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    Comparison of soluble suppression of tumorigenicity 2 and brachial hemodynamic parameters between dialysis modalities in patients with end-stage kidney disease
    (Springer, 2023) Yeter, Haci Hasan; Karacalik, Ceren; Eraslan, Esra; Durantas, Halil; Akcay, Omer Faruk; Derici, Kursat; Derici, Ulver
    Purpose Major cardiovascular events (MACE) are the leading cause of mortality in patients with chronic kidney disease. Although hemodialysis (HD) and peritoneal dialysis (PD) are comparable in survival, patients with HD have a significantly higher risk of developing MACE. Soluble suppression of tumorigenicity 2 (sST2) is a cardiac biomarker, that does not vary with age, gender, and kidney function. This study aimed to compare arterial stiffness, fluid status, and sST2 levels, between patients with PD and those with in-center HD.Methods This was a cross-sectional study, which was conducted with 36 PD patients, 36 HD patients, and 36 age, and gender-matched healthy controls. We used noninvasive methods for the assessment of arterial stiffness and fluid status.Results The patients with PD overhydrated compared to HD patients and healthy control (p < 0.001, and p = 0.05, respectively). Patients with PD had higher central systolic blood pressure and central pulse pressure than patients with HD and the control group (p = 0.004, and p = 0.01; p < 0.001, and p = 0.004, respectively). HD patients had a significantly higher level of plasma sST2 level compared to PD patients and the control group (p = 0.03, and p = 0.005). HD as maintenance dialysis modality and dialysis vintage was associated with higher plasma sST2 concentration, and having a residual renal function in dialysis patients was related to the lower plasma sST2 concentration.Conclusion PD is associated with better sST2 levels even though higher volume load than HD. In addition, the loss of RRF may be the most important factor related to increased sST2.
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    Impact of medium cut-off membranes on S100A12 and soluble receptor for advanced glycation end products
    (Wiley, 2023) Korucu, Berfu; Yeter, Hasan; Gonen, Sevim; Derici, Mehmet Kursat; Ronco, Claudio; Derici, Ulver
    Introduction Of the most remarkable molecules associated with atherosclerosis and the cardiovascular outcome are S100A12 (10,379.5 Da) and soluble receptor for advanced glycation end products (sRAGE-42,803 Da) in the hemodialysis (HD) population. We designed a study investigating the effects of the medium cut-off (MCO) dialyzers focusing on S100A12 and sRAGE in HD patients compared with low-flux and high-flux dialyzers. Methods This single-site, prospective, observational study comprises age and sex-matched HD groups (low-flux, high-flux, and MCO). Blood samples were drawn at baseline (predialysis and postdialysis) and the sixth month (predialysis). Results Groups had similar demographic features and laboratory parameters. Baseline S100A12 levels of the groups were similar [34.3 (+/- 66.5), 30.9 (+/- 42.7), and 40.6 (+/- 29.6); p = 0.13]. Compared to their baseline, the sixth-month S100A12 levels were constant in low-flux and high-flux group and significantly lower in MCO group (p = 0.16, p = 0.33, and p = 0.004). Baseline sRAGE levels of the groups were similar at baseline [2.8 (+/- 0.8), 2.7 (+/- 0.6), and 2.6 (+/- 0.7); p = 0.65], and the sixth-month [2.9 (+/- 0.5), 2.4 (+/- 0.7), and 2.4 (+/- 0.8); p = 0.24]. sRAGE levels remained constant in all groups [p = 0.84, p = 0.13, and p = 0.39]. S100A12/sRAGE ratio at baseline and sixth month was constant in low-flux [22.3 (+/- 63.7) and 18.1 (+/- 24.8); p = 0.17] and high-flux groups [11.9 (+/- 15.3) and 13.1 (+/- 5.8); p = 0.26], the ratio decreased significantly in MCO group [16.5 (+/- 11.6) to 7.8 (+/- 5.5); p = 0.03]. Conclusion Our study suggests that prolonged use of MCO dialyzers is associated with better S100A12 and sRAGE levels. Long-term studies with larger samples are needed to understand the effects of a better S100A12-sRAGE profile provided by MCO dialyzers on HD patients' cardiovascular outcomes.
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    Is it possible to prevent contrast-induced nephropathy with dexpanthenol?
    (Springer, 2019) Sutcuoglu, Osman; Derici, Mehmet Kursat; Pasaoglu, Ozge Tugce; Dumludag, Burak; Helvaci, Ozant; Ogut, Betul; Derici, Ulver
    PurposeContrast-induced nephropathy (CIN) is one of the side effects of diagnostic procedures. Oxidative stress plays an important role in CIN's pathophysiology. Dexpanthenol (Dexp) is a substance with antioxidant efficacy. We investigated the likely protective effects of dexpanthenol for CIN.MethodsTwenty-four Sprague-Dawley rats were divided randomly into four groups of 6 rats; control (group 1), Dexp (group 2), CIN (group 3) and Dexp+CIN (group 4). All rats were restricted of water moderately to facilitate of nephrotoxicity. Dexp was administered into the intraperitoneally at a dose of 500mg/kg for 5days in groups 2 and 4. The same amount of saline was applied via intraperitoneally to group 1 and 3. In CIN and Dexp+CIN groups, L-NAME (10mg/kg), tenoxicam (0.5mg/kg) and sodium amidotrizoate (10ml/kg) were administered on the 4th day via the tail vein for CIN. All rats were euthanized on the 6th day and samples for biochemical and pathological evaluations were collected.ResultsWhen the Dexp+CIN group and the CIN group were compared, it was found to be provide a significant decline at the level of acute tubular injury and necrosis in kidney biopsies by dexp. Furthermore Dexp significantly reduced the serum cystatin C (Cys-C) levels, not serum creatinine. There was no statistically significant difference between the groups in total oxidant and antioxidant levels.ConclusionsDexpanthenol did not have significant effect on oxidative stress of acute kidney injury on this rat model. However, it has ameliorated serum Cys-C levels and histopathological findings of CIN.
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    LIPID PEROXIDATION AND THE ANTIOXIDANT CAPACITY OF DIALYSIS PATIENTS: The Effects of a Single Hemodialysis Session with Different Dialysis Membranes
    (Gazi Univ, Fac Med, 2008) Derici, Ulver; Ebinc, Fatma Ayerden; Yilmaz, Murat; Kulaksizoglu, Sevsen; Arinsoy, Turgay; Sindel, Sukrur
    Objective: To estimate lipid peroxidation and the antioxidant defense capacity of dialysis patients and the effects of different types of dialysis membranes on these parameters. Methods: Fifty-four dialysis patients and 30 healthy controls were included in this study. Ten of the dialysis patients were on continuous ambulatory peritoneal dialysis treatment and the rest were on hemodialysis with either polycarbonate membrane (n=10) or hemophan membrane (n=34). Polycarbonate membranes were switched with a vitamin E-coated dialyzer in the subsequent dialysis session. Total antioxidant status and malondialdehyde levels were studied to determine the antioxidant defense capacity and lipid peroxidation, respectively, before and after the dialysis session. Results: Plasma total antioxidant status levels were lower (1.51 +/- 0.2 mmol/l vs. 1.75 +/- 0.20 mmol/l p<0.05) and malondialdehyde levels were higher (2.2 +/- 1.17 nmol/ml vs. 0.60 +/- 0.20 nmol/ml p<0.05) in all dialysis patients compared to the control group. After one hemodialysis session, there were no significant alterations in parameters for either type of dialysis membrane. Conclusion: All dialysis patients have an increased oxidative status. A single hemodialysis session with different dialysis membranes does not seem to significantly change the oxidant or antioxidant levels.
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    Relationship between Serum Adipocyte Fatty Acid-Binding Protein Levels and Systemic Inflammation in Hemodialysis Patients
    (AVES, 2020) Korucu, Berfu; Derici, Mehmet Kursat; Deger, Serpil Muge; Cokay, Abdurrahman; Helvaci, Ozant; Elbeg, Sehri; Derici, Ulver
    Objective: Adipocyte fatty acid-binding protein (A-FABP) is expressed in adipose tissue and macrophages. It regulates cholesterol trafficking and is involved in atherosclerosis formation. A-FABP levels are associated with cardiovascular diseases (CVDs) in patients with or without chronic kidney disease. In this study, we evaluated A-FABP levels in healthy controls and hemodialysis (HD) patients and compared the results with C-reactive protein (CRP) and interleukin-6 (IL-6) levels to determine their relationship with systemic inflammation. Materials and Methods: The study comprised 23 healthy controls and 70 HD patients, excluding individuals with an active infection, malignancy, anorexia, obesity, and hypo- or hyperthyroidism. Demographic features, laboratory findings, A-FABP levels, and levels of inflammatory markers were evaluated between and within the groups. Results: Levels of A-FABP and inflammatory markers were significantly higher in HD patients. In the HD group, 20% of the patients had documented CVD. Levels of A-FABP and inflammatory markers were similar in nondiabetic and diabetic HD patients. Age was negatively correlated with A-FABP levels. Presence of diabetes was not correlated with A-FABP. Serum CRP and IL-6 levels were significantly correlated with A-FABP levels (r=0.354, p=0.003 and r=0.393, p=0.001, respectively). Conclusion: A-FABP levels are elevated in HD patients. Systemic inflammation is significantly related to A-FABP levels in both nondiabetic and diabetic HD patients and decreases with age. Findings of this study support the adverse cardiovascular effects of systemic inflammation in HD patients.
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    Role of silymarin (Silybum marianum) in the prevention of colistin-induced acute nephrotoxicity in rats
    (TAYLOR & FRANCIS LTD, 2020) Dumludag, Burak; Derici, Mehmet Kursat; Sutcuoglu, Osman; Ogut, Betul; Pasaoglu, Ozge Tugce; Gonul, Ipek Isik; Derici, Ulver
    Silymarin (Silybum marianum) has some protective effects against drug toxicity (cisplatin, acetaminophen, adriamycin, gentamicin etc.). Colistin is a strong antimicrobial, which is frequently used in the treatment of resistant gram-negative bacterial infections in recent years although it has nephrotoxic potential. This study was aimed to determine the role of silymarin against colistin-induced acute nephrotoxicity (CIN). Rats were randomly divided into four groups. The control group was treated with tap water whereas groups 2 and 3 received silymarin (orally, 100 mg/kg/day) and colistin (intraperitoneally, 750.000 IU/kg/day) for seven days, respectively. Group 4 received both 750,000 IU/kg/day colistin and 100 mg/kg/day silymarin for seven days. After euthanasia, histopathological and biochemical examinations were completed for the kidney tissue specimens and blood samples. All parameters of the control and silymarin groups were similar. Severe weight loss was seen in the groups receiving colistin (groups 3 and 4). Silymarin significantly increased glutathione peroxidase and superoxide dismutase levels when administered with colistin in group 4 only. Acute tubular injury, tubular necrosis, meduller congestion, interstitial inflammation and apoptotic indices of colistin group were significantly higher than the control group. The administration of colistin with silymarin (group 4) was able to make some improvements in tubular necrosis and significant increase in antioxidant capacity. Silymarin increased antioxidant enzyme activity only when used in combination with colistin. The effects of silymarin may become more pronounced when used at higher doses or with a longer duration of treatment and may prevent nephrotoxicity.