İlter Bozacı - Academia.edu (original) (raw)

Papers by İlter Bozacı

Research paper thumbnail of Nefroloji Kitabı

Research paper thumbnail of Obez Hastalarda Ve Obez Kroni̇k Böbrek Hastalarinda Enflamasyon Beli̇rteci̇ Olarak Hemogram Parametreleri̇ni̇n Değerlendi̇ri̇lmesi̇

Acta medica alanya, Dec 31, 2021

Amaç: Kronik inflamasyon hem obezitenin hem de kronik böbrek hastalığının patogenezi ile ilişkili... more Amaç: Kronik inflamasyon hem obezitenin hem de kronik böbrek hastalığının patogenezi ile ilişkilidir. Çalışmamızda obez hastalarda ve obez kronik böbrek hastalarında inflamasyon belirteci olarak tam kan sayımı parametrelerinin değerlendirilmesini amaçladık. Yöntemler: Çalışmada yer alan bireyler 3 ayrı gruba bölündü. Grup-1 obez hastalardan, grup-2 obez kronik böbrek hastalarından, grup-3 kontrol grubu olarak sağlıklı bireylerden oluşmakta idi. Çalışmamız, 6 aylık bir sürede bir eğitim ve araştırma hastanesinde gerçekleştirildi. Bulgular: Kırkbir hasta grup-1'de; 41 hasta grup-2'de ve 22 sağlıklı birey grup-3'de yer aldı. Beyaz küre sayıları grup-3'e kıyasla grup-1 ve grup-2'de anlamlı düzeyde yüksek saptandı (7,5±1,4 x103/µL vs 8,4±2,4 x103/µL vs 6,5±1,3 x103/µL, sırasıyla, p<0.001) ve nötrofil lenfosit oranı grup-3'e kıyasla grup-1 ve grup-2'de anlamlı düzeyde yüksek saptandı (1,9±0,7 vs 2,5±1,5 vs 1,7±0,4, sırasıyla, p<0.001). Nötrofil lenfosit oranı ve beyaz küre sayısının, sistolik kan basıncı, ürik asit, üre ve kreatinin arasında pozitif; glomerüler filtrasyon hızı ile negatif korelasyon saptandı. Sonuçlar: Rutin klinik pratikte sıkça kullanılan hemogramdan elde edilen parametrelerin inflamasyon belirteçleri olarak anlamlı sonuçlanması önemlidir.

Research paper thumbnail of Hi̇dronefroz Olmadan Post Renal Akut Böbrek Yetmezli̇ği̇ / Post Renal Acute Kidney Failure Without Hydronephrosis

Osmangazi tıp dergisi, Dec 25, 2015

Akut böbrek yetmezliği, temel olarak 3 kısma ayrılmakla birlikte en sık neden pre-renal nedenler ... more Akut böbrek yetmezliği, temel olarak 3 kısma ayrılmakla birlikte en sık neden pre-renal nedenler iken post-renal nedenler %5 kadar olguda görülmektedir. Post-renal nedenler büyük oranda görüntüleme yöntemleri ile saptanabilmekle birlikte nadir de olsa bazı olgularda görüntülemenin tamamen normal olduğu vakalar da görülebilmektedir. Bizim vakamız, erken dönemde üriner sistem obstrüksiyonuna ait görüntüleme bulgusu olmayan olguda post-renal bir neden saptanıp hızla müdahale edilerek olası bir böbrek hasarının önüne geçilebilmiş olması sebebiyle önem arz etmektedir.

Research paper thumbnail of Association of Two Diseases with Autoimmunity: Membranous Glomerulonephritis and Vitiligo: Case Report

Türkiye klinikleri nefroloji, 2015

Research paper thumbnail of EVALUATION OF VIRAL LOAD, CD4 T LYMPHOCYTE COUNT, eGFR, COMPLETE BLOOD COUNTS AND VITAMIN D METABOLISM PARAMETERS IN HIV-INFECTED PATIENTS AT THE TIME OF DIAGNOSIS

Research paper thumbnail of Effects of cinacalcet treatment on QT interval in hemodialysis patients

The anatolian journal of cardiology, Nov 26, 2015

The Anatolian Journal of Cardiology is an international monthly periodical on cardiology publishe... more The Anatolian Journal of Cardiology is an international monthly periodical on cardiology published on independent, unbiased, double-blinded and peerreview principles. The journal's publication language is English however titles of articles, abstracts and Keywords are also published in Turkish on the journal's web site. The Anatolian Journal of Cardiology aims to publish qualified and original clinical, experimental and basic research on cardiology at the international level. The journal's scope also covers editorial comments, reviews of innovations in medical education and practice, case reports, original images, scientific letters, educational articles, letters to the editor, articles on publication ethics, diagnostic puzzles, and issues in social cardiology. The target readership includes academic members, specialists, residents, and general practitioners working in the fields of adult cardiology, pediatric cardiology, cardiovascular surgery and internal medicine.

Research paper thumbnail of The Relationship of Hepatits B Core Antibody Positivity with Demographic and Laboratory Parameters in Hemodialysis Patients

Haseki Tıp Bülteni, Jun 3, 2021

The presence of hepatitis B core antibody (HBcAb) is an indication of exposure to hepatitis B vir... more The presence of hepatitis B core antibody (HBcAb) is an indication of exposure to hepatitis B virus infection. We aimed to investigate the rates of positive HBcAb and its' association with demographical and laboratory parameters among patients undergoing hemodialysis. Methods: Patients were divided into two groups as HBcAb positive and HBcAb negative. This study was conducted at a training and research hospital over 3 months period between October and December 2020. Demographical data and laboratory results were recruited from most recent medical records. Results: A sum of 237 patients on hemodialysis were enrolled in the study. Fifty nine patients (25%) were HBcAb positive and 178 patients (75%) were HBcAb negative. Statistically significant difference was found between groups in terms of anti-HBs positivity (96.6% vs 79.2%; p=0.002), diabetes mellitus (DM) prevalence (32% vs 19%; p=0.036) and white blood cell count (WBC) levels (7.7±2.5 x10 3 / µL vs 7.1±2.1 x10 3 /µL; p=0.044). In linear regression analysis (variables: age, HBsAb, WBC and DM) HBcAb was found independently associated with age (t: 3.139; p=0.002), HBsAb (t: 3.998; p<0.001), WBC (t: 2.166; p=0.031) and DM (t: 2.749; p=0.006). Conclusion: We found high rates of positive HBcAb. Positive HBcAb should be taken into account in immune-compromised patients such as dialysis patients.

Research paper thumbnail of SP233The Relationship Among Serum Kallistatin, Cardiovascular Markers and Mortality in Geriatric Patients with Acute Kidney Injury

Nephrology Dialysis Transplantation, Jun 1, 2019

The aim of this study was to evaluate the effectiveness of HFR-SUPRA in the reduction of FLC and ... more The aim of this study was to evaluate the effectiveness of HFR-SUPRA in the reduction of FLC and its effect on albumin. METHODS: An observational prospective study was performed. Twelve MM patients (7 kappa, 5 lambda) who developed ARF between 2012-2018 were included. All patients were treated with chemotherapy and HFR-SUPRA. Blood samples (pre and post-dialysis) and ultrafiltrate samples (pre and post-resin at 5 minutes after the start of the session and 5 minutes before the end) were collected. RESULTS: The mean FLC reduction rate in blood was 53614% kappa and 33622% lambda. A decline of albumin in blood was not observed. In the ultrafiltrate, the mean FLC reduction rate at the start of the dialysis session was: 99.2% kappa, 97.06% lambda and 0.7% albumin; and at the end of the session was: 63.7% kappa, 33.62% lambda and 0.015% albumin. Regarding the evolution of patients: 36.4% had renal recovery, 18.2% died at the first year and 45.5% of patients remained dependent on dialysis. CONCLUSIONS: An effective FLC reduction is obtained and maintained throughout the session. HFR-SUPRA is effective as an adjunctive therapy for MM and has the advantage that albumin loss is not produced.

Research paper thumbnail of Eculizumab Experince at a Patient With Atypical Hemolitic Uremic Syndrome

Kocaeli tıp dergisi, 2018

Thrombotic microangiopathy discribes a specific pathologic lesion in which abnormalities in the v... more Thrombotic microangiopathy discribes a specific pathologic lesion in which abnormalities in the vessel wall of arterioles and capillaries lead to microvascular thrombosis. Microangiopathic hemolytic anemia is a descriptive term for non-immun hemolytic anemia resulting from intravascular red blood cell fragmentation that produces schistocytes on the peripheral blood smear. Atypical hemolytic uremic syndrome is a type of primer thrombotic microangiopathy and using eculizumab in the early phase of therapy reduces the risk of irreversible renal damage. We mentioned both the importance of early diagnosis at the patients presenting with microangiopathic hemolytic anemia and thrombocytopenia like our patient and the benefit of eculizumab therapy at the early phase of atypical hemolytic uremic syndrome therapy.

Research paper thumbnail of Risk Factors and Seroprevalence of Syphilis Among Naive HIV Patients: A Cross-Sectional Study From a Tertiary Center

Haseki Tıp Bülteni, Sep 1, 2021

Syphilis coinfection is common among human immune deficiency virus (HIV)/acquired immune deficien... more Syphilis coinfection is common among human immune deficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) diagnosed patients. We aimed to investigate the rates of syphilis coinfection, social-demographical features, viral and immunological properties among naive HIV/AIDS patients. Methods: Socio-demographical data, CD4+ T lymphocyte counts, HIV viral load, syphilis antibody results and physical examinations at the time of diagnosis of naive HIV infected patients who were admitted to our center between January 2017 and January 2021, were evaluated retrospectively from the medical records. Results: Three hundred-two naive HIV patients were enrolled in the study. Positive syphilis antibody rate was detected as 21.5% and 86.2% of those patients were male and also found 31.4% (p<0.01) in patients in which route of transmission was men sex with men (MSM). Positive syphilis antibody rate was found to be statistically higher in patients with substance abuse (p<0.01), CD4+ T lymphocyte counts were under 200 cell/mm³ (p=0.018) and viral load above 100.000 copies/mL (p<0.01). Conclusion: Among HIV-infected patients, those with MSM and substance abuse constitute the group at highest risk of syphilis. Therefore, syphilis must be screened and treated, especially at HIV diagnosis and high-risk behaviors.

Research paper thumbnail of Comparison of the Frequency and Severity of Depression Between Patients with Stage 4 and 5 Chronic Kidney Disease with and Without Kidney Transplantation

Haseki Tıp Bülteni, Sep 10, 2020

Patients with chronic kidney disease (CKD) are at an increased risk for depression. In the presen... more Patients with chronic kidney disease (CKD) are at an increased risk for depression. In the present study, we aimed to compare the frequency and severity of depression and its' association with demographical and laboratory parameters between stage 4 and 5 CKD patients with and without kidney transplantation. Methods: The study included stage 4 and stage 5 CKD patients not on dialysis. The patients were separated into two groups. Group 1 was composed of patients with renal transplantation and group 2 was composed of patients without renal transplantation. The prevalence of depression was evaluated using the Beck Depression Inventory. Results: Forty-nine patients were in group 1 and 52 patients in group 2. The mean depression score in group 1 was statistically significantly higher than in group 2 (16±15 vs 13.5±10; p=0.031). We found that depression score was correlated with parathormone levels (p=0.023) and serum ferritin levels (p=0.019). In multivariate linear regression analysis, depression scores were independently associated with parathormone [Exp (B): 0.997 (confidence interval (CI): 0.995-1.0); p=0.023] and ferritin [Exp (B): 0.996 (CI: 0.994-0.998); p=0.01]. Conclusion: Higher prevalence of depression in patients with CKD who received renal transplantation is a significant finding. Routine psychiatric evaluation should become a part of follow-up and treatment in both groups.

Research paper thumbnail of The role of azurocidin in patients with familial Mediterranean fever and AA amyloidosis and its association with cardiovascular risk factors

International Urology and Nephrology, Oct 15, 2020

Background Familial Mediterranean fever (FMF) is characterized by sporadic, recurrent attacks of ... more Background Familial Mediterranean fever (FMF) is characterized by sporadic, recurrent attacks of fever and serosal inflammation. AA amyloidosis (AAA) is a disorder characterized by the extracellular tissue deposition of serum amyloid A protein (SAA). Azurocidin is a neutrophil-derived granule protein. We aimed to investigate the significance of azurocidin in FMF and AAA and the correlation between azurocidin levels and carotid artery intima media thickness (CA-IMT) and cardiovascular plaque existence. Methods A sum of 52 FMF patients were enrolled in the study. FMF patients were composed of two groups. Group-1 included 30 patients with non-complicated FMF. Group-2 included 22 patients whom received renal transplantation due to FMF complicated with AAA and being followed up at stable state for at least one year. 24 healthy individuals who matched with FMF patients in terms of age and gender consisted the control group. Results We found statistically significant difference between patient and control groups in terms of urea (38.52 ± 19.96 mg/dl vs 29.08 ± 5.83 mg/dl; p = 0.003), creatinine (1.11 ± 0.39 mg/dl vs 0.91 ± 0.16 mg/dl; p = 0.002), serum uric acid (6.2 ± 2 mg/ dl vs 4.5 ± 0.9 mg/dl; p < 0.001), serum CRP (8.62 ± 9.5 mg/dl vs 3.91 ± 3.9 mg/dl; p = 0.004), ferritin (151.4 ± 317 ng/ml vs 33.3 ± 34 ng/ml; p = 0.014), white blood cell (WBC) levels (7.97 ± 2.3 × 10 3/µL vs 6.6 ± 1.7 × 10 3/µL ; p = 0.018), serum azurocidin levels (137.16 ± 65.62 ng/ml vs 102.35 ± 51.61 ng/ml; p = 0.015) and mean CA-IMT (0.57 ± 0.15 mm vs 0.47 ± 0.07 mm; p = 0.001). Comparison of group 1 and group 2 revealed statistically significant differences in terms of urea (26 ± 8 mg/dl vs 54 ± 19 mg/dl; p < 0.001), creatinine (0.87 ± 0.1 mg/dl vs 1.44 ± 0.3 mg/dl; p < 0.001), estimated glomerular filtration rate (eGFR) (99 ± 21 ml/min/1.73m 2 vs 53 ± 16 ml/min/1.73m 2 ; p < .001), uric acid (4.9 ± 1.3 mg/dl vs 7.6 ± 1.7 mg/dl; p < 0.001), ferritin (31.7 ± 27 ng/ml vs 292.8 ± 431 ng/ml; p = 0.010) and albumin (4.5 ± 0.3 g/dl vs 4.1 ± 0.3 g/dl; p = 0.001). There was no statistically significant difference between group 1 and group 2 in terms of mean CA-IMT (CA-IMT (M) (mm): 0.54 ± 0.14 vs 0.62 ± 0.17, p = 0.057). Serum azurocidin levels were not significantly different between group 1 and group 2 (121.73 ± 53.24 ng/ml vs 158.19 ± 75.77 ng/ml; p = 0.061). In multivariate linear regression analysis (variables: MBP, urea, creatinine, eGFR, ferritin, uric acid, CA-IMT) azurocidin was independently associated with urea (t:2.658; p = 0.010) and CA-IMT (t:2.464; p = 0.017). Discussion Based on our findings, azurocidin seems to be a good inflammation marker in patients with FMF. Increase in azurocidin levels might be associated with development of amyloidosis. Also, serum azurocidin levels may be used as a predictor of both inflammatory state and cardiovascular risk, especially when used with other markers such as CA-IMT.

Research paper thumbnail of Atipik Hemolitik Üremik Sendrom Olgusunda Eculizumab Deneyimi

Kocaeli tıp dergisi, 2018

Research paper thumbnail of Oral D Vitamin Replasmanına Bağlı Gelişen Hiperkalsemi ve Akut Böbrek Hasarı

Türk nefroloji diyaliz ve transplantasyon dergisi, May 3, 2018

Research paper thumbnail of Diyabetik Olgularda Renal Transplantasyon

Turkiye Klinikleri Journal of Nephrology Special Topics, 2016

Research paper thumbnail of CA 125 Elevation Due to Minimal Change Disease

Türk nefroloji diyaliz ve transplantasyon dergisi, Aug 24, 2016

Research paper thumbnail of Primary Antiphospholipid Antibody Syndrome Presenting with Acute Kidney Injury, Case Report

Türk nefroloji diyaliz ve transplantasyon dergisi, Aug 24, 2016

Research paper thumbnail of Light Chain Cast Nephropathy Presenting With Asymptomatic Proteinuria

Turkish journal of internal medicine, Jan 29, 2020

Kidney disease is a common complication of monoclonal gammopathies including multiple myeloma. Pa... more Kidney disease is a common complication of monoclonal gammopathies including multiple myeloma. Patients with multiple myeloma and other monoclonal gammopathies can present with a variety of kidney manifestations that depend upon the pathologic monoclonal proteins involved and the compartments of the kidney that are targeted. The most common clinical findings include acute or subacute kidney injury, chronic kidney disease, albuminuria or nephrotic syndrome and electrolyte abnormalities. The spectrum of kidney impairment ranges from mild to severe acute kidney injury (AKI) requiring hemodialysis. Most patients presenting with AKI have light chain cast nephropathy. 58-year-old female patient was referred to our clinic due to proteinuria. We aimed to represent a light chain cast nephropathy patient presenting with asymptomatic, non-nephrotic range proteinuria and whom were eventually treated with autologous stem cell transplantation. Light chain cast nephropathy should be kept in mind at the differential diagnosis of patients presenting with asymptomatic nonnephrotic range proteinuria especially whom were treated with anti-proteinuric medications. Kidney biopsy should not be deferred during the diagnostic process.

Research paper thumbnail of Mikroanjiyopatik Hemolitik Anemi Ayırıcı Tanısında Altın Standart Nedir? ADAMTS13 Aktivitesi mi, Trombosit Sayısı mı, Serum Kreatinin Düzeyi mi?

Haydarpaşa Numune Eğitim ve Araştırma Hastanesi Tıp Dergisi, 2017

Research paper thumbnail of Immune Tolerance in Transplant Kidney

Turkish Journal of Nephrology, 2021

Research paper thumbnail of Nefroloji Kitabı

Research paper thumbnail of Obez Hastalarda Ve Obez Kroni̇k Böbrek Hastalarinda Enflamasyon Beli̇rteci̇ Olarak Hemogram Parametreleri̇ni̇n Değerlendi̇ri̇lmesi̇

Acta medica alanya, Dec 31, 2021

Amaç: Kronik inflamasyon hem obezitenin hem de kronik böbrek hastalığının patogenezi ile ilişkili... more Amaç: Kronik inflamasyon hem obezitenin hem de kronik böbrek hastalığının patogenezi ile ilişkilidir. Çalışmamızda obez hastalarda ve obez kronik böbrek hastalarında inflamasyon belirteci olarak tam kan sayımı parametrelerinin değerlendirilmesini amaçladık. Yöntemler: Çalışmada yer alan bireyler 3 ayrı gruba bölündü. Grup-1 obez hastalardan, grup-2 obez kronik böbrek hastalarından, grup-3 kontrol grubu olarak sağlıklı bireylerden oluşmakta idi. Çalışmamız, 6 aylık bir sürede bir eğitim ve araştırma hastanesinde gerçekleştirildi. Bulgular: Kırkbir hasta grup-1'de; 41 hasta grup-2'de ve 22 sağlıklı birey grup-3'de yer aldı. Beyaz küre sayıları grup-3'e kıyasla grup-1 ve grup-2'de anlamlı düzeyde yüksek saptandı (7,5±1,4 x103/µL vs 8,4±2,4 x103/µL vs 6,5±1,3 x103/µL, sırasıyla, p<0.001) ve nötrofil lenfosit oranı grup-3'e kıyasla grup-1 ve grup-2'de anlamlı düzeyde yüksek saptandı (1,9±0,7 vs 2,5±1,5 vs 1,7±0,4, sırasıyla, p<0.001). Nötrofil lenfosit oranı ve beyaz küre sayısının, sistolik kan basıncı, ürik asit, üre ve kreatinin arasında pozitif; glomerüler filtrasyon hızı ile negatif korelasyon saptandı. Sonuçlar: Rutin klinik pratikte sıkça kullanılan hemogramdan elde edilen parametrelerin inflamasyon belirteçleri olarak anlamlı sonuçlanması önemlidir.

Research paper thumbnail of Hi̇dronefroz Olmadan Post Renal Akut Böbrek Yetmezli̇ği̇ / Post Renal Acute Kidney Failure Without Hydronephrosis

Osmangazi tıp dergisi, Dec 25, 2015

Akut böbrek yetmezliği, temel olarak 3 kısma ayrılmakla birlikte en sık neden pre-renal nedenler ... more Akut böbrek yetmezliği, temel olarak 3 kısma ayrılmakla birlikte en sık neden pre-renal nedenler iken post-renal nedenler %5 kadar olguda görülmektedir. Post-renal nedenler büyük oranda görüntüleme yöntemleri ile saptanabilmekle birlikte nadir de olsa bazı olgularda görüntülemenin tamamen normal olduğu vakalar da görülebilmektedir. Bizim vakamız, erken dönemde üriner sistem obstrüksiyonuna ait görüntüleme bulgusu olmayan olguda post-renal bir neden saptanıp hızla müdahale edilerek olası bir böbrek hasarının önüne geçilebilmiş olması sebebiyle önem arz etmektedir.

Research paper thumbnail of Association of Two Diseases with Autoimmunity: Membranous Glomerulonephritis and Vitiligo: Case Report

Türkiye klinikleri nefroloji, 2015

Research paper thumbnail of EVALUATION OF VIRAL LOAD, CD4 T LYMPHOCYTE COUNT, eGFR, COMPLETE BLOOD COUNTS AND VITAMIN D METABOLISM PARAMETERS IN HIV-INFECTED PATIENTS AT THE TIME OF DIAGNOSIS

Research paper thumbnail of Effects of cinacalcet treatment on QT interval in hemodialysis patients

The anatolian journal of cardiology, Nov 26, 2015

The Anatolian Journal of Cardiology is an international monthly periodical on cardiology publishe... more The Anatolian Journal of Cardiology is an international monthly periodical on cardiology published on independent, unbiased, double-blinded and peerreview principles. The journal's publication language is English however titles of articles, abstracts and Keywords are also published in Turkish on the journal's web site. The Anatolian Journal of Cardiology aims to publish qualified and original clinical, experimental and basic research on cardiology at the international level. The journal's scope also covers editorial comments, reviews of innovations in medical education and practice, case reports, original images, scientific letters, educational articles, letters to the editor, articles on publication ethics, diagnostic puzzles, and issues in social cardiology. The target readership includes academic members, specialists, residents, and general practitioners working in the fields of adult cardiology, pediatric cardiology, cardiovascular surgery and internal medicine.

Research paper thumbnail of The Relationship of Hepatits B Core Antibody Positivity with Demographic and Laboratory Parameters in Hemodialysis Patients

Haseki Tıp Bülteni, Jun 3, 2021

The presence of hepatitis B core antibody (HBcAb) is an indication of exposure to hepatitis B vir... more The presence of hepatitis B core antibody (HBcAb) is an indication of exposure to hepatitis B virus infection. We aimed to investigate the rates of positive HBcAb and its' association with demographical and laboratory parameters among patients undergoing hemodialysis. Methods: Patients were divided into two groups as HBcAb positive and HBcAb negative. This study was conducted at a training and research hospital over 3 months period between October and December 2020. Demographical data and laboratory results were recruited from most recent medical records. Results: A sum of 237 patients on hemodialysis were enrolled in the study. Fifty nine patients (25%) were HBcAb positive and 178 patients (75%) were HBcAb negative. Statistically significant difference was found between groups in terms of anti-HBs positivity (96.6% vs 79.2%; p=0.002), diabetes mellitus (DM) prevalence (32% vs 19%; p=0.036) and white blood cell count (WBC) levels (7.7±2.5 x10 3 / µL vs 7.1±2.1 x10 3 /µL; p=0.044). In linear regression analysis (variables: age, HBsAb, WBC and DM) HBcAb was found independently associated with age (t: 3.139; p=0.002), HBsAb (t: 3.998; p<0.001), WBC (t: 2.166; p=0.031) and DM (t: 2.749; p=0.006). Conclusion: We found high rates of positive HBcAb. Positive HBcAb should be taken into account in immune-compromised patients such as dialysis patients.

Research paper thumbnail of SP233The Relationship Among Serum Kallistatin, Cardiovascular Markers and Mortality in Geriatric Patients with Acute Kidney Injury

Nephrology Dialysis Transplantation, Jun 1, 2019

The aim of this study was to evaluate the effectiveness of HFR-SUPRA in the reduction of FLC and ... more The aim of this study was to evaluate the effectiveness of HFR-SUPRA in the reduction of FLC and its effect on albumin. METHODS: An observational prospective study was performed. Twelve MM patients (7 kappa, 5 lambda) who developed ARF between 2012-2018 were included. All patients were treated with chemotherapy and HFR-SUPRA. Blood samples (pre and post-dialysis) and ultrafiltrate samples (pre and post-resin at 5 minutes after the start of the session and 5 minutes before the end) were collected. RESULTS: The mean FLC reduction rate in blood was 53614% kappa and 33622% lambda. A decline of albumin in blood was not observed. In the ultrafiltrate, the mean FLC reduction rate at the start of the dialysis session was: 99.2% kappa, 97.06% lambda and 0.7% albumin; and at the end of the session was: 63.7% kappa, 33.62% lambda and 0.015% albumin. Regarding the evolution of patients: 36.4% had renal recovery, 18.2% died at the first year and 45.5% of patients remained dependent on dialysis. CONCLUSIONS: An effective FLC reduction is obtained and maintained throughout the session. HFR-SUPRA is effective as an adjunctive therapy for MM and has the advantage that albumin loss is not produced.

Research paper thumbnail of Eculizumab Experince at a Patient With Atypical Hemolitic Uremic Syndrome

Kocaeli tıp dergisi, 2018

Thrombotic microangiopathy discribes a specific pathologic lesion in which abnormalities in the v... more Thrombotic microangiopathy discribes a specific pathologic lesion in which abnormalities in the vessel wall of arterioles and capillaries lead to microvascular thrombosis. Microangiopathic hemolytic anemia is a descriptive term for non-immun hemolytic anemia resulting from intravascular red blood cell fragmentation that produces schistocytes on the peripheral blood smear. Atypical hemolytic uremic syndrome is a type of primer thrombotic microangiopathy and using eculizumab in the early phase of therapy reduces the risk of irreversible renal damage. We mentioned both the importance of early diagnosis at the patients presenting with microangiopathic hemolytic anemia and thrombocytopenia like our patient and the benefit of eculizumab therapy at the early phase of atypical hemolytic uremic syndrome therapy.

Research paper thumbnail of Risk Factors and Seroprevalence of Syphilis Among Naive HIV Patients: A Cross-Sectional Study From a Tertiary Center

Haseki Tıp Bülteni, Sep 1, 2021

Syphilis coinfection is common among human immune deficiency virus (HIV)/acquired immune deficien... more Syphilis coinfection is common among human immune deficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) diagnosed patients. We aimed to investigate the rates of syphilis coinfection, social-demographical features, viral and immunological properties among naive HIV/AIDS patients. Methods: Socio-demographical data, CD4+ T lymphocyte counts, HIV viral load, syphilis antibody results and physical examinations at the time of diagnosis of naive HIV infected patients who were admitted to our center between January 2017 and January 2021, were evaluated retrospectively from the medical records. Results: Three hundred-two naive HIV patients were enrolled in the study. Positive syphilis antibody rate was detected as 21.5% and 86.2% of those patients were male and also found 31.4% (p<0.01) in patients in which route of transmission was men sex with men (MSM). Positive syphilis antibody rate was found to be statistically higher in patients with substance abuse (p<0.01), CD4+ T lymphocyte counts were under 200 cell/mm³ (p=0.018) and viral load above 100.000 copies/mL (p<0.01). Conclusion: Among HIV-infected patients, those with MSM and substance abuse constitute the group at highest risk of syphilis. Therefore, syphilis must be screened and treated, especially at HIV diagnosis and high-risk behaviors.

Research paper thumbnail of Comparison of the Frequency and Severity of Depression Between Patients with Stage 4 and 5 Chronic Kidney Disease with and Without Kidney Transplantation

Haseki Tıp Bülteni, Sep 10, 2020

Patients with chronic kidney disease (CKD) are at an increased risk for depression. In the presen... more Patients with chronic kidney disease (CKD) are at an increased risk for depression. In the present study, we aimed to compare the frequency and severity of depression and its' association with demographical and laboratory parameters between stage 4 and 5 CKD patients with and without kidney transplantation. Methods: The study included stage 4 and stage 5 CKD patients not on dialysis. The patients were separated into two groups. Group 1 was composed of patients with renal transplantation and group 2 was composed of patients without renal transplantation. The prevalence of depression was evaluated using the Beck Depression Inventory. Results: Forty-nine patients were in group 1 and 52 patients in group 2. The mean depression score in group 1 was statistically significantly higher than in group 2 (16±15 vs 13.5±10; p=0.031). We found that depression score was correlated with parathormone levels (p=0.023) and serum ferritin levels (p=0.019). In multivariate linear regression analysis, depression scores were independently associated with parathormone [Exp (B): 0.997 (confidence interval (CI): 0.995-1.0); p=0.023] and ferritin [Exp (B): 0.996 (CI: 0.994-0.998); p=0.01]. Conclusion: Higher prevalence of depression in patients with CKD who received renal transplantation is a significant finding. Routine psychiatric evaluation should become a part of follow-up and treatment in both groups.

Research paper thumbnail of The role of azurocidin in patients with familial Mediterranean fever and AA amyloidosis and its association with cardiovascular risk factors

International Urology and Nephrology, Oct 15, 2020

Background Familial Mediterranean fever (FMF) is characterized by sporadic, recurrent attacks of ... more Background Familial Mediterranean fever (FMF) is characterized by sporadic, recurrent attacks of fever and serosal inflammation. AA amyloidosis (AAA) is a disorder characterized by the extracellular tissue deposition of serum amyloid A protein (SAA). Azurocidin is a neutrophil-derived granule protein. We aimed to investigate the significance of azurocidin in FMF and AAA and the correlation between azurocidin levels and carotid artery intima media thickness (CA-IMT) and cardiovascular plaque existence. Methods A sum of 52 FMF patients were enrolled in the study. FMF patients were composed of two groups. Group-1 included 30 patients with non-complicated FMF. Group-2 included 22 patients whom received renal transplantation due to FMF complicated with AAA and being followed up at stable state for at least one year. 24 healthy individuals who matched with FMF patients in terms of age and gender consisted the control group. Results We found statistically significant difference between patient and control groups in terms of urea (38.52 ± 19.96 mg/dl vs 29.08 ± 5.83 mg/dl; p = 0.003), creatinine (1.11 ± 0.39 mg/dl vs 0.91 ± 0.16 mg/dl; p = 0.002), serum uric acid (6.2 ± 2 mg/ dl vs 4.5 ± 0.9 mg/dl; p < 0.001), serum CRP (8.62 ± 9.5 mg/dl vs 3.91 ± 3.9 mg/dl; p = 0.004), ferritin (151.4 ± 317 ng/ml vs 33.3 ± 34 ng/ml; p = 0.014), white blood cell (WBC) levels (7.97 ± 2.3 × 10 3/µL vs 6.6 ± 1.7 × 10 3/µL ; p = 0.018), serum azurocidin levels (137.16 ± 65.62 ng/ml vs 102.35 ± 51.61 ng/ml; p = 0.015) and mean CA-IMT (0.57 ± 0.15 mm vs 0.47 ± 0.07 mm; p = 0.001). Comparison of group 1 and group 2 revealed statistically significant differences in terms of urea (26 ± 8 mg/dl vs 54 ± 19 mg/dl; p < 0.001), creatinine (0.87 ± 0.1 mg/dl vs 1.44 ± 0.3 mg/dl; p < 0.001), estimated glomerular filtration rate (eGFR) (99 ± 21 ml/min/1.73m 2 vs 53 ± 16 ml/min/1.73m 2 ; p < .001), uric acid (4.9 ± 1.3 mg/dl vs 7.6 ± 1.7 mg/dl; p < 0.001), ferritin (31.7 ± 27 ng/ml vs 292.8 ± 431 ng/ml; p = 0.010) and albumin (4.5 ± 0.3 g/dl vs 4.1 ± 0.3 g/dl; p = 0.001). There was no statistically significant difference between group 1 and group 2 in terms of mean CA-IMT (CA-IMT (M) (mm): 0.54 ± 0.14 vs 0.62 ± 0.17, p = 0.057). Serum azurocidin levels were not significantly different between group 1 and group 2 (121.73 ± 53.24 ng/ml vs 158.19 ± 75.77 ng/ml; p = 0.061). In multivariate linear regression analysis (variables: MBP, urea, creatinine, eGFR, ferritin, uric acid, CA-IMT) azurocidin was independently associated with urea (t:2.658; p = 0.010) and CA-IMT (t:2.464; p = 0.017). Discussion Based on our findings, azurocidin seems to be a good inflammation marker in patients with FMF. Increase in azurocidin levels might be associated with development of amyloidosis. Also, serum azurocidin levels may be used as a predictor of both inflammatory state and cardiovascular risk, especially when used with other markers such as CA-IMT.

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Research paper thumbnail of Light Chain Cast Nephropathy Presenting With Asymptomatic Proteinuria

Turkish journal of internal medicine, Jan 29, 2020

Kidney disease is a common complication of monoclonal gammopathies including multiple myeloma. Pa... more Kidney disease is a common complication of monoclonal gammopathies including multiple myeloma. Patients with multiple myeloma and other monoclonal gammopathies can present with a variety of kidney manifestations that depend upon the pathologic monoclonal proteins involved and the compartments of the kidney that are targeted. The most common clinical findings include acute or subacute kidney injury, chronic kidney disease, albuminuria or nephrotic syndrome and electrolyte abnormalities. The spectrum of kidney impairment ranges from mild to severe acute kidney injury (AKI) requiring hemodialysis. Most patients presenting with AKI have light chain cast nephropathy. 58-year-old female patient was referred to our clinic due to proteinuria. We aimed to represent a light chain cast nephropathy patient presenting with asymptomatic, non-nephrotic range proteinuria and whom were eventually treated with autologous stem cell transplantation. Light chain cast nephropathy should be kept in mind at the differential diagnosis of patients presenting with asymptomatic nonnephrotic range proteinuria especially whom were treated with anti-proteinuric medications. Kidney biopsy should not be deferred during the diagnostic process.

Research paper thumbnail of Mikroanjiyopatik Hemolitik Anemi Ayırıcı Tanısında Altın Standart Nedir? ADAMTS13 Aktivitesi mi, Trombosit Sayısı mı, Serum Kreatinin Düzeyi mi?

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Research paper thumbnail of Immune Tolerance in Transplant Kidney

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