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Öğe 25 (OH) Vitamin D in Patients with Chronic Kidney Disease and Dialysis Patients(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2012) Ulutas, Ozkan; Taskapan, HulyaIn addition to its role on calcium homeostasis, vitamin D exhibits local (paracrine) effects on cell proliferation differentiation and immune function. Most cells in the body express Vitamin D receptors and 1 alpha-hydroxylase, thereby permitting local production of 1,25 dihydroxycholecalciferol, which has therapeutic implications (paracrine effects). Studies have shown that chronic vitamin D deficiency may have serious adverse consequences such as increased risk of hypertension, multiple sclerosis, rheumatoid arthritis, cancer of the colon, prostate, breast, ovary, and type 1 diabetes. However, information about the effect of vitamin D supplementation and replacement, and cardiometabolic outcomes is very limited. Studies on Vitamin D replacement in patients with chronic kidney disease and dialysis patients are needed.Öğe Accidental Falls and Risk of Mortality among Older Adults on Chronic Peritoneal Dialysis(Amer Soc Nephrology, 2014) Farragher, Janine; Chiu, Ernest; Ulutas, Ozkan; Tomlinson, George; Cook, Wendy L.; Jassal, Sarbjit V.Background and objectives More than 40% of elderly hemodialysis patients experience one or more accidental falls within a 1-year period. Such falls are associated with higher mortality. The objectives of this study were to assess whether falls are also common in elderly patients established on peritoneal dialysis and evaluate if patients with falls have a higher risk of mortality than patients who do not experience a fall. Design, setting, participants, & measurements Using a prospective cohort study design, patients ages years on chronic peritoneal dialysis from April 2002 to April 2003 at the University Health Network were recruited. Patients were followed biweekly, and falls occurring within the first 15 months were recorded. Outcome data were collected until death, study end (July 31, 2012), transplantation, or transfer to another dialysis center. Results Seventy-four of seventy-six potential patients were recruited, assessed at baseline, and followed biweekly for falls; 40 of 74 (54%) peritoneal dialysis patients experienced 89 falls (adjusted mean fall rate, 1.7 falls per patient-year; 95% confidence interval, 1.0 to 2.7). Patients with falls were more likely to have had previous falls, be more recently initiated onto dialysis, be men, be older, and have higher comorbidity. Twenty-eight patients died during the follow-up period. After adjustment for known risk factors, each successive fall was associated with a 1.62-fold higher mortality (hazard ratio, 1.62; 95% confidence interval, 1.29 to 2.02; P<0.001). Conclusions Accidental falls are common in the peritoneal dialysis population and often go unrecognized. Falls were associated with higher mortality risk. Because fall interventions are effective in other populations, screening peritoneal dialysis patients for falls may be a simple measure of clinical importance.Öğe The causes of death-censored graft loss among kidney transplant recipients(2024) Ciftci, Felat; Simsek, Arife; Piskin, Turgut; Unal, Bulent; Dogan, Sait Murat; Ulutas, Ozkan; Tabel, YilmazAim: This study presents the causes of death-censored graft loss among kidney transplant recipients. Materials and Methods: Medical records of the patients, who had undergone kidney transplantation at a tertiary center between November 2010 and December 2018, were retrospectively reviewed. Death-censored graft loss was described as an irreversible graft failure signified by return to long-term dialysis (or re-transplantation). Inclusion criteria were: patients who had undergone kidney transplantation, and subsequently lost their first graft, and a follow-up of more than one year after kidney transplantation. Results: Of 269 kidney transplant recipients, 33 recipients with a mean age of 33.54 ± 15.37 years (17 male and 16 female) were included in the study. The rate of death-censored graft loss was 12.26%. Of graft failures, 3.03% occurred in the hyperacute phase, 18.18% in the acute phase, and 78.78% in the chronic phase. Chronic allograft nephropathy was the leading cause of graft failure (48.48%). Other causes were medical problems (18.18), immunological problems (18.18%) and surgical complications (15.15%). Conclusion: Identification of the true causes of graft failure described under the heading chronic allograft nephropathy is noteworthy. Comprehensive biochemical, physiological, pathological, immunological, and genetÖğe An Epidermolysis Bullosa Patient Complicated with Chronic Renal Failure(Galenos Yayincilik, 2013) Ulutas, Ozkan; Taskapan, Hulya; Sari, Funda; Senol, MustafaA 32-yr-old man with epidermolysis bullosa presented with clinical and laboratory findings of chronic renal failure. The patient was supposed to be suffering from mesangial IgA glomerulonephritis in view of the repeated persistent macroscopic episodes of hematuria and raised serum IgA levels, especially polimeric IgA. Because continuous vascular access could not be established, the patient died due to uremia and sepsis. Renal complications are associated with life-threatening problems in this inherited mechanobullous disease because it is impossible to obtain a continuous vascular access or a continuous peritoneal access. The possibility of IgA nephropathy should be considered in patients with epidermolysis bullosa. They should be periodically set up screened for IgA levels and hematuria.Öğe EQUIVALENT FALL RISK IN ELDERLY PATIENTS ON HEMODIALYSIS AND PERITONEAL DIALYSIS(Multimed Inc, 2016) Farragher, Janine; Rajan, Tasleem; Chiu, Ernest; Ulutas, Ozkan; Tomlinson, George; Cook, Wendy L.; Jassal, Sarbjit V.Background: Accidental falls are common in the hemodialysis (HD) population. The high fall rate has been attributed to a combination of aging, kidney disease-related morbidity, and HD treatment-related hazards. We hypothesized that patients maintained on peritoneal dialysis (PD) would have fewer falls than those on chronic HD. The objective of this study was to compare the falls risk between cohorts of elderly patients maintained on HD and PD, using prospective data from a large academic dialysis facility. Methods: Patients aged 65 years or over on chronic in-hospital HD and PD at the University Health Network were recruited. Patients were followed biweekly, and falls occurring within the first year recorded. Fall risk between the 2 groups was compared using both crude and adjusted Poisson lognormal random effects modeling. Results: Out of 258 potential patients, 236 were recruited, assessed at baseline, and followed biweekly for falls. Of 74 PD patients, 40 (54%) experienced 86 falls while 76 out of 162 (47%) HD patients experienced a total of 305 falls (crude fall rate 1.25 vs 1.60 respectively, odds ratio [OR] falls in PD patients 0.78, 95% confidence interval [CI] 0.61 - 0.92, p = 0.04). After adjustment for differences in comorbidity, number of medications, and other demographic differences, PD patients were no less likely to experience accidental falls than HD patients (OR 1.63, 95% CI 0.88 - 3.04, p = 0.1). Conclusions: We conclude that accidental falls are equally common in the PD population and the HD population. These data argue against post-HD hypotension as the sole contributor to the high fall risk in the dialysis population.Öğe FUNCTIONAL DISABILITY IN OLDER ADULTS MAINTAINED ON PERITONEAL DIALYSIS THERAPY(Sage Publications Inc, 2016) Ulutas, Ozkan; Farragher, Janine; Chiu, Ernest; Cook, Wendy L.; Jassal, Sarbjit V.Background: Older in-center hemodialysis patients have a high burden of functional disability. However, little is known about patients on home chronic peritoneal dialysis (PD). As patients opting for home dialysis are expected to play a greater role in their own dialysis care, we hypothesized that a relatively low number of PD patients would require help with basic self-care tasks (ADL) and instrumental activities of daily living (IADL). Methods: We used a cross-sectional study design to measure the proportion of patients aged 65 years and older undergoing outpatient PD who needed help with day-to-day activities. Patients living in nursing homes were excluded from the study. Functional dependence in ADL and IADL tasks were measured by the Barthel and Lawton Scales. Physical performance measures used included the timed up-and-go (TUG) test, chair stands and Folstein mini-mental score (MMSE). Results: A total of 74 of 76 (97%) eligible PD patients participated. Patients had a mean age of 76.2 +/- 7.5 years. Thirty-six percent had impaired MMSE scores, 69% were unable to stand from a chair without the use of their arms and 51% had abnormal TUG scores. Only 8 patients (11%) were fully independent for both ADL and IADL activities. Dependence in one or more ADL activity was reported by 64% of participants, while 89% reported dependence in one or more IADL. Conclusions: Impaired physical and functional performance is common in older patients maintained on PD. Collaborative geriatric-renal programs may be beneficial within the dialysis community.Öğe Investigation of Kidney Morphology and Somatotype Components in Early-Stage Kidney Patients(Kare Publ, 2023) Ulubaba, Hilal Er; Cinarli, Fahri Safa; Ciftci, Rukiye; Ulutas, OzkanObjectives: The aim of this study is to examine the kidney morphology and somatotype components of adult patients with early-stage chronic kidney disease (CKD). Methods: The sample consisted of 46 individuals with early-stage CKD (26 men and 20 women, mean age=45.92 +/- 16.53 years). The pathological subjects were compared with a control group consisting of 46 healthy subjects (28 men and 18 women, mean age=41.96 +/- 11.48 years). The Heath-Carter method was used to determine somatotype components. Abdominal computed tomography (CT) of patients with Stage 2 CKD and healthy volunteers taken within the past 3 months was scanned to determine kidney morphology. Kidney measurements were performed on CTs (length, width, depth, and volume of kidney). Results: Kidney patients (mean somatotype: 6.33-5.37-0.6) were less ectomorphic and more endomorphic than the controls (mean somatotype: 4.35-4.40-3.02). Moderate effect size (ES) was found in endomorphy (ES=0.87; p=0.035) and ectomorphy (ES=1.08; p=0.012) between groups. No significant difference was observed in the kidney morphology (ES=0.04-0.19; p>0.05). Conclusion: In the early-stage CKD, kidney morphology may not be the distinguishing factor. On the other hand, patients differed significantly in terms of endomorph components. Being overweight can also be one of the negative findings for kidney disease. Somatotype classification could be a suitable tool for monitoring kidney disease.Öğe Living Donor Kidney Transplantation: Why Potential Donors and Recipients do not Achieve it. Malatya Algorithm(Asoc Regional Dialisis Trasplantes Renales, 2020) Simsek, Arife; Dogan, Sait Murat; Gurbu, Huseyin; Ulutas, Ozkan; Toplu, Sibel; Turgut, Asli; Yildirim, Ismail OkanIntroduction: In some countries, organ donation is not widespread enough due to medical, cultural, ethical and socioeconomic factors. Living-donor kidney transplant constitutes the main source of kidney donation. Aim: To evaluate the causes of cancellation of living-donor kidney transplant and improve the effectiveness of transplant programs. Methods: Medical records of possible donors and recipients who were evaluated for living-donor kidney transplant at a tertiary medical center between November 2010 and September 2019 were reviewed retrospectively. Results: Evaluations were performed on 364 potential donors and 338 living-donor kidney transplant recipients; 207 of the latter (61.24%) underwent living-donor kidney transplant. Immune disorders represented the majority of cancellations (38.84%). Fifty-six donors (15.38%) were rejected mainly due to renal disorders (39%). Conclusion: Timely referral of patients to transplant centers must be guaranteed in order to overcome immune problems. Transplant centers should invest in programs adequate both for their resources and for their patients: paired kidney exchange, desensitization protocols, future research, etc.Öğe NGAL and NT-proBNP levels in diabetic patients with macroproteinuria(Taylor & Francis Ltd, 2013) Taskapan, Hulya; Taskapan, Mehmet Cagatay; Orman, Ibrahim; Ulutas, Ozkan; Yigit, Ali; Ozyalin, Fatma; Yologlu, SaimBackground: In patients with heart failure plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels are correlated to urine neutrophil gelatinase-associated lipocalin (NGAL) levels. We prospectively evaluated the relationship among glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (ACR), urine and serum NGAL and NT-proBNP levels in 20 type II diabetic patients with macroalbuminuria at 4-month intervals. Results: Compared with 20 age, gender-matched healthy controls, diabetic patients had higher urine and serum NGAL, serum NT-proBNP and lower eGFR. The eGFR of the patients at the baseline, the 4th and the 8th month were 29.6 +/- 12.0, 27.8 +/- 13.7 and 22.9 +/- 10.4 mL/min/1.73m(2), respectively. No significant change in urine NGAL levels was detected (p > 0.05), whereas there were significant increases in NT-proBNP, serum NGAL and urine ACR and significant decrease in eGFR as the study progressed (p < 0.05). Both the baseline and the 4th month urine ACR were positively correlated to NT-proBNP levels measured at the same periods (r: 0.451; p: 0.046; r: 0.489; p: 0.029 respectively). In all measurements, urine ACR was negatively correlated to serum albumin levels measured at the same periods (r: -0.792; p: 0.000; r: -0.716; p: 0.000; r: -0.531; p: 0.016 respectively). None of eGFR measurements was correlated with NT-proBNP (p > 0.05). Neither serum NGAL nor urinary NGAL levels are associated with NT-proBNP (p > 0.05). Conclusion: Our findings show an association between NT-proBNP and proteinuria in type II diabetic patients with macroalbuminuria but not with serum and urine NGAL.Öğe Peripheral Blood Smear Findings of COVID-19 Patients Provide Information about the Severity of the Disease and the Duration of Hospital Stay(Mattioli 1885, 2021) Berber, Ilhami; Cagasar, Ozlem; Sarici, Ahmet; Berber, Nurcan Kirici; Aydogdu, Ismet; Ulutas, Ozkan; Yildirim, AsliBackground: Data about the morphological changes in peripheral blood smears during COVID-19 infection and their clinical severity association are limited. We aimed to examine the characteristics of the cells detected in the pathological rate and/or appearance and whether these findings are related to the clinical course by evaluating the peripheral blood smear at the time of diagnosis in COVID-19 patients. Methods: Clinical features, laboratory data, peripheral blood smear of fifty patients diagnosed with COVID-19 by PCR was evaluated at diagnosis. Peripheral smear samples of the patients were compared with the age and sex-matched 30 healthy controls. Pictures were taken from the patient's peripheral blood smear. Patients were divided into two groups. Mild and severe stage patient groups were compared in terms of laboratory data and peripheral smear findings. The relationship between the laboratory values of all patients and the duration of hospitalization was analyzed. Results: The number of segmented neutrophils and eosinophils were low, pseudo-Pelger-Huet, pseudo-Pelger-Huet/mature lymphocyte ratio, atypical lymphocytes, monocytes with vacuoles, bands, and pyknotic neutrophils rates were higher in the peripheral blood smear of the patient group (p<0.05). Increased pseudo-Pelger-Huet anomaly, pseudo-Pelger Huet/mature lymphocyte ratio, a decreased number of mature lymphocytes, and eosinophils in peripheral blood smear were observed in the severe stage patients (p<0.05). A negative correlation was observed between hospitalization duration and mature lymphocyte and monocytes with vacuoles rates (p<0.05). Conclusion: A peripheral blood smear is an inexpensive, easily performed, and rapid test. Increased Pseudo-Pelger-Huet anomaly/mature lymphocyte rate suggests a severe stage disease, while high initial mature lymphocyte and monocytes with vacuoles rates at the time of diagnosis may be an indicator of shortened duration of hospitalization.Öğe Pulmonary Embolism as the Initial Presentation of Testicular Carcinoma(Hindawi Ltd, 2013) Berber, Ilhami; Bentli, Recep; Erkurt, Mehmet Ali; Ulutas, Ozkan; Ediz, Caner; Nizam, Ilknur; Berber, Nurcan KiriciObjective. The risk of pulmonary embolism is well recognized as showing an increase in oncological patients. We report a case presenting with pulmonary embolism initially, which was then diagnosed with testicular cancer. Clinical Presentation and Intervention. A 25-year-old man was admitted to the emergency department with a complaint of dyspnoea. Thoracic tomography, lung ventilation/perfusion scintigraphy, and an increased D-dimer level revealed pulmonary embolism. For the aetiology of pulmonary embolism, a left orchiectomy was performed and the patient was diagnosed with a germinal cell tumour of the testicle. Conclusion. In this paper, we present a patient for whom pulmonary embolism was the initial presentation, and a germinal cell tumour was diagnosed later during the search for the aetiology.Öğe The safety profile of favipiravir in COVID-19 patients with severe renal impairment(Wiley-Hindawi, 2021) Gok, Selim; Bahcecioglu, Omer Faruk; Durmus, Mefkure; Gun, Zeynep Ulku; Ersoy, Yasemin; Aytemur, Zeynep Ayfer; Ulutas, OzkanObjective The safety profile of favipiravir in patients with severe renal impairment has not been investigated and available data are insufficient. The study aimed to compare the incidence of favipiravir-associated adverse events amongst patients with varying renal function statuses. Methods Records of 921 patients who were hospitalised for COVID-19 and had received at least 5 days of favipiravir treatment were retrospectively evaluated and 228 patients were included in the study. Patients' age, sex, comorbidities, estimated glomerular filtration rate (eGFR) and haematological and biochemical values were recorded. The incidence of adverse events was compared with the age, sex, comorbidities and eGFR of the patients. Results The mean age of the patients was 59.3 +/- 15.6 years, and 38.2% of the patients were women. One hundred and thirty-one (57.5%) patients had experienced adverse events. These adverse effects consisted of ALT elevation (35.5%), AST elevation (21.5%), anaemia (16.2%), hyperuricaemia (10.5%), hepatocellular injury (9.2%), neutropenia (3.5%) and thrombocytopenia (2.6%). The incidence of adverse events was not significantly different when patients had eGFR >60 mL/min/1.73 m(2) or eGFR 30-60 mL/min/1.73 m(2) (P > .05), but significantly increased when the eGFR dropped to <30 (P < .05). The differences seen with hyperuricaemia and anaemia were significant (P < .05). Conclusion Even though favipiravir appeared to be well tolerated in the individuals with renal failure in this study, its use in this population remains a challenge that requires more research and analysis.Öğe Serum Fetuin-A Levels, QT Dispersion and P Dispersion in Dialysis Patients(Taylor & Francis Ltd, 2013) Taskapan, Mehmet Cagatay; Taskapan, Hulya; Comert, Melda; Temel, Ismail; Yagmur, Julide; Ulutas, OzkanBackground: This study aims to find association of fetuin-A with serum lipids, QT dispersion (QT-d), and P dispersion (P-d) in dialysis patients. Methods: Fetuin-A serum levels were assessed in 50 dialysis patients. Results: Serum fetuin-A levels were significantly associated with QT-d (r = 0.289, p = 0.044), P-d (r = 0.39, p = 0.005), total cholesterol (r = 0.526, p = 0.000), low-density lipoprotein cholesterol (LDL-C) (r = 0.456, p = 0.00), triglyceride (r = 0.360, p = 0.011) and highly sensitive C-reactive protein (hsCRP) (r = -0.347, p = 0.030). In step-wise multiple regression analysis including being on hemodialysis (HD), presence of diabetes mellitus (DM), total cholesterol, LDL-C, triglycerides, hsCRP, only total cholesterol (b = 0.419, p = 0.03), and hsCRP (b = -0.316, p = 0.03) proved to be independent predictors of serum fetuin-A levels. QT-d showed a linear correlation with total cholesterol (r = 0.309, p = 0.029), LDL-C (r = 0.304, p = 0.038), P-d (r = 0.390, p = 0.005), and fetuin-A levels (r = 0.289, p = 0.044). In multiple regression analyses, the independent predictor of QT-d was being on HD (b = -0.417, p = 0.004), whereas total cholesterol, LDL-C, presence of DM, serum fetuin-A levels, and P-d had no independent effect on corrected QT (QT-C). Being on HD and age were important determinants of P-d whereas presence of DM, total cholesterol, LDL-C, fetuin-A, and QT-d had no independent effect on P-d. Conclusions: Lower fetuin-A levels are associated with high hsCRP and low cholesterol levels in dialysis patients.Öğe Significant Independent Predictors of Vitamin D Deficiency in Inpatients and Outpatients of a Nephrology Unit(Hindawi Ltd, 2013) Bentli, Recep; Taskapan, Hulya; Toktas, Halil; Ulutas, Ozkan; Ozkahraman, Adnan; Comert, MeldaAims. Kidney disease was found to be a major risk factor for vitamin D deficiency in a population study of patients hospitalized. The aims of the study were to describe the prevalence of vitamin D deficiency inpatients and outpatients in a nephrology department during fall and to evaluate effect of assessing serum 25-hydroxyvitamin D (25(OH) D) levels and previous supplementation of cholecalciferol on vitamin D status. Methods. We studied 280 subjects in total, between October and January. The subjects were recruited from the following two groups: (a) inpatients and (b) outpatients in nephrology unit. We examined previous documentary evidence of vitamin D supplementation of the patients. Results. The prevalence of vitamin D deficiency among these 280 patients was 62,1% (174 patients). Fifty-three patients (18.9%) had severe vitamin D deficiency, 121 patients (43.2%) moderate vitamin D deficiency, and 66 patients (23.6%) vitamin D insufficiency. In logistic regression analysis female gender, not having vitamin D supplementation history, low serum albumin, and low blood urea nitrogen levels were significant independent predictors of vitamin D deficiency while no association of vitamin D deficiency with diabetes mellitus, serum creatinine, eGFR, and being hospitalized was found. Conclusion. Vitamin D deficiency, seems to be an important problem in both inpatients and outpatients of nephrology. Monitoring serum 25(OH) D concentrations regularly and replacement of vitamin D are important. Women in Turkey are at more risk of deficiency and may therefore need to consume higher doses of vitamin D.Öğe Somatotype Characteristics of Patients with Non-Dialysis Chronic Kidney Disease and its Relationships with Physical Activity and Depression(Soc Chilena Anatomia, 2022) Cinarli, Fahri Safa; Ciftci, Rukiye; Cinarli, Sena; Ulutas, OzkanSomatotype characters have been defined for many diseases. However, there is insufficient infonnation on the somatotype characters of chronic kidney patients. The first aim of our study was to define the specific somatotype in patients diagnosed with CKD. The second aim was to investigate the relationship between somatotype characters and physical activity and depression in CKD patients. A total of 88 (52.7 %) patients diagnosed with CKD between January and December 2021 at the Department of Nephrology, Inonu University Hospital (Malatya, Turkey) and 79 (47.3 %) healthy volunteers were included in the study. Somatotype analysis was performed using the Heath-Carter method. Physical activity was assessed with the International Physical Activity Questionnaire (IPAQ) and depressive symptoms with the Beck Depression Inventory (BDI). Analysis revealed that patients had greater medial calf girth (p = 0.036), higher triceps (p = 0.007) and suprailiac (p = 0.042) skinfold thicknesses and higher body mass index (p = 0.007) compared to controls. Patients also had significantly higher endomorphy (patients: 6.57 +/- 1.35 vs. controls: 6.04 +/- 1.3; effect size (ES): 0.40, p=0.010) and significantly higher mesomorphy (patients: 7.44 +/- 2 vs. controls: 6.85 +/- 2.3; ES: 0.27, p=0.039) as well as significantly lower ectomorphy (patients: 0.71 +/- 0.69 vs. controls: 1.10 +/- 0.93; ES: 0.47, p=0.006). Significant positive correlations were also observed between mesomorphy and IPAQ (rho = 0.219, p = 0.04), endomorphy and BDI (rho = 0.423, p < 0.001) and mesomorphy and BDI (rho = 0.392, p > 0.001). Significant negative correlations were observed between ectomorph and BDI (rho = -0.325, p = 0.002). We observed that the dominant somatotype was endomorphic mesomorph in patients with CKD. In addition, the fact that CKD patients with ectomorphic body structure have lower depressive symptoms could have an impact on their well-being.Öğe Total Macular Volume and Foveal Retinal Thickness Alterations in Healthy Pregnant Women(Taylor & Francis Inc, 2013) Cankaya, Cem; Bozkurt, Murat; Ulutas, OzkanPurpose: To evaluate whether there are alterations in total macular volume (TMV) and foveal retinal thickness (FT) values during pregnancy. Methods: This study included 60 healthy pregnant women in their first, second, and third trimester (groups 1, 2, and 3) and 20 nonpregnant women (group 4). TMV and FT values were measured by optical coherence tomography (OCT) in each group. Results: Mean TMV was 1.43 +/- 0.56 mm(3), 1.88 +/- 0.54 mm(3), 2.04 +/- 0.66 mm(3) and 1.35 +/- 0.41 mm(3) in groups 1, 2, 3, and 4, respectively. Mean FT was 199.20 +/- 64.35 mu, 274.35 +/- 67.45 mu, 287.95 +/- 95.50 mu and 192.100 +/- 58.61 mu in groups 1, 2, 3, and 4, respectively. There was statistical significance among group 1-2 (p(1) = 0.014, p(2) = 0.001), group 1-3 (p(1) = 0.003, p(2) = 0.002), group 2-4 (p(1) = 0.001, p(2) = 0.001), and group 3-4 (p(1) = 0.001, p(2) = 0.001) for both TMV and FT, respectively. Conclusion: The increase of fluid in the body, in particular in the second and last trimester, may cause an increase of TMV and FT.Öğe Vitamin D deficiency, insulin resistance, serum adipokine, and leptin levels in peritoneal dialysis patients(Springer, 2013) Ulutas, Ozkan; Taskapan, Hulya; Taskapan, Mehmet Cagatay; Temel, IsmailAssociations between 25 hydroxy vitamin D [25(OH)D], adipokines levels, and insulin resistance have been reported. The aim of this study was to explore the effects of cholecalciferol supplementation on vitamin D levels, insulin resistance, leptin, and adiponectin levels in vitamin D-deficient peritoneal dialysis (PD) patients. In nineteen vitamin D-deficient PD patients, who were treated with cholecalciferol, fasting serum glucose, insulin, adiponectin, leptin, 25(OH)D and parathyroid hormone (PTH) were measured before and after cholecalciferol replacement therapy. Eighteen (94.7 %) PD patients with vitamin D deficiency were receiving active vitamin D compounds (alphacalciferol) for PTH control. Alphacalciferol dosing was kept constant during treatment with cholecalciferol. While mean 25(OH)D significantly increased from (10.2 +/- A 4.9 ng/ml) to (82.9 +/- A 56.5 ng/ml) (p < 0.05), mean homeostatic model assessment-insulin resistance index significantly decreased from (4.6 +/- A 3.6) to (2.8 +/- A 2.0) after cholecalciferol replacement therapy (p < 0.05). Serum leptin levels (12.9 +/- A 17.6 ng/ml) significantly increased (18.1 +/- A 19.5 ng/ml) (p < 0.05), while there was no change in serum adiponectin, calcium, and phosphate after vitamin D replacement. Serum PTH levels significantly decreased from 551.9 +/- A 276.6 pg/ml to 434.0 +/- A 273.4 ng/ml. Cholecalciferol replacement therapy significantly decreases PTH levels and insulin resistance. The results of this study need to be confirmed in larger clinical trials.
