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TUĞLULAR, ZÜBEYDE SERHAN

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TUĞLULAR

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ZÜBEYDE SERHAN

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2021 - 202424
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Author: TUĞLULAR, ZÜBEYDE SERHAN × Subject: Klinik Tıp (MED) ×

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    PublicationOpen Access
    C-reactive protein to albumin ratio is associated with disease activity in anti-neutrophil cytoplasmic antibody associated vasculitis
    (2023-01-01) ALİBAZ ÖNER, FATMA; DİRESKENELİ, RAFİ HANER; TUĞLULAR, ZÜBEYDE SERHAN; AŞICIOĞLU, EBRU; Atas D. B., Sahin G. K., ŞENGÜL Ş., KAYA B., PAYDAŞ S., ALİBAZ ÖNER F., DİRESKENELİ R. H., TUĞLULAR Z. S., AŞICIOĞLU E.
    Objective/Aim: C-reactive protein to albumin ratio (CAR) has recently been recognized as an independent prognostic marker for vasculitides. This study aims to investigate CAR and its relationship with disease activity and damage in prevalent ANCA associated vasculitis (AAV) patients. Methods: Fifty-one patients with AAV and 42 age-sex-matched healthy controls were enrolled in this crosssectional study. Birmingham vasculitis score (BVAS) was used to assess vasculitis activity and vasculitis damage index (VDI) to provide information on disease damage. Results: The median (25th-75th) age of the patients were 55 (48-61) years. CAR was significantly higher in AAV patients than controls (1.9±2.7 vs 0.7±0.4; p=0.006). The 75th percentile of BVAS was defined as high BVAS (BVAS≥5) and ROC curve analysis showed that CAR≥0.98 predicted BVAS≥5 with 70.0% sensitivity and 68.0% specificity (AUC:0.660, CI: 0.482-0.837, p=0.049). When patients with CAR≥0.98 were compared to those without, BVAS [5.0 (3.5-8.0) vs. 2.0 (0-3.25), p<0.001], BVAS≥5 [16 (64.0%) vs 4 (15.4%) patients, p:0.001], VDI [4.0 (2.0-4.0) vs. 2.0 (1.0-3.0), p=0.006], and CAR [1.32 (1.07-3.78) vs. 0.75 (0.60-0.83), p<0.001] were higher whereas albumin [3.8 (3.1-4.3) vs. 4.1 (3.9-4.4) g/dL, p=0.025] and haemoglobin [12.1 (10.4-13.4) vs. 13.0 (12.5-14.2) g/dL, p=0.008] were lower. Multivariate analysis revealed that BVAS [OR(95% CI):1.313 (1.003-1.719), p=0.047] was an independent factor associated with CAR≥0.98 in patients with AAV. Furthermore, correlation analysis showed that CAR significantly correlated with BVAS (r: 0.466, p=0.001). Conclusion: In this study, we observed that CAR was significantly associated with disease activity in AAV patients and can be used to monitor disease activity
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    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.
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    Kronik hemodiyaliz hastalarında bnt162b2 ve coronavac’a karşı hümoral yanıt: çok merkezli prospektif kohort çalışması
    (2022-11-09) TUĞLULAR, ZÜBEYDE SERHAN; TUĞCU, MURAT; Mirioğlu Ş., Kazancıoğlu R., Cebeci E., Eren N., Sakacı T., Alagöz S., Tuğcu M., Tuğlular Z. S., Sümbül B., Seyahi N., et al.
    Giriş: Kronik hemodiyaliz (HD) hastalarında SARS-CoV-2 için geliştirilmiş olan inaktif aşılara dair veriler hala sınırlıdır. Bu çalışmada, kronik HD hastalarında CoronaVac’ın uyardığı hümoral yanıtları BNT162b2 ile kıyaslayarak araştırmayı amaçladık. Yöntemler: COVID-19 geçirmemiş ve BNT162b2 veya CoronaVac ile aşılanmayı planlayan erişkin kronik HD hastaları bu çok merkezli prospektif kohorta dahil edildi. Katılımcılardan aşılanmadan önce ve 2 doz aşıdan 1 ile 3 ay sonra serum örnekleri alındı. Virüsün reseptör bağlayıcı bölgesine karşı gelişen anti-SARS-CoV-2 IgG antikorları ölçüldü ve ≥50 AU/ml pozitif kabul edildi. Aşılanmaya rağmen yaşanan COVID-19 enfeksiyonları ve aşıdan sonra gelişen advers olaylar kaydedildi. Bulgular: Doksan iki hasta çalışmaya dahil edildi ve 68’i (% 73.9) başlangıçta seronegatifti. BNT162b2 ve CoronaVac sırasıyla 38 (% 55.9) ve 30 (% 44.1) hastaya uygulandı, bu iki grubun başlangıçtaki özellikleri genel olarak benzerdi (Tablo 1). Birinci ayda seropozitiflik oranı BNT162b2 grubunda % 93.1 iken CoronaVac grubunda % 88’di (p=0.519), antikor seviyeleri ise BNT162b2 grubunda daha yüksekti (p<0.001). Üçüncü ayda seropozitiflik oranı (% 96.4 ile % 78.3, p=0.045) ve antikor seviyeleri (p=0.001) BNT162b2 grubunda CoronaVac’a kıyasla daha yüksek bulundu (Tablo 2). Beş hasta (% 7.4) aşılanmaya rağmen COVID-19 yaşadı ancak hepsi sekelsiz iyileşti. Advers olaylar BNT162b2 ile daha sık görüldü, fakat tamamı hafif seyirliydi. Çoklu lineer regresyon modeli sadece aşı seçiminin (BNT162b2) hümoral yanıtla ilişkili olduğunu gösterdi (β=0.272, p=0.038). Başlangıçta seropozitif olan hastalar (n=24) tüm ölçüm noktalarında daha yüksek antikor seviyelerine sahipti. Sonuç: BNT162b2 ve CoronaVac naif kronik HD hastalarında hümoral yanıtları uyarmaktadır, ancak bu yanıtlar BNT162b2 ile daha güçlü ve uzun ömürlüdür. Her iki aşı da başlangıçta seropozitif olan hastalarda yüksek antikor seviyelerini sağlamaktadır (Bu çalışma Bezmialem Vakıf Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi tarafından desteklenmiştir. Proje numarası: 20210613)
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    PublicationOpen Access
    Distribution, preparedness and management of Ukrainian adult refugees on dialysis - an international survey by the Renal Disaster Relief Task Force of the European Renal Association
    (2023-10-01) TUĞLULAR, ZÜBEYDE SERHAN; Pawłowicz-Szlarska E., Vanholder R., Sever M. S., TUĞLULAR Z. S., Luyckx V., Eckardt K., Gallego D., Ivanov D., Nistor I., Shroff R., et al.
    Background: Due to the Russian-Ukrainian war, some of the about 10 000 adults requiring dialysis in Ukraine fled their country to continue dialysis abroad. To better understand the needs of conflict-affected dialysis patients, the Renal Disaster Relief Task Force of the European Renal Association conducted a survey on distribution, preparedness and management of adults requiring dialysis who were displaced due to the war. Methods: A cross-sectional online survey was sent via National Nephrology Societies across Europe and disseminated to their dialysis centers. Fresenius Medical Care shared a set of aggregated data. Results: Data were received on 602 patients dialyzed in 24 countries. Most patients were dialyzed in Poland (45.0%), followed by Slovakia (18.1%), Czech Republic (7.8%) and Romania (6.3%). The interval between last dialysis and the first in the reporting center was 3.1 ± 1.6 days, but was ≥4 days in 28.1% of patients. Mean age was 48.1 ± 13.4 years, 43.5% were females. Medical records were carried by 63.9% of patients, 63.3% carried a list of medications, 60.4% carried the medications themselves and 44.0% carried their dialysis prescription, with 26.1% carrying all of these items and 16.1% carrying none. Upon presentation outside Ukraine, 33.9% of patients needed hospitalization. Dialysis therapy was not continued in the reporting center by 28.2% of patients until the end of the observation period. Conclusions: We received information about approximately 6% of Ukrainian dialysis patients, who had fled their country by the end of August 2022. A substantial proportion were temporarily underdialyzed, carried incomplete medical information and needed hospitalization. The results of our survey may help to inform policies and targeted interventions to respond to the special needs of this vulnerable population during wars and other disasters in the future.
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    PublicationOpen Access
    Recommendations for kidney patients in covid-19 era based on current evidence
    (2022-01-01) VELİOĞLU, ARZU; TUĞLULAR, ZÜBEYDE SERHAN; Ozturk S., VELİOĞLU A., TUĞLULAR Z. S.
    Patients with chronic kidney disease, patients on dialysis, and kidney transplant recipients are at high risk of mortality and morbidity due to coronavirus disease-19. Most patients with chronic kidney disease are elderly and have other comorbidities. In addition, some of these patients have been exposed to immunosuppressive drugs to treat their underlying primary disease or to prevent allograft rejection. This general profile of chronic kidney disease patients renders them susceptible to a more severe course of coronavirus disease-19 once they are infected with severe acute respiratory syndrome coronavirus 2. Many studies showed that impaired kidney function on admission is an independent risk factor for a more severe course of coronavirus disease-19 with significantly increased risk for hospital and intensive care unit admission, intubation, mechanical ventilation, and death. Coronavirus disease-19 vaccination is crucial to create immunity in the general community, but the evidence addressing this specific population is scarce. However, based on the current evidence, all patients with chronic kidney disease are strongly recommended to receive the available vaccine in their country against coronavirus disease-19, and booster doses will presumably prove necessary for this group of patients. Furthermore, vigilant use of protective measures is strongly recommended for this patient population. Current studies and recommendations from health authorities should be followed closely.
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    PublicationOpen Access
    Armed conflicts and kidney patients: a consensus statement from the Renal Disaster Relief Task Force of the ERA
    (2022-08-01) TUĞLULAR, ZÜBEYDE SERHAN; Sever M. S. , Vanholder R., Luyckx V., Eckardt K., Kolesnyk M., Wiecek A., Pawlowicz-Szlarska E., Gallego D., Shroff R., Skoberne A., et al.
    During conflicts, people with kidney disease, either those remaining in the affected zones or those who are displaced, may be exposed to additional threats because of medical and logistical challenges. Acute kidney injury developing on the battlefield, in field hospitals or in higher-level hospital settings is characterized by poor outcomes. People with chronic kidney disease may experience treatment interruptions, contributing to worsening kidney function. Patients living on dialysis or with a functioning graft may experience limitations of dialysis possibilities or availability of immunosuppressive medications, increasing the risk of severe complications including death. When patients must flee, these threats are compounded by unhealthy and insecure conditions both during displacement and/or at their destination. Measures to attenuate these risks may only be partially effective. Local preparedness for overall and medical/kidney-related disaster response is essential. Due to limitations in supply, adjustments in dialysis frequency or dose, switching between hemodialysis and peritoneal dialysis and changes in immunosuppressive regimens may be required. Telemedicine (if possible) may be useful to support inexperienced local physicians in managing medical and logistical challenges. Limited treatment possibilities during warfare may necessitate referral of patients to distant higher-level hospitals, once urgent care has been initiated. Preparation for disasters should occur ahead of time. Inclusion of disaster nephrology in medical and nursing curricula and training of patients, families and others on self-care and medical practice in austere settings may enhance awareness and preparedness, support best practices adapted to the demanding circumstances and prepare non-professionals to lend support.
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    Kidney failure in Sudan: thousands of lives at risk
    (2023-08-19) TUĞLULAR, ZÜBEYDE SERHAN; Hassan H. A., Hafez M. H., Luyckx V. A., TUĞLULAR Z. S., Abu-Alfa A. K.
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    Böbrek Nakli Dirençli Akut Rejeksiyon Tedavisinde Ekulizumab Deneyimi
    (2022-12-08) TUĞCU, MURAT; BARUTÇU ATAŞ, DİLEK; TUĞLULAR, ZÜBEYDE SERHAN; VELİOĞLU, ARZU; Berke Menteşe İ., Barutçu Ataş D., Tuğcu M., Tuğlular Z. S. , Velioğlu A.
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    PublicationOpen 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.
    PROP
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    PublicationOpen 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.