Mehmet Deniz Ayli

Ankara Atatürk Training and Research Hospital, Engüri, Ankara, Turkey

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Publications (9)13.12 Total impact

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    ABSTRACT: Atherosclerotic cardiovascular disease is one of the major causes of mortality and morbidity in peritoneal dialysis (PD) patients. S100A12 is an endogenous receptor ligand of advanced glycation end-products. It was shown to contribute to the development of atherosclerosis in animal models. The aim of this study was to evaluate the relationship between S100A12 levels and carotid atherosclerosis in PD patients. A cross-sectional study was performed in 56 PD patients and 20 control subjects. Plasma S100A12 levels were measured from all participants beside routine laboratory evaluation. All subjects underwent high-resolution B-mode ultrasonography to determine carotid intima media thickness (CIMT). S100A12 levels were compared between patient and control groups. Correlation analyses of S100A12 with other laboratory values and CIMT were also performed. Plasma S100A12 levels were higher in PD patients compared with control subjects (129.5 ± 167.2 ng/mL vs. 48.5 ± 30.3 ng/mL, respectively, p < 0.001). In the patient group, CIMT was found to be positively correlated with age (r = 0.354; p = 0.007), CRP level (r = 0.269; p = 0.045), and S100A12 (r = 0.293; p = 0.028) level while it was found to be negatively correlated with hemoglobin concentration (r = -0.264; p = 0.049). In the linear regression analysis, the model, including CRP, S100A12, age, and Hgb, was found to be significant (F: 4.177, p: 0.005). When the parameters are analyzed age and S100A12 were found to be independent determinants of CIMT (β = 0.308, p = 0.018 and β = 0.248, p = 0.049, respectively). This study suggests that an elevated plasma S100A12 level was closely associated with atherosclerosis. With aging elevated plasma S100A12 may show a powerful proatherogenic potential in patients undergoing PD.
    Renal Failure 05/2015; DOI:10.3109/0886022X.2015.1033633 · 0.78 Impact Factor
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    ABSTRACT: Abstract Background: Cardiovascular disease (CVD) is the most important cause of morbidity and mortality in patients with end stage renal disease (ESRD). Apelin expressed in endothelial and other tissues including brain and kidney is an adipocytokine defined recently and is emerging an important mediator of cardiovascular homeostasis. The aim of this study was to test whether apelin levels might be associated with carotid artery atherosclerosis and left ventricular mass index (LVMI) in peritoneal dialysis patients. Patients and methods: Fifty peritoneal dialysis patients (25 female, mean age 41.4 ± 11.9 years, mean dialysis vintage 65.0 ± 35.4 months) and 18 healthy individuals (9 female, mean age 41.7 ± 6.8 years) were included in this cross-sectional study. Serum apelin 12 levels, echocardiographic findings and carotid intima media thickness (CIMT) were recorded as well as clinical and laboratory data. Results: There were no differences between the patient and the control groups with regard to demographic characteristics. In patient group, LVMI, CIMT, CRP and apelin levels were elevated compared to control group. However there was no association between apelin, LVMI and CIMT. There was a positive correlation between apelin and CRP, which was not statistically significant. When patients were divided into two groups according to the mean serum apelin levels, LVMI, CIMT and CRP were higher in the high apelin group but this difference did not reach statistical significance. Conclusion: We observed an increased inflammation and CVD risk in peritoneal dialysis patients. However, serum apelin levels seem not to be associated with cardiovascular risk in this group of patients.
    Renal Failure 01/2015; 37(3):1-6. DOI:10.3109/0886022X.2014.996108 · 0.78 Impact Factor
  • Peritoneal dialysis international: journal of the International Society for Peritoneal Dialysis 06/2014; 34(4):470-1. DOI:10.3747/pdi.2013.00069 · 2.20 Impact Factor
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    ABSTRACT: Introduction and Aims: Premature cardiovascular disease limits the quality and length of life on long-term haemodialysis. The epidemiology of cardiovascular events in this context needs to be better defined and more effective management strategies developed. Adjudicated cardiovascular event data collected during the Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) Trial were used to define the frequency of fatal and non-fatal cardiovascular events attributable to atherosclerotic and non-atherosclerotic mechanisms. The risk factors for these events and the impact of assignment to treatment with cinacalcet or placebo were evaluated. Methods: A multicenter, global, randomized, double-blind, placebo-controlled clinical trial assessing mortality and non-fatal cardiovascular events in 3883 patients on haemodialysis with secondary hyperparathyroidism (median parathyroid hormone concentration 693 pg/mL (10%, 90% range 363 to 1694 pg/mL). The post hoc outcome measures were fatal and non-fatal cardiovascular events reflecting atherosclerosis and non-atherosclerotic cardiovascular diseases. Results: 1518 subjects experienced an adjudicated cardiovascular event, including 958 who experienced an event attributable to non-atherosclerotic disease. Of 1421 deaths during the trial, 768 (54%) were due to cardiovascular disease. Sudden death was the most frequent fatal cardiovascular event, accounting for 25% of overall mortality. Patients randomised to cinacalcet had a lower risk for time to first non-atherosclerotic cardiovascular event (hazard ratio 0.84, 95% CI 0.74, 0.96), whilst we were not able to able to detect a lower risk with cinacalcet treatment on time to atherosclerotic events (hazard ratio 0.88, 95% CI 0.76, 1.01). Conclusions: Accepting the limitations of post-hoc analysis, the benefit of cinacalcet on cardiovascular disease in the context of haemodialysis may mainly result from attenuation of non-atherosclerotic processes. number: NCT00345839
    Nephrology Dialysis Transplantation 05/2014; 29(suppl 3):iii233-iii245. DOI:10.1093/ndt/gfu155 · 3.49 Impact Factor
  • Nefrologia: publicacion oficial de la Sociedad Espanola Nefrologia 11/2013; 33(6):861-862. DOI:10.3265/Nefrologia.pre2013.Jul.12178 · 1.44 Impact Factor
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    ABSTRACT: Objective: It is the examination of whether there is a correlation between Cystatin C and creatinine clearance among glomerulonephritis patients with stage 1-4 chronic renal failure. The study researched early and severely decreased stage (1-4) patients with chronic renal failure. Primary glomerular patients were selected in order to see the result in isolation connected with glomerular exposure. Material and Method: From November 2009 to August 2010, patients referred to nephrology clinics, were enrolled in the study. During the patients' routine controls, their other data were obtained. Cystatin C level was studied in biochemistry laboratory of H. M. Dışkapı Yıldırım Beyazıt Training and Research Hospital. Patients who had histologic diagnosis were taken into the study. Resultant correlation between Cystatin C and creatinine clearance was analyzed. Whether there was a significant correlation between MDRD and Cystatin C was researched by Spearman's correlation test. Results: 26 subjects with the age of 18-72 were included in the research. It was seen that there was a significantly high level correlation between MDRD and Cystatin C measurements(r=0,884; p<0,001). When the cases were separated to two groups in regard to their MDRD and Cystatin C levels, it was seen that there was statistically significant but low concordance between two examinations (κ=0,308; p=0,002).Conclusion: In the end of the study, the significant correlation between Cystatin C and creatinine clearance was determined. Concordance level was found low by the subgroup analyses of the study. When it is taken with all the other studies, Cystatin C is seen like an appropriate method for measure the GFR. But, after all the positive and negative results were taken together, it is more appropriate to judge on these results. To get more clear information in this case, wider and detailed comparative studies are required.
  • 09/2012; 21(03):316-318. DOI:10.5262/tndt.2012.1003.24
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    ABSTRACT: The demand for kidney transplantation due to improved recipient outcomes has stimulated surgeons to expand the criteria for usable donors, but still the use of organs from deceased donors with terminal acute renal failure is uncommon. We report 2 kidney transplant recipients from a cadaveric donor who was not accepted by other centers because of acute renal failure. The donor, a 24-year-old man with an intracerebral hemorrhage, displayed a serum creatinine (SCr) value of 0.6 mg/dL on hospital admission, which increased to 7.3 mg/dL on the fourth hospital day. After the diagnosis of brain death and refusal of the kidneys by other regional centers, we decided to transplant the 2 kidneys. Recipient 1, a 31-year-old man on an 11-year dialysis program, discontinued hemodialysis after 7 days of delayed graft function. The SCr level decreased gradually and was stable at 1.08 mg/dL on postoperative day (POD) 45. The contralateral graft was transplanted into a 30-year-old man (recipient 2) undergoing dialysis treatment for 7 years. After 10 days of delayed graft function, the SCr decreased gradually with continued hemodialysis until POD 24. The SCr level has been stable at 1.34 mg/dL on POD 52. At the end of the third month the SCr levels in recipients 1 and 2 were 1.1 mg/dL and 1.4 mg/dL, respectively. In conclusion, one may safely expand the donor pool with kidneys from deceased donors with acute renal failure (ARF) with good short-term outcomes.
    Transplantation Proceedings 07/2012; 44(6):1764-6. DOI:10.1016/j.transproceed.2012.04.010 · 0.95 Impact Factor
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    ABSTRACT: Fibroblast growth factor-23 (FGF-23) is a phosphorus-regulating substance. Circulating FGF-23 levels increase markedly in dialysis patients and are independently associated with increased risk of mortality. Given the fact that cardiovascular disease is the leading cause of death in dialysis patients, the aim of this study was to test if elevated FGF-23 levels might be associated with left ventricular mass index (LVMI) and left ventricular index of myocardial performance (MPI) in maintenance haemodialysis patients. In this cross-sectional study, plasma FGF-23 concentrations were measured using a C-terminal human enzyme-linked immunosorbent assay kit, and echocardiography was performed in 128 maintenance haemodialysis patients (65 women and 63 men, mean age: 55.5 ± 13 years, mean haemodialysis vintage: 52 ± 10 months, all patients are on haemodialysis thrice a week) and 40 control subjects (21 women and 19 men; mean age: 54 ± 11 years) with normal kidney function (eGFR > 90 mL/min/1.73 m(2)). Serum FGF-23 levels were elevated when compared with age- and gender-matched controls with preserved kidney function [(median 958 RU/mL; interquartile range 106-1894 RU/mL) vs (median 27 RU/mL; interquartile range 11-35), P < 0.0001]. Patients with a history of coronary artery disease and aortic valve calcifications had higher levels of log FGF-23 than those without (3.00 ± 0.22 vs 2.82 ± 0.26, P = 0.002; and 3.06 ± 0.19 vs 2.83 ± 0.26, P = 0.0001, respectively). Patients with MPI > 0.47 had higher serum FGF-23 levels than those with MPI < 0.47 [(median 1156 RU/mL; interquartile range 396-1894 RU/mL) vs (median 657 RU/mL; interquartile range 106-1102 RU/mL), P = 0.0001]. Significant correlations were recorded between log FGF-23 levels and LVMI (r = 0.281, P = 0,007) and MPI (r = 0.555, P = 0.0001). Multivariable-adjusted regression analyses revealed that increased log FGF-23 concentrations were independently associated with increased left ventricular mass index (30% increase per 1-SD increase in log FGF-23 concentration, P = 0.002) and increased MPI (28.5% increase per 1-SD increase in log FGF-23 concentration, P = 0.001). Plasma FGF-23 concentration is independently associated with LVMI and MPI in maintenance haemodialysis patients. Further prospective studies are needed to clarify whether increased serum FGF-23 level is a marker or a potential mechanism for left ventricular involvement in patients with end-stage renal disease.
    Nephrology Dialysis Transplantation 04/2011; 26(4):1346-54. DOI:10.1093/ndt/gfq539 · 3.49 Impact Factor