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Öğe Brucella and peritoneal dialysis related peritonitis: case report and review of literature(Dustri-Verlag Dr Karl Feistle, 2014) Koz, Suleyman; Sahin, Idris; Kayabas, Uner; Kuzucu, CigdemIsolated case reports of peritonitis due to Brucella spp. during peritoneal dialysis (PD) continue to surface in the medical literature. However, the optimal treatment regimen for these patients, in particular with regards to the fate of PD catheter, is still largely unknown. We report a case of brucella peritonitis successfully treated with intraperitoneal administration of amikacin, along with oral rifampicin and doxycycline but without catheter removal. Furthermore, we have reviewed the literature up until present day.Öğe Comparison of dialysate and plasma NTproBNP in prediction of clinical outcomes of diabetic and nondiabetic peritoneal dialysis patients(Dustri-Verlag Dr Karl Feistle, 2018) Koz, Suleyman; Sahin, Idris; Kayatas, Mansur; Koz, Sema TulayBackground: Plasma level of N-terminal pro-brain natriuretic peptide (P-NTproBNP) is a useful marker in prediction of mortality in peritoneal dialysis (PD) patients. However, the predictive value of spent dialysate counterpart (D-NTproBNP) of plasma NTproBNP on mortality and dropout is not known. Materials and methods: Simultaneous P-NTproBNP and D-NTproBNP assays were performed after an overnight dwell in 44 scheduled ambulatory PD patients. Patients were followed for similar to 47 months. Deceased patients or patients who were transferred to hemodialysis were regarded as dropouts. Results: 14 patients (31.8%) dropped out at similar to 4 years (9 deaths and 5 transfers to hemodialysis). Diabetics, males, and patients with higher membrane permeability had higher dropout rates. Patients with P-and D-NTproBNP higher than median values had higher mortality and dropout rates (Kaplan-Meier test, log-rank Test p < 0.05). Odds ratios of D-NTproBNP for death and dropouts were (3.807 (0.907-15.971), p = 0.068) and (2.87 (1.009-8.138) p = 0.048), respectively; odds ratios of P-NTproBNP for death and dropouts were (4.652 (0.914-23.693), p = 0.064) and (2.67 (0.924-7.716), p = 0.07), respectively; in ROC analysis for death, AUC for P-and D-NTproBNP were 0.762 (0.578-0.946, p = 0.016) and 0.765 (0.590-0.940, p = 0.015), respectively. Exclusion of diabetic patients from the analyses resulted in significant changes in the predictive value P-and D-NTproBNP. Although death and dropout rates were still higher in nondiabetic patients with higher NTproBNP levels, the differences between groups lost statistical significance. Conclusion: Both P-NTproBNP and D-NTproBNP are significant predictors of outcomes of interest. Predictive value of NTproBNP might be different in diabetics and non-diabetic CAPD patients.Öğe Course of Encephalopathy in a Cirrhotic Dialysis Patient Treated Sequentially with Peritoneal and Hemodialysis(Hindawi Ltd, 2015) Koz, Suleyman; Sahin, Idris; Terzi, Zafer; Koz, Sema TulayEnd-stage kidney disease and advanced cirrhosis are sometimes seen concomitantly. There is no consensus on dialysis modality in terms of determining the optimal way of treating these patients. It has been suggested that peritoneal dialysis is a better choice for these patients, but efficacy of hemodialysis in stable cirrhotic patients has not been evaluated sufficiently. We report a case with advanced cirrhosis and end-stage kidney disease who was faced with hepatic encephalopathy episodes up on starting renal replacement therapy. The case is also interesting in that it reveals effects of hemodialysis and peritoneal dialysis on hepatic encephalopathy episodes and quality of life of the patient.Öğe Effects of resveratrol on blood homocysteine level, on homocysteine induced oxidative stress, apoptosis and cognitive dysfunctions in rats(Elsevier Science Bv, 2012) Koz, Sema Tulay; Etem, Ebru Onalan; Baydas, Gyasettin; Yuce, Huseyin; Ozercan, Halil Ibrahim; Kuloglu, Tuncay; Koz, SuleymanWe aimed to examine the protective effects of resveratrol against homocysteine induced oxidative stress, apoptosis and cognitive impairment. Rats were randomly divided into three groups. Control group received standard rat food; homocysteine group (I-Icy group) received daily methionine at a dose of 1 g/kg-body weight dissolved in drinking water for thirty days; third group (Hcy+Res group) received same amount of methionine plus 20 mg/kg/day resveratrol intraperitoneally for thirty days. Cognitive performances of the animals were tested by Morris water maze test. Then all animals were sacrificed to study lipid peroxidation (LPO), DNA fragmentation and p53 mRNA expression in the rat brain. The aortas of the sacrificed rats were processed for histopathological examination. Apoptosis in the aortas was assessed by TUNEL staining. Resveratrol significantly decreased serum levels of homocysteine, reversed Hcy induced LPO increase, decreased DNA fragmentation and p53 mRNA expression in the rat brains, and improved homocysteine induced impairment of long term spatial memory. Resveratrol could inhibit homocysteine induced apoptosis and histopathological deterioration in the rat aortic sections. In conclusion, resveratrol is effective in preventing homocysteine induced vascular and neural defects. In hyperhomocysteinemic rat model, our findings consequently warrant in future studies to reveal the true improvement mechanism of resveratrol. (C) 2012 Elsevier B.V. All rights reserved.Öğe Elimination of NTproBNP in peritoneal dialysis patients Does peritoneal membrane type make a difference in plasma level and elimination of NTproBNP?(Dustri-Verlag Dr Karl Feistle, 2016) Koz, Suleyman; Sahin, Idris; Temel, Ismail; Koz, Sema T.; Terzi, ZaferBackground: Brain natriuretic peptide and its derivative peptide NTproBNP are utilized to exclude cardiac diseases, and predicting risk of mortality in dialysis patients. Our aim was to evaluate both elimination of NTproBNP through dialysate and a possible relationship between plasma and/or dialysate NTproBNP level and membrane transport status of peritoneal dialysis patients. Methods: 57 plasma (P) and dialysate (D) samples of 44 peritoneal dialysis (PD) patients were analyzed for NTproBNP. Modified peritoneal equilibration test (PET) results and other variables were obtained from the charts. Results: Median (IQR) NTproBNP concentrations (pg/mL x 1,000) in P and D were 3.3 (1 - 13) and 0.5 (0.2 - 3.6), respectively. There was a linear correlation between P-NTproBNP and D-NTproBNP (r = 0.928, p = 0.0001; regression equation was y = 0.897(*)x -0.28). Mean P/D-NTproBNP ratio was 5.5 +/- 0.5. Median P and D-NTproBNP levels by the membrane transport status were aligned as high (H) > high average (HA) > low average (LA), and the difference between H and LA was statistically significant (p < 0.001). Mean arterial pressure (MAP), residual Kt/V and dialysate/plasma ratio of crearinine (D/P Cr) were significant predictors of D-NTproBNP; whereas only MAP and residual Kt/V were significant predictors of P-NTproBNP in multiple regression analysis. Both P-and D-NTproBNP have significant and similar size of correlations with MAP, albumin, D/P Cr ratio, and Na. Conclusions: D-NTproBNP level is similar to 1/5 of P-NTproBNP, and the issue of relationship between membrane transport status and natriuretic peptide levels needs more work.Öğe Estimated Dialysate Magnesium Clearance in Peritoneal Dialysis Patients(Wiley-Blackwell, 2015) Koz, Suleyman; Sahin, Idris; Koz, Sema Tulay; Terzi, Zafer; Ataman, Engin; Akkus, Hadi[Abstract Not Available]Öğe Features of Hemodialysis in Cirrhotic Patients: Single Center Experience(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2015) Koz, Suleyman; Sahin, Idris; Terzi, Zafer; Koz, Sema TulayOBJECTIVE: End-stage kidney disease and advanced cirrhosis are sometimes seen concomitantly. Our purpose was to compare hemodialysis (HD) sessions in critically ill cirrhotic patients from ICU versus stable cirrhotic patients from outpatient clinic, and observe endurance of both stable and acutely ill cirrhotic patients to intermittent HD. MATERIAL and METHODS: All of the Child-Pugh class B or C cirrhotic patients requiring renal replacement therapy during a period of three years were included in the study. If hypotension, arrhythmia, bleeding, or any other health problems were present during dialysis, the dialysis session was regarded as a troubled session. RESULTS: There were two groups of patients. All of the stable patients lived more than three months, whereas all patients in the ICU group died within a month. Mean ultrafiltration volume per session was 1786 +/- 210 ml in ICU and 1616 +/- 266 ml in stable patients (p>0.05). The number of the troubled sessions was 24 in ICU and 1 in stable patients (p<0.0001). Bleeding was a problem in a minority of the patients. CONCLUSION: Intermittent HD may be an acceptable choice for stable cirrhotic dialysis patients. Hypotension is a frequent complication of intermittent HD in ICU patients.Öğe Gingko biloba Extract Inhibits Oxidative Stress and Ameliorates Impaired Glial Fibrillary Acidic Protein Expression, but Can Not Improve Spatial Learning in Offspring from Hyperhomocysteinemic Rat Dams(Wiley, 2012) Koz, Sema T.; Baydas, Giyasettin; Koz, Suleyman; Demir, Nevgul; Nedzvetsky, Viktor S.We aimed to study the effects of gingko biloba extract (EGb) on oxidative stress, astrocyte maturation and cognitive disfunction in offspring of hyperhomocysteinemic rats. Hyperhomocysteinemia was induced in the pregnant rats by administration of methionine (1?gr/kg body weight) dissolved in drinking water throughout pregnancy. One group of animals has received same amount of methionine plus 100?mg/kg/day EGb during pregnancy. On the postnatal day 1, half of the pups from all groups were sacrificed to study the lipid peroxidation (LPO) in different subfractions of brain. Other half of pups were tested in Morris water maze to assess differences in learning and memory performance at the 75?days of age. Maternal hyperhomocysteinemia significantly increased LPO levels especially in mitochondrial subfraction of fetal pup brains. EGb significantly prevented this LPO inrease. Methionine administration to animals reduced glial fibrillary acidic protein (GFAP) expression in pup brains significantly. EGb administration improved GFAP expression significantly. Offspring of hyperhomocysteinemic animals had poor long term spatial memory performance on Morris water maze and EGb administration had no effect on impaired spatial memory. In conclusion, maternally induced hyperhomocysteinemia significantly increased oxidative stress, decreased expression of GFAP and impaired learning performance. Copyright (c) 2011 John Wiley & Sons, Ltd.Öğe Hypernatremia in the Emergency Department(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2012) Yucel, Neslihan; Sahin, Idris; Akgun, Feride Sinem; Koz, Suleyman; Berber, Ilhami; Ozdemir, Muzaffer GalipINTRODUCTION: To determine the symptoms, clinical characteristics, prevalence and outcome of patients with hypernatremia who presented at the emergency department. MATERIA LAND METHODS: We retrospectively studied patients who presented at the emergency department with hypernatremia (Na>148 meq/l) from January 2008 to December 2008. RESULTS: A total of 25.545 cases presented at the Emergency Department and hypernatremia was seen in 86 patients. The prevalence of hypernatremia was 0.34%. The mean age was 69.5 +/- 15.2 (2096, median age: 75) years and 51 of them (59%) were male. Forty percent of the patients died. There were no significant differences according to age, gender and admission Na levels. A comorbid disease were seen 99% of patients. Cerebrovascular disease(CVD), dementia/Alzheimer and hypertension were the most common co-morbid diseases (respectively, 34%, 34%, and 27%). Central neurological system disorders (such as thrombotic or hemorrhagic CVD, Alzheimer, etc.) were seen in 72% of the cases. Fifty patients had acute infection at the time of admission. Acute urinary infection, pneumonia and acute CVD were the most common acute illnesses. CONCLUSION: Hypernatremia is usually seen in the geriatric population and associated with a high mortality and morbidity rate and the majority of patients with hypernatremia have a comorbid disease. The prevalence of hypernatremia was 0.34% in our emergency department.Öğe Screening for Celiac Disease among Patients with Chronic Kidney Disease(Informa Healthcare, 2012) Sahin, Idris; Eminbeyli, Lokman; Andic, Safak; Tuncer, Ilyas; Koz, SuleymanAim: Celiac disease (CD) is considered to be a risk factor for chronic kidney disease (CKD) but there is no study determining the prevalence of CD, among patients with CKD. We aim to determine the prevalence of CD in patients with CKD. Materials and methods: Anti-endomysial IgA (EMA) antibody was screened in patients with CKD (glomerular filtration rate <60 mL/min). Patients who were EMA positive underwent upper gastrointestinal system endoscopy and intestinal biopsy for confirmation of definite diagnosis for CD. Results: Two hundred and ninety-two patients (161 males, mean age was 47.3 +/- 16.3 years) with CKD were included. The EMA testing was positive in 10 patients (6F/4M). Of these, eight underwent upper gastrointestinal endoscopy and biopsies, two of them rejected endoscopy. Biopsy specimen of one of the patients was not appropriate for histopathological examination. Specimens of remaining cases (4F/3M) were compatible with CD on histopathological examination. The EMA-positive CKD patients were 3.42% (1/29 cases) and frequency of CD was 2.39% (1/42 cases). Frequency of CD was 3.1% in females and 1.85% in males. Female/male ratio was 1.67. We did not find statistically significant difference between two groups according to age and gender. Apparent chronic gastrointestinal symptoms such as abdominal pain, distension, constipation, dyspepsia, and diarrhea were absent in patients diagnosed with CD. Differences between some laboratory parameters (such as complete blood count, albumin, calcium, phosphate, total cholesterol, ferritin, parathormone) of CD and non-CD patients were not significant statistically. Conclusion: Our results showed increased frequency of CD among patients with CKD and screening for CD in CKD population can be helpful.
