Mehmet Tanrisev - Academia.edu (original) (raw)

Papers by Mehmet Tanrisev

Research paper thumbnail of Akut Kalp Yetmezlikli Hastalarda Artmış İdrar Nötrofil Jelatinaz’lı Lipokalin Düzeylerinin Böbrek İşlevlerinin Bozulmasındaki Öngörü Değeri

Aim: Renal dysfunction is mostly associated with poor prognosis in the patients with acute heart ... more Aim: Renal dysfunction is mostly associated with poor prognosis in the patients with acute heart failure. Elevated serum creatinine values in patients with heart failure also increase the risk of cardiovascular death. In these patients, renal dysfunction can be avoided by early detection of acute kidney injury. Neutrophil Gelatinase –Associated Lipocalin is an early marker for acute renal tubular damage and secreted by the nephrons when the tubulus epithelium is damaged . We assessed Neutrophil Gelatinase –Associated Lipocalin as an early marker of acute kidney damage in patients with congestive heart failure. Methods: Forty patients with acute heart failure admitted to Tepecik Education and Research Hospital Internal Medicine Clinic between 01.01.2009 and 01.12.2009 were included in the study. Seventeen patients were female (%42,5), and 23 were male (%57,5). The mean age of the patients was 67±10 years. Age, sex, comorbid diseases, medications, serum levels of urea and creatinine, ...

Research paper thumbnail of Tuberous sclerosis diagnosed in adult age

Pakistan Journal of Medical Sciences Online

Tuberous sclerosis (Bourneville Disease, Vogt triad) is an autosomal dominant hereditary disease ... more Tuberous sclerosis (Bourneville Disease, Vogt triad) is an autosomal dominant hereditary disease characterized by hamartomas. It can affect all body organs, but is most commonly seen on the skin, brain, eyes, lungs, heart and kidney. We describe the successful management of a case of forty two years old women who presented to us with complaints of nausea, vomiting, bilateral flank pain.

Research paper thumbnail of The role of neutrophil gelatinase-associated lipocalin (NGAL) in assessing contrast-induced nephropathy (CIN) in patients undergoing percutaneous coronary angiography

European Geriatric Medicine, 2012

Introduction.-Contrast induced nephropathy (CIN) is one of the reasons of acute renal failure dev... more Introduction.-Contrast induced nephropathy (CIN) is one of the reasons of acute renal failure developing after the use of intravascular contrast, excluding all other causes. As much as CIN increases cost, morbidity and mortality, it seemed to have more importance detecting acute renal failure in the earliest possible time. In recent studies; both plasma and urinary biomarker neutrophil Gelatinase-Associated Lipocalin (NGAL) came into prominence. In this study, we aimed to determine the role of NGAL in urine among these patients for early diagnosis of contrast induced nephropathy as an important cause of acute renal failure. Text.-One hundred patients were included in the study 60 patients were male, and 40 were female. The mean age of patients was 61.6 ± 10, 71% of these patients had chronic diseases 69% of patients were using drugs. The mean creatinine of patients was 0.97 ± 0.2 mg/dl, the mean GFR was 92.4 ± 28.3 ml/min. In seven patients at 48th hour after angiography the 25% or more increase at creatinine values were detected and they were accepted as CIN and all those patients' 4th hours urinary NGAL levels were above the threshold value. Six of patients who developed CIN was male and one of them was female. Comparing the CIN developed group and non-developing group; gender, number of chronic diseases and the number of drugs used statistically significant difference was found between two groups. We believe that for the use of NGAL as a marker for acute kidney injury more studies including larger numbers of patients are needed. Disclosure.-No significant relationships. http://dx.

Research paper thumbnail of Kidney transplantation from a donor with nutcracker syndrome

El Mednifico Journal, 2014

Research paper thumbnail of Relationship Between Epicardial Adipose Tissue, Inflammation and Volume Markers in Hemodialysis and Transplant Patients

Therapeutic Apheresis and Dialysis, 2015

Cardiovascular (CV) diseases are still the most important cause of morbidity and mortality in bot... more Cardiovascular (CV) diseases are still the most important cause of morbidity and mortality in both patients receiving hemodialysis (HD) treatment and individuals with renal transplantation (Rtx). Measurement of epicardial adipose tissue (EAT) thickness is an easily applied, cheap, and useful recent method predicting increased CV risk. We aimed to compare EAT changes in HD and Rtx patients and the association between EAT and inflammatory and CV volume markers in both groups. A total of 124 patients: 45 Rtx, 43 HD patients and 36 healthy controls were enrolled in the study. Laboratory parameters and inflammatory markers (interleukin-6 [IL-6] and high sensitive C-reactive protein [Hs-CRP]) were evaluated from venous blood samples after an overnight fast. EAT thickness was measured with transthoracic echocardiography. The levels of Hs-CRP, IL-6, systolic and diastolic blood pressures, left atrial (LA) diameter, left atrial index (LAI), left ventricular mass (LVM) and LVM index (LVMI) were significantly higher in the HD patients than in the other groups. EAT was positively correlated with age, body mass index (BMI), time on dialysis, serum creatinine, total cholesterol, Low density lipoprotein-cholesterol, and LVM in Rtx group and positively correlated with age, BMI, duration of dialysis, Hs-CRP, IL-6, LAI and LVMI and inversely correlated with inferior vena cava collapse index (IVC-CI) in HD group. EAT thickness of RTx patients (whose previous HD duration was similar to those in HD group) are similar to the healthy population and significantly thinner than patients on HD.

Research paper thumbnail of The Role of Neutrophil Gelatinase-Associated Lipocalin (Ngal) in the Determination of Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography

Turkish Nephrology Dialysis Transplantation, 2014

ObJECTIVE: Contrast-induced nephropathy (CIN) is the acute kidney injury developing following the... more ObJECTIVE: Contrast-induced nephropathy (CIN) is the acute kidney injury developing following the administration of contrast agent after all other reasons are excluded. We aimed to determine the role of NGAL in the urine for early diagnosis of contrast-induced nephropathy, as the disorder is an important reason of acute renal failure in cases subject to cardiac catheterization clinical practice, and the frequency is increasing.

Research paper thumbnail of Comparision of Anti-HLA Antibodies of Kidney Transplant Candidates with Chronic Renal Failure by Two Different Methods: Flow-PRA and Luminex PRA

Transplantation Proceedings, 2013

The aim of the study was to compare anti-HLA antibodies examined as panel-reactive antibody (PRA)... more The aim of the study was to compare anti-HLA antibodies examined as panel-reactive antibody (PRA) in kidney transplant candidates with chronic renal failure (CRF) with the use of 2 methods: Flow-PRA and Luminex-PRA. CRF patients displaying class I PRA (n = 34) and/or class II PRA (n = 41) were tested by the 2 different methods from April 2012 to September 2012, using antigen-coated beads. Eleven (32.3%) 34 patients tested for class I PRA were female and 23 (67.7%) male; 17 (41.5%) 41 patients tested for class II PRA were female and 24 (58.5%) male. Only 2 patients were preemptive, the others had been subjected to dialysis. The concordance ratio of class I PRA test results between Flow-PRA and Luminex PRA was 67.6%. Whereas 13 samples (38.2%) were positive by Flow-PRA, 22 (64.7%) were positive by Luminex-PRA. Two of the 3 patients not previously immunized were found to be positive only by Luminex PRA; 1 was noted to be positive only by Flow-PRA. Regarding class II PRA screening, the concordance between Flow-PRA and Luminex PRA was 70.7%. Whereas 14 (34.1%) samples were positive for Flow-PRA; 24 (58.5%) were positive for Luminex-PRA. The 2 patients not previously immunized were positive only in Luminex PRA. We speculated that the reason for the low concordance ratios was due to the use of sera that had been previously found to be indeterminate in PRA tests. We also speculated that the low concordance ratios were due to the coating procedure for the beads, which may cause changes in antigenic epitopes and decrease concordance between Flow-PRA and Luminex-PRA.

Research paper thumbnail of Impact of diabetic and pre-diabetic state on development of contrast-induced nephropathy in patients with chronic kidney disease

Nephrology Dialysis Transplantation, 2007

Background. The aim of the present study was to assess the influence of diabetic and pre-diabetic... more Background. The aim of the present study was to assess the influence of diabetic and pre-diabetic state on the development of contrast-induced nephropathy (CIN) in chronic kidney disease patients undergoing coronary angiography. Methods. A total of 421 patients with Cockcroft clearance between 15 and 60 ml/min were divided into three groups [diabetes mellitus (DM), n ¼ 137; pre-diabetes (pre-DM), n ¼ 140; and normal fasting glucose (NFG), n ¼ 144]. CIN was defined as an increase of !25% in creatinine over baseline within 48 h of angiography, DM as glucose !126 mg/dl, pre-DM as glucose between 100 and 125 mg/dl and NFG as glucose <100 mg/dl. Results. CIN occurred in 20% of the DM [relative risk (RR) 3.6, P ¼ 0.001], 11.4% of the pre-DM (RR 2.1, P ¼ 0.314) and 5.5% of the NFG group. The decrease of glomerular filtration rate (GFR) was higher in DM and pre-DM (P ¼ 0.001 and P ¼ 0.002, respectively). GFR 30 ml/min (RR 19.22), multivessel involvement (RR 7.59), hyperuricaemia (RR 3.95), use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blocker (RR 2.70) and DM (RR 2.34) were predictors of CIN. Length of hospital stay was 2.45 AE 1.45 day in DM, 2.27 AE 0.68 day in pre-DM and 1.97 AE 0.45 day in NFG (P < 0.001, DM vs NFG and P ¼ 0.032, pre-DM vs NFG). The rate of major adverse cardiac events was 8.7% in DM, 5% in pre-DM and 2.1% in NFG (P ¼ 0.042, DM vs NFG). Haemodialysis was required in 3.6% of DM and 0.7% in pre-DM (P ¼ 0.036, DM vs NFG), and the total number of haemodialysis sessions during 3 months was higher in DM and pre-DM (P < 0.001). Serum glucose !124 mg/dl was the best cut-off point for prediction of CIN.

Research paper thumbnail of Preventive effect of nebivolol on contrast-induced nephropathy in rats

Nephrology Dialysis Transplantation, 2007

Background. Altered renal vasodilatation and oxidative stress are important mechanisms of contras... more Background. Altered renal vasodilatation and oxidative stress are important mechanisms of contrast-induced nephropathy (CIN). The aim of the present study was to assess the effect of nebivolol, a beta blocker, on prevention of CIN. We hypothesized that nebivolol may prevent CIN due to its renal vasodilatation and antioxidant effects. Methods. Thirty-two Wistar-albino rats were divided into four groups (n = 8 each): control (C), contrast media (CM), nebivolol (N), and nebivolol + contrast media (NCM). CIN was induced by administration of intravenous highosmolar contrast media diatrizoate (6 ml/kg) after 72 h of dehydration. Nebivolol (2 mg/kg) was given internally once daily for 5 days. Kidney function parameters, nitric oxide metabolites and oxidative stress markers were measured. Kidneys were excised for pathological evaluation. Results. The decrease of creatinine clearance was 0.180 ± 0.11 mg/dl in CM, and 0.030 ± 0.10 mg/dl in NCM (P = 0.01). Microproteinuria was ameliorated using nebivolol (P = 0.001). Serum protein carbonyl content, malonyldialdehyde and kidney thiobarbituric acid-reacting substances levels were higher in CM than in C (P = 0.003, P < 0.001 and P = 0.034, respectively) and serum thiol was lower in CM than in C (P = 0.001). However, oxidative stress markers were similar in NCM and C. Diatrizoate decreased kidney nitrite levels, but nebivolol increased them (P = 0.027). Nebivolol attenuated the tubular necrosis, proteinaceous casts and medullary congestion, although significant protective effects, were observed in tubular necrosis (P = 0.001) and proteinaceous cast (P < 0.001). Conclusion. This study demonstrated the protective role of nebivolol against CIN.

Research paper thumbnail of Relation between serum estradiol levels and mortality in postmenopausal female hemodialysis patients

International Urology and Nephrology, 2013

Recently, low serum estradiol levels have been associated with increased cardiovascular risk and ... more Recently, low serum estradiol levels have been associated with increased cardiovascular risk and mortality in non-uremic patient populations. We investigated the predictive value of serum estradiol levels for mortality in female hemodialysis patients. One hundred and forty-seven prevalent female hemodialysis patients were included in March 2005 and followed up for 32 ± 16 months. Serum estradiol levels were determined by ELISA at baseline and studied in relation to cardiovascular and overall mortality. Mean serum estradiol level was 28.6 ± 15.4 pg/ml (5.7-81.3). Patients in the higher estradiol tertile were likely to be more often diabetic and to have more cardiovascular diseases and higher body mass index (BMI). Serum estradiol was inversely correlated with age and urea reduction rate and positively correlated with postdialysis body weight, BMI and hs-CRP levels. During the follow-up period, 52 (35.6 %) patients died. Patients who died were older, had shorter dialysis vintage, were more likely to have a history of diabetes and cardiovascular disease, and lower serum creatinine, albumin, hemoglobin, and higher hs-CRP levels than those who survived. In Cox regression analysis, estradiol levels, in a bimodal (U-shaped) distribution, along with diabetes, low serum albumin and high hs-CRP levels, were predictors for overall mortality. A U-shaped association between serum estradiol levels and cardiovascular and overall mortality was found in postmenopausal hemodialysis patients.

Research paper thumbnail of Renal Tubular Acidosis in Renal Transplant Patients: The Effect of Immunosuppressive Drugs

Annals of Transplantation, 2015

Renal tubular acidosis (RTA) is a non-anion gap metabolic acidosis and is generally mild and asym... more Renal tubular acidosis (RTA) is a non-anion gap metabolic acidosis and is generally mild and asymptomatic in kidney recipients. Calcineurine inhibitors (CNIs) increase the frequency of RTA but the frequency of RTA development in kidney transplant recipients receiving mammalian target of rapamycin inhibitors (mTORi) treatment remains unclear. In this study, we aimed to investigate the frequency of RTA in kidney transplant recipients on mTORi and CNI treatment and to compare both groups. We enrolled 137 adult renal transplant patients - 82 patients on mTORi and 55 patients on CNI who had similar age, sex, posttransplant follow-up period, and graft functions. We recorded the parameters of venous blood gas analysis, including serum pH value, serum bicarbonate (HCO3) concentration, presence of metabolic acidosis defined as low HCO3 (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;22 mEq/L), and serum pH value (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;7.35), as well as base excess and urine pH at last follow-up. RTA was defined to be metabolic acidosis with normal serum anion gap and positive urine anion gap. The mean age of our study population was 41.2±11.3 years. RTA frequency was 35% in the mTORi group and 41% in the CNI group. mTORi and CNI groups did not differ significantly in terms of the development of metabolic and renal tubular acidosis. Type I RTA was common in both groups. RTA was affected by duration of time since transplantation and graft functions in both groups. The rates of RTA development in patients on long-term CNI and mTORi treatment were similar.

Research paper thumbnail of Akut Kalp Yetmezlikli Hastalarda Artmış İdrar Nötrofil Jelatinaz’lı Lipokalin Düzeylerinin Böbrek İşlevlerinin Bozulmasındaki Öngörü Değeri

Aim: Renal dysfunction is mostly associated with poor prognosis in the patients with acute heart ... more Aim: Renal dysfunction is mostly associated with poor prognosis in the patients with acute heart failure. Elevated serum creatinine values in patients with heart failure also increase the risk of cardiovascular death. In these patients, renal dysfunction can be avoided by early detection of acute kidney injury. Neutrophil Gelatinase –Associated Lipocalin is an early marker for acute renal tubular damage and secreted by the nephrons when the tubulus epithelium is damaged . We assessed Neutrophil Gelatinase –Associated Lipocalin as an early marker of acute kidney damage in patients with congestive heart failure. Methods: Forty patients with acute heart failure admitted to Tepecik Education and Research Hospital Internal Medicine Clinic between 01.01.2009 and 01.12.2009 were included in the study. Seventeen patients were female (%42,5), and 23 were male (%57,5). The mean age of the patients was 67±10 years. Age, sex, comorbid diseases, medications, serum levels of urea and creatinine, ...

Research paper thumbnail of Tuberous sclerosis diagnosed in adult age

Pakistan Journal of Medical Sciences Online

Tuberous sclerosis (Bourneville Disease, Vogt triad) is an autosomal dominant hereditary disease ... more Tuberous sclerosis (Bourneville Disease, Vogt triad) is an autosomal dominant hereditary disease characterized by hamartomas. It can affect all body organs, but is most commonly seen on the skin, brain, eyes, lungs, heart and kidney. We describe the successful management of a case of forty two years old women who presented to us with complaints of nausea, vomiting, bilateral flank pain.

Research paper thumbnail of The role of neutrophil gelatinase-associated lipocalin (NGAL) in assessing contrast-induced nephropathy (CIN) in patients undergoing percutaneous coronary angiography

European Geriatric Medicine, 2012

Introduction.-Contrast induced nephropathy (CIN) is one of the reasons of acute renal failure dev... more Introduction.-Contrast induced nephropathy (CIN) is one of the reasons of acute renal failure developing after the use of intravascular contrast, excluding all other causes. As much as CIN increases cost, morbidity and mortality, it seemed to have more importance detecting acute renal failure in the earliest possible time. In recent studies; both plasma and urinary biomarker neutrophil Gelatinase-Associated Lipocalin (NGAL) came into prominence. In this study, we aimed to determine the role of NGAL in urine among these patients for early diagnosis of contrast induced nephropathy as an important cause of acute renal failure. Text.-One hundred patients were included in the study 60 patients were male, and 40 were female. The mean age of patients was 61.6 ± 10, 71% of these patients had chronic diseases 69% of patients were using drugs. The mean creatinine of patients was 0.97 ± 0.2 mg/dl, the mean GFR was 92.4 ± 28.3 ml/min. In seven patients at 48th hour after angiography the 25% or more increase at creatinine values were detected and they were accepted as CIN and all those patients' 4th hours urinary NGAL levels were above the threshold value. Six of patients who developed CIN was male and one of them was female. Comparing the CIN developed group and non-developing group; gender, number of chronic diseases and the number of drugs used statistically significant difference was found between two groups. We believe that for the use of NGAL as a marker for acute kidney injury more studies including larger numbers of patients are needed. Disclosure.-No significant relationships. http://dx.

Research paper thumbnail of Kidney transplantation from a donor with nutcracker syndrome

El Mednifico Journal, 2014

Research paper thumbnail of Relationship Between Epicardial Adipose Tissue, Inflammation and Volume Markers in Hemodialysis and Transplant Patients

Therapeutic Apheresis and Dialysis, 2015

Cardiovascular (CV) diseases are still the most important cause of morbidity and mortality in bot... more Cardiovascular (CV) diseases are still the most important cause of morbidity and mortality in both patients receiving hemodialysis (HD) treatment and individuals with renal transplantation (Rtx). Measurement of epicardial adipose tissue (EAT) thickness is an easily applied, cheap, and useful recent method predicting increased CV risk. We aimed to compare EAT changes in HD and Rtx patients and the association between EAT and inflammatory and CV volume markers in both groups. A total of 124 patients: 45 Rtx, 43 HD patients and 36 healthy controls were enrolled in the study. Laboratory parameters and inflammatory markers (interleukin-6 [IL-6] and high sensitive C-reactive protein [Hs-CRP]) were evaluated from venous blood samples after an overnight fast. EAT thickness was measured with transthoracic echocardiography. The levels of Hs-CRP, IL-6, systolic and diastolic blood pressures, left atrial (LA) diameter, left atrial index (LAI), left ventricular mass (LVM) and LVM index (LVMI) were significantly higher in the HD patients than in the other groups. EAT was positively correlated with age, body mass index (BMI), time on dialysis, serum creatinine, total cholesterol, Low density lipoprotein-cholesterol, and LVM in Rtx group and positively correlated with age, BMI, duration of dialysis, Hs-CRP, IL-6, LAI and LVMI and inversely correlated with inferior vena cava collapse index (IVC-CI) in HD group. EAT thickness of RTx patients (whose previous HD duration was similar to those in HD group) are similar to the healthy population and significantly thinner than patients on HD.

Research paper thumbnail of The Role of Neutrophil Gelatinase-Associated Lipocalin (Ngal) in the Determination of Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography

Turkish Nephrology Dialysis Transplantation, 2014

ObJECTIVE: Contrast-induced nephropathy (CIN) is the acute kidney injury developing following the... more ObJECTIVE: Contrast-induced nephropathy (CIN) is the acute kidney injury developing following the administration of contrast agent after all other reasons are excluded. We aimed to determine the role of NGAL in the urine for early diagnosis of contrast-induced nephropathy, as the disorder is an important reason of acute renal failure in cases subject to cardiac catheterization clinical practice, and the frequency is increasing.

Research paper thumbnail of Comparision of Anti-HLA Antibodies of Kidney Transplant Candidates with Chronic Renal Failure by Two Different Methods: Flow-PRA and Luminex PRA

Transplantation Proceedings, 2013

The aim of the study was to compare anti-HLA antibodies examined as panel-reactive antibody (PRA)... more The aim of the study was to compare anti-HLA antibodies examined as panel-reactive antibody (PRA) in kidney transplant candidates with chronic renal failure (CRF) with the use of 2 methods: Flow-PRA and Luminex-PRA. CRF patients displaying class I PRA (n = 34) and/or class II PRA (n = 41) were tested by the 2 different methods from April 2012 to September 2012, using antigen-coated beads. Eleven (32.3%) 34 patients tested for class I PRA were female and 23 (67.7%) male; 17 (41.5%) 41 patients tested for class II PRA were female and 24 (58.5%) male. Only 2 patients were preemptive, the others had been subjected to dialysis. The concordance ratio of class I PRA test results between Flow-PRA and Luminex PRA was 67.6%. Whereas 13 samples (38.2%) were positive by Flow-PRA, 22 (64.7%) were positive by Luminex-PRA. Two of the 3 patients not previously immunized were found to be positive only by Luminex PRA; 1 was noted to be positive only by Flow-PRA. Regarding class II PRA screening, the concordance between Flow-PRA and Luminex PRA was 70.7%. Whereas 14 (34.1%) samples were positive for Flow-PRA; 24 (58.5%) were positive for Luminex-PRA. The 2 patients not previously immunized were positive only in Luminex PRA. We speculated that the reason for the low concordance ratios was due to the use of sera that had been previously found to be indeterminate in PRA tests. We also speculated that the low concordance ratios were due to the coating procedure for the beads, which may cause changes in antigenic epitopes and decrease concordance between Flow-PRA and Luminex-PRA.

Research paper thumbnail of Impact of diabetic and pre-diabetic state on development of contrast-induced nephropathy in patients with chronic kidney disease

Nephrology Dialysis Transplantation, 2007

Background. The aim of the present study was to assess the influence of diabetic and pre-diabetic... more Background. The aim of the present study was to assess the influence of diabetic and pre-diabetic state on the development of contrast-induced nephropathy (CIN) in chronic kidney disease patients undergoing coronary angiography. Methods. A total of 421 patients with Cockcroft clearance between 15 and 60 ml/min were divided into three groups [diabetes mellitus (DM), n ¼ 137; pre-diabetes (pre-DM), n ¼ 140; and normal fasting glucose (NFG), n ¼ 144]. CIN was defined as an increase of !25% in creatinine over baseline within 48 h of angiography, DM as glucose !126 mg/dl, pre-DM as glucose between 100 and 125 mg/dl and NFG as glucose <100 mg/dl. Results. CIN occurred in 20% of the DM [relative risk (RR) 3.6, P ¼ 0.001], 11.4% of the pre-DM (RR 2.1, P ¼ 0.314) and 5.5% of the NFG group. The decrease of glomerular filtration rate (GFR) was higher in DM and pre-DM (P ¼ 0.001 and P ¼ 0.002, respectively). GFR 30 ml/min (RR 19.22), multivessel involvement (RR 7.59), hyperuricaemia (RR 3.95), use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blocker (RR 2.70) and DM (RR 2.34) were predictors of CIN. Length of hospital stay was 2.45 AE 1.45 day in DM, 2.27 AE 0.68 day in pre-DM and 1.97 AE 0.45 day in NFG (P < 0.001, DM vs NFG and P ¼ 0.032, pre-DM vs NFG). The rate of major adverse cardiac events was 8.7% in DM, 5% in pre-DM and 2.1% in NFG (P ¼ 0.042, DM vs NFG). Haemodialysis was required in 3.6% of DM and 0.7% in pre-DM (P ¼ 0.036, DM vs NFG), and the total number of haemodialysis sessions during 3 months was higher in DM and pre-DM (P < 0.001). Serum glucose !124 mg/dl was the best cut-off point for prediction of CIN.

Research paper thumbnail of Preventive effect of nebivolol on contrast-induced nephropathy in rats

Nephrology Dialysis Transplantation, 2007

Background. Altered renal vasodilatation and oxidative stress are important mechanisms of contras... more Background. Altered renal vasodilatation and oxidative stress are important mechanisms of contrast-induced nephropathy (CIN). The aim of the present study was to assess the effect of nebivolol, a beta blocker, on prevention of CIN. We hypothesized that nebivolol may prevent CIN due to its renal vasodilatation and antioxidant effects. Methods. Thirty-two Wistar-albino rats were divided into four groups (n = 8 each): control (C), contrast media (CM), nebivolol (N), and nebivolol + contrast media (NCM). CIN was induced by administration of intravenous highosmolar contrast media diatrizoate (6 ml/kg) after 72 h of dehydration. Nebivolol (2 mg/kg) was given internally once daily for 5 days. Kidney function parameters, nitric oxide metabolites and oxidative stress markers were measured. Kidneys were excised for pathological evaluation. Results. The decrease of creatinine clearance was 0.180 ± 0.11 mg/dl in CM, and 0.030 ± 0.10 mg/dl in NCM (P = 0.01). Microproteinuria was ameliorated using nebivolol (P = 0.001). Serum protein carbonyl content, malonyldialdehyde and kidney thiobarbituric acid-reacting substances levels were higher in CM than in C (P = 0.003, P < 0.001 and P = 0.034, respectively) and serum thiol was lower in CM than in C (P = 0.001). However, oxidative stress markers were similar in NCM and C. Diatrizoate decreased kidney nitrite levels, but nebivolol increased them (P = 0.027). Nebivolol attenuated the tubular necrosis, proteinaceous casts and medullary congestion, although significant protective effects, were observed in tubular necrosis (P = 0.001) and proteinaceous cast (P < 0.001). Conclusion. This study demonstrated the protective role of nebivolol against CIN.

Research paper thumbnail of Relation between serum estradiol levels and mortality in postmenopausal female hemodialysis patients

International Urology and Nephrology, 2013

Recently, low serum estradiol levels have been associated with increased cardiovascular risk and ... more Recently, low serum estradiol levels have been associated with increased cardiovascular risk and mortality in non-uremic patient populations. We investigated the predictive value of serum estradiol levels for mortality in female hemodialysis patients. One hundred and forty-seven prevalent female hemodialysis patients were included in March 2005 and followed up for 32 ± 16 months. Serum estradiol levels were determined by ELISA at baseline and studied in relation to cardiovascular and overall mortality. Mean serum estradiol level was 28.6 ± 15.4 pg/ml (5.7-81.3). Patients in the higher estradiol tertile were likely to be more often diabetic and to have more cardiovascular diseases and higher body mass index (BMI). Serum estradiol was inversely correlated with age and urea reduction rate and positively correlated with postdialysis body weight, BMI and hs-CRP levels. During the follow-up period, 52 (35.6 %) patients died. Patients who died were older, had shorter dialysis vintage, were more likely to have a history of diabetes and cardiovascular disease, and lower serum creatinine, albumin, hemoglobin, and higher hs-CRP levels than those who survived. In Cox regression analysis, estradiol levels, in a bimodal (U-shaped) distribution, along with diabetes, low serum albumin and high hs-CRP levels, were predictors for overall mortality. A U-shaped association between serum estradiol levels and cardiovascular and overall mortality was found in postmenopausal hemodialysis patients.

Research paper thumbnail of Renal Tubular Acidosis in Renal Transplant Patients: The Effect of Immunosuppressive Drugs

Annals of Transplantation, 2015

Renal tubular acidosis (RTA) is a non-anion gap metabolic acidosis and is generally mild and asym... more Renal tubular acidosis (RTA) is a non-anion gap metabolic acidosis and is generally mild and asymptomatic in kidney recipients. Calcineurine inhibitors (CNIs) increase the frequency of RTA but the frequency of RTA development in kidney transplant recipients receiving mammalian target of rapamycin inhibitors (mTORi) treatment remains unclear. In this study, we aimed to investigate the frequency of RTA in kidney transplant recipients on mTORi and CNI treatment and to compare both groups. We enrolled 137 adult renal transplant patients - 82 patients on mTORi and 55 patients on CNI who had similar age, sex, posttransplant follow-up period, and graft functions. We recorded the parameters of venous blood gas analysis, including serum pH value, serum bicarbonate (HCO3) concentration, presence of metabolic acidosis defined as low HCO3 (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;22 mEq/L), and serum pH value (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;7.35), as well as base excess and urine pH at last follow-up. RTA was defined to be metabolic acidosis with normal serum anion gap and positive urine anion gap. The mean age of our study population was 41.2±11.3 years. RTA frequency was 35% in the mTORi group and 41% in the CNI group. mTORi and CNI groups did not differ significantly in terms of the development of metabolic and renal tubular acidosis. Type I RTA was common in both groups. RTA was affected by duration of time since transplantation and graft functions in both groups. The rates of RTA development in patients on long-term CNI and mTORi treatment were similar.