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ABSTRACT: Carotid intima media thickness (CIMT) and carotid plaques (CP) were shown to be independent predictors of mortality in end-stage renal disease (ESRD) patients. In this study, the authors aimed to compare the two dialysis modalities for CIMT and CP presence (CPP).
ESRD patients who had been on the same renal replacement therapy for at least 24 months were selected. CIMT, CPP, known risk factors, and laboratory parameters for atherosclerosis were determined for each patient.
A total of 77 hemodialysis (HD) patients (68% male, 47.6±17.0 years), 61 continuous ambulatory peritoneal dialysis (CAPD) patients (51% male, 45.3±13.9 years), and 36 age- and sex-matched controls (61% male, 43.3±10.6 years) were included. The mean CIMT (m-CIMT) were 0.99±0.24, 0.86±0.22, and 0.60±0.13 mm in the HD, CAPD, and control groups, respectively (HD vs. CAPD, P=0.001; HD vs. control, P<0.001; and CAPD vs. control, P<0.001). The CPP occurred more frequently in the HD group compared to the CAPD group (64% vs. 39%, respectively, P=0.004). The backward linear and logistic regression analysis of potential confounders revealed that both m-CIMT and CPP was independently associated with dialysis type (beta=0.249, P=0.008; and odds ratio [OR]=4.11, 95% CI, 1.72 to 6.73, P=0.015, respectively).
The authors have shown that dialysis type may be an independent predictor of m-CIMT and CPP in long-term ESRD patients.
Advances in Therapy 03/2012; 29(4):370-82. · 2.11 Impact Factor
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ABSTRACT: The impact of dialysis type on the biomarkers that reflect the severity of cardiovascular diseases is not clearly known. We aimed to investigate the effect of dialysis type on biomarkers of cardiovascular diseases in patients with end-stage renal disease (ESRD).
The study included 108 patients who had been on dialysis treatment (57 patients receiving hemodialysis, 51 patients receiving peritoneal dialysis) for ESRD for at least three months. Blood samples were collected just after the dialysis. Serum N-terminal prohormone of brain natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), cardiac troponin I (TnI), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and plasma fibrinogen levels were measured and compared between the two dialysis groups.
The two dialysis groups were similar with respect to age and gender. The frequency of hypertension was significantly higher in patients receiving peritoneal dialysis. This group also had higher total cholesterol, HDL cholesterol, LDL cholesterol, and hemoglobin levels. Serum levels of NT-proBNP, hs-CRP, IL-6, and TNF-α, and plasma fibrinogen levels were similar in the two dialysis groups (p>0.05), but TnI was significantly higher in patients receiving peritoneal dialysis (p=0.04). Comparison of the patient subgroups based on the duration of dialysis (<12 months, 12-36 months, and >36 months) showed that longer dialysis duration was associated with significantly lower values of NT-proBNP, TNF-α, and hs-CRP (p<0.05).
The dialysis type does not affect serum NT-proBNP, hs-CRP, IL-6, TNF-α, and plasma fibrinogen levels, but TnI level is higher in patients treated with peritoneal dialysis.
Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 09/2011; 39(6):456-62.
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ABSTRACT: Uremia is associated with accelerated atherosclerosis and increased cardiovascular mortality in patients with end-stage renal disease (ESRD). Cardiac injury markers, such as myoglobin, creatine kinase-MB (CK-MB), or troponins, frequently used to recognize acute coronary events, may be falsely elevated in this patient group. In this study, our aim was to (i) test serum levels of myoglobin, CK-MB, and troponin I (cTnI) in ESRD patients without coronary artery disease (CAD) and compare the results with healthy controls and (ii) to investigate the association between these markers and carotid artery intima-media thickness (CA-IMT), high-sensitive C-reactive protein (hs-CRP), and serum uric acid (SUA) levels in ESRD patients.
Fifty-two ESRD patients (25 hemodialysis and 27 peritoneal dialysis) and 17 healthy controls were included in the study. Serum levels of myoglobin, CK-MB, and cTnI were measured and ultrasonographic CA-IMT was determined in all participants. SUA and hs-CRP levels were only measured in the ESRD group.
Serum myoglobin, CK-MB levels, and the mean CA-IMT were significantly higher in ESRD group (p < 0.01), whereas cTnI levels were not different compared to healthy controls (p = 0.70). There was also a positive correlation between CA-IMT and cTnI levels (p = 0.003, r = 0.35) and CA-IMT and hs-CRP (p = 0.03, r = 0.30) or SUA levels (p = 0.003, r = 0.43).
cTnI may serve as a more sensitive marker in detecting cardiovascular events in patients with renal failure. Besides the traditional risk factors of atherosclerosis, cTnI, hs-CRP, and SUA may have a predictive role in recognizing premature atherosclerosis in ESRD patients.
Renal Failure 05/2010; 32(4):448-54. · 0.82 Impact Factor
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Fatma Ayerden Ebinç,
Yasemin Erten,
Haksun Ebinç,
Hatice Paşaoğlu,
Canan Demirtaş,
Gülten Taçoy, Rüya Mutluay,
Eyüp Koç,
Ulver Derici,
Kadriye Altok Reis,
Musa Bali,
Turgay Arinsoy,
Sükrü Sindel
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ABSTRACT: Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of endothelial-based nitric oxide synthase. Its level is increased by end stage renal disease. However, most studies showing an increase in ADMA in dialysis patients have focused on hemodialysis. Results with peritoneal dialysis patients have been more inconclusive. Recent studies suggest that ADMA may be a new cardiovascular risk factor. The aim of the present study was to evaluate the relationship between ADMA levels, residual renal function, and left ventricular hypertrophy in peritoneal dialysis patients. Serum ADMA measurements and echocardiographic evaluations were performed in 54 peritoneal dialysis patients and 26 healthy volunteers. Residual renal function was measured in peritoneal dialysis patients by urea clearance from a urine collection. Thirty-two of the 54 peritoneal dialysis patients had residual renal function. ADMA levels of the peritoneal dialysis group were found to be significantly higher than those of healthy individuals (p = 0.03). Within the peritoneal dialysis group, ADMA levels of patients with residual renal function were significantly lower than those without residual renal function (p = 0.01), though they were still higher than the ADMA levels of the control group (p = 0.04). Serum levels of ADMA were positively correlated with left ventricular mass index (r = 0.29, p = 0.01) and negatively correlated with early mitral inflow velocity (Em) (r = -0.28, p = 0.01), Em/Late mitral inflow velocity (Am) (r = -0,32, p = 0.00), and isovolumetric relaxation time (r = -0.30, p = 0.01). In conclusion, increased ADMA levels seem to be associated with left ventricular hypertrophy in peritoneal dialysis patients, and residual renal function may lead to a reduction of serum ADMA levels.
Renal Failure 02/2008; 30(4):401-6. · 0.82 Impact Factor
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ABSTRACT: The most important cause of increased mortality in end-stage renal disease (ESRD) is cardiovascular diseases. We investigated the prognostic value of cardiac troponin T (cTnT) and homocysteine in the long-term follow-up of ESRD patients.
The study included 78 patients (54 males, 24 females; mean age 53.2+/-16.6 years) with ESRD, who had been on hemodialysis treatment for at least three months. Baseline troponin T and homocysteine levels were measured and the patients were followed-up from March 2002 to May 2007 for major adverse cardiovascular events (MACE).
Major adverse cardiovascular events occurred in 26 patients (33.3%), including cerebrovascular events (n=3, 3.9%), congestive heart failure (CHF) (n=18, 23.1%), coronary artery disease (CAD) (n=19, 24.4%), and death (n=19, 24.4%). Two-thirds of diabetic patients developed MACE and the mean age in the MACE group was significantly greater (p<0.001). Troponin T levels were significantly higher in patients who developed MACE (0.21+/-0.43 ng/ml vs 0.06+/-0.28 ng/ml, p=0.002), whereas homocysteine levels did not differ significantly between the two groups (p=0.82). For a cutoff value of 0.10 ng/ml, cTnT was > or =0.1 ng/ml in 17 patients (21.8%), and <0.10 ng/ml in 61 patients (78.8%). Patients having a cTnT level of > or =0.10 ng/ml showed significantly higher rates of MACE (64.7% vs 24.6%; p=0.003), CHF (47.1% vs 16.4%; p=0.02), and death (52.9% vs 16.4%; p=0.004). There was also a greater tendency to CAD in this group (41.2% vs 19.7%, p=0.10). In multivariate logistic regression analysis, age and diabetes mellitus were the independent predictors of MACE development.
Homocysteine levels cannot predict MACE in ESRD patients in the long-term follow-up. Despite a significantly higher incidence of MACE in patients with high cTnT levels, cTnT was not an independent predictor of cardiovascular outcome.
Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 01/2008; 36(6):382-7.
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ABSTRACT: Dorfman-Chanarin syndrome (DCS), is a rare, autosomal recessive disorder associated with lipid metabolism. It is characterized
by ichthyosiform nonbullous erythroderma, lipid vacuoles in peripheral leukocytes and variable involvement of organs. We report
a Turkish man with the complete syndrome, who described family history of ichthyosis. To best of our knowledge this is the
sixth case from Turkish origin to date. In addition to congenital ichthyosis he had also strabismus, horizantal nystagmus,
bilateral neurosensory hearing loss, hepatomegaly and splenomegaly. Liver biopsy revealed hidrophic degeneration in hepatocytes,
steatosis, enlargement and inflammation in portal areas and portal central fibrosis, consistent with cirrhosis. Write stained
peripheral blood smear examination revealed lipid vacuoles in all of the neutrophils consistent with Jordan’s anomaly. We
think that, it is essential to evaluate the peripheral blood smear of the patients with ichthyosis and also patients with
DCS should be informed and warned about the results of consanquinous marriage.
Central European Journal of Medicine 02/2007; 2(1):116-121. · 0.31 Impact Factor
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ABSTRACT: The etiopathogenesis of inflammatory bowel disease remains unclear, with various extraintestinal features often found with the disease. Sometimes more than one extraintestinal finding is found in the same patient. In this case report, a patient with more than one extraintestinal manifestation of Crohn's disease is presented. Extensive thrombi in the venous system and pyoderma gangrenosum in the left lower extremity was observed but there was complete recovery following treatment with both systemic and topical agents.
The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology 04/2002; 13(1):66-9. · 0.47 Impact Factor
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Fatma Ayerden Ebinç,
Haksun Ebinç,
Ulver Derici,
Arzu Aral,
Cemalettin Aybay,
Gülten Taçoy,
Eyüp Koç, Rüya Mutluay,
Kadriye Altok Reis,
Yasemin Erten,
Turgay Arinsoy,
Sükrü Sindel
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ABSTRACT: Adiponectin is increased in end-stage renal disease. However, efforts to clarify the cause of that increase and its clinical effects have been inconclusive. The aim of this study was to compare serum adiponectin levels of dialysis patients against healthy individuals and evaluate the relationship among adiponectin levels, IL-6, TNF- alpha and left ventricular mass index (LVMI).
Adiponectin, IL-6 and TNF- alpha measurements and echocardiographic evaluations were performed in 36 hemodialysis, 30 continuous ambulatory peritoneal dialysis (CAPD) patients and 22 healthy volunteers. Adiponectin, IL-6 and TNF- alpha levels were measured by ELISA.
Adiponectin was found to be higher in hemodialysis (52.78+/-18.01 ng/mL) and CAPD (52.96+/-17.53 ng/mL) groups than controls (28.36+/-13.20 ng/ mL; p=0.0003, p=0.0003, respectively). No difference was observed between the hemodialysis and CAPD groups. Adiponectin was positively correlated with IL-6 (r=0.293, p=0.02), TNF- alpha (r=0.458, p=0.0003) and LVMI (r=0.283, p=0.02). In the partial correlation analysis, by controlling for body mass index, the correlation between adiponectin and TNF- alpha (r=0.466, p=0.0003) persisted. When IL-6 was controlled with TNF- alpha, the relation between adiponectin and LVMI disappeared (r=0.145, p=0.30). In the linear regression analysis, with adiponectin as the dependent variable, and IL-6, TNF- alpha and body mass index as independent variables, a significant relationship was found between adiponectin and TNF- alpha (beta=0.488, p=0.001).
Increased adiponectin seems to be associated with increased proinflammatory cytokines in dialysis patients, and this relationship suggests adiponectin may have a role in the development of left ventricular hypertrophy.
Journal of nephrology 22(2):216-23. · 1.65 Impact Factor
