Orcun Altunoren

• Professor (Associate) at Kahramanmaraş Sütçü İmam University

Objective: Cognitive impairment increases the risk of mortality in patients with chronic kidney disease. Progressive cognitive decline can be a serious issue for hemodialysis (HD) patients even if they are young with few comorbid conditions. The aim of this prospective study is to evaluate HD patients using Montreal Cognitive Assessment (MoCA) and...

Objective: Chronic kidney disease (CKD) is characterized by an irreversible decrease in kidney functions and accumulation of uremic toxins in the body. Platelet indices have the potential to predict the inflammatory status and disease progression in patients with CKD. In this study it was aimed to investigate platelet indices and their relations wi...

Amaç: Böbrek biyopsisi, renal parankimal hastalıkların tanısal değerlendirmesinde altın standarttır. Bir nefrolog ya da girişimsel radyolog tarafından ultrasonografi eşliğinde perkütan olarak uygulanmaktadır. Bu çalışmamızda böbrek biyopsi yapılan hastaların demografik özellikleri, biyopsi endikasyonları, biyopsi sonrası gelişen komplikasyonları, b...

During the follow-up of patients with renal failure, many medications may be required due to the clinical condition and comorbidities. Care should be taken in terms of the nephrotoxic effect of these drugs used or the accumulation of renally excreted drugs in the body and causing toxic effects. One of the most important side effects of carbapenems...

BACKGROUND AND AIMS There is not enough data on the post-COVID-19 (coronavirus disease 2019) period for peritoneal dialysis (PD) patients affected from COVID-19. We aimed to compare the clinical and laboratory data retrospectively obtained in the follow-up of PD patients after COVID-19 with a control PD group. METHOD This study, supported by the T...

BACKGROUND AND AIMS Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease with diffuse cysts in both kidneys and is responsible for 5–10% of end-stage renal disease Levy and Feingold (Estimating prevalence in single-gene kidney diseases progressing to renal failure. Kidney Int. 2000;58(3):925). Recently,...

BACKGROUND AND AIMS Haemodialysis (HD) patients are at increased risk for adverse short-term consequences of COVID-19. In this study, we investigated the characteristics of chronic HD patients in the post-COVID-19 period and compared them with the control group. METHOD We conducted a national multicentre observational study involving adult chronic...

BACKGROUND AND AIMS Although existing data suggest an increased mortality rate, data about the course of coronavirus disease 2019 (COVID-19) in peritoneal dialysis (PD) patients, its short- and long-term effects on the patient and technique survival are limited. Moreover, specific factors associated with increased risk of death have not been clearl...

Ev Hemodiyalizinin Kısa Tarihi Sadichhya Lohani; Daphne H. Knicely Zeynep Gürlek Akol, Yavuz Yeniçerioğlu Ev Hemodiyalizi İçin Hasta Alımı ve Eğitimi Joel D. Glickmanve ve Rebecca Kurnik Seshasai Alper Alp, Hakan Akdam Ev Hemodiyalizinde Vasküler Erişim Anil K. Agarwal; Khaled Y. Boubes; Nabil F. Haddad Zeki Aydın, Necmi Eren Ev Hemodiyalizi Reçete...

Introduction: Sarcopenia was determined to be associated with increased arterial stiffness in the nondialysis patient population, but there is no available data on this subject in dialysis patients. Methods: A total of 79 patients were included in the study. Sarcopenia was diagnosed according to the EWSGOP-2 criteria. Arterial stiffness was meas...

Background/aim: This study aimed to investigate pregnancy frequency and evaluate the factors affecting live births in hemodialysis (HD) patients. Materials and methods: Female HD patients whose pregnancy was retrospectively reported between January 1, 2014, and December 31, 2019. The duration of HD, primary disease, whether the pregnancy resulted...

Introduction: Polycystic kidney disease (PKD) is responsible for 5-10% of end-stage renal disease. We examined the relationship between renal and extrarenal findings, disease severity, and the level of consciousness of PKD patients. Materials and methods: Patients were asked to answer the questionnaire about PKD. Disease severity was determined...

Hemolitik üremik sendrom (HÜS), mikroanjiyopatik hemolitik anemi, trombositopeni ve akut böbrek yetmezliği ile karakterize olan ciddi bir hastalıktır. Hızlı tanı konulup uygun tedavi başlanmadığı takdirde ölümcül seyredebilir. Etyolojide enfeksiyöz ajanlar sıklıkla suçlanmaktadır. Genellikle verositotoksin (Shiga benzeri toksin) üreten mikroorganiz...

Background Hemodialysis (HD) patients have increased risk for short-term adverse outcomes of COVID-19. However, complications and survival at the post-COVID-19 period have not been published extensively. Methods We conducted a national, multicenter observational study that included adult maintenance HD patients recovered from confirmed COVID-19. A...

Background/aim: This study aimed to investigate pregnancy frequency and evaluate the factors affecting live births in hemodialysis (HD) patients. Materials and methods: Female HD patients whose pregnancy was retrospectively reported between January 1, 2014, and December 31, 2019. The duration of HD, primary disease, whether the pregnancy resulte...

Background The inhibition and activation cycles of the NK cells are mainly regulated by killer cell immunoglobulin-like receptors (KIRs). In this study, we examined KIR genes/genotypes in kidney transplant recipients and healthy subjects. We aimed to determine if there are relations between certain KIR genes and allograft kidney function. Methods...

Introduction The main cause of death in hemodialysis patients is cardiovascular diseases. Increased arterial stiffness is a predictor of cardiovascular events for hemodialysis patients. Among the nondialysis patient population, arterial stiffness increases in those with hepatic fibrosis and nonalcoholic fatty liver disease. This study aims to exami...

Renal Anatomi Orçun ALTUNÖREN Garip BEKFİLAVİOĞLU Renal Fizyoloji Ceren ÖNAL Bülent ALTUN Öykü ve Fizik İnceleme Tekin AKPOLAT Klirens Kavramı ve Glomerüler Filtrasyon Hızı Ölçüm Metotları Ebru SEVİNÇ OK İdrar Analizi ve Yorumlanması Çiğdem MENGÜŞ Ahmet Uğur YALÇIN Renal Görüntüleme Kenan TURGUTALP Caner ÖZER Renal Biyopsi ve Temel Patolojik İncele...

Background and Aims There is increasing evidence about the alloreactivity of natural killer (NK) cells after kidney transplantation. The inhibition and activation cycles of the NK cells are mainly regulated by killer cell immunoglobulin-like receptors (KIRs) which may have extensive allelic polymorphisms within the population. In this study, we exa...

Kardiyak aritmilere bağlı ani ölüm, kronik hemodiyaliz (HD) hastaları için önemli bir mortalite nedenidir. Çalışmamızda HD hastalarında, aritmi riski ile ilişkili olabilecek elektrokardiyogram (EKG) repolarizasyon parametrelerinin (QT, düzeltilmiş QT (QTc), T peak-end (Tp-e), Tp-e/QT ve Tp-e/QTc) klinik özellikler ile olası ilişkilerini araştırdık....

Özet Gebelerde patolojik olmayan miktarda proteinüri (300 mg/gün’ün altında) ve ödem görülebilmektedir. Patolojik ödem ve proteinürinin en sık nedeni ise preeklampsidir. Mirror sendromu gebelikte çok nadir görülen ancak potansiyel olarak önemli bir patolojidir. Genellikle beraberinde hidrops fetalis mevcuttur. Burada yaygın ödem ve proteinüri neden...

It has been demonstrated that NT‐proBNP and macrophage inhibitor cytokine‐1 (MIC‐1/GDF‐15) are associated with cognitive functions in patients without renal disease. In the present study, we examined the association of these two molecules with cognitive functions in hemodialysis patients for the first time in the literature. A total of 94 patients...

Background. Chronic kidney disease (CKD) and immunosuppression, such as in renal transplantation (RT), stand as one of the established potential risk factors for severe coronavirus disease 2019 (COVID-19). Case morbidity and mortality rates for any type of infection have always been much higher in CKD, haemodialysis (HD) and RT patients than in the...

Objective: Renal tubular acidosis (RTA) is a clinical manifestation that occurs with insufficiency in restoring bicarbonate or disruption in hydrogen ion elimination as a result of a disruption in tubulus functions, causing normal anion gap-opening metabolic acidosis. In the present study, we aimed to investigate the prevalence of RTA in the large...

Background Hematological parameters like red cell distribution width (RDW) and mean platelet volume (MPV) were reported to be associated with inflammation, atherosclerosis, and chronic kidney disease (CKD) progression. In this study, we evaluated RDW and MPV along with clinical features in patients with advanced CKD. We also aimed to detect clues f...

Background: Glomerular filtration surface area and glomerular filtration rate (GFR) are increased in patients with diabetic nephropathy, especially in the early phase of the disease. Glomerular neoangiogenesis contributes to this increased GFR. Increased GFR is associated with glomerular neoangiogenesis. Vasohibin-1 is an inhibitor of neoangiogenes...

Background: Glomerular filtration surface area and glomerular filtration rate (GFR) are increased in patients with diabetic nephropathy. Glomerular neoangiogenesis contributes to this increased GFR. Vasohibin-1 is an inhibitor of neoangiogenesis. The aim of this study is to evaluate serum vasohibin-1 levels of diabetic patients with and without dia...

The prevalence of arrhythmia has increased in hemodialysis (HD) patients and the most frequent is atrial fibrillation (AF). It was reported that the amount of epicardial fat tissue (EFT) in the population without renal disease is closely related to AF. In the present study of ours, the relation between EFT thickness and AF was examined in HD patien...

Background Endothelial dysfunction (ED) is associated with high cardiovascular disease burden in hemodialysis (HD) patients. Vasohibin‐1, an endothelium‐derived angiogenesis inhibitor, is essential for endothelial cell survival, therefore it may be a promising marker of ED. We aimed to investigate whether vasohibin‐1 levels are associated with ED m...

PurposeBecause of the increase in globalization, clinicians all over the world are confronted the questions about safety of Ramadan fasting. However, there is no clear information about whether there is an obstacle for fasting patients with chronic disease. Hence, in the present study, we aimed to investigate the effects of Ramadan fasting on kidne...

Background and Aims Several glomerular disease registries in Europe, and they shared their data; however, there was a lack of current data on trends of primary glomerulopathy in Turkey. Glomerular disease patterns can change geographical areas and populations decade by decade. Our aim is to present Turkey's primary glomerular disease pattern from 2...

Background and Aims According to the data of the Turkish Society of Nephrology-Glomerular Diseases Working Group (TSN-GOLD Working Group), IgA nephropathy is the most common primary glomerular disease in Turkey. The purpose of this study was to investigate the epidemiological and clinical data of IgA nephropathy patients in Turkey. Method 4399 pat...

Renal transplant recipients have an increased risk of malignancy, especially skin cancers. Therefore, skin lesions in transplant patients should not be ignored. Pyogenic granuloma (PG) is a benign hyperplastic lesion of the connective tissue that manifests ulcerous and hemorrhagic masses and is therefore confused with malignancies. Repeated minor t...

Erectile dysfunction is a common problem which is seen among hypertensive patients. It is thought that medications used in treatment of hypertension may contribute this problem as well. Contrary to common belief, new generation drugs doesn’t produce adverse effect on erectile function. Phosphodiesterase 5 inhibitors can be used safely in treatment...

Objectives: Sclerostin, a peptide secreted primarily by osteocytes, suppresses osteoblast maturation, thus reducing bone formation. Here, we evaluated the relationship between sclerostin levels and osteoporosis in kidney transplant recipients. Materials and methods: This cross-sectional study included 78 kidney transplantrecipients > 18 years ol...

BACKGROUND: Cognitive impairment is common among hemodialysis (HD) patients and is associated with poor treatment compliance and mortality. The aim of this study is to evaluate relatively young HD patients with less comorbidities using the Montreal Cognitive Assessment (MoCA) and identify clues for earlier detection of cognitive impairment with the...

Purpose Chronic kidney disease (CKD) is an inflammatory process. In addition to increased morbidity and mortality, inflammation also contributes to the progression of CKD. Neutrophil/lymphocyte ratio (NLR) is a marker of inflammation. Some recent data suggest that NLR may predict the progression of CKD. Methods In this study, 5-year data of 740 pa...

Abstract Renal elastography is an ultrasonographic method that has been recently found to provide information on renal functions and fibrosis. In this study, we aimed to investigate the relationship between elastography scores and renal functions and proteinuria levels in patient populations with various kidney diseases. Seventy-five diabetic nephr...

Purpose Renal infarction is a clinical condition which is caused by renal artery occlusion and leads to permanent renal parenchymal damage. In the literature, there are generally case reports on this subject, and few studies that include a large group of patients. Therefore, we aimed to present the data of a large group of patients who were diagnos...

BACKGROUNDS AND AIMS: Cardiovascular calcification is an important cause of morbidity and mortality in hemodialysis (HD) patients. Vascular and valvular calcification are indicators of increased tissue calcification. The relationship of osteopontin (OPN) - which is known as a vascular calcification inhibitor - and fibroblast growth factor-23 (FGF-2...

OBJECTIVE: In our study, we aimed to evaluate the history and awareness of hepatitis in HD patients with viral hepatitis who were followed up at our center and in different provinces. MATERIAL and METHODS: A total of 260 HD patients with chronic viral hepatitis from 6 different provinces were included in the study. A total of 27 multiple-choice que...

Purpose: Hemoglobin variability is a common problem among hemodialysis patients. We have previously demonstrated an association between Hb variability and left ventricular mass index. In this study, we investigated a possible relation between Hb variability and carotid intima-media thickness (CIMT). Methods: Twelve-month hemoglobin (Hb) values o...

Objective Increased inflammation, associated with the increase in chronic kidney disease (CKD) stage, has a very important influence in vascular injury and cardiovascular diseases. In this study, we aimed to investigate the levels of IL-33 and ST2 in the different stages of CKD and to determine their effect on vascular damage and cardiovascular eve...

Ultrasonography has an important role of in the evaluation of kidney diseases. Elastography is a special kind of ultrasound indicating renal fibrosis and has been developed in recent years. In this article we overview the technical features and usage of elastography in clinical conditions such as chronic renal failure, renal transplantation and ren...

Objective: Iron preperations are frequently used in hemodalysis (HD) patients and iron may accumulate liver and other tissues. Noninvasively methods are needed to detect liver iron accumulation in HD patients. Hepatic iron accumulation with Fibroscan was shown in non-renal population. In this study, we aim to investigate whether or not the hepatic...

Renal infarction is a rare cause of bilateral loin pain. The most common etiologic reason is thromboembolism due to atrial fibrillation. Abuse of drugs such as ecstasy is a very rare cause of renal infarction. Here, we present a case diagnosed with bilateral renal infarction due to ecstasy usage after excluding other reasons.

OBJECTIVE: Renal transplantation is the best treatment method of end-stage renal disease. Unfortunately, renal transplantation rates have not reached the desired level yet in our country. In this study, we aimed to evaluate the willingness, knowledge levels and expectation of hemodialysis patients about renal transplantation. MATERIAL and METHODS:...

Heart failure is a common disorder in the general population and causes serious mortality and morbidity. Diuretic agents are generally used in addition to salt and water restriction in its treatment. However, an insufficient response and some adverse affects restrict the usage of diuretics. Furthermore, it is believed that diuretic agents also incr...

Posterior reversible encephalopathy syndrome (PRES) is characterised with neurological symptoms and typical radiological appearances. Hypertension is the most common cause of PRES. Systemic lupus erythematosus is a rare cause of PRES. Here, we present a 55-year-old case who presented with headache and convulsion and was diagnosed with concomitant l...

Tubulointerstitial nephritis and uveitis syndrome is characterized by a combination of acute tubulointerstitial nephritis and uveitis. It is thought to be an autoimmune disease. Currently, 200 cases have been described in the literature. Most patients with this syndrome are young women and adolescents although it may occur in adults and older patie...

Treatment of secondary hyperparathyroidism is a major problem in hemodialysis patients. Medical treatment is commonly inadequate in these patients. Parathyroid surgery should be considered in appropriate patients. In this review, we evaluate the techniques, features, results and complications of parathyroid surgery procedures.

OBJECTIVE: Cinacalcet reduces parathyroid hormone levels by increasing the sensitivity of the parathyroid gland to calcium. In this study, we firstly aimed to evaluate the efficacy of cinacalcet in Turkish hemodialysis patients. MATERIAL and METHODS: 4483 hemodialysis patients were screened and 469 patients who had used cinacalcet were included in...

Fungal peritonitis is an important reason of catheter loss among peritoneal dialysis patients. The most frequently isolated agents are Candida species and some patients do not respond to the treatment and die. Two siblings who lived in the same house and followed-up at our center were admitted to the hospital for peritonitis and both were transferr...

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a cause of euvolemic hyponatremia. Neoplasms, infections and some drugs are the most frequent reasons of SIADH. Brucella melitensis is an infectious microorganism that is frequently seen in some regions of our country. It may cause multisystemic disease or nonspecific symptoms....

Hyperlipidemia is a component of the nephrotic syndrome and should be treated for increased risk of cardiovascular diseases. Statins are first choice in treatment. However, gastrointestinal side effects are commonly seen in patients with statin therapy. A 73-year-old man who used statin therapy for hyperlipidemia due to nephrotic syndrome presented...

Patients treated with hemodialysis are predisposed to infections. Catheter-related infections are the most common infections in patients who have a central venous hemodialysis catheter. These infections may lead to bacteremia or metastatic infection. Cutaneous vasculitis is a form of vasculitis characterized by purpuric eruption localized to the lo...

Central venous hemodialysis catheter applications are still the most common route for acute hemodialysis and some complications may be seen at the time of insertion or later and some of these may be fatal. Catheter malpositions and great vessel perforations have an important place among these complications. Vessel perforations may be fatal if not d...

Background/Aims: Contrast induced nephropathy (CIN) has multifactorial etiopatogenesis including oxidative stress and vasoconstriction. Nebivolol is an antioxidant and has vasodilatatory effect via NO release and may prevent CIN development. We have noticed that a few number of studies that have evaluated the effectiveness of nebivolol for the prev...

Apelin is an adipokine secreted by the adipose tissue and by the endothelial cells in various parts of the body. Apelin is also expressed by the glomerular arteriolar rectus and glomerular capillary cells. We evaluated the relationship between the initial serum levels of apelin 13 with the trend of glomerular filtration rate (GFR) during a 1-year f...

Familial Mediterranean fever (FMF) is defined as an inherited and autosomal recessive disease. Many researches have been done about this subject, and we believe that it should be necessary to focus on phenotype-genotype correlation, especially novel mutation types. We aim to announce the results of FMF sequence analysis in Kahramanmaras/Turkey. The...

We present a 53-year-old female patient who was admitted for renal failure and where spinal ossification similar to ankylosing spondylitis was detected due to hypoparathyroidism. On physical examination, she had extreme inability to move her neck and waist, as in ankylosing spondylitis. X-Ray examination showed full-length paravertebral calcificati...

Chronic kidney disease (CKD) is an important and costly health problem in developed countries and has a tendency to progress in end stage renal disease regardless of etiology. This progress ends in interstitial fibrosis which decreases the elasticity of the tissue. Elastography is a developing technique to assess tissue elasticity. The aim of this...

Background: Renal tubular acidosis (RTA) is a non-anion gap metabolic acidosis and is generally mild and asymptomatic in kidney recipients. Calcineurine inhibitors (CNIs) increase the frequency of RTA but the frequency of RTA development in kidney transplant recipients receiving mammalian target of rapamycin inhibitors (mTORi) treatment remains un...

Introduction and Aims: Despite modern heart failure (HF) therapy, the prognosis of patients with HF remains poor. During hospital stay acute kidney injury (AKI can complicate HF with ominous prognostic implications. Endothelial dysfunction is present in both HF and renal disease. Moreover, endothelial activation biomarker as vascular cell adhesion...

Introduction: Most common two causes of primary hyperaldosateronism are bilateral idiopathic hyperplasia and aldosteron secreting adenoma but unilateral adrenal hyperplasia is a rare cause. We presented a primary hyperaldosteronism case that caused by unilateral adrenal hyperplasia. Case: A 56-year-old male admitted to endocrinology policlinic with...

Abstract Orofacial digital syndrome type 1 is condition which is characterized with, in addition to oral-facial and digital congenital anomalies, polycystic renal disease in most patient, and the prognosis is dependent on renal involvement in such patients. Our case was a 22-year-old patient who was presented with clinical picture of chronic renal...

Hemodialysis (HD) patients had higher cardiovascular mortality and it is related to atherosclerosis. Epicardial adipose tissue (EAT) thickness is a marker of atherosclerosis and independent predictor of coronary artery disease. The aim of our study was to evaluate the relationship between EAT and carotid intima-media thickness (CIMT) predictors of...

Background and objectives: Most hemodialysis patients show hemoglobin fluctuations between low-normal and high levels. This hemoglobin variability may cause left ventricle hypertrophy and may increase mortality as well. Recently, many studies were designed to evaluate the effect of hemoglobin variability on mortality but results were conflicting....

Introduction: Valvular abnormalities frequently occur in patients with chronic kidney failure. This study evaluated the prevalence of heart valve calcification (HVC) in hemodialysis patients and factors associated with it. Materials and methods: Medical charts of 129 hemodialysis patients were reviewed retrospectively. Demographic features and l...

Thrombi are the most frequent cardiac masses followed by metastatic masses and primary neoplasms respectively. While myxomas are the most common primary heart neoplasms, hemangiomas are quite rare. They are usually asymptomatic and diagnosed incidentally. Cardiac neoplasms may be confused with thrombi both radyologically and clinically. Treatment o...

Compared with the general population, patients with chronic renal failure have increased tuberculosis (TB) prevalence and mortality rates. In this study, we aimed to investigate tuberculin skin test (TST) positivity rates in hemodialysis (HD) and peritoneal dialysis (PD) patients and the factors influencing TST positivity. Ninety-two HD patients an...

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