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Öğe Diabetic nephropathy: diagnosis, prevention and treatment(İnönü Üniversitesi, Tıp Fakültesi, Nefroloji Anabilim Dalı, Malatya, Türkiye, 2016) Yigit, Irem Pembegul; Taskapan, HulyaÖz: Diyabetik nefropati (DN) hem tip 1 hem tip 2 Diabetes Mellitus (DM)'da görülen mikrovasküler bir komplikasyon olup sıklığı tüm dünyada artmaktadır. Patogenezinde hemodinamik, metabolik ve genetik faktörler sorumlu tutulmaktadır. İlk bulgusu mikroalbuminüri (30-300 mg/gün veya 20-200 µ/dk). Mikroalbuminüri için tarama Tip 1 DM'de tanıdan 5 yıl sonra, tip 2 DM de tanı konduğunda yılda bir kere yapılmalıdır. DN oluşumunda ve ilerlemesinde hiperglisemi, hipertansiyon, sigara içme, yüksek proteinli diyet, hiperlipidemi, cinsiyet, ırk, obezite ve genetik yatkınlık bağımsız risk faktörleridir. İyi glisemik kontrol (HbA1c < 7%), hipertansiyonun tedavisi (< 130/80 mmHG veya proteinüri > 1 gr/gün ise < 125/75 mmHg), hiperlipidemi tedavisi (LDL < 100 mg/dl) ve düşük proteinli diyet ile mikroalbuminüri gelişimi ve DN'nin ilerlemesini engelleyecek etkili tedavilerdirÖğe Extrapulmonary tuberculosis in ten hemodialysis patients: a single center experience(İnönü Üniversitesi, Tıp Fakültesi, Nefroloji Anabilim Dalı, Malatya, Türkiye, 2016) Yigit, Irem Pembegul; Taskapan, Hulya; Gurel, Ali[Abstract Not Acailable]Öğe Neutrophil gelatinase-associated lipocalin reflects the severity of anemia without iron deficiency and secondary hyperparathyroidism in hemodialysis patients(Kare Publ, 2017) Yigit, Irem Pembegul; Ulu, Ramazan; Gozel, Nevzat; Taskapan, Hulya; Ilhan, Necip; Dogukan, AyhanOBJECTIVE: Secondary hyperparathyroidism (SHPT) and anemia are the primary and most common complications in patients receiving hemodialysis (HD). Neutrophil gelatinase-associated lipocalin (NGAL) is a new marker to assess iron deficiency and manage iron therapy for HD patients. The aim of this study was to determine any association between serum NGAL level and anemia without iron deficiency in patients with SHPT on chronic HD. METHODS: Total of 61 SHPT patients on chronic HD were enrolled in the study and divided into 3 groups: mild SHPT group (n=17), moderate SHPT group (n=21), and severe SHPT group (n=23). Hemogram, biochemical assays, and level of ferritin, high sensitivity C-reactive protein (hs-CRP), and NGAL were evaluated in all groups. RESULTS: Serum NGAL level was significantly higher and hemoglobin (Hb) level was significantly lower in severe SHPT patients compared with both mild and moderate SHPT patients. Furthermore, in severe SHPT group, serum NGAL level was significantly positively correlated with serum parathyroid hormone (r=0.79; p=0.00) and hs-CRP (r=0.52; p=0.01) level and negatively correlated with serum Hb (r=-0.56; p=0.00) level. CONCLUSION: SHPT was important factor affecting anemia in HD patients. Even when iron deficiency anemia is excluded in patients with SHPT, there was significant negative correlation between serum NGAL and Hb.Öğe The relationship between severity of liver cirrhosis and pulmonary function tests(Springer, 2008) Yigit, Irem Pembegul; Hacievliyagil, Suleyman Savas; Seckin, Yuksel; Oner, Ramazan Ilyas; Karincaoglu, MelihPulmonary complications, mainly hepatopulmonary syndrome (HPS), are frequently observed in liver cirrhosis. In this study, the aim was to investigate the frequency of hypoxemia and impairment of pulmonary function tests (PFT) in patients with liver cirrhosis and to examine the relationships of these impairments with liver failure. A total of 39 patients with cirrhosis, 24 males and 15 females, were included in our study. The mean age of the patients was 47.5 +/- 17.2 years. Arterial blood gases, PFT, and carbon monoxide diffusion tests (DLCO) were performed in all patients. Out of 39 cirrhotic patients, 21 (53.8%) had ascites, whereas 18 (46.2%) did not. Seven patients were in the Child-Pugh A group, 21 in the Child-Pugh B group, and 11 patients were in the Child-Pugh C group. Hypoxia was found in 33.3% of the patients. Although the PaO2 and SaO(2) values of patients with ascites were lower compared to those without ascites (P < 0.05), no statistically significant difference was determined in the comparison of hypoxia between the groups (P > 0.05). Among the PFT parameters, FEV1/FVC and FEF25-75% values were found to be lower in patients with ascites than those without (P < 0.05). No differences were established between these two groups of patients in terms of DLCO (P > 0.05). While no differences were found in comparison of the DLCO values in between the groups (P > 0.05), there was a statistically significant difference in the ratio of DLCO to the alveolar ventilation (DLCO/VA) in between the groups (P < 0.05). On the other hand, a negative correlation was found between the DLCO/VA and Child points when the relationship between the Child-Pugh score and PFT parameters were investigated (r = -0.371, P < 0.05). Consequently, a relationship was established between the severity of liver failure and diffusion tests showing pulmonary complications invasively. We believe diffusions tests should be performed in addition to the PFT in order to determine pulmonary involvements particularly in patients who are candidates for liver transplantation.Öğe Relationships between plasma pentraxin 3 levels and inflammation markers patients with tunneled permanent catheter in hemodialysis(Wichtig Publ, 2015) Yigit, Irem Pembegul; Dogukan, Ayhan; Taskapan, Hulya; Comert, Melda; Ilhan, Necip; Ulu, Ramazan; Aygen, BilgePurpose: Vascular access (VA) devices may contribute to chronic inflammation in hemodialysis (HD). Pentraxin 3 (PTX3) is a recently discovered acute phase protein that responds more rapidly than other inflammatory markers. This study compared PTX3 and other markers between HD patients and healthy controls. Methods: The study population included 30 patients with tunneled permanent catheter (TPC), 30 patients with arteriovenous fistula (AVF) and 30 healthy controls. Hemogram, biochemical assays, ferritin, high sensitive Creactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-alpha) and PTX3 were evaluated in all groups. Results: PTX levels were highest in HD patients with TPC, intermediated in HD patients with AVF and lowest in healthy controls (5.2 + 2.4 vs. 3.1 + 1.3 vs. 1.8 + 0.7, p<0.001 for all comparisons). PTX3 levels correlated strongly to hs-CRP (r = 0.857) and moderately to TNF-alpha, NLR, ferritin and total neutrophil count. PTX3 and albumin levels had a negative correlation. PTX3 levels were higher in patients with 8 months of TPC than those with 7 months or less. Conclusions: PTX3 levels are significantly elevated in all patients on HD, but presence and extended duration of TPC are associated with incrementally higher levels of PTX3 and other inflammatory markers. PTX3 and NLR may be useful in assessing chronic inflammatory states in HD.
