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Uysal C, Oguz H, Cifci H, Kocyigit I. Widespread form of Majocchi's granuloma in a kidney transplant recipient. CEN Case Rep 2024:10.1007/s13730-024-00883-1. [PMID: 38763967 DOI: 10.1007/s13730-024-00883-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/23/2024] [Indexed: 05/21/2024] Open
Abstract
Kidney transplantation is the encouraged kidney replacement therapy due to providing more prolonged survival with a better quality of life. Unfortunately, kidney transplant recipients are susceptible to infections because of long-term utilization of immunosuppression. Despite dermatophyte infections are generally not life-threatening, the clinical significance has been recently enhanced by an increasing number of immunocompromised patients. We have presented a rare dermatophytosis course, Majocchi's granuloma, that spreads to all extremities during the early post-transplant period. A young kidney transplant recipient was exposed to intensive immunosuppression therapy due to acute rejection in the early period of post-transplantation. After four months, numerous nodular skin lesions were raised on various body parts. An invasive fungal infection was identified in the skin biopsy. Also, Trichophyton rubrum was isolated in the tissue cultures. Consequently, the patient was diagnosed with Majocchi's granuloma. An effectual treatment was attained with an oral terbinafine tablet. Majocchi's granuloma is a distinct form of dermatophytosis characterized by the spreading of infection into the dermis. In this unexpected case, we alerted physicians to opportunistic infections in the kidney transplant recipient.
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Affiliation(s)
- Cihan Uysal
- Department of Nephrology, Erciyes University Medical Faculty, Köşk Distinct, Dede Efendi Street, 38039, Melikgazi, Kayseri, Turkey.
| | - Hanife Oguz
- Department of Internal Medicine, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Hasan Cifci
- Department of Internal Medicine, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Ismail Kocyigit
- Department of Nephrology, Erciyes University Medical Faculty, Köşk Distinct, Dede Efendi Street, 38039, Melikgazi, Kayseri, Turkey
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Sahin A, Kocyigit I, Aslan K, Eroglu E, Demiray A, Eken A. Elevated checkpoint inhibitor expression and Treg cell number in autosomal dominant polycystic kidney disease and their correlation with disease parameters and hypertension. Clin Exp Med 2023; 23:3631-3640. [PMID: 36869968 DOI: 10.1007/s10238-023-01031-2] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 02/18/2023] [Indexed: 03/05/2023]
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) has cancer-like pathophysiology. In this study, we aimed to investigate the phenotype of peripheral blood (PB) T cell subsets and immune checkpoint inhibitor expression of ADPKD patients across different chronic kidney disease (CKD) stages. Seventy-two patients with ADPKD and twenty-three healthy controls were included in the study. The patients were grouped into five different CKD stages, according to glomerular filtration rate (GFR). PB mononuclear cells were isolated and T cell subsets and cytokine production were examined by flow cytometry. CRP levels, height-adjusted total kidney volume (htTKV), rate of hypertension (HT) differed significantly across different GFR stages in ADPKD. T cell phenotyping revealed significantly elevated CD3+ T cells, CD4+, CD8+, double-negative, and double-positive subsets and significantly elevated IFN-γ and TNF-α producing subsets of CD4+, CD8+ cells. The expression of checkpoint inhibitors CTLA-4, PD-1, and TIGIT by T cell subsets was also increased to various extent. Additionally, Treg cell numbers and suppressive markers CTLA-4, PD-1, and TIGIT were significantly elevated in ADPKD patients' PB. Treg CTLA4 expression and CD4CD8DP T cell frequency in patients with HT were significantly higher. Lastly, HT and increased htTKV and higher frequency of PD1+ CD8SP were found to be risk factors for rapid disease progression. Our data provide the first detailed analyses of checkpoint inhibitor expression by PB T cell subsets during stages of ADPKD, and that a higher frequency of PD1+ CD8SP cells is associated with rapid disease progression.
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Affiliation(s)
- Ali Sahin
- Division of Nephrology, Department of Internal Medicine, Erciyes University School of Medicine, 38030, Kayseri, Turkey
| | - Ismail Kocyigit
- Division of Nephrology, Department of Internal Medicine, Erciyes University School of Medicine, 38030, Kayseri, Turkey.
| | - Kubra Aslan
- Department of Medical Biology, Erciyes University School of Medicine, 38030, Kayseri, Turkey
- Betul Ziya Eren Genome and Stem Cell Center, Kayseri, Turkey
| | - Eray Eroglu
- Department of Nephrology, Kilis State Hospital, Kilis, Turkey
| | - Alparslan Demiray
- Division of Nephrology, Department of Internal Medicine, Erciyes University School of Medicine, 38030, Kayseri, Turkey
| | - Ahmet Eken
- Department of Medical Biology, Erciyes University School of Medicine, 38030, Kayseri, Turkey.
- Betul Ziya Eren Genome and Stem Cell Center, Kayseri, Turkey.
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Uysal C, Ketenci Ertas S, Civan M, Akgun H, Kocyigit I. Pauci-immune crescentic glomerulonephritis caused to dilemma in a patient with suspected systemic lupus erythematosus: a case report. CEN Case Rep 2023:10.1007/s13730-023-00825-3. [PMID: 37837535 DOI: 10.1007/s13730-023-00825-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 09/13/2023] [Indexed: 10/16/2023] Open
Abstract
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease and there is a distinct differentiation of clinical manifestations. Lupus nephritis (LN) is clinically apparent in approximately half of patients. A kidney biopsy is essential to define the kidney injury, exclude other injurious causes, and determine the histopathologic subtypes. Autoantibodies are crucial to the pathogenesis and the deposition of immune complexes in glomeruli is a hallmark of LN. The histopathology of LN is quite varied. Despite pauci-immune LN being an unexpected condition in SLE, it has been observed rarely with the presence of antineutrophil cytoplasmic autoantibodies (ANCA). We present a young male who was admitted to the emergency with syncope. The brain imaging revealed small infarct areas and signs of cerebral vasculitis. Also, he had elevated inflammatory markers, moderate proteinuria, and preserved kidney function. Anti-nuclear antibodies and anti-dsDNA were positive. Pauci-immune crescentic glomerulonephritis (PICGN) was observed in a kidney biopsy, however, ANCA was negative. SLE diagnosis was established by neurological manifestation, specific antibodies, proteinuria, and kidney biopsy findings. We administered a combination induction regimen, including pulse steroid and parenteral cyclophosphamide. The proteinuria was resolved in the follow-up. Our case highlights that SLE-associated ANCA-negative PICGN can be the initial presentation in the absence of typical manifestations. LN exhibits various pathological mechanisms in the kidney. As a consequence, SLE should be considered in the differential diagnosis of all forms of kidney injury.
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Affiliation(s)
- Cihan Uysal
- Department of Nephrology, Erciyes University School of Medicine, Dede Efendi Street, Köşk District, Melikgazi, 38030, Kayseri, Turkey.
| | | | - Merve Civan
- Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey
| | - Hulya Akgun
- Department of Pathology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Ismail Kocyigit
- Department of Nephrology, Erciyes University School of Medicine, Dede Efendi Street, Köşk District, Melikgazi, 38030, Kayseri, Turkey
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Koyuncu S, Sipahioglu H, Bol O, İlik HKZ, Dilci A, Elmaağaç M, Yalçınkaya M, Gencer V, Ozan F, Günal Aİ, Kocyigit I. The Evaluation of Different Treatment Approaches in Patients With Earthquake-Related Crush Syndrome. Cureus 2023; 15:e47194. [PMID: 37854473 PMCID: PMC10580897 DOI: 10.7759/cureus.47194] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND On February 6, 2023, an earthquake occurred in Kahramanmaras, Turkey, resulting in loss of life, injuries, and the displacement of thousands of people. The aim of this study is to determine the factors affecting amputation and fasciotomy decisions in patients with crush syndrome, along with clinical laboratory parameters. MATERIALS AND METHODS The study included patients over 18 years of age who presented with crush injuries and exhibited systemic symptoms. Inclusion criteria comprised patients with creatine kinase (CK) levels exceeding 1,000 IU/L, oliguria (urine output less than 400 mL per day), elevated blood urea nitrogen (BUN) levels surpassing 40 mg/dL, serum creatinine exceeding 1.5 mg/dL, potassium levels over 6 mEq/L, phosphorus levels surpassing 8 mg/dL, and serum calcium levels below 8 mg/dL. Multiple parameters were evaluated, including blood glucose, serum sodium, potassium, calcium, phosphorus, BUN, creatinine, uric acid, CK, albumin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, direct bilirubin, prothrombin time (international normalized ratio (INR)), urinalysis, C-reactive protein (CRP), venous blood gas, ECG, and chest radiography. RESULTS Following the Maraş earthquake, a total of 3,184 patients were admitted to our hospital within the first seven days. Out of these patients, 2,216 received outpatient treatment, 639 were hospitalized in the general ward, and 128 were admitted to the intensive care unit. Among the admitted patients, 237 were diagnosed with crush syndrome, with 126 being male and 111 being female. The average duration of being trapped under debris was eight hours, ranging from four to 36 hours. In the study population, extremity trauma was observed in 84 patients, thoracic trauma in 32 patients, and abdominal trauma in 20 patients. Erythrocyte replacement was administered to 123 patients, while fresh frozen plasma was given to 69 patients, for a total of 1008 units utilized. Mannitol infusions were provided to 58 patients, while bicarbonate infusions were administered to 116 patients. Among the cohort, 71 patients underwent dialysis, with nine of them receiving hemodialysis along with mannitol. Additionally, 67 patients experienced stage 3 acute kidney injury, and 41 patients were deceased. None of the patients required permanent hemodialysis. CONCLUSION Earthquakes are considered to be one of nature's most significant and inevitable disasters. While it is impossible to prevent them, effective management strategies are crucial in mitigating the ensuing chaos and reducing casualties. In order to achieve this, it is imperative to draw lessons from past seismic events and apply appropriate treatment protocols to the affected individuals.
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Affiliation(s)
| | - Hilal Sipahioglu
- Internal Medicine, Kayseri City Training and Research Hospital, Kayseri, TUR
| | - Oğuzhan Bol
- Emergency Medicine, University of Health Sciences, Kayseri City Hospital, Kayseri, TUR
| | | | - Aslıhan Dilci
- Internal Medicine, Kayseri City Hospital, Kayseri, TUR
| | | | | | - Vedat Gencer
- Internal Medicine, Kayseri City Hospital, Kayseri, TUR
| | - Fırat Ozan
- Orthopaedics, Kayseri City Hospital, Kayseri, TUR
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Aydin Z, Yilmaz M, Sipahioglu M, Dervisoglu E, Aydemir N, Uzun S, Istemihan Z, Unsal O, Tatar E, Berktas HB, Ozdemir A, Sumnu A, Kumru G, Cetinkaya H, Kazan S, Kocyigit I, Gokalp C, Hasbal B, Artan AS, Ozelsancak R, Taymez D, Yadigar S, Alagoz S, Aslan BB, Yaylaci S, Jabrayilov J, Turgutalp K, Dursun B, Sahin G. Demographic, clinical and laboratory characteristics of adult-onset minimal change disease in Turkey: Turkish Society of Nephrology-Glomerular Diseases (TSN-GOLD) Working Group. Int Urol Nephrol 2023; 55:975-982. [PMID: 36178610 DOI: 10.1007/s11255-022-03382-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 09/24/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE In our study, diagnostic and demographic characteristics of patients diagnosed with minimal change disease (MCD) by biopsy, clinical and laboratory findings in our country were investigated. METHODS Data were obtained from the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) Working Group database. Demographic characteristics, indications for biopsy, diagnosis of the glomerular diseases, comorbidities, laboratory and biopsy findings of all patients were recorded. The data presented are cross-sectional and includes application data for the biopsy period. RESULTS Of 3875 patients, 233 patients with MCD (median age 35.0 years) were included in the study, which constitutes 6.0% of the total glomerulonephritis database. Renal biopsy was performed in 196 (84.1%) patients due to nephrotic syndrome. Median serum creatinine was 0.7 (0.6-1.0) mg/dl, mean eGFR was 104 ± 33 ml/min/1.73 m2 and median proteinuria 6000 mg/day. The number of patients under the age of 40 years was 139 (59.7%) (Group A), and the number of patients aged 40 years and over was 94 (40.3%) (Group B). Compared to Group A, global sclerotic glomeruli (24 vs. 43, p < 0.001) interstitial inflammation (15 vs. 34, p < 0.001), interstitial fibrosis (20 vs. 31, p = 0.001, vascular changes (10 vs. 25, p < 0.001) and tubular atrophy (18 vs. 30, p < 0.001) were found to be significantly higher in Group B. There was no difference in immunofluorescent staining properties between the two groups. CONCLUSION Our data are generally compatible with the literature. Chronic histopathological changes were more common in patients aged 40 years and older than younger patients. Studies investigating the effects of these different features on renal survival are needed.
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Affiliation(s)
- Zeki Aydin
- Department of Nephrology, Darica Farabi Training and Research Hospital, University of Health Sciences, Fevziçakmak, Dr. Zeki Acar Ave. No: 62, 4170, Darica, Kocaeli, Turkey.
| | - Murvet Yilmaz
- Department of Nephrology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Murat Sipahioglu
- Division of Nephrology, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey
| | - Erkan Dervisoglu
- Division of Nephrology, Department of Internal Medicine, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Nihal Aydemir
- Department of Nephrology, Ankara Numune Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Sami Uzun
- Department of Nephrology, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Zulal Istemihan
- Division of Nephrology, Department of Internal Medicine, Istanbul University School of Medicine, Istanbul, Turkey
| | - Oktay Unsal
- Division of Nephrology, Department of Internal Medicine, Uludag University School of Medicine, Bursa, Turkey
| | - Erhan Tatar
- Department of Nephrology, Bozyaka Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Haci Bayram Berktas
- Division of Nephrology, Department of Internal Medicine, Inonu University School of Medicine, Malatya, Turkey
| | - Arzu Ozdemir
- Department of Nephrology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Abdullah Sumnu
- Department of Nephrology, Medipol University School of Medicine, Istanbul, Turkey
| | - Gizem Kumru
- Division of Nephrology, Department of Internal Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Hakki Cetinkaya
- Department of Nephrology, Sultan Abdülhamid Han Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Sinan Kazan
- Department of Nephrology, Afyonkarahisar School of Medicine, University of Health Sciences, Afyonkarahisar, Turkey
| | - Ismail Kocyigit
- Division of Nephrology, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey
| | - Cenk Gokalp
- Division of Nephrology, Department of Internal Medicine, Trakya University School of Medicine, Edirne, Turkey
| | - Baris Hasbal
- Department of Nephrology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ayse Serra Artan
- Division of Nephrology, Department of Internal Medicine, Bezm-I Alem Vakif University School of Medicine, Istanbul, Turkey
| | - Ruya Ozelsancak
- Division of Nephrology, Department of Internal Medicine, Cukurova University School of Medicine, Adana, Turkey
| | - Dilek Taymez
- Department of Nephrology, Kocaeli State Hospital, Kocaeli, Turkey
| | - Serap Yadigar
- Department of Nephrology, Dr. Lutfi Kırdar Kartal Training and Research Hospital, Istanbul, Turkey
| | - Selma Alagoz
- Division of Nephrology, Department of Internal Medicine, Istanbul Cerrahpasa University School of Medicine, Istanbul, Turkey
| | - Bilal Burcak Aslan
- Department of Nephrology, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Selcuk Yaylaci
- Division of Nephrology, Department of Internal Medicine, Sakarya University School of Medicine, Sakarya, Turkey
| | - Jabrayil Jabrayilov
- Division of Nephrology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Kenan Turgutalp
- Division of Nephrology, Department of Internal Medicine, Mersin University School of Medicine, Mersin, Turkey
| | - Belda Dursun
- Division of Nephrology, Department of Internal Medicine, Pamukkale University School of Medicine, Denizli, Turkey
| | - Garip Sahin
- Division of Nephrology, Department of Internal Medicine, Osmangazi University School of Medicine, Eskisehir, Turkey
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Yildiz A, Ulu S, Oruc A, Ucar AR, Ozturk S, Alagoz S, Eren N, Kocyigit I, Koksal Cevher S, Haras AB, Sumnu A, Arinsoy T, Sahin G, Suleymanlar G, Cavdar C, Kumru Sahin G, Kurultak I, Unsal A, Sahin G, Kazan S, Tatar E, Dıkec M, Dursun B, Sayarlioglu H, Turkmen K, Artan AS, Aktas N, Yilmaz Z, Behlul A, Dheir H, Kutlay S, Seyahi N. Clinical and pathologic features of primary membranous nephropathy in Turkey: a multicenter study by the Turkish Society of Nephrology Glomerular Diseases Working Group. Ren Fail 2022; 44:1048-1059. [PMID: 35786180 PMCID: PMC9258435 DOI: 10.1080/0886022x.2022.2079526] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background We aimed to evaluate the features of primary membranous nephropathy (MNP) in Turkish people. Methods This is a retrospective analysis of patients with biopsy-proven primary MNP. We obtained the data collected between 2009 and 2019 in the primary glomerulonephritis registry of the Turkish Society of Nephrology Glomerular Diseases Study Group (TSN-GOLD). Patients with a secondary cause for MNP were excluded. Clinical, demographic, laboratory, and histopathological findings were analyzed. Results A total of 995 patients with primary MNP were included in the analyses. Males constituted the majority (58.8%). The mean age was 48.4 ± 13.9 years. The most common presentation was the presence of nephrotic syndrome (81.7%) and sub nephrotic proteinuria (10.3%). Microscopic hematuria was detected in one-third of patients. The median estimated glomerular filtration rate (eGFR) was 100.6 mL/min/1.73 m2 (IQR, 75.4–116.3), and median proteinuria was 6000 mg/d (IQR, 3656–9457). Serum C3 and C4 complement levels were decreased in 3.7 and 1.7% of patients, respectively. Twenty-four (2.4%) patients had glomerular crescents in their kidney biopsy samples. Basal membrane thickening was detected in 93.8% of cases under light microscopy. Mesangial proliferation and interstitial inflammation were evident in 32.8 and 55.9% of the patients, respectively. The most commonly detected depositions were IgG (93%), C3 complement (68.8%), and kappa and lambda immunoglobulin light chains (70%). Although renal functions were normal at presentation, vascular, interstitial, and glomerular findings were more prominent on biopsy in hypertensive patients. No significant effect of BMI on biopsy findings was observed. Conclusions Despite some atypical findings, the main features of primary MNP in Turkey were similar to the published literature. This is the largest MNP study to date conducted in Turkish people.
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Affiliation(s)
| | - Sena Ulu
- Department of Nephrology, Med Fac, Afyon Kocatepe Univ, Afyon, Turkey
| | - Aysegul Oruc
- Department of Nephrology, Med Fac, Uludag Univ, Bursa, Turkey
| | - Ali Riza Ucar
- Department of Nephrology, Istanbul Fac Med, Istanbul Univ, Istanbul, Turkey
| | - Savas Ozturk
- Department of Nephrology, Haseki Training and Res Hosp, Istanbul, Turkey
| | - Selma Alagoz
- Department of Nephrology, Cerrahpasa Med Fac, Istanbul Univ, Istanbul, Turkey
| | - Necmi Eren
- Department of Nephrology, Med Fac, Kocaeli Univ, Kocaeli, Turkey
| | - Ismail Kocyigit
- Department of Nephrology, Med Fac, Erciyes Univ, Kayseri, Turkey
| | - Simal Koksal Cevher
- Department of Nephrology, Ankara Numune Training and Res Hosp, Ankara, Turkey
| | - Ali Burak Haras
- Department of Nephrology, Dr Lutfi Kirdar Kartal Training and Res Hosp, Istanbul, Turkey
| | - Abdullah Sumnu
- Department of Nephrology, Med Fac, Medipol Univ, Istanbul, Turkey
| | - Turgay Arinsoy
- Department of Nephrology, Med Fac, Gazi Univ, Ankara, Turkey
| | - Garip Sahin
- Department of Nephrology, Med Fac, Eskisehir Osmangazi Univ, Eskisehir, Turkey
| | | | - Caner Cavdar
- Department of Nephrology, Med Fac, Dokuz Eylul Univ, Izmir, Turkey
| | | | - Ilhan Kurultak
- Department of Nephrology, Med Fac, Trakya Univ, Edirne, Turkey
| | - Abdulkadir Unsal
- Department of Nephrology, Hamidiye Sisli Etfal Training and Res Hosp, Istanbul, Turkey
| | - Gulizar Sahin
- Department of Nephrology, Sultan Abdulhamit Han Res and Training Hosp, Istanbul, Turkey
| | - Sinan Kazan
- Department of Nephrology, Med Fac, Afyon Kocatepe Univ, Afyon, Turkey
| | - Erhan Tatar
- Department of Nephrology, Bozyaka Training & Res Hosp, Izmir, Turkey
| | - Mehmet Dıkec
- Department of Nephrology, Bakirkoy Sadi Konuk Training and Res Hosp, Istanbul, Turkey
| | - Belda Dursun
- Department of Nephrology, Med Fac, Pamukkale Univ, Denizli, Turkey
| | | | - Kultigin Turkmen
- Department of Nephrology, Meram Med Fac, Necmettin Erbakan Univ, Konya, Turkey
| | - Ayse Serra Artan
- Department of Nephrology, Med Fac, Bezmialem Vakif Univ, Istanbul, Turkey
| | - Nimet Aktas
- Department of Nephrology, Med Fac, Bezmialem Vakif Univ, Istanbul, Turkey
| | - Zulfikar Yilmaz
- Department of Nephrology, Med Fac, Dicle Univ, Diyarbakir, Turkey
| | - Ahmet Behlul
- Department of Nephrology, Burhan Nalbantoglu State Hosp, Nicosia, Cyprus
| | - Hamad Dheir
- Department of Nephrology, Med Fac, Sakarya Univ, Sakarya, Turkey
| | - Sim Kutlay
- Med Fac, Ibni Sina Hosp, Ankara Univ, Ankara, Turkey
| | - Nurhan Seyahi
- Department of Nephrology, Cerrahpasa Med Fac, Istanbul Univ, Istanbul, Turkey
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7
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Kocyigit I, Taheri S, Uysal C, Memis M, Ozayturk SG, Zararsiz G, Rassoulzadegan M. Predicting Progression of Autosomal Dominant Polycystic Kidney Disease by Changes in the Telomeric Epigenome. Cells 2022; 11:cells11203300. [PMID: 36291168 PMCID: PMC9600909 DOI: 10.3390/cells11203300] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/15/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited cause of chronic kidney disease with Polycystin (PKD) 1 and 2 gene mutation. However, the intra-familial variability in symptoms further suggests a non-Mendelian contribution to the disease. Our goal was to find a marker to track the epigenetic changes common to rapidly progressing forms of the disease. The risk of ADPKD increases with age, and aging shortens the telomere length (TL). Telomeres are a nucleoprotein structure composed mainly of three complexes, shelterin, CST and RNA-containing telomere repeat(TERRA), which protects the ends of chromosomes from degradation and fusion, and plays a role in maintaining cellular stability and in the repair of telomeric damage. TERRAs are transcribed from telomeric regions and a part of them is engaged in a DNA/RNA hybrid (R-loop) at each chromosome end. We tracked TL and TERRA levels in blood samples of 78 patients and 20 healthy control. Our study demonstrates that TL was shortened and TERRA expression levels in the DNA-attached fraction increased in autosomal dominant polycystic kidney patients with mutations in PKD1 and PKD2 compared to the control group. Moreover, it was observed that the expression of TERRA engaged in the R-loop was higher and the length of telomeres shorter in patients with ADPKD who showed rapid disease progression. Intrafamilial variation in TL and TERRA levels with the same mutation would indicate reliable epigenetic potential biomarkers in disease monitoring.
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Affiliation(s)
- Ismail Kocyigit
- Department of Nephrology, Medical School, Erciyes University, 38280 Kayseri, Turkey
- Correspondence:
| | - Serpil Taheri
- Betul Ziya Eren Genome and Stem Cell Center, Erciyes University, 38280 Kayseri, Turkey
- Department of Medical Biology, Medical School, Erciyes University, 38280 Kayseri, Turkey
| | - Cihan Uysal
- Department of Nephrology, Medical School, Erciyes University, 38280 Kayseri, Turkey
| | - Mehmet Memis
- Betul Ziya Eren Genome and Stem Cell Center, Erciyes University, 38280 Kayseri, Turkey
| | - Salih Guntug Ozayturk
- Department of Internal Medicine, Medical School, Erciyes University, 38280 Kayseri, Turkey
| | - Gokmen Zararsiz
- Department of Biostatistics, Medical School, Erciyes University, 38280 Kayseri, Turkey
| | - Minoo Rassoulzadegan
- Betul Ziya Eren Genome and Stem Cell Center, Erciyes University, 38280 Kayseri, Turkey
- INSERM-CNRS, Université de Nice, 06107 Nice, France
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8
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Gursu M, Yegenaga I, Tuglular S, Dursun B, Bek SG, Bardak S, Onan E, Demir S, Derici U, Dogukan A, Sevinc M, Kocyigit I, Altun E, Haras AB, Altiparmak MR, Tonbul HZ. Acute kidney injury in Turkey: epidemiological characteristics, etiology, clinical course, and prognosis. BMC Nephrol 2022; 23:326. [PMID: 36199011 PMCID: PMC9533605 DOI: 10.1186/s12882-022-02933-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 09/02/2022] [Indexed: 11/11/2022] Open
Abstract
Background This study aimed to evaluate the etiologies, comorbidities, and outcomes of acute kidney injury (AKI) in Turkey and determine any potential differences among different geographical parts of the country. Methods This prospective observational study was conducted by the Acute Kidney Injury Working Group of the Turkish Society of Nephrology. Demographical and clinical data of patients with AKI at the time of diagnosis and at the 1st week and 1st, 3rd, and 6th months of diagnosis were evaluated to determine patient and renal survival and factors associated with patient prognosis. Results A total of 776 patients were included (54.7% male, median age: 67 years). Prerenal etiologies, including dehydration, heart failure, and sepsis, were more frequent than other etiologies. 58.9% of the patients had at least one renal etiology, with nephrotoxic agent exposure as the most common etiology. The etiologic factors were mostly similar throughout the country. 33.6% of the patients needed kidney replacement therapy. At the 6th month of diagnosis, 29.5% of the patients had complete recovery; 34.1% had partial recovery; 9.5% developed end-stage kidney disease; and 24.1% died. The mortality rate was higher in the patients from the Eastern Anatolian region; those admitted to the intensive care unit; those with prerenal, renal, and postrenal etiologies together, stage 3 AKI, sepsis, cirrhosis, heart failure, and malignancy; those who need kidney replacement therapy; and those without chronic kidney disease than in the other patients. Conclusion Physicians managing patients with AKI should be alert against dehydration, heart failure, sepsis, and nephrotoxic agent exposure. Understanding the characteristics and outcomes of patients with AKI in their countries would help prevent AKI and improve treatment strategies.
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Affiliation(s)
- Meltem Gursu
- Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Bezmialem Vakıf University, Istanbul, Turkey.
| | - Itir Yegenaga
- Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Maltepe University, Istanbul, Turkey
| | - Serhan Tuglular
- Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Marmara University, Pendik Training and Research Hospital, Istanbul, Turkey
| | - Belda Dursun
- Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Pamukkale University, Denizli, Turkey
| | - Sibel Gokcay Bek
- Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Kocaeli University, Kocaeli, Turkey
| | - Simge Bardak
- Department of Internal Medicine, Division of Nephrology, Batman State Hospital, Batman, Turkey
| | - Engin Onan
- Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Cukurova University, Adana, Turkey
| | - Serap Demir
- Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Mersin University, Mersin, Turkey
| | - Ulver Derici
- Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Gazi University, Ankara, Turkey
| | - Ayhan Dogukan
- Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Firat University, Elazig, Turkey
| | - Mustafa Sevinc
- Department of Internal Medicine, Division of Nephrology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Ismail Kocyigit
- Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Erciyes University, Kayseri, Turkey
| | - Eda Altun
- Department of Internal Medicine, Division of Nephrology, Golcuk State Hospital, Kocaeli, Turkey
| | - Ali Burak Haras
- Department of Internal Medicine, Division of Nephrology, University of Health Sciences, Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
| | - Mehmet Riza Altiparmak
- Cerrahpasa Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Halil Zeki Tonbul
- Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Meram University, Konya, Turkey
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9
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Kocyigit I, Seyahi N, Ates K, Suleymanlar G. The Turkish Society of Nephrology 2020 Registry: COVID-19 Report. Turk J Nephrol 2022. [DOI: 10.5152/turkjnephrol.2022.22312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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10
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Dogan E, Eren N, Gül Özcan Ş, Altunoren O, Gungor O, Dheir H, Tanrisev M, Kocyigit H, ülmecit Yıldız A, Kocyigit I, Seyahi N, Tatar E. MO013: Relationship between Disease Awareness and Severity of Kidney Disease in Autosomal Dominant Polycystic Kidney Disease Patients. Nephrol Dial Transplant 2022; 37. [DOI: 10.1093/ndt/gfac061.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
Abstract
BACKGROUND AND AIMS
Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease with diffuse cysts in both kidneys and is responsible for 5–10% of end-stage renal disease Levy and Feingold (Estimating prevalence in single-gene kidney diseases progressing to renal failure. Kidney Int. 2000;58(3):925). Recently, tolvaptan, which can improve kidney survival, was approved for the management of the disease (Drug Approval Package: Jynarque (tolvaptan) Otsuka Pharmaceutical Development & Commercialization, Inc. application Number: 204 441, Approval Date: 04/23/2018). We examined the relationship between renal and extrarenal findings, disease severity and the level of consciousness of patients with ADPKD patients.
METHOD
About 516 patients who applied to nephrology clinics of seven different centers in Turkey were asked to answer the questionnaire about ADPKD that consisted of 38 questions. Disease severity was determined according to e-GFR, and disease awareness was assessed on a four-point scale by adapting the Disease Perception Scale to ADPKD. Awareness of patients was evaluated comparatively with chronic kidney disease stage, age, region and symptoms.
RESULTS
One out of five patients does not know that this disease is inherited. Mean awareness scores of the patients decreased significantly with increasing age. The average awareness score of the Central Anatolia region was significantly higher compared to other regions. Awareness scores were significantly higher in patients with flank pain and urinary tract stones.
CONCLUSION
To the best of our knowledge, this is the first study about ADPKD awareness. Although ADPKD is the most common hereditary kidney disease, the rate of patients’ knowledge on this subject is low. Awareness levels may vary according to age, regional differences or symptoms. Increased awareness might lead to better treatment and improved survival in those patients.
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Affiliation(s)
- Ege Dogan
- Department of Internal Medicine, University of Health Science, Bozyaka Education and Research Hospital, Izmir Faculty of Medicine, Izmir, Turkey
| | - Necmi Eren
- Division of Nephrology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Şeyda Gül Özcan
- Istanbul University-Cerrahpasa, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Orcun Altunoren
- Department of Nephrology, Kahramanmaraş Sütçü İmam University, Turkey
| | - Ozkan Gungor
- Department of Nephrology, Kahramanmaraş Sütçü İmam University, Turkey
| | - Hamad Dheir
- Department of Nephrology, Sakarya University, Turkey
| | - Mehmet Tanrisev
- Department of Nephrology, University of Health Science, Izmir Faculty of Medicine, Tepecik Education and Research Hospital, Turkey
| | - Hafsa Kocyigit
- Department of Internal Medicine, Erciyes University, Turkey
| | | | | | - Nurhan Seyahi
- Department of Nephrology, Istanbul University-Cerrahpasa, Turkey
| | - Erhan Tatar
- Department of Nephrology, University of Health Science, Bozyaka Education and Research Hospital, Izmir Faculty of Medicine, Turkey
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Gül Özcan Ş, Bek S, Eren N, Atli Z, Yıldız A, Kocyigit I, Cavdar C, Seyahi N, Ecder T, Waldreus N. MO014: Development and Validation of the Thirst Distress Scale for Patients with Autosomal Dominant Polycystic Kidney Disease. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac061.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Abundant water intake is advised for patients with autosomal dominant polycystic kidney disease (ADPKD) Meijer and Casteleijn (Riding the waves: evidence for a beneficial effect of increased water intake in autosomal dominant polycystic kidney disease patients? Nephrol Dialysis Transpl. 2014;29(9):1615–1617). Thirst, which can be defined as a sensation of dryness in the mouth and throat associated with a desire for liquids, is the main driver for fluid consumption Fitzsimons (Thirst. Physiol Rev 1972;52(2):468–561). However, daily routines may limit water intake. There is no established tool to quantify the drivers of water intake in ADPKD patients. In this study, it was aimed to develop and validate a thirst distress scale (TDS) to quantify the factors of water intake in ADPKD patients.
METHOD
The TDS-heart failure questionnaire was first (i) translated to Turkish using the approach recommended by the guidelines of the World Health Organization and finally (ii) modified to adapt to patients with ADPKD with totally 12 questions assessing (a) what may affect water intake, (b) what limit water intake and (c) what disturbing effects thirst may have on quality of life. The guidelines of the World Health Organization were used to translate the questionnaire to Turkish. An electronic survey with SurveyMonkey platform was used to collect data on thirst with TDS-PKD and thirst intensity (visual analog scale, VAS). Internal consistency of the TDS-PKD was evaluated with Cronbach’s alpha. Exploratory factor analysis was conducted to reveal the validity and the factor structure of the questions in the questionnaire.
RESULTS
The questionnaire was filled in by 154 ADPKD patients, of which 116 were on tolvaptan therapy. The time taken to answer the questions was about 4 min. The TDS-PKD questionnaire showed good internal consistency with a Cronbach's alpha value of 0.867. According to the exploratory factor analysis, a three-factor structure was obtained, meaning that there are three constructs about thirst in the TDS-PKD. Three factors explained 62.57% of the total variance. Factor one consisted of questions 1–7, factor two 8–10 and factor three 11–12. All three factors were significantly associated with thirst intensity (r = 0.505, r = 0.244 and r = 197, respectively). The average score of TDS-PDK was 40.2 ± 10.5, and the average VAS score was 8.5 ± 0.7.
CONCLUSION
The TDS-PKD questionnaire is a valid and reliable tool for evaluating the thirst distress in ADPKD patients.
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Affiliation(s)
- Şeyda Gül Özcan
- Cerrahpasa Medical Faculty, Internal Medicine, Istanbul, Turkey
| | - Sibel Bek
- Kocaeli Medical Faculty, Nephrology, Turkey
| | - Necmi Eren
- Kocaeli Medical Faculty, Nephrology, Turkey
| | - Zeynep Atli
- Account and Tax Application, Sinop University, Istanbul, Turkey
| | | | | | - Caner Cavdar
- Dokuz Eylul Medical Faculty, Nephrology, Istanbul, Turkey
| | - Nurhan Seyahi
- İstanbul Üniversitesi-Cerrahpaşa Cerrahpaşa Tıp Fakültesi, Nephrology, Istanbul, Turkey
| | - Tevfik Ecder
- Demiroglu Bilim Medical Faculty, Nephrology, Istanbul, Turkey
| | - Nana Waldreus
- Karolinska Institutet, Neurobiology, Care Sciences and Society, Sweden
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Seyahi N, Kocyigit I, Ates K, Suleymanlar G. Current Status of Renal Replacement Therapy in Turkey: A Summary of 2020 Turkish Society of Nephrology Registry Report. Turk J Nephrol 2022. [DOI: 10.5152/turkjnephrol.2022.22308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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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13
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Koyuncu S, Gundogdu A, Uysal C, Kocyigit I, Sipahioglu M, Oymak O, Tokgoz B. Analysis of the Factors Affecting the Reasons of Transition From Peritoneal Dialysis to Hemodialysis. Turk J Nephrol 2021. [DOI: 10.5152/turkjnephrol.2021.4654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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14
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Koyuncu S, Tutus B, Akgun H, Kocyigit I, Sipahioglu M, Oymak O, Tokgoz B. Severe Complication of Iatrogenic Sodium Phosphate Enema Overdose: Acute Kidney Injury. Turk J Nephrol 2021. [DOI: 10.5152/turkjnephrol.2021.4755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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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15
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Koyuncu S, Solak EO, Karakukcu C, Gundogdu A, Uysal C, Zararsız G, Kocyigit I, Sipahioğlu MH, Oymak O, Borlu M, Tokgoz B. Evaluation of the causes affecting the development of pruritus in patients with peritoneal dialysis. Int Urol Nephrol 2021; 54:619-625. [PMID: 34213714 DOI: 10.1007/s11255-021-02929-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 06/15/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Several factors play a role in the pathogenesis of pruritus in uremic patients. The pathophysiology is complex and many factors have been identified in these patients. The aim of this study was to investigate the presence, severity, and possible causes of pruritus in patients with peritoneal dialysis (PD) . METHODS Eighty patients, who received continuous ambulatory peritoneal dialysis (CAPD) treatment, were included in this study. Biochemical measurements, parathormone, C-reactive protein (CRP), and vitamin B12 levels of all the patients were recorded. Furthermore, substance P (SP) levels were measured by ELISA methods. Patients were examined by a dermatologist and pruritus degrees were queried using the visual analog score (VAS) with skin dryness. RESULTS In generalized linear model analysis, total urea clearance and SP independently predicted VAS scores. SP was significantly predictive in ROC analysis in identifying the VAS score in patients with peritoneal dialysis. The sensitivity and specificity of SP were 80% and 67% (cut-off > 364), respectively, with an area under the ROC curve of 0.757 (95% CI 0.650-0.865, p < 0.001). SP also was significantly predictive in ROC analysis in identifying xerosis in PD patients. CONCLUSION Pruritus was proportional to the amount of substance P and total urea clearance was another reason affecting pruritus in peritoneal dialysis patients.
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Affiliation(s)
- Sumeyra Koyuncu
- Department of Nephrology, Erciyes Medical Faculty, Kayseri, Turkey.
| | - Eda Oksum Solak
- Department of Dermatology, Erciyes Medical Faculty, Kayseri, Turkey
| | - Cigdem Karakukcu
- Departments of Biochemistry, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Ali Gundogdu
- Department of Nephrology, Erciyes Medical Faculty, Kayseri, Turkey
| | - Cihan Uysal
- Department of Nephrology, Erciyes Medical Faculty, Kayseri, Turkey
| | - Gökmen Zararsız
- Department of Nephrology, Erciyes Medical Faculty, Kayseri, Turkey
- Department of Dermatology, Erciyes Medical Faculty, Kayseri, Turkey
- Departments of Biochemistry, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Ismail Kocyigit
- Department of Nephrology, Erciyes Medical Faculty, Kayseri, Turkey
| | | | - Oktay Oymak
- Department of Nephrology, Erciyes Medical Faculty, Kayseri, Turkey
| | - Murat Borlu
- Department of Dermatology, Erciyes Medical Faculty, Kayseri, Turkey
| | - Bulent Tokgoz
- Department of Nephrology, Erciyes Medical Faculty, Kayseri, Turkey
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16
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Koyuncu S, Herdem N, Uysal C, Kahriman G, Kocyigit I, Sipahioğlu M, Tokgoz B, Oymak O. A rare complication following internal jugular vein catheterization to malposition: acute Budd Chiari syndrome. BMC Nephrol 2020; 21:525. [PMID: 33272229 PMCID: PMC7713328 DOI: 10.1186/s12882-020-02182-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 11/23/2020] [Indexed: 08/30/2023] Open
Abstract
Background Tunneled catheters can be used as an alternative vascular access in patients with limited health expectancy,vascular access problems and several comorbidities. We aimed to present a patient with venous stenosis related- reversible acute Budd-Chiari syndrome after catheter malposition. Case presentation After changing of tunneled catheter insertion, 36-year old man was admitted to our hospital with sudden onset of nausea, fever, chills and worsening general condition In computed tomography (CT) imaging, a hypodense thrombus was observed in which the distal end of the catheter is at the level of drainage of the hepatic veins in the inferior vena cava and that blocked hepatic vein drainage around the catheter. The catheter was removed and a new catheter was inserted in the same session. Because patient’s general condition was good and without fever, he was discharged with advices on the 9th day of hospitalization. Conclusion Although catheter malposition and thrombosis are not a common complication, clinicians should be alert of these complications.
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Affiliation(s)
- Sumeyra Koyuncu
- Department of Internal Medicine, Division of Nephrology, Erciyes University School of Medicine, Kayseri, Turkey.
| | - Nevzat Herdem
- Department of Radiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Cihan Uysal
- Department of Internal Medicine, Division of Nephrology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Guven Kahriman
- Department of Radiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Ismail Kocyigit
- Department of Internal Medicine, Division of Nephrology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Murat Sipahioğlu
- Department of Internal Medicine, Division of Nephrology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Bulent Tokgoz
- Department of Internal Medicine, Division of Nephrology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Oktay Oymak
- Department of Internal Medicine, Division of Nephrology, Erciyes University School of Medicine, Kayseri, Turkey
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Eroglu E, Kocyigit I, Kahriman G, Karakukcu C, Tuncay A, Zararsiz GE, Eren D, Kalay N, Sipahioglu MH, Oymak O, Tokgoz B. Soluble vascular endothelial growth factor receptor-1 as a novel marker of arteriovenous fistula stenosis in hemodialysis patients. Hemodial Int 2020; 25:164-172. [PMID: 33155365 DOI: 10.1111/hdi.12903] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 10/13/2020] [Accepted: 10/20/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Arteriovenous fistula (AVF) stenosis is one of the most important clinical problems in hemodialysis patients. The histopathological findings of neointimal hyperplasia and impaired angiogenesis have been well established in stenotic AVFs. Soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) has been implicated in pathological angiogenesis. Thus, we aimed to investigate the association between sVEGFR-1 and AVF stenosis in hemodialysis patients. METHODS This prospective cohort study included 70 patients with end-stage renal disease. Forty-five patients were included in the final analysis, and the median follow-up period was 36 months. Venous stenosis was detected by physical examination and documented by fistulography. Blood samples were analyzed a day before the fistula operation, and serum levels of sVEGFR-1 were measured. FINDINGS The median sVEGFR-1 level was higher in the stenosis group than in the nonstenosis group (17 pg/mL [89.5%] vs. 5 pg/mL [19.2%], respectively; P < 0.001]. According to body mass index (BMI) categories, obese patients (BMI > 30 kg/m2 ) had the shortest stenosis-free survival (20 months [9.35-30.65]). Multivariate Cox analysis showed that sVEGFR-1, serum creatinine, and parathyroid hormone levels were associated with AVF stenosis risk. Kaplan-Meier survival curves showed that patients with less than the median value of sVEGFR-1 (<6093.07 pg/mL) had longer cumulative stenosis-free survival than patients with sVEGFR-1 levels above the median value (P < 0.001). DISCUSSION Increased levels of sVEGFR-1 and obesity were found to be associated with AVF stenosis in hemodialysis patients.
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Affiliation(s)
- Eray Eroglu
- Department of Internal Medicine, Division of Nephrology, Erciyes University School of Medicine, Kayseri, Turkey.,Division of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden
| | - Ismail Kocyigit
- Department of Internal Medicine, Division of Nephrology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Guven Kahriman
- Department of Radiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Cigdem Karakukcu
- Department of Biochemistry, Kayseri City Hospital, Kayseri, Turkey
| | - Aydin Tuncay
- Department of Cardiovascular Surgery, Erciyes University School of Medicine, Kayseri, Turkey
| | | | - Davut Eren
- Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey
| | - Nihat Kalay
- Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Murat Hayri Sipahioglu
- Department of Internal Medicine, Division of Nephrology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Oktay Oymak
- Department of Internal Medicine, Division of Nephrology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Bulent Tokgoz
- Department of Internal Medicine, Division of Nephrology, Erciyes University School of Medicine, Kayseri, Turkey
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Yılmaz M, Sipahioğlu M, Dervişoğlu E, Aydemir N, Uzun S, Istemihan Z, Unsal O, Tatar E, Berktas HB, Ozdemir Kayalar A, Sumnu A, Kumru Şahin G, Çetinkaya H, Kazan S, Kocyigit I, Gokalp C, Hasbal NB, Ucar AS, Ozelsancak R, Guven Taymez D, Yadigar S, Alagoz S, Aslan BB, Yaylaci S, Aydin Z, Jabrayilov J, Turgutalp K, Dursun B, SAHIN G. P0459ADULT MINIMAL CHANGE DISEASE IN TURKEY: THE RESULTS OF TURKISH SOCIETY OF NEPHROLOGY GLOMERULAR DISEASES WORKING GROUP. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
Minimal change disease (MCD) is the most common cause of the nephrotic syndrome (NS) in children. Although there are many data regarding the course, response to treatment, and outcomes in pediatric patients, only a few series have examined these issues in adults. The aim of the study was to delineate the demographic and clinical properties of MCD of adult population in our country.
Method
All over the country, a total of 47 centers entered data between May 2009 and May 2019 to the database created by of Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) Working Group. Demographic and clinical characteristics and biopsy findings recorded to the database were analyzed.
Results
In total, 258 patients were compatible with the pathological diagnosis of MCD. Mean age was 36.16±15.44 years and 53.88% were male. At diagnosis, 66.7% patients presented with pretibial edema,15.9% with hypertension. Microscopic hematuria occured in 18.2% patients. Only 24 patients (9.3%) presented with a decrease in renal function (serum creatinine greater than 1.3 mg/dl). The mean daily proteinuria was 6.3 g, and serum albumin was 2.6 mg/dl. The most frequent indication for biopsy was NS (86.4%). On kidney biopsy, the mean number of glomeruli was 18.08±11.11. Mezangial proliferation and mezangial IgM were present in 27.5% and 22.5%, respectively. Only in 3.5% of the included patients, electron microscopic studies were performed.
Conclusion
This study describes the characteristics of a cohort of adult patients with MCD. MCD in adults may sometimes present concurrently with hematuria, hypertension, and acute kidney injury.
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Affiliation(s)
- Mürvet Yılmaz
- Health Sciences University, Nephrology, İstanbul, Turkey
| | | | | | | | - Sami Uzun
- Haseki Training and Research Hospital, Nephrology, Turkey
| | | | | | - Erhan Tatar
- Bozyaka Training and Research Hospital, Nephrology, Turkey
| | | | | | | | | | - Hakkı Çetinkaya
- Sultan Abdulhamit Han Training and Research Hospital, Nephrology, Turkey
| | | | | | | | | | | | | | | | - Serap Yadigar
- Kartal Training and Research Hospital, Nephrology, Turkey
| | - Selma Alagoz
- Bagcilar Training and Research Hospital, Nephrology, Turkey
| | | | | | - Zeki Aydin
- Darica Farabi Training and Research Hospital, Nephrology
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Yildiz A, Ulu MS, Oruc A, Ucar AR, Ozturk S, Alagoz S, Eren N, Kocyigit I, Koksal Cevher S, Haras AB, Sumnu A, Arinsoy T, SAHIN G, Suleymanlar G, Cavdar C, Kumru Şahin G, Kurultak I, Unsal A, Manga Sahin G, Kazan S, Vatansever B, Dikec M, Dursun B, Sayarlioglu H, Turkmen K, Artan AS, Aktas N, Yilmaz Z, Behlül A, Dheir H, Kutlay S, Seyahi N. P0425MEMBRANOUS NEPHROPATHY IN TURKEY: TURKISH SOCIETY OF NEPHROLOGY GLOMERULER DISEASES (TSN-GOLD) DATABASE RESULTS. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
Membranous nephropathy (MN) is the most common cause of nephrotic syndrome in the adult population. The aim of our study is to determine the demographic and clinical characteristics and biopsy findings of the patients diagnosed with MN in our country.
Method
The study included 991 patients with renal biopsy who were followed in 47 nephrology clinics and enrolled in the database of Turkish Nephrology Primary Glomerular Diseases (TSN-GOLD) Working Group between May 1, 2009, and June 1, 2019. The demographic and clinical characteristics and biopsy findings of all patients included in the study were analyzed.
Results
The mean age of patients included in our study was 46±14.8 years and the gender distribution was (M / F, 582/409). 80.3% (n = 796) of the patients had nephrotic proteinuria at the time of diagnosis. Before the biopsy, the PLAR2 antibody was examined in 137 patients and positive in 71.5% (n = 98) patients. Hypertension was present in 34.6% (n = 343) of the patients. Mean estimated glomerular filtration rate was 93.9±32.8 ml/min/1.73 m2, albumin level was 2.7 ± 0.2 mg/dL, proteinuria level in urine was 7,1±6,4 gr/day and total cholesterol level was 295±3.7 mg/dL. On light microscopy, baseline membrane thickening was found in 92% (n=907) and interstitial inflammation in 53% (n=524) specimens. In immunofluorescence staining, 3 (+) IgG accumulation was highest in 578 (58.3%) of the specimen.
Conclusion
This multicentre study is the largest study to analyze clinical, laboratory, and biopsy specimens of MN patients at the time of biopsy in our country. The findings are consistent with the literature. Prospective follow-up results of these patients will help us to understand the renal prognosis and treatment response better.
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Affiliation(s)
| | | | - Aysegul Oruc
- Uludag University, Medical Faculty, Nephrology, Bursa, Turkey
| | - Ali Riza Ucar
- Istanbul University, Istanbul Medical Faculty, Nephrology, Istanbul, Turkey
| | - Savas Ozturk
- Haseki Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Selma Alagoz
- Istanbul University, Cerrahpasa Medical Faculty, Nephrology, Istanbul, Turkey
| | - Necmi Eren
- Kocaeli University, Medical Faculty, Nephrology, Kocaeli, Turkey
| | - Ismail Kocyigit
- Erciyes University, Medical Faculty, Nephrology, Kayseri, Turkey
| | | | - Ali Burak Haras
- Dr. Lutfi Kirdar Kartal Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Abdullah Sumnu
- Medipol University, Medical Faculty, Nephrology, Istanbul, Turkey
| | - Turgay Arinsoy
- Gazi University, Medical Faculty, Nephrology, Ankara, Turkey
| | - Garip SAHIN
- Eskisehir Osmangazi University, Medical Faculty, Nephrology, Eskisehir, Turkey
| | | | - Caner Cavdar
- Dokuz Eylul University, Medical Faculty, Nephrology, Izmir, Turkey
| | - Gizem Kumru Şahin
- Ankara University, Medical Faculty, İbni Sina Hospital, Nephrology, Ankara, Turkey
| | - Ilhan Kurultak
- Trakya University, Medical Faculty, Nephrology, Edirne, Turkey
| | - Abdulkadir Unsal
- Hamidiye Sisli Etfal Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Gulizar Manga Sahin
- Sultan Abdulhamit Han Research and Training Hospital, Nephrology, Istanbul, Turkey
| | - Sinan Kazan
- Afyon University, Medical Faculty, Nephrology, Afyon, Turkey
| | - Bulent Vatansever
- Bozyaka Training and Research Hospital, Internal Medicine, Izmir, Turkey
| | - Mehmet Dikec
- Bakirkoy Sadi Konuk Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Belda Dursun
- Pamukkale University, Medical Faculty, Nephrology, Denizli, Turkey
| | | | - Kultigin Turkmen
- Necmettin Erbakan University, Meram Medical Faculty, Nephrology, Konya, Turkey
| | - Ayse Serra Artan
- Bezmialem Vakif University, Medical Faculty, Nephrology, Istanbul, Turkey
| | - Nimet Aktas
- Bursa Yuksek Ihtisas Training and Research Hospital, Nephrology, Bursa, Turkey
| | - Zulfikar Yilmaz
- Dicle University, Medical Faculty, Nephrology, Diyarbakir, Turkey
| | - Ahmet Behlül
- Burhan Nalbantoglu State Hospital, Nephrology, Lefkosa, Cyprus
| | - Hamad Dheir
- Sakarya University, Medical Faculty, Nephrology, Sakarya, Turkey
| | - Sim Kutlay
- Ankara University, Medical Faculty, İbni Sina Hospital, Nephrology, Ankara, Turkey
| | - Nurhan Seyahi
- Istanbul University, Cerrahpasa Medical Faculty, Nephrology, Istanbul, Turkey
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Eroglu E, Turkmen U, Kocyigit I, Akgun H, Koyuncu S, Sipahioglu MH, Tokgoz B, Oymak O. Possible Link between IgA Nephropathy and B-cell Acute Lymphoblastic Leukemia. Turk J Nephrol 2020. [DOI: 10.5152/turkjnephrol.2020.3909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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Affiliation(s)
- I. Kocyigit
- Department of Nephrology Erciyes University Medical Faculty Kayseri, Turkey
| | - A. Unal
- Department of Nephrology Erciyes University Medical Faculty Kayseri, Turkey
| | - M.H. Sipahioglu
- Department of Nephrology Erciyes University Medical Faculty Kayseri, Turkey
| | - B. Tokgoz
- Department of Nephrology Erciyes University Medical Faculty Kayseri, Turkey
| | - O. Oymak
- Department of Nephrology Erciyes University Medical Faculty Kayseri, Turkey
| | - C. Utas
- Department of Nephrology Erciyes University Medical Faculty Kayseri, Turkey
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Eroglu E, Cetin M, Kocyigit I, Akgun H, Sipahioglu MH, Tokgoz B, Oymak O. Lupus Nephritis Presenting with Preeclampsia. Turk J Nephrol 2020. [DOI: 10.5152/turkjnephrol.2020.3579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Kocyigit I, Eroglu E, Ecder T. Urinary Findings and Biomarkers in Autosomal Dominant Polycystic Kidney Disease. Turk J Nephrol 2020. [DOI: 10.5152/turkjnephrol.2020.3554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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Eroglu E, Kocyigit I, Cetin M, Zararsiz G, Imamoglu H, Bayramov R, Tastan S, Sipahioglu MH, Tokgoz B, Oymak O. Multiple urinary tract infections are associated with genotype and phenotype in adult polycystic kidney disease. Clin Exp Nephrol 2019; 23:1188-1195. [PMID: 31165946 DOI: 10.1007/s10157-019-01752-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 05/24/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Urinary tract infections (UTI) are one of the important clinical presentations in patients with autosomal dominant polycystic kidney disease (ADPKD). The association between UTI among genotypic and phonotypic properties of ADPKD patients is still obscure. Thus, we investigated the relationship between UTI and polycystin gene mutation with total kidney volume. METHODS Forty patients with ADPKD patients with a history of more than two UTI and age-gender-matched 40 ADPKD patients without UTI history enrolled in the study. Ambulatory blood pressure monitoring was performed in all participants. Magnetic resonance imaging (MRI) was performed with a 1.5-T system, and total kidney volumes were calculated using mid-slice technique. To determine PKD1 and PKD2 genotype, we performed molecular and genetic tests involving the following steps: DNA isolation, next-generation sequencing (NGS) and data analysis. RESULTS ADPKD patients with UTI had lower eGFR values than those without UTI [64.9 (32.2-100.8) vs 89.5 (59.0-110.0) (p = 0.041)]. In addition, patients with UTI had significantly increased height-adjusted total kidney volume than patients without UTI [950 (290-1350) vs 345 (243-780.0) (p = 0.005)]. Multiple logistic regression analysis showed that the PKD1-truncating mutation and hTKV independently predicted UTI. The sensitivity and specificity of hTKV were 65% and 77% (cutoff > 727 cm3) with an area of under the ROC curve of 0.70 (95% CI 0.56-0.85, p = 005). CONCLUSIONS ADPKD patients with larger kidneys and PKD1 mutation are susceptible to increased risk of multiple UTI. Additionally, renal function decreased in ADPKD patients with multiple UTI history.
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Affiliation(s)
- Eray Eroglu
- Division of Nephrology, Department of Internal Medicine, Erciyes University Medical Faculty, 38039, Kayseri, Turkey.
| | - Ismail Kocyigit
- Division of Nephrology, Department of Internal Medicine, Erciyes University Medical Faculty, 38039, Kayseri, Turkey
| | - Mustafa Cetin
- Department of Internal Medicine, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Gokmen Zararsiz
- Department of Biostatistics, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Hakan Imamoglu
- Department of Radiology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Ruslan Bayramov
- Department of Genetics, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Sinem Tastan
- Department of Infectious Disease, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Murat Hayri Sipahioglu
- Division of Nephrology, Department of Internal Medicine, Erciyes University Medical Faculty, 38039, Kayseri, Turkey
| | - Bulent Tokgoz
- Division of Nephrology, Department of Internal Medicine, Erciyes University Medical Faculty, 38039, Kayseri, Turkey
| | - Oktay Oymak
- Division of Nephrology, Department of Internal Medicine, Erciyes University Medical Faculty, 38039, Kayseri, Turkey
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Kocyigit I, Ozturk F, Eroglu E, Karaca Z, Kaynar AS, Cetin M, Tokgoz B, Sipahioglu MH, Bayramov R, Sen A, Oymak O, Ecder T, Axelsson J. Dysmetabolic markers predict outcomes in autosomal dominant polycystic kidney disease. Clin Exp Nephrol 2019; 23:1130-1140. [PMID: 31134465 DOI: 10.1007/s10157-019-01748-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 05/10/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Overweight and obesity were recently associated with a poor prognosis in patients with autosomal dominant polycystic kidney disease (ADPKD). Whether the metabolic consequences of obesity as defined by the metabolic syndrome (MS) are also linked with disease progression remains untested. METHODS Eligible ADPKD patients with different stages of CKD (n = 105) and 105 non-diabetic controls matched for CKD stage were enrolled in the study. Groups were evaluated at baseline for presence of MS, blood markers of metabolism, homeostasis model assessment of insulin resistance (HOMA-IR) score, and biochemical markers of inflammation (hs-CRP, IL-1β, IL-6, TNF-α and PON-1). MS was defined according to the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III). Patients were followed for 12 months and progression defined as a decrease in baseline eGFR > 10%. RESULTS MS and hypertension were more prevalent amongst ADPKD patients than in the control group. Meanwhile, markers of inflammation such as hs-CRP (3.63 [3.45-5.17] vs. 4.2 [3.45-8.99] mg/dL; p = 0.014), IL-6 (21.65 [14.1-27.49] vs. 24.9 [16.23-39.4] pg/mL; p = 0.004) and IL-1β (21.33 [15.8-26.4] vs. 26.78 [18.22-35] pg/mL; p < 0.001) levels were all more elevated in ADPKD patients than in non-diabetic CKD subjects. In multivariate analysis having a truncating PKD1 mutation predicted (OR 1.25 [1.09-1.43]; p = 0.002) fulfilling the MS criteria. Finally, ADPKD patients fulfilling MS criteria had a significantly more rapid progression during 12 months of follow-up than did those that did not (OR 3.28 [1.09-9.87]; p = 0.035). CONCLUSIONS Our data supports the notion that dysmetabolisms part of the ADPKD phenotype and associated with a poor outcome, especially in patients with a truncating PKD1 mutation.
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Affiliation(s)
- Ismail Kocyigit
- Department of Nephrology, Erciyes University Medical Faculty, Kayseri, Turkey.
| | - Fahir Ozturk
- Department of Internal Medicine, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Eray Eroglu
- Department of Nephrology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Zuleyha Karaca
- Department of Endocrinology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Ahmet Safa Kaynar
- Department of Internal Medicine, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Mustafa Cetin
- Department of Internal Medicine, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Bulent Tokgoz
- Department of Nephrology, Erciyes University Medical Faculty, Kayseri, Turkey
| | | | - Ruslan Bayramov
- Department of Genetics, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Ahmet Sen
- Department of Biochemistry, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Oktay Oymak
- Department of Nephrology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Tevfik Ecder
- Department of Nephrology, Istanbul Bilim University Medical Faculty, Istanbul, Turkey
| | - Jonas Axelsson
- Transplant Immunology Division, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Immunology, Karolinska University Hospital, Stockholm, Sweden
- Clinical Research Center, Lund University, Lund, Sweden
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Eroglu E, Sipahioglu MH, Senel S, Ertas SK, Savas S, Ozturk F, Kocyigit I, Tokgoz B, Oymak O. Successful treatment of tubulointerstitial nephritis in immunoglobulin G4-related disease with rituximab: A case report. World J Clin Cases 2019; 7:2309-2315. [PMID: 31531324 PMCID: PMC6718787 DOI: 10.12998/wjcc.v7.i16.2309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 07/09/2019] [Accepted: 07/27/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated condition that consisted of disorders that share particular clinical, serologic and pathologic properties. The common presentation of disease includes tumor-like swelling of involved organs and the histopathological findings are a lymphoplasmacytic infiltrate enriched with IgG4-positive plasma cells, and a variable degree of fibrosis that has a characteristic "storiform" pattern in biopsy specimens of tumor-like masses. Major presentations of this disease, which often affects more than one organ, include autoimmune pancreatitis, salivary gland disease (sialadenitis), orbital disease and retroperitoneal fibrosis. The steroid treatment is essential for the treatment of the disease however, other immunosuppressive drugs including cyclophosphamide or rituximab could be an option in resistant cases.
CASE SUMMARY Herein, we reported a 34-year-old woman whom previously had diagnosed with asthma, rheumatoid arthritis and Sjögren’s syndrome (SS) referred our nephrology department due to acute kidney failure development at the last rheumatology visit. After kidney biopsy she has been diagnosed with IgG4-RD and tubuluointerstitial nephritis. She had been accepted resistant to steroid, mycophenolate mofetil, methotrexate and azathioprine therapies due to receiving in last two years. She refused to receive cyclophosphamide due to potential gonadotoxicity of the drug. Thus, rituximab therapy was considered. She received 1000 mg infusion, 15 d apart and 6 mo later it has been administered same protocol. After one year from the last rituximab dose serum creatinine decreased from 4.4 mg/dL to 1.6 mg/dL, erythrocyte sedimentation rate decreased from 109 mm/h to 13 mm/h [reference range (RR) 0-20], and C-reactive protein decreased from 55.6 mg/L to 5 mg/L (RR 0–6). All pathologic lymph nodes and masses were also disappeared.
CONCLUSION Patients with IgG4-RD usually misdiagnosed with rheumatologic diseases including systemic lupus erythematous or SS and also they were screened for the presence of malignancy. Rituximab could be an important treatment option in cases with steroid resistant tubulointerstitial nephritis in IgG4-RD.
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Affiliation(s)
- Eray Eroglu
- Division of Nephrology, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri 38039, Turkey
| | - Murat Hayri Sipahioglu
- Division of Nephrology, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri 38039, Turkey
| | - Soner Senel
- Division of Rheumatology, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri 38039, Turkey
| | - Sule Ketenci Ertas
- Division of Rheumatology, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri 38039, Turkey
| | - Seyma Savas
- Department of Internal Medicine, Erciyes University School of Medicine, Kayseri 38039, Turkey
| | - Figen Ozturk
- Department of Pathology, Erciyes University School of Medicine, Kayseri 38039, Turkey
| | - Ismail Kocyigit
- Division of Nephrology, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri 38039, Turkey
| | - Bulent Tokgoz
- Division of Nephrology, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri 38039, Turkey
| | - Oktay Oymak
- Division of Nephrology, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri 38039, Turkey
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Kocyigit I, Taheri S, Eroglu E, Sener EF, Zararsız G, Uzun I, Tufan E, Mehmetbeyoglu E, Korkmaz Bayramov K, Sipahioglu MH, Ozkul Y, Tokgoz B, Oymak O, Axelsson J. Systemic Succinate, Hypoxia-Inducible Factor-1 Alpha, and IL-1β Gene Expression in Autosomal Dominant Polycystic Kidney Disease with and without Hypertension. Cardiorenal Med 2019; 9:370-381. [PMID: 31319406 DOI: 10.1159/000500478] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 04/09/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Cyst pressure induces renin-angiotensin-aldosterone system activation and kidney hypoxia in autosomal dominant polycystic kidney disease (ADPKD). Lipopolysaccharide-induced Toll-like receptor activation causes metabolic disturbances that are triggered by increased succinate levels and hypoxia inducible factors, which results in inflammation via IL-1β activation. Since we aimed to investigate the role of both inflammation and hypoxia in the clinical course of ADPKD, via succinate levels from sera samples, HIF-1α gene expression from whole blood and urine samples and IL-1βgene expression from whole blood were measured. METHODS One hundred ADPKD patients and 100 matched healthy controls were enrolled to this cross-sectional study. Twenty-four-hour ambulatory blood pressure monitoring was conducted in all participants. Blood, serum, and urine samples were taken after 12-h fasting for the measurement of biochemical parameters and succinate levels. Whole blood and urine samples were used for HIF-1α and IL-1β geneexpression by using quantitative real-time PCR. RESULTS There were significant differences in whole blood HIF-1α, IL-1β geneexpression, and serumsuccinate levels between the ADPKD patients and the control subjects. Whole blood HIF-1αgene expression, IL-1β geneexpression, and serumsuccinate levels were also significantly different in ADPKD patients with hypertension in comparison with normotensive ones (p < 0.05). Serum succinate levels and blood IL-1β geneexpression were increased in ADPKD patients with high levels of HIF-1α geneexpression (p = 0.018 and p = 0.029, respectively). CONCLUSIONS Increased age,low eGFR, and HIF-1α and IL-1β geneexpressions were also independently associated with hypertension in ADPKD patients. Inflammation and hypoxia are both relevant factors that might be associated with hypertension in ADPKD.
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Affiliation(s)
- Ismail Kocyigit
- Department of Nephrology, Erciyes University Medical Faculty, Kayseri, Turkey,
| | - Serpil Taheri
- Department of Medical Biology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Eray Eroglu
- Department of Nephrology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Elif Funda Sener
- Department of Medical Biology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Gokmen Zararsız
- Department of Biostatistics, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Ilknur Uzun
- Department of Internal Medicine, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Esra Tufan
- Betul-Ziya Eren Genome and Stem Cell Center, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Ecmel Mehmetbeyoglu
- Betul-Ziya Eren Genome and Stem Cell Center, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Kezban Korkmaz Bayramov
- Betul-Ziya Eren Genome and Stem Cell Center, Erciyes University Medical Faculty, Kayseri, Turkey
| | | | - Yusuf Ozkul
- Department of Genetics, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Bulent Tokgoz
- Department of Nephrology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Oktay Oymak
- Department of Nephrology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Jonas Axelsson
- Transplant Immunology Division, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Immunology, Karolinska University Hospital, Stockholm, Sweden.,Clinical Research Center, Lund University, Lund, Sweden
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Kocyigit I, Taheri S, Eroglu E, Zararsiz G, Sener EF, Uzun I, Imamoglu H, Mehmetbeyoglu E, Unal A, Korkmaz K, Sipahioglu MH, Oymak O, Tokgoz B. Association of OSR-1 With Vascular Dysfunction and Hypertension in Polycystic Kidney Disease. Ther Apher Dial 2019; 24:64-71. [PMID: 31020807 DOI: 10.1111/1744-9987.12814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 09/11/2018] [Revised: 03/22/2019] [Accepted: 04/23/2019] [Indexed: 11/30/2022]
Abstract
Autosomal-dominant polycystic kidney disease (ADPKD) is associated with oxidative stress and hypertension development before renal function decline and cardiovascular disease development. Oxidative stress-responsive kinase-1 (OSR-1) participates in the signaling regulating Na+ transport during oxidative stress and also plays a role in the regulation of cell volume and blood pressure. Therefore, we aimed to investigate the potential role of OSR-1 in ADPKD patients. Eighty ADPKD patients, 80 healthy controls, and 80 non-ADPKD patients with hypertension were enrolled in this cross-sectional study. Twenty-four-hour ambulatory blood pressure monitoring was conducted in all participants. Blood samples were taken after 12-h fasting for the measurement of biochemical parameters and OSR-1 gene expression. Vascular dysfunction was assessed using ischemia-induced forearm flow-mediated vasodilation (FMD). Briefly, of the 80 ADPKD patients, 41(51%) were male, and 53(66%) of them were hypertensive. The mean age of the 80 controls was 35.3 ± 12.6 years, and 37(46%) of them were male. The mean age of the 80 non-ADPKD patients with hypertension was 44.6 ± 11.9 years, and 38(47.5) of them were male. There were significant differences in serum OSR-1 gene expression between the ADPKD patients and the control subjects. Serum OSR-1 gene expression was also significantly increased in hypertensive ADPKD patients in comparison with both normotensive ADPKD counterparts and non-ADPKD hypertensive subjects. Serum OSR-1 gene expression was increased in patients with ADPKD than healthy subjects. Low estimated glomerular filtration rate (eGFR), OSR-1 gene expression, total kidney volume (TKV), and high-density lipoprotein (HDL) were also independently associated with hypertension in ADPKD patients.
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Affiliation(s)
- Ismail Kocyigit
- Department of Internal Medicine, Division of Nephrology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Serpil Taheri
- Department of Medical Biology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Eray Eroglu
- Department of Internal Medicine, Division of Nephrology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Gokmen Zararsiz
- Department of Biostatistics, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Elif Funda Sener
- Department of Medical Biology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Ilknur Uzun
- Department of Internal Medicine, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Hakan Imamoglu
- Department of Radiology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Ecmel Mehmetbeyoglu
- Betul-Ziya Eren Genome and Stem Cell Center, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Aydin Unal
- Department of Internal Medicine, Division of Nephrology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Keziban Korkmaz
- Betul-Ziya Eren Genome and Stem Cell Center, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Murat Hayri Sipahioglu
- Department of Internal Medicine, Division of Nephrology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Oktay Oymak
- Department of Internal Medicine, Division of Nephrology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Bulent Tokgoz
- Department of Internal Medicine, Division of Nephrology, Erciyes University Medical Faculty, Kayseri, Turkey
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Eroglu E, Kontas ME, Kocyigit I, Kontas O, Donmez H, Kucuk A, Sipahioglu MH, Tokgoz B, Oymak O. Brown tumor of the thoracic spine presenting with paraplegia in a patient with peritoneal dialysis. CEN Case Rep 2019; 8:227-232. [PMID: 31089951 DOI: 10.1007/s13730-019-00398-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 04/18/2019] [Indexed: 11/26/2022] Open
Abstract
Secondary and tertiary hyperparathyroidism is an important problem of chronic kidney disease. Brown tumor is a benign, unusual, reactive lesion as a result of disturbed bone remodeling, from long-standing increase in parathyroid hormone level. Brown tumors may cause morbidity due to pressure symptoms on neural structures and spontaneous bone fractures. Herein, we presented a peritoneal dialysis patient with tertiary hyperparathyroidism under calcand calcitriol treatment for 4 years due to refusing of the parathyroidectomy operation. She admitted to hospital for sudden onset back pain with difficulty in gait and walking, and imaging studies showed an expansile mass lesion in the thoracic spine. She was operated for mass and diagnosed with brown tumor. After operation, she lost the ability of walking than become paraplegic and she underwent rehabilitation program. Preventive measures including calcitriol and cinacalcet may cause a modest decrease in parathyroid hormone levels but it should be remembered for the development of bone complications such as brown tumor formation in patients with moderate elevated PTH levels, especially those with tertiary hyperparathyroidism. Parathyroidectomy should be performed without delay in these cases.
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Affiliation(s)
- Eray Eroglu
- Division of Nephrology, Department of Internal Medicine, Erciyes University Medical Faculty, 38039, Kayseri, Turkey.
| | - Mustafa Eymen Kontas
- Department of Internal Medicine, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Ismail Kocyigit
- Division of Nephrology, Department of Internal Medicine, Erciyes University Medical Faculty, 38039, Kayseri, Turkey
| | - Olgun Kontas
- Department of Pathology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Halil Donmez
- Department of Radiology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Ahmet Kucuk
- Department of Neurosurgery, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Murat Hayri Sipahioglu
- Division of Nephrology, Department of Internal Medicine, Erciyes University Medical Faculty, 38039, Kayseri, Turkey
| | - Bulent Tokgoz
- Division of Nephrology, Department of Internal Medicine, Erciyes University Medical Faculty, 38039, Kayseri, Turkey
| | - Oktay Oymak
- Division of Nephrology, Department of Internal Medicine, Erciyes University Medical Faculty, 38039, Kayseri, Turkey
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Eroglu E, Kocyigit I, Eren D, Unal A, Sipahioglu MH, Akgun H, Tokgoz B, Oymak O. The Possible Association of Chronic Hepatitis B with Renal AA Amyloidosis. Turk J Nephrol 2019. [DOI: 10.5152/turkjnephrol.2019.3160] [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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Hossein Abedi A, Eroglu E, Kocyigit I, Unal A, Sipahioglu MH, Tokgoz B, Oymak O. Colchicine-and Clarithromycin-Induced Rhabdomyolysis in a Hemodialysis Patient with Familial Mediterranean Fever. Turk J Nephrol 2019. [DOI: 10.5152/turkjnephrol.2019.2976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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Eren N, Gungor O, Kocyigit I, Guzel FB, Erken E, Altunoren O, Tatar E, Eroglu E, Senel E, Kaya B, Paydaş S, Onan B, Sahin S, Yilmaz M, Ulu S, Gursu M, Ozkok A, Yildiz A, Kurultak I, Ucar AR, Tanrisev M, Turgutalp K, Turan MN, Huzmeli C, Soypacaci Z, Akdam H, Huddam B, Adibelli Z, Kara E, Inci A, Turkmen E, Tekce H, Dogukan A, Turkmen A. Acute renal infarction in Turkey: a review of 121 cases. Int Urol Nephrol 2018; 50:2067-2072. [PMID: 30251011 DOI: 10.1007/s11255-018-1979-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 06/27/2018] [Accepted: 09/05/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE Renal infarction is a clinical condition which is caused by renal artery occlusion and leads to permanent renal parenchymal damage. In the literature, there are generally case reports on this subject, and few studies that include a large group of patients. Therefore, we aimed to present the data of a large group of patients who were diagnosed with acute renal infarction in our country in this retrospective study. METHODS The data of patients who were diagnosed with acute renal infarction according to clinical and radiological findings in Turkey in the last 3 years were examined. For this purpose, we contacted with more than 40 centers in 7 regions and obtained support from clinically responsible persons. Demographic data of patients, laboratory data at the time of diagnosis, tests performed for etiologic evaluation, given medications, and patients' clinical status during follow-up were obtained from databases and statistical analysis was performed. RESULTS One-hundred and twenty-one patients were included in the study. The mean age was 53 ± 1.4 (19-91) years. Seventy-one (58.7%) patients were male, 18 (14.9%) had diabetes, 53 (43.8%) had hypertension, 36 (30%) had atrial fibrillation (AF), and 6 had a history of lupus + antiphospholipid syndrome (APS). Forty-five patients had right renal infarction, 50 patients had left renal infarction, and 26 (21.5%) patients had bilateral renal infarction. The examinations for the ethiologies revealed that, 36 patients had thromboemboli due to atrial fibrillation, 10 patients had genetic anomalies leading to thrombosis, 9 patients had trauma, 6 patients had lupus + APS, 2 patients had hematologic diseases, and 1 patient had a substance abuse problem. Fifty-seven (57%) patients had unknown. The mean follow-up period was 14 ± 2 months. The mean creatinine and glomerular filtration rate (GFR) values at 3 months were found to be 1.65 ± 0.16 mg/dl and 62 ± 3 ml/min, respectively. The final mean creatinine and GFR values were found to be 1.69 ± 0.16 mg/dl and 62 ± 3 ml/min, respectively. CONCLUSIONS Our study is the second largest series published on renal infarction in the literature. More detailed studies are needed to determine the etiological causes of acute renal infarction occurring in patients.
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Affiliation(s)
- Necmi Eren
- Nephrology Department, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
| | - Ozkan Gungor
- Department of Nephrology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Ismail Kocyigit
- Department of Nephrology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Fatma Betul Guzel
- Department of Nephrology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Ertugrul Erken
- Department of Nephrology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Orcun Altunoren
- Department of Nephrology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Erhan Tatar
- Department of Nephrology, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Eray Eroglu
- Department of Nephrology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Egemen Senel
- Department of Nephrology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Bulent Kaya
- Department of Nephrology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Saime Paydaş
- Department of Nephrology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Bilen Onan
- Department of Nephrology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Safak Sahin
- Department of Internal Medicine, Gaziosmanpasa University Faculty of Medicine, Tokat, Turkey
| | - Mumtaz Yilmaz
- Department of Nephrology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Sena Ulu
- Department of Nephrology, Faculty of Medicine, Kocatepe University, Afyonkarahisar, Turkey
| | - Meltem Gursu
- Department of Nephrology, Faculty of Medicine, Bezmi Alem University, Istanbul, Turkey
| | - Abdullah Ozkok
- Department of Nephrology, Medeniyet University Training and Research Hospital, Istanbul, Turkey
| | - Abdulmecit Yildiz
- Department of Nephrology, Faculty of Medicine, Uludag University, Bursa, Turkey
| | - Ilhan Kurultak
- Department of Nephrology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Ali Rıza Ucar
- Department of Nephrology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Tanrisev
- Department of Nephrology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Kenan Turgutalp
- Department of Nephrology, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Mehmet Nuri Turan
- Department of Nephrology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Can Huzmeli
- Department of Nephrology, Necip Fazıl City Hospital, Kahramanmaras, Turkey
| | - Zeki Soypacaci
- Department of Nephrology, Atatürk Training and Research Hospital, Izmir, Turkey
| | - Hakan Akdam
- Department of Nephrology, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey
| | - Bulent Huddam
- Department of Nephrology, Faculty of Medicine, Mugla University, Mugla, Turkey
| | - Zelal Adibelli
- Department of Nephrology, Faculty of Medicine, Usak University, Usak, Turkey
| | - Ekrem Kara
- Department of Nephrology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Ayca Inci
- Department of Nephrology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ercan Turkmen
- Department of Internal Medicine, Ordu State Hospital, Ordu, Turkey
| | - Hikmet Tekce
- Department of Nephrology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
| | - Ayhan Dogukan
- Department of Nephrology, Faculty of Medicine, Fırat University, Elazig, Turkey
| | - Aydin Turkmen
- Department of Nephrology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Kocyigit I, Eroglu E, Kaynar AS, Kocer D, Kargi S, Zararsiz G, Bayramov R, Imamoglu H, Sipahioglu MH, Tokgoz B, Dundar M, Oymak O. The association of endothelin-1 levels with renal survival in polycystic kidney disease patients. J Nephrol 2018; 32:83-91. [DOI: 10.1007/s40620-018-0514-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 06/13/2018] [Indexed: 12/29/2022]
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Unal A, Ata S, Karakurkcu C, Ciraci MZ, Kocyigit I, Sipahioglu MH, B Tokgoz, Oymak O. Does Renal Tubular Injury-Induced Local Tissue Hypoxia Involve Post-Transplantation Erythrocytosis? Transplant Proc 2018; 49:1930-1934. [PMID: 28923650 DOI: 10.1016/j.transproceed.2017.04.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/10/2017] [Accepted: 04/27/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND The pathogenesis of post-transplantation erythrocytosis (PTE) is not well understood and appears to be multifactorial. Our hypothesis in this study was that several factors, including toxicity of calcineurin inhibitor, immunologic factors, and chronic allograft nephropathy, can trigger local tissue hypoxia in peritubular interstitium, which is where production of erythropoietin (EPO) takes place. This local interstitial tissue hypoxia can cause an increase in renal EPO production, which induces the development of PTE. METHODS This cross-sectional study included 15 renal transplant recipients, in whom polycythemia developed after kidney transplantation, with elevated hematocrit level to >51%. Forty-eight age- and gender-matched renal transplant recipients with normal hematocrit level were included as the renal transplant control group. In addition, 13 age- and gender-matched healthy subjects were also included as the healthy control group. We used urine hypoxia-inducible factor-2 alpha (HIF-2α) levels to evaluate whether there is local tissue hypoxia in renal allograft. HIF-2α levels were measured by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). Serum EPO and insulin-like growth factor-1 (IGF-1) levels were also measured. RESULTS HIF-2α levels were significantly lower in the polycythemia group than the other two groups, but there was no significant difference between the healthy control group and the renal transplant control group with regard to HIF-2α levels. There was no significant difference among the 3 study groups in terms of levels of serum EPO and IGF-1. CONCLUSION Local tissue hypoxia in renal allograft does not seem to play an important role in the development of PTE.
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Affiliation(s)
- A Unal
- Department of Nephrology, Erciyes University Medical School, Kayseri, Turkey.
| | - S Ata
- Department of Internal Medicine, Erciyes University Medical School, Kayseri, Turkey
| | - C Karakurkcu
- Department of Biochemistry, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - M Z Ciraci
- Department of Biochemistry, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - I Kocyigit
- Department of Nephrology, Erciyes University Medical School, Kayseri, Turkey
| | - M H Sipahioglu
- Department of Nephrology, Erciyes University Medical School, Kayseri, Turkey
| | - B Tokgoz
- Department of Nephrology, Erciyes University Medical School, Kayseri, Turkey
| | - O Oymak
- Department of Nephrology, Erciyes University Medical School, Kayseri, Turkey
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Eroglu E, Kocyigit I, Kaynar A, Kocer D, Zararsiz G, Bayramov R, Imamoglu H, Sipahioglu M, Tokgoz B, Dundar M, Oymak O. FP049THE ASSOCIATION OF ENDOTHELIN-1 LEVELS WITH RENAL SURVIVAL IN POLYCYSTIC KIDNEY DISEASE PATIENTS. Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.fp049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Eray Eroglu
- Nephrology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | | | - Ahmet Kaynar
- Internal Medicine, Erciyes University, Kayseri, Turkey
| | - Derya Kocer
- Biochemistry, Kayseri Training and Research Hospital, Kayseri, Turkey
| | | | | | | | | | | | | | - Oktay Oymak
- Nephrology, Erciyes University, Kayseri, Turkey
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Gungor O, EREN N, Guzel FB, Senel E, Ciftcioglu M, Tuncay M, Akkus G, Coskun Yavuz Y, Kocyigit I, Erken E, Altunoren O. FP686AWARENESS OF HEPATITIS AND ITS COMPLICATIONS IN HEMODIALYSIS PATIENTS WITH VIRAL HEPATITIS. Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.fp686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Ozkan Gungor
- Nephrology, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Necmi EREN
- Nephrology, Kocaeli University, Kocaeli, Turkey
| | - Fatma Betül Guzel
- Nephrology, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Egemen Senel
- Nephrology, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | | | - Mehmet Tuncay
- Nephrology, Dr. Ersin Arslan State Hospital, Gaziantep, Turkey
| | - Gulsum Akkus
- Nephrology, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | | | | | - Ertugrul Erken
- Nephrology, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Orcun Altunoren
- Nephrology, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
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Eroglu E, Kocyigit I, Taheri S, Zararsiz G, Sener E, Uzun I, Imamoglu H, Mehmetbeyoglu E, Unal A, Korkmaz K, Sipahioglu M, Oymak O, Tokgoz B. FP053THE ASSOCIATION OF OSR-1 BETWEEN VASCULAR DYSFUNCTION AND HYPERTENSION IN POLYCYSTIC KIDNEY DISEASE. Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.fp053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Eray Eroglu
- Nephrology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | | | - Serpil Taheri
- Medical Biology, Erciyes University, Kayseri, Turkey
| | | | - Elif Sener
- Medical Biology, Erciyes University, Kayseri, Turkey
| | - Ilknur Uzun
- Internal Medicine, Erciyes University, Kayseri, Turkey
| | | | | | - Aydin Unal
- Nephrology, Erciyes University, Kayseri, Turkey
| | | | | | - Oktay Oymak
- Nephrology, Erciyes University, Kayseri, Turkey
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Kocyigit I, Eroglu E, Gungor O. Clinical problems in hemodialysis patients with autosomal dominant polycystic kidney disease. Semin Dial 2018; 31:268-277. [DOI: 10.1111/sdi.12696] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Ismail Kocyigit
- Department of Nephrology; Erciyes University Medical Faculty; Kayseri Turkey
| | - Eray Eroglu
- Department of Nephrology; Erciyes University Medical Faculty; Kayseri Turkey
| | - Ozkan Gungor
- Department of Nephrology; Sutcu Imam University Medical Faculty; Kahramanmaras Turkey
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Eroglu E, Unal HU, Guclu A, Kocyigit I, Karaman M, Saglam M, Gezer M, Tas A, Zararsiz G, Eyileten T, Aydin İ, Oguz Y, Gungor O, Yilmaz MI. The association of profilin-1 levels with survival in chronic kidney disease. Eur J Clin Invest 2017; 47. [PMID: 28981140 DOI: 10.1111/eci.12839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 10/01/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Profilin-1 is a ubiquitous, actin-binding protein that plays an important role in the regulation of actin polymerization and cytoskeleton remodelling and contributes to vascular dysfunction. We conducted this study to investigate the association of serum profilin-1 levels with fatal and nonfatal CVE in a cohort of patients with stage 1-5 CKD. MATERIALS AND METHODS Serum concentrations of profilin-1 levels were determined by enzyme-linked immunosorbent assay. Endothelium-dependent vasodilatation (flow-mediated dilatation [FMD]) and endothelium-independent vasodilatation (nitroglycerine-mediated dilatation [NMD]) of the brachial artery were assessed noninvasively, using high-resolution ultrasound. RESULTS Both fatal and nonfatal CVE were significantly higher in patients with high profilin-1 levels. Kaplan-Meier survival curves showed that patients with profilin-1 below the median value (114 pg/mL) had higher cumulative survival compared with patients who had profilin-1 levels above the median value (log-rank test, P < .001). CONCLUSIONS This is the first study that demonstrates the serum profilin-1 is independently associated with endothelial dysfunction, cardiovascular events and survival in patients with CKD.
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Affiliation(s)
- Eray Eroglu
- Department of Nephrology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Hilmi U Unal
- Department of Nephrology, Gulhane School of Medicine, Ankara, Turkey
| | - Aydin Guclu
- Department of Nephrology, Ahi Evran University, Training and Research Hospital, Kirsehir, Turkey
| | - Ismail Kocyigit
- Department of Nephrology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Murat Karaman
- Department of Nephrology, Gulhane School of Medicine, Ankara, Turkey
| | - Mutlu Saglam
- Department of Radiology, Gulhane School of Medicine, Ankara, Turkey
| | - Mustafa Gezer
- Department of Nephrology, Gulhane School of Medicine, Ankara, Turkey
| | - Ahmet Tas
- Department of Biochemistry, Gulhane School of Medicine, Ankara, Turkey
| | - Gokmen Zararsiz
- Department of Biostatistics, Erciyes University School of Medicine, Kayseri, Turkey
| | - Tayfun Eyileten
- Department of Nephrology, Gulhane School of Medicine, Ankara, Turkey
| | - İbrahim Aydin
- Department of Biochemistry, Gulhane School of Medicine, Ankara, Turkey
| | - Yusuf Oguz
- Department of Nephrology, Gulhane School of Medicine, Ankara, Turkey
| | - Ozkan Gungor
- Department of Nephrology, Sutcu Imam University School of Medicine, Kahramanmaras, Turkey
| | - Mahmut I Yilmaz
- Department of Nephrology, Gulhane School of Medicine, Ankara, Turkey
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Abstract
Patients with end-stage renal disease undergoing dialysis commonly experience derangements in the hypothalamic-pituitary-gonadal axis together with alterations at the level of synthesis and clearance of many hormones. This hormonal imbalance, even if asymptomatic, has recently been associated with increased mortality in these patients. In this review, we summarize observational and mechanistic evidence linking hormonal alterations at the level of the thyroid and sex-hormone systems with this mortality risks.
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Affiliation(s)
- Ozkan Gungor
- Nephrology Department, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaras, Turkey
| | - Ismail Kocyigit
- Nephrology Department, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Juan Jesus Carrero
- Division of Renal Medicine, Centre for Gender Medicine and Centre for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
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Gungor O, Unal HU, Guclu A, Gezer M, Eyileten T, Guzel FB, Altunoren O, Erken E, Oguz Y, Kocyigit I, Yilmaz MI. IL-33 and ST2 levels in chronic kidney disease: Associations with inflammation, vascular abnormalities, cardiovascular events, and survival. PLoS One 2017; 12:e0178939. [PMID: 28614418 PMCID: PMC5470678 DOI: 10.1371/journal.pone.0178939] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 05/22/2017] [Indexed: 02/07/2023] Open
Abstract
Objective Increased inflammation, associated with the increase in chronic kidney disease (CKD) stage, has a very important influence in vascular injury and cardiovascular diseases. In this study, we aimed to investigate the levels of IL-33 and ST2 in the different stages of CKD and to determine their effect on vascular damage and cardiovascular events (CVE). Methods This was an observational cohort study in which serum IL-33 and ST2 were obtained from 238 CKD (stages 1–5) patients. We examined the changes in IL-33/ST2 levels in CKD patients, as well as the association with a surrogate of endothelial dysfunction. Fatal and non-fatal CVE were recorded for a mean of 24 months. We also performed a COX regression analysis to determine the association of IL-33/ST2 levels with CVE and survival. Results IL-33 and ST2 levels were significantly increased and estimated glomerular filtration rates (eGFR) were decreased. Flow-mediated dilatation (FMD) was significantly decreased from stage 1 to stage 5 CKD. IL-33 and ST2 levels were associated with FMD, and ST2 was a predictor. Multivariate Cox analysis showed that the presence of diabetes mellitus, smoking, and proteinuria and haemoglobin, Hs-CRP, IL-33, and ST2 were associated with the risk of CVE. Kaplan-Meier survival curves showed that patients with IL-33 and ST2 levels below the median value (IL-33 = 132.6 ng/L, ST2 = 382.9 pg/mL) had a higher cumulative survival compared with patients who had IL-33 and ST2 levels above the median value (log-rank test, p = 0.000). Conclusion This is the first study that demonstrates that serum IL-33 and ST2 are associated with vascular injury, cardiovascular events, and survival in CKD patients.
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Affiliation(s)
- Ozkan Gungor
- Department of Nephrology, Sütçü İmam University, Kahramanmaras, Turkey
- * E-mail:
| | - Hilmi Umut Unal
- Department of Nephrology, Gulhane School of Medicine, Ankara, Turkey
| | - Aydin Guclu
- Department of Nephrology, Ahi Evran University, Kirsehir, Turkey
| | - Mustafa Gezer
- Department of Nephrology, Gulhane School of Medicine, Ankara, Turkey
| | - Tayfun Eyileten
- Department of Nephrology, Gulhane School of Medicine, Ankara, Turkey
| | - Fatma Betül Guzel
- Department of Nephrology, Sütçü İmam University, Kahramanmaras, Turkey
| | - Orcun Altunoren
- Department of Nephrology, Sütçü İmam University, Kahramanmaras, Turkey
| | - Ertugrul Erken
- Department of Nephrology, Sütçü İmam University, Kahramanmaras, Turkey
| | - Yusuf Oguz
- Department of Nephrology, Gulhane School of Medicine, Ankara, Turkey
| | - Ismail Kocyigit
- Department of Nephrology, Erciyes University, Kayseri, Turkey
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Gungor O, Kocyigit I, Yilmaz MI, Sezer S. Role of vascular calcification inhibitors in preventing vascular dysfunction and mortality in hemodialysis patients. Semin Dial 2017; 31:72-81. [DOI: 10.1111/sdi.12616] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Ozkan Gungor
- Department of Nephrology; Faculty of Medicine; Kahramanmaraş Sütçü İmam University; Kahramanmaras Turkey
| | - Ismail Kocyigit
- Department of Nephrology; Erciyes University Faculty of Medicine; Kayseri Turkey
| | | | - Siren Sezer
- Department of Nephrology; Faculty of Medicine; Baskent University; Ankara Turkey
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Kocyigit I, Taheri S, Sener EF, Eroglu E, Ozturk F, Unal A, Korkmaz K, Zararsiz G, Sipahioglu MH, Ozkul Y, Tokgoz B, Oymak O, Ecder T, Axelsson J. Serum micro-rna profiles in patients with autosomal dominant polycystic kidney disease according to hypertension and renal function. BMC Nephrol 2017; 18:179. [PMID: 28558802 PMCID: PMC5450105 DOI: 10.1186/s12882-017-0600-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 05/23/2017] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Autosomal dominant polycystic kidney disease (ADPKD) is a common hereditary disorder with unclear disease mechanism. Currently, overt hypertension and increased renal volume are the best predictors of renal function. In this study, we assessed the usefulness of selected circulating microRNAs (miRs) to predict disease progress in a cohort with ADPKD. METHODS Eighty ADPKD patients (44.6 ± 12.7 years, 40% female, 65% hypertensive) and 50 healthy subjects (HS; 45.4 ± 12.7, 44% female) were enrolled in the study. Serum levels of 384 miRs were determined by Biomark Real Time PCR. Groups were compared using the limma method with multiple-testing correction as proposed by Smyth (corrected p < 0.01 considered significant). RESULTS Comparing ADPKD to HS, we found significant differences in blood levels of 18 miRs (3 more and 15 less abundant). Of these, miR-3907, miR-92a-3p, miR-25-3p and miR-21-5p all rose while miR-1587 and miR-3911 decreased as renal function declined in both cross-sectional and longitudinal analysis. Using ROC analysis, an increased baseline miR-3907 in the circulation predicted a > 10% loss of GFR over the following 12 months (cut-off >2.2 AU, sensitivity 83%, specificity 78%, area 0.872 [95% CI: 0.790-0.953, p < 0.001]). Adjusting for age and starting CKD stage using multiple binary logistic regression analysis did not abrogate the predictive value. CONCLUSION Increased copy numbers of miR-3907 in the circulation may predict ADPKD progression and suggest pathophysiological pathways worthy of further study.
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Affiliation(s)
- Ismail Kocyigit
- Department of Internal Medicine, Division of Nephrology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Serpil Taheri
- Department of Medical Biology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Elif Funda Sener
- Department of Medical Biology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Eray Eroglu
- Department of Internal Medicine, Division of Nephrology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Fahir Ozturk
- Department of Internal Medicine, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Aydin Unal
- Department of Internal Medicine, Division of Nephrology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Kezban Korkmaz
- Betul-Ziya Eren Genome and Stem Cell Center, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Gokmen Zararsiz
- Department of Biostatistics, Erciyes University, Kayseri, Turkey
| | - Murat Hayri Sipahioglu
- Department of Internal Medicine, Division of Nephrology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Yusuf Ozkul
- Betul-Ziya Eren Genome and Stem Cell Center, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Bulent Tokgoz
- Department of Internal Medicine, Division of Nephrology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Oktay Oymak
- Department of Internal Medicine, Division of Nephrology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Tevfik Ecder
- Department of Internal Medicine, Division of Nephrology, Istanbul Bilim University, Istanbul, Turkey
| | - Jonas Axelsson
- Division of Vascular Biology, Department of Medical Biochemistry and Biophysics, Karolinska institutet, Karolinska University Hospital, Stockholm, Sweden. .,Department of Clinical Immunology, Karolinska University Hospital, C2:66 ImmTrans, 141 86, Stockholm, Sweden.
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Kocyigit I, Yilmaz M, Gungor O, Eroglu E, Unal A, Orscelik O, Tokgoz B, Sipahioglu M, Sen A, Carrero J, Oymak O, Axelsson J. SP006VASOPRESSIN-RELATED COPEPTIN IS A NOVEL PREDICTOR OF EARLY ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH ADULT POLYCYSTIC KIDNEY DISEASE. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx137.sp006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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45
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Gungor O, Unal HU, Guclu A, Gezer M, Eyileten T, Altunoren O, Erken E, Oguz Y, Kocyigit I, Yilmaz MI. SP197IL-33 AND ST2 LEVELS IN CHRONIC KIDNEY DISEASE: ASSOCIATIONS WITH INFLAMMATION, VASCULAR ABNORMALITIES, CARDIOVASCULAR EVENTS AND SURVIVAL. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx143.sp197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Eroglu E, Kocyigit I, Unal A, Sipahioglu MH, Akgun H, Kaynar L, Tokgoz B, Oymak O. Unicentric Castleman’s disease associated with end stage renal disease caused by amyloidosis. World J Clin Cases 2017; 5:119-123. [PMID: 28352636 PMCID: PMC5352960 DOI: 10.12998/wjcc.v5.i3.119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 11/29/2016] [Accepted: 01/18/2017] [Indexed: 02/05/2023] Open
Abstract
Castleman’s disease (CD), also known as angiofolicular lymph node hyperplasia, is a rare heterogenous group of lymphoproliferative disorders. Histologically, it can be classified as hyaline vascular type, plasma cell type, or mixed type. Clinically two different subtypes of the CD are present: Unicentric and multicentric. Unicentric CD is generally asymptomatic and associated with hyaline vascular type, and its diagnoses depend on the localized lymphadenopathy on examination or imaging studies. However, multicentric CD presents with generalized lymphadenopathy and systemic symptoms including malaise, fever, night sweats, weight loss, and it is associated with the plasma cell type and mix type. Herein, we report a patient with unicentric CD of the plasma cell type without systemic symptoms, who developed end stage renal failure caused by amyloidosis 6 years after onset of CD.
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Affiliation(s)
- Hakan Imamoglu
- Department of Radiology, Erciyes University Medical School, Kayseri, Turkey
| | - Mehmet Gokce
- Department of Radiology, Erciyes University Medical School, Kayseri, Turkey
| | - Serkan Senol
- Department of Radiology, Erciyes University Medical School, Kayseri, Turkey
| | - Serap Dogan
- Department of Radiology, Erciyes University Medical School, Kayseri, Turkey
| | - Eray Eroglu
- Division of Nephrology, Department of Internal Medicine, Erciyes University Medical School, Kayseri, Turkey
| | - Ismail Kocyigit
- Division of Nephrology, Department of Internal Medicine, Erciyes University Medical School, Kayseri, Turkey
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Kocyigit I, Eroglu E, Ecder T. Nebivolol can be used for combination therapy in patients with autosomal dominant polycystic kidney disease. Expert Opin Pharmacother 2017; 18:455. [DOI: 10.1080/14656566.2017.1293653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Ismail Kocyigit
- Department of Internal Medicine, Division of Nephrology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Eray Eroglu
- Department of Internal Medicine, Division of Nephrology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Tevfik Ecder
- Department of Internal Medicine, Division of Nephrology, Istanbul Bilim University School of Medicine, Istanbul, Turkey
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Turkmen K, Guclu A, Sahin G, Kocyigit I, Demirtas L, Erdur FM, Sengül E, Ozkan O, Emre H, Turgut F, Unal H, Karaman M, Acıkel C, Esen H, Balli E, Bıtırgen G, Tonbul HZ, Yılmaz MI, Ortiz A. The Prevalence of Fabry Disease in Patients with Chronic Kidney Disease in Turkey: The TURKFAB Study. Kidney Blood Press Res 2016; 41:1016-1024. [PMID: 28006774 DOI: 10.1159/000452605] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Fabry disease is a treatable cause of chronic kidney disease (CKD) characterized by a genetic deficiency of α-galactosidase A. European Renal Best Practice (ERBP) recommends screening for Fabry disease in CKD patients. However, this is based on expert opinion and there are no reports of the prevalence of Fabry disease in stage 1-5 CKD. Hence, we investigated the prevalence of Fabry disease in CKD patients not receiving renal replacement therapy. METHODS This prospective study assessed α-galactosidase activity in dried blood spots in 313 stage 1-5 CKD patients, 167 males, between ages of 18-70 years whose etiology of CKD was unknown and were not receiving renal replacement therapy. The diagnosis was confirmed by GLA gene mutation analysis. RESULTS Three (all males) of 313 CKD patients (0.95%) were diagnosed of Fabry disease, for a prevalence in males of 1.80%. Family screening identified 8 aditional Fabry patients with CKD. Of a total of 11 Fabry patients, 7 were male and started enzyme replacement therapy and 4 were female. The most frequent manifestations in male patients were fatigue (100%), tinnitus, vertigo, acroparesthesia, hypohidrosis, cornea verticillata and angiokeratoma (all 85%), heat intolerance (71%), and abdominal pain (57%). The most frequent manifestations in female patients were fatigue and cornea verticillata (50%), and tinnitus, vertigo and angiokeratoma (25%). Three patients had severe episodic abdominal pain attacks and proteinuria, and were misdiagnosed as familial Mediterranean fever. CONCLUSIONS The prevalence of Fabry disease in selected CKD patients is in the range found among renal replacement therapy patients, but the disease is diagnosed at an earlier, treatable stage. These data support the ERBP recommendation to screen for Fabry disease in patients with CKD of unknown origin.
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Affiliation(s)
- Kultigin Turkmen
- Necmettin Erbakan University, Meram School of Medicine, Department of Internal Medicine, Division of Nephrology, Konya, Turkey
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Kocyigit I, Sener EF, Taheri S, Eroglu E, Ozturk F, Unal A, Zararsiz G, Uzun I, Imamoglu H, Sipahioglu MH, Tokgoz B, Oymak O, Ecder T. Toll-Like Receptors in the Progression of Autosomal Dominant Polycystic Kidney Disease. Ther Apher Dial 2016; 20:615-622. [PMID: 27928906 DOI: 10.1111/1744-9987.12458] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 01/20/2016] [Revised: 04/24/2016] [Accepted: 05/26/2016] [Indexed: 01/07/2023]
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary cause of chronic kidney disease. The intriguing role of innate immune system and inflammation become a target for potential therapeutic approach to slow progression. When toll-like receptors (TLRs) signaling and their receptors activate, they start a cascade of intracellular signaling that induces the production of the inflammatory cytokines and chemokines. Thus, we aim to investigate the association of TLRs between progression of ADPKD. Ninety ADPKD patients and ninety matched controls were enrolled this prospective study and were followed during 3 years. TLR-2 and TLR-4 gene polymorphisms and expressions were measured. Hypertension was diagnosed with ambulatory blood pressure monitoring. Rapid progression was defined as sustained decline in estimated glomerular filtration rate (eGFR) of more than 5 mL/min per 1.73 m2 per year. TLR-4Asp299Gly polymorphisms were significantly different between patient and control group (P < 0.05). Also, TLR-2 and TLR-4 gene expressions were significantly different between the ADPKD patients and the control subjects (P < 0.05). The expression levels of both TLR-2 and TLR-4 were found to be higher in the rapid progression groups comparing the slow progression group (P < 0.05). TLR-2 gene expression, hypertension and uric acid were found to be independent risk factors in identifying rapid progression in ADPKD patients. TLR-2 and TLR-4 gene expressions are associated with rapid progression in ADPKD patients. TLRs may play a role in the progression of ADPKD.
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Affiliation(s)
- Ismail Kocyigit
- Erciyes University Medical Faculty, Department of Internal Medicine, Division of Nephrology, Kayseri, Turkey
| | - Elif Funda Sener
- Erciyes University Medical Faculty, Department of Medical Biology, Kayseri, Turkey
| | - Serpil Taheri
- Erciyes University Medical Faculty, Department of Medical Biology, Kayseri, Turkey
| | - Eray Eroglu
- Erciyes University Medical Faculty, Department of Internal Medicine, Kayseri, Turkey
| | - Fahir Ozturk
- Erciyes University Medical Faculty, Department of Internal Medicine, Kayseri, Turkey
| | - Aydin Unal
- Erciyes University Medical Faculty, Department of Internal Medicine, Division of Nephrology, Kayseri, Turkey
| | - Gokmen Zararsiz
- Erciyes University Medical Faculty, Department of Bioistatistics, Kayseri, Turkey
| | - Ilknur Uzun
- Erciyes University Medical Faculty, Department of Internal Medicine, Kayseri, Turkey
| | - Hakan Imamoglu
- Erciyes University Medical Faculty, Department of Radiology, Kayseri, Turkey
| | - Murat Hayri Sipahioglu
- Erciyes University Medical Faculty, Department of Internal Medicine, Division of Nephrology, Kayseri, Turkey
| | - Bulent Tokgoz
- Erciyes University Medical Faculty, Department of Internal Medicine, Division of Nephrology, Kayseri, Turkey
| | - Oktay Oymak
- Erciyes University Medical Faculty, Department of Internal Medicine, Division of Nephrology, Kayseri, Turkey
| | - Tevfik Ecder
- Istanbul Bilim University Medical Faculty, Department of Internal Medicine, Division of Nephrology, Istanbul, Turkey
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