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  • Küçük Resim
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    Effects of medium cut-off dialysis membranes on inflammation and oxidative stress in patients on maintenance hemodialysis
    (SPRINGER, 2020) Yeter, Hasan Haci; Korucu, Berfu; Akcay, Ömer Faruk; Derici, Kürşat; Derici, Ülver; Arinsoy, Turgay
    Purpose Medium cut-off membranes were developed for providing increased clearance of larger middle-molecule uremic toxins. We compared the effect of low-flux, medium cut-off, and high-flux membranes on chronic inflammation and oxidative stress in patients with maintenance hemodialysis. Methods A total of 42 patients were enrolled in this study. Total antioxidant status, total oxidant status, paraoxonase-1, ischemia-modified albumin, total Thiol, disulfide bond, and native Thiol were measured to determine oxidative stress. C-reactive protein was measured to define inflammation. Results 37% of the total patients were females, and the mean age was 52.9 +/- 16 years. Serum albumin and Kt/V were similar between groups during the study period. We did not find any significant difference at baseline in the 3rd and 6th months of the study when we compared the inflammatory marker and oxidative indicator levels between three hemodialysis membranes in the whole study group. In the subgroup analysis of 19 patients with a high C-reactive protein level, we found that the medium cut-off membrane significantly reduced serum C-reactive protein level, when compared to low-flux and high-flux membrane [2.8 mg/L vs. 13.7 mg/L and 6.1 mg/L, respectively,p = 0.05]. However, we did not find a significant change in oxidative stress indicators in patients with high C-reactive protein levels between the three dialysers. Conclusion The medium cut-off membrane has favorable effects on inflammation in patients with maintenance hemodialysis. However, this positive effect could not be demonstrated in oxidative stress.
  • Küçük Resim
    Öğe
    Lipid peroxidation and the antioxidant capacity of dialysis patients: The effects of a single hemodialysis session with different dialysis membranes
    (2008) Derici, Ülver; Ebinç, Fatma Ayerden; Yılmaz, Murat; Kulaksızoğlu, Sevsen; Arınsoy, Turgay; Sindel, Şükrü
    Amaç: Bu çalışmanın amacı diyaliz hastalarının lipid peroksidasyon ve antioksidan savunma kapasitelerini tespit etmek ve değişik tipteki diyaliz membranlarının bu parametreler üzerine etkilerini göstermektir. Metot: Çalışmaya 54 diyaliz hastası ve kontrol grubu olarak 30 sağlıklı birey alındı. 54 diyaliz hastasının 10’u periton diyalizi, 44’ü hemodiyaliz hastasından oluşmaktaydı. Hemodiyaliz hastaları polikarbonat (n10) ya da hemophan membran (n34) kullanılarak hemodiyalize alınmaktaydı. Polikarbonat membran kullanılan grupta, sonraki diyaliz seansında membranlar vitamin-E kaplı dializer ile değiştirildi. Antioksidan savunma kapasitesi ve lipid peroksidasyonunu belirlemek için total antioksidan durumu ve malondialdehid seviyeleri diyaliz öncesi ve diyaliz sonrasında çalışıldı. Sonuçlar: Kontrol grubu ile karşılaştırıldığında tüm diyaliz hastalarında plazma total antioksidan seviyesi daha düşük (1.510.2 mmol/L ‘ye karşı 1.750.20 mmol/L p0.05) ve malondialdehit seviyesi daha yüksek (2.21.17 nmol/mL’ ye karşı 0.600.20nmol/mL p0.05) bulundu. Bir hemodiyaliz seansı sonrasında tüm diyaliz membranları için parametrelerde anlamlı değişiklik tespit edilmedi. Sonuç: Tüm diyaliz hastaları artmış bir oksidatif duruma sahiptirler. Farklı tipte diyaliz membranları ile yapılan tek bir diyaliz seansı oksidan ve anti-oksidan seviyelerini anlamlı olarak değiştirmiyor gibi gözükmektedir.
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    Öğe
    The relationship between adiponectin levels and proinflammatory cytokines and left ventricular mass in dialysis patients
    (Springer Heidelberg, 2009) Ebinc, Fatma Ayerden; Ebinc, Haksun; Derici, Ülver; Aral, Arzu; Aybay, Cemalettin; Tacoy, Gülten; Sindel, Şükrü
    Introduction: Adiponectin is increased in end-stage renal disease. However, efforts to clarify the cause of that increase and its clinical effects have been inconclusive. The aim of this study was to compare serum adiponectin levels of dialysis patients against healthy individuals and evaluate the relationship among adiponectin levels, IL-6, TNF-alpha and left ventricular mass index (LVMI). Methods: Adiponectin, IL-6 and TNF-a measurements and echocardiographic evaluations were performed in 36 hemodialysis, 30 continuous ambulatory peritoneal dialysis (CAPD) patients and 22 healthy volunteers. Adiponectin, IL-6 and TNF-alpha levels were measured by ELISA. Results: Adiponectin was found to be higher in hemodialysis (52.78 +/- 18.01 ng/mL) and CAPD (52.96 +/- 17.53 ng/mL) groups than controls (28.36 +/- 13.20 ng/ mL; p = 0.0003, p = 0.0003, respectively). No difference was observed between the hemodialysis and CAPD groups. Adiponectin was positively correlated with IL-6 (r = 0.293, p = 0.02), TNF-alpha (r = 0.458, p = 0.0003) and LVMI (r = 0.283, p = 0.02). In the partial correlation analysis, by controlling for body mass index, the correlation between adiponectin and TNF-alpha (r = 0.466, p = 0.0003) persisted. When IL- 6 was controlled with TNF- a, the relation between adiponectin and LVMI disappeared (r = 0.145, p = 0.30). In the linear regression analysis, with adiponectin as the dependent variable, and IL-6, TNF-alpha and body mass index as independent variables, a significant relationship was found between adiponectin and TNF-alpha (beta = 0.488, p = 0.001). Conclusions: Increased adiponectin seems to be associated with increased proinflammatory cytokines in dialysis patients, and this relationship suggests adiponectin may have a role in the development of left ventricular hypertrophy.