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Öğe Evaluation of the Association of Serum Sclerostin and Carotid Intima Media Thickness with Chronic Kidney Failure and Kidney Transplantation(Taiwan Society of Geriatric Emergency and Critical Care Medicine (TSGECM), 2024) Keskiner, Ozlem Oguz; Ozturk, Yasin; Ozer, Hakan; Baloglu, İsmail; Uysal, Saliha; Toker, Aysun; Keskin, SuatPurpose: This study aimed to determine the serum sclerostin levels in kidney transplant recipients, dialysis patients, and patients with non-dialysis chronic kidney disease (CKD), and evaluate their associations with carotid intima-media thickness (CIMT) and carotid artery plaque presence. Methods: The study groups included kidney transplant recipients (n = 61), dialysis patients (n = 43), non-dialysis CKD patients (n = 43), and healthy controls (n = 19). Serum sclerostin levels were measured by the ELISA method. All participants underwent imaging tests for the evaluations of CIMT and carotid plaque presence. Results: Serum sclerostin levels were highest in dialysis patients, followed by the non-dialysis CKD group. Kidney transplant patients and healthy controls had the lowest sclerostin levels. There was a positive correlation between CIMT and sclerostin levels in the CKD group. Sclerostin levels were significantly high in individuals with calcified plaques. Conclusion: The CIMT and serum sclerostin levels of kidney transplant recipients compared to those of CKD patients with and without dialysis may suggest that transplantation may prevent further atherosclerosis, with sclerostin levels promising a predictive role. © 2024, Taiwan Society of Geriatric Emergency & Critical Care Medicine.Öğe Liver-Spleen Ratio: Can It Be Used for the Prediction of Coronary Artery Disease?(Aves, 2022) Poyraz, Necdet; Ozer, Hakan; Baloglu, Ismail; Kadiyoran, Cengiz; Yilmaz, Pinar Diydem; Sertdemir, Ahmet Lutfu; Turkmen, KultiginBackground: Considering that ectopic fat accumulation in various organs, especially the heart and liver, is a cardiometabolic risk factor, the need for easily accessible markers of ectopic fat accumulation is inevitable. The main starting point of the study is based on the hypothesis of predicting cardiovascular disease risk through the link that can be established between the liver-spleen ratio, which is one of the strong indicators of hepatosteatosis, and epicardial adipose tissue volume. Methods: This was a retrospective study. The records of 283 consecutive patients who underwent coronary computed tomography angiography in our Radiology Department were reviewed retrospectively from our hospital's system. All patients' epicardial adipose tissue volume and liver-spleen ratio were calculated using appropriate criteria on non-contrast computed tomography images. Additionally, the Coronary Artery Disease-Reporting and Data System was calculated on contrast computed tomography images. The participating patients were divided into groups according to the liver-spleen ratio and Coronary Artery Disease-Reporting and Data System score. Results: We found that while there was a negative correlation between the liver-spleen ratio and epicardial adipose tissue volume in the hepatosteatosis group, this relationship was not observed in the non-steatosis group. In addition, we observed that the family history of cardiovascular disease and the frequency of cardiovascular disease were higher in the hepatosteatosis group than in the other group, and there was a correlation between cardiovascular disease and the liver-spleen ratio. Also, we found that age and liver- spleen ratio values were found to be independent predictors of coronary artery disease. Conclusion: In our study, we found that the frequency of cardiovascular disease was lower in patients with a high liver-spleen ratio. We also demonstrated in the study that the liver-spleen ratio, which indicates a low level of epicardial adipose tissue volume accumulation, is an independent predictor of cardiovascular disease. In addition, the use of liver-spleen ratio, which is more valuable than liver attenuation in predicting hepatic steatosis, may be more useful in evaluating the risk of hepatosteatosis-related cardiovascular disease.Öğe Membranous Nephropathy: Current Understanding in The Light of New Advances(Aves, 2023) Ozer, Hakan; Baloglu, Ismail; Fervenza, Fernando C.; Turkmen, KultiginMembranous nephropathy is the most common cause of primary nephrotic syndrome in adults. The most important mech-anism in its pathogenesis is loss of immune tolerance. New developments in membranous nephropathy are mostly related to the diagnosis and treatment of the disease, and until recently, the gold standard method in diagnosis was a kidney biopsy. In recent years, many membranous nephropathy-associated antigens and antibodies have been identified. The increased availability of these biomarkers is beneficial in predicting the treatment response, determining the treatment plan, and eliminating the necessity of kidney biopsy in the diagnosis of membranous nephropathy. Because of both the difference in treatment responses and the treatment-related side effects, membranous nephropathy treatment should be individualized. In addition, it is recommended to make a treatment plan by calculating the risk of progressive kidney fail-ure of the disease. Parallel to the changes in diagnosis and follow-up, treatment plans in membranous nephropathy have undergone severe changes in recent years. As the autoimmunity targets in the pathogenesis of the disease become clearer, treatment has turned to more specific therapies that are more selective in targeting antibody-producing cells, such as rituximab. This article described the new developments in the pathogenesis, diagnosis, and treatment of membranous nephropathy.Öğe Monocyte-HDL Ratio: Can It Be Included in the Follow-Up of Diabetes Mellitus and Diagnosis of Diabetic Nephropathy?(2023) Ozer, Hakan; Aydoğan, Kader Zeybek; Ozturk, Yasin; Yonet, Fethi; Baloglu, IsmailBackground and Aim: Diabetic nephropathy is the most common cause of end-stage renal disease and albuminuria is the earliest manifestation of diabetic nephropathy.Oxidative stress and inflammation caused by advanced glyco-oxidation end products contribute to micro and macrovascular complications of diabetes. Monocyte to high-density lipoprotein (HDL) cholesterol ratio (MHR) is an essential indicator of inflammation and oxidative stress. In this study, we aimed to reveal the relationship between diabetes regulation and complications and MHR. Material and Method: A total of 182 subjects, including 152 patients with diabetes mellitus (DM) and 30 healthy controls, were included in this study. All data of the subjects were scanned retrospectively. The DM group was divided into two groups nephropathy (n=68) and non-nephropathy (n=84), with a limit of 30 mg/day for albuminuria. MHR was calculated by dividing the monocyte count by the HDL cholesterol count. Results: When patients with DM were divided into nephropathy and non-nephropathy, patients with nephropathy had higher MHR levels than the other group. We showed that MHR correlated with albuminuria, creatinine, and HbA1c in patients with diabetic nephropathy. In addition, in the regression analysis, albuminuria and MHR were predictors of DN, while MHR, age, and creatinine were found to be independent predictors of albuminuria. Conclusion: MHR, which is an easily calculated marker with simple laboratory tests, which is frequently requested in routine practice in the follow-up of diabetes patients, can help predict the regulation of diabetes and its kidney complications.Öğe The relationship between FGF23 and anemia in HD and renal transplant patients(Springer, 2022) Baloglu, Ismail; Ozer, Hakan; Ozturk, Yasin; Erdur, Mehmet Fatih; Tonbul, Halil Zeki; Turkmen, KultiginPurpose Recent studies claim that FGF23 is also associated with anemia and inflammation. In this study, the relationship between FGF23 and anemia in hemodialysis (HD) and renal transplantation patients (RTx patients) patients was investigated. Methods This was a cross-sectional study involving 40 RTx patients (13 females, 27 males; mean age, 45.93 +/- 12.49 years) who had transplantation at least 6 months before, 25 HD patients (12 females, 13 males; mean age, 54.72 +/- 15.5 years), and 20 healthy control subjects (13 females, 7 males; mean age, 36.7 +/- 9.38 years). FGF23 was studied using Elisa method. Parameters such as iron, ferritin, total iron binding capacity, and transferrin saturation were assessed. Results FGF23 level was significantly higher in HD patients when compared with the RTx patients and control groups. In the bivariate correlation analysis, hemoglobin was positively correlated with albumin (r = 0.681, p = 0.000), ferritin (r = 0.446, p = 0.043), and negatively correlated with CRP (r = - 0.476, p = 0.016) and FGF23 (r = 0.493, p = 0.043). FGF23 was found to be an independent predictor of decreased hemoglobin in HD patients. In addition, this association was observed to disappear after transplantation. Conclusion While FGF23 is closely related to hemoglobin levels in HD patients, we have shown that this relationship disappears after transplantation.Öğe Two Different Presentation of C3 Glomerulonephritis Treated with Eculizumab: Two Cases and Brief Overview(Aves, 2023) Ozturk, Yasin; Ozer, Hakan; Baloglu, Ismail; Turkmen, KultiginC3 glomerulopathy is a newly defined glomerular disease dominated by C3 complement storage and uncertain C1, C4, and immunoglobin accumulations. Hereditary mutations associated with Complement Factor H (CFH) causing hyperactivation of the alternative complement pathway were identified. Most mutations associated with C3 glomerulopathy are associated with the N-terminal end. Whether mutations are pathogenic or not will direct diagnosis and treatment. We present 2 cases, one 61-year-old and one 24-year-old attending our clinic at different times with hematuria, proteinuria, edema, and kidney failure. Both patients had C3 glomerulopathy diagnosed based on the results of kidney biopsy and were treated with eculizumab. Both cases had CFH-associated mutations.
