Person: ARIKAN, İZZET HAKKI
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ARIKAN
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İZZET HAKKI
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Publication Open Access Epidemiological features of primary glomerular disease in Turkey: a multicenter study by the Turkish Society of Nephrology Glomerular Diseases Working Group(BMC, 2020-12) ARIKAN, İZZET HAKKI; Turkmen, Aydin; Sumnu, Abdullah; Cebeci, Egemen; Yazici, Halil; Eren, Necmi; Seyahi, Nurhan; Dilek, Kamil; Dede, Fatih; Derici, Ulver; Unsal, Abdulkadir; Sahin, Garip; Sipahioglu, Murat; Gok, Mahmut; Tatar, Erhan; Dursun, Belda; Sipahi, Savas; Yilmaz, Murvet; Suleymanlar, Gultekin; Ulu, Sena; Gungor, Ozkan; Kutlay, Sim; Bahcebasi, Zerrin Bicik; Sahin, Idris; Kurultak, Ilhan; Turkmen, Kultigin; Yilmaz, Zulfikar; Kazancioglu, Rumeyza Turan; Cavdar, Caner; Candan, Ferhan; Aydin, Zeki; Oygar, Duriye Deren; Gul, Cuma Bulent; Arici, Mustafa; Paydas, Saime; Taymez, Dilek Guven; Kucuk, Mehmet; Trablus, Sinan; Turgutalp, Kenan; Koc, Leyla; Sezer, Siren; Duranay, Murat; Bardak, Simge; Altintepe, Lutfullah; Arikan, Izzet Hakki; Azak, Alper; Odabas, Ali Riza; Sahin, Gulizar Manga; Ozturk, SavasBackground 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 syndrome (17.8%). The most common PGD was IgA nephropathy (25.7%) followed by membranous nephropathy (25.6%) and focal segmental glomerulosclerosis (21.9%). The mean total number of glomeruli per biopsy was 17 +/- 10. The mean baseline systolic blood pressure was 130 +/- 20 mmHg and diastolic blood pressure was 81 +/- 12 mmHg. The median proteinuria, serum creatinine, estimated GFR, and mean albumin values were 3300 (IQR: 1467-6307) mg/day, 1.0 (IQR: 0.7-1.6) mg/dL, 82.9 (IQR: 47.0-113.0) mL/min and 3.2 +/- 0.9 g/dL, respectively. Conclusions The distribution of PGDs in Turkey has become similar to that in other European countries. IgA nephropathy diagnosed via renal biopsy has become more prevalent compared to membranous nephropathy.Publication Metadata only Histopathological changes and tumour necrosis factor-alpha, transforming growth factor-beta and tenascin expression in patients with primary type I membranoproliferative glomerulonephritis in remission(WILEY, 2009) ARIKAN, İZZET HAKKI; Arikan, Hakki; Koc, Mehmet; Cakalagaoglu, Fulya; Tuglular, Serhan; Ozener, Cetin; Akoglu, EmelAim: Primary type I membranoproliferative glomerulonephritis (MPGN) is a rare cause of glomerular disease with a high relapse rate and poor prognosis. The aim of this study was: (i) to evaluate the histopathological findings associated with remission; and (ii) to document the possible clinical and histopathological factors predicting relapses. Methods: Eleven type I MPGN patients (five men, six women; mean age, 38.8 +/-13.5 years) who were in remission for at least 1 year after the cessation of immunosuppressive drugs were re-biopsied. The intensity of immunostaining for tumor necrosis factor (TNF)-alpha, transforming growth factor (TGF)-beta 1, and tenascin was graded from 0 (no staining) to 3+ (maximum staining). Results: Mean baseline mesangial cellularity score and tubulointerstitial infiltration score were reduced and mesangial matrix expansion score was increased at protocol re-biopsies compared to baseline. The glomerular and tubulointerstitial staining scores for TGF-beta 1 and tenascin were higher than that of baseline. Reduced tubulointerstitial TNF-alpha expression was found in re-biopsy specimens compared to baseline. Patients have been followed for a mean time of 51.5 +/- 22.2 months after the protocol biopsy. Eight patients had a relapse. Mesangial cellularity score and glomerular tenascin expression at re-biopsy specimens were higher in relapsed patients compared to those without a relapse. Conclusion: Our study shows that mesangial cellularity and tubulointerstitial cell infiltration are reducing whereas mesangial matrix expansion, glomerular and tubulointerstitial TGF-beta 1 and tenascin expression are increasing with remission. The higher mesangial cell proliferation and glomerular tenascin scores in remission are associated with the development of relapse.Publication Metadata only Hemodiyaliz ve Periton Diyalizi Tedavisi Alan Hastalarda Uzun Dönemde Gelişen Kognitif ve Fiziksel Bozukluklar.(2021-10-13) BARUTÇU ATAŞ, DİLEK; VELİOĞLU, ARZU; ARIKAN, İZZET HAKKI; AŞICIOĞLU, EBRU; Süleymanova G., BARUTÇU ATAŞ D., TUĞCU M., VELİOĞLU A., ARIKAN İ. H., AŞICIOĞLU E.Giriş: Diyaliz hastalarında uzun dönemde gelişen kognitif ve fiziksel fonksiyonlardaki gerileme yaşam kalitesinde bozulma ve artmış mortalite ile ilişkilidir. Bu çalışmada hemodiyaliz ve periton diyalizi tedavisi alan hastalarda kognitif ve fiziksel bozuklukları belirleyerek karşılaştırmayı hedefledik. Yöntemler: Çalışmamıza 20 periton diyalizi (PD) ve 24 hemodiyaliz (HD) hastası dahil edildi. Hastaların kognitif bozukluklarını değerlendirmek için MoCA (Montreal Kognitif Değerlendirme) ve MMSE (Mini Mental Durum Değerlendirme) testleri, fiziksel bozuklukları değerlendirmek için Lawton ve Brody EGYA(Enstrümental Günlük Yaşam Aktivitesi) ile Katz GYA (Günlük Yaşam Aktivitesi) testleri kullanılmıştır. Hastaların medikal özgeçmişi, kronik hastalıkları, diyalize başlama tarihleri sorgulandı. Laboratuvar verileri kaydedildi. Bulgular:HD tedavisi alan hastalar daha yaşlıydı (55.3±15.3 vs 48.2±10.1 yıl p=0.036). Grupların demografik ve laboratuvar verileri Tablo 1’de gösterilmiştir. PD hastalarının MoCA (21.9±6.0 vs 16.6±7.1, p=0,008).Lawton ve Brody EGYA (7.6±1.6 vs 6.4±2.4, p=0.025) ve Katz GYA(6.0±0.0 vs 5.5±1.0, p=0.018) skorları HD hastalarından yüksekti. Gruplarının kognitif ve fiziksel fonksiyonları Tablo 2’de karşılaştırılmıştır. Korelasyon analizinde yaş ile MoCA (r= -0.482, p= 0.001), MMSE (r= -0.462, p= 0.002) ve EGYA (r= -0.549, p= 0.001) arasında negatif korelasyon mevcuttu. Sonuç: Bu çalışmada her iki grupta da hastaların önemli bir kısmında kognitif ve fiziksel fonksiyonlarda bozulma mevcuttu. Ancak PD grubunda hastaların kognitif ve fiziksel fonksiyonlarının HD grubuna nazaran daha iyi korunduğunu gösterdik. İlerleyen dönemlerde diyaliz hastalarında gelişecek bu bozuklukların önlenmesi için hastaların yakından takip edilmesi gerekmektedir.Publication Open Access Acute Renal Failure due to Bladder Injury after Cesarean Section: Case Report and Review of the Literature(TURK NEFROLOJI DIYALIZ TRANSPLANTASYON DERGISI, 2019-11-05) AŞICIOĞLU, EBRU; Atas, Dilek Barutcu; Asicioglu, Ebru; Durgay, Meryem; Arikan, Hakki; Koc, Mehmet; Tuglular, Serhan; Ozener, CetinA 31-year-old woman who had an uncomplicated cesarean section five days prior to admission presented with abdominal distention. Evaluation revealed acute renal failure and abdominal ascites. Diagnostic paracentesis showed urinary ascites, which confirmed a bladder injury. The patient was conservatively treated by placement of a Foley catheter that resulted in complete resolution of the renal failure.Publication Open Access Toll-like receptor expression in monocytes in patients with chronic kidney disease and haemodialysis: relation with inflammation(OXFORD UNIV PRESS, 2011-03-01) AŞICIOĞLU, EBRU; Koc, Mehmet; Toprak, Ahmet; Arikan, Hakki; Odabasi, Zekaver; Elbir, Yesim; Tulunay, Aysin; Asicioglu, Ebru; Eksioglu-Demiralp, Emel; Glorieux, Griet; Vanholder, Raymond; Akoglu, EmelBackground. Inflammation is one of the main contributors to atherosclerosis in haemodialysis (HD) patients. Activation of Toll-like receptors (TLRs) leads to inflammatory response. In this study, we aimed to evaluate the expression of TLRs on monocytes and relate their expression with inflammation in chronic kidney disease (CKD) and HD patients. Methods. Thirty-four age- and gender-matched controls and stage 3-4 CKD patients and thirty-two HD patients were included in each study group. The effect of HD on the expression of Toll-like receptor-2 (TLR-2) and Toll-like receptor-4 (TLR-4) on CD14(+) monocytes was determined at the beginning (baseline), during (120 min) and following (300 min and 24 h) HD and compared with control and stage 3-4 CKD groups. The HD procedure was performed by using low-flux polysulphone dialysers. In addition, serum IL-6 levels were evaluated in both groups at baseline and after a HD session. Results. The percentage of CD14(+) monocytes expressing TLR-2 were similar in all of the study groups, whereas the percentage of CD14(+) monocytes expressing TLR-4 were significantly lower in both stage 3-4 CKD and HD patients at baseline than in controls. The mean fluorescence intensities (MFI) of TLR-2 were significantly lower in controls than in stage 3-4 CKD and HD patients at baseline. The MFI of TLR-4 was similar in all of the groups. The percentage of CD14(+) monocytes expressing TLR-2 did not change during and after HD. The MFI of TLR-2 decreased at 120 min of HD compared with baseline (1837 +/- 672 vs 1650 +/- 578, P < 0.05), and recovered back to baseline values at 300 min and at 24 h post-HD. MFI of TLR-4 increased at 24 h compared with baseline (941 +/- 294 vs 1087 +/- 441, P < 0.05). Serum IL-6 levels correlated with MFI of TLR-2 and TLR-4 in stage 3-4 CKD patients and in HD patients at baseline and after HD in univariate analysis. Stepwise multiple regression analysis revealed that MFI of TLR-2 was an independent determinant of serum IL-6 concentrations in stage 3-4 CKD and in HD patients at baseline, at 300 min and at 24 h post-HD. Conclusions. Our study demonstrates that TLR-2 is associated with the inflammatory response of non-dialysed and dialysed CKD patients.Publication Open Access Low bone density, vertebral fracture and FRAX score in kidney transplant recipients: A cross-sectional cohort study(PUBLIC LIBRARY SCIENCE, 2021-04-30) VELİOĞLU, ARZU; Velioglu, Arzu; Kaya, Burcu; Aykent, Basar; Ozkan, Bige; Karapinar, Melis Sevil; Arikan, Hakki; Asicioglu, Ebru; Bugdayci, Onur; Yavuz, Dilek Gogas; Tuglular, SerhanBackground Kidney transplantation (KT) recipients are at increased risk of low bone density (LBD) and fractures. In this retrospective study, we investigated bone mineral density (BMD), vertebral fractures, calculated risk for major osteoporotic fractures (MOF), and hip fractures in the KT recipients. Patients-method Patients who completed at least one year after KT were included in the analysis. Demographic, clinical, and laboratory data were recorded. Measurements of BMD were performed by dual-energy X-ray absorptiometry. Vertebral fractures were assessed using semi-quantitative criteria with conventional radiography. The ten-year risk for MOF and hip fracture were calculated using the FRAX@ tool with BMD. Results One hundred fifty-three KT recipients were included in the study. The population included 77 women. The mean age at evaluation was 46,511,9 years. Seventy-eight (50.9%) patients had normal femoral neck BMD while osteoporosis and osteopenia at the femoral neck were present in 12 (7.8%) and 63 (41.1%) of the patients, respectively. Age at evaluation was the risk factor for LBD (OR 1.057; 95% CI 1.024-1.091; p = 0.001). In female KT recipients, LBD was principally affected by menopausal status whereas in males, mammalian target of rapamycin (mTOR) inhibitor use and lower BMI levels were the risk factors. The prevalent vertebral fracture was found in 43.4% of patients. In multivariate analysis, only steroid use (OR 0.121; 95% CI 0.015-0.988; p = 0.049) was found to be associated with prevalent fracture. Among all KT recipients, 1.9% had a high MOF probability (>= 20% risk of fracture), and 23.5% had high hip fracture probability (>= 3% risk of hip fracture) according to FRAX. Conclusion Exploring the prevalence of LBD and vertebral fracture and the risk factors would help clinicians to modify long-term follow-up strategies. Furthermore, the high hip fracture risk probability in our cohort suggested that there is a need for longitudinal studies to confirm the validity of the FRAX tool in the transplant population.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 Sepsiste serum laktat yüksekliği-sidemi ilişkisinin böbrek fonksiyonları penceresinden incelenmesi(2022-12-08) TUĞCU, MURAT; AŞICIOĞLU, EBRU; ARIKAN, İZZET HAKKI; BARUTÇU ATAŞ, DİLEK; TUĞLULAR, ZÜBEYDE SERHAN; VELİOĞLU, ARZU; Karadağ H., Berke Menteşe İ., Barutçu Ataş D., Tuğcu M., Aşıcıoğlu E., Velioğlu A., Tuğlular Z. S. , Arıkan İ. H.Publication Open Access Characteristics and outcomes of acute kidney injury in hospitalized COVID-19 patients: A multicenter study by the Turkish society of nephrology(PUBLIC LIBRARY SCIENCE, 2021-08-10) ARIKAN, İZZET HAKKI; Arikan, Hakki; Ozturk, Savas; Tokgoz, Bulent; Dursun, Belda; Seyahi, Nurhan; Trabulus, Sinan; Islam, Mahmud; Ayar, Yavuz; Gorgulu, Numan; Karadag, Serhat; Gok, Mahmut; Akcali, Esra; Bora, Feyza; Aydin, Zeki; Altun, Eda; Ahbap, Elbis; Polat, Mehmet; Soypacaci, Zeki; Oguz, Ebru Gok; Koyuncu, Sumeyra; Colak, Hulya; Sahin, Idris; Dolarslan, Murside Esra; Helvaci, Ozant; Kurultak, Ilhan; Eren, Zehra; Dheir, Hamad; Ogutmen, Melike Betul; Taymez, Dilek Guven; Genek, Dilek Gibyeli; Ozkurt, Sultan; Bakir, Elif Ari; Yuksel, Enver; Sahutoglu, Tuncay; Oto, Ozgur Akin; Boz, Gulsah; Sengul, Erkan; Kara, Ekrem; Tuglular, SerhanBackground Acute kidney injury (AKI) is common in coronavirus disease-2019 (COVID-19) and the severity of AKI is linked to adverse outcomes. In this study, we investigated the factors associated with in-hospital outcomes among hospitalized patients with COVID-19 and AKI. Methods In this multicenter retrospective observational study, we evaluated the characteristics and in-hospital renal and patient outcomes of 578 patients with confirmed COVID-19 and AKI. Data were collected from 34 hospitals in Turkey from March 11 to June 30, 2020. AKI definition and staging were based on the Kidney Disease Improving Global Outcomes criteria. Patients with end-stage kidney disease or with a kidney transplant were excluded. Renal outcomes were identified only in discharged patients. Results The median age of the patients was 69 years, and 60.9% were males. The most frequent comorbid conditions were hypertension (70.5%), diabetes mellitus (43.8%), and chronic kidney disease (CKD) (37.6%). The proportions of AKI stages 1, 2, and 3 were 54.0%, 24.7%, and 21.3%, respectively. 291 patients (50.3%) were admitted to the intensive care unit. Renal improvement was complete in 81.7% and partial in 17.2% of the patients who were discharged. Renal outcomes were worse in patients with AKI stage 3 or baseline CKD. The overall in-hospital mortality in patients with AKI was 38.9%. In-hospital mortality rate was not different in patients with preexisting non-dialysis CKD compared to patients without CKD (34.4 versus 34.0%, p = 0.924). By multivariate Cox regression analysis, age (hazard ratio [HR] [95% confidence interval (95%CI)]: 1.01 [1.0-1.03], p = 0.035], male gender (HR [95%CI]: 1.47 [1.04-2.09], p = 0.029), diabetes mellitus (HR [95%CI]: 1.51 [1.06-2.17], p = 0.022) and cerebrovascular disease (HR [95%CI]: 1.82 [1.08-3.07], p = 0.023), serum lactate dehydrogenase (greater than two-fold increase) (HR [95%CI]: 1.55 [1.05-2.30], p = 0.027) and AKI stage 2 (HR [95%CI]: 1.98 [1.25-3.14], p = 0.003) and stage 3 (HR [95%CI]: 2.25 [1.44-3.51], p = 0.0001) were independent predictors of in-hospital mortality. Conclusions Advanced-stage AKI is associated with extremely high mortality among hospitalized COVID-19 patients. Age, male gender, comorbidities, which are risk factors for mortality in patients with COVID-19 in the general population, are also related to in-hospital mortality in patients with AKI. However, preexisting non-dialysis CKD did not increase in-hospital mortality rate among AKI patients. Renal problems continue in a significant portion of the patients who were discharged.Publication Metadata only Elevated Plasma Levels of PAI-1 Predict Cardiovascular Events and Cardiovascular Mortality in Prevalent Peritoneal Dialysis Patients(TAYLOR & FRANCIS LTD, 2009) ARIKAN, İZZET HAKKI; Arikan, Hakki; Koc, Mehmet; Tuglular, Serhan; Ozener, Cetin; Akoglu, EmelBackground. Elevated plasminogen activator inhibitor-1 (PAI-1) levels are associated with increased cardiovascular (CV) risk in the general population. It has been shown that peritoneal dialysis (PD) patients have increased plasma levels of PAI-1. The aim of this study was to investigate whether PAI-1 independently predicted CV outcome in PD patients. Material and Methods. Seventy-two PD patients (53% females, mean age 49.9 +/- 16.1 years) were studied. Twelve patients who underwent kidney transplantation and 14 patients who transferred to hemodialysis during follow-up were excluded from the analysis. The remaining 46 patients (54% female, mean age 54 +/- 16 years, dialytic age 42 +/- 30 months) were followed a mean time of 45.4 +/- 19.4 months (range 8-71 months). Baseline PAI-1, clinical, and laboratory parameters were assessed in all patients. Survival analyses were made with Kaplan-Meier and Cox regression analysis, with all-cause mortality and CV mortality and CV events (CVEs) as clinical end points. Results. During the follow-up, 29 patients died (17 from CV causes), and 28 fatal and non-fatal CVEs were recorded. The patients were divided according to plasma PAI-1 levels (i.e., <= or >41 ng/mL). The significant independent predictors of all-cause of mortality were age (>60 years; p = 0.018), CRP (>5 mg/L; p = 0.015), and serum albumin (<3.5 g/L; p = 0.011). Multivariable Cox regression analysis showed that plasma PAI-1 >41 ng/mL was independently predictive of higher CV mortality (p = 0.021) and CVEs (p = 0.001). The only other independent predictor of CV mortality was only CRP (>5 mg/L; p = 0.008). Conclusions. Plasma levels of PAI-1 >41 ng/mL is a significant predictor of CV mortality and CVEs in PD patients.