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    Retrospective Evaluation of Therapeutic Plasma Exchange in Nephrology Clinic: A Single-Center Experience
    (Aves, 2023) Serin, Hatice Ozge; Baloglu, Ismail; Tonbul, Halil Zeki; Turkmen, Kultigin; Selcuk, Nedim Yilmaz
    Objective: The indication for use of therapeutic plasma exchange has been increasing in recent years. It is a method that contributes significantly to the reduction of mortality and morbidity with immunosuppressive treatments in many life -threatening diseases. The aim of this study is to examine, research, and develop therapeutic plasmapheresis procedures performed in a nephrology department.Methods: In this study, we retrospectively reviewed the therapeutic plasma exchange procedures performed in our center. The demographic characteristics, clinical features, and laboratory results before and after the procedure of all patients were screened.Results: A total of 67 patients (36 females, 31 males; mean age, 45.73 +/- 15.89 years) and 398 apheresis sessions were analyzed. The most common nephrological indication of the therapeutic plasma exchange was acute humoral rejection (40.3%). When the laboratory values of the patients before and after the procedure were examined, it was observed that there was a statistically significant decrease in creatinine and platelet values after the procedure and a significant increase in bicarbonate values. When therapeutic plasma exchange was performed for hemolytic uremic syndrome, it was found that there was a decrease in lactate dehydrogenase level and an increase in platelet count. Complications were detected in 2 of the patients during the procedure.Conclusion: Therapeutic plasmapheresis exchange can be performed by many different indications in a nephrology department. Acute humoral rejection was the most common indication for plasmapheresis in our center. We think that the procedure performed with the right indications will contribute to better outcomes.
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    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, Kultigin
    Purpose 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.