Introduction: The aim of the study was to assess whether neutrophil gelatinaseassociated lipocali... more Introduction: The aim of the study was to assess whether neutrophil gelatinaseassociated lipocalin (NGAL) and cystatin C could reflect kidney function in pregnant healthy women. Material and methods: The studies were performed on 130 healthy pregnant women (n = 63, 3 rd trimester; n = 21, 2 nd trimester; n = 46, 1 st trimester) and 30 healthy female volunteers. Serum NGAL, cystatin C, IL-6, and hs-CRP were assayed using commercially available kits. Results: Serum cystatin C rose steadily during the pregnancy, whereas NGAL rose in the 2 nd trimester, then decreased in the 3 rd trimester. In univariate analysis, NGAL correlated with serum cystatin C, number of pregnancies, white blood cell count, total iron-binding capacity (TIBC), ferritin, and IL-6, and tended to correlate with eGFR. In multiple regression analysis the only predictor of serum NGAL was cystatin C. Conclusions: Serum NGAL in pregnancy might reflect subclinical inflammation rather than kidney function. It seems that NGAL, similarly to cystatin C, is not useful to monitor renal function in pregnancy.
International Urology and Nephrology, Oct 26, 2015
Neutrophil gelatinase-associated lipocalin (NGAL) is a member of the lipocalin family best known ... more Neutrophil gelatinase-associated lipocalin (NGAL) is a member of the lipocalin family best known as a novel and early marker of acute kidney injury (AKI). Recent data suggest that NGQueryAL is not only a marker of AKI, but also an important player in the vascular remodeling, atherosclerotic plaque stability and thrombus formation. We conducted this study to investigate the association of serum NGAL levels with fatal and composite (fatal and non-fatal) cardiovascular events (CVE) in a cohort of patients with stage 1-5 CKD. This was an observational cohort study in which serum NGAL was obtained from 298 CKD (stages 1-5) patients. Fatal and composite CVE were recorded for a median 41 months. We examined alteration of serum NGAL through CKD groups as well as association with inflammatory markers. We also performed a Cox regression analysis to determine the association of NGAL with predefined clinical outcomes. The median value of NGAL was 50.5 ng/mL (IR 47.6-54.9 ng/mL), and higher NGAL values were recorded in diabetic patients. In a multiple linear regression model, including all univariate associates of NGAL, only log eGFR, log hs-CRP and log HDL cholesterol maintained an independent association with log NGAL. During the observational period, 30 patients died due to cardiovascular causes and 69 non-fatal CVE were registered. In the fully adjusted model, we observed a 2.08-fold increase in the risk of fatal CVE and a 1.50-fold increase in the risk of fatal and non-fatal CVE for each increment of 1 SD in log NGAL values. This is the first study that shows that serum NGAL is associated with cardiovascular events (fatal and non-fatal) in patients with CKD, independently of traditional risk factors, renal function and inflammation.
Page 1. Genel Tıp Derg 2009;19(4) SAPD hastalarında amino asitli diyalizatların etkileri-Güney ve... more Page 1. Genel Tıp Derg 2009;19(4) SAPD hastalarında amino asitli diyalizatların etkileri-Güney ve ark 153 Amino asitli diyalizatların malnütrisyonlu SAPD hastalarında nütrisyonel ve diğer laboratuar parametreleri üzerine 1 yıllık dönemdeki etkileri ...
International Urology and Nephrology, Dec 29, 2009
Background The most common cause of death in patients with chronic kidney disease is cardiovascul... more Background The most common cause of death in patients with chronic kidney disease is cardiovascular. Coexistence of reduced estimated glomerular filtration rate (eGFR) and erectile dysfunction (ED) may predate severe underlying coronary artery disease (CAD). The aim of this study was to evaluate the predictive value of presence and severity of ED and reduced estimated eGFR in the risk stratification of CAD in patients with chest pain. Methods Two hundred and sixty-five consecutive male patients with chest pain were included. All patients underwent exercise stress test (EST), of whom those with positive EST underwent coronary angiography. eGFR was calculated and sexual health inventory for men (SHIM) form was applied to evaluate ED. The relation between SHIM scores, eGFR and the number of arteries with significant lesions was evaluated. Results Of the 265 male patients, 105 had positive EST while the remaining 160 patients had negative EST. ED was present in 62 patients (38.8%) in the EST (-) group and in 64 patients (61%) in the EST (?) group (P = 0.000). In the EST (?) group, coronary angiography (CAG) revealed normal coronary anatomy or insignificant coronary lesions in 19 (18%), one-vessel disease in 45 (43%), two-vessel disease in 22 (21%) and three-vessel disease in 19 (18%) patients, respectively. The lowest ED prevalence (36.8%) was seen in patients who had normal coronary anatomy or insignificant coronary lesions while the highest prevalence was in those with threevessel disease (89.5%). When eGFR were taken into account, there was a significant difference between the groups as well (107.2 ± 19.2 ml/min in the EST (-) group versus 94.1 ± 20.0 ml/min in the EST (?) group; P = 0.001). Conclusion The presence and severity of ED and reduced eGFR are associated with the severity of underlying CAD in patients presenting with chest pain, and they could be implemented in the risk stratification of these patients.
Background: Haemophilus influenzae infection is a mild and self-limited disease in the healthy po... more Background: Haemophilus influenzae infection is a mild and self-limited disease in the healthy population. However, it may show an aggressive course in the immunocompromised state which underlines the importance of vaccination against this agent. On the other hand, posttranplant immunosuppression may impair immune responses and thus the efficacy of the vaccination. Methods: Forty-three renal transplant recipients with well-functioning allografts were immunized with H. influenzae type b vaccine in order to investigate the immune response. The patients received a double or a triple immunosuppressive protocol. Seven healthy members of the dialysis unit served as controls. After obtaining basal serum samples, the patients and the control subjects were immunized with H. influenzae type b conjugate vaccine. After 6 and 12 weeks, serum samples obtained again to determine H. influenzae type b antibody titers. Results: The antibody titers 6 and 12 weeks after vaccination were significantly higher as compared with the basal values, similar to those of the control subjects. These titers did not show statistically significant differences between the double and triple immunosuppressive therapy groups. After 12 weeks of vaccination, the antibody titers did not show a statistically significant difference as compared with those obtained after 6 weeks. Conclusion: H. influenzae type b vaccination is safe and effective in patients with well-functioning renal allografts and should be recommended to renal transplant recipients who may have the risk of invasive disease on the basis of the immunosuppressive state.
International Journal of Artificial Organs, May 1, 1998
Patients with chronic renal disease are at a higher risk of serious influenza virus infection tha... more Patients with chronic renal disease are at a higher risk of serious influenza virus infection than healthy subjects (1). They should therefore be annually immunized with inactivated influenza vaccine. However, in patients on chronic hemodialysis, the seroresponsiveness to influenza is impaired because of deterioration in both humoral and cellular immunity, especially the latter in uremia (2-5). Uremic immunological disturbances are related to different factors, including the state of zinc (Zn) deficiency (6). An abnormal Zn metabolism is well-documented in uremic patients (7). The mechanisms by which Zn deficiency impairs the immunological function in uremia are still unknown. The effects of Zn supplementation on the immune system and on antibody response to different vaccines are Artificial Kidney and Dialysis
Natriuretic peptides are structurally similar, but genetically distinct, hormones that participat... more Natriuretic peptides are structurally similar, but genetically distinct, hormones that participate in cardiovascular homeostasis by regulating blood and extracellular fluid volume and blood pressure. We investigated the distribution of natriuretic peptides and their receptors in goat (Capra hircus) heart tissue using the peroxidase-anti-peroxidase (PAP) immunohistochemical method. Strong staining of atrial natriuretic peptide (ANP) was observed in atrial cardiomyocytes, while strong staining for brain natriuretic peptide (BNP) was observed in ventricular cardiomyocytes. Slightly stronger cytoplasmic C-type natriuretic peptide (CNP) immunostaining was detected in the ventricles compared to the atria. Natriuretic peptide receptor-A (NPR-A) immunoreactivity was more prominent in the atria, while natriuretic peptide receptor-B (NPR-B) immunoreactivity was stronger in the ventricles. Cytoplasmic natriuretic peptide receptor-C (NPR-C) immunoreactivity was observed in both the atria and ventricles, although staining was more prominent in the ventricles. ANP immunoreactivity ranged from weak to strong in endothelial and vascular smooth muscle cells. Endothelial cells exhibited moderate to strong BNP immunoreactivity, while vascular smooth cells displayed weak to strong staining. Endothelial cells exhibited weak to strong cytoplasmic CNP immunoreactivity. Vascular smooth muscle cells were labeled moderately to strongly for CNP. Weak to strong cytoplasmic NPR-A immunoreactivity was found in the endothelial cells and vascular smooth muscle cells stained weakly to moderately for NPR-A. Endothelial and vascular smooth cells exhibited weak to strong cytoplasmic NPR-B immunoreactivity. Moderate to strong NPR-C immunoreactivity was observed in the endothelial and smooth muscle cells. Small gender differences in the immunohistochemical distribution of natriuretic peptides and receptors were observed. Our findings suggest that endothelial cells, vascular smooth cells and cardiomyocytes express both natriuretic peptides and their receptors.
Journal of Clinical Laboratory Analysis, Jul 12, 2010
Ischemia-Modified albumin (IMA) has been used as an early marker in the evaluation of the patient... more Ischemia-Modified albumin (IMA) has been used as an early marker in the evaluation of the patients with acute coronary syndrome. We aimed to evaluate IMA in end-stage renal disease (ESRD) patients on hemodialysis and the effect of albumin methods on albumin-adjusted IMA levels. A total of 30 ESRD patients were included in this study. Serum IMA and albumin levels were measured before and after a hemodialysis session. Albumin concentrations were determined with bromocresol green and bromocresol purple methods. Postdialysis IMA and albumin-adjusted IMA levels with two different albumin methods were significantly increased compared with the predialysis levels (Po0.05). However, we did not find any difference in albumin-adjusted IMA levels in either at the beginning or at the end of the dialysis session. IMA levels increase after hemodialysis, whereas albumin method has no effect on albuminadjusted IMA levels.
Electronic journal of general medicine, Jul 15, 2014
The incidence of neoplasia is increased in end-stage renal disease (ESRD) patients. Zinc (Zn) def... more The incidence of neoplasia is increased in end-stage renal disease (ESRD) patients. Zinc (Zn) deficiency is associated with neoplasia and also commonly seen in ESRD patients. However, the data regarding the relationship between Zn levels and tumor markers is scant in this population. We aimed to investigate the relationship between Zn levels and tumor markers in hemodialysis patients. Twenty-six hemodialysis patients (11 male, 15 female, mean age 41.6±14.3 years) and 11 healthy subjects (6 male and 5 female, mean age 38.7±7.2 years) were included. Serum Alpha fetoprotein (AFP), carcinoembriyonic antigen (CEA), CA 19-9, CA 15-5, CA 125, beta subunit of human corionic gonadotrophin (β-HCG) and beta-2 microglobulin (β2M) and Zn levels were measured. Data were analysed by Student's t test. Serum Zinc levels were significantly lower in ESRD patients (group 1) compared to healthy subjects (group 2) (p<0.0001, for all). Serum CEA and β2M levels were also significantly higher in group 1 patients compared to group 2 subjects (p<0.005, p<0.0001, respectively). Serum Ca15-3 and CA-125 levels were found to be significantly lower in group 1 patients compared to group 2 subjects (p<0.005, p<0.001, respectively). There were no statistically significant difference in terms of serum CA 19-9, β-HCG and AFP between group 1 and group 2 patients. In group 1 patients, there was a negative correlation between serum Zn levels and AFP, while a positive correlation was obsorved between serum Zn levels and CA15-3. The measurement of AFP may be beneficial in HD patients. Further studies are needed.
Coenzyme Q10 (CoQ10) supplementation has been shown to decrease oxidative stress in a number of c... more Coenzyme Q10 (CoQ10) supplementation has been shown to decrease oxidative stress in a number of clinical settings. However, there are mixed results regarding the role of CoQ10 supplementation on exercise performance. Chronic kidney disease is recognized as an inflammatory state, and hemodialysis patients have low level of exercise performance. We aimed to evaluate the effect of CoQ10 supplementation on oxidative stress markers and exercise performance measures. This was a prospective, double-blind, placebo-controlled, crossover study in which all patients received placebo and oral CoQ10 200 mg/d. Participants underwent 6-minute walking test and cycle ergometer. Blood samples were drawn to determine malondialdehyde, oxidized low-density lipoprotein, superoxide dismutase, and glutathione peroxidase. Walking distance in 6-minute walking test and estimated maximal oxygen consumption (VO2max) were recorded. Twenty-eight patients were randomized, but 23 patients completed the study protocol. Serum CoQ10 level significantly increased with supplementation compared with basal values (P &lt; 0.05). Neither walking distance nor estimated VO2max was different between the placebo and CoQ10 groups (P &gt; 0.05). Serum malondialdehyde levels significantly increased in both groups compared with baseline values just after the exercise (P &lt; 0.05). There was no difference in markers of oxidative stress and antioxidant system between placebo and CoQ10 supplementation with exercise (P &gt; 0.05). The results of this study showed no significant effect of CoQ10 supplementation on exercise performance measures and oxidative system markers compared with placebo in maintenance hemodialysis patients.
Background. Malnutrition, inflammation, and atherosclerosis (MIA syndrome) are common in end-stag... more Background. Malnutrition, inflammation, and atherosclerosis (MIA syndrome) are common in end-stage renal disease (ESRD) patients. Each component of MIA syndrome is the predictor of outcomes in ESRD patients. In this cross-sectional study, we aimed to compare both dialysis modalities for MIA syndrome components. Material and Methods. Thirty hemodialysis (HD) (mean age 44 ± 11 years, 14 male and 16 female, mean time on dialysis: 31.0 ± 19.0 months) and 30 continuous ambulatory peritoneal dialysis (CAPD) patients (41 ± 9 years, 12 male and 18 female, mean time on dialysis: 25.5 ± 21.5 months) were included. In order to determine malnutrition in ESRD patients, serum albumin level and anthropometric measurements were used. For inflammation, serum C-reactive protein level, erythrocyte sedimentation rate, and fibrinogen levels were measured. Mean-carotid artery intima media thickness (m-CIMT), presence of carotid plaque and serum homocysteine level were used to determine atherosclerosis. Results. Five CAPD patients (16%) and one HD patient (3%) was hypoalbuminemic. HD and CAPD groups were similar for inflammation. Mean-CIMT and serum homocysteine level were higher in HD patients than CAPD patients. There was a positive correlation between homocysteine and m-CIMT. Conclusion. Before choosing renal replacement therapy, malnutrition, inflammation, and atherosclerosis parameters must be investigated in ESRD patients. Hemodialysis seems to be more advantageous for malnutrition components than CAPD. Both dialysis modalities seem to be similar for inflammation, and CAPD modality has superiority for atherosclerosis. Before choosing the type of renal replacement therapy, assessment of MIA syndrome components could be useful for individualization of the decision on which dialytic modality is appropriate in ESRD patients.
Introduction: The aim of the study was to assess whether neutrophil gelatinaseassociated lipocali... more Introduction: The aim of the study was to assess whether neutrophil gelatinaseassociated lipocalin (NGAL) and cystatin C could reflect kidney function in pregnant healthy women. Material and methods: The studies were performed on 130 healthy pregnant women (n = 63, 3 rd trimester; n = 21, 2 nd trimester; n = 46, 1 st trimester) and 30 healthy female volunteers. Serum NGAL, cystatin C, IL-6, and hs-CRP were assayed using commercially available kits. Results: Serum cystatin C rose steadily during the pregnancy, whereas NGAL rose in the 2 nd trimester, then decreased in the 3 rd trimester. In univariate analysis, NGAL correlated with serum cystatin C, number of pregnancies, white blood cell count, total iron-binding capacity (TIBC), ferritin, and IL-6, and tended to correlate with eGFR. In multiple regression analysis the only predictor of serum NGAL was cystatin C. Conclusions: Serum NGAL in pregnancy might reflect subclinical inflammation rather than kidney function. It seems that NGAL, similarly to cystatin C, is not useful to monitor renal function in pregnancy.
International Urology and Nephrology, Oct 26, 2015
Neutrophil gelatinase-associated lipocalin (NGAL) is a member of the lipocalin family best known ... more Neutrophil gelatinase-associated lipocalin (NGAL) is a member of the lipocalin family best known as a novel and early marker of acute kidney injury (AKI). Recent data suggest that NGQueryAL is not only a marker of AKI, but also an important player in the vascular remodeling, atherosclerotic plaque stability and thrombus formation. We conducted this study to investigate the association of serum NGAL levels with fatal and composite (fatal and non-fatal) cardiovascular events (CVE) in a cohort of patients with stage 1-5 CKD. This was an observational cohort study in which serum NGAL was obtained from 298 CKD (stages 1-5) patients. Fatal and composite CVE were recorded for a median 41 months. We examined alteration of serum NGAL through CKD groups as well as association with inflammatory markers. We also performed a Cox regression analysis to determine the association of NGAL with predefined clinical outcomes. The median value of NGAL was 50.5 ng/mL (IR 47.6-54.9 ng/mL), and higher NGAL values were recorded in diabetic patients. In a multiple linear regression model, including all univariate associates of NGAL, only log eGFR, log hs-CRP and log HDL cholesterol maintained an independent association with log NGAL. During the observational period, 30 patients died due to cardiovascular causes and 69 non-fatal CVE were registered. In the fully adjusted model, we observed a 2.08-fold increase in the risk of fatal CVE and a 1.50-fold increase in the risk of fatal and non-fatal CVE for each increment of 1 SD in log NGAL values. This is the first study that shows that serum NGAL is associated with cardiovascular events (fatal and non-fatal) in patients with CKD, independently of traditional risk factors, renal function and inflammation.
Page 1. Genel Tıp Derg 2009;19(4) SAPD hastalarında amino asitli diyalizatların etkileri-Güney ve... more Page 1. Genel Tıp Derg 2009;19(4) SAPD hastalarında amino asitli diyalizatların etkileri-Güney ve ark 153 Amino asitli diyalizatların malnütrisyonlu SAPD hastalarında nütrisyonel ve diğer laboratuar parametreleri üzerine 1 yıllık dönemdeki etkileri ...
International Urology and Nephrology, Dec 29, 2009
Background The most common cause of death in patients with chronic kidney disease is cardiovascul... more Background The most common cause of death in patients with chronic kidney disease is cardiovascular. Coexistence of reduced estimated glomerular filtration rate (eGFR) and erectile dysfunction (ED) may predate severe underlying coronary artery disease (CAD). The aim of this study was to evaluate the predictive value of presence and severity of ED and reduced estimated eGFR in the risk stratification of CAD in patients with chest pain. Methods Two hundred and sixty-five consecutive male patients with chest pain were included. All patients underwent exercise stress test (EST), of whom those with positive EST underwent coronary angiography. eGFR was calculated and sexual health inventory for men (SHIM) form was applied to evaluate ED. The relation between SHIM scores, eGFR and the number of arteries with significant lesions was evaluated. Results Of the 265 male patients, 105 had positive EST while the remaining 160 patients had negative EST. ED was present in 62 patients (38.8%) in the EST (-) group and in 64 patients (61%) in the EST (?) group (P = 0.000). In the EST (?) group, coronary angiography (CAG) revealed normal coronary anatomy or insignificant coronary lesions in 19 (18%), one-vessel disease in 45 (43%), two-vessel disease in 22 (21%) and three-vessel disease in 19 (18%) patients, respectively. The lowest ED prevalence (36.8%) was seen in patients who had normal coronary anatomy or insignificant coronary lesions while the highest prevalence was in those with threevessel disease (89.5%). When eGFR were taken into account, there was a significant difference between the groups as well (107.2 ± 19.2 ml/min in the EST (-) group versus 94.1 ± 20.0 ml/min in the EST (?) group; P = 0.001). Conclusion The presence and severity of ED and reduced eGFR are associated with the severity of underlying CAD in patients presenting with chest pain, and they could be implemented in the risk stratification of these patients.
Background: Haemophilus influenzae infection is a mild and self-limited disease in the healthy po... more Background: Haemophilus influenzae infection is a mild and self-limited disease in the healthy population. However, it may show an aggressive course in the immunocompromised state which underlines the importance of vaccination against this agent. On the other hand, posttranplant immunosuppression may impair immune responses and thus the efficacy of the vaccination. Methods: Forty-three renal transplant recipients with well-functioning allografts were immunized with H. influenzae type b vaccine in order to investigate the immune response. The patients received a double or a triple immunosuppressive protocol. Seven healthy members of the dialysis unit served as controls. After obtaining basal serum samples, the patients and the control subjects were immunized with H. influenzae type b conjugate vaccine. After 6 and 12 weeks, serum samples obtained again to determine H. influenzae type b antibody titers. Results: The antibody titers 6 and 12 weeks after vaccination were significantly higher as compared with the basal values, similar to those of the control subjects. These titers did not show statistically significant differences between the double and triple immunosuppressive therapy groups. After 12 weeks of vaccination, the antibody titers did not show a statistically significant difference as compared with those obtained after 6 weeks. Conclusion: H. influenzae type b vaccination is safe and effective in patients with well-functioning renal allografts and should be recommended to renal transplant recipients who may have the risk of invasive disease on the basis of the immunosuppressive state.
International Journal of Artificial Organs, May 1, 1998
Patients with chronic renal disease are at a higher risk of serious influenza virus infection tha... more Patients with chronic renal disease are at a higher risk of serious influenza virus infection than healthy subjects (1). They should therefore be annually immunized with inactivated influenza vaccine. However, in patients on chronic hemodialysis, the seroresponsiveness to influenza is impaired because of deterioration in both humoral and cellular immunity, especially the latter in uremia (2-5). Uremic immunological disturbances are related to different factors, including the state of zinc (Zn) deficiency (6). An abnormal Zn metabolism is well-documented in uremic patients (7). The mechanisms by which Zn deficiency impairs the immunological function in uremia are still unknown. The effects of Zn supplementation on the immune system and on antibody response to different vaccines are Artificial Kidney and Dialysis
Natriuretic peptides are structurally similar, but genetically distinct, hormones that participat... more Natriuretic peptides are structurally similar, but genetically distinct, hormones that participate in cardiovascular homeostasis by regulating blood and extracellular fluid volume and blood pressure. We investigated the distribution of natriuretic peptides and their receptors in goat (Capra hircus) heart tissue using the peroxidase-anti-peroxidase (PAP) immunohistochemical method. Strong staining of atrial natriuretic peptide (ANP) was observed in atrial cardiomyocytes, while strong staining for brain natriuretic peptide (BNP) was observed in ventricular cardiomyocytes. Slightly stronger cytoplasmic C-type natriuretic peptide (CNP) immunostaining was detected in the ventricles compared to the atria. Natriuretic peptide receptor-A (NPR-A) immunoreactivity was more prominent in the atria, while natriuretic peptide receptor-B (NPR-B) immunoreactivity was stronger in the ventricles. Cytoplasmic natriuretic peptide receptor-C (NPR-C) immunoreactivity was observed in both the atria and ventricles, although staining was more prominent in the ventricles. ANP immunoreactivity ranged from weak to strong in endothelial and vascular smooth muscle cells. Endothelial cells exhibited moderate to strong BNP immunoreactivity, while vascular smooth cells displayed weak to strong staining. Endothelial cells exhibited weak to strong cytoplasmic CNP immunoreactivity. Vascular smooth muscle cells were labeled moderately to strongly for CNP. Weak to strong cytoplasmic NPR-A immunoreactivity was found in the endothelial cells and vascular smooth muscle cells stained weakly to moderately for NPR-A. Endothelial and vascular smooth cells exhibited weak to strong cytoplasmic NPR-B immunoreactivity. Moderate to strong NPR-C immunoreactivity was observed in the endothelial and smooth muscle cells. Small gender differences in the immunohistochemical distribution of natriuretic peptides and receptors were observed. Our findings suggest that endothelial cells, vascular smooth cells and cardiomyocytes express both natriuretic peptides and their receptors.
Journal of Clinical Laboratory Analysis, Jul 12, 2010
Ischemia-Modified albumin (IMA) has been used as an early marker in the evaluation of the patient... more Ischemia-Modified albumin (IMA) has been used as an early marker in the evaluation of the patients with acute coronary syndrome. We aimed to evaluate IMA in end-stage renal disease (ESRD) patients on hemodialysis and the effect of albumin methods on albumin-adjusted IMA levels. A total of 30 ESRD patients were included in this study. Serum IMA and albumin levels were measured before and after a hemodialysis session. Albumin concentrations were determined with bromocresol green and bromocresol purple methods. Postdialysis IMA and albumin-adjusted IMA levels with two different albumin methods were significantly increased compared with the predialysis levels (Po0.05). However, we did not find any difference in albumin-adjusted IMA levels in either at the beginning or at the end of the dialysis session. IMA levels increase after hemodialysis, whereas albumin method has no effect on albuminadjusted IMA levels.
Electronic journal of general medicine, Jul 15, 2014
The incidence of neoplasia is increased in end-stage renal disease (ESRD) patients. Zinc (Zn) def... more The incidence of neoplasia is increased in end-stage renal disease (ESRD) patients. Zinc (Zn) deficiency is associated with neoplasia and also commonly seen in ESRD patients. However, the data regarding the relationship between Zn levels and tumor markers is scant in this population. We aimed to investigate the relationship between Zn levels and tumor markers in hemodialysis patients. Twenty-six hemodialysis patients (11 male, 15 female, mean age 41.6±14.3 years) and 11 healthy subjects (6 male and 5 female, mean age 38.7±7.2 years) were included. Serum Alpha fetoprotein (AFP), carcinoembriyonic antigen (CEA), CA 19-9, CA 15-5, CA 125, beta subunit of human corionic gonadotrophin (β-HCG) and beta-2 microglobulin (β2M) and Zn levels were measured. Data were analysed by Student's t test. Serum Zinc levels were significantly lower in ESRD patients (group 1) compared to healthy subjects (group 2) (p<0.0001, for all). Serum CEA and β2M levels were also significantly higher in group 1 patients compared to group 2 subjects (p<0.005, p<0.0001, respectively). Serum Ca15-3 and CA-125 levels were found to be significantly lower in group 1 patients compared to group 2 subjects (p<0.005, p<0.001, respectively). There were no statistically significant difference in terms of serum CA 19-9, β-HCG and AFP between group 1 and group 2 patients. In group 1 patients, there was a negative correlation between serum Zn levels and AFP, while a positive correlation was obsorved between serum Zn levels and CA15-3. The measurement of AFP may be beneficial in HD patients. Further studies are needed.
Coenzyme Q10 (CoQ10) supplementation has been shown to decrease oxidative stress in a number of c... more Coenzyme Q10 (CoQ10) supplementation has been shown to decrease oxidative stress in a number of clinical settings. However, there are mixed results regarding the role of CoQ10 supplementation on exercise performance. Chronic kidney disease is recognized as an inflammatory state, and hemodialysis patients have low level of exercise performance. We aimed to evaluate the effect of CoQ10 supplementation on oxidative stress markers and exercise performance measures. This was a prospective, double-blind, placebo-controlled, crossover study in which all patients received placebo and oral CoQ10 200 mg/d. Participants underwent 6-minute walking test and cycle ergometer. Blood samples were drawn to determine malondialdehyde, oxidized low-density lipoprotein, superoxide dismutase, and glutathione peroxidase. Walking distance in 6-minute walking test and estimated maximal oxygen consumption (VO2max) were recorded. Twenty-eight patients were randomized, but 23 patients completed the study protocol. Serum CoQ10 level significantly increased with supplementation compared with basal values (P &lt; 0.05). Neither walking distance nor estimated VO2max was different between the placebo and CoQ10 groups (P &gt; 0.05). Serum malondialdehyde levels significantly increased in both groups compared with baseline values just after the exercise (P &lt; 0.05). There was no difference in markers of oxidative stress and antioxidant system between placebo and CoQ10 supplementation with exercise (P &gt; 0.05). The results of this study showed no significant effect of CoQ10 supplementation on exercise performance measures and oxidative system markers compared with placebo in maintenance hemodialysis patients.
Background. Malnutrition, inflammation, and atherosclerosis (MIA syndrome) are common in end-stag... more Background. Malnutrition, inflammation, and atherosclerosis (MIA syndrome) are common in end-stage renal disease (ESRD) patients. Each component of MIA syndrome is the predictor of outcomes in ESRD patients. In this cross-sectional study, we aimed to compare both dialysis modalities for MIA syndrome components. Material and Methods. Thirty hemodialysis (HD) (mean age 44 ± 11 years, 14 male and 16 female, mean time on dialysis: 31.0 ± 19.0 months) and 30 continuous ambulatory peritoneal dialysis (CAPD) patients (41 ± 9 years, 12 male and 18 female, mean time on dialysis: 25.5 ± 21.5 months) were included. In order to determine malnutrition in ESRD patients, serum albumin level and anthropometric measurements were used. For inflammation, serum C-reactive protein level, erythrocyte sedimentation rate, and fibrinogen levels were measured. Mean-carotid artery intima media thickness (m-CIMT), presence of carotid plaque and serum homocysteine level were used to determine atherosclerosis. Results. Five CAPD patients (16%) and one HD patient (3%) was hypoalbuminemic. HD and CAPD groups were similar for inflammation. Mean-CIMT and serum homocysteine level were higher in HD patients than CAPD patients. There was a positive correlation between homocysteine and m-CIMT. Conclusion. Before choosing renal replacement therapy, malnutrition, inflammation, and atherosclerosis parameters must be investigated in ESRD patients. Hemodialysis seems to be more advantageous for malnutrition components than CAPD. Both dialysis modalities seem to be similar for inflammation, and CAPD modality has superiority for atherosclerosis. Before choosing the type of renal replacement therapy, assessment of MIA syndrome components could be useful for individualization of the decision on which dialytic modality is appropriate in ESRD patients.
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