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Öğe Comparison of Therapeutic Plasma Exchange and Double Filtration Plasmapheresis: Five Year Experience of Nephrology Unit(Dicle Üniversitesi, 2021) Bek, Sibel Gokcay; Bakırdöğen, Serkan; Eren, Necmi; Hanazay, Yusuf; Kalender Gönüllü, BetülObjective: The aim of the study was to evaluate the outcomes and characteristics of therapeutic plasma exchange (TPE) and double filtration plasmapheresis (DFPP) in one center. Method: The data of cases treated with therapeutic plasmapheresis at the university hospital between 2007 and 2012 were retrospectively analyzed. 445 TPE and 391 DFPP sessions were done totally. Results: In the 5.5 years, in 116 cases 445 TPE and 391 DFPP sessions were done. The mean age was 46.61±16.83 years. There were 49 female and 67 male patients. Guillain-Barre syndrome ( 8.6%) was the commonly encountered indication for neurological diseases, glomerulonephritis ( 25%) was the leading indication for the renal-related diseases. Skin involvement due to diabetes mellitus (13.8%) and Pemphigus Vulgaris (5.2%) were the dermatological diseases. Complication rates were similar between DFPP and TPE sessions (p= 0.411). Conclusion: TPE and DFPP are safe and vital membrane separation techniques used as a treatment for a wide spectrum of diseases. These treatments can be safely done in hemodialysis units intensive care units and DFPP should be considered for the therapy refractory neurological diseases.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 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.
