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AŞICIOĞLU, EBRU

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2010 - 2019122020 - 202213
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Author: TUĞLULAR, ZÜBEYDE SERHAN × Has files: false ×

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    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 Ishak
    Atherosclerosis 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.
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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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    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.
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    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, Cetin
    Carotid 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.
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    Protective Effect of the Vasopressin Agonist Terlipressin in a Rat Model of Contrast-Induced Nephropathy
    (KARGER, 2011) VELİOĞLU, ARZU; Ari, Elif; Yilmaz, Yusuf; Kedrah, Alla Elden; Alahdab, Yesim; Cakalagaoglu, Fulya; Arikan, Hakki; Kocak, Huseyin; Macunluoglu, Beyza; Atakan, Aydin; Kahveci, Arzu; Asicioglu, Ebru; Tuglular, Serhan; Ozener, Cetin
    Background/Aims: Contrast-induced nephropathy (CIN) remains a leading cause of iatrogenic acute renal failure. Terlipressin, a long-acting analog of vasopressin, may improve renal function. This study aimed to investigate the possible protective effect of terlipressin against the development of experimental CIN in rats. Methods: Wistar albino rats (n = 32) were allocated randomly into four equal groups of 8 each, i.e. control, terlipressin, contrast media (CM), and terlipressin plus contrast media (TCM). CIN was induced by intravenous administration of indomethacin (10 mg/kg), N-nitro L-arginine methyl ester (L-NAME, 10 mg/kg, twice at 15 and 30 min), and high-osmolar contrast media meglumine amidotrizoate 60%. Renal function parameters, kidney histology, and tubular expression of vascular endothelial growth factor (VEGF) were determined. Results: Mean serum creatinine levels were decreased (p < 0.05) and creatinine clearance (p < 0.05) increased in the TCM group compared with the group. Notably, rats in the TCM group displayed less tubular necrosis (p < 0.05), medullary congestion (p < 0.05), and a reduced tubular expression of VEGF (p < 0.05) compared with the CM group. Conclusion: These results demonstrate that terlipressin can inhibit the development of CIN. Copyright (C) 2011 S. Karger AG, Basel
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    Peri̇ton di̇yali̇zi̇ hastasında leclerci̇a adecarboksi̇lata peri̇toni̇ti̇
    (2015-10-21) BARUTÇU ATAŞ, DİLEK; VELİOĞLU, ARZU; ARIKAN, İZZET HAKKI; KOÇ, MEHMET; TUĞLULAR, ZÜBEYDE SERHAN; AŞICIOĞLU, EBRU; BARUTÇU ATAŞ D., VELİOĞLU A., AŞICIOĞLU E., AYKENT M. B., ARIKAN İ. H., KOÇ M., TUĞLULAR Z. S., ÖZENER İ. Ç.
    Giriş: Peritonit, sürekli ayaktan periton diyalizinin (SAPD) en sık ve önemli komplikasyonudur. Leclercia adecarboksilata, Enterobactericea ailesinden gram negatif, hareketli bir basildir. Periton diyalizi (PD) ilişkili peritonitin çok nadir bir sebebidir. Olgu Sunumu: Kronik glomerulonefrite bağlı son dönem böbrek yetmezliği (SDBY) nedeniyle 12 yıldır SAPD tedavisi gören 72 yaşında kadın hasta ateş, bulantı, kusma, karın ağrısı ve diyalizatta bulanıklaşma şikayeti ile hastaneye başvurdu. Fizik muayenede kan basıncı 90/60 mm/Hg, ateş 38,8 C°, batında yaygın hassasiyet saptandı. Diyaliz sıvısında silme lökosit izlendi. Laboratuvar tetkiklerinde WBC 4.600/µL, CRP 135 mg/L (N: 0-5) ve prokalsitonin 63 ng/mL (N: 0-0.5) izlendi. Kan ve periton sıvısı kültürleri alındıktan sonra ampirik olarak intraperitoneal sefuroksim ve oral siprofloksasin başlandı. Ertesi gün hastada klinik kötüleşme oldu ve periton sıvısı kültüründe Acinetobacter Baumanii ve Leclercia Adecarboksilata üremesi bildirildi. Antibiyograma göre tedaviye intravenöz imipenem ile devam edildi. Klinik düzelme sağlandı, Diyalizat hücre sayısı tedavinin 5. gününde negatifleşti. 2 hafta sonra antibiyotik rezistansını önlemek için imipenem kesilerek intraperitoneal amikasin ve oral siprofloksasine geçildi. Toplam üç hafta süren antibiyotik tedavisi sonrası hasta tamamen iyileşti ve tekrarlayan kültürlerde üreme olmadı. PD katateri çekilmeyen hastanın takiplerinde relaps peritonit izlenmedi. Tartışma: Gram negatif mikroorganizmalarla ilişkili peritonitlerde mortalite daha yüksektir ve daha sık olarak PD kateterinin çıkarılması gerekmektedir. Leclercia Adecarboxilata tek başına ya da bizim hastamızda olduğu gibi polimikrobial infeksiyonların bir komponenti olarak izole edilebilir. Epidemiyolojisi tam olarak bilinmemekle birlikte hastaların çoğunluğu immunsupresiftir. Ancak Leclercia Adecarboksilatanın etken olduğu infeksiyonların çoğunluğu hayati tehdit oluşturmaz. Acinetobacter Baumanii gibi tehlikeli bir mikroorganizma ile birlikte üretilmesine rağmen uygun antibiyotik tedavisi ile başarılı bir sonuç alınmıştır.
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    Vitamin D Levels in Patients With Small and Medium Vessel Vasculitis [Niveles de vitamina D en pacientes con vasculitis de pequeños y vasos medianos]
    (Ediciones Doyma, S.L., 2021) AŞICIOĞLU, EBRU; Korkmaz F.N., Ozen G., Unal A.U., Odabasi A., Can M., Asıcıoglu E., Tuglular S., Direskeneli H.
    Objectives: To determine the prevalence of vitamin D deficiency in patients with small and medium vessel systemic vasculitis. Methods: In this cross-sectional study, 25-hydroxy (OH) vitamin D3 levels were measured in adult patients with systemic small and medium vessel vasculitis including antineutrophil cytoplasmic antibody-associated vasculitis (AAV), cryoglobulinaemic vasculitis (CryV), IgA vasculitis (IgAV) and polyarteritis nodosa (PAN), and age- and sex-matched healthy subjects (HS) and patients with rheumatoid arthritis (RA) as control groups. 25OH vitamin D3 levels < 30 ng/ml and <20 ng/ml were regarded as insufficiency and deficiency, respectively. Results: Fifty-seven patients (42 AAV, 2 CryV, 8 IgA vasculitis, 5 PAN) with systemic vasculitis, 101 HS, and 111 RA patients were included. The mean 25OH vitamin D3 level was 21.8 ± 14.2 ng/mL in patients with vasculitis, 42.7 ± 27.6 ng/mL in HS (p < .001) and 20.1 ± 18.47 ng/mL in patients with RA (p = .54). Vitamin D insufficiency and deficiency were significantly higher in patients with systemic vasculitis compared to HS (75.4% vs 33.7%, p < .001; %50 vs 21.8%, p < .001, respectively). Vitamin D status was not different in patients with systemic vasculitis compared to RA. There was a negative correlation between vitamin D status and CRP levels (=−.364, p = .007). The multivariate logistic regression analysis showed that renal involvement was significantly associated with vitamin D deficiency/insufficiency in patients with vasculitis (OR 22.5 [95% CI 1.6–128.9]. Conclusion: Vitamin D deficiency and insufficiency are more frequent in patients with systemic small and medium vessel vasculitis and RA than HS. Renal involvement is one of the factors associated with vitamin D deficiency/insufficiency in patients with vasculitis. © 2020 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología
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    Determinants of hemoglobin variability in stable peritoneal dialysis patients
    (SPRINGER, 2014) VELİOĞLU, ARZU; Arikan, Hakki; Asicioglu, Ebru; Velioglu, Arzu; Nalcaci, Serdar; Birdal, Gurdal; Guler, Derya; Koc, Mehmet; Tuglular, Serhan; Ozener, Cetin
    Significant within-patient hemoglobin (Hb) level variability is well recognized in particularly hemodialysis patients. Several factors such as hospitalizations, intercurrent diseases and IV iron therapy are found to be related to Hb variability (Hb-var). In this observational study, we aimed to identify predictors and outcome of Hb-var in peritoneal dialysis (PD) patients without hospitalization, intercurrent disease and IV iron therapy during the study period. All patients were in the maintenance phase of short-acting erythropoiesis-stimulating agents (ESAs) therapy. The target range of Hb was 11-12 g/dL according to KDOQI Guidelines in 2007. The desired range of Hb was 11-12.5 g/dL. Patients' demographic and laboratory data were collected at baseline. Atherosclerotic disease was assessed using carotid intima-media thickness (CIMT). We assessed Hb variability with various methods using SD Hb(mean), SD Hb(range) and the velocity of Hb change. Hb deflect(positive), Hb deflect(negative), Hb values and ESA dosing were recorded monthly for 6 months. This study included 50 prevalent PD patients (mean age 46.9 +/- A 13.7 years, 25 women). The mean velocity of Hb change was negatively correlated with age and positively correlated with frequent ESA dose changes. Higher albumin and residual renal function (RRF) were also positively correlated with Hb deflect(positive). Patients with CIMT a parts per thousand yen0.7 cm had lower SD Hb range compared to CIMT < 0.7 cm. Cumulative survival was better in patients with Hb levels consistently a parts per thousand yen10 g/dL compared to patients who had Hb < 10 g/dL for at least 1 month. However, Hb-var was not associated with mortality. In PD patients without hospitalization, intercurrent disease(s) or IV iron therapy, young age, higher albumin or RRF and lower CIMT were associated with greater oscillations in response to ESA therapy. Careful and appropriate ESA dose changes considering these parameters could minimize Hb variability in these patients.
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    Fibroscan detection of fatty liver and liver fibrosis in patients with systemic lupus erythematosus
    (2022-05-01) YILMAZ, YUSUF; BARUTÇU ATAŞ, DİLEK; ALİBAZ ÖNER, FATMA; DİRESKENELİ, RAFİ HANER; TUĞLULAR, ZÜBEYDE SERHAN; AŞICIOĞLU, EBRU; VELİOĞLU, ARZU; Yetginoglu O., Atas D., Yilmaz Y., Velioglu A., Arikan H., Alibaz-Oner F., Direskeneli H., Tuglular S., Asicioglu E.
    Objective Although liver dysfunction is not considered the main organ involvement in Systemic Lupus Erythematosus (SLE), the frequency of liver dysfunction or abnormal liver enzyme values may be observed in 50-60% of patients. The aim of this study was to assess fatty liver and liver fibrosis in SLE patients using Fibroscan as well as determine associated factors such as immunosuppressive medications. Methods 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. Results The prevalence of fatty liver disease was similar between SLE patients and healthy controls (21.7 vs 26.7%, p = .597). Liver fibrosis was also similar between the two groups (26.7 vs 10.0%, p = .069). Since the majority of SLE patients were female, we performed a subgroup analysis in female patients (n = 51) and controls (n = 25). Fatty liver disease was similar between female SLE patients and controls (23.5 vs 24.0%, p = .964). However, liver fibrosis in female patients with SLE was increased compared to female controls (29.4 vs 4.0%, p = .011) and was associated with age (Exp (B) 95% CI: 1.083 (1.006-1.166), p = .034) and low-dose cumulative glucocorticoid use (Exp (B) 95% CI: 14.116 (1.213-164.210), p = .034). Conclusion The prevalence of fatty liver was similar between SLE patients and 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. Larger studies are needed to confirm our findings and determine whether immunosuppressive use has any impact on the development of liver fibrosis in SLE patients.
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    Periton diyalizi hastalarında 25-OH vitamin D eksikliği: Tek merkezli bir çalışma
    (2020-10-15) BARUTÇU ATAŞ, DİLEK; VELİOĞLU, ARZU; ARIKAN, İZZET HAKKI; TUĞLULAR, ZÜBEYDE SERHAN; AŞICIOĞLU, EBRU; BARUTÇU ATAŞ D., AŞICIOĞLU E., VELİOĞLU A., ARIKAN İ. H., TUĞLULAR Z. S., ÖZENER İ. Ç.
    Giriş: D vitamini, kronik böbrek hastalığında (KBH) görülen mineral-kemik bozukluklarında önemli bir role sahiptir. Diyaliz tedavisi alan hastaların düşük 25-hidroksivitamin D (25-OH vitamin D) seviyelerine sahip olduğu iyi bilinmektedir. Düşük 25-OH D vitamini seviyeleri, hareketsiz yaşam tarzı, azalan güneş ışığı maruziyeti, KBH ile ilişkili diyet kısıtlaması ve azalmış D vitamini sentezi gibi birçok nedenden kaynaklanabilir. Yöntemler: 64 periton diyalizi hastasını içeren tek merkezli retrospektif bir çalışma yapıldı. (33 E / 31K). Hastaların 25-OH D vitamini ölçüldü ve kan örnekleri incelendi. Bulgular: Hastaların demografik ve laboratuvar bulguları tablo 1’de gösterilmiştir. Hastaların ortalama yaşı 49,7 ± 13,3 ve ortalama periton diyalizi süresi 61 ± 55 aydı. Son dönem böbrek hastalığının nedenleri diabetes mellitus (5 hasta), hipertansiyon (11 hasta), glomerülonefrit (19 hasta), polikistik böbrek (9 hasta), VUR (4 hasta) ve nedeni bilinmeyen (14 hasta) idi. Hastaların %73,4’ü kalsiyum karbonat, %23,4’ü sevelamer, %48,4’ü kalsitriol ve %15,6’sı sinakalset alıyordu. Hiçbir hasta D vitamini desteği almıyordu. Hastaların serum 25-OH vitamin D seviyeleri düşüktü (8,9±2,4 ng/ml). KDOQI kılavuzlarına göre hiçbir hasta normal 25-OH vitamin D seviyesine sahip değildi. Hastaların %84,4’ünde (%57,8 hafif;%26,6 şiddetli) d vitamini eksikliği izlenirken; %15,6’sında d vitamini yetersizliği izlendi (Şekil 1). 25-OH D vitamini ile yaş, cinsiyet, VKİ, periton diyaliz süresi ve son dönem böbrek yetersizliği nedeni arasında anlamlı bir ilişki yoktu. Korelasyon analizinde serum 25-OH vitamin D düzeyi ile ürik asit ve paratiroid hormon düzeyleri arasında negatif korelasyon saptandı (Şekil 2). Lojistik regresyon analizi, serum ürik asit seviyesinin, D vitamini eksikliğinin bağımsız bir belirleyicisi olduğunu ortaya koydu ( OR(%95CI): 0,139 (0,029- 0,667); p değeri: 0,014). Sonuç: 25-OH D vitamini eksikliğinin periton diyalizi hastalarında son derece yaygın olduğu ve güncel uygulama kılavuzlarına göre tetkik ve tedavi edilmesi gerektiği sonucuna vardık.