Person: KOÇ, MEHMET
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Publication Metadata only Waist circumference is associated with carotid intima media thickness in peritoneal dialysis patients(SPRINGER, 2013) VELİOĞLU, ARZU; Asicioglu, Ebru; Kahveci, Arzu; Arikan, Hakki; Koc, Mehmet; Tuglular, Serhan; Ozener, Cetin IshakAtherosclerosis is responsible for the high mortality rate in end-stage renal disease patients. Defining risk factors for atherosclerosis may lead to reduction in cardiovascular disease through modification of these factors. Peritoneal dialysis (PD) patients are subjected to high glucose loads on a daily basis, which results in considerable weight gain and an increase in waist circumference (WC). WC as an indicator of abdominal obesity is a risk factor for atherosclerosis in the general population. Carotid artery intima media thickness (CIMT) measurement is a reliable method for the detection of early atherosclerosis. The aim of this study was to investigate the relationship between WC and CIMT and to define risk factors associated with CIMT in PD patients. Fifty-five PD patients and 40 healthy controls were included. Atherosclerosis was assessed using measurement of CIMT. Fasting blood was collected for analysis. Anthropometric parameters (age, weight, BMI, and WC) were measured. Peritoneal dialysis patients had higher WC (93.9 +/- A 1.7 vs. 87.3 +/- A 1.2 cm, p < 0.05) and CIMT (0.70 +/- A 0.02 vs. 0.57 +/- A 0.01 mm, p < 0.01) than the control group. On univariate analysis, age, WC, plaque formation, and D/P creatinine were positively correlated with CIMT, whereas residual renal function, albumin, ultrafiltration volume, and D/D0 glucose were negatively correlated. On multivariate analysis, only age, WC, and plaque formation showed correlation (p < 0.001). Carotid artery intima media thickness is associated with age, plaque formation, and WC in PD patients. WC measurement is a simple, inexpensive, reproducible, and reliable method of evaluating atherosclerosis risk in PD patients and should be assessed at every visit. Appropriate counsel should be provided to patients with greater WC who are deemed to be at risk for atherosclerosis.Publication Metadata only Determinants of hemoglobin variability in stable peritoneal dialysis patients(SPRINGER, 2014) VELİOĞLU, ARZU; Arikan, Hakki; Asicioglu, Ebru; Velioglu, Arzu; Nalcaci, Serdar; Birdal, Gurdal; Guler, Derya; Koc, Mehmet; Tuglular, Serhan; Ozener, CetinSignificant within-patient hemoglobin (Hb) level variability is well recognized in particularly hemodialysis patients. Several factors such as hospitalizations, intercurrent diseases and IV iron therapy are found to be related to Hb variability (Hb-var). In this observational study, we aimed to identify predictors and outcome of Hb-var in peritoneal dialysis (PD) patients without hospitalization, intercurrent disease and IV iron therapy during the study period. All patients were in the maintenance phase of short-acting erythropoiesis-stimulating agents (ESAs) therapy. The target range of Hb was 11-12 g/dL according to KDOQI Guidelines in 2007. The desired range of Hb was 11-12.5 g/dL. Patients' demographic and laboratory data were collected at baseline. Atherosclerotic disease was assessed using carotid intima-media thickness (CIMT). We assessed Hb variability with various methods using SD Hb(mean), SD Hb(range) and the velocity of Hb change. Hb deflect(positive), Hb deflect(negative), Hb values and ESA dosing were recorded monthly for 6 months. This study included 50 prevalent PD patients (mean age 46.9 +/- A 13.7 years, 25 women). The mean velocity of Hb change was negatively correlated with age and positively correlated with frequent ESA dose changes. Higher albumin and residual renal function (RRF) were also positively correlated with Hb deflect(positive). Patients with CIMT a parts per thousand yen0.7 cm had lower SD Hb range compared to CIMT < 0.7 cm. Cumulative survival was better in patients with Hb levels consistently a parts per thousand yen10 g/dL compared to patients who had Hb < 10 g/dL for at least 1 month. However, Hb-var was not associated with mortality. In PD patients without hospitalization, intercurrent disease(s) or IV iron therapy, young age, higher albumin or RRF and lower CIMT were associated with greater oscillations in response to ESA therapy. Careful and appropriate ESA dose changes considering these parameters could minimize Hb variability in these patients.Publication Metadata only Peritoneal Fluid Trefoil Factor-3 Peptide Levels and Associated Factors in Chronic Peritoneal Dialysis Patients(TURK NEFROLOJI DIYALIZ TRANSPLANTASYON DERGISI, 2018) AŞICIOĞLU, EBRU; Aktas, Gokmen; Arikan, Hakki; Erken, Ertugrul; Asicioglu, Ebru; Koc, Mehmet; Ozener, CetinOBJECTIVE: TFF3 is a small peptide hormone secreted from mucous producing cells and many epithelial cells. TFF3 inhibits apoptosis, promotes migration and facilitates restoration against injury. In our cross-sectional study, TFF3 levels in peritoneal fluids of peritoneal dialysis (PD) patients were measured and associated factors were investigated. MATERIAL and METHODS: Peritoneal fluid after a 12-hour dwell and concurrent serum samples of 48 chronic PD patients were collected. Serum and peritoneal fluid TFF3 levels were measured by ELISA. The SPSS15.0 package was used for statistical analysis of database files. RESULTS: The study included 48 patients (men/women; 24/24, mean age: 51.6813.9 years) with a median PD vintage of 43 months (3-200). Median effluent TFF3 level was 17.07 ng/ml (2.38-99.4). There was no relationship between the number of peritonitis episodes and TFF3 levels. There was a positive correlation between effluent TFF3 levels and PD vintage (r=0.349, p<0.015). There was also a positive correlation between effluent TFF3 and serum PTH. Median serum TITS was 1.56 ng/ml (0.79-11.05). There was no association between serum TFF3 levels and clinical features. After multivariate analysis, the only association was between effluent TFF3 and PD vintage. CONCLUSION: Effluent TFF3 levels increasing with dialysis vintage may be related to local production or peritoneal transport.Publication Open Access Fibroblast Growth Factor-23 Levels Are Associated with Vascular Calcifications in Peritoneal Dialysis Patients(KARGER, 2013) VELİOĞLU, ARZU; Asicioglu, Ebru; Kahveci, Arzu; Arikan, Hakki; Koc, Mehmet; Tuglular, Serhan; Ozener, Cetin IshakBackground: The aim of the study was to assess the relationship between fibroblast growth factor-23 (FGF-23) and vascular calcifications (VC) in peritoneal dialysis (PD) patients. Methods: A cross-sectional study was performed in 55 PD patients who underwent pelvic X-ray to assess for VC. Patients with and without linear calcifications were recorded. Results: Fifteen patients (27.3%) had linear calcifications on pelvic X-ray. FGF-23 levels were higher in patients with VC (299.5 (30.4-2,410.0) vs. 74.4 (14.8-1,030) pg/ml, p < 0.01). Diabetic patients had lower FGF-23 values (43.2 (14.9-134.0) vs. 103.5 (14.8-2,410) pg/ml, p < 0.01). Patients with residual renal function (RRF) had lower FGF-23 levels (70.6 (14.8-513) vs. 179.5 (30.4-2,410) pg/ml, p = 0.06); however, this did not reach statistical significance. FGF-23 levels, age, creatinine, Ca, dialysis duration and HbA1c were positively correlated with VC, whereas RRF, Ca intake and ALP were negatively associated. Multivariate logistic analysis confirmed FGF-23 levels, age, dialysis duration and RRF to be associated with VC. Conclusions: FGF-23 levels are associated with VC in PD patients. Further studies are needed to clarify whether it is simply a marker or a potential factor. It may prove to be an important therapeutic target for VC management. (C) 2013 S. Karger AG, BaselPublication Metadata only Left Ventricular Hypertrophy Patterns and Cardiovascular Outcome in Peritoneal Dialysis Patients(ORTADOGU AD PRES & PUBL CO, 2011) BEKİROĞLU, GÜLNAZ NURAL; Tezcan, Hakan; Toprak, Ahmet; Arikan, Izzet Hakki; Koc, Mehmet; Bekiroglu, Nural; Ozener, Ishak CetinObjective: Left ventricular hypertrophy (LVH) is highly predictive of cardiovascular (CV) events in dialysis patients. The impact of different left ventricular (LV) geometric patterns on cardiovascular outcome has not been well established. The aim of this prospective observational study was to define the patterns of LVH and find out their impact on future cardiovascular events in patients on continuous ambulatory peritoneal dialysis (CAPD). Material and Methods: Patients were followed up between 1999 and 2006 for cardiovascular events. Left ventricular mass and geometric patterns were determined by echocardiography. Kaplan-Meier method and Cox regression analysis were used to evaluate the impact of LV geometric patterns on CV event free survival. Results: Sixty-five CAPD patients were enrolled in the study and were followed for 76 +/- 15 months. There were a total of 16 (14 fatal, two non-fatal) CV events. Mean event-free survival time for patients without LVH was 79 +/- 3 months (95% CI of 73 to 86 months). The mean CV event-free survival for the patients with concentric LV hypertrophy and eccentric hypertrophy was 75 +/- 3 months (95% CI of 69 to 81 months), and 76 +/- 3 months (95% CI of 69 to 82 months) respectively. Patients with eccentric [hazard ratio (HR): 20.2] and concentric (HR:18.7) LV hypertrophy had shorter time to CV event when compared to the patients without LV hypertrophy (p= 0.042). Conclusion: Left ventricular hypertrophy is a marker of poor cardiovascular prognosis irrespective of its pattern. Both eccentric and concentric LV hypertrophy are associated with shorter CV event-free survival compared to normal geometry and concentric remodeling.