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Akarsu M, Dolu S, Harputluoglu M, Yilmaz S, Akyildiz M, Gencdal G, Polat KY, Dincer D, Adanir H, Turan I, Gunsar F, Karasu Z, Gokcan H, Karademir S, Kabacam G, Kayhan MA, Kiyici M, Gulsen MT, Balaban Y, Dogrul AB, Senkaya A, Ellik ZM, Eren F, Idilman R. Changing trends in the etiology of liver transplantation in Turkiye: A multicenter study. Hepatol Forum 2024; 5:3-6. [PMID: 38283275 PMCID: PMC10809344 DOI: 10.14744/hf.2023.2023.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 09/17/2023] [Accepted: 09/27/2023] [Indexed: 01/30/2024]
Abstract
Background and Aim This study aimed to identify the indications for liver transplantation (LT) based on underlying etiology and to characterize the patients who underwent LT. Materials and Methods We conducted a multicenter cross-sectional observational study across 11 tertiary centers in Turkiye from 2010 to 2020. The study included 5,080 adult patients. Results The mean age of patients was 50.3±15.2 years, with a predominance of female patients (70%). Chronic viral hepatitis (46%) was the leading etiological factor, with Hepatitis B virus infection at 35%, followed by cryptogenic cirrhosis (24%), Hepatitis C virus infection (8%), and alcohol-related liver disease (ALD) (6%). Post-2015, there was a significant increase in both the number of liver transplants and the proportion of living donor liver transplants (p<0.001). A comparative analysis of patient characteristics before and after 2015 showed a significant decline in viral hepatitis-related LT (p<0.001), whereas fatty liver disease-related LT significantly increased (p<0.001). Conclusion Chronic viral hepatitis continues to be the primary indication for LT in Turkiye. However, the proportions of non-alcoholic fatty liver disease (NAFLD) and ALD-related LT have seen an upward trend over the years.
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Affiliation(s)
- Mesut Akarsu
- Department of Gastroenterology, Dokuz Eylul University School of Medicine, Izmir, Turkiye
| | - Suleyman Dolu
- Department of Gastroenterology, Dokuz Eylul University School of Medicine, Izmir, Turkiye
| | - Murat Harputluoglu
- Liver Transplantation Institute, Inonu University School of Medicine, Malatya, Turkiye
| | - Sezai Yilmaz
- Liver Transplantation Institute, Inonu University School of Medicine, Malatya, Turkiye
| | - Murat Akyildiz
- Department of Gastroenterology, Koc University School of Medicine, Istanbul, Turkiye
| | - Genco Gencdal
- Department of Gastroenterology, Koc University School of Medicine, Istanbul, Turkiye
| | - Kamil Yalcin Polat
- Liver Transplant Center, Memorial Atasehir/Bahcelievler Hospitals, Istanbul, Turkiye
| | - Dinc Dincer
- Department of Gastroenterology, Akdeniz University School of Medicine, Antalya, Turkiye
| | - Haydar Adanir
- Department of Gastroenterology, Akdeniz University School of Medicine, Antalya, Turkiye
| | - Ilker Turan
- Department of Gastroenterology, Ege University School of Medicine, Izmir, Turkiye
| | - Fulya Gunsar
- Department of Gastroenterology, Ege University School of Medicine, Izmir, Turkiye
| | - Zeki Karasu
- Department of Gastroenterology, Ege University School of Medicine, Izmir, Turkiye
| | - Hale Gokcan
- Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkiye
| | - Sedat Karademir
- Department of Gastroenterology, Guven Hospital, Ankara, Turkiye
| | - Gokhan Kabacam
- Department of Gastroenterology, Guven Hospital, Ankara, Turkiye
| | - Meral Akdogan Kayhan
- Department of Gastroenterology, University of Health Sciences, Ankara City Hospital, Ankara, Turkiye
| | - Murat Kiyici
- Department of Gastroenterology, Uludag University School of Medicine, Bursa, Turkiye
| | - Murat Taner Gulsen
- Department of Gastroenterology, Gaziantep University School of Medicine, Gaziantep, Turkiye
| | - Yasemin Balaban
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkiye
| | - Ahmet Bulent Dogrul
- Department of General Surgery, Hacettepe University, School of Medicine, Ankara, Turkiye
| | - Ali Senkaya
- Department of Gastroenterology, Ege University School of Medicine, Izmir, Turkiye
| | | | - Fatih Eren
- Department of Gastroenterology, Uludag University School of Medicine, Bursa, Turkiye
| | - Ramazan Idilman
- Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkiye
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Dolu S, Onem S, Htway Z, Hajıyev F, Bilgen A, Binicier HC, Kalemoglu E, Sagol O, Akarsu M. Endoscopic and histological characteristics of small bowel tumors diagnosed by double-balloon enteroscopy. Clin Endosc 2023; 56:83-91. [PMID: 36733990 PMCID: PMC9902692 DOI: 10.5946/ce.2022.131] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/09/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND/AIMS Double-balloon enteroscopy (DBE) allows for the diagnoses and treatment of small bowel tumors (SBTs). This study aimed to evaluate the utility of DBE for the diagnosis and treatment of SBTs. METHODS Patients diagnosed with SBTs who underwent DBE were included in this study. According to their endoscopic appearances, they were categorized as polyps or masses, and according to their histological characteristics, they were categorized as benign or malignant SBTs. RESULTS A total of 704 patients were retrospectively analyzed, and 90 (12.8%) were diagnosed with SBTs. According to their endoscopic appearance, 48 (53.3%) had polyps and 42 (46.7%) had masses. Additionally, 53 (58.9%) and 37 (41.1%) patients had malignant and benign SBTs, respectively, depending on their histological characteristics. Patients diagnosed with polyps were younger than those diagnosed with masses (p<0.001). Patients diagnosed with benign SBTs were younger than those diagnosed with malignant SBT (p<0.001). Overall, histological diagnosis was determined using DBE in 73 (81.1%) patients. CONCLUSION DBE is a useful method for diagnosing SBTs. Additionally, the histological type of the lesion can be determined using DBE.
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Affiliation(s)
- Suleyman Dolu
- Department of Gastroenterology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey,Correspondence: Suleyman Dolu Department of Gastroenterology, Dokuz Eylul University Hospital, Inciraltı 35000, Izmir, Turkey E-mail:
| | - Soner Onem
- Department of Gastroenterology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Zarni Htway
- Department of Gastroenterology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Farid Hajıyev
- Department of Gastroenterology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Ali Bilgen
- Department of Gastroenterology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Hatice Cilem Binicier
- Department of Gastroenterology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Ecem Kalemoglu
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Ozgul Sagol
- Department of Pathology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Mesut Akarsu
- Department of Gastroenterology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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Akarsu M, Onem S, Htway Z, Cengiz O, Dolu S, Iyilikci L. Double Balloon Enteroscopy in a Pregnant Woman with Peutz-Jeghers Syndrome. J Coll Physicians Surg Pak 2022; 32:99-101. [PMID: 34983157 DOI: 10.29271/jcpsp.2022.01.99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 12/14/2020] [Indexed: 06/14/2023]
Abstract
Peutz-Jeghers syndrome is an autosomal dominant disorder characterised by multiple hamartomatous polyps and muco-cutaneous pigmentation. Most polyps are found in the small intestine, especially in the jejunum. Enteroscopy with polypectomy is a reliable method to prevent polyp-related complications. A pregnant woman, who was diagnosed as a case of Peutz-Jeghers syndrome with a history of intestinal resection, was admitted to our clinic. Termination was recommended to the patient due to the possibility of polyps, causing obstruction during pregnancy. She underwent double balloon enteroscopy in the second trimester. Large polyps that could cause intussusception were removed and post-polypectomy bleeding was successfully controlled. This procedure was the first double balloon enteroscopy during pregnancy, reported in the literature. The procedure should be performed by experienced endoscopists, who can cope well with the complications in expert centres, as the procedure carries a high risk. Key Words: Double baloon enteroscopy, Pregnancy, Peutz-Jeghers syndrome, Polyps.
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Affiliation(s)
- Mesut Akarsu
- Department of Gastroenterology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Soner Onem
- Department of Gastroenterology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Zarni Htway
- Department of Gastroenterology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Ozan Cengiz
- Department of Gastroenterology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Suleyman Dolu
- Department of Gastroenterology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Leyla Iyilikci
- Department of Anaesthesiology and Reanimation, Dokuz Eylul University School of Medicine, Izmir, Turkey
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Uyar S, Dolu S, Yolcular BO, Ellidag HY, Kok M, Bostan F, Sahinturk Y, Cekin AH. Short-Term Effect of High-Dose Pantoprazol on Serum and Urinary Magnesium Levels. Clin Lab 2019; 64:263-268. [PMID: 29739099 DOI: 10.7754/clin.lab.2017.170822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Proton pump inhibitor (PPI) induced hypomagnesemia is a completely unexplained issue and cases are still being reported. Long-term use is the main factor, but there are a few articles stating that it may also emerge with short-term use. We aimed to evaluate the changes of serum and urine magnesium levels during shortterm high dose pantoprazol treatment. METHODS The serum and 24-hour urine magnesium levels of 58 patients were evaluated during the course of 2 days. Of 58 patients, 25 were allowed oral intake on the 3rd day of hospitalization and thus, 24-hour urine for 3 days was collected from 33 patients. RESULTS There were no significant differences in the mean levels of serum magnesium and the median levels of urine magnesium. When the magnesium levels were evaluated by age over and under 60 years, the baseline serum magnesium level was significantly higher than the 1st level in patients aged ≥ 60 years (p = 0.029). The 3rd day serum magnesium level was significantly higher than the baseline and 1st day levels in those aged < 60 years (p = 0.049). CONCLUSIONS We showed that plasma levels and urinary excretion of magnesium did not change significantly during high-dose pantoprazol treatment. It can be hypothesized that magnesium levels are not affected by PPIs in short-term usage. Age and other contributing factors may have more impact on PPI induced hypomagnesemia. Patients aged over 60 years might be handled carefully under proton pump inhibitors treatment.
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Inci A, Akin O, Ellidag HY, Eren E, Dolu S, Sari F. Fibulin Levels in Autosomal Dominant Polycystic Kidney Disease and Its Relationship to Arterial Stiffness. Clin Lab 2019; 63:1869-1874. [PMID: 29226648 DOI: 10.7754/clin.lab.2017.170617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The objective of the present study was to evaluate fibulin 1 levels in different stages of patients with autosomal dominant polycystic kidney disease (ADPKD) and investigate possible connections between fibulin-1 and arterial stiffness. METHODS For this cross-sectional study, we included 74 patients with ADPKD (mean age, 50.92 ± 15.70 years) and 32 healthy controls (mean age, 49.53 ± 7.32 years). Patients with ADPKD were classified based on CKD epidemiology collaboration (CKD-EPI) equation assessments of estimated glomerular filtration rate (eGFR). Blood levels of fibulin 1 and creatinine levels were analyzed. We measured brachial artery PWV (baPWV), augmentation index (AIx), and pulse pressure (PP) for the assessment of arterial stiffness and systolic and diastolic blood pressures (SBP and DBP, respectively). RESULTS Fibulin 1 was significantly higher in the patient group (p < 0.001). SBP, DBP, MAP, PP, and baPWV levels were also significantly higher in the patient group. A statistically significant positive correlation was found between fibulin 1 and creatinine (r = 0.377, p = 0.001). No significant correlation was found between the fibulin 1 levels and age, SBP, DBP, MAP, baPWV, and AIx. CONCLUSIONS Plasma concentrations of fibulin 1 increased in patients with ADPKD. Arterial stiffness measured by baPWV increased in patients with ADPKD, but it was not related to fibulin 1 levels.
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Uyar S, Kok M, Unal A, Koker G, Dolu S, Inci A, Cekin AH. The Validity of Malnutrition Universal Screening Tool (MUST) for Nutritional Screening in Hemodialysis Patients. Turk J Nephrol 2019. [DOI: 10.5152/turkjnephrol.2019.3349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Uyar S, Harmandar F, Kök M, Taș Z, Dolu S, Tokuç A, Köker G, Görar S, Çekin AH. Management of hypertriglyceridemia induced acute pancreatitis and therapeutic plasmapheresis : Report of nine cases and review of literature. Acta Gastroenterol Belg 2017; 80:71-74. [PMID: 29364102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Hypertriglyceridemia is one of the rare causes of the acute pancreatitis. The prevalance of hypertriglyceridemia has increased recently due to the changing eating habits, sedentary lifestyle, alcohol consumption, obesity and concomitant diabetes mellitus. Therefore, the frequency of the acute pancreatitis due to hypertriglyceridemia may increase in coming years. Diagnosis of the acute pancreatitis by hypertriglyceridemia can be overlooked easily and may be very severe if untreated accurately on time. In addition to the standard management of pancreatitis, specific treatment for hypertriglyceridemia that is insulin, heparin and anti-hypertriglyceridemic drugs are used. Therapeutic plasmapheresis is the last treatment option and seems the most effective one in this subject through developing device and membrane technologies when we review the current literature. Not only triglycerides but also proinflammatory cytokines and adhesion molecules that play an active role in pathogenesis are removed by plasmapheresis. So, the effectiveness of treatment appears promising. However, the exact pathophysiology of hypertriglyceridemia-induced pancreatitis could not be fully understood and the majority of published experience comes from the case reports and the benefit of randomized clinical trials is not available. Therefore, there are no data about what are the exact indications and when we start therapeutic plasmapheresis in literature. This manuscript describes our hospital experience with treatment options and analyzes reports published recently about plasmapheresis as a treatment modality for hypertriglyceridemia induced acute pancreatitis.
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Sari F, Inci A, Dolu S, Ellidag HY, Cetinkaya R, Ersoy FF. High serum soluble α-Klotho levels in patients with autosomal dominant polycystic kidney disease. J Investig Med 2016; 65:358-362. [DOI: 10.1136/jim-2016-000193] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2016] [Indexed: 11/03/2022]
Abstract
This study aims to determine fibroblast growth factor-23 and soluble α-Klotho levels in patients with autosomal dominant polycystic kidney disease. A total of 76 patients with autosomal dominant polycystic kidney disease and 32 healthy volunteers were included in the study. Serum fibroblast growth factor-23 and soluble α-Klotho levels were measured with ELISA kits. Parathyroid hormone, phosphate, calcium, creatinine, 25-hydroxyvitamin D3 levels, urinary protein to creatinine ratio and estimated glomerular filtration rate were also measured or calculated. Patients with autosomal dominant polycystic kidney disease had significantly higher serum parathyroid hormone (p<0.001), fibroblast growth factor-23 (p<0.001), soluble α-Klotho levels (p=0.001) and lower serum 25-hydroxyvitamin D3 levels (p<0.001) as compared with healthy volunteers. Serum fibroblast growth factor-23, soluble α-Klotho and 25-hydroxyvitamin D3 levels were similar in all five chronic kidney disease stages of autosomal dominant polycystic kidney disease (p>0.05). Fibroblast growth factor-23 (r=−0.251, p=0.034) and soluble α-Klotho levels (r=−0.251, p=0.034) were found to be negatively correlated with estimated glomerular filtration rate. This study shows increased fibroblast growth factor-23 levels in patients with autosomal dominant polycystic kidney disease which is in harmony with the general trend in patients with chronic kidney disease of other aetiologies, but, unlike them, also a significant increase in serum soluble α-Klotho levels in patients with autosomal dominant polycystic kidney disease suggesting an aberrant production or a decreased clearance of α-Klotho molecule. Considering the unique increases in erythropoietin levels due to erythropoietin production in renal cysts, we assume, patients with autosomal dominant polycystic kidney disease may potentially have different soluble α-Klotho production/clearance characteristics than the patients with other parenchymal renal diseases.
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Ellidag HY, Yilmaz N, Kurtulus F, Aydin O, Eren E, Inci A, Dolu S, Ince FDA, Giray Ö, Yaman A. The Three Sisters of Fate in Multiple Sclerosis: Klotho (Clotho), Fibroblast Growth Factor-23 (Lachesis), and Vitamin D (Atropos). Ann Neurosci 2016; 23:155-161. [PMID: 27721584 DOI: 10.1159/000449181] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 05/19/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The klotho (Klt)-fibroblast growth factor-23 (FGF-23)-vitamin D axis is the main component of calcium (Ca) and phosphorus (P) metabolisms; on the contrary, it is also secreted from the choroid plexus (CP). PURPOSE This study is aimed at evaluating serum soluble Klt (sKlt), FGF-23, and 25-(OH)-vitamin D levels in multiple sclerosis (MS) patients. METHODS Thirty-two relapsing-remitting MS patients (11 males and 21 females; mean age 38.3 years) and 31 age-sex matched healthy controls (12 males and 19 females; median age 38.5 years) were included in this study. All patients were diagnosed with MS according to the criteria of McDonald. RESULTS Serum sKlt, FGF-23, and P levels were significantly higher in MS patients compared to the control group (p < 0.01, p < 0.01, and p = 0.02, respectively). Serum 25-(OH)-vitamin D and Ca levels were significantly lower in MS patients (p < 0.01 and p = 0.04, respectively). CONCLUSION Klt, which is secreted from CP, could be a response to the inflammatory condition in MS. Elevated FGF-23 levels suppress 1α-hydroxylase and upregulates 24α-hydroxylase, which results in a decrease in 1,25-(OH)2D3 levels. Thus, the neuroprotective and immunomodulatory effects of vitamin D might not be seen in MS patients.
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Affiliation(s)
- Hamit Yasar Ellidag
- Central Laboratories, Antalya Education and Research Hospital of Ministry of Health, Antalya, Turkey
| | - Necat Yilmaz
- Central Laboratories, Antalya Education and Research Hospital of Ministry of Health, Antalya, Turkey
| | - Fatma Kurtulus
- Neurology Clinic, Antalya Education and Research Hospital of Ministry of Health, Antalya, Turkey
| | - Ozgur Aydin
- Biochemistry Laboratory, Maternity and Children's Hospital, Batman, Turkey
| | - Esin Eren
- Central Laboratories, Antalya Education and Research Hospital of Ministry of Health, Antalya, Turkey
| | - Ayca Inci
- Nephrology Clinic, Antalya Education and Research Hospital of Ministry of Health, Antalya, Turkey
| | - Suleyman Dolu
- Nephrology Clinic, Antalya Education and Research Hospital of Ministry of Health, Antalya, Turkey
| | - Fatma Demet Arslan Ince
- Department of Biochemistry, Tepecik Education and Research Hospital of Ministry of Health, Izmir, Turkey
| | - Özlem Giray
- Central Laboratories, Antalya Education and Research Hospital of Ministry of Health, Antalya, Turkey
| | - Aylin Yaman
- Neurology Clinic, Antalya Education and Research Hospital of Ministry of Health, Antalya, Turkey
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Inci A, Sari F, Olmaz R, Coban M, Dolu S, Sarikaya M, Ellidag HY. Soluble Klotho levels in diabetic nephropathy: relationship with arterial stiffness. Eur Rev Med Pharmacol Sci 2016; 20:3230-3237. [PMID: 27466997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE In this cross-sectional study, we investigate the relationship between soluble Klotho (s-Klotho) levels, markers of bone mineral metabolism and arterial stiffness in 109 diabetic nephropathy patients (median age 61.00± 9.77 years) and 32 healthy controls (median age 49.23 ± 7.32 years). PATIENTS AND METHODS Blood samples were collected to measure the levels of s-Klotho, and FGF23, serum creatinine, Calcium (Ca), Phosphorus (P), 25-hydroxyvitamin D3 (25hD) and parathyroid hormone (PTH). Pulse wave velocity (PWV) and blood pressure were also measured using a combined monitor. RESULTS s-Klotho, FGF23 and PTH levels were significantly higher and 25hD was significantly lower in the patients than in controls (p < 0.001). Systolic blood pressure, pulse pressure and PWV were also significantly higher in the patients (p < 0.001). s-Klotho, FGF23 and 25hD levels significantly varied between sub-groups according to CKD stages, defined according to the CKD epidemiology collaboration equation. A strong positive correlation was found between s-Klotho and FGF23 (r = 0.768, p = 0.001) levels, but not with other bone mineral metabolism, blood pressure or arterial stiffness parameters. Creatinine levels significantly differed (p = 0.009) between three s-Klotho-level sub-groups, with the high creatinine levels in the sub-group with the lowest s-Klotho levels and estimated glomerular filtration rate (eGFR). CONCLUSIONS There was no correlation between eGFR and s-Klotho levels. Arterial stiffness increased in CKD but was not related to s-Klotho or FGF23 levels. Among all parameters, FGF23 levels had the greatest effect on s-Klotho levels.
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Affiliation(s)
- A Inci
- Division of Nephrology, Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey.
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Inci A, Sari F, Coban M, Olmaz R, Dolu S, Sarıkaya M, Yılmaz N. Soluble Klotho and fibroblast growth factor 23 levels in diabetic nephropathy with different stages of albuminuria. J Investig Med 2016; 64:1128-33. [PMID: 27323770 DOI: 10.1136/jim-2016-000142] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2016] [Indexed: 01/02/2023]
Abstract
The relationship between soluble Klotho (s-Klotho) levels, fibroblast growth factor 23 (FGF23) levels, and albuminuria in patients with diabetic chronic kidney disease (CKD) remains unclear. A total of 109 patients with type 2 diabetes (mean age 61.63±9.77 years), at the outpatient clinic of the Antalya Research and Training Hospital Nephrology Unit between January and June 2014, as well as 32 healthy controls (mean age 49.53±7.32 years) were enrolled for this cross-sectional study. Patients were classified into three groups according to their urinary albumin creatinine ratio (UACR), normoalbuminuria (UACR<30 mg/g), microalbuminuria (UACR 30-300 mg/g), and macroalbuminuria (UACR>300 mg/g). The blood was analyzed for FGF23, s-Klotho, parathyroid hormone (PTH), P, Ca, creatinine, and 25-hydroxyvitamin D3 (25hD) levels. Creatinine, s-Klotho, FGF23, and PTH levels were significantly higher and 25hD levels were significantly lower in the patient group than in the healthy controls (p<0.001). Between the groups according to UACR, 1-way analysis of variance revealed statistically significant differences for creatinine (p<0.001), 25hD (p<0.001), PTH (p=0.002), Ca (p=0.002), and albumin levels (p<0.001). A statistically significant positive correlation was found between s-Klotho and FGF23 (r=0.768; p=0.001), and between FGF23 levels and UACR (r=0.768; p=0.001). In conclusion, the results of the present study suggest that s-Klotho levels are significantly elevated in patients with diabetes and s-Klotho levels decreased with increasing albumin excretion in our patients despite a reduction in estimated glomerular filtration rate.
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Affiliation(s)
- Ayca Inci
- Antalya Training and Research Hospital, Antalya, Turkey
| | - Funda Sari
- Department of Nephrology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Melahat Coban
- Antalya Egitim ve Arastirma Hastanesi, Antalya, Turkey
| | - Refik Olmaz
- Antalya Training and Research Hospital, Antalya, Turkey
| | - Suleyman Dolu
- Antalya Training and Research Hospital, Antalya, Turkey
| | | | - Necat Yılmaz
- Department of Biochemistry, Antalya Training and Research Hospital, Antalya, Turkey
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Cekin Y, Kizilates F, Dolu S, Oztoprak N, Cekin A. The first urinary tract infection caused by Cedecea lapagei: a case report and review of the literature. ACTA ACUST UNITED AC 2014. [DOI: 10.5455/gmj-30-153282] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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