Person: ARIKAN, İZZET HAKKI
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ARIKAN
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İZZET HAKKI
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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 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 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.Publication Metadata only Mo174fibroscan detection of fatty liver and liver fibrosis in systemic lupus erythematosus(2021-05-01) BARUTÇU ATAŞ, DİLEK; VELİOĞLU, ARZU; ARIKAN, İZZET HAKKI; ALİBAZ ÖNER, FATMA; DİRESKENELİ, RAFİ HANER; TUĞLULAR, ZÜBEYDE SERHAN; AŞICIOĞLU, EBRU; Yetginoğlu Ö., BARUTÇU ATAŞ D., VELİOĞLU A., ARIKAN İ. H., YILMAZ Y., ALİBAZ ÖNER F., DİRESKENELİ R. H., TUĞLULAR Z. S., AŞICIOĞLU E.BACKGROUND AND AIMS: Systemic Lupus Erythematosus (SLE) is a chronic, multi-organ, systemic autoimmune disease that is more common in women than men and is typically diagnosed during the reproductive age. Although liver dysfunction is not considered the main organ pathology in SLE, the frequency of liver dysfunction or abnormal liver enzyme values may be observed in 50-60% of patients. Liver-related complications may present as asymptomatic hepatomegaly, subclinical steatosis and abnormal liver enzymes. The most common causes are drug-associated liver injury, lupus-associated hepatitis, and fatty liver disease. The aim of this study was to assess fatty liver and liver fibrosis in SLE patients using the FibroScan method as well as associated factors such as immunosuppressive medications. METHOD: Sixty SLE patients and 30 healthy controls were included. Patients with HBV, HCV or cirrhosis, malignancy, cardiac disease, or patients on dialysis were excluded. All participants underwent FibroScan measurements. Demographic data and cumulative doses of immunosuppressive medications were extracted from patient charts. Fasting blood was collected for analysis RESULTS: Demographic and clinical characteristics of the study groups are shown in Tables 1. The prevalence of fatty liver disease was similar between SLE patients and healthy controls (21.7% vs 26.7%, p= 0.597) and was associated with body mass index (BMI) (p= 0.026) and C-reactive protein (CRP) (p= 0.046) in multivariate analysis. Liver fibrosis was also similar between the two groups (26.7% vs 10.0%, p= 0.069). There was no relationship between cumulative drug doses including glucocorticoids with either fatty liver disease or liver fibrosis. Since the majority of SLE patients were female, we performed a subgroup analysis in female patients (n=51) and healthy controls (n=25). Fatty liver disease was similar between female SLE patients and healthy controls (23.5% vs 24.0%, p= 0.964). However, liver fibrosis in female patients with SLE was increased compared to the female healthy population (29.4% vs 4.0%, p= 0.011) and was associated with age (p= 0.034) and low-dose cumulative glucocorticoid use (p = 0.034). Low-dose cumulative glucocorticoid use was defined as less than 17.45 g, which was the 75th percentile value. Only 1 out of 15 female patients with fibrosis had high-dose cumulative glucocorticoid use (>17.45 g), while the remaining 14 patients had used lower doses (<17.45 g). CONCLUSION: The prevalence of fatty liver was similar between SLE patients and healthy controls, while liver fibrosis was increased in the female patient group as compared to controls. Furthermore, liver fibrosis was associated with age and low dose cumulative glucocorticoid use. Interestingly, fatty liver did not precede liver fibrosis in the majority of cases, contrary to what is observed in the general population. We hypothesized that liver fibrosis may be the result of subclinical inflammation and autoimmunity associated with SLE itself and the use of steroids may prevent or prolong fibrosis formation in the liver.Publication Metadata only Baseline carotid intima-media thickness is associated with cardiovascular morbidity and mortality in peritoneal dialysis patients(WILEY, 2021) VELİOĞLU, ARZU; Asicioglu, Ebru; Velioglu, Arzu; Arikan, Hakki; Koc, Mehmet; Tuglular, Serhan; Ozener, CetinCarotid intima-media thickness (CIMT) is an early marker of atherosclerosis and is increased in peritoneal dialysis (PD) patients. Association of CIMT with cardiovascular disease (CVD) or mortality is less clear. Fibroblast growth factor-23 (FGF-23) is a hormone associated with vascular calcification, atherosclerosis, and mortality in the hemodialysis population. We investigated whether baseline CIMT and FGF-23 are associated with CVD and mortality in PD patients. Fifty-five PD patients were included. CVD was defined as ischemic heart disease, stroke, or peripheral artery disease. Intact FGF-23 was measured in plasma. CIMT was measured by ultrasonography. Twenty-one patients developed CVD and 12 died over 47.1 +/- 33.8 months. Patients with CVD were older (55.9 +/- 10.5 vs. 42.5 +/- 12.9 years, P < .01), had lower albumin (3.8 +/- 0.5 vs. 4.2 +/- 0.3 g/dL, P < .01) and higher CIMT (0.87 +/- 0.22 vs. 0.61 +/- 0.11 mm, P < .01). Patients with mortality were also older (53.5 +/- 11.5 vs. 45.8 +/- 13.8 years, P = .05), had lower albumin (3.7 +/- 0.6 vs. 4.1 +/- 0.3 g/dL, P < .01), higher CRP (15.0 +/- 8.5 vs. 7.6 +/- 8.4 mg/L, P < .01) and CIMT (0.9 +/- 0.3 vs. 0.6 +/- 0.1 mm, P < .01). Albumin and CIMT were associated with CVD and CIMT > 0.75 mm was associated with cardiovascular mortality. FGF-23 did not show any correlations. CIMT at baseline is associated with CVD and mortality in PD patients.Publication Metadata only Cyclosporine-A induced nephrotoxicity is associated with decreased renal bone morphogenetic protein-7 expression in rats(ELSEVIER SCIENCE INC, 2004) YAVUZ, DİLEK; Tuglular, S; Yavuz, DG; Cakalagaoglu, F; Citak, L; Arikan, H; Kocak, H; Ozener, C; Akoglu, EThe aim of our study was to investigate bone morphogenetic protein-7 (BMP-7) expression in a rat model of chronic cyclosporine (CsA) toxicity compare with healthy controls, as well as the influence of treatment with the angiotensin-converting enzyme inhibitor (ACEI) quinapril. Twenty-four male Wistar rats were divided into groups of eight animals treated with CsA (15 mg/kg intraperitoneally) for 8 weeks (CsA group) without or with quinapril (10 mg/kg per day in the drinking water: CsA group + Q) for comparison with healthy controls (H group). The renal tissues were examined by light microscopy for CsA toxicity; specifically, tubulointerstitial damage and afferent arteriolopathy as well as BMP-7 expression were serniquantitatively scored by immunohistochemical staining. Mean CsA levels were 1982 ng/mL and 1968 ng/mL for the CsA and CsA + Q groups, respectively. At the end of the study period, the mean serum creatinine levels were 0.8 +/- 0.2 mg/dL, 1.6 +/- 0.8 mg/dL, and 1.4 +/- 0.8 mg/dL for the H, CsA, and CsA + Q groups, respectively. Interstitial fibrosis, tubular atrophy, and afferent arteriolar hyalinization were present in the CsA group and, to a lesser degree, in the CsA + Q group, compared with the H group. CsA-treated rats displayed significantly decreased BMP-7 expression compared with healthy controls (P < .0005). BMP-7 expression was higher among the CsA + Q group than the the group CsA group. In a rat model histologic changes characteristic of CsA-induced nephrotoxicity are associated with decreased expression of BMP-7, which seems to be at least partially restored by ACE inhibition.