Ibrahim Dogan

Evaluation of serum Spondin 2 levels in the different stages of Type 2 diabetic nephropathy

We aimed to determine whether serum SPON2 is a useful biomarker in the detection of Diabetic Nephropathy (DN) and to compare serum SPON2 levels with 24‐hour urinary albumin excretion rate (UAER) in patients with DN at different stages.

Urea to creatinine ratio: a forgotten marker of poor nutritional state in patients undergoing hemodialysis treatment

Abstract Background: Malnutrition is common in subjects undergoing hemodialysis and is associated with increased morbidity and mortality. Studies investigating factors associated with malnutrition and effect of various interventions to treat these patients are needed. We aimed to screen older and young patients undergoing chronic hemodialysis, for malnutrition, and seek its association with clinical factors including anxiety and depression and laboratory variables including urea/creatinine ratio (UCR). Methods: Duration of hemodialysis treatment, medications taken, anthropometric measurements and routine laboratory results were recorded. Mini nutritional assessment and Beck anxiety and Beck depression inventories were applied. Study variables between subjects with malnutrition, malnutrition risk and normal nutritional states were compared. Older and younger patients were also compared regarding malnutrition and laboratory results. Linear regression analysis was performed to seek independent factors associated with malnutrition score. Results: Clinical and laboratory data except for UCR were found to be similar among young and older patients. UCR increased, while albumin, body mass index and weight circumference decreased along with worse nutritional state. Low albumin level, body mass index and UCR and higher hemoglobin level and depression score were independent factors associated with malnutrition. Conclusion: In addition to routinely used markers of malnutrition UCR may provide additional information regarding malnutrition in this population.

Investigation of mindin levels in hypertensive patients with left ventricular hypertrophy and QRS fragmentation on electrocardiography

Abstract Purpose: Mindin was associated with diabetic nephropathy, podocyte injury, colitis, allergic asthma, liver ischaemia and reperpusion injury and ischaemic brain injury. On the other hand, it was reported as a protective factor against obesity, cardiac hypertrophy, fibrosis and remodelling. Fragmented QRS complexes (fQRS) are markers of altered ventricular depolarisation owing to a prior myocardial scar and fibrosis. In this study, we aimed to investigate mindin levels in hypertensive patients with left ventricular hypertrophy and fQRS on electrocardiography. Methods: This observational case-control study enrolled 70 (36 female) hypertensive patients with fQRS and 38 (23 female) hypertensive control patients. All patients were evaluated by transthoracic echocardiography. Mindin levels were measured by the enzyme-linked immunosorbent assay (ELISA). Clinical, echocardiographic and laboratory data were compared between patient and control groups. Results: There was no significant difference between patient and control groups in terms of clinical, echocardiographic and routine laboratory parameters. The mindin levels were significantly higher in the patient group than controls (11.3 (7.21–19.31) vs 4.15 (2.86–6.34); pu2009<u2009.001). Multiple logistic regression analyses defined increased mindin levels as an independent predictor for the presence of fQRS (Odds ratio: 1.733; pu2009=u2009.034). Mindin levels >6.74 predicted the presence of fQRS with a sensitifity of 84.3% and specificity of 79.9% on receiver operating characteristic (ROC) curve analysis (The area under the curve:0.889; Confidence Interval: 0.827–0.951; pu2009<u2009.001). Conclusion: Mindin expressin is upregulated in hypertensive patients with fQRS complexes. In contrary to previous studies, increased mindin levels may be associated with myocardial fibrosis.

Evaluation of potential long‐term changes in endothelial functions and basic echocardiographic parameters in unilateral nephrectomy patients

Decreased nephron count may result in lower glomerular filtration rate (GFR) and cardiorenal injury in the absence of compensatory hyperfunction. In this study, we aimed to evaluate long‐term effects of 50% nephron loss on endothelial functions and cardiac morphology in nondonor nephrectomy patients.

Haemostatic Changes in Patients with Diabetic Nephropathy due to Proteinuria

OBJeCTIVe: It is known that diabetes may cause to hypercoagulability. The pathogenetic mechanism of coagulation activation is not completely clear and the origin is multifactorial. While chronic hyperglycemia is considered to be the main underlying pathology, there are various comments on the association between glycemic control and haemostatic disorders. In this study, we have aimed to compare patients with diabetic nephropathy and patients with idiopathic nephrotic syndrome with respect to haemostatic differences. mATeRIAL and meThODS: We compared 10 newly diagnosed idiopathic nephrotic syndrome patients with 10 normoalbuminuric, 10 microalbuminuric and 10 macroalbuminuric Type II diabetic patients in terms of haemostatic disorders. We included 12 healthy controls in the study. In all groups, protein C activity, free protein S, Antithrombin III, Factor VII, VIII, IX, XI, plasminogen, fibrinogen and platelet count were evaluated. ReSuLTS: Antithrombin III levels of patients with nephrotic syndrome were significantly lower than the control group and macroalbuminuric diabetics but fibrinogen levels were significantly higher than controls. Fibrinogen levels of microlalbuminuric diabetics were significantly higher than controls. Other haemostatic parameters were all in normal range in all patient groups. COnCLuSIOnS: These findings suggest that the mechanism of hypercoagulation works in a different pathway than the hypercoagulation in nephrotic patients.

Renal Oncocytoma in a Patient with Non-Hodgkin Lymphoma in Remission

Renal onkositoma goreceli olarak bobregin nadir gorulen neoplazmadir. Literaturde cok az vakada oncesinde non-Hodgkin lenfoma (NHL) tanisi ile izlenen bir hastada renal onkositoma tanimlanmistir. Bu yazida NHL tanisi ile izlenirken renal onkositoma tanisi konulan bir hasta sunuldu. Otuz alti yasinda kadin hasta poliklinigimize 2 gundur olan yan agrisi ve dizuri yakinmasi ile basvurdu. Hasta 15 yil once NHL tanisi ile 8 kur kemoterapi almis, halen son 10 yildir remisyonda olarak izleniyordu. Fiziki muayenesi normaldi. Hem renal ultrasonografide hem de abdominal tomografide sag bobrekte 2.5x3 cm boyutunda solid kitle tespit edildi. Renal tru-cut biyopsi sonrasindaki patolojik degerlendirmede onkositoma tespit edildi. Tedavi olarak konservatif yaklasim uygulandi ve hem renal fonksiyonlari hem de tumor sonucu stabil oldugundan cerrahi tedavi uygulanmadi. Renal onkositoma genellikle soliter formda olan bobregin iyi huylu tumorudur. Literaturde cok az vakada lokal invazyon ve metastaz rapor edilmistir. Renal onkositomali hastalar nonspesifik sikayetlerle basvurabilirler. Bu hastalar semptomatik olmadikca veya ani buyume ile basvurmadikca konservatif tedavi yapilmalidir ve takip edilmelidir. Anahtar sozcukler: Konservatif tedavi; lenfoma; onkositoma. SUMMARY