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Öğe Are the anticardiolipin antibodies a risk factor for coronary artery disease in chronic renal failure patients?(Taylor & Francis Ltd, 2008) Ucar, Edip; Kuvandik, Guven; Sert, Mehmet; Kuvandik, Ceren; Temizkan, Aysegul; Borazan, AliObjective. It has been proposed that anticardiolipin (aCL) antibodies are a risk factor for coronary artery disease (CAD) in recently studies. In this study, we aimed to investigate the existence of coronary artery disease in dialysis patients who were aCL positive and undergoing hemodialysis and peritoneal dialysis due to end stage renal failure and also to determine its relationship with risk factors in patients with coronary artery disease. Methods. This study has been conducted in the end stage renal failure in 140 hemodialysis patients, 18 peritoneal dialysis patients, and 38 healthy controls. The urea, creatinine, total cholesterol, HDL cholesterol, LDL cholesterol, triglyceride, total protein, and albumin values are obtained. In all cases, aCL levels are investigated with ELISA method. Results. In the HD and CAPD patients, no significant relationship could be found between the age, gender, dialysis time, total cholesterol, HDL cholesterol, LDL cholesterol, total protein, and albumin values (p 0.05). HD and CAPD vs. controls (aCL), 9.2% (13/140), 11.1% (2/18) vs. 2.6% (1/38), p = 0.002. No significant difference was noted between aCL-positive and -negative patients in serum urea, creatinine, total cholesterol, HDL cholesterol, LDL cholesterol, triglyceride, total protein, and albumin levels. The coronary artery disease was determined in three patients out of 16 patients with aCL positivity. Conclusion. The prevalence of aCL antibodies positivity in our study was similar to the prevalence of aCL positivity in other studies. Therefore, we do not think aCL antibodies positivity is a risk factor for coronary artery disease.Öğe Coronary Artery Disease Risk Factors in Patients on Continuous Ambulatory Peritoneal Dialysis(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2008) Pocan, Bekir; Ucar, Edip; Kuvandik, Guven; Borazan, Ali; Guven, Oguz; Gursurer, Metin; Camizci, RaleAim: We aimed to investigate especially early stage non traditional cardiovascular risk factors in end stage renal failure patients who were in Continued Ambulatory Peritoneal Dialysis (CAPD) programme in our center. Methods: In this study 21 CAPD patients and 21 sex and age matched controls were enrolled. The clinical history and demographic parameters were obtained and than for physical evaluation blood samples were drawn for 12 hours fasting glucose, serum total cholesterol, HDL-cholesterol, LDL-cholesterol, triglyceride, apoA, apoB, total protein, albumin, calcium, phosphorus, parathormon (PTH), hemoglobin (Hb), Lp(a), C-reactive protein (CRP), homocysteine (tHcy), anticardiolipin antibody (ACLA), fibrinogen. Results: While age, sex, Body Mass Index (BMI), smoking status and hereditary factors were comparable between the groups, diabetes mellitus and hypertension were significantly higher in CAPD patients. There was no statistical significance between the groups considering mean serum total cholesterol, HDL-cholesterol, LDL-cholesterol, triglyceride, PTH, Lp(a), tHcy, ACLA Ig M and ACLA Ig G levels. In the present study mean apoA level was significantly lower in the study group, while apoB and phosphorus were higher (p=0.003). Also mean total protein, albumin, calcium, and Hb level were significantly lower, while mean CRP and fibrinogen were higher in the study group (p=0.0003). Conclusion: Because of the high rates of increased risk factors for coronary artery disease in CAPD patients at early stages, these patients should be closely followed for coronary artery disease.Öğe The effect of renal replacement therapies on serum gastrointestinal system hormones(Taylor & Francis Inc, 2007) Borazan, Ali; Cavdar, Zahide; Saglam, FundaBackground. The kidney is a major site for the inactivation, degradation, and clearance of a variety of peptide hormones. It has been shown that the uremia increases or decreases gastrointestinal system (GIS) hormones. Moreover, studies investigating the serum GIS hormones levels in chronic renal failure (CRF) were conducted mainly in a particular period of the renal replacement therapy, and the changes caused by continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) could not be fully demonstrated. In this study, we investigated the effect of CAPD and HD on serum GIS hormones (amylase, lipase, trypsinogen, and gastrin) levels in CRF patients who were diagnosed for the first time. Methods. Serum amylase, lipase, trypsinogen, and gastrin levels were measured in 36 patients who were just diagnosed with CRF, 22 patients with CAPD and 14 patients with HD. GIS hormones of these patients were measured before treatment and three months from the beginning of CAPD and HD treatment. As the control group, 20 normal healthy cases with well-matched age and gender were used. Results. The mean serum amylase, lipase, secretin, and gastrin levels were found meaningfully decreased according to the beginning values at third months of the CAPD and HD treatment. However, they were higher than control group. Conclusion. In patients receiving CAPD or HD as renal replacement therapy, GIS hormone levels were found to be lower, albeit higher than the healthy control group.Öğe The Effects of Low-Dose Erythropoiesis-Stimulating Agents on Peritoneal Fibrosis Induced by Chemical Peritonitis and on Peritoneal Tissue MMP-2 and TIMP-2 Levels in Rats(Taylor & Francis Ltd, 2009) Yildirim, Ayse; Ozkan, Orhan Veli; Aslan, Ahmet; Koseoglu, Zikret; Borazan, AliAim. The objective of the present study was to investigate the effect of low-dose erytropoesis-stimulating agents (ESA) on the development of peritoneal fibrosis in chlorhexidine gluconate-induced peritoneal sclerosing rats and to assess the peritoneal tissue levels of MMP-2 and TIMP-2, which may be regarded as factors in the development of peritoneal fibrosis. Subjects and methods. Twenty-four Wistar albino rats were divided into three groups. The control group received 0.9% saline (3 ml/d) intraperitoneally, the CH group received 3 ml daily injections of 0.1% chlorhexidine gluconate (CH) intraperitoneally, and the CH+ESA group received 3 ml daily injections of 0.1% CH intraperitoneally and epoetin beta (3 x 20 IU/kg/week) subcutaneously. On the twenth-first day, rats were sacrificed, and parietal peritoneum samples were obtained from the left anterior abdominal wall. Pathological samples were examined using Hematoxyline & Eosin (HE) stains. The thickness, vascular proliferation, and inflammation were determined by light microscopy. MMP-2 and TIMP-2 were studied immunohistochemically by monoclonal antibody staining. Results. Inflammation, vascular proliferation, and fibrotic area percentages were not statistically significant between groups. Histopathologically control, CH, CH+ESA groups peritoneal thickness were 8.02 +/- 2.89, 146.74 +/- 26.1, and 48.12 +/- 16.8 micrometers, respectively. The decrease in thickness of parietal peritoneum in CH+ESA group was statistically significant when compared to CH. Immunohistochemically, interferon was shown to decrease MMP-2 expression on parietal peritoneum than group CH, but has no effect on TIMP-2. Discussion. Low-dose ESA histopatologically reduces peritoneal fibrosis induced by chlorhexidine gluconate. However, from dosage and duration points of view, we need extended clinical and experimental studies.Öğe Markers of inflammation as determinants of mortality in intensive care unit patients(Springer, 2007) Kuvandik, Guven; Ucar, Edip; Borazan, Ali; Aydemir, Selim; Ilikhan, Sevil; Sekitmez, Nedred; Duru, MehmetIn this study, the investigators explored the relationship between mortality rate and serum levels of C-reactive protein (CRP), erythrocyte sedimentation ratio (ESR), albumin, and hemoglobin, leukocyte, and platelet counts of patients at the time of first admission to the intensive care unit (ICU). A total of 123 patients were admitted to 2 different ICUs. In the emergency departments, serum levels of CRP, ESR, and albumin and hematologic parameters of 81 patients who died and were 42 patients who survived were compared. Student t test and the chi(2) test were used for statistical analyses. Mean CRP and ESR levels and leukocyte counts were higher in nonsurvivor than in survivor groups (P<.001 for all). Additionally, serum CRP and ESR elevations and leukocyte counts were determined to be individually related to mortality (P<.001, P<.05, and P<.05, respectively). The investigators concluded that initial serum levels of CRP and ESR and leukocyte counts can be used as determinants of mortality in ICU patients.Öğe Metformin and parameters of physical health(Japan Soc Internal Medicine, 2008) Helvaci, Mehmet Rami; Kaya, Hasan; Borazan, Ali; Ozer, Cahit; Seyhanli, Mahmut; Yalcin, AtillaBackground The prevalence of excess weight, including overweight and obesity, is increasing with a high cost on health in society. Methods Consecutive cases with excess weight, aged between 50 and 70 years and desiring weight loss, were divided into two subgroups according to wishes of patients about whether they prefer medication or just a diet. Metformin at a daily dose of 2,550 mg was given to the medication group. Results As for the very high prevalences, 84.8% (313/369) of cases at or above the age of 50 years were overweight or obese, 67.2% (248/369) of them had white coat hypertension (WCH)or hypertension (HT), 52.5% (194/369) of them had impaired glucose tolerance (IGT) or diabetes mellitus (DM), and 68.8% (254/369) of them had dyslipidemia. Initially 143 cases with excess weight preferred the diet and 162 of them preferred the metformin therapy. But 42 cases (25.9%) stopped the drug because of excessive anorexia. At the end of the six-month period, there were highly significant differences between the two groups according to prevalences of resolved WCH, hyperbetalipoproteinemia, hypertriglyceridemia, dyslipidemia, overweight, and obesity and a decreased fasting plasma glucose below 110 mg/dL (p < 0.001 for all). Conclusion Due to the very high prevalences of excess weight and probably many associated disorders with the excess weight, including IGT or DM, WCH or HT, and dyslipidemia, above the age of 50 years, and the detected significant benefits of metformin on all of the above parameters, metformin treatment should be initiated in patients with excess weight in their fifties.Öğe Positive correlation of CRP and fibrinogen levels as cardiovascular risk factors in early stage of continuous ambulatory peritoneal dialysis patients(Taylor & Francis Ltd, 2008) Tekin, Ishak Ozel; Pocan, Bekir; Borazan, Ali; Ucar, Edip; Kuvandik, Guven; Ilikhan, Sevil; Demircan, NejatWe aimed to study the relationship between the C-reactive protein (CRP), albumin, and fibrinogen as cardiovascular risk factors in continuous ambulatory peritoneal dialysis (CAPD) patients, in the early stage of their therapy. The study included 21 CAPD patients as the study group (SG) and age- and sex-matched 21 healthy patients as the control group (CG). History and physical exam data were obtained for all cases, and demographic baseline characteristics were taken. Twelve-hour fasting serum levels of glucose, total cholesterol, HDL cholesterol, LDL cholesterol, triglyceride, total protein, albumin, hemoglobin, CRP, and fibrinogen were obtained. There was no statistically significant difference between the SG and CG in baseline characteristics, including age, sex, body mass index (BMI), smoking, and family history of cardiovascular disease. However, diabetes mellitus (DM) and hypertension (HTN) were significantly more common among the study group. The average total protein, albumin, and hemoglobin levels were significantly lower, and the CRP and fibrinogen levels were significantly higher (p < 0.001) in the SG. A positive correlation was seen (r = 0.443, p < 0.05) among CRP and fibrinogen levels in SG. There was no correlation among the other parameters in SG. For CG, there was no correlation seen for any studied parameters. When patients with and without cardiovascular disease (CVD) were compared, no correlation was seen between CRP and other parameters. A positive correlation of CRP and fibrinogen levels as cardiovascular risk factors was shown in early stage of CAPD patients. The CAPD patients with elevated levels of CRP and fibrinogen should receive close follow-up for cardiovascular disease prevention.Öğe A Rare Cause of Renovascular Hypertension: Takayasu Arteritis with Only Renal Artery Involvement(Taylor & Francis Inc, 2009) Borazan, Ali; Sevindik, Omur Gokmen; Solmaz, Dilek; Gulcu, Aytac; Cavdar, Caner; Sifil, Aykut; Celik, AliTakayasu arteritis is a chronic inflammatory disease that affects mainly the aorta, main branches of aorta, and pulmonary arteries with unknown etiology. Disease affecting solely the renal arteries is rare. We will present a case that had hypertension, hypokalemia, and metabolic alkalosis where the etiology was type 2 Takayasu arteritis, affecting renal arteries.Öğe Relationship between Insulin Resistance and Inflamation Markers in Hemodialysis Patients(Taylor & Francis Ltd, 2010) Borazan, Ali; Binici, Dogan NasirObjective. The prevalence and risk factors of cardiovascular disease (CVD) are increasing in end stage renal disease (ESRD) patients. In this study, we sought to research the relationship between the insulin resistance, which is one of the risk factors for CVD, and the inflammation markers, especially Creactive protein, fibrinogen, uric acid, and homocysteine levels in our patients who were recently diagnosed with ESRD and started hemodialysis. Materials and methods. 64 HOMA-IR-positive and 114 HOMA-IR-negative patients were enrolled in this study. Blood samples were obtained from the patients for fasting plasma glucose, insulin, CRP, fibrinogen, uric acid, total homocysteine, urea, total cholesterol, HDL-cholesterol, LDLcholesterol, triglyceride, total protein, and albumin analysis after physical examinations and anamnesis were completed. Results. Fibrinogen and CRP levels of HOMA-IR-positive HD patients were significantly increased compared to non-insulin resistants. Furthermore, there is significant positive relationship between insulin resistance and serum CRP and fibrinogen levels in these HOMA-IR-positive HD patients (r = 0.258, p < 0.001). Conclusion. We found out that the fibrinogen and CRP levels are significantly high in HOMA-IR positive HD patients, according to determine the risk ratio for coronary artery disease in HD patients, and think that an assessment of insulin resistance is necessary.Öğe Sürekli ayaktan periton diyalizi uygulanan hastalarda koroner arter hastalığı risk faktörleri(2008) Poçan, Bekir; Uçar, Edip; Kuvandık, Güven; Borazan, Ali; Güven, Oğuz; Gürsürer, Metin; Camızcı, Rale; Ünsal, Birsen; Sökmen, Coşkun; İlikhan, SevilAmaç: Bu çalışmada merkezimizde son dönem böbrek yetmezliğ i tanısı konularak sürekli ayaktan periton diyalizi (SAPD) uyguladığı mız hastalarımızdaki özellikle geleneksel olmayan kardiyovasküler risk faktörlerini erken dönemde araştırmayı amaçladık. Materyal ve Metod: Çalışmaya 21 SAPD hastası ile kontrol grubu olarak yaş ve cinsiyetleri uyumlu 21 sağlıklı birey alındı. Olguları n demografik özellikleri ve anamnezleri alındıktan sonra fizik muayeneleri yapıldı. 12 saatlik açlık sonrası açlık kan şekeri, serum total kolesterol, HDL-kolesterol, LDL-kolesterol, trigliserit, apoA, apoB, total protein, albümin, kalsiyum, fosfor, parathormon (PTH), hemoglobin (Hb), Lp(a), C-reaktif protein (CRP), homosistein (tHcy), antikardiyolipin antikorları (ACLA), fibrinojen için kan örneği alındı. Bulgular: Gruplar arasında yaş, cinsiyet, vücut kitle indeksi (BMI) sigara içimi, heredite açısından fark bulunmazken, diabetes mellitus (DM) ve hipertansiyon (HT) SAPD hastalarında anlamlı olarak yüksek bulundu. Total kolesterol, HDL-kolesterol, LDL-kolesterol, trigliserit, PTH, Lp(a), tHcy, ACLA IgM ve IgG’nin ortalama değerleri arasında istatistiksel olarak anlamlı fark bulunmadı. Çalışmamızda apoA’nın düşüklüğü, apoB ve fosforun yüksekliği istatistiksel olarak anlamlıydı (p=0.03). Ortalama total protein, albümin, kalsiyum, Hb’nin düşüklüğü, CRP ve fibrinojenin yüksekliği kontrol grubuna göre istatistiksel olarak anlamlı bulundu (p=0.0003). Sonuç: SAPD olgularının erken dönemde yüksek KAH risk faktörleri ile karşı karşıya olması nedeniyle, KAH açısından yakın takibi gerekmektedir.
