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    Acute chorea characterized by bilateral basal ganglia lesions in a patient with diabetic nephropathy
    (Turkish Society of Nephrology, 2015) Doğan, İbrahim; Kahvecioğlu, Serdar; Kurtoğlu, Ünal; Yıldız, Demet; Yıldız, Abdulmecit
    The syndrome of acute bilateral basal ganglia lesions associated with uremia presents with parkinsonism, altered mental status, and chorea in association with specific imaging findings in the basal ganglia. It is an uncommon syndrome seen generally in patients with diabetes mellitus and renal failure. We report a male patient with diabetes mellitus who received hemodialysis treatment 3 days a week for 5 years and suffered from choreic movements developed suddenly and associated with bilateral basal ganglia lesions. In the brain magnetic resonance (MR) imaging, isointense was detected in sequence T1 in the bilateral basal ganglions and hyperintense lesion was determined in T2 and FLAIR sequences. The patient was administered daily hemodialysis and neuroleptic treatment. After intensified hemodialysis, his symptoms and follow-up brain MR imaging showed marked improvement. The underlying mechanism of such lesions may be associated with metabolic, as well as vascular factors. Acute choreic movements may be seen in patients with diabetic nephropathy and intensification of hemodialysis treatment along with blood glucose regulation may provide improvement in this syndrome.
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    Relationship of serum asymmetric dimethylarginine levels with inflammation and cardiac functions in autosomal dominant polycystic kidney disease
    (Turkish Society of Nephrology, 2018) Doğan, İbrahim; Altuner, Şakir; Kahvecioğlu, Serdar; Hünük, Ahmet; Eser, Barış; Yayar, Özlem; Kurtoğlu, Ünal; Bayol, Hakan
    OBJECTIVE: Most deaths in autosomal dominant polycystic kidney disease (ADPKD) are attributable to cardiovascular disease (CVD). The relationship between serum asymmetric dimethylarginine (ADMA) and CVD has been investigated. We aimed to search the relationship between serum ADMA, atherosclerosis, inflammation and cardiac functions in ADPKD. MATERIAL and METHODS: Fifty-seven ADPKD patients and 23 healthy control subjects were enrolled. Carotid artery intima-media thickness (CIMT) and echocardiographic measurements were performed. ADMA, inflammatory markers, Neutrophil Count/Lymphocyte Count (NLR), echocardiographic findings and CIMT values were compared between the groups. Correlation analyses were performed. RESULTS: ADMA levels were lower in patients compared to controls [10106 ng/L (2010-60000) vs. 20161 ng/L (2902-60000), p=0.006]. CIMT was 0.67±0.03 mm in the patient group and 0.62±0.03 mm in the control group (p>0.05). In the patient group, left ventricular mass (LVM), left ventricular mass index (LVMI), left atrial diameter (LAD) and left ventricular end-diastolic diameter (LVEDD) values were higher (p<0.001, p<0.001, p<0.05, p<0.01). NLR was 2.0 (0.96-13) in the patient group and 1.6 (0.81-6.06) in the control group (p<0.01). Serum ADMA levels were negatively correlated with CIMT and LAD (p<0.05, p<0.001). CONCLUSION: Serum ADMA levels were found to be low in ADPKD patients. Additional studies are needed to determine the possible affect of ADMA on atherosclerosis and inflammation in early stage of ADPKD. © 2018 Turkish Society of Nephrology. All rights reserved.
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    Significance of apelin-13 for inflammation and cardiac morphology in peritoneal dialysis patients
    (Turkish Society of Nephrology, 2018) Doğan, İbrahim; Kahvecioğlu, Serdar; Eser, Barış; Kayadibi, Hüseyin; Yayar, Özlem; Doğan, Tolga; Kurtoğlu, Ünal; Ünallı Özmen, Sevda; Saka Karagöz, İsminur
    OBJECTIVE: Apelin-13 is a biomarker that was shown to be related to cardiovascular disease risk in peritoneal dialysis patients. The aim of our study was to investigate the association of serum apelin-13 levels with inflammation, carotid artery intima media thickness (CIMT) and echocardiographic parameters in peritoneal dialysis patients. MATERIAL and METHODS: 33 patient receiving peritoneal dialysis treatment (15 female) and 27 healthy controls (11 female) were enrolled. CIMT and echocardiographic measurements of all patients and controls were taken. Serum apelin-13 levels were measured by ELISA. Apelin-13, c-reactive protein (CRP), neutrophil-To-lymphocyte ratio (NLR), echocardiographic parameters and CIMT values were compared between patients and controls. RESULTS: Apelin-13 was lower in the patient group [58 (12-131) ng/L] than in the control group [76 (18-130) ng/L] (p=0.083). CRP, NLR, CIMT were significantly higher in patients than controls (p<0.001). CIMT was 0.8 (0.4-1.5) mm and 0.60 (0.3-0.7) mm in the patients and the controls, respectively. Negative correlations were observed between Apelin-13 and age, ferritin, CRP, NLR and CIMT while positive correlations were found between calcium, ejection fraction (EF) and albumin. There was no correlation between apelin-13 and echocardiographic parameters except EF. CONCLUSION: Apelin-13 levels tend to be lower in peritoneal dialysis patients, and may be important in the development of inflammation, endothelial dysfunction, and atherosclerosis. © 2018 Turkish Society of Nephrology. All rights reserved.