Nurhan Seyahi

Istanbul University, İstanbul, Istanbul, Turkey

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Publications (39)106.28 Total impact

  • The journal of vascular access 03/2015; DOI:10.5301/jva.5000352 · 1.02 Impact Factor
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    ABSTRACT: Data on transplantation survival is widely available for developed countries where cadaveric transplantation is the dominant transplantation type. We aimed to assess patient and graft survival and to determine the possible factors affecting graft survival in a developing country where kidney transplantations were mainly performed from living donors. We retrospectively analyzed data from 427 adult kidney transplantations performed at our center from January 1990 to November 2010. We collected data from patient files, including characteristics of the recipients and donors, transplantation-related factors, post-transplantation features, causes of graft loss, and patient death. The Kaplan-Meier method was used to analyze survival, and Cox regression analysis was used to evaluate the effects of multiple factors on graft survival. Most of the recipients (82.6%) received their organs from living donors. One-year and 5-year graft survival rates were 87.5% and 78.3%, respectively, where the 5-year graft survival rates were 87.1% for living donors and 74.8% for cadaveric donors. The 1-year and 5-year patient survival rates were 90.9% and 88.9%, respectively. Univariate analysis showed that predictors for better graft survival were serum creatinine levels <1.5 mg/dL at 1 month after transplantation, proteinuria <500 mg/d at 1 year after transplantation, use of tacrolimus and mycophenolic acid derivative-based immunosuppression at baseline, living-donor transplantation, and transplantations performed in the years 2000-2010. We report data on kidney transplantation in an emerging country where living-donor transplantation constitutes a large proportion of kidney transplant activities. Modern immunosuppressive medications help to achieve a better survival. Our 5-year results are similar to those of developed countries. Copyright © 2015 Elsevier Inc. All rights reserved.
    Transplantation Proceedings 03/2015; 47(2):348-353. DOI:10.1016/j.transproceed.2014.10.054 · 0.95 Impact Factor
  • 01/2015; 24(01):10-16. DOI:10.5262/tndt.2015.1001.02
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    ABSTRACT: Abstract Aim: The relation of chronic kidney disease (CKD) with metabolic, psychiatric and endocrinologic disorder is well-known. Depressive mood and sexual dysfunction are frequently observed as renal functions deteriorate. We aimed to analyze the relationship of sexual dysfunction, depressive mood and life quality in patients with CKD at predialysis stage. Patients and methods: Fifty-three patients; 27 female and 26 male with CKD who had estimated glomerular filtration rate (eGFR) between 15 and 90 mL/min and followed up in the Nephrology Department, Bursa Sevket Yılmaz Education and Research Hospital, were enrolled. Age- and sex-matched 20 female and 20 male healthy control subjects were assigned to the control group. Detailed medical and sexual history was obtained by using Female Sexual Function Index (FSFI), Erectile Function International Evaluation Form (IEFF), Short form (SF) 36 Form and Beck Depression Questionnaire (BDI). Biochemical and hormonal parameters including urea, creatinine, uric acid, sedimentation rate, c-reactive protein, total testosterone, DHEA-S, FSH, LH, TSH, estradiol and prolactin were analyzed. Findings: Depression was observed in 12 male (46%) and 14 female (51%) patients. The frequency of depression among male patients and control subjects was similar, however, significantly higher in female patients than female controls (p = 0.036). Physical function score, physical role score and pain score in SF 36 of entire patients were significantly lower than controls (p = 0.0001, 0.0001, 0.001, respectively). The frequency of depression was similar between patients and controls (p > 0.05). When SF 36 tests of male and female patients were compared, general health status, vitality and mental health status were significantly better in male patients (p = 0.005, 0.016, 0.035, respectively). SF 36 scores of female patients were significantly lower than female controls (p = 0.0001). The frequency of erectile dysfunction (ED) was similar between male patients (84%) and controls (75%) (p = 0.62). On the other hand, sexual dysfunction was significantly higher in female patients when compared to female controls (92% vs. 30%; p = 0.0001). Conclusion: We showed that sexual dysfunction and depression are more frequent among female patients with CKD at predialysis stage; however, it does not have significant impact on life quality. When life quality of female and male patients was compared, general health status, vitality and mental health status of female patients were poorer. We failed to demonstrate a relationship between sexual dysfunction and sex hormone level.
    Renal Failure 12/2014; 37(2):1-6. DOI:10.3109/0886022X.2014.990348 · 0.78 Impact Factor
  • Article: Abstracts.
  • Annals of Noninvasive Electrocardiology 11/2014; DOI:10.1111/anec.12225 · 1.08 Impact Factor
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    ABSTRACT: BACKGROUND: The aim of our study was to delineate the demographic and clinical properties of primary glomerular diseases of adult population in our country in the light of global knowledge. METHODS: All over the country, a total of 25 centers entered data between May 2009 and July 2012 to the database created by 'Glomerulonephritis Study Group' of Turkish Society of Nephrology. Demographic and clinical characteristics, specific diagnoses of glomerular diseases and biopsy findings recorded to the database were analyzed. RESULTS: Among the 1,274 patients, who had renal biopsy within the defined time period, 55 % were male and 45 % were female. The mean age was 40.8 ± 14.6 years. The most frequent indication for biopsy was nephrotic syndrome (57.8 %), followed by nephritic syndrome including rapidly progressive glomerulonephritis (16.6 %) and asymptomatic urinary abnormalities (10.8 %). The most frequent primary glomerular disease was membranous nephropathy (28.8 %), followed by focal segmental glomerulosclerosis (19.3 %) and IgA nephropathy (17.2 %). CONCLUSION: The presented study displayed important data about the epidemiology of primary glomerular diseases among adults in our country. The predominance of membranous nephropathy in contrast to other countries, in which the most frequent etiology is IgA nephropathy, seems to be due to differences in the indications for renal biopsy.
    International Urology and Nephrology 09/2014; DOI:10.1007/s11255-014-0838-3 · 1.29 Impact Factor
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    ABSTRACT: Background: Data on the long-term mortality and morbidity of living kidney donors are scarce. In the general population, coronary artery calcification (CAC) and progression of CAC are predictors of future cardiac risk. We conducted a study to determine the progression of CAC in renal transplant donors. Methods: We used multidetector computed tomography to examine CAC in 75 former renal transplant donors. A baseline and a follow-up scan were performed and changes in CAC scores were evaluated in each subject individually to calculate the incidence of CAC progression. Results: Baseline CAC prevalence was 16% and the mean CAC score was 5.3 ± 25.8. At the follow-up scan that was performed after an average of 4.8 ± 0.3 years, CAC prevalence increased to 72% and the mean CAC score to 12.5 ± 23.4. Progression of the individual CAC score was found between 18.7 and 26.7%, depending on the method used to define progression. In patients with baseline CAC, the mean annualized rate of CAC progression was 2.1. Presence of hypertension, high systolic blood pressure and an increase in BMI were the determinants of CAC progression. Conclusions: The rate of CAC progression does not seem to be high in carefully selected donors. © 2014 S. Karger AG, Basel.
    Nephron Clinical Practice 04/2014; 126(3):144-150. DOI:10.1159/000362169 · 1.65 Impact Factor
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    ABSTRACT: Metabolic syndrome, which is closely related to insulin resistance, is highly prevalent in renal transplant recipients. We aimed to investigate prevalence, risk factors, and progression of metabolic syndrome in renal transplant recipients. One hundred fifty-eight renal transplant recipients who had been on transplantation for more than 1 year and 79 age-sex matched healthy controls were included in the cross-sectional phase of the study. We measured baseline characteristics, blood pressure, fasting blood glucose, and lipid profiles and we defined metabolic syndrome using the National Cholesterol Education Program Adult Treatment Panel III criteria. One hundred twenty-four renal transplant recipients were eligible for the second evaluation after 22.9 ± 3.8 months. Metabolic syndrome prevalence and homeostasis model assessment insulin resistance levels were evaluated during the follow-up period. Overall, metabolic syndrome was present in 34.2% of the patients and 12.7% of the controls at the cross-sectional phase of the study (P = .000). Only the hypertension component of metabolic syndrome was significantly increased in patients compared to controls (P = .000). Pretransplantation weight and body mass index were significantly higher in patients who had metabolic syndrome (P = .000). During the follow-up period, prevalence of metabolic syndrome did not change (P = .510); however, body mass index and blood pressure increased and the high density lipoprotein cholesterol component of metabolic syndrome decreased (P = .001). We did not find any significant difference in glomerular filtration rate change among patients with and without metabolic syndrome (-2.2 ± 11.36 vs -6.14 ± 13.19; P = .091). Glucose metabolism parameters including hemoglobin A1c, insulin, and homeostasis model assessment insulin resistance were disturbed in patients with metabolic syndrome (P = .000, P = .001, P = .002, respectively). Metabolic syndrome is highly prevalent in renal transplant recipients and closely associated with insulin resistance. The prominent criterion of metabolic syndrome in patients seems to be hypertension, especially high systolic blood pressure. The identification of metabolic syndrome as a risk factor may yield new treatment modalities to prevent it.
    Transplantation Proceedings 11/2013; 45(9):3273-8. DOI:10.1016/j.transproceed.2013.06.005 · 0.95 Impact Factor
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    ABSTRACT: Abstract We aimed to investigate the performance of various creatinine based glomerular filtration rate estimation equations that were widely used in clinical practice in Turkey and calculate a correction coefficient to obtain a better estimate using the isotope dilution mass spectrometry (IDMS)-traceable Modification of the Diet in Renal Disease (MDRD) formula. This cross-sectional study included adult (>18 years) outpatients and in patients with chronic kidney disease as well as healthy volunteers. Iohexol clearance was measured and the precisions and bias of the various estimation equations were calculated. A correction coefficient for the IDMS-traceable MDRD was also calculated. A total of 229 (113 male/116 female; mean age 53.9 ± 14.4 years) subjects were examined. A median iohexol clearance of 39.21 mL/min/1.73 m(2) (range: 6.01-168.47 mL/min/1.73 m(2)) was found. Bias and random error for the IDMS-traceable MDRD equation were 11.33 ± 8.97 mL/min/1.73 m(2) and 14.21 mL/min/1.73 m(2), respectively. MDRD formula seems to provide the best estimates. To obtain the best agreement with iohexol clearance, a correction factor of 0.804 must be introduced to IDMS-traceable MDRD equation for our study population.
    Renal Failure 07/2013; DOI:10.3109/0886022X.2013.817278 · 0.78 Impact Factor
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    ABSTRACT: Candidal infections occur commonly in renal transplant recipients especially in genitourinary system. Although the epidemiology of candiduria has not been well characterized in renal transplant population, it is the most common cause of fungal infections. However, candidal psoas abscess is very rare in the literature. We report a 42-year-old male renal transplant recipient with prolonged pyuria and candiduria followed by candidal psoas abscess formation. The treatment consisted of prolonged antifungal therapy along with percutaneous drainage. However, eventually, a surgical drainage had to be performed for the successful eradication.
    International Urology and Nephrology 11/2012; DOI:10.1007/s11255-012-0316-8 · 1.29 Impact Factor
  • 01/2012; 21(01):101-104. DOI:10.5262/tndt.2012.1001.19
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    Cells Tissues Organs 01/2012; · 2.14 Impact Factor
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    ABSTRACT: Kidney assessment before transplantation is very important especially on the back-table preparation. Besides evaluation of viability, vascular structure and the ureter anatomy of the transplant candidate kidney, visible masses which could be placed on the kidney architecture should be carefully evaluated. A 44-year-old man was prepared as a heart-beating cadaver after brain death due to subarachnoid hemorrhage. The donor’s left kidney was removed in a hospital and sent to our clinic for transplantation. We had prepared our recipient and the patient was taken into the operating theatre. We opened the preservation box and took the graft kidney to the back table after the patient had been anaesthetized just before the skin incision. The graft kidney had been put in solution with ice. There were frozen and necrotic areas on the surface of the kidney. We observed a mass lesion of 1.5 cm diameter on the middle-lateral surface of the kidney (Figure 1). We decided that the graft kidney was inappropriate for transplantation. The kidney was sent for histological evaluation and the patient had been awakened. Papillary renal cell carcinoma was diagnosed by histological evaluation. Many sophisticated and complex techniques are being tried to use marginal organs for transplantation as a result of high pressing necessity. However, the simple techniques of kidney harvesting and preservation are not known or not considered in some centers.
  • Heart (British Cardiac Society) 10/2011; 97(Suppl 3):A186-A186. DOI:10.1136/heartjnl-2011-300867.544 · 6.02 Impact Factor
  • Heart (British Cardiac Society) 10/2011; 97(Suppl 3):A186-A186. DOI:10.1136/heartjnl-2011-300867.545 · 6.02 Impact Factor
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    ABSTRACT: Cardiovascular disease is the leading cause of mortality among renal transplant recipients. In the general population, coronary artery calcification (CAC) and progression of CAC are predictors of future cardiac risk. We conducted a study to determine the progression of CAC in renal transplant recipients; we also examined the factors associated with progression and the impact of the analytic methods used to determine CAC progression. We used multi-detector computed tomography to examine CAC in 150 prevalent renal transplant recipients, who did not have a documented cardiovascular disease. A baseline and a follow-up scan were performed and changes in CAC scores were evaluated in each patient individually, to calculate the incidence of CAC progression. Multivariate logistic regression analysis was used to evaluate the determinants of CAC progression. Baseline CAC prevalence was 35.3% and the mean CAC score was 60.0 ± 174.8. At follow-up scan that was performed after an average of 2.8 ± 0.4 years, CAC prevalence increased to 64.6% and the mean CAC score to 94.9 ± 245.7. Progression of individual CAC score was found between 28.0 and 38.0%, depending on the method used to define progression. In patients with baseline CAC, median annualized rate of CAC progression was 11.1. Baseline CAC, high triglyceride and bisphosphonate use were the independent determinants of CAC progression. Renal transplantation does not stop or reverse CAC. Progression of CAC is the usual evolution pattern of CAC in renal transplant recipients. Beside baseline CAC, high triglyceride level and bisphosphonate use were associated with progression of CAC.
    Nephrology Dialysis Transplantation 09/2011; 27(5):2101-7. DOI:10.1093/ndt/gfr558 · 3.49 Impact Factor
  • Nurhan Seyahi
    Nephrology Dialysis Transplantation 05/2011; 26(7):2418-9; author reply 2419. DOI:10.1093/ndt/gfr204 · 3.49 Impact Factor
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    ABSTRACT: We compared the tolerability and efficacy of mycophenolate mofetil (MMF) versus mycophenolate sodium (MPS) among renal transplant recipients on tacrolimus-based immunosuppression. The 105 patients who underwent kidney transplantation between January 2002 and March 2008 and were treated with steroid, tacrolimus, and a mycophenolic acid compound were enrolled in the study. From patient files we collected on demographics data, donors, immunosuppressive drug doses, biochemical and hematologic parameters, gastrointestinal and hematologic side effects, and kidney function. Fifty-six patients were prescribed MMF and 49 of them were taking MPS. Demographic parameters and pretransplantation dialysis duration were similar between the 2 groups. After the third month, the MPS dose was higher than that of MMF. There were no clinically important differences between the 2 groups, regarding other immunosuppressive drug doses. Gastrointestinal side effects were similar: 42.4% in the MMF versus 44.8% in the MPS group (P = .846). Six patients in the MMF group and 1 patient in the MPS group underwent a switch of the mycophenolic acid therapy due to severe gastrointestinal side effects (P = .183). Biopsy-proven acute rejection was reported in 6 patients on MMF and 7 patients on MPS therapy (P = .768). The log-rank test evaluating a 50% reduction in glomerular filtration rate (GFR) showed no significant difference between the 2 groups (P = .719). No deaths were recorded during the study period; there was only 1 graft loss, which occurred in the MMF group. We did not observe a significant difference in tolerability and efficacy between the 2 widely used mycophenolic acid derivatives. Economic considerations can be an important factor when choosing the drug.
    Transplantation Proceedings 04/2011; 43(3):833-6. DOI:10.1016/j.transproceed.2011.01.096 · 0.95 Impact Factor
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    ABSTRACT: National renal registry studies providing data for incidence, prevalence, and characteristics of end-stage renal disease and renal replacement therapy (RRT) serve as a basis to determine national strategies for the prevention and treatment of these diseases and identify new areas for special studies. Since 1990, the Turkish Society of Nephrology has been coordinating a national renal registry that collects data on patients receiving RRT. This report focuses on data collected from 1996-2008. Data were collected in dialysis centers for patients on RRT. Year. Point prevalence and incidence of RRT, RRT modalities, demographic and clinical characteristics of patients on RRT. From 1996 to 2008, the number of centers (199 and 760) and response rates to the registry (76% and 99.4%) increased. In 2008, the point prevalence of RRT was 756 per million population (pmp) and incidence was 188 pmp, including pediatric patients. In prevalent patients, the most common RRT modality was hemodialysis (77.0% of patients), followed by peritoneal dialysis (10.1%) and transplant (12.9%). The age of hemodialysis and transplant patients increased, with a predominance of male patients. Percentages of diabetes mellitus and hypertension as causes of ESRD increased, whereas those of chronic glomerulonephritis and urologic disease decreased. Infection and crude death rates decreased in all treatment modalities. The main study limitations were registry design and low number of kidney transplants. With increasing numbers of dialysis centers and RRT patients during the last 12 years, the need for RRT in Turkey has been better met. The quality of RRT care has improved, especially regarding prevention and treatment of infections.
    American Journal of Kidney Diseases 03/2011; 57(3):456-65. DOI:10.1053/j.ajkd.2010.12.007 · 5.76 Impact Factor