elevation of aspartate aminotransferase (AST) (HR; 3.909 [95% CI, 2.143–7.132], p < 0.001) and low platelet count (< 150 × 103 per mm3) during hospitalization (HR; 1.864 [95% CI, 1.025–3.390], p = 0.041) were risk factors for mortality. Conclusion Hospitalized MHD patients with COVID-19 had a high mortality rate. Older age, presence of heart failure, clinical severity of the disease at presentation, ferritin level on admission, decrease in platelet count and increase in AST level during hospitalization may be used to predict the mortality risk of these patients.
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    PublicationOpen Access
    Association of calcium channel blocker use with lower hemoglobin levels in chronic kidney disease
    (2013-09-01) Karatoprak, CUMALİ; CIKRIKCIOGLU, M. A.; Cakirca, MUSTAFA; Kiskac, MUHARREM; Zorlu, MEHMET; Cetin, GÜVEN; YILDIZ, KEMALETTİN; ERKOC, R.; ALAY, M.; Erkal, S.; Erkal, S. N.; DOGAN, S.; Kazancioglu, RÜMEYZA; KARATOPRAK, CUMALİ; ÇAKIRCA, MUSTAFA; KISKAÇ, MUHARREM; ZORLU, MEHMET; ÇETİN, GÜVEN; YILDIZ, KEMALETTİN; KAZANCIOĞLU, RÜMEYZA
    Aim: To search whether calcium channel blockers (CCBs) are associated with lower hemoglobin levels in chronic kidney disease (CKD) patients who are not on renal replacement therapy (RRT), vitamin D and anti-anemic treatment. Patients and methods: CKD patients were classified into two groups. Patients on CCBs treatment (103 patients) and patients not using CCBs (104 patients) were compared cross-sectionally regarding clinical findings, complete blood count (CBC), biochemistry and regular medication use. Patients with polycystic kidney disease, comorbidities that could influence CBC other than iron deficiency of obscure origin, patients receiving RRT, erythropoietin (EPO), vitamin D, phosphate binders and drugs that could influence CBC were excluded. Under dependent variable of CCB use, all significantly different independent variables were subjected to multivariate binary logistic regression analysis (MBLRA). Results: Lower hemoglobin, lower bilirubinemia, higher serum EPO, higher systolic blood pressure were observed in CCB users. Two groups were similar concerning age, gender, BMI, CKD etiology, CKD stage, pretibial edema prevalence, cardiothoracic index, diastolic blood pressure, corrected reticulocyte count, BUN, creatinine, eGFR, proBNP, parathormone, alkaline phosphatase, phosphorous, corrected calcemia, sCRP, relative EPO deficiency and prevalence of relative EPO deficient patients. Groups were comparable regarding comorbidities, types and usage frequencies of all antihypertensive medications other than CCBs. Higher systolic blood pressure and lower hemoglobin were significantly associated with CCB use after MBLRA. Conclusions: Hemoglobin was significantly lower in CCB users compared to non-users, among CKD patients who did not receive RRT, EPO, phosphate binders, vitamin D, iron, vitamin B12 and folic acid.
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    PublicationOpen Access
    Availability, coverage, and scope of health information systems for kidney care across world countries and regions.
    (2020-12-22T00:00:00Z) See, Emily J; Bello, Aminu K; Levin, Adeera; Lunney, Meaghan; Osman, Mohamed A; Ye, Feng; Ashuntantang, Gloria E; Bellorin-Font, Ezequiel; Benghanem Gharbi, Mohammed; Davison, Sara; Ghnaimat, Mohammad; Harden, Paul; Htay, Htay; Jha, Vivekanand; Kalantar-Zadeh, Kamyar; Kerr, Peter G; Klarenbach, Scott; Kovesdy, Csaba P; Luyckx, Valerie; Neuen, Brendon; O'Donoghue, Donal; Ossareh, Shahrzad; Perl, Jeffrey; Rashid, Harun Ur; Rondeau, Eric; Syed, Saad; Sola, Laura; Tchokhonelidze, Irma; Tesar, Vladimir; Tungsanga, Kriang; Kazancioglu, Rümeyza; Wang, Angela Yee-Moon; Yang, Chih-Wei; Zemchenkov, Alexander; Zhao, Ming-Hui; Jager, Kitty J; Caskey, Fergus; Perkovic, Vlado; Jindal, Kailash K; Okpechi, Ikechi G; Tonelli, Marcello; Feehally, John; Harris, David C; Johnson, David W; KAZANCIOĞLU, RÜMEYZA
    Background. Health information systems (HIS) are fundamental tools for the surveillance of health services, estimation of disease burden and prioritization of health resources. Several gaps in the availability of HIS for kidney disease were highlighted by the first iteration of the Global Kidney Health Atlas. Methods. As part of its second iteration, the International Society of Nephrology conducted a cross-sectional global survey between July and October 2018 to explore the coverage and scope of HIS for kidney disease, with a focus on kidney replacement therapy (KRT). Results. Out of a total of 182 invited countries, 154 countries responded to questions on HIS (85% response rate). KRT registries were available in almost all high-income countries, but few low-income countries, while registries for non-dialysis chronic kidney disease (CKD) or acute kidney injury (AKI) were rare. Registries in high-income countries tended to be national, in contrast to registries in low-income countries, which often operated at local or regional levels. Although cause of end-stage kidney disease, modality of KRT and source of kidney transplant donors were frequently reported, few countries collected data on patient-reported outcome measures and only half of low-income countries recorded process-based measures. Almost no countries had programs to detect AKI and practices to identify CKD-targeted individuals with diabetes, hypertension and cardiovascular disease, rather than members of high-risk ethnic groups. Conclusions. These findings confirm significant heterogeneity in the global availability of HIS for kidney disease and highlight important gaps in their coverage and scope, especially in low-income countries and across the domains of AKI, non-dialysis CKD, patient-reported outcomes, process-based measures and quality indicators for KRT service delivery.
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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
    A rare case of paralysis in an endemic area
    (2015-01-01) YARDIMCI, Bulent; KAZANCIOĞLU, RÜMEYZA; KAZANCIOĞLU, RÜMEYZA
    Thyrotoxicosis mostly presents with tachycardia, tremor, weight loss and other hypermetabolism signs. However, there are other unusual signs of thyrotoxicosis such as paralysis. This unusual clinical presentation may postpone prompt diagnosis and treatment. In this case report, we present a 27-years-old woman, who presented with quadriparesis at the emergency department.
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    PublicationOpen Access
    Epidemiological features of primary glomerular disease in Turkey: a multicenter study by the Turkish Society of Nephrology Glomerular Diseases Working Group.
    (2020-11-14T00:00:00Z) Turkmen, A; Sumnu, A; Cebeci, E; Yazici, H; Eren, N; Seyahi, N; Dilek, K; Dede, F; Derici, U; Unsal, A; Sahin, G; Sipahioglu, M; Gok, M; Tatar, E; Dursun, B; Sipahi, S; Yilmaz, M; Suleymanlar, G; Ulu, S; Gungor, O; Kutlay, S; Bahcebasi, ZB; Sahin, I; Kurultak, I; Turkmen, K; Yilmaz, Z; Kazancioglu, Rümeyza; Cavdar, C; Candan, F; Aydin, Z; Oygar, DD; Gul, CB; Arici, M; Paydas, S; Taymez, DG; Kucuk, M; Trablus, S; Turgutalp, K; Koc, L; Sezer, S; Duranay, M; Bardak, S; Altintepe, L; Arikan, IH; Azak, A; Odabas, AR; Sahin, GM; Ozturk, S; KAZANCIOĞLU, RÜMEYZA