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 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 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 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 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 Open Access Low serum 25-OH vitamin D levels are associated with increased D/P creatinine ratio in peritoneal dialysis patients(2021-09-01) BARUTÇU ATAŞ, DİLEK; TUĞCU, MURAT; VELİOĞLU, ARZU; ARIKAN, İZZET HAKKI; AŞICIOĞLU, EBRU; BARUTÇU ATAŞ D., AYKENT M. B., ARIKAN İ. H., TUĞCU M., VELİOĞLU A., AŞICIOĞLU E.Low 25-OH vitamin D levels have been linked to peritonitis and cardiovascular mortality in peritoneal dialysis (PD) patients. In this study we aimed to investigate the association of 25-OH vitamin D levels with peritoneal membrane characteristics in chronic PD patients. Consecutive 103 PD patients were enrolled in this retrospective study. Peritoneal dialysate to plasma (D/P) creatinine increase more than 0.1 with time were accepted as significant according Roc curve analysis. Patients with and without an increase in the D/P creatinine ratio of 0.1 were classified as Group 1 and Group 2, respectively. The relationship between baseline 25-OH vitamin D and peritoneal membrane characteristics were investigated. Mean age of the patients was 53.4±14.9 years and duration of PD was 72.1±50.3 months. There were thirty (29.1%) patients in Group 1. The duration of PD [73.5 (52.3-133.8) vs 49.0 (33.5-94.0) months, p:0.008]; hemoglobin [11.4 (10.4-12.2) vs. 10.2 (9.4-11.0) g/dL, p:0.001]and PTH [500.5 (254.5-748.3) vs 329.0 (205.0-549.5)ng/mL, p:0.047] levels were significantly higher in Group 1, whereas 25-OH vitamin D levels [5.0 (3.0-9.3) vs 7.8 (4.5-11.1)μg/L, p:0.027] and CRP [4.0 (3.0-7.2) vs. 8.0 (3.0-13.5)mg/L, p:0.028] were significantly lower. Multivariate analysis revealed duration of PD [Exp(B):1.012 (95%CI:1.001-1.022), p:0.028]; hemoglobin [Exp(B):1.756 (95%CI:1.199-2.571), p:0.004]; C-reactive protein (CRP) [Exp(B):0.882 (95%CI:0.789-0.985), p:0.026] and 25-OH vitamin D [Exp(B):0.853 (95%CI:0.754-0.965), p:0.012] were independent predictors of an increase in D/P creatinine ratio in PD patients. Increased D/P creatinine ratio was negatively correlated with 25-OH vitamin D level (r: -0.217, p:0.028). Lower levels of initial 25-OH vitamin D were associated with an increase in D/P creatinine ratio over-time.Publication Open Access Low-dose valacyclovir use with preemptive monitoring in kidney transplant recipients with intermediate cytomegalovirus infection risk(2022-01-01) VELİOĞLU, ARZU; ARIKAN, İZZET HAKKI; AŞICIOĞLU, EBRU; TUĞLULAR, ZÜBEYDE SERHAN; AKSU, MEHMET BURAK; VELİOĞLU A., Alagoz S., Atas D. B. , ARIKAN İ. H. , AŞICIOĞLU E., AKSU M. B. , Seyahi N., TUĞLULAR Z. S.PROPPublication Open Access Prediction of subclinical left ventricular dysfunction by speckle-tracking echocardiography in patients with anti-neutrophil cytoplasmic antibody--associated vasculitis(2021-12-24) İZGİ, TUBA NUR; ATAŞ, HALİL; VELİOĞLU, ARZU; BARUTÇU ATAŞ, DİLEK; ILGIN, CAN; ALİBAZ ÖNER, FATMA; DİRESKENELİ, RAFİ HANER; ARIKAN, İZZET HAKKI; TUĞLULAR, ZÜBEYDE SERHAN; AŞICIOĞLU, EBRU; Izgi T. N., Atas D., ATAŞ H., Akaslan D., Ilgin C., VELİOĞLU A., ARIKAN İ. H., Alibaz-Oner F., DİRESKENELİ R. H., TUĞLULAR Z. S., et al.Objectives: This study aims to evaluate left ventricular functions using speckle-tracking echocardiography (STE) in patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Patients and methods: Between June 2018 and July 2019, a total of 31 AAV patients (17 males, 14 females; median age: 53 years; range, 47 to 62 years) and 21 healthy controls (11 males, 10 females; median age: 56 years; range, 46 to 60 years) were included in the study. Clinical and biochemical characteristics of all participants were recorded. All participants underwent conventional and two-dimensional STE. The receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off value of serum N-terminal prohormone of brain natriuretic peptide (NT-pro-BNP) that predicted subclinical left ventricular dysfunction. The Spearman correlation analysis was used to determine the correlation between left ventricular global longitudinal strain (LV-GLS) and NT-pro-BNP. Results: The LV-GLS was lower in AAV patients (19.3% vs. 21.7%, respectively; p=0.014). NT-pro-BNP was negatively correlated with LV-GLS (p=0.005, r=0.401). Conclusion: Subclinical left ventricular dysfunction can be detected by STE in patients with AAV who have free of clinically overt cardiovascular disease. The LV-GLS is negatively correlated with serum NT-pro-BNP levels.