Person: VELİOĞLU, ARZU
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VELİOĞLU
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ARZU
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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 Metadata only Cardiac Risk Assessment in Kidney Transplant Candidates: Clinical Usefulness of Different Guidelines(ELSEVIER SCIENCE INC, 2019) ÇİNÇİN, AHMET ALTUĞ; Mehdiyev, S.; Velioglu, A.; Arikan, H.; Asicioglu, E.; Cincin, A.; Demirbas, T.; Tinay, I; Ozener, C.; Tuglular, S.Although cardiovascular (CV) assessment is recommended to minimize perioperative risk in all potential kidney transplant recipients, the utility and reliability of various assessment methods are not well established. In this study, we investigated the CV evaluations and outcomes of standardized CV assessment protocols (Lisbon and American Society of Transplantation [AST]) in potential kidney transplant recipients. Data were analyzed for 266 end-stage renal disease patients (mean age 45.4 +/- 13 years, female-to-male ratio 126:140) accepted for kidney transplantation wait-listing. Patients were classified as low and high cardiac risk according to their first cardiac evaluation. Major cardiovascular events (CVEs) and deaths were recorded. At the end of follow-up (median 639 days), 72 (27.1%) patients underwent kidney transplantation. A total of 49 patients (18.4%) had CVEs and 42 (15.8%) patients died. Being over 45 years of age and having dialysis vintage over 1 year were found to be independent risk factors for CVEs. Forty-eight out of 60 high-risk patients evaluated with noninvasive tests had negative results. Twelve out of these 48 patients had a CVE in due course. Among 10 patients who underwent coronary angiography, 1 had a CVE and 1 died. The sensitivity and specificity of the AST guidelines (area under the curve = 0.647, P = .005, sensitivity 83%, specificity 54%) were higher than Lisbon. In conclusion, the predictive risk factors for CVEs were age over 45 years and dialysis vintage over a year. Our results also suggest that exercise electrocardiography and myocardial perfusion scintigraphy for cardiac evaluation are less sensitive in CVE prediction. We recommend clinicians to use the AST guidelines and to prioritize coronary angiography in pretransplant CV assessment.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 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 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.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 Metadata only 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, CetinBackground/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