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VELİOĞLU, ARZU

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VELİOĞLU

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    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.
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    PublicationOpen Access
    Pseudoporphyria in a Peritoneal Dialysis Patient
    (MULTIMED INC, 2015-03) VELİOĞLU, ARZU; Velioglu, Arzu; Ergun, Tulin; Ozener, Cetin
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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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    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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    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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    Thymic Neuroendocrine Carcinoma Presenting as Cushing's Syndrome: Treatment with Octreotide Combined with Surgery and Radiotherapy
    (KARGER, 2011) VELİOĞLU, ARZU; Asicioglu, Ebru; Gonenli, Gokhan; Kahveci, Arzu; Yildizeli, Bedrettin; Deyneli, Oguzhan; Yavuz, Dilek; Yuksel, Mustafa; Akalin, Sema
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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.
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    Donor Contraindications to Living Kidney Donation: A Single-Center Experience
    (ELSEVIER SCIENCE INC, 2015) VELİOĞLU, ARZU; Magden, K.; Ucar, F. B.; Velioglu, A.; Arikan, H.; Yegen, S. C.; Tuglular, S.; Ozener, I. C.
    Objective. Kidney transplantation is the treatment of choice in end-stage renal disease. In Turkey, the inadequate cadaveric donor supply has resulted in transplantation from living kidney donors (LKD) in 80% of transplant operations. LKD candidates undergo a thorough general medical evaluation and are approved to donate their kidneys only if no contraindication is found. In our study we aimed to investigate the reasons and rate of denial for living kidney donation in our center. Methods. We included all LKD candidates who applied to our center between June 2012 to June 2014. Demographic data, rate of rejection, and the reasons for denial to organ donation were analyzed retrospectively. Results. Of the 97 LKD candidates included in the study, 60 (62%) were unable to donate their kidneys. Among the reasons for denial were hypertension with target organ damage in 30% (n = 18), immunologic reasons in 23% (n = 14), impaired renal function in 20% (n = 12) cardiovascular reasons 13.3% (n = 8), diabetes mellitus in 10% (n = 6), malignity in 10% (n = 6), obesity (body mass index > 35 kg/m(2)) in 5% (n = 3), and miscellaneous in 18.3% (n = 11). There were >1 reasons in 13 candidates. Conclusions. The problems detected in donor candidates offer a possibility for early detection of disorders and increased awareness.
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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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    PublicationOpen Access
    Uncommon presentation of CAPD-related peritonitis with unusual organism: Kocuria kristinae. Case report and review of the literature
    (MARMARA UNIV, FAC MEDICINE, 2017-01-15) VELİOĞLU, ARZU; Barutcu Atas, Dilek; Arikan, Hakki; Aykent, Basar; Asicioglu, Ebru; Velioglu, Arzu; Tuglular, Serhan; Ozener, Cetin
    Kocuria kristinae is a gram-positive coccus of Micrococcaceae family. Kocuria kristinae inhabits the skin and mucous membranes. It can cause opportunistic infections in patients with indwelling devices and severe underlying diseases. We describe here a case of acute peritonitis caused by Kocuria kristinae in a patient on continuous ambulatory peritoneal dialysis (CAPD). Additionally, a review of other reported CAPD related peritonitis by Kocuria kristinae is provided. The importance of Kocuria kristinae as a pathogen in patients with CAPD peritonitis should not be underestimated.