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Öğe Assesment of long term cardiovascular effects of unileteral nephrectomy(Oxford Univ Press, 2017) Özkurt, Sultan; Karavelioğlu, Yusuf; Kalçık, Macit; Doğan, İsmail Çağrı; Musmul, Ahmet; Yetim, Mücahit; Karaarslan, Osman; Çelik, Oğuzhan; Ekinözü, İsmail[Abstract Not Available]Öğe Assessment of long-term cardiovascular effects of unilateral nephrectomy(Springer Netherlands, 2017) Özkurt, Sultan; Karavelioğlu, Yusuf; Kalçık, Macit; Musmul, AhmetPurpose: There is conflicting evidence regarding long-term effects of unilateral nephrectomy such as cardiovascular diseases. Excessive increase in blood pressure (BP) during exercise called “hypertensive response to exercise” may be a sign of unborn hypertension and increased cardiovascular risk. Decrease in glomerular filtration rate (GFR) in patients with unilateral nephrectomy may be associated with disturbance of circadian BP changes without affecting the absolute levels of BP. We aimed to investigate the circadian BP changes and hypertensive response to exercise in normotensive patients with preserved renal functions who had undergone unilateral nephrectomy for other causes rather than organ donation. Methods: This study enrolled 32 patients (mean age 43.4 ± 9.9 years, male 15) with unilateral nephrectomy and 40 healthy controls (mean age 47 ± 6.1 years, male 17). All patients were undergone both office and ambulatory BP measurements and treadmill stress test. Results: The median time since nephrectomy was 12 (9–22) years in the patient group. The median GFR of the patient group was lower than that of the controls without significance [85.1 (76.0–97.9) vs. 93.2 (84.5–104.9), respectively; p = 0.14]. There was no significant difference between groups in terms of office BP measurements, night time diastolic and systolic BP, mean arterial pressure (MAP), night/day time ratio of MAP in ambulatory BP measurements. The results of treadmill stress tests and hypertensive response to exercise ratios were also similar between the groups. Conclusion: This study revealed that there was no increase in long-term cardiovascular risks one decade after unilateral nephrectomy based on circadian BP changes and hypertensive response to exercise in normotensive patients. © 2017, Springer Science+Business Media Dordrecht.Öğe Correlation of serum galectin-3 level with renal volume and function in adult polycystic kidney disease(Springer Netherlands, 2019) Özkurt, Sultan; Doğan, İbrahim; Özcan, Oğuzhan; Fidan, Nurdan; Bozacı, İlter; Yılmaz, Behice; Bilgin, MuzafferPurpose: The decrease in kidney functions in autosomal dominant polycystic kidney disease (ADPKD) is strongly correlated with the severity and growth of kidney cysts. Total kidney volume (TKV) was shown to be an early marker of the severity of the disease and a predictor of reduction in kidney functions. New treatment approaches for ADPKD have led to a need for easily applicable strong biomarkers predicting progression of the disease. The profibrotic mediator of galectin-3 (Gal-3) is linked to development of renal fibrosis. Methods: The study included 74 patients with ADPKD diagnosis and 40 healthy controls. The TKV of patients was calculated using the manual tracing method on MR images. The serum Gal-3 levels of patient and healthy control groups were measured with the ELISA method. The correlations between serum Gal-3 value with TKV and kidney function were assessed in patients. Results: As the stage of chronic kidney disease (CKD) increased, serum Gal-3 and TKV values increased (p < 0.001, p = 0.049, respectively). Correlation analysis found a negative relationship between serum Gal-3 levels and eGFR (r: ? 0.515, p < 0.001); however, there was no relationship between serum Gal-3 and TKV (r = 0.112, p = 0.344). Linear regression analysis showed the major parameter affecting Gal-3 was eGFR (p = 0.016). Conclusions: In our study, we showed that renal impairment is an important determinant of Gal-3, and there is no correlation of Gal-3 and TKV in ADPKD. As a result, there is an urgent clinical need for new biomarkers to identify individuals with the chance of treatment in the early stage among ADPKD patients. © 2019, Springer Nature B.V.Öğe Dream anxiety in hemodialysis and peritoneal dialysis patients(Kare Yayıncılık, 2017) Özkurt, Sultan; Yazla Asaf, Ece; Musmul, AhmetIntroduction: Sleep disorders are frequently reported in hemodialysis and peritoneal dialysis patients, but there are no studies investigating the dreams of these patients. This study was an examination of differences in the level of dream anxiety between hemodialysis patients and peritoneal dialysis patients. A comparison of depression and anxiety symptoms, sleep quality, and sleepiness between these 2 groups was also performed.Methods: In this observational, cross-sectional study, 49 hemodialysis patients and 29 peritoneal dialysis patients treated at an outpatient nephrology clinic were enrolled. A sociodemographic data collection form, the Van Dream Anxiety Scale, the Pittsburgh Sleep Quality Index, the Insomnia Severity Index, and the Beck Depression and Anxiety Inventories were administered, and hemoglobin level and fractional clearance of body water by dialysis (Kt/V urea) were measured.Results: There were no significant differences between the groups in terms of dream anxiety (p=0.517), depression (p=0.889), sleep quality (p=0.221), insomnia severity (p=0.152) or hemoglobin level (p=0.505).Discussion and Conclusion: We did not find any significant difference in the level of depression, anxiety, sleep quality, or insomnia severity between hemodialysis and peritoneal dialysis patients in our study. Similarly, the level of dream anxiety was consistent with these findings.Öğe Dream anxiety in renal transplant recipients(Taylor and Francis Ltd, 2015) Yazla Asaf, Ece; Özkurt, Sultan; Musmul, AhmetObjective: Although low quality of sleep has been reported in kidney transplant patients with functioning allografts, there are no previous studies investigating the dreams of these patients. We aimed to investigate the differences in dream anxiety level between renal transplant patients and healthy control subjects. We also planned to compare depression and anxiety symptoms, sleep quality and sleepiness level between these two groups. Methods: Twenty-two living-donor renal transplant recipients followed at an outpatient nephrology clinic and 22 healthy controls were enrolled in this observational cross-sectional study. Sociodemographic Data Collection Form, and the Van Dream Anxiety Scale (VDAS), the Pittsburg Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), Beck Depression and Anxiety Inventories were used for the assessment of the necessary features. Hemoglobin (Hb), blood urea nitrogen (BUN), creatinine (Cr) and glucose levels were measured. Results: There were no significant differences between the groups in terms of dream anxiety (p = 0.45), depression (p = 0.76), sleep quality (p = 0.8), insomnia severity (p = 0.08) and Hb (p = 0.11) and glucose levels (p = 0.14). Although, BUN (p = 0.00) and creatinine (p = 0.00) levels differed significantly between the two groups, both parameters were found to be within their normal range. Conclusions: In our study, chronic renal failure patients with a successful kidney transplant were found to be able to completely return to normal in terms of metabolic parameters, sleep quality and mood. Similar levels of dream anxiety are also consistent with these findings. © 2015 Informa Healthcare USA, Inc. All rights reserved.Öğe Echocardiographic assessment of right ventricular functions in nondiabetic normotensive hemodialysis patients(Akademiai Kiado Rt., 2015) Karavelioğlu, Yusuf; Özkurt, Sultan; Kalçık, Macit; Karapınar, Hekim; Arısoy, ArifPurpose: Heart is affected structurally and functionally in end-stage renal disease (ESRD). However, the data available about adverse effects of ESRD on right ventricle (RV) is scarce. We aimed to evaluate echocardiographic parameters of RV in nondiabetic, normotensive patients with ESRD undergoing hemodialysis (HD). Methods: A total of 45 (24 women; mean age 52.4 ± 12.4 years) consecutive nondiabetic, normotensive patients with ESRD undergoing HD and 39 healthy age and sex-matched control subjects (22 women; mean age 50.3 ± 6.6 years) were enrolled in the study. M-mode and two dimensional images, color, pulsed and continuous wave Doppler, and tissue Doppler measurements were acquired from all subjects. Echocardiographic evaluation was performed in the days between HD dates of the patients. Results: RV fractional area change, tricuspid annular plane systolic excursion, tricuspid E velocity, E/A ratio, tricuspid annular E´ velocity, and E´/A´ ratio were lower in patients than controls (p < 0.001, p = 0.003, p = 0.007, p = 0.005, p < 0.001, and p = 0.034, respectively). However, RV diastolic area, RV myocardial performance index, E/E´ ratio, and mean and systolic pulmonary artery pressure were higher in patients than controls (p < 0.001, p = 0.007, p = 0.005, p < 0.001, p = 0.006, respectively). Conclusions: RV systolic and diastolic functions of nondiabetic, normotensive HD patients are deteriorated as compared to healthy controls. © 2015 Akadémiai Kiadó, Budapest.Öğe Echocardiographic evaluation of epicardial adipose tissue in non-diabetic, non-hypertensive hemodialysis patients(2013) Özkurt, Sultan; Karavelioğlu, Yusuf; Musmul, AhmetPurpose: It has been found out that the epicardial adipose tissue (EAT) measured by echocardiography is related with various metabolic parameters. Being accepted as the new cardiovascular risk indicator, there have been few studies on EAT in relation to the patients with end-stage renal failure. In our study, we aim to evaluate EAT and carotid intima media thickness (CIMT) in non-diabetic, non-hypertensive hemodialysis (HD) patients. Methods: Our study recruited 47 non-diabetic, non-hypertensive HD patients (22 males, 25 females, median age 54 (44.3-60.8) years) and an age-gender matched control group consisting 41 healthy subjects (17 males, 24 females, median age 52 (48-56) years). In all patients, EAT was measured by echocardiography and CIMT by ultrasonography; and routine laboratory parameters were studied. Results: In our study, we obtained laboratory findings matching with the profiles of uremic patients among HD patients and CIMT values of HD patients are significantly higher than that of the control group [0.79 (0.64-0.93) vs. 0.6 (0.53-0.68) p < 0.001], and EAT values are similar [0.5 (0.33-0.6) vs. 0.4 (0.4-0.53) p > 0.05]. Conclusions: EAT is not a cardiovascular risk indicator in HD patients without diabetes mellitus and hypertension. Besides, echocardiographic measurement of EAT is easy, non-invasive, cheap and credible method. © 2013 Informa Healthcare USA, Inc.Öğe Effect of arteriovenous fistula and usage of arm with fistula on bone mineral density in hemodialysis patients(Taylor and Francis Ltd, 2016) Çağlıyan Türk, Ayla; Şahin, Füsun; Özkurt, Sultan; Tomak, Leman; Güray, GürkanWe aimed to determine the incidence of osteoporosis in hemodialysis patients, to evaluate the differences due to arteriovenous fistula on bone mineral density (BMD) and to investigate whether usage of arm with fistula has an effect on BMD. In this cross-sectional study, 96 patients with chronic renal disease undergone to dialysis were included. Place of fistula (radial and brachial) and dominant hand were recorded. All patients were asked to complete Likerts scale in order to determine the frequency of their usage of arm with fistula. Patients were assigned in two groups: age >51 and < 50 years. Age-matched control group included 60 subjects. BMD measurements were done on lumbar vertebra, femur and both forearms. BMD measurement of proximal femur and total radius were significantly lower in patients >50 years compared to healthy controls and bone density measurement of lumbar vertebra, proximal femur, 1/3 distal and total radius were significantly lower in patients < 50 years compared to healthy controls (p < 0.05). BMD measurement was significantly lower in arms with fistula, especially with radial fistula, compared to both arms without fistula and healthy controls (p < 0.05). When all patients were evaluated, BMD scores were lowering by increasing age, duration of dialysis and fistula and decreasing usage of arm with fistula. BMD in hemodialysis patients is lower than normal population. BMD of arm with fistula is lower than arm without fistula and healthy controls. Both radial and brachial fistula affect negatively ipsilateral BMD. Movement of arm with fistula has positive effects on BMD. © 2016 Taylor & Francis.Öğe Evaluation of atrial electromechanical coupling times in hemodialysis patients(Blackwell Publishing Inc., 2014) Karavelioğlu, Yusuf; Karapınar, Hekim; Özkurt, Sultan; Sarıkaya, Savaş; Küçükdurmaz, Zekeriya; Arısoy, Arif; Kurt, Recep; Yılmaz, Ahmet; Kaya, Mehmet G.BackgroundThere are no definite data about the atrial electromechanical coupling times (AEMCT) in patients with end stage renal failure (ESRF). The aim of this study was to investigate the AEMCT in ESRF patients without hypertension (HT) and diabetes mellitus.MethodsThe study population consisted of 47 normotensive, nondiabetic ESRF patients and 41 healthy age/gender-matched control subjects. The time intervals from the onset of P-wave on the surface electrocardiogram to the beginning of late diastolic A-wave (PA) were obtained from the lateral mitral annulus (PA-lateral, maximum AEMCT), septal annulus (PA-septal), and tricuspid lateral annulus (PA-tricuspid). Time intervals were corrected according to the heart rate. The difference between PA-septal and PA-tricuspid (right AEMCT), PA-lateral and PA-septal (left AEMCT), and PA-lateral and PA-tricuspid (inter AEMCT) were calculated. Corrected time intervals were used for calculations.ResultsGroups were similar for age (52 ± 12.3 vs. 49.9 ± 6 years, P > 0.05) and gender. Maximum (61 ± 20 vs. 47 ± 13 ms; P < 0.001) AEMCT was significantly higher in the patients compared with the control group, but septal and tricuspid EMCT were not different (P > 0.05). Both inter-atrial (37 ± 21 vs. 24 ± 16 ms, P = 0.002) and left atrial (25 ± 18 vs. 12 ± 9 ms; P < 0.001) EMCT were significantly higher in patients when compared with the controls but intra-right atrial EMCT was not different.ConclusionsAtrial conduction parameters such as maximal EMCT, left atrial, and inter-atrial EMCTs were prolonged in ESRF patients. This prolongation is seen in ESRF patients even in the absence of factors that affect atrial coupling, such as HT. © 2013, Wiley Periodicals, Inc.Öğe Evaluation of left ventricular diastolic function in nonhypertensive nondiabetic hemodialysis patients(2013) Karavelioğlu, Yusuf; Özkurt, Sultan; Karapınar, Hekim; Küçükdurmaz, Zekeriya; Arısoy, Arif; Kurt, Recep; Yılmaz, Ahmet; Yarlıoğlueş, Mikail; Akpek, Mahmut; Kaya, Mehmet G.AIM: Diastolic dysfunction (DD) is common in hemodialysis (HD) patients. Because diabetes mellitus (DM) and hypertension (HT) are also common in this patient group, the exact reason for DD in HD patients is not clear. The present study evaluated left ventricular (LV) diastolic function in HD patients without DM and HT. METHODS: Fifty patients on HD and 34 age-matched and sex-matched healthy control individuals were enrolled. Echocardiography was performed in all participants. LV systolic and diastolic functions were evaluated by B-mode echocardiography, pulsed wave, and tissue Doppler imaging. The HD patients were divided into two groups according to the presence or absence of left ventricular hypertrophy (LVH) in echocardiography. RESULTS: LV dimensions and systolic function were within normal limits and similar between groups. However, the HD patients had significantly worse diastolic function (E/A: 0.78±0.26 vs. 1.19±0.28, P<0.001, e?/a? septal: 0.77±0.36 vs. 1.04±0.21, P<0.001) and increased filling pressure (E/e?: 8.55±3.2 vs. 5.79±1.93, P<0.001). Thirty-one (62%) patients had LVH, whereas 19 (38%) patients did not have LVH. LV systolic and diastolic functions were similar in HD patients with and without LVH. Seventeen (55%) hypertrophies were concentric and 14 (45%) were eccentric. Diastolic functions were similar in patients with either concentric or eccentric hypertrophy. CONCLUSION: Diastolic function is impaired in HD patients even in the absence of diseases that can cause DD such as HT and DM. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.Öğe Evaluation of potential long-term changes in endothelial functions and basic echocardiographic parameters in unilateral nephrectomy patients(Blackwell Publishing Inc., 2017) Özkurt, Sultan; Karavelioğlu, Yusuf; Kalçık, Macit; Doğan, İbrahim; Musmul, AhmetAim: Decreased nephron count may result in lower glomerular filtration rate (GFR) and cardiorenal injury in the absence of compensatory hyperfunction. In this study, we aimed to evaluate long-term effects of 50% nephron loss on endothelial functions and cardiac morphology in nondonor nephrectomy patients. Methods: This study comprised 26 patients (median age: 44 [37.5–50] years, male: 14) with unilateral nephrectomy and 25 healthy controls (median age: 47 [42–50] years, male: 9). Echocardiography was performed in all patients. Endothelial function was examined by measuring ischemia-induced flow-mediated dilation (FMD) of the brachial artery. Results: The mean nephrectomy time was 12.5 (8.75–23.25) years. Estimated glomerular filtration rate (eGFR [CKD-EPI]) was significantly lower in the patient group than controls (85.54±16.27 vs 96.35±11.68 mL/min, P=0.009). Uric acid levels were significantly higher in the patient group than controls (5.7±1.3 vs 4.5±0.8, P<0.001). Percentage of FMD was significantly lower in the unilateral nephrectomy patients than the control group (11.6±6.2 vs 16.1%±7.9%; P=0.029). Left ventricular posterior wall thickness (LVPWT) (P<0.001), interventricular septal thickness (IVST) (P<0.001), left ventricular (LV) mass (P=0.014), and left ventricular mass index (P=0.014) were significantly higher in the patient group. Conclusion: In conclusion, 50% decrease in nephron mass due to unilateral nephrectomy may result in decreased eGFR, impaired endothelial functions and cardiac hypertrophy. What triggers endothelial dysfunction and cardiac hypertrophy in the event of mild decrease in GFR when creatinine has not been elevated yet remains unclear, but uric acid may be playing a role in this process necessitating large-scaled studies. © 2017, Wiley Periodicals, Inc.Öğe FGF-23, Inflammation and Iron Metabolism in the Early Stages of Autosomal Dominant Polycystic Kidney Disease(2020) Doğan, İbrahim; Ocak, Birol; Eser, Barış; Kayadibi, Hüseyin; Özkurt, Sultan; Kısakol, GürcanTo investigate the correlation of Fibroblast Growth Faktör-23 (sFGF-23) with iron status, inflammation and carotid intima-media thickness (CIMT) in the early stages of autosomal dominant polycystic kidney disease (ADPKD). Forty ADPKD patients (24 female) with normal creatinine levels and 40 healthy volunteers (21 female) were included in the study. Serum FGF-23 levels were measured using the ELISA technique. The associations between sFGF-23 with CIMT, hs-CRP, neutrophil lymphocyte ratio (NLR) and iron parameters were evaluated using correlation analysis. Patients’ sFGF-23 levels were significantly higher [245 (182-963) pg/mL; vs. 219.6 (34-494) pg/mL], (P< 0.001). NLR and hs-CRP were also found to be statistically higher in patients than controls (P< 0.001 and P= 0.003, respectively). CIMT was significantly higher in the patient group (P= 0.037). There were statistically significant negative correlations between sFGF-23 and calcium, hemoglobin, hematocrit, serum iron, ferritin, and NLR (P= 0.009, P= 0.035, P= 0.002, P= 0.033, P= 0.017, P= 0.023, respectively), and positive correlations with phosporus, total iron binding capacity and sFGF-23 (P= 0.010, P= 0.049, respectively). There was no statistically significant correlation between sFGF23 and PTH, hs-CRP and CIMT. In multivariate lineer regression analysis, serum phosphorus level was statistically significiant independent risk factor for the determinantion of sFGF-23 level [B: 0.318, OR:130,662(32,715-228,610), P=0.010]. Our study results support an inverse relationship between sFGF-23 and iron deficiency but no relationship between sFGF-23 and inflammation and atherosclerosis in the early stages of ADPKD.Öğe Is oxidative stress associated with total kidney volume in patients with autosomal dominant polycystic kidney disease?(Oxford Univ Press, 2020) Doğan, İbrahim; Eser, Barış; Aydemir, Nihal; Kayadibi, Hüseyin; Özcan, Oğuzhan; Fidan, Nurdan; Özkurt, SultanBackground and Aims : Ischemia Modified Albumin (IMA) is a marker of cardiovascular risk factor associated with oxidative stress. In this study, our aim was to determine oxidative stress status in autosomal dominant polycystic kidney disease (ADPKD) and to evaluate its relationship with total renal volume.Öğe Painful and painless shoulder Magnetic Resonance Imaging comparisons in hemodialysis patients and correlation with clinical findings(IOS Press, 2017) Çağlıyan Türk, Ayla; Fidan, Nurdan; Özcan, Oğuzhan; Özdemir, Ferda; Tomak, Leman; Özkurt, Sultan; Şahin, FüsunBACKGROUND: Shoulder pain is frequently observed in haemodialysis patients. OBJECTIVE: To compare haemodialysis patients with or without shoulder pain in terms of shoulder motion ranges, ?2 microglobulin levels and magnetic resonance imaging findings. METHODS: Forty-three patients undergoing dialysis were enrolled, of which 23 patients had explicit shoulder pain at night, which appeared during dialysis. Range of joint motion was evaluated. ?2 microglobulin value was recorded. MRI was used to evaluate rotator cuff tendons for thickness, homogeneity, integrity and presence of effusion. RESULTS: Ranges of motion were significantly lower in the painful shoulder group. Supraspinatus tendon thickness and the number of areas with effusion were higher in the painful group. There was a positive correlation between the ?2 microglobulin level and supraspinatus (r:0.352 p <0.05) and subscapular (r:0.454 p <0.05) tendon thicknesses. While effusion areas and pain (r:0.351 p < 0.05) showed positive correlation, there was a negative correlation between pain and shoulder motion ranges. CONCLUSIONS: Shoulder pain in dialysis patients can be related with tendon thickness and effusion.While the ?2 microglobulin level affects tendon thickness, it has no relation to pain and movement constraint. © 2017 - IOS Press and the authors.Öğe Pseudoexfoliation syndrome in chronic kidney disease patients(Informa Healthcare, 2015) Niyaz, Leyla; Özkurt, Sultan; Musmul, AhmetThis study was performed to determine whether chronic kidney disease (CKD) is associated with an increased risk of pseudoexfoliation (PEX) syndrome. This is an age-matched case control study evaluating frequency of PEX in patients over age 40 with the diagnosis of stage 1–4 CKD and those undergoing hemodialysis (HD). Subjects over age 40 with hypertension and/or diabetes mellitus (DM) and normal kidney functions were studied as a control group. CKD was diagnosed as decreased glomerular filtration rate (GFR) of less than 60?mL/min/1.73?m2 for at least 3 months. Study groups were arranged as group 1 consisting of HD receiving CKD patients, group 2 consisting of CKD patients who do not need HD and group 3 as a control. Demographic properties and the prevalence of PEX were evaluated and compared between groups. Because of the effect of DM on PEX occurrence, it was also evaluated after exclusion of diabetic patients. A total of 101 cases in group 1, 106 cases in group 2 and 117 cases in group 3 were included in the study. Pseudoexfoliation was found in 7 (6.9%) patients in group 1, 5 (4.7%) patients in group 2 and 7 (5.9%) patients in group 3 (p?>?0.05). After exclusion of diabetic patients the prevalence of PEX changed as 4 (5.6%) in group 1, 2 (4.4%) in group 2 and 1 (1.8%) in group 3 (p?>?0.05). In conclusion, CKD was not associated with increased prevalence of PEX in this study.Öğe Serum ADMA, endothelial dysfunction, and atherosclerosis in hypervolemic hemodialysis patients(TÜBİTAK, 2018) Doğan, İbrahim; Eser, Barış; Özkurt, Sultan; Yayar, Özlem; Özgür, Bülent; Kayadibi, Hüseyin; Doğan, Tolga; Musmul, Ahmet; Soydan, MehmetBackground/aim: Asymmetric dimethyl arginine (ADMA) is a strong predictor of cardiovascular disease and mortality in patients under hemodialysis treatment. We aimed to investigate the relationship among volume status, endothelial dysfunction, and ADMA in hemodialysis patients. Materials and methods: A total of 120 patients with a history of hemodialysis treatment were included. ADMA and CRP were measured. Echocardiographic evaluation and carotid artery intima–media thickness (CIMT) measurements were performed. Patients were divided into two groups according to clinical evaluation, ultrafiltration rate, vena cava inferior diameter (VCI), and cardiothoracic index (CTI); the two groups were hypervolemic and normovolemic. Results: The hypervolemic group included 61 patients while the normovolemic group included 59 patients. CIMT was higher in the hypervolemic group, but this result was not statistically significant (0.95 mm versus 0.85 mm, P = 0.232). There was a statistically significant difference between the hypervolemic and normovolemic groups in terms of ADMA (P < 0.001) (0.69 ± 0.57 µmol/L and 0.41 ± 0.04 µmol/L, respectively). Positive correlations were observed between serum ADMA, VCI, CTI, CRP, CIMT, and cardiac mass (P < 0.001, P = 0.016, P < 0.001, P = 0.006, P = 0.022, respectively), and negative correlations were observed between ADMA and ejection fraction and albumin (P = 0.024, P = 0.024, respectively). In multiple linear regression analysis, ADMA was independently associated with age, systolic blood pressure, CTI, and volume status. Conclusion: ADMA may be a potential determinant of hypervolemia as well as atherosclerosis in patients under hemodialysis treatment. © TÜBİTAK.Öğe The association between the prevalence of restless leg syndrome, fatigue, and sleep quality in patients undergoing hemodialysis(Saudi Medical Journal, 2018-08) Çağlıyan Türk, Ayla; Özkurt, Sultan; Turgal, Ebru; Şahin, FüsunObjective: To determine the prevalence of restless legs syndrome (RLS) in patients with chronic renal failure (CRF) and to compare CRF patients with or without RLS in terms fatigue and sleep quality. Methods: A cross-sectional study was conducted on 220 patients (18-75 years) who were undergoing dialysis 3 times weekly in Corum Province, Corum, Turkey, between January 2014 and January 2016. The diagnosis of RLS was based on the diagnostic form proposed by the international RLS study group. Sleep quality was evaluated using the Pittsburgh sleep quality index (PSQI), and severity of fatigue was determined by using fatigue severity scale (FSS). Results: Of all the participants, 16.8% (n=37) (Group 1) were found to have RLS, while 183 patients had no RLS (Group 2). The mean ages were similar between groups. With respect to laboratory analyses, a p-value of <0.05 was considered in Group 1 than in Group 2. Restless legs syndrome was mild (7.1%), moderate (46.4%) and severe (39.3%) in patients with RLS. Factors associated with the severity of RLS included weight, duration of dialysis, anuria, iron, total iron binding capacity, calcium and transferrin saturation. The PSQI and FSS scores were significantly worse in Group 1 (p<0.001). Conclusion: Restless legs syndrome is a common condition in patients undergoing hemodialysis; the results of our study confirm the adverse effects of RLS in terms of many aspects of sleep quality and fatigue.Öğe The effects of cholecalciferol treatment on mineral metabolism and inflammation markers in Turkish hemodialysis patients(2013) Özkurt, Sultan; Musmul, AhmetObjectives: To evaluate the effects of 25-hydroxycholecalciferol (25-[OH] D) on bone mineral metabolism and inflammation parameters in hemodialysis patients. Methods: The study was carried out at Hitit University Corum Education and Research Hospital, Corum, Turkey between July and September 2012. All of the 36 patients that underwent treatment in our hemodialysis unit were included in this study. Four patients were excluded from the study due to other complications. Of the remaining 32 patients, 28 patients (mean age; 52 ± 18 years; 15 males and 13 females) with a 25- (OH) vitamin D level of <30 ng/mL were included in the study. Four of the 32 remaining patients were excluded as their 25-(OH) vitamin D levels was >30 ng/ml. Patients with a 25-(OH) D level of <30 ng/mL were treated with 20,000 IU oral cholecalciferol once a week for 12 weeks. The level of vitamin D, mineral metabolism markers, and C-reactive protein (CRP) were evaluated. Results: After the treatment, the 25-(OH) D levels increased to >30 ng/mL in all patients (12.5±7.1 ng/mL versus 59.9±15.5 ng/mL; p<0.001). While there was a significant, but not life-threatening, increase in calcium levels (7.9 [7.26 to 8.32] mg/dL versus 8.48 [7.55 to 9.25] mg/dL, p<0.001), a statistically significant decrease was observed in CRP levels (9.34±4.4mg/L versus 4.4±1.6mg/L; p<0.001). Alkaline phosphatase, phosphorus, and parathyroid hormone levels did not change. Conclusion: Vitamin D deficiency is a common problem in HD patients. Short-term weekly cholecalciferol treatment is safe and effective in this patient group, and cholecalciferol treatment had a positive effect on inflammatory markers.Öğe Worm-like thrombus in the right heart treated with low dose fibrinolytic therapy in a patient with pulmonary embolism(2015) Karavelioğlu, Yusuf; Karpınar, Hekim; Küçükdurmaz, Zekeriya; Özkurt, SultanA 71 years old female patient presented with shortness of breath, cough, pleuretic chest pain and hemoptysis. Blood pressure was 160/90 mm/Hg and heart rate was irregular with 125 beats per minute.
