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Öğe Acute Kidney Injury: Medical Causes and Pathogenesis(Mdpi, 2023) Turgut, Faruk; Awad, Alaa S. S.; Abdel-Rahman, Emaad M. M.Acute kidney injury (AKI) is a common clinical syndrome characterized by a sudden decline in or loss of kidney function. AKI is not only associated with substantial morbidity and mortality but also with increased risk of chronic kidney disease (CKD). AKI is classically defined and staged based on serum creatinine concentration and urine output rates. The etiology of AKI is conceptually classified into three general categories: prerenal, intrarenal, and postrenal. Although this classification may be useful for establishing a differential diagnosis, AKI has mostly multifactorial, and pathophysiologic features that can be divided into different categories. Acute tubular necrosis, caused by either ischemia or nephrotoxicity, is common in the setting of AKI. The timely and accurate identification of AKI and a better understanding of the pathophysiological mechanisms that cause kidney dysfunction are essential. In this review, we consider various medical causes of AKI and summarize the most recent updates in the pathogenesis of AKI.Öğe Akut böbrek yetmezliği ile prezente olan lenfoma olgusu(2017) Yaprak, Mustafa; İlhan, Gül; Bay, Feyyaz; Gezici Güneş, Ümran; Turgut, FarukKanser hastalarında da akut böbrek yetmezliği (ABY), normal popülasyonda olduğu gibi prerenal, renal ve postrenal nedenlere bağlı olarak ortaya çıkmaktadır. Böbreğe tümör infiltrasyonu genellikle yaygın değildir. Fakat akut lösemi veya lenfoma gibi hızlı büyüyen hematolojik malignitelerde tümör tutulumuna bağlı böbrek fonksiyonları bozulabilmektedir. Burada akut böbrek yetmezliği ile başvuran ve daha sonra lenf nodu biyopsisi ile B hücreli Nonhodgkin lenfoma tanısı alan bir olgu sunulmuştur. Tümör infiltrasyonuna bağlı ABY gelişmesi nadir olmakla birlikte, akut böbrek yetmezliği gelişimi açısından risk faktörü bulunmayan olgularda lösemik veya lenfomatöz infiltrasyon düşünülmelidir.Öğe The association between methylation levels of targeted genes and albuminuria in patients with early diabetic kidney disease(Taylor & Francis Ltd, 2017) Aldemir, Ozgur; Turgut, Faruk; Gokce, CumaliObjective: The incidence of diabetes and its complications are greatly increasing world-wide. Diabetic nephropathy (DN) is the main cause of end-stage renal disease and is associated with high morbidity and mortality. It is important to predict patients with high risk for DN in the early stage. We selected the genes which have an important role on diabetic kidney disease. We aimed to investigate the association between DNA methylation levels of targeted genes and albuminuria in patients with early DN. Methods: We collected the clinical data of patients with type 2 diabetes mellitus. We measured spot urine albumin creatinine ratio to calculate albuminuria level. We divided patients into two groups based on albumin excretion as patients with (n = 69) and without DN (n = 27). We performed methylation profiling after bisulfite conversion by pyrosequencing method. The mean value of percent methylation level of each gene was calculated. Results: We compared targeted genes (TIMP-2, AKR1B1, MMP-2, MMP-9, MYL9, SCL2A4, SCL2A1, SCL4A3) methylation levels and albuminuria. We found significant negative correlation between TIMP-2 and AKR1B1 gene methylation levels and albuminuria levels. Conclusions: The present study provided evidence that hypomethylation of TIMP-2 and AKR1B1 genes can be associated with albuminuria in patients with early DN. We may speculate that the hypomethylation of TIMP-2 and AKR1B1 genes may be an early surrogate marker of DN.Öğe A Case of Ecstacy Induced Rhabdomyolysis and Acute Renal Failure(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2016) Sahan, Mustafa; Turgut, Faruk; Eren, Abdulrahim; Duru, Mehmet3,4-methylenedioxymethamphetamine (MDMA), popularly known as ecstasy, is a synthetic, psychoactive drug. MDMA has been reported to have several severe adverse effects including rhabdomyolysis, acute renal failure, liver failure and even sudden death. Herein, we present the case of a young man who presented with severe rhabdomyolysis and renal failure after taking 2 ecstasy pills. The patient initially received supportive care but he eventually needed hemodialysis.Öğe A case of lymphoma presented with acute renal failure(2017) Yaprak, Mustafa; İlhan, Gül; Bay, Feyyaz; Gezici, Ümran Güneş; Turgut, FarukKanser hastalarında da akut böbrek yetmezliği (ABY), normal popülasyonda olduğu gibi prerenal, renal ve postrenal nedenlere bağlı olarak ortaya çıkmaktadır. Böbreğe tümör infiltrasyonu genellikle yaygın değildir. Fakat akut lösemi veya lenfoma gibi hızlı büyüyen hematolojik malignitelerde tümör tutulumuna bağlı böbrek fonksiyonları bozulabilmektedir. Burada akut böbrek yetmezliği ile başvuran ve daha sonra lenf nodu biyopsisi ile B hücreli Nonhodgkin lenfoma tanısı alan bir olgu sunulmuştur. Tümör infiltrasyonuna bağlı ABY gelişmesi nadir olmakla birlikte, akut böbrek yetmezliği gelişimi açısından risk faktörü bulunmayan olgularda lösemik veya lenfomatöz infiltrasyon düşünülmelidir.Öğe A Case of Severe Hypernatremia and Rhabdomyolysis Treated by Hemodialysis without Sequelae(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2016) Yaprak, Mustafa; Turgut, Faruk; Sunger, Osman; Dayanan, Ramazan; Sikgenc, Mehmet Mahfuz; Akin, Selcuk; Degirmen, ElifHypernatremia is defined as plasma sodium concentration above 145 mEq/L. While severe symptoms are generally seen in case of plasma sodium concentration of 158 mEq/L, higher levels above 180 mEq/L are associated with a high mortality rate. Herein, a case of severe hypernatremia with a sodium level of 189 mEq/L and rhabdomyolysis treated by hemodialysis was presented. A 24-year-old woman was brought to the emergency department because of impaired general condition and confusion. She had a history of tuberculosis meningitis 1.5 years ago and left hemiplegia. Urea, creatinine, sodium, LDH and CK were 95 mg/dL, 2.6 mg/dL, 189 mEq/L, 1630 U/L, and 12601 U/L, respectively. The patient was diagnosed with hypernatremia, rhabdomyolysis and acute renal failure. Hemodialysis was performed because of anuria, increased urea and creatinine levels and metabolic acidosis. On the 5th day, the sodium level was reduced to 140 mEq/L. She was discharged from hospital uneventfully after the acute renal failure improved. In conclusion, both hypernatremia itself and its quick correction carry a risk of high mortality and morbidity. Therefore, in patients with chronic hypernatremia and need of dialysis, dialysate sodium should be lower than 10 mEq/L of serum sodium level, and if this is impossible, the duration of dialysis and blood flow rate should be reduced.Öğe Challenges Associated with Managing End-Stage Renal Disease in Extremely Morbid Obese Patients: Case Series and Literature Review(Karger, 2017) Turgut, Faruk; Abdel-Rahman, Emaad M.Obesity has grown into an epidemic across the globe. Mirroring this growth in the number of obese individuals in the general population, the prevalence of obesity and extremely morbid obesity (body mass index >50 kg/m(2)) is similarly rising in patients with end-stage renal disease (ESRD). Obesity, and more so, extremely morbid obesity, creates additional challenges for clinicians aiming at providing the best treatment options to patients with ESRD. Although literature is available regarding renal replacement therapy (RRT) for obese patients, literature about challenges facing clinicians managing ESRD in the extremely obese patients is lacking. Furthermore, the optimal strategies and goals for managing these patients with ESRD are not well defined. To our knowledge, no study has been done evaluating RRT options available to extremely morbid obese patients and the challenges associated with these options. Here, we report a case series and discuss the potential challenges faced by extremely obese patients with ESRD requiring RRT. (C) 2017 S. Karger AG, BaselÖğe Corneal endothelial cell density and microvascular changes of retina and optic disc in autosomal dominant polycystic kidney disease(Wolters Kluwer Medknow Publications, 2021) Kurtul, Bengi Ece; Elbeyli, Ahmet; Kakac, Ahmet; Turgut, FarukPurpose: Vascular endothelial dysfunction in autosomal dominant polycystic kidney disease (ADPKD) may affect the retinal vascular parameters due to structural similarities of kidney and retina. We aimed to evaluate the microvascular changes of retina and optic disc and also corneal endothelial cell density in patients with ADPKD. Methods: Forty-six eyes of 23 patients with ADPKD (Group 1), and 46 eyes of 23 sex- and age-matched healthy controls (Group 2) were included in this cross-sectional study. Demographic and ophthalmic findings of participants were collected. Corneal endothelial cell density (CECD) measurements were obtained by noncontact specular microscopy. Foveal retinal thickness, peripapillary retinal nerve fiber layer (RNFL) thickness, vessel density in different sections of the retina and optic nerve head were analyzed by optical coherence tomography angiography. Results: The mean ages were 41 +/- 11 years for Group 1 and 39 +/- 10 years for Group 2 (P = 0.313). CECD values were significantly lower in group 1 when compared to group 2 (2653 +/- 306 cells/mm(2) and 2864 +/- 244 cells/mm(2), respectively, P < 0.001). The foveal retinal thickness and RNFL thickness were similar, but superior quadrant thickness of RNFL was significantly lower in Group 1 than Group 2 (126 +/- 14 mu m vs. 135 +/- 15 mu m, P = 0.003). In Group 1, whole image of optic disc radial peripapillary capillary densities were significantly lower compared to Group 2 (49.4 +/- 2.04%, and 50.0 +/- 2.2%, respectively, P = 0.043). There was no significant difference regarding superficial, deep retinal vessel densities, foveal avascular zone and flow areas between the groups (P > 0.05 for all). Conclusion: Lower CECD values and decreased superior quadrant RNFL thickness, and microvascular densities of optic disc were revealed in patients with ADPKD. Evaluation of CECD and retinal microvasculature may be helpful in the management of these patients.Öğe Determinants of Outcomes of Acute Kidney Injury: Clinical Predictors and Beyond(Mdpi, 2021) Abdel-Rahman, Emaad M.; Turgut, Faruk; Gautam, Jitendra K.; Gautam, Samir C.Acute kidney injury (AKI) is a common clinical syndrome characterized by rapid impairment of kidney function. The incidence of AKI and its severe form AKI requiring dialysis (AKI-D) has been increasing over the years. AKI etiology may be multifactorial and is substantially associated with increased morbidity and mortality. The outcome of AKI-D can vary from partial or complete recovery to transitioning to chronic kidney disease, end stage kidney disease, or even death. Predicting outcomes of patients with AKI is crucial as it may allow clinicians to guide policy regarding adequate management of this problem and offer the best long-term options to their patients in advance. In this manuscript, we will review the current evidence regarding the determinants of AKI outcomes, focusing on AKI-D.Öğe Determination of perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) in food and beverages(Taylor & Francis Ltd, 2018) Sungur, Sana; Koroglu, Muaz; Turgut, FarukThe determination of perfluorooctanoic acid (PFOA) and perfluorooctanesulfonate (PFOS) in food and beverages sold in Turkey was carried out using liquid chromatography-tandem mass spectrometry (LC-MS/MS). A total of 123 samples of selected food and beverages such as fish, meat, offal, egg, cracker, chips, cake, chocolate, vegetable, milk and juice were examined. The highest PFOA concentrations were determined in cow meat (5.15 ng g(-1)), cow kidney (5.65 ng g(-1)), cow spleen (5.06 ng g(-1)) and chicken liver (5.02 ng g(-1)). The highest PFOS levels were found in horse mackerel (52.43 ng g(-1)), pike-perch (45.87 ng g(-1)), sardine (42.83 ng g(-1)) and black cod (41.33 ng g(-1)). Fish was found to be major source of the PFOS intake, while meat and offal were found to be major sources of the PFOA intake.Öğe Determination of Serum Perfluorooctanoic Acid and Perfluorooctanesulfonic Acid Levels with Different Stages of Chronic Kidney Disease(Wolters Kluwer Medknow Publications, 2021) Erdal, Huseyin; Sungur, Sana; Koroglu, Muaz; Turgut, FarukThe aim of this study is to investigate the perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS) levels in patients with different stages of chronic kidney disease (CKD). Sixty-one CKD stage 1-4 patients who applied to the nephrology outpatient clinic were recruited. A control group consisting of 26 age- and sex-matched healthy controls were also included in the study. Concentrations of PFOA and PFOS were determined by comparing their peak areas with their standard curves. All samples were analyzed three times. The average values of blank samples were subtracted from the detected PFOA and PFOS values. PFOA and PFOS levels were significantly higher in CKD group than the controls (11.4 +/- 7.47, 0.45 +/- 0.55; 0.13 +/- 0. 17, 0.19 +/- 0.4 ng/mL, respectively) (P = 0.001). Hemoglobin, serum albumin, and estimated glomerular filtration rate (eGFR) levels were significantly lower and potassium and uric acid levels were higher in the CKD group than the controls. PFOA and PFOS levels were significantly higher in all stages of CKD patients than healthy controls. However, there was no correlation between eGFR, and PFOS and PFOA. We have demonstrated significantly increased PFOA and PFOS concentrations in different stages of CKD patients. We could not find an association between eGFR, age, and serum PFOS and PFOA concentrations.Öğe Dialysis Requirement and Long-Term Major Adverse Cardiovascular Events in Patients with Chronic Kidney Disease and Superimposed Acute Kidney Injury(Karger, 2017) Omotoso, Bolanle A.; Turgut, Faruk; Abdel-Rahman, Emaad M.; Xin, Wenjun; Ma, Jennie Z.; Scully, Kenneth W.; Arogundade, Fatiu A.Background: Chronic kidney disease (CKD) patients who experience superimposed acute kidney injury (AKI) have been shown to be at higher risk of long-term sequelae of AKI when compared to those who do not experience AKI. It remains unclear whether the need for temporary dialysis intervention following superimposed AKI in patients with CKD has any effect on the long-term major adverse cardiovascular events (MACE). This study examines the relationship between temporary dialysis therapy following AKI and long-term major cardiovascular events in patients with background CKD. Methods: The study population consists of adults who developed AKI while on admission at the University of Virginia Medical Center between January 1, 2002 and December 31, 2012, and who had preadmission estimated glomerular filtration rate (eGFR) between 20 and 60 mL/min/1.73 m(2) and survived beyond 30 days of AKI. Demographic and baseline clinical variables were used to generate propensity score. Survivors who had temporary dialysis were matched to those managed conservatively according to the propensity score in a ratio of 1:3. Results: Overall, 6,634 (n = 381 and 6,253 in the temporary dialysis-requiring AKI and non-dialysis AKI groups respectively) met entry criteria for the full cohort. Of these, 381 (5.7%) received temporary dialysis. There were 3,147 (47.4% of all patients) MACE events during the study period. The crude incidence for MACE after 30 days of AKI was similar in both dialyzed and non-dialyzed patients. After the propensity score matching, the adjusted hazard ratio for MACE in dialyzed versus non dialyzed patients was 1.162 (95% CI 0.978-1.381). Conclusions: Treatment of AKI with temporary dialysis in hospitalized patients with baseline eGFR between 20 and 60 mL/min/1.73 m(2) was not associated with an increased risk for subsequent admission for MACE. If confirmed by prospective studies, clinicians may not need to worry that the dialysis procedure may contribute to additional risk for long-term MACE in CKD patients with superimposed AKI. (C) 2017 S. Karger AG, BaselÖğe Diyabet hastalarında serum magnezyum düzeyi ile glisemik regülasyon ve proteinüri arasındaki ilişki(Celal Bayar Üniversitesi, 2020) Mısırlıoğlu, Mehmet Ali; Erdal, Hüseyin; Özcan, Oğuzhan; Turgut, FarukGiriş ve Amaç: Magnezyum vücutta birçok önemli fonksiyonu olan eser elementlerden biridir. Magnezyum eksikliğinde en sık karşılaşılan klinik problemlerden birisi insülin direncidir. Diyabet son dönem böbrek hastalığının en sık nedenidir. Magnezyum eksikliği diyabetik hastalarda sık görülmektedir ve diyabet komplikasyonları ile ilişkili olduğu gösterilmiştir. Bu çalışmada diyabetik hastalarda serum magnezyum düzeyi ile glisemik regülasyon ve proteinüri arasında ilişki olup olmadığının araştırılması amaçlanmıştır. Gereç ve Yöntemler: Bu kesitsel çalışmaya 189 Tip 2 diabetes mellitus (DM) hastası alındı. Hastaların demografik ve klinik özellikleri ile kan basınçları kaydedildi. Hastalardan alınan serum örneklerinden glukoz, Hemoglobin A1c (HbA1c), BUN, kreatinin, elektrolitler, lipit profili, magnezyum, kalsiyum düzeyleri ve tam kan sayımı çalışıldı. 24 saatlik idrarda proteinüri bakıldı. Bulgular: Hipomagnezemi (<1,7 mg/dl) 64 hastada (% 34) saptandı. Hipomagnezemi grubunda ortalama glukoz ve HbA1c düzeyleri anlamlı bir şekilde daha yüksek saptandı. Aynı şekilde hipomagnezemi grubunda ortalama proteinüri miktarı belirgin olarak daha yüksek bulundu. Serum magnezyum düzeyi ile HbA1c, glukoz ve proteinüri değerleri arasında zayıf da olsa negatif bir korelasyon saptandı (sırasıyla r=-0.187, p= 0.011, r=-0.152, p=0.039, r=-0.149, p=0.044). Serum magnezyum düzeyi ile yaş, beden kitle indeksi, eGFR, diyastolik ve sistolik kan basıncı arasında anlamlı bir ilişki saptanmadı. Sonuç: Hipomagnezemi Tip 2 DM hastalarında sık görülmektedir. Glisemi regülasyonu bozuk olan diyabetik hastalarda serum magnezyum düzeyinin kontrol edilmesi önemlidir. Bu hasta grubunda serum magnezyum düzeyi ile glisemi regülasyonu ve proteinüri arasında zayıf da olsa anlamlı bir ilişki olabilir.Öğe Electrolyte Abnormalities in Patients with Type 2 Diabetes Mellitus(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2017) Ozsan, Muge; Yaprak, Mustafa; Ozcan, Oguzhan; Kiriktir, Esra; Turgut, FarukOBJECTIVE: The aim of the was is to evaluate electrolyte changes and the relationship between electrolytes and glucose regulation in type 2 diabetic patients. MATERIAL and METHODS: Data of diabetic patients aged 30-90 years who came to the Endocrinology and Metabolism and the Nephrology outpatient clinics between 01.02.2015 and 30.12.2015 for any reason were reviewed. Patients with type 1 diabetes mellitus, using diuretics, renin-angiotensin-aldosterone system blockers or combination of these drugs, or calcium, magnesium, vitamin D supplementation, patients with vomiting and diarrhea, serious heart failure, cirrhosis, active malignancy, estimated glomerular filtration rate <= 60 mL/min 1.73 m(2), and those diagnosed with diabetic ketoacidosis are excluded from the study. RESULTS: According to the inclusion and exclusion criteria, 323 type 2 diabetic patients consisting of 161 women and 162 men were evaluated. Hypomagnesemia was the major electrolyte problem in our study group with a prevalence of 20.2%. A negative correlation was observed between serum glucose and sodium (p<0.05; r=-0.28). There was no correlation between glucose and other electrolytes (potassium, calcium, phosphorus and magnesium). CONCLUSION: Electrolyte imbalances are frequently seen in diabetic patients because of physiopathologic changes and therapeutic drugs as well as comorbidities. Evaluation of electrolytes during the follow up period of these patients, and in the case of any electrolyte abnormalities their appropriate management is important for decreasing both mortality and morbidity.Öğe Fabry Disease: The Role of Screening for Early Diagnosis(Aves, 2024) Turgut, Faruk[Abstract Not Available]Öğe Hatay ilinde yüksek hemodiyaliz hasta sayısı ve olası nedenler(2016) Turgut, Faruk; Yaprak, Mustafa; Özsan, Müge; Güler, Gökhan; Bardakçı, MehmetHatay ilinde hemodiyaliz tedavisi alan hasta sayılarının ve altta yatan böbrek hastalığı nedenlerinin tüm Türkiye değerleri ile karşılaştırılması ve nedenlerinin tartışılması amaçlandı. GEREÇ ve YÖNTEMLER: Çalışmamızda, Hatay ilinde kronik hemodiyaliz programında olan hasta sayıları ve altta yatan böbrek hastalığı nedenleri hemodiyaliz merkezlerinden toplanarak kaydedildi. Türkiye geneli ve komşu illerde hemodiyaliz programında olan hasta verileri için; Sağlık Bakanlığı Türkiye Diyaliz Bilgi Yönetim Sistemi (DYOB) verileri ve Türk Nefroloji Derneği kayıt sistemi verileri kullanıldı. BULGULAR: Hatay'a komşu iller ile kıyaslandığında hemodiyalize giren hasta sayısının milyon nüfus başına oldukça yüksek olduğu gözlendi. 2014 yılı sonu itibari ile hemodiyaliz tedavisi almakta olan hasta sayısı 1.487 olup, milyon nüfus başına prevalans 978, insidans 156 olarak bulundu. Bölgemizde Türkiye geneli ile karşılaştırıldığında hem prevalans hem de insidans belirgin olarak daha yüksek saptandı. Hatay ilinde hemodiyaliz hastalarında son dönem böbrek hastalığının altta yatan etiyolojik nedenlerine bakıldığında diyabet %46,2 ile en sık, hipertansiyon %27,1 ile ikinci en sık neden olarak bulundu.SONUÇ: Çalışmamızda, SDBH prevalansı ve diyabete bağlı böbrek hastalığı ülkemiz geneli ile karşılaştırıldığında bölgemizde daha yüksek bulunmuştur ve diyabetin bölge için önemli bir sağlık sorunu olduğu ortaya konmuşturÖğe The High Number of Hemodialysis Patients in Hatay Province and Possible Causes(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2016) Turgut, Faruk; Yaprak, Mustafa; Ozsan, Muge; Guler, Gokhan; Bardakci, MehmetOBJECTIVE: We aimed to compare the number of the patients receiving hemodialysis therapy and the causes of underlying renal disease in Hatay and Turkey, and to discuss the possible causes. MATERIAL and METHODS: The number of the patients on chronic hemodialysis, and the causes of underlying renal disease were recorded from hemodialysis centers in Hatay. The Ministry of Health of Turkey Dialysis Information Management System data and Turkish Society of Nephrology Registry data were used to obtain data of the patients on chronic hemodialysis in Turkey in general and in the neighboring provinces. RESULTS: It was observed that the number of hemodialysis patients per million population was quite high compared to the neighboring provinces. By the year 2014, the number of patients receiving hemodialysis was 1.487 with a prevalence of 978 and an incidence of 156 per million population. Both the prevalence and incidence were quite high in our region compared with the general numbers for Turkey. When we looked at the causes of underlying renal disease in hemodialysis patients in Hatay province, the most common cause was diabetes at 46.2% and hypertension was the second most common cause at 27.1%. CONCLUSION: The prevalence of end-stage renal disease and diabetic kidney disease was found to be quite high compared to the general numbers for Turkey and the results showed that diabetes is an important health problem for the region.Öğe Higher Serum Bisphenol A Levels in Diabetic Hemodialysis Patients(Karger, 2016) Turgut, Faruk; Sungur, Sana; Okur, Ramazan; Yaprak, Mustafa; Ozsan, Muge; Ustun, Ihsan; Gokce, CumaliBackground: Bisphenol A (BPA) has been implicated as an 'endocrine disruptor'. We aimed at exploring the association between serum BPA levels and patient characteristics, particularly the presence of diabetes mellitus, and laboratory parameters in hemodialysis patients. Methods: This study included 47 chronic hemodialysis patients. Patient characteristics were recorded. Blood was drawn before and after hemodialysis session. Serum BPA levels were measured by the high-performance-liquid-chromatography and laboratory parameters were measured by using standard methods. Results: In hemodialysis patients, postdialysis serum BPA levels were significantly higher than predialysis after a single hemodialysis session (5.57 +/- 1.2 vs. 4.06 +/- 0.73, p < 0.0001). Predialysis serum BPA levels were significantly higher in patients with diabetes than non-diabetics (4.4 +/- 0.6 vs. 3.9 +/- 0.7, p = 0.025). No association was found between serum BPA levels and patient characteristics, and particularly laboratory parameters. Conclusion: Serum BPA levels were rising significantly after a single dialysis session. Diabetic hemodialysis patients had higher predialysis serum BPA levels. (C) 2016 S. Karger AG, BaselÖğe How lipid-lowering agents work: The good, the bad, and the ugly(Springer New York, 2014) Turgut, Faruk; Ustun, Ihsan; Go, CumaliHyperlipidemia in the general population is strongly associated with atherosclerotic cardiovascular disease. Dyslipidemia is a common finding in patients with chronic kidney disease (CKD) at all stages. Trial results from the general population may not be applicable to all patients with CKD because they have a different lipid profile with increased atherogenic lipid fractions. Lipid-lowering therapies in these patients may have substantial benefit. Statin therapy is recommended in patients with CKD of any stage if they have elevated serum cholesterol levels. Treatment of dyslipidemia in patients with early stage CKD clearly reduces cardiovascular risk; however, available data do not support a strong nephroprotective role for statins in CKD population. In contrast to the predialysis patient population, statins do not seem to have substantial improvement in cardiovascular outcomes in dialysis patients. Although fibrates can be used to treat mixed dyslipidemia, they need to be used carefully in patients with CKD, and limited available data suggest that fibrates may have a place in reducing cardiovascular risk in patients with mild to moderate CKD. © Springer Science+Business Media New York 2014.Öğe Hypertension in the Elderly Unique Challenges and Management(W B Saunders Co-Elsevier Inc, 2013) Turgut, Faruk; Yesil, Yusuf; Balogun, Rasheed A.; Abdel-Rahman, Emaad M.Elderly individuals, worldwide, are on the rise, posing new challenges to care providers. Hypertension is highly prevalent in elderly individuals, and multiple challenges face care providers while managing it. In addition to treating hypertension, the physician must treat other modifiable cardiovascular risk factors in patients with or without diabetes mellitus or chronic kidney disease to reduce cardiovascular events and mortality. This review discusses some of the unique characteristics of high blood pressure in the elderly and provides an overview of the challenges facing care providers, as well as the current recommendations for management of hypertension in the elderly.
