Research Interests:
Research Interests:
Research Interests:
Research Interests: Medicine()
()
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
ABSTRACT Hyponatremia is the most common electrolyte disorder and can develop due to many different reasons disrupting the perfect balance of sodium and water. Determination of these factors is important in the diagnosis and treatment of... more
ABSTRACT Hyponatremia is the most common electrolyte disorder and can develop due to many different reasons disrupting the perfect balance of sodium and water. Determination of these factors is important in the diagnosis and treatment of hyponatremia. Symptoms of hyponatremia depend mostly on the rate of development. Brain edema due to acute hyponatremia and osmotic demyelination due to rapid correction of chronic hyponatremia can cause an increased risk of death. Inappropriate therapeutic approaches can therefore lead to an increase in morbidity and mortality. New guidelines about the diagnosis and treatment of hyponatremia have been published recently. However, there is controversy regarding some of these recommendations. In this review, we summarize the current literature on hyponatremia and discuss the different approaches in hyponatremia management.
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Background: Differential diagnosis between minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) is important because prognosis and treatment response of each disease is different. However, in some cases these two... more
Background: Differential diagnosis between minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) is important because prognosis and treatment response of each disease is different. However, in some cases these two diseases cannot be distinguished from each other clinically and histopathologically.The aim of this study is to determine whether glomerular complement 4d (C4d), nephrin, Renal Wilms' tumor-1 (WT1) staining can be used to differentiate FSGS and MCD.Method: Patients with primary FSGS and MCD were included in the study. Specificity and sensitivity of C4d, nephrin, WT-1 staining was calculated for the diagnosis of FSGS and MCD.Results: Glomerular focal segmental C4d positivity (C4dP) was higher in FSGS compared to MCD patients. Nephrin staining positivity (NsP) was higher in MCD than FSGS patients (p<0.05). Specificity and sensitivity of glomerular C4dP for FSGS diagnose (85% and 73.9%) was higher compared to MCD (26.1% and 15.4%). Specificity and ...
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Chronic inflammation may be one of the factors that contribute to the development of diabetic nephropathy (DN). However, erythropoiesis, erythrocyte circulatory half-life and erythrocyte deformability may be influenced by inflammation.... more
Chronic inflammation may be one of the factors that contribute to the development of diabetic nephropathy (DN). However, erythropoiesis, erythrocyte circulatory half-life and erythrocyte deformability may be influenced by inflammation. Thus, red blood cell distribution width (RDW) levels increase in inflammatory conditions. We investigated the RDW values and related factors in patients with uncomplicated type 2 diabetes mellitus (DM) and diabetic patients with DN. We carried out a retrospective study on patients with type 2 DM admitted to our hospital. Subjects were divided into three groups. Group 1 consisted of healthy subjects. Group 2 consisted of patients with uncomplicated type 2 DM. Patients with various stages of DN were included in Group 3. The RDW values in group 1 subjects were significantly lower than those in group 2 and 3 patients (p<0.05). The RDW values of group 3 patients were higher than those in the other two groups (p<0.05). While the RDW values had positiv...
Research Interests:
Research Interests:
Although several renal biopsy registry reports have been published worldwide, there are no data on primary glomerular disease trends in Turkey. Three thousand eight-hundred fifty-eight native kidney biopsy records were assessed in the... more
Although several renal biopsy registry reports have been published worldwide, there are no data on primary glomerular disease trends in Turkey. Three thousand eight-hundred fifty-eight native kidney biopsy records were assessed in the Turkish Society of Nephrology Primary Glomerulopathy Working Group (TSN-GOLD) Registry. Secondary disease and transplant biopsies were not recorded in the registry. These records were divided into four periods, before 2009, 2009 to 2013, 2013–2017, and 2017–current. A total of 3858 patients (43.6% female, 6.8% elderly) were examined. Nephrotic syndrome was the most common biopsy indication in all periods (58.6%, 53%, 44.1%, 51.6%, respectively). In the whole cohort, IgA nephropathy (IgAN) (25.7%) was the most common PGN with male predominance (62.7%), and IgAN frequency steadily increased through the periods (× 2 = 198, p < 0.001). MGN was the most common nephropathy in the elderly (> 65 years), and there was no trend in this age group. An increasing trend was seen in the frequency of overweight patients (× 2 = 37, p < 0.0001). Although the biopsy rate performed with interventional radiology gradually increased, the mean glomeruli count in the samples did not change over the periods. In Turkey, IgAN is the most common primary glomerulonephritis, and the frequency of this is increasing.
Research Interests:
Background: In this study, we aimed to evaluate the etiology, comorbidities and outcome of acute kidney injury (AKI) in our country, and if there is, to demonstrate any potential differences in different geographical parts of the country.... more
Background: In this study, we aimed to evaluate the etiology, comorbidities and outcome of acute kidney injury (AKI) in our country, and if there is, to demonstrate any potential differences in different geographical parts of the country. Methods: This prospective observational study was carried on by Acute Kidney Injury Working Group of Turkish Society of Nephrology. Demographical and clinical data of AKI patients at the time of diagnosis, at the 1st week and 1st, 3rd and 6th months were evaluated to determine patient and renal survival, and factors associated with prognosis. Results: 776 patients were included (54.7% male, median age: 67 years). Prerenal causes were more frequent, namely dehydration, heart failure and sepsis. 58.9% of patients had at least one renal etiology, most frequently nephrotoxic agent exposure. Etiologic factors were mostly similar through the country. 33.6% of patients needed renal replacement therapy. At the 6th month of diagnosis, 29.5% of patients had ...
Research Interests:
Aim: Peritoneal dialysis (PD) is the more preferred renal replacement therapy (RRT) option for most patients with end-stage renal disease (ESRD) who can not achieve a kidney transplantation. By an enhanced national PD program, more... more
Aim: Peritoneal dialysis (PD) is the more preferred renal replacement therapy (RRT) option for most patients with end-stage renal disease (ESRD) who can not achieve a kidney transplantation. By an enhanced national PD program, more patients may have a chance to take the advantage of this treatment option. In this study, we aim to investigate whether PD is preferred as the first dialysis treatment modality in Northern Cyprus and reveal the outcomes in order to improve the further PD program. Material and Method: Peritoneal dialysis patients aged above 18 years who were followed between 2003-2021 in Northern Cyprus were investigated retrospectively. Demographic data, primary kidney diseases, comorbidities and previous RRT modalities were analysed. Episode(s) of peritonitis, total duration on PD therapy, switch to kidney transplantation or HD, and mortality rate were evaluated. Outcomes of elderly (≥ 65 years) and diabetic patients who were dropped out from PD were found out. Results: ...
Research Interests: Orthopedic Surgery, Medicine, Case Report, Humans, von Willebrand factor, and 12 moreTibia, Female, Clinical Sciences, Middle Aged, Plasmapheresis, Sjogren´s Syndrome, Knee Osteoarthritis, Postoperative Complication, Thrombotic Thrombocytopenic Purpura, Renal Dysfunction, Hemolytic Anemia, and Osteotomy
Purpose: Accurate blood pressure measurement (BPM) is the main point for the proper diagnosis and management of hypertension. In this paper, we aim to assess the approaches taken by family physicians (FPs) about BPM and blood pressure... more
Purpose: Accurate blood pressure measurement (BPM) is the main point for the proper diagnosis and management of hypertension. In this paper, we aim to assess the approaches taken by family physicians (FPs) about BPM and blood pressure measurement devices’ (BPMDs) standards. Materials and Methods: A survey was prepared in accordance with the current hypertension guidelines to assess the knowledge and awareness of FPs about BPM methods and BPMDs’ standards. Questionnaires were filled out face-to-face with family physicians. Results: In total, 300 of 412 local FPs were included in this study. Office BPMs were preferred by 41.7% of physicians, whereas 42.7% expressed their preference for HBPMs for hypertension diagnosis and treatment. Aneroid devices were chosen by 61.3% of FPs who believed that their knowledge and skills about BPM were excellent. The rate of FPs who preferred devices not compatible with one of the recommended devices in the guidelines was 79.7%. A total of 53% of FPs r...
Research Interests: Medicine()
()
Aim: Sickle Cell Disease and Sickle Cell Trait (SCT) is commonly seen in Cukurova region in Turkey. Renal manifestations of the sickle cell trait (SCT) include renal concentration defects, renal papillary necrosis, and hematuria.... more
Aim: Sickle Cell Disease and Sickle Cell Trait (SCT) is commonly seen in Cukurova region in Turkey. Renal manifestations of the sickle cell trait (SCT) include renal concentration defects, renal papillary necrosis, and hematuria. Conflicting results were reported regarding whether the SCT leads to chronic renal failure. Frequency of Sickle Cell Trait in the patients with chronic kidney diseases has yet to be reported in Turkey. This study evaluated the SCT frequency in patients with chronic kidney diseases in a single center in Turkey. Materials and Methods: A total of 164 patients with chronic kidney disease such as chronic renal failure, tubulopathy, proteinuria, and hematuria who were followed-up in the Pediatric and Adult Nephrology Departments in a center were enrolled in the study. Information regarding diagnosis, hemoglobin levels, glomerular filtration rate, urine density, proteinuria, hematuria, and family history for sickle cell disorder were collected from the records ret...
Research Interests: Medicine()
()
There may be different clinical presentations of kidney involvement in the course of paroxysmal nocturnal hemoglobinuria, within a spectrum of acute kidney injury, generally due to hemolysis, to chronic kidney disease. Herein we discuss a... more
There may be different clinical presentations of kidney involvement in the course of paroxysmal nocturnal hemoglobinuria, within a spectrum of acute kidney injury, generally due to hemolysis, to chronic kidney disease. Herein we discuss a case of PNH with recurrent hematuria and acute kidney injury.
Research Interests:
Background and Aims Autosomal dominant polycystic kidney disease (ADPCK) is the most prevelant inherited kidney disease in adults, and the fourth common cause for renal replacement therapy worldwide and preventive measures should be taken... more
Background and Aims Autosomal dominant polycystic kidney disease (ADPCK) is the most prevelant inherited kidney disease in adults, and the fourth common cause for renal replacement therapy worldwide and preventive measures should be taken to slow the decline in renal functions. From previous studies we already know that hereditary kidney diseases such as medullary kidney disease and tubular kidney diseases are frequent in Cyprus. In this study, we aim to find out the situation for ADPKC in North Cyprus and declare the overall magnitude of the problem in our region. Method From January 2004 to January 2021, we collected data from all patients with ADPCK irrespective of whether they were on RRT or not and who were followed in nephrology departments within Northern Cyprus. Clinical and demographic data of all the patients aged above 18 were collected. The affected families and their route of inheritance were determined. Need for renal replacement therapy (RRT) and types of RRT were not...
Research Interests:
Background Galactose-deficient IgA1 (Gd-IgA1) has an increased tendency to form immunocomplexes with IgG in the serum, contributing to IgAN pathogenesis by accumulating in the glomerular mesangium. Several studies showed that glomerular... more
Background Galactose-deficient IgA1 (Gd-IgA1) has an increased tendency to form immunocomplexes with IgG in the serum, contributing to IgAN pathogenesis by accumulating in the glomerular mesangium. Several studies showed that glomerular IgG deposition in IgAN is an important cause of mesangial proliferation and glomerular damage. This study aims to determine the association of the positivity of IgG and the intensity of IgG staining with a poor renal prognosis. Methods A total of 943 IgAN patients were included in the study. Glomerular IgG staining negative and positive patients were compared using Oxford classification scores, histopathological evaluations, proteinuria, eGFR, albumin, blood pressures. IgG positive patients were classified as (+), (++), (+++) based on their staining intensity, and the association with the prognostic criteria was also evaluated. Results 81% (n = 764) of the patients were detected as IgG negative, while 19% (n = 179) were positive. Age, gender, body ma...
Research Interests:
Abstract Purpose: As the population gets older, the elderly and very elderly patients are increasingly been treated in nephrology intensive care units (ICU). In this study we evaluated the characteristics and outcomes of the... more
Abstract
Purpose: As the population gets older, the elderly and very elderly patients are increasingly been treated in nephrology intensive care units (ICU). In this study we evaluated the characteristics and outcomes of the octogenarians (80-89 years old), nonagenarians (≥ 90 years old) and compared them with elderly (65-79 years old) patients treated in nephrology ICU.
Methods: Eighteen nonagenarians, 70 octogenarians and 88 elderly patients were included in the study. Indication for hospitalization, presence of comorbid diseases, and requirement for acute dialysis treatment were investigated. Need for mechanical ventilation, vasopressors, central venous catheterization, urinary catheterization, anticoagulation, and transfusion of blood products were evaluated. Mortality rate and hospital cost were calculated. Data about survival at 1 month after discharge was collected.
Results: Causes of hospitalization, need for dialysis treatment, mechanical ventilation, vasopressors, central venous catheterization, urinary catheterization, anticoagulation, and transfusion of blood products were not different between age groups. Diabetes mellitus and malignancy were more frequent in elderly, whereas dementia/Alzheimer's disease was more common in nonagenarians. Although, mortality in ICU was increased as the age increased, it was statistically insignificant. However, 1 month mortality rate after discharge from hospital was increased especially in nonagenarians. In nonagenarians infection, whereas in octogenarians need for dialysis treatment, were related with mortality. Length of intensive care stay and hospital cost did not differ between age groups.
Conclusion: Length of nephrology intensive care stay, mortality rate and hospital cost did not differ for very elderly age groups, but mortality risk was higher for nonagenarians after discharge from hospital.
Purpose: As the population gets older, the elderly and very elderly patients are increasingly been treated in nephrology intensive care units (ICU). In this study we evaluated the characteristics and outcomes of the octogenarians (80-89 years old), nonagenarians (≥ 90 years old) and compared them with elderly (65-79 years old) patients treated in nephrology ICU.
Methods: Eighteen nonagenarians, 70 octogenarians and 88 elderly patients were included in the study. Indication for hospitalization, presence of comorbid diseases, and requirement for acute dialysis treatment were investigated. Need for mechanical ventilation, vasopressors, central venous catheterization, urinary catheterization, anticoagulation, and transfusion of blood products were evaluated. Mortality rate and hospital cost were calculated. Data about survival at 1 month after discharge was collected.
Results: Causes of hospitalization, need for dialysis treatment, mechanical ventilation, vasopressors, central venous catheterization, urinary catheterization, anticoagulation, and transfusion of blood products were not different between age groups. Diabetes mellitus and malignancy were more frequent in elderly, whereas dementia/Alzheimer's disease was more common in nonagenarians. Although, mortality in ICU was increased as the age increased, it was statistically insignificant. However, 1 month mortality rate after discharge from hospital was increased especially in nonagenarians. In nonagenarians infection, whereas in octogenarians need for dialysis treatment, were related with mortality. Length of intensive care stay and hospital cost did not differ between age groups.
Conclusion: Length of nephrology intensive care stay, mortality rate and hospital cost did not differ for very elderly age groups, but mortality risk was higher for nonagenarians after discharge from hospital.
Research Interests:
Background The largest data on the epidemiology of primary glomerular diseases (PGDs) are obtained from the databases of countries or centers. Here, we present the extended results of the Primary Glomerular Diseases Study of the Turkish... more
Background The largest data on the epidemiology of primary glomerular diseases (PGDs) are obtained from the databases of countries or centers. Here, we present the extended results of the Primary Glomerular Diseases Study of the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) Working Group. Methods Data of patients who underwent renal biopsy and received the diagnosis of PGD were recorded in the database prepared for the study. A total of 4399 patients from 47 centers were evaluated between May 2009 and May 2019. The data obtained at the time of kidney biopsy were analyzed. After the exclusion of patients without light microscopy and immunofluorescence microscopy findings, a total of 3875 patients were included in the study. Results The mean age was 41.5 ± 14.9 years. 1690 patients were female (43.6%) and 2185 (56.3%) were male. Nephrotic syndrome was the most common biopsy indication (51.7%). This was followed by asymptomatic urinary abnormalities (18.3%) and nephritic...
Research Interests:
Background and Aims Several glomerular disease registries in Europe, and they shared their data; however, there was a lack of current data on trends of primary glomerulopathy in Turkey. Glomerular disease patterns can change geographical... more
Background and Aims Several glomerular disease registries in Europe, and they shared their data; however, there was a lack of current data on trends of primary glomerulopathy in Turkey. Glomerular disease patterns can change geographical areas and populations decade by decade. Our aim is to present Turkey's primary glomerular disease pattern from 2009 to 2017. Method 3878 native kidney biopsy records were assessed in the Turkish Society of Nephrology Glomerulopathy (TSN-GOLD) Working Group Registry. Secondary disease (lupus, etc.) and transplant biopsies do not enroll in the registry. These records divided into four periods, before 2009, 2009 to 2013, 2013 to 2017, and 2017 to current. Results A total of 3858 patients (M = 2173, K = 1685) were examined. There was no difference in the distribution of number of patients according to periods (Q1 = 968, Q2 = 960, Q3 = 968, Q4 = 962). Nephrotic syndrome was the most common biopsy indication in all quarters (58.6%, 53%, 44.1%, 51.6%, ...
Research Interests:
Background and Aims Anemia is one of the most important complications in chronic renal disease and inadequate erythropoietin production is the most important reason for anemia. Fibrosis of renal interstitium may be associated with... more
Background and Aims Anemia is one of the most important complications in chronic renal disease and inadequate erythropoietin production is the most important reason for anemia. Fibrosis of renal interstitium may be associated with inadequate synthesis of erythropoietin and anemia. In our study, we investigated the relationship between the severity of interstitial fibrosis (IF) in patients with primary glomerulonephritis (PGN) and anemia parameters. Method A total of 2794 patients who were recorded to the database of the Turkish Society of Nephrology, Glomerular Diseases (TSN-GOLD) Working Group between May 2009 and June 2019 were included in our national multicenter (44 centers) study. Patients aged 16 years or more with documented biopsy were included in the study. Patients were divided into four groups according to IF severity. IF was not detected in the interstitial area, was defined as none, if fibrosis was present in less than 25% of the area, defined as mild, if fibrosis was p...
Research Interests:
Background and Aims The largest data on the epidemiology of primary glomerular diseases (PGD) are obtained from the databases of countries or centers. Here, we presented the extended results of the Primary Glomerular Diseases Study of the... more
Background and Aims The largest data on the epidemiology of primary glomerular diseases (PGD) are obtained from the databases of countries or centers. Here, we presented the extended results of the Primary Glomerular Diseases Study of the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD)Working Group. Method The data of patients who underwent renal biopsy and diagnosed as primary glomerular disease were recorded in the database prepared for the study. Between May 2009 and May 2019, a total of 4399 patients from 47 centers were evaluated. Basal data of 3875 patients were analyzed after exclusion of those lacking light microscopy and immunofluorescence findings. Results The mean age was 41.5 ± 14.9 years. Of the patients, 1690 were female (43.6%) and 2180 (56.3%) were male. Nephrotic syndrome was the most common biopsy indication (51.7%). This was followed by asymptomatic urinary abnormalities (18.3%) and nephritic syndrome (17.8%). The most common PGH was IgA nephropathy (...