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Öğe ADULT MINIMAL CHANGE DISEASE IN TURKEY: THE RESULTS OF TURKISH SOCIETY OF NEPHROLOGY GLOMERULAR DISEASES WORKING GROUP(Oxford Univ Press, 2020) Yilmaz, Murvet; Sipahioglu, Murat; Dervisoglu, Erkan; Aydemir, Nihal; Uzun, Sami; Istemihan, Zulal; Sahin, Garip[Abstract Not Available]Öğe Effects of diet and exercise on adipocytokine levels in patients with moderate to severe chronic kidney disease(Elsevier Sci Ltd, 2020) Aydemir, Nihal; Pike, Mindy M.; Alsouqi, Aseel; Headley, Samuel A. E.; Tuttle, Katherine; Evans, Elizabeth E.; Robinson-Cohen, CassianneBackground and aims: Obesity is a pro-inflammatory risk factor for progression of CKD and cardiovascular disease. We hypothesized that implementation of caloric restriction and endurance exercise would improve adipocytokine profiles in patients with moderate to severe CKD. Methods and results: We enrolled patients with moderate to severe CKD through a multi-center pilot randomized trial of diet and exercise in a 4-arm design (dietary restriction of 10%-15% reduction in caloric intake, exercise three times/week, combined diet and exercise, and control) (NCT01150851). Adipocytokines (adiponectin and leptin) were measured at the beginning and end of the study period as secondary outcomes. Treatment effect was analyzed in a multivariable model adjusted for baseline outcome values, age, gender, site and diabetes. A total of 122 participants were consented, 111 were randomized (42% female, 25% diabetic, and 91% hypertensive), 104 started intervention and 92 completed the study (Figure 1). Plasma adiponectin levels increased significantly in response to diet by 23% (95% CI: 0.2%, 49.8%, p = 0.048) among participants randomized to the caloric restriction and usual activity arm but not to exercise, whereas circulating leptin did not change by either treatment. Conclusion: Our data suggest that dietary caloric restriction increases plasma adiponectin levels in stage 3-4 CKD patients, with limited effect on leptin levels. These findings suggest the potential for improving the metabolic milieu of CKD with moderate calorie restriction. (C) 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.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 Relationship between renal tubulointerstitial fibrosis and serum prolidase enzyme activity(Walter De Gruyter Gmbh, 2020) Eser, Barış; Doğan, İbrahim; Komut, Erdal; Koyuncu, Sümeyra; Aydemir, Nihal; Çolak, Aysel; Kayadibi, HüseyinObjectives: The severity of interstitial fibrosis/tubular atrophy (IFTA) is the most important determinant of the irreversible progression of chronic kidney disease (CKD). Prolidase is the key enzyme in collagen turnover and is associated with an extracellular matrix increase. We aimed to evaluate the relationship between the presence and degree of IFTA and serum prolidase enzyme activity (SPEA) in patients undergoing a renal biopsy. Methods: This cross-sectional study included 56 patients who underwent a renal biopsy (30 males; mean age 45.3 +/- 16.8 years) and also 54 healthy volunteers (21 males; mean age 42.7 +/- 8.2 years). IFTA scoring was performed on the basis of percentage of IFTA presence in renal biopsy tissues (1=<10%; 2=10-24%; 3=25-50%; 4=>50%). SPEA was measured by spectrophotometric method. Results: The proteinuria and SPEA levels of the patients were significantly higher than the controls (p<0.001 and p<0.001, respectively). SPEA decreased significantly when the IFTA score increased (p<0.002). In the correlation analysis, the IFTA score was negatively correlated with SPEA (r(s)=-0.461, p<0.001), and positively correlated with proteinuria (r(s)=0.274, p=0.041). Conclusion: These findings suggest that increased collagen turnover decreases over time concerning the progression of renal fibrosis. Monitoring of SPEA level may useful as a biomarker for early determination of CKD progression and severity.Öğe Urinay neutrophil gelatinase-associated lipocalin as a biomarker in different renal problems(Tubitak Scientific & Technical Research Council Turkey, 2020) Turgut, Didem; Piskinpasa, Serhan Vahit; Yenigun, Ezgi Coskun; Aydemir, Nihal; Dede, FatihBackground/aim: Neutrophil gelatinase-associated lipocalin (NGAL) is used previously to estimate the etiology, severity, and clinical outcomes of acute kidney injury (AKI). However, the role of urinary NGAL (uNGAL) in the postrenal setting is not clear. In our study, we aimed to discover the cut-off value of uNGAL that can be used in the differential diagnosis of underlying AKI etiologies. Materials and methods: In this prospective cross-sectional study, we examined 82 subjects in four groups: patients that had (1) postrenal AKI; (2) AKI other than postrenal etiologies; (3) stable chronic kidney disease; and (4) healthy subjects. A renal function assessment was carried out by measuring serum creatininc (sCr) and uNGAL at the time of diagnosis [0th min (T0)]. We followed the study group for three months. Results: At the time of diagnosis, sCr (T0) was highest in the postrenal AKI and AKI groups in contrast to stable chronic kidney disease patients and healthy subjects (P < 0.001), as expected. T0 median uNGAL was highest in the postrenal group (P < 0.001). Area under curve (AUC) of uNGAL to estimate postrenal AKI presence was 0.957 (95% CI, 0.897-1.000; P < 0.001). The cut-off point of uNGAL was 42.625 ng/mL for this estimation. Conclusion: Patients with AKI must be classified according to the underlying etiologies as soon as possible. uNGAL may be useful to estimate the etiologies, and whether the problem is acute or chronic in the course. In postrenal kidney problems, to plan the urgency of the urologic procedures, it is crucial.
