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Öğe Akut böbrek hasarı olan hastalarda serum düzeltilmiş ve iyonize kalsiyum seviyelerinin karşılaştırılması(2021) Akman, Canan; Bakirdogen, Serkan; Daş, Murat; Balcı, Serdal; Aykan, Okyanus NecdetGiriş: Hastaneye yatırılan hastalarda akut böbrek hasarı (ABH) sık olarak görülmektedir (%1,92). ABH’lı hastalarda serum düzeltilmiş ve iyonize kalsiyum düzeylerinin acil hemodiyalizi öngörmedeki etkisi bilinmemektedir. Bu çalışmada acil serviste ABH tanısı alan hastalarda serum düzeltilmiş ve iyonize kalsiyum düzeylerini karşılaştırmayı amaçladık. Yöntem: Çalışmamız retrospektif olarak planlandı. Grup 1: En az bir kez acil hemodiyaliz seansı alan ABH hastaları. Grup 2: Hemodiyalize girmeyen AKIN evre 1-3 olan hastalar. Hastaların başvuru anında serum düzeltilmiş ve iyonize kalsiyum, kreatinin ve albümin değerleri incelendi. Çalışmanın tüm verileri SPSS 19.0 ile kaydedildi. İstatistiksel anlamlılık için p <0,050 kabul edildi. Bulgular: Serum düzeltilmiş kalsiyum düzeylerinin ortalaması grup 1'de grup 2'ye göre daha düşüktü ve fark istatistiksel olarak anlamlıydı (p <0,001). Kan gazındaki ortalama iyonize kalsiyum seviyeleri grup 1'de grup 2'ye göre daha düşüktü ve fark istatistiksel olarak anlamlıydı (p = 0,002).Öğe Antioxidant Effect of Thioredoxin and Vitamin D3 in Peritoneal Dialysis Patients(Hindawi Ltd, 2022) Ileri, Sara Yavuz; Batman, Adnan; Eraldemir, Ceyla; Bakirdogen, Serkan; Dervisoglu, ErkanBackground. Among the chronic diseases, chronic kidney failure is one of diseases that have the most difficulty in coping with oxidative stress due to the deterioration of the antioxidant system balance in the body. Beyond being a vitamin, 1 alpha,25-dihydroxycholecalciferol (vitamin D3) is a molecule that positively or negatively affects many enzymes which are in protein structures. Thioredoxin (TRX), which has an important role in the antioxidant system, is one of these proteins. By conducting this study, we wanted to emphasize the role of vitamin D3 in reducing the oxidative stress load on patients undergoing peritoneal dialysis (PD) via serum TRX level measurement. Methods. In this study, we evaluated the medical treatments of 69 PD patients who were followed up routinely. The patients were divided into 2 groups according to whether they used vitamin D3 or not. 49 of our patients were using vitamin D3. While requesting routine laboratory tests, we reserved a separate serum sample to measure serum TRX levels by double-antibody sandwich enzyme-linked immunosorbent assay for all patients. Results. Only one parameter has a significant statistical relationship with serum TRX level and the treatment protocol. The serum TRX level was significantly higher (211,62 U/l +/- 314,46) in the group receiving vitamin D3 compared to the group which is not using Vitamin D3 (101,63 U/l +/- 215,03) (p < 0,006). Conclusion. This study highlights the importance of appropriate dose of vitamin D3 replacement especially in PD patients who are under intense oxidative stress compared to healthy individuals.Öğe Effects of incremental peritoneal dialysis with low glucose-degradation product neutral pH solution on clinical outcomes(Springer, 2024) Yeter, Hasan Haci; Altunok, Murat; Cankaya, Erdem; Yildirim, Saliha; Akturk, Serkan; Bakirdogen, Serkan; Akoglu, HadimPurpose Incremental peritoneal dialysis (IPD) could decrease unfavorable glucose exposure results and preserve (RKF). However, there is no standardization of dialysis prescriptions for patients undergoing IPD. We designed a prospective observational multi-center study with a standardized IPD prescription to evaluate the effect of IPD on RKF, metabolic alterations, blood pressure control, and adverse outcomes. Methods All patients used low GDP product (GDP) neutral pH solutions in both the incremental continuous ambulatory peritoneal dialysis (ICAPD) group and the retrospective standard PD (sPD) group. IPD patients started treatment with three daily exchanges five days a week. Control-group patients performed four changes per day, seven days a week. Results A total of 94 patients (47 IPD and 47 sPD) were included in this study. The small-solute clearance and mean blood pressures were similar between both groups during follow-up. The weekly mean glucose exposure was significantly higher in sPD group than IPD during the follow-up (p < 0.001). The patients with sPD required more phosphate-binding medications compared to the IPD group (p = 0.05). The rates of peritonitis, tunnel infection, and hospitalization frequencies were similar between groups. Patients in the sPD group experienced more episodes of hypervolemia compared to the IPD group (p = 0.007). The slope in RKF in the 6th month was significantly higher in the sPD group compared to the IPD group (65% vs. 95%, p = 0.001). Conclusion IPD could be a rational dialysis method and provide non-inferior dialysis adequacy compared to full-dose PD. This regimen may contribute to preserving RKF for a longer period.Öğe Efficacy of adalimumab therapy in experimental rat sclerosing encapsulated peritonitis model(Medicinska Naklada, 2019) Akgun, Yeliz; Bakirdogen, Serkan; Kocak, Meral Gulay Kadioglu; Bektas, Sibel; Demir, Ceren; Akbal, Erdem; Elmas, SaitAim To investigate the efficacy of adalimumab treatment in an experimental rat sclerosing encapsulated peritonitis (SEP) model. Methods The study involved 40 Wistar albino rats divided into four groups: chlorhexidine (CH) group, control group, CH + adalimumab group, and CH + resting group. The control group received normal saline intraperitoneally (i.p.). Other groups received 0.1% CH gluconate, 15% ethanol, and normal saline mixture i.p. for three weeks in order to induce SEP. CH + adalimumab group received 5 mg/kg adalimumab i.p. at the beginning of week 4 and week 6, while CH + resting group was followed-up for three weeks without applying any procedure after the onset of SEP. Rats in groups CH and control group were sacrificed on day 21, and rats in group CH + adalimumab and CH + resting were sacrificed on day 42. All groups were evaluated for peritoneal thickness, inflammation, vascularization, and fibrosis. Results CH + adalimumab group showed a significant decrease in peritoneal thickness, fibrosis score, and vascular score compared with CH group and CH + resting group. Conclusion Adalimumab can prevent SEP development.Öğe Evaluation of von Willebrand factor and protein/creatinine ratio in idiopathic sudden hearing loss(Elsevier Espana Slu, 2023) Cil, Ozge Caglar; Bakirdogen, Serkan; Cakir, Dilek Ulker; Gul, Hasan; Oymak, SibelObjective: The objective of this study was to evaluate the levels of von Willebraund Factor (vWF) in plasma and the protein/creatinine ratio in urine in patients with idiopathic sudden acute hearing loss, which we think to be caused by epithelial dysfunction. Materials-Methods: Thirty patients with a sudden hearing loss and thirty healthy individuals were included in the study. Before the treatment, blood and urine were collected from the patients and the control group to investigate the levels of the protein/creatinine ratio and the levels of vWF. The test results of the patients group were compared with those of the control group. Results: We found that the levels of vWF increased in the patient group, which was statistically significant (P <.05). The protein/creatinine ratio in the urine increased in the patient group, but this was not statistically significant (P >.05). In addition, we found that the vWF and urine protein/creatin ratio of the patients who benefited from treatment were lower than those who did not benefit. Conclusions: This study showed that sudden sensorineural hearing loss may result from endothelial dysfunction. However, more studies that include more patients are needed in order to support this. (c) 2022 Published by Elsevier Espana, S.L.U. on behalf of Sociedad Espanola de Otorrinolaringolog ' ia y Cirug ' ia de Cabeza y Cuello.Öğe HEPCIDIN AND VITAMIN D LEVELS: MUTUAL EFFECTS IN ANEMIA OF CHRONIC KIDNEY DISEASE(2021) Ustuner, Berna; Bek, Sibel Gökçay; Eren, Necmi; Bakirdogen, Serkan; Kalender, Betül GönüllüObjective: Hepcidin is a peptide with anti-microbial properties that is largely synthesized in the liver and has important roles in iron homeostasis,with serum levels elevated in chronic inflammatory conditions, including chronic kidney disease (CKD). Our aim was to discuss on the role ofvitamin D in regulation of hepcidin and anemia of CKD.Methods: The study group included 103 patients with CKD and 59 healthy individuals. The serum concentration of hepcidin was measured usingELISA, and the association to the following factors was evaluated: age, sex, body mass index, renal functions (estimated glomerular filtration rate,eGFR), drug history, serum biochemistry, complete blood count, iron and total iron binding capacity, ferritin, vitamin D, high sensitive C-reactiveprotein, C-reactive protein, and the erythrocyte sedimentation rate.Results: The mean age of the CKD group was 58.63 ± 11.8 years (with 16, 26, 27, 19, and 15 patients; respectively in each chronic kidney diseasestage, from I through V and nine on haemodialysis, six on peritoneal dialysis). The mean hepcidin concentration was higher in the chronic kidneydisease (30.3±24.7 ng/ml) than control (17.8 ± 8.4ng/ml) group (p<0.05). There was a positive association between hepcidin and CRP, ESR and thefollowing serum factors (urea, creatinine, ferritin, phosphate, pH, parathyroid hormone and alkaline phosphatase), with a negative association witheGFR, haemoglobin, haematocrit, calcium, magnesium, 25-OH vitamin D and bicarbonate levels.Conclusion: Hepcidin levels were found negatively correlated with 25-OH vitamin D levels which was related with the inflammatory effects ofvitamin D and hepcidin.Öğe Rh (D) alloimmunization treated by double filtration plasmapheresis(Pergamon-Elsevier Science Ltd, 2019) Bek, Sibel Gokcay; Eren, Necmi; Uzay, Ant; Bakirdogen, SerkanHere in this report a 31 year old pregnant woman with positive serum antiglobulin test against anti-D antierythrocyte antibodies who was treated succesfully with double filtration plasmapheresis (DFPP) is presented. The DFPP was started in the early stage of pregnancy together with intravenous immunoglobulin therapy and the antierythrocyte antibody titer of the patient was successfully maintained in a stable level below 1:64 dilution. She delivered successfully on the 30th week of gestation. The favorable outcome of this patient implies that DFPP is an effective and safe treatment modality in pregnant women with red cell all oimmunization.Öğe The Association Between Serum Uric Acid and 25-Hydroxyvitamin D in Peritoneal Dialysis Patients(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2018) Bakirdogen, Serkan; Eren, Necmi; Bek, Sibel Gokcay; Yavuz, Sara; Tuncay, MehmetOBJECTIVE: In peritoneal dialysis (PD) patients, a low level of serum 25-hydroxyvitamin D is associated with an increased risk of cardiovascular events. Hyperuricemia is also associated with an increased mortality rate in chronic kidney disease patients. The aim of our study was to determine whether there was a relationship between serum uric acid and 25-hydroxyvitamin D in PD patients. MATERIAL and METHODS: A total of 48 PD patients were included in the study. Uric acid and 25-hydroxyvitamin D were determined simultaneously in each patient's serum. Mean serum uric acid and 25-hydroxyvitamin D levels of the patients were compared with each other. The cases where the P-value was below 0.05 were considered statistically significant. RESULTS: There was a statistically significant positive correlation between mean serum uric acid and 25-hydroxyvitamin D levels in PD patients (p=0.003; r=0.427). CONCLUSION: Serum uric acid and 25-hydroxyvitamin D levels in peritoneal dialysis patients may be indicative of dietary incompatibility. Prospective studies involving more patients are needed in PD patients to prove a relationship between these two serum markers.Öğe The Effect of Erythropoiesis-Stimulating Agents on Platelet Aggregation in Peritoneal Dialysis Patients(Istanbul Training & Research Hospital, 2019) Bakirdogen, Serkan; Eren, Necmi; Bek, Sibel Gokcay; Yavuz, SaraIntroduction: Erythropoietin (Epo) is a hormone that is synthesized in the kidneys and that stimulates the erythropoiesis in the bone marrow. Epo has effects apart from the erythropoiesis. In chronic renal failure (CRF) patients, hemorrhagic diathesis is observed, and Epo production is decreased. Erythropoiesis-stimulating agents (ESAs) are widely used in the treatment of renal anemia in these patients. Our study aimed to investigate the effect of ESA5 use on platelet aggregation in peritoneal dialysis (PD) patients due to CRF. Methods: Forty-three PD patients were included in the study. Seventeen patients had been using ESAs for anemia for at least three months (ESAs user group). Twenty-six patients were not using ESAs since they did not have indications (non-ESAs user group). Platelet aggregation measurement from the whole blood was carried out in each patient by a multiplate device. The calculated values [area under the curve (AUC), aggregation, and velocity] were recorded. The results were evaluated statistically, and p<0.05 was accepted as statistically significant. Results: In the non-ESAs user group, the mean hemoglobin level was found higher when compared to the other group, and this difference was statistically significant (p<0.001). The percentage of transferrin saturation was found higher in the ESAs user group (p=0.021). It was observed that AUC, aggregation, and velocity values were lower in the ESA5 user group, and the result was not statistically significant (p values were 0.202, 0.329, 0.290, respectively). Conclusion: ESAs use in PD patients did not have any effect on platelet aggregation. Further prospective studies involving platelet aggregation tests before and after ESA treatment in dialysis patients are needed.Öğe The Effect of Serum Calcium Levels on Uremic Encephalopathy in Patients with Acute Kidney Injury in the Emergency Department(Mdpi, 2019) Akman, Canan; Cakir, Dilek Ulker; Bakirdogen, Serkan; Balci, SerdalBackground and objectives: Uremic encephalopathy is the most important complication of renal failure and urgent dialysis treatment is required. Parathormone (PTH) contributes to the etiopathogenesis of uremic encephalopathy. PTH is a hormone that acts in the calcium balance in the organism. The aim of our study was to investigate the effect of serum adjusted and ionized calcium on the development of uremic encephalopathy in patients with acute renal injury (acute kidney injury network (AKIN) stage 3). Materials and Methods: Our study was supported by Canakkale Onsekiz Mart University Scientific Research Projects Unit (ID:1278). Three groups were formed for the study. The first group was acute renal failure AKIN stage 3 (N: 23), the second group was AKIN stage 3, and the patients who had emergency hemodialysis (N: 17) and the third group (N: 9) had AKIN stage 3 hemodialysis due to uremic encephalopathy. In these patient groups, 25-hydroxy vitamin D, PTH, calcium, albumin, urea, creatinine, and blood-gas-ionized calcium were observed in their serum during the first application. Calcium, albumin, urea, creatinine, and ionized calcium in blood gas were also examined in serum at 24th and 72th hours. Data were analyzed using SPSS version 19.0. Kruskal-Wallis test and Mann-Whitney U test were applied for the variables that did not comply with normal distribution. p < 0.005 was accepted statistically. Results: A statistically significant difference was found between the measurement creatinine values at the 24th and 72th hours of admission in AKIN stage 3 patients who applied to the emergency department (p = 0.008). A statistically significant difference was found in the measured calcium values (p = 0.013). A statistically significant difference was found in the measured ionized calcium values (p = 0.035). Conclusions: In our study, the effect of ionized calcium level on uremic encephalopathy in serum creatinine, calcium, and blood gas in patients presenting with acute renal injury, AKIN stage 3, was significant, but studies with new and large groups are needed.Öğe The effects of serum leptin levels on thrombocyte aggregation in peritoneal dialysis patients(Professional Medical Publications, 2016) Bakirdogen, Serkan; Eren, Necmi; Bek, Sibel Gokcay; Mehtap, Ozgur; Cekmen, Mustafa BakiObjective: Serum leptin levels of chronic kidney disease patients have been detected higher than normal population. The aim of this study was to investigate the effects of serum leptin levels on thrombocyte aggregation in peritoneal dialysis patients. Methods: Fourty three peritoneal dialysis patients were included in the study. Thrombocyte aggregation was calculated from the whole blood subsequently the effects of different concentrations of human recombinant leptin on thrombocyte aggregations were investigated. Four test cells were used for this process. While leptin was not added into the first test cell, increasing amounts of leptin was added into the second, third and fourth test cells to attain the concentrations of 25, 50 and 100 ng/ml respectively. Results: Thrombocyte aggregation was inhibited by recombinant leptin in peritoneal dialysis patients. Thrombocyte aggregation mean values were found statistically significantly higher in first test cell when compared to leptin groups in peritoneal dialysis patients. For leptin groups we could not find any statistically significant differences for thrombocyte aggregation mean values between any of the groups. Conclusion: Further studies with larger number of peritoneal dialysis patients are required to prove the action of leptin on thrombocyte aggregation.Öğe The efficacy of a wearable hemodialysis with tentative equipment in chronic renal failure(E-Century Publishing Corp, 2020) Oguz, Sonay; Asgun, Halil Fatih; Bakirdogen, Serkan; Cakir, Dilek UlkerObjective: The aim of this study was to find an effective and simple method by which outpatient hemodialysis can be performed using diffusion and ultrafiltration methods with different procedures on a model. Methods: A solution containing high-level urea and creatinine similar to the blood values of patients with chronic renal failure was used, with the expectation of clearing it as in hemodialysis using a model with the designed system. The product values at the beginning and end of the process were determined, and the cleaning rates were calculated. Results: The clearance rates obtained in the serum were 79.2% for urea and 93.7% for creatinine. Greater than 65% clearance rates were detected in all products except calcium and magnesium. Statistical significance was found in all products (P < 0.05) except magnesium (P = 0.065). Conclusions: Using this method, we achieved a clearance rate greater than the desired clearance rates (65%) in hemodialysis.Öğe The Impact of Serum Creatinine, Albumin, Age, and Gender on the Development of Contrast-Induced Nephropathy in Patients Exposed to Contrast Agent Upon Admission to the Emergency Department(Springernature, 2020) Akman, Canan; Bakirdogen, SerkanBackground and objectives As the stage progresses in chronic kidney disease (CKD), the risk of contrast-induced nephropathy (CIN) also increases. Serum albumin level is the strongest predictor of CIN development in patients with CKD. It is widely known that females of age 75 are at risk for the development of CIN. Our study aims to investigate the impact of age, gender, serum creatinine, and albumin levels on the development of CIN in patients who were admitted to the emergency department and have had contrast-enhanced computerized tomography (CECT) for diagnosis. Materials and methods The study was planned retrospectively. Patients who applied to the emergency department between January 1, 2018, and January 1, 2020, and had CECT were included in the study. A 25% or 0.5 mg/dL increase in serum basal creatinine level within 72 hours following the implementation of contrast agent was accepted as CIN. The patients were divided into two groups: CIN (+) and CIN (-). Results One-hundred twenty-two patients (53 female and 69 male), whose average age was 72.27 +/- 12, were included in the study. Forty-five of the patients were found to be CIN (+) and 77 CIN (-). There was no significant difference between the groups (p> 0.05) in terms of age. It was found that the serum creatinine level during admission to the emergency department was the determinant for the development of CIN (p = 0.024). In addition, it was observed that serum albumin levels during the admission had no impact on the development of CIN (p = 0.326). When the serum albumin values of female and male patients diagnosed with CIN measured at the first admission to the emergency service were compared, the mean values were found to be lower in male patients (p = 0.027). Conclusion Serum creatinine and albumin levels, age, and gender parameters should be considered in terms of the risk of CIN development in patients who are admitted to the emergency department and given contrast agents.Öğe The relationship between renal resistive index and simple hematologic indices in patients with chronic kidney disease(2021) Kamış, Fatih; Bakirdogen, Serkan; Çam, Ayşe BurcuIntroduction: The renal resistive index (RRI) in Doppler ultrasonography is a useful marker for measuring the blood flowchanges in kidney diseases as well as showing tubulointerstitial damage. Although there have been many studies on therelationship between RRI increase and kidney damage, only a few provide information on RRI and inflammation markers.This study aimed to compare RRI with blood inflammatory markers derived from hemogram in patients with chronic kidneydisease (CKD).Material and Method: Ninety (33 female, 57 male) CKD patients who followed up at a nephrology clinic between January 2017and December 2018 were included in this retrospective study. The RRI, serum creatinine, C-reactive protein (CRP), completeblood count results, leukocyte count (WBC), neutrophil to lymphocyte ratio (NLR), monocyte or lymphocyte (MLR), plateletto lymphocyte ratio (PLR), mean platelet volume (MPV) and red cell distribution width (RDW) values of each patient wererecorded. The eGFR was calculated with a CKD-EPI formula. Nonparametric tests were used to compare age, gender, RRI,biochemistry and hemogram values for the study patients.Results: The mean age of the patients was 55.24±14.35 years. Regarding the comparison of the RRI with age and serum CRP,a statistically significant positive relationship was found (r=.398, p<.001; r=.365, p<.001, respectively). The mean eGFR wasfound to be 42.47±26.57 ml/min/1.73 m2. A statistically significant negative correlation was found between the RRI and theeGFR (r=-.312, p=.003). When the RRI was compared with the WBC and the PLR, no statistically significant relationshipwas found (p=.229, p=.45, respectively). However, statistically significant positive relationships were found when the RRIwas compared to the NLR and the MLR, a (r=.259, p=.014/r=.228, p=.031, respectively). Additionally, there was a statisticallysignificant positive relationship between the RRI and the RDW (p<.001, r=.383). In contrast, there was no relationship betweenthe MPV and the RDW (p>.05).Conclusions: The negative relationship between the RRI and the eGFR in CKD patients show that the resistive index maydetermine the level of renal damage.
