Okan Akyüz - Academia.edu (original) (raw)

Papers by Okan Akyüz

Magnesium is one of the intracellular cations that play an essential role in many biological reac... more Magnesium is one of the intracellular cations that play an essential role in many biological reactions. Intracellular magnesium is an important cofactor for various enzymes, carriers and nucleic acids required for normal cellular function, energy metabolism and replication. It is required for normal cardiac electrical activity. Magnesium deficiency can cause many disorders including cardiac arrhythmias. Intravenous magnesium has long been used in the treatment and prevention of arrhythmia since it has a high therapeutic to toxic ratio and minimal negative inotropic effect. Many studies have shown a beneficial effect of intravenous Mg administration in tachycardia attacks. But this positive effect varies according to the type of tachycardia. Especially in the treatment of supraventricular tachycardia and in the acute treatment of atrial fibrillation with a ventricular rate ≤ 100/ min, the beneficial effects are more pronounced. The administration of intavenous magnesium appears to be useful in the treatment and prevention of cardiac arrhythmias and is a common component of a complex antiarrhythmic treatment.

Journal of surgery and medicine, Jun 1, 2021

Background/Aim: Diabetic nephropathy (DN) occurs in approximately 40% of patients with Type 1 and... more Background/Aim: Diabetic nephropathy (DN) occurs in approximately 40% of patients with Type 1 and Type 2 diabetes mellitus (DM) and is one of the most common causes of end-stage renal disease (ESRD). New treatment strategies are needed to prevent DN. This study aims to investigate the effect of the use of isosorbide-mononitrate (IMN) on diabetic nephropathy. Methods: In this study, patients with type 2 diabetes mellitus were divided into two groups, as those using and not using IMN to evaluate whether IMN reduces proteinuria. Biochemical parameters and proteinuria values were recorded and comparatively analyzed. Results: The urea and creatinine values of patients with type 2 DM who were using IMN were significantly higher and e-GFR values were significantly lower than those of the control group (P=0.049, P=0.001, P=0.013, respectively). However, the proteinuria amounts of Type 2 DM patients using IMN (0.98 g/day [0.52-1.43]) were significantly lower than those who were not (1.61 g/day [1.02-2.69] (P=0.001)). Conclusion: The addition of nitrate to angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) in the treatment of patients with DN may be a new alternative for reducing proteinuria.

The aim of this study was to evaluate the clinical and pathological evaluation of renal biopsies ... more The aim of this study was to evaluate the clinical and pathological evaluation of renal biopsies performed between January 2015 and December 2019. In this study, renal biopsy data of 64 patients who were performed in the Internal Medicine Clinic of Kanuni Sultan Suleyman Training and Research Hospital between January 2015 and December 2019 were analyzed retrospectively. All renal biopsies were performed under ultrasonography guidance and all were native kidney biopsies. Demographic, clinical and laboratory data of the patients were obtained from hospital records. The study group consisted of 26 (41.2%) males and 38 (58.8%) females with a mean age of 44.41 ± 8.55 years. In the study, nephrotic proteinuria and hematuria were the most common biopsy indications (65.1%). Biopsy revealed the most common focal segmental glomerulosclerosis (FSGS) (29.7%) and followed membranous glomerulonephritis (MGN) (20.4%). In conclusion, the most common indication for biopsy was nephrotic proteinuria and hematuria. It was noteworthy that the most common pathology detected by biopsy was FSGS.

Journal of surgery and medicine, Dec 2, 2019

Aim: Volume load assessment is an important problem in patients with chronic renal failure (CRF).... more Aim: Volume load assessment is an important problem in patients with chronic renal failure (CRF). Apart from classical volume assessment methods, the number of studies on echocardiographic evaluation of right heart functions is limited. In this study, we aimed to evaluate right heart functions echocardiographically in end-stage renal failure patients receiving hemodialysis (HD) therapy and its utility in volume load determination. Methods: This case-control study included 49 patients receiving HD treatment as the study group. The control group consisted of 46 healthy individuals whose age and gender were matched. Echocardiographic evaluation was performed for all participants. Tricuspid annular plane systolic excursion (TAPSE), systolic pulmonary artery pressure (SPAB), tricuspid E wave velocity, A wave velocity, E / A ratio, right ventricular ejection fraction (RVEF) and left ventricular ejection fraction (LVEF) were measured. Results: Right ventricular diastolic diameter (2.55 (0.3) vs 2.30 (0.29) respectively, P<0.001) SPAP (37.4 (8.3) vs 19 (6.8), P<0.001, respectively) were statistically significant higher in the study group, while TAPSE (1.61 (0.35) vs 2.09 (0.27), P<0.001, respectively), A rate, (0.63 (0.27) vs 0.45 (0.26), P<0.001, respectively), E / A ratio (0.93 (0.25) vs 1.37 (0.24), P<0.001, respectively) were significantly lower. Right ventricular (RV) E velocity was insignificantly lower in the study group (P=0.523). There were no statistically significant differences between the groups in terms of age, gender, and body mass index. Conclusion: In our study, we found that TAPSE was low and SBAP and RV diastolic diameter were high in HD patients. We think that TAPSE and SPAB can be used together with conventional methods for evaluating hypervolemia in HD patients. Further studies are required to explore this clinical tool.

Selçuk Üniversitesi Tıp Fakültesi dergisi, Mar 1, 2021

Amaç: Hemodiyaliz (HD) hastalarında ventriküler aritmiler ve ani kardiyak ölüm (AKÖ) dahil kardiy... more Amaç: Hemodiyaliz (HD) hastalarında ventriküler aritmiler ve ani kardiyak ölüm (AKÖ) dahil kardiyovasküler olaylar birincil ölüm kaynağıdır. QT aralığı, QT dispersiyonu (QTd), TPe aralığı, TPe / QT oranı ve kardiyak-elektrofizyolojik denge (iCEB = QT / QRS) gibi EKG parametrelerinin kontrol edilmesi, yüksek aritmi ve SCD riski olan hastaların sınıflandırılmasında yararlı olabilir. Çalışmamız, HD seansı öncesi ve sonrasında elektrokardiyografik parametrelerdeki değişimi sağlıklı kontrol grubu ile karşılaştırmayı amaçladı. Hastalar ve Yöntem: Çalışma Ocak 2020 ile Mart 2020 arasında 49 HD hastası ve 50 sağlıklı gönüllü dahil edilerek yapıldı. Gruplar hemodiyaliz ve kontrol grubu olarak iki gruba ayrıldı. Hemodiyaliz grubunun EKG'leri diyaliz öncesi ve sonrası değerlendirildi. EKG verileri tarandı ve dijital bir platformda değerlendirildi. QT, cQT, QTd, TPe, TPe / QT, TPe / cQT, QT / QRS ve cQT / QRS ölçüldü. Bulgular: Hemodiyaliz sonrası QTd, cQTd, TPe, TPe / QTc ve QRS pre-HD'ye göre anlamlı olarak azalırken (her biri için p <0,05), diyaliz tedavisi sonrası HR, iCEB ve iCEBc anlamlı artış gösterdi (p <0,05 için her biri). Diyaliz öncesi EKG parametreleri ile kontrol grubu karşılaştırıldığında QT, cQT, QTd, cQTd, TPe ve iCEBc pre-HD'de anlamlı olarak daha yüksekti (her biri için p <0.05). Diyaliz sonrası EKG parametreleri karşılaştırıldığında, HR, cQT, QTd, cQTd, iCEB ve iCEBc değerleri kontrol grubuna göre anlamlı olarak yüksekti (her biri için p <0.05). Sonuç: HD hastalarında ventriküler repolarizasyon ve depolarizasyonu birlikte gösteren elektrokardiyografik parametreler değerlendirilerek aritmi ve ani kardiyak ölüm riski öngörülebilir.

Southern clinics of İstanbul eurasia, 2021

Objective: Hemodialysis is a treatment modality for patients, in which physical and psychological... more Objective: Hemodialysis is a treatment modality for patients, in which physical and psychological stress factors are together. Intense anxiety and stress caused by treatment are very favorable for alexithymic feelings. Hemodialysis patients undergo continuous biochemical changes hemodynamically. Our aim in this study was to investigate the relationship between biochemical parameters; we use in hemodialysis patients' follow-up and alexithymic emotions and stress factors. Methods: Fifty-one patients who received hemodialysis treatment due to end-stage renal failure in Bilecik Province in 2019 were included in the study. Routine biochemical follow-up data of patients, hemodialysis stressor scale, and Toronto alexithymia scale (TAS) were used in the study. The statistical significance level was determined as p<0.05 between routinely monitored hemodialysis parameters and scales. Results: It was observed that 58.8% of the patients included in the study were alexithymic. The mean hemodialysis stressor was 86.6, and the mean TAS was 62.76. The high levels of stress and alexithymic emotion scales in hemodialysis patients were noted. A significant relationship was found between inlet creatinine, urea reduction ratio, Kt/V, dry weight, albumin, output urea, and calcium between the hemodialysis stress scale and TAS subgroups. Conclusion: Psychiatric evaluation should be routine in the follow-up of hemodialysis patients, and the monthly psychologist/psychiatric examination, which was abolished with the last regulation change, should be restarted. It is also essential to increase the awareness of health-care professionals working in the dialysis unit about coping with stress and stressful patient management.

Bratislavské lekárske listy, 2021

BACKGROUND: Renal transplantation stands out with lower cost advantages in life expectancy, quali... more BACKGROUND: Renal transplantation stands out with lower cost advantages in life expectancy, quality of life and especially in the long-term perspective compared to dialysis. Having signifi cant side effects of immunosuppressive drugs in terms of patient and graft survival limits the use of these drugs. A variety of markers are being explored to prolong the renal graft life. One of these molecules, monocide chemoattractant protein (MCP-1) is a marker involved in renal infl ammation. The production of MCP-1 was blocked in kidney diseases and the disease was improved. Along with these promising developments, we decided to investigate whether there is a signifi cant relationship between immunosuppressive therapies used in renal transplantation therapy and serum MCP-1 levels. METHODS: Our study was performed in 80 patients who underwent kidney transplantation followed in Haydarpaşa Numune Training and Research Hospital. These 80 patients were examined in 4 groups as Group 1 (cyclosporin), Group 2 (tacrolimus), Group 3 (sirolimus) and Group 4 (everolimus). Serum MCP-1 levels were compared between the groups by using ELISA method. RESULTS: In our study, serum MCP-1 levels were signifi cantly higher in cyclosporine and tacrolimus groups than in sirolimus (p< 0.05). When calcineurin inhibitors and everolimus were compared, it was not statistically signifi cant, although calcineurin inhibitors were higher. CONCLUSION: Understanding the role of MCP-1 in monocyte homeostasis and the effects of MCP-1 inhibition in kidney disease will help to design better diagnostic and treatment strategies in patients with infl ammatory kidney disease (Tab. 2, Fig. 7, Ref. 45).

Biological Trace Element Research, Sep 19, 2021

The homeostasis model assessment of insulin resistance (HOMA-IR) is widely used in clinical pract... more The homeostasis model assessment of insulin resistance (HOMA-IR) is widely used in clinical practice to estimate insulin resistance. In particular, magnesium (Mg) is an extensively studied mineral that has been shown to function in the management of hyperglycemia and insulin resistance (IR) action. The pathophysiology of IR in non-obese patients has not been clearly demonstrated. From this point of view, we aimed to investigate the relationship between serum Mg level and IR in non-obese patients. We analyzed 957 patients who are not obese and estimated glomerular filtration rate (e-GFR) ≥ 60 mL/min/1.73 m2. Patients were divided into two groups, with and without IR. The results of the IR detected group (HOMA-IR ≥ 2.5, n = 544) and the IR undetected group (HOMA-IR < 2.5, n = 413) were compared. The median Mg value of the patients was 1.76 [0.21] mg/dL. A statistically significant difference was observed between the two groups regarding serum Mg levels (p = 0.043). A negative correlation was found between the HOMA-IR index and serum Mg levels among patients (r = - 0.064, p = 0.049). Multivariable logistic regression analysis revealed that serum Mg level (p = 0.039, odds ratio [OR] = 0.770[95%CI: [0.917-0.989]) was independent risk factors for IR. HOMA-IR increases as the Mg level decreases in advanced ages without obesity, especially in men with low e-GFR.

Nephrology Dialysis Transplantation, May 1, 2016

Cumhuriyet medical journal, Feb 5, 2021

Index of cardiac electrophysiological balance (iCEB) is a relatively new electrocardiographic (EC... more Index of cardiac electrophysiological balance (iCEB) is a relatively new electrocardiographic (ECG) parameter that shows the balance between ventricular depolarization and repolarization, thus providing more information than other conventional ECG parameters such as QT and corrected QT (cQT) intervals. This study aimed to evaluate the condition of iCEB with the treatment of hydroxychloroquine and azithromycin used in COVID-19 patients. Method: The study was designed as cross-sectional and descriptive. Sixty three (52 male, 28.4 ± 10.7 years) COVID-19 patients with mild symptoms who received hydroxychloroquine and azithromycin treatment between 30 March and 30 June 2020 were included in the study. iCEB and corrected iCEB (iCEBc) values were calculated by dividing the respective QT and cQT intervals by the QRS duration. Results: In the study group, the mean PR, QRS, QT and cQT intervals were similar between groups. While heart rate was significantly higher before treatment, iCEB and iCEBc increased significantly after treatment. Conclusions: Our study did not observe a significant difference in QT and cQT intervals with hydroxychloroquine and azithromycin treatment in COVID-19. Still, there was a significant increase in the iCEB and iCEBc. We believe that the cardiac electrophysiological balance index can be used to monitor arrhythmias in patients undergoing short-term treatment at COVID-19.

Қазақстанның клиникалық медицинасы, Feb 25, 2022

This study aims to evaluate the association between prognostic nutritional index (PNI) and contra... more This study aims to evaluate the association between prognostic nutritional index (PNI) and contrast-induced nephropathy (CIN). Material and methods: A total of 251 patients who were at high risk for contrast nephropathy were included in the study. The patients were grouped according to their PNI score (PNI score <45 or PNI score ≥45). CIN was defined as a 25% relative increase, or 0.5 mg/dL absolute increase in serum creatinine level above baseline within 72 hours of contrast exposure, in the absence of an alternative explanation. Results: Two groups were assigned according to the PNI score. The first group consists of 111 patients (PNI<45) and the second group has 140 patients (PNI≥45). CIN developed in 162 (%64.8) patients. C-reactive protein was higher in the low-PNI group. Also, the patients with the low-PNI group had lower ejection fraction, lower serum albumin levels, and lower hemoglobin levels. CIN, postprocedure renal replacement therapy requirement and in-hospital mortality were higher in the low PNI group. Multivariable logistic regression analysis revealed that advanced age (p=0.012, [OR] = 1.044 [1.009-1.079]), low baseline GFR (p=0.033, [OR]= 1.022 [1.002-1.043]), high amount of contrast media (p=0.022, [OR]= 1.017 [1.002-1.031]), and low PNI score (p=0.033 , [OR]= 2.069 [1.060-4.039]) were independent predictors of CIN. Conclusion: Our study demonstrated that the PNI score was an independent risk factor for the development of CIN.

During pregnancy structural and functional changes occur in organs to meet the changing needs of ... more During pregnancy structural and functional changes occur in organs to meet the changing needs of the fetus. Naturally, the kidneys and urinary tract also change during pregnancy. Firstly, physiological changes in pregnancy will be emphasized then pathologies will be mentioned.

International Journal of Research Studies in Medical and Health Sciences, 2020

Introduction: Thyroid hormones play an important role in almost all metabolic events in the body.... more Introduction: Thyroid hormones play an important role in almost all metabolic events in the body. Historically, the relationship between uric acid levels and thyroid diseases has been a matter of curiosity. Our aim in the study was to investigate how uric acid metabolism is affected in hypothyroid patients. Materials and Methods: Patients diagnosed with hypothyroidism were included in the study. It was divided into two groups, as an apparent and subclinical hypothyroid group. Patients who were treated with the diagnosis of hypothyroidism were divided into two groups as TSH targeted and non-targeted. Participants without the disease and drug use affecting uric acid levels were designed as a control group. The groups included in the study were compared both among themselves and with the control group. Results: The number of female patients in the hypothyroid group was statistically significant compared to the control group (p<0.001). As expected, TSH levels were significantly higher and fT4 significantly lower in the patient group (p <0.001 and p <0.001, respectively). There was no significant difference in uric acid values in both groups (p <0.05). No statistically significant difference was found between subgroups of patients with hypothyroidism and when the control group and serum uric acid levels were compared (p <0.05). Conclusions: We think that the thyroid dysfunction of the patient should be known to correctly evaluate the laboratory parameters that can be measured. More extensive randomized controlled trials are needed for this.

The Journal of Vascular Access, 2021

Background: Here we aimed to investigate the predictors of catheter-related bloodstream infection... more Background: Here we aimed to investigate the predictors of catheter-related bloodstream infections (CRBSI) in patients with acute kidney injury or chronic kidney disease who required renal replacement therapy through a non-tunneled hemodialysis catheter. Methods: A total of 111 patients who received non-tunneled hemodialysis catheters were retrospectively evaluated. Patients were divided into two groups; those who developed CRBSI and those who did not. Patient’s demographic data, laboratory results at admission, information regarding catheter infections, and culture results were obtained from electronic medical records. Results: The mean age of the patients was 64 ± 16 years, and 51 of them were male. CRBSI occurred in 14 patients (12.6%). Admission serum albumin level (OR: 0.119, 95% CI: 0.019–0.756, p = 0.024), admission mean platelet volume (OR: 2.207, 95% CI: 1.188–4.100, p = 0.012) and catheter duration (OR: 1.580, 95% CI: 1.210–2.064, p = 0.001) were independent predictors for...

Journal of Elementology, 2020

Journal of Cardiothoracic Surgery, 2019

Background: We aimed to investigate the predictive value of the prognostic nutritional index (PNI... more Background: We aimed to investigate the predictive value of the prognostic nutritional index (PNI) regarding the development of acute kidney injury (AKI) after elective coronary artery bypass grafting (CABG). Methods: A total of 336 consecutive patients with normal serum creatinine levels undergoing CABG were enrolled in this retrospective study. AKI was defined as meeting Acute Kidney Injury Network (AKIN) criteria based on the occurrence of creatinine changes within the first 48 h after CABG surgery. The patients were grouped according to whether they developed AKI or not into an AKI (−) and an AKI (+) group. Results: AKI developed in 88 (26.2%) of all patients. The PNI was independently predictive of AKI (OR: 0.829, 95% CI: 0.783-0.877, p < 0.001). Moreover, C-reactive protein (CRP), a history of diabetes mellitus, and positive inotropric usage were independent risk factors for AKI in the multivariate logistic regression analysis. The area under the curve (AUC) of the multivariable model, including positive inotrope support, a history of diabetes mellitus, and CRP, was 0.693 (95% CI: 0.626-0.760, p < 0.001) in predicting AKIN. When the PNI was added to the multivariable model, the AUC was 0.819 (95% CI, 0.762-0.865, z = 3.777, difference p = 0.0002). Also, the addition of the PNI to the multivariable model was associated with a significant net reclassification improvement estimated at 88.2% (p < 0.001) and an integrated discrimination improvement of 0.22 (p < 0.001). Conclusions: Our study demonstrated that decreasing the PNI could be associated with the development of AKI after coronary artery bypass surgery.

Cumhuriyet medical journal, 2021

Journal of Surgery and Medicine, 2021

Southern Clinics of Istanbul Eurasia, 2021