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    Ischemia modified albumin levels and its association with clinical follow-up in acute renal failure
    (2017) Uzun, Mehmet; Topaloğlu, Ömercan; Kurtulmuş, Yusuf; Turkon, Hakan; Duman, Can; Karakas, Burak; Akar, Harun
    Aim: In cases with acute ischemia, albumin’s binding capacity for transition metals decreases and the resulting albumin is defined as ischemia modified albumin (IMA). In this study, we aimed to investigate the relationship between IMA and clinical follow-up in patients with acute renal failure (ARF).Material and Methods: Levels of IMA were measured in 51(23 male, 28 female) patients with ARF. Venous blood samples were drawn from patients for biochemical tests and put in plain tubes containing the gel.Results: Mean age of male and female patients was 65.39±15.28 and 70.11±15.25, respectively. The IMA levels in 25.5% of the patients were within the normal range (<400 ABSU), while the IMA levels were higher (>400 ABSU) in 75.5% of the patients. The survival rates of patients in IMA <400 ABSU group for 12 and 24 months were 66.7% and for 30 and 32 months it was 33.3%; while the survival rates of patients in IMA ?400 ABSU group for 12 months were 85.8%, for 24 months were 61.3%, and for 30 and 32 months were 30.6%. No significant difference was determined among survival rates of IMA groups (p=0.719).Conclusion: The comparison between the groups having normal or higher IMA values did not show any significant differences in terms of survival. However, in our study the proportion of patients who needed dialysis during treatment were significantly higher in higher IMA group(IMA?400 ABSU). Therefore, we believe that higher IMA levels may indicate a necessity for dialysis in patients with ARF.
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    Ischemia Modified Albumin Levels And Its Association With Clinical Follow-Up In Acute Renal Failure
    (2017) Uzun, Mehmet; Topaloglu, Omercan; Kurtulmus, Yusuf; Turkon, Hakan; Duman, Can
    Aim: In cases with acute ischemia, albumin’s binding capacity for transition metals decreases and the resulting albumin is defined as ischemia modified albumin (IMA). In this study, we aimed to investigate the relationship between IMA and clinical follow-up in patients with acute renal failure (ARF).Material and Methods: Levels of IMA were measured in 51(23 male, 28 female) patients with ARF. Venous blood samples were drawn from patients for biochemical tests and put in plain tubes containing the gel.Results: Mean age of male and female patients was 65.39±15.28 and 70.11±15.25, respectively. The IMA levels in 25.5% of the patients were within the normal range (400 ABSU) in 75.5% of the patients. The survival rates of patients in IMA 400 ABSU group for 12 and 24 months were 66.7% and for 30 and 32 months it was 33.3%; while the survival rates of patients in IMA ≥400 ABSU group for 12 months were 85.8%, for 24 months were 61.3%, and for 30 and 32 months were 30.6%. No significant difference was determined among survival rates of IMA groups (p=0.719).Conclusion: The comparison between the groups having normal or higher IMA values did not show any significant differences in terms of survival. However, in our study the proportion of patients who needed dialysis during treatment were significantly higher in higher IMA group(IMA≥400 ABSU). Therefore, we believe that higher IMA levels may indicate a necessity for dialysis in patients with ARF.Keywords: Acute Renal Failure; Ischemia Modified Albumin; Acute Kidney Injury.
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    Isolated Maternal Hypothyroxinemia May be Associated with Insulin Requirement in Gestational Diabetes Mellitus
    (Georg Thieme Verlag Kg, 2023) Topaloglu, Omercan; Uzun, Mehmet; Topaloglu, Seda Nur; Sahin, Ibrahim
    An insulin regimen may be necessary for about 30 % of the patients with gestational diabetes mellitus (GDM). We aimed to investigate the association of free T4(fT4) levels with insulin requirement in pregnant women with GDM. We included pregnant women whose TSH levels were within the normal range and who were diagnosed with GDM, and excluded patients with thyroid dysfunction, chronic illnesses, or any previous history of antithyroid medication, levothyroxine, or antidiabetic medication use. The diagnosis and treatment of GDM were based on American Diabetes Association guidelines. Demographic features, previous history of GDM and gestational hypertension were recorded. Baseline (at diagnosis of GDM) fasting blood glucose, HbA1c, TSH, fT4, and fT3 levels were analyzed. We grouped the patients according to their baseline fT4 levels: isolated maternal hypothyroxinemia (IMH) (group A) vs. in the normal range (group B). We grouped those also based on insulin requirement in 3rd trimester. Of the patients (n = 223), insulin requirement was present in 56, and IMH in 11. Insulin requirement was more frequent in group A than in group B (p = 0,003). HbA1c ( = 47,5 mmol/mol) and fT4 level (lower than normal range) were positive predictors for insulin requirement (OR: 35,35, p = 0,001; and OR:6,05, p = 0,008; respectively). We showed that IMH was closely associated with insulin requirement in GDM. Pregnant women with IMH and GDM should be closely observed as regards to glycemic control. If supported by future large studies, levothyroxine treatment might be questioned as an indication for patients with GDM and IMH.
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    May ischemia modified albumin be a predictor in diagnosis of contrast induced nephropathy?
    (2018) Topaloglu, Omercan; Demir, Bilgin; Ekinci, Ferhat; Uzun, Mehmet; Kurtulmus, Yusuf; Turkon, Hakan; Duman, Cem; Akar, Harun; Tanrisev, Mehmet
    Aim: “Ischemia modified albumin” (IMA) was investigated as a possible biomarker in several diseases such as vascular disorders. We aimed to reveal the possible value of IMA in predicting the development of contrast induced nephropathy (CIN) after coronary angiography in patients with stable angina pectoris. Material and Methods: 106 patients underwent coronary angiography with a diagnosis of stable angina pectoris were included in our study. Basic demographic and clinical findings and laboratory values were recorded and analyzed. Serum creatinine (SCre) levels were also measured 48 hours after coronary angiography and recorded. Amount of contrast agent (CA) given during coronary angiography was recorded. The patients were divided into 2 groups: CIN positive and CIN negative groups. Results: CIN was developed in 14 patients (13%); and IMA levels were similar in CIN positive and negative groups (p>0.05). SCre (both measurements before and after CA administration) was not correlated with IMA levels. There was no association between drug usage and development of CIN (p>0.05). Comorbidities were not associated with the development of CIN (p>0.05) with the exception of hypertension (HT). Presence of hypertension (p=0.0393) and female gender (p=0.0199) was associated with development of CIN. Mean age was 61.3 and 52.3 in CIN positive and negative groups, respectively (p>0.05). Conclusion: Any specific biomarker indicating CIN is not available yet. Most frequently used marker is the measurement of SCre 24- 48 hours after administration of CA. We found IMA levels not to be a predictor for the development of CIN. Further investigations will clearly determine the importance of IMA as a biomarker in renal failure developed after CA administration.
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    May ischemia modified albumin be a predictor in diagnosis of contrast induced nephropathy?
    (2018) Topaloğlu, Ömercan; Demir, Bilgin; Ekinci, Ferhat; Uzun, Mehmet; Kurtulmuş, Yusuf; Turkon, Hakan; Duman, Can
    Aim: “Ischemia modified albumin” (IMA) was investigated as a possible biomarker in several diseases such as vascular disorders. We aimed to reveal the possible value of IMA in predicting the development of contrast induced nephropathy (CIN) after coronary angiography in patients with stable angina pectoris.Material and Methods: 106 patients underwent coronary angiography with a diagnosis of stable angina pectoris were included in our study. Basic demographic and clinical findings and laboratory values were recorded and analyzed. Serum creatinine (SCre) levels were also measured 48 hours after coronary angiography and recorded. Amount of contrast agent (CA) given during coronary angiography was recorded. The patients were divided into 2 groups: CIN positive and CIN negative groups.Results: CIN was developed in 14 patients (13%); and IMA levels were similar in CIN positive and negative groups (p>0.05). SCre (both measurements before and after CA administration) was not correlated with IMA levels. There was no association between drug usage and development of CIN (p>0.05). Comorbidities were not associated with the development of CIN (p>0.05) with the exception of hypertension (HT). Presence of hypertension (p=0.0393) and female gender (p=0.0199) was associated with development of CIN. Mean age was 61.3 and 52.3 in CIN positive and negative groups, respectively (p>0.05).Conclusion: Any specific biomarker indicating CIN is not available yet. Most frequently used marker is the measurement of SCre 24- 48 hours after administration of CA. We found IMA levels not to be a predictor for the development of CIN. Further investigations will clearly determine the importance of IMA as a biomarker in renal failure developed after CA administration.