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Research Interests: Medicine, Humans, Female, Renal failure, Medical Physiology, and 12 moreAnti-inflammatory agents, Clinical Sciences, Middle Aged, Pericardium, Cyclophosphamide, Renal Dialysis, Methylprednisolone, Immunosuppressive Agents, cardiac tamponade, Granulomatosis with polyangiitis, renal insufficiency, and Fatal outcome
Renal impairment is a frequent complication of multiple myeloma (MM). Our aim was to assess the expression of podocyte-associated nephrin, podocin, and vascular endothelial growth factor (VEGF) A and their relation to renal function,... more
Renal impairment is a frequent complication of multiple myeloma (MM). Our aim was to assess the expression of podocyte-associated nephrin, podocin, and vascular endothelial growth factor (VEGF) A and their relation to renal function, proteinuria, and clinical outcome in patients with newly diagnosed multiple myeloma. This study included 27 patients with newly diagnosed MM and 20 healthy volunteers as control. Patients were evaluated for clinical and laboratory parameters, renal function, proteinuria, and podocyturia at the time of diagnosis and at six months. Seven patients died before completing of treatment (within the first 6 months). Proteinuria was measured in daily urine samples. First-morning spot urine RNA was isolated, cDNA was produced, and polymerase chain reaction (PCR) was processed. Podocytes were identified by PCR tagging nephrin, podocin, and VEGF-A. The mean ages were 59.63 ± 10.21 and 34.75 ± 12.07 for patients and controls, respectively. After six months proteinuria decreased from 885.45 ± 2033.12 mg/day to 398.55 ± 811.34 mg/day (P = 0.002). Comparing to baseline urinary nephrin/creatinine, podocin/creatinine, VEGF-A/creatinine were significantly increased (P = 0.039, P = 0.001, P = 0.001 respectively) while renal function and proteinuria were improved in patients. In controls urinary protein and nephrin/creatinine were lower than that of patients (P = 0.001, P = 0.044). The presence of renal failure at the initial diagnosis was the most important for death (P <0.029). Proteinuria and renal dysfunction were found in 74% and 33%, in patients with newly diagnosed MM, respectively. The presence of podocyte injury at the beginning and also increase after therapy while improvement of proteinuria and renal failure, suggests that podocyte injury can be seen in MM and is affected with treatment. This is the first report about podocyte injury in MM.
Research Interests: Urology, Medicine, Internal Medicine, Renal Function, Proteinuria, and 3 moreNephrin, Podocin, and Creatinine
Research Interests: Medicine, Biyofizik, Toksikoloji, Adli tıp, Acil Tıp, and 3 moreDiş Hekimliği, genel anestezi, and alerji
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Research Interests: Kidney transplantation, Clinical Pharmacology, Medicine, Prospective studies, Humans, and 15 moreInternal Medicine, Female, Male, Medical Physiology, Clinical Sciences, Aged, Middle Aged, Adult, Immunoassay, Digoxin, Chronic Kidney Failure, Blood Proteins, Radioimmunoassay, Pharmacology and pharmaceutical sciences, and Kidney function tests
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Autosomal dominant polycystic kidney disease (ADPKD) has a prevalence of 1:3,000 among all types of hospital admissions, accounts for 10&percnt; of end-stage renal failure, is seen all over the world equally between genders and... more
Autosomal dominant polycystic kidney disease (ADPKD) has a prevalence of 1:3,000 among all types of hospital admissions, accounts for 10&percnt; of end-stage renal failure, is seen all over the world equally between genders and usually between the ages of 30 and 50 years.
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A 58-year-old male patient with a history of hypertension presented with abdominal pain and nausea. Five months previously, he had presented with dyspnoea, abdominal fullness and pretibial oedema and was hospitalised in the coronary... more
A 58-year-old male patient with a history of hypertension presented with abdominal pain and nausea. Five months previously, he had presented with dyspnoea, abdominal fullness and pretibial oedema and was hospitalised in the coronary intensive care unit with the diagnosis of decompensated heart failure. At that time, renal function and serum sodium and potassium levels were completely normal. Low-dose aspirin, propranolol, nitrate, frusemide (furosemide), amiodarone and spironolactone were prescribed. At the last admission to our hospital, his body temperature was 36 C, blood pressure was 140 ⁄ 100 mm Hg, heart rate was 100 ⁄ min, regular. He was orientated and co-operative. Skin was normal, external jugular veins were not engorged. On auscultation of chest, there were bilateral crepitations. The heart was tachycardic and arrhythmic with no murmurs heard. No organomegaly or tenderness were found. Peripheral pulses were palpable in all extremities; there was no pretibial oedema. Laboratory findings were as follows: white blood cell, 11.900; haematocrit, 42.1; MCV, 83.9; platelets, 278.000; serum Na, 107 mEq ⁄ l; serum K, 4.1 mEq ⁄ l; blood urea nitrogen, 14 mg ⁄ dl; Creatinine, 1.0 mg ⁄ dl; total protein, 7.1 g ⁄ dl; albumin, 4.5 g ⁄ dl; TSH 0.76; free T3, 2.8; free T4, 2.6; CRP 3.1; uric acid, 2.7 mg ⁄ dl; AST, 36 IU ⁄ l; ALT, 32 IU ⁄ l; LDH, 499; urinary Na, 31 mEq ⁄ l; urinary osmolarity, 677. Blood lipids were within normal limits. On ultrasound, both kidneys were within the normal range with a simple renal cyst on the left kidney. There was mucosal thickening of the bladder wall with increased trabeculation. On transthoracic echocardiography, ejection fraction (EF) was 63% with dilatation of left atrial, right atrial and ventricular, 1 ⁄ 2 mitral regurgitation, 1 ⁄ 2 tricuspid regurgitation and mild pulmonary hypertension. Our primary diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH) was based on hyponatremia, high urinary osmolarity, high-normal urinary Na, hypouric acidemia and absence of hypervolemia. But the aetiology was not apparent. Limiting the water and salt intake did not correct the serum Na level. Although malignancy was a well-known cause of SIADH, there was no abnormality on routine X-ray and ultrasound to suggest further examinations, such as CT or MR scanning. With the suspicion of druginduced SIADH, we discontinued amiodarone and observed the patient. Because he was asymptomatic, we discharged him with serum Na of 117 mEq ⁄ l. One and two weeks later in the outpatient clinic, serum Na levels were 123 and 130 mEq ⁄ l, respectively. A review of the literature revealed four case reports of SIADH-induced hyponatremia associated with amiodarone treatment between 1999 and 2004. In two of them, hyponatremia developed during the loading dose of amiodarone treatment and responded well to dose reduction without discontinuation of drug (1, 2). In one of these cases, the serum Na level was improved within 3 weeks of dose reduction (1). In a 67-year-old male patient with multiple medical problems and a complex drug regimen, hyponatremia developed consistent with SIADH (3). After exclusion of common comorbid conditions associated with SIADH, amiodarone was discontinued based on a case report suggesting SIADH with this drug. The serum sodium level began to rise within 3 days of discontinuation and returned to normal within 1 month. In a similar case, hyponatremia resolved after discontinuation and did not recur during 6 months follow-up (4). We confirm with this case that SIADH can be associated with amiodarone therapy; speed of recovery may be related to the dose and duration of therapy. Although SIADH induced hyponatremia occurs only rarely, clinicians should be aware of this complication during treatment with amiodarone.
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Bu çalışma, hemodiyaliz tedavisi gören kronik böbrek yetmezliği hastalarının Roper, Logan, Tierney'in Yaşam Aktivitelerine Dayalı Hemşirelik Modeli’nden yararlanarak hemşirelik tanılarının belirlenmesi amacıyla planlanmıştır.... more
Bu çalışma, hemodiyaliz tedavisi gören kronik böbrek yetmezliği hastalarının Roper, Logan, Tierney'in Yaşam Aktivitelerine Dayalı Hemşirelik Modeli’nden yararlanarak hemşirelik tanılarının belirlenmesi amacıyla planlanmıştır. Tanımlayıcı ve kesitsel tipte yapılan çalışmanın evrenini bir üniversite hastanesinin hemodiyaliz ünitesinde düzenli hemodiyaliz tedavisi gören 66 hasta oluşturmuş olup örneklemini araştırmaya katılma kriterlerine uyan 42 hasta oluşturmuştur. Araştırma öncesi, etik kurul onayı ve kurum izni alınmıştır. Araştırmanın verileri literatürden yararlanılarak araştırmacılar tarafından hazırlanan “Hasta Bilgi formu” ve Hemşirelik Modeli’ne uygun günlük yaşam aktivitelerine göre oluşturulan “Bakım Gereksinimlerini Belirleme Formu” kullanılarak toplanmıştır. Toplanılan veriler analiz edilerek uygun NANDA-I tanıları konulmuştur. Verilerin analizinde sayı ve yüzde değerleri kullanılmıştır. Hastaların yaş ortalamaları 57.31+16.59 olup %54.8’i kadındır. Toplamda 12 günlük...
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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%, ...
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Leptospirosis, enfeksiyonlu hayvanların idrar yoluyla bulaşan bir zoonozdur. Leptospiroz; solunum, renal, hepatik ve hematolojik komplikasyonlar ile ilişkili olabilir ve tedavi edilmediğinde yüksek mortalite riski taşır. Bu yazıda ... more
Leptospirosis, enfeksiyonlu hayvanların idrar yoluyla bulaşan bir zoonozdur. Leptospiroz; solunum, renal, hepatik ve hematolojik komplikasyonlar ile ilişkili olabilir ve tedavi edilmediğinde yüksek mortalite riski taşır. Bu yazıda leptospirozise bağlı akut böbrek yetmezliği, akut hepatit, hiperbilirubinemi ve soğuk aglutinin hastalığı gelişen nadir bir vaka sunulmuştur. .
Research Interests: Medicine, Biyofizik, Gynecology, Toksikoloji, Adli tıp, and 4 moreAcil Tıp, Diş Hekimliği, genel anestezi, and alerji
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Purpose: We investigated the effects of hypokalemia on clinical outcomes in hospitalized patients with Covid-19 pneumonia. Materials and Methods: In this single-center retrospective study, we recorded characteristics of hospitalized... more
Purpose: We investigated the effects of hypokalemia on clinical outcomes in hospitalized patients with Covid-19 pneumonia. Materials and Methods: In this single-center retrospective study, we recorded characteristics of hospitalized covid-19 pneumonia patients and laboratory test results on the first hospital day. Duration of hospitalization, requiring intensive care including mechanical ventilation and survival, were determined. Results: Our study included 185 patients and of them 111 male (60% male) patients with mean age of 64 ± 14.5 (23-90). Patients were grouped as hypokalemic (16.8%) and normokalemic patients (83.2%). The number of diabetic patients was higher in the normokalemic group. Serum total protein and albumin levels were lower in hypokalemic group, while alkaline phosphatase, gamma-glutamyl transpeptidase, total bilirubin, direct bilirubin, blood pH and bicarbonate level were higher. In multiple logistic regression analyses, alkalosis increased risk of hypokalemia 5.7...
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Twenty-seven consecutive mushroom poisoning cases were followed up over a period of 14 days. Fourteen out of 27 died of liver failure. There were no deaths from renal failure. The mushrooms were identified as the amatoxin-containing... more
Twenty-seven consecutive mushroom poisoning cases were followed up over a period of 14 days. Fourteen out of 27 died of liver failure. There were no deaths from renal failure. The mushrooms were identified as the amatoxin-containing Lepiota species. Therapeutic measures included nasogastric lavage, charcoal, vitamin C, vitamin B, penicillin G, corticosteroids, oral streptomycin and, in the case of a few patients, limited amounts of thioctic acid. Of the ten haemodialysed, nine died. Unfortunately charcoal haemoperfusion was not available. It appeared that therapeutic measures were ineffective and it also seemed that the amount of mushroom ingested was the determining factor for the prognosis. An important point to make is that renal failure does not occur and liver failure is always delayed (group II). For this reason all suspected cases of mushroom poisoning, regardless of absence of clinical signs and symptoms, must be hospitalised for a period of at least one week. The poisonous properties of wild mushrooms have been recognized since ancient times. However, despite awareness of their inherent dangers, serious poisoning continues to occur. Fatal intoxications can be attributed almost entirely to the amtoxin-containing species. Amanita phalloides have been blamed for over 90% of poisoning deaths in North America. There are reports of intoxications of other amatoxin-containing species in Europe, but fatalities due to Lepiota species are reported only rarely. It was previously acknowledged that the interval between ingestion of mushrooms and the onset of symptoms is longer than expected in serious poisonings.(ABSTRACT TRUNCATED AT 250 WORDS)