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ARIKAN, İZZET HAKKI

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ARIKAN

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İZZET HAKKI

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    PublicationOpen 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, Savas
    Background 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.
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    PublicationOpen 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, Cetin
    A 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.
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    PublicationOpen 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, Emel
    Background. 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.
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    PublicationOpen 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, Serhan
    Background 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.
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    PublicationOpen 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, Serhan
    Background 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.
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    PublicationOpen Access
    Diagnosing latent tuberculosis infection in haemodialysis patients: T-cell based assay (T-SPOT.TB) or tuberculin skin test?
    (OXFORD UNIV PRESS, 2012-04-01) ARIKAN, İZZET HAKKI; Soysal, Ahmet; Toprak, Demet; Koc, Mehmet; Arikan, Hakki; Akoglu, Emel; Bakir, Mustafa
    Background. The international guidelines recommend screening haemodialysis (HD) patients for latent tuberculosis infection (LTBI). The aim of this study is to compare the diagnostic utility of tuberculin skin test (TST) with an interferon-gamma-based assay (T-SPOT.TB) for the diagnosis of LTBI in HD patients. Methods. A total of 411 patients [233 male (57%), mean age 56 +/- 16 years] in five HD centres were prospectively tested by TST and T-SPOT.TB assays. A total of 302 patients (75%) had Bacillus Calmette-Guerin vaccination scar. Results. LTBI was detected in 39 and 61% of patients by one-step TST and T-SPOT.TB, respectively. The booster phenomenon determined additional 60 (25%) LTBI among 243 patients. Overall, 218 (53%) patients showed a positive reaction to TST after performing the two-step TST. Among 250 one-step TST negative patients T-SPOT.TB assay was positive in 118 (47%). Of 158 patients with a positive one-step TST, T-SPOT.TB was negative in 34 (22%). On the other hand, T-SPOT.TB was negative in 16 (27%) of boosted patients. T-SPOT.TB was negative in 50 (23%) of overall TST-positive patients and positive in 71 (39%) of TST negative ones. Multivariate logistic regression analysis revealed that male gender was independently associated with positive T-SPOT.TB, and positive T-SPOT.TB was inversely associated with the presence of BCG vaccine scar, serum albumin level and HD duration. Annual conversion rates were 12 and 32% for TST and T-SPOT.TB tests, respectively. Conclusion. Usage of T-SPOT.TB in HD patients with negative TST may enhance diagnosis of LTBI.
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    PublicationOpen Access
    Peritoneal dialysis-related peritonitis with an unexpected micro-organism: enterococcus hirae
    (2017-01-01) BARUTÇU ATAŞ, DİLEK; AŞICIOĞLU, EBRU; VELİOĞLU, ARZU; TUĞLULAR, ZÜBEYDE SERHAN; ARIKAN, İZZET HAKKI; BARUTÇU ATAŞ D., AYKENT M. B., AŞICIOĞLU E., ARIKAN İ. H., VELİOĞLU A., TUĞLULAR Z. S., ÖZENER İ. Ç.
    Enterococcus Hirae is a gram-positive, facultative, anaerobic bacterium which is usually a zoonotic pathogen rarely isolated from human infections. There are no published reports describing continuous ambulatory peritoneal dialysis (CAPD) related- peritonitis with Enterococcus Hirae in the literature. With the following report, we describe the case of peritoneal dialysis (PD)-related peritonitis due to Enterococcus Hirae.
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    PublicationOpen 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.
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    PublicationOpen Access
    The Intensity of PLA2R and C4d_x000D_ Immunoexpression in Primary_x000D_ Membranous Nephropathy
    (2019) FİLİNTE, DENİZ; Deniz FİLİNTE;Hakkı ARIKAN;Mehmet KOÇ;Handan KAYA;İshak Çetin ÖZENER;Gamze AKBAŞ
    Objective: Antibodies against the phospholipase A2 receptor (PLA2R) on podocyte membranes result in the formation of immune complexes that cause loss of function of theglomerular basement membrane in primary membranous nephropathy (PMN). It has alsobeen demonstrated that there is a deposition of complement 4d (C4d) in the glomeruli inPMN. The present study aims to evaluate PLA2R and C4d immunoexpressions in PMN casesand search the correlation with the clinical parameters.Methods: In this study, clinicopathological data and paraffin-embedded specimens werecollected from 51 patients. The formalin-fixed paraffin-embedded tissues were stained usingroutine hematoxylin-eosin, periodic acid-Schiff, and silver methenamine stains and immunostained for anti-PLA2R and C4d. Ten normal kidney tissues and 10 focal segmental glomerulosclerosis (FSGS) cases were selected as controls for PLA2R and C4d immunoexpression.Results: Of the PMN cases, 51 (100%) cases were positive for PLA2R, including 15 (29%)cases that scored 2+, and 36 (71%) cases that scored 3+. Forty of the 51 cases (78%) werepositive for C4d. The percentages of cases staining positively for C4d, per scoring group,were as follows: 31 (61%) cases faintly (1+) positive and 9 (18%) cases moderately (2+)positive. No strong positivity was observed. All of the control cases (100%) were negativefor PLA2R and C4d. There was no statistically significant difference between the intensity ofthe staining of PLA2R and the staining of C4d, proteinuria levels, creatinine levels, and complement 3 (C3) positivity. Similarly, there was no statistically significant difference betweenthe intensity of the staining of C4d and proteinuria levels, creatinine levels, and C3 positivity.Conclusion: Immunohistochemical detection of PLA2R and C4d is a safe and easy methodfor the diagnosis of PMN. In cases where fresh tissue is not available for the detection of IgGand C3 using the immunofluorescence method, positivity for PLA2R and C4d with immunohistochemistry may be beneficial for the diagnosis of PMN.
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    PublicationOpen Access
    Unusual causes of peritonitis in a peritoneal dialysis patient: Alcaligenes faecalis and Pantoea agglomerans
    (BMC, 2011) VELİOĞLU, ARZU; Kahveci, Arzu; Asicioglu, Ebru; Tigen, Elif; Ari, Elif; Arikan, Hakki; Odabasi, Zekaver; Ozener, Cetin
    An 87-year-old female who was undergoing peritoneal dialysis presented with peritonitis caused by Alcaligenes faecalis and Pantoea agglomerans in consecutive years. With the following report we discuss the importance of these unusual microorganisms in peritoneal dialysis patients.