Murat Duranay

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

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Publications (133)253.04 Total impact

  • F Sapmaz · S Ünverdi · A Azak · M Duranay · Y Fidan · D Yücel

    No preview · Article · Feb 2016 · The West Indian medical journal
  • Osman Saglam · Selman Unverdi · Murat Duranay

    No preview · Article · Feb 2016 · Nefrologia: publicacion oficial de la Sociedad Espanola Nefrologia
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    ABSTRACT: Objective: In this study, we aimed to detect the incidence and risk factors of Staphylococcus aureus nasal carriage and possible relationship between wound culture and nasal carriage in patients with diabetic foot (DF) wounds. Methods: Three groups each one comprising 40 patients were established with nondiabetics (Group 1), diabetics without DF wounds (Group 2), and diabetics with DF wounds (Group 3). Wagner grading was used for classification of DF lesions. The incidence of S. aureus nasal carriage and effects of determined factors to nasal carriage were investigated. The relationship between nasal carriage and result of wound culture was also investigated in the last group. Results: The incidence of S. aureus nasal carriage were 17.5%, 20% and 10% in Groups 1, 2 and 3, respectively (p=0.47). Age, sex, use of insulin/oral anti-diabetic drugs, duration of diabetes, HbA1c level, fasting and after meal glucose measures did not affect the S. aureus nasal carriage. We observed a higher possibility of nasal swab positivity for MRSA in diabetic patients compared to the controls. We did not detect any relationship between Wagner grade and culture results of wounds and S. aureus nasal carriage in Group 3. Conclusions: We detected that having DF wound or diabetes did not alter the risk of S. aureus nasal carriage, and likewise nasal carriage did not affect the results of wound cultures.
    Full-text · Article · Dec 2015
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    ABSTRACT: Background: Peritoneal dialysis (PD) is used as an alternative to hemodialysis in end-stage renal disease (ESRD). Icodextrin has been used as a hyperosmotic agent in PD. The aim of the study was to assess two different point-of-care testing (POCT) glucose strips, affected and not affected by icodextrin, with serum glucose concentrations of the patients using and not using icodextrin. Methods: Fifty-two chronic ambulatory peritoneal dialysis (CAPD) patients using icodextrin (Extraneal®) and 20 CAPD patients using another hyperosmotic fluid (Dianeal®) were included in the study. Duplicate capillary and serum glucose concentrations were measured with two different POCT glucose strips and central laboratory hexokinase method. Assay principles of glucose strips were based on glucose dehydrogenase-pyrroloquinoline quinone (GDH-PQQ) and a mutant variant of GDH (Mut Q-GDH). The results of both strips were compared with those of hexokinase method. Results: Regression equations between POCT and hexokinase methods in icodextrin group were y = 2.55x + 1.12 mmol/l and y = 1.057x + 0.16 mmol/l for the GDH-PQQ and Mut Q-GDH methods, respectively. The mean difference between the results of hexokinase and those of GDH-PQQ and Mut Q-GDH in icodextrin group was 3.41 ± 1.56 and 0.72 ± 0.64 mmol/l, respectively. However, the mean differences were found much lower in the control group; 0.64 mmol/l for GDH-PQQ and 0.52 mmol/l for Mut Q-GDH. Conclusion: Compared to GDH-PQQ, glucose strips of Mut Q-GDH correlated better with hexokinase method in PD patients using icodextrin.
    Full-text · Article · Oct 2015 · Journal of Clinical Laboratory Analysis
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    ABSTRACT: Purpose: Patients diagnosed with chronic kidney disease (CKD) have a greater rate of cardiovascular mortality when compared with the general population. The soluble form of TNF-like weak inducer of apoptosis (TWEAK) and monocyte chemoattractan protein 1 (MCP-1) play important roles in cellular proliferation, migration and apoptosis. The current study aimed to analyze whether soluble TWEAK (sTWEAK) and MCP-1 levels are associated with the severity of coronary arterial disease (CAD) in CKD patients. Methods: Ninety-seven patients diagnosed with CKD stages 2-3 according to their estimated glomerular filtration rate and the presence of kidney injury were included in the study. Plasma sTWEAK and MCP-1 concentrations were determined using commercially available ELISA kits. Coronary angiographies were performed through femoral artery access using the Judkins technique. Results: Correlation analysis of sTWEAK and Gensini scores showed significant association (p < 0.01, r(2) = 0.287). Also significant correlation has been found in MCP-1 levels and Gensini scores (p < 0.01, r(2) = 0.414). When patients were divided into two groups with a limit of 17 according to their Gensini score, sTWEAK levels indicated a statistically significant difference (p < 0.01). Conclusions: Our findings support a relationship between sTWEAK and MCP-1 levels and CAD in CKD stages 2-3 patients.
    Full-text · Article · Sep 2015 · Renal Failure
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    B Bitik · S Unverdi · A Tufan · N Yesil · MA Ozturk · M Duranay

    Full-text · Article · Sep 2015 · Pediatric Rheumatology
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    ABSTRACT: Encapsulated peritoneal sclerosis (EPS) is a rare complication of long-term peritoneal dialysis usually associated with the inadequacy and early termination of dialysis modality. Adequate treatment of peritoneal fibrosis has not been achieved by medical intervention so far. Mycophenolate mofetil (MMF), which inhibits inosine monophosphate dehydrogenase reversibly and highly selectively, is the most widely used drug for maintenance immunosupression in renal transplantation. Recent studies have shown that MMF has also antifibrotic effects. In this study, we evaluated the effects of MMF on EPS model in rats based on antifibrotic effects. Twenty-four Wistar albino rat have been randomly divided into four groups. Group I (control group) received isotonic saline intraperitoneally (i.p) 2 ml/day for (0-3rd weeks). Group II (chlorhexidine (CG) group) received CG 2 ml/day i.p. for (0-3rd weeks). Group III (chlorhexidine + MMF group) received CG (2 ml/day) i.p. for (0-3rd weeks) plus MMF 30 mg/kg/day peroral (4th-6th weeks). Group IV (resting group) received CG 2 ml/day) i.p. (0-3rd weeks) plus peritoneal resting without any treatment (4th-6th weeks) At the end of the sixth weeks, all of the rats were killed. All of the groups were analyzed in terms of peritoneal thickness, degree of inflammation, vasculopathy, neovascularization and fibrosis. Also, the parietal peritoneal tissue samples were evaluated for matrix metalloproteinase 2 (MMP-2) by using the immunohistochemical analysis. When the CG group was compared with the MMF group, the medication resulted in a statistically significant reduction in peritoneal thickness, inflammation and fibrosis score (53.23 ± 16.24 vs. 17.22 ± 3.62, 1 ± 1.225 vs. 1 ± 0, 1.6 ± 0.548 vs. 0.2 ± 0.447, respectively, all p < 0.05). In the resting group, no beneficial effects on morphological abnormality of the peritoneum were observed as compared with MMF group. However, according to immunohistochemical analysis of the expression of MMP-2 on peritoneal samples, the highest expression of MMP-2 was observed in the MMF group. MMF was effective for the treatment of encapsulating peritoneal fibrosis in our rat model. Most recently, MMF may be first choice for EPS due to antifibrotic effect.
    Full-text · Article · Jul 2015 · International Urology and Nephrology

  • No preview · Article · Jun 2015 · Balkan Journal of Medical Genetics
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    Full-text · Article · May 2015
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    ABSTRACT: Background: We aimed to measure small, dense LDL (sdLDL) and lipoprotein-associated phospholipase A2 (Lp-PLA2) concentrations and to evaluate their relationship with other risk factors of atherosclerotic heart disease in dialysis patients. Methods: Study group consisted of 30 peritoneal dialysis and 20 hemodialysis patients with 20 healthy control subjects. sdLDL was measured by homogeneous LDL assay after precipitation of Apo B containing lipoproteins with heparin-magnesium. Lp-PLA2 mass was measured by immunoturbidimetric assay. Results: sdLDL concentrations in the samples collected before hemodialysis and peritoneal dialysis treatment were significantly higher than the control group (p < 0.05). Lp-PLA2 concentrations of both pre-hemodialysis and peritoneal dialysis groups were higher than control group (p < 0.05). There was not a significant correlation between sdLDL and Lp-PLA2. sdLDL concentrations are significantly decreased after a hemodialysis session. Conclusions: sdLDL and Lp-PLA2 concentrations are increased independently in the end stage renal failure patients who are receiving dialysis treatment.
    Full-text · Article · Oct 2014 · Clinical laboratory
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    ABSTRACT: This study was conducted to evaluate the efficacy and safety of once-monthly continuous erythropoietin receptor activator (CERA) for maintenance of stable haemoglobin (Hb) levels in adult chronic renal anaemia patients on dialysis according to local clinical judgment in Turkey. This was a prospective, open-label, single-arm, multi-centre study conducted in 20 centres in Turkey. After a 4-week screening period, eligible patients receiving conventional erythropoiesis-stimulating agents were converted to monthly intravenous CERA and entered a 16-week CERA dose-titration period (DTP) followed by an 8-week efficacy evaluation period (EEP) and a 4-week safety follow-up. The primary endpoint was the proportion of patients whose Hb concentration remained stable within ±1.0 g/dL of their reference Hb and within the range of 10.0-12.0 g/dL during the EEP. A total of 173 patients were screened, 132 entered the DTP and 84 completed the study. Thirty-nine patients [46.4% (95% confidence interval: 35.5-57.7%)] maintained stable target Hb concentrations. The mean change in time-adjusted average Hb concentration was 0.29 ± 1.08 g/dL between baseline and the EEP. The mean CERA monthly dose was 112.4 ± 76.78 µg during the EEP, and the CERA dose was adjusted in 39 patients (36.4%). Eleven patients (8.4%) reported 13 treatment-related adverse events, the most frequent adverse events being infections and infestations, gastrointestinal and vascular disorders. Once-monthly CERA maintains stable Hb concentrations in chronic renal anaemia patients on dialysis in Turkey. The study results confirm the known efficacy and safety profile of CERA.
    Full-text · Article · Oct 2014 · CKJ: Clinical Kidney Journal
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    ABSTRACT: Background/aim: Oral essential amino acids (AAs) containing supplements (EAS) and AA containing dialysate (ACD) are frequently used in peritoneal dialysis (PD) patients with malnutrition. The present study was conducted to investigate two strategies and compare their effects on the malnutrition status of PD patients. Materials and methods: A total of 31 EAS, 14 ACD patients were enrolled in this study. Serum albumin levels were lower than 3.5 g/dL in all subjects. EAS group patients took five pills containing AAs three times a day with meals. In the other, 2.000 cc of 1.1% ACD was given to patients daily during the study. Demographic and laboratory parameters were analyzed and compared at baseline and 6th month. Results: Significant increases in BMI, albumin, and protein in both groups. Mean albumin levels increased significantly by 0.54 g/dL in ACD group (p < 0.005) and 0.49 g/dL in EAS group (p < 0.001) following 6 months. Mean albumin and delta albumin levels did not differ between two groups. Conclusion: These strategies may play an important role in increasing albumin levels and improving the nutritional status of PD patients.
    No preview · Article · Sep 2014 · Renal Failure
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    ABSTRACT: Introduction: Long-term exposure to dialysis solutions is an important contributor to the ongoing inflammatory process in peritoneal dialysis (PD) patients. Some studies have shown amelioration of this adverse effect with biocompatible solutions. We aimed to compare the neutrophil-to-lymphocyte (N/L) ratio in PD patients using biocompatible and standard solutions and to find out the association between N/L ratio and peritonitis indices. Materials and methods: This was a cross-sectional, multicenter study involving 120 prevalent PD patients. Seventy-one patients (59%) were using biocompatible solutions and 49 patients (41%) were using standard solutions. From blood samples, N/L ratio and platelet-to-lymphocyte ratio were calculated and mean platelet volume, erythrocyte sedimentation rate and hs-CRP values were detected. Data regarding the peritonitis rate and time to first peritonitis episode were also recorded. Results: Biocompatible and standard groups were similar regarding age and gender. N/L ratio and hs-CRP levels have been found significantly higher in patients using biocompatible solutions (3.75 ± 1.50 vs. 3.27 ± 1.3, p = 0.04 and 3.2 ± 2.5 vs. 1.8 ± 2.0, p < 0.01, respectively). Peritonitis rates and time to the first peritonitis episode were found similar in patients using both types of solutions (0.23 ± 0.35 vs. 0.27 ± 0.32, p = 0.36 and 32.8 ± 35.8 vs. 21.5 ± 26.9 months, p = 0.16, respectively). Discussion: N/L ratio was significantly higher in biocompatible solution users in parallel to hs-CRP levels, so biocompatible solutions seem to be related with increased inflammation in PD patients. Although we cannot make a certain explanation, we assume that there may be an association between acidity of the peritoneal content and virulence of microorganisms.
    Full-text · Article · Jul 2014 · Renal Failure
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    ABSTRACT: Objective: The association between hantavirus seropositivity and chronic renal failure has been reported in several studies. The objective of this study is to investigate the prevalence of hantavirus antibodies among patients with end-stage renal failure undergoing hemodialysis and continuous ambulatory peritoneal dialysis in Ankara and Ki{dotless}ri{dotless}kkale cities. Methods: A total of 125 patients including 68 females (mean age, 48 years) and 57 males (mean age, 45.8 years) with chronic renal failure undergoing hemodialysis or continuous ambulatory peritoneal dialysis, and 47 healthy subjects including 24 females (mean age, 55.9 years) and 23 males (mean age, 49.5 years) were included in the study. Hantavirus IgM and IgG antibodies were investigated by ELISA. Results: Hantavirus IgM and IgG positivity were not detected in any of the patients and control group. Conclusions: Controlled studies performed on endemic patient groups including more cases are required to establish the role of hantavirus infection in patients with chronic renal failure.
    No preview · Article · Jun 2014 · Klimik Dergisi

  • No preview · Article · May 2014
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    ABSTRACT: Background: Chronic Heart Failure (CHF) is highly prevalent and is associated with high morbidity and mortality rates. It has been well established that excessive intake of sodium chloride (salt) induced hypertension in some populations. Although salt seems to induce cardiovascular diseases through elevation of blood pressure, it has also been indicated that salt can induce cardiovascular diseases independently from blood pressure elevation. Objectives: The present study aimed to evaluate the association between salt consumption and inflammation in CHF patients. Patients and Methods: This study was conducted on 86 patients between 18 and 65 years old who were diagnosed with New York Heart Association (NYHA) functional class I and II heart failure. Salt intake was calculated by using 24 hour urine sodium excretion. Besides, the association between inflammation and daily salt intake was evaluated regarding C -reactive protein (CPR), High sensitive CRP (HsCPR), Erythrocyte Sedimentation Rate (ESR), and ferritin and fibrinogen levels using Pearson correlation analysis. Results: Our results showed a statistically significant difference between the low (n = 41) and high (n = 45) salt intake groups in terms of serum HsCRP levels (5.21 ± 2.62 vs. 6.36 ± 2.64) (P < 0.048). Additionally, a significant correlation was observed between the amount of salt consumption and HsCRP levels. In this study, daily salt consumption of the enrolled patients was 8.53 gram/day. The medications and even the blood pressures were similar in the two groups, but daily pill count, prevalence of hypertension, and coronary heart disease were higher in the high salt intake group; however, the differences were not statistically significant (P = 0.065). Also, no significant difference was observed between the groups concerning the inflammation markers, such as CRP, ESR, ferritin, and fibrinogen. Conclusions: Neurohumoral and inflammatory factors are thought to contribute to high mortality and morbidity rates in CHF. Yet, inflammatory markers may early diagnose CHF and predict the prognosis. Excessive salt intake also worsens the inflammation as well as volume control. ►Implication for health policy/practice/research/medical education: Our work is about the association of inflammation and salt intake in chronic heart failure patients. Salt restriction is recommended to these patients. This approach may also contribute to lower the degree of inflammation besides volume and blood pressure control. Even there has been no intervention in our study, our results show the association between salt intake and inflammation in patients with heart failure.
    Full-text · Article · May 2014 · International Cardiovascular Research Journal
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    ABSTRACT: Introduction and Aims: Admissions and deaths have been shown to vary according to day of the week in patients receiving haemodialysis. Patients with a range of chronic diseases are more likely to be admitted on a Monday, and have higher hospital associated mortality at the weekend. We set out to explore these associations in patients receiving peritoneal dialysis (PD).mortality at the weekend. These associations are explored in patients receiving peritoneal dialysis (PD). Methods: Information on patients receiving PD from a cohort of patients starting renal replacement therapy in England between 2002 and 2006 collected by the UK Renal Registry was linked to hospitalisation data. Admission and death rates (in hospital and out of hospital) by day of the week whilst receiving PD were calculated. 90 day technique survival following admission for PD peritonitis according to day of the week was analysed using cox regression with a random effects term for renal centre, comparing each day of the week to Wednesday when services should be optimal. Results: 27,649 admissions in 6363 patients over 17,620 patient years were available for analysis. Mortality rate was 7.8 per 100 patient years and was stable across the week for both in hospital and out of hospital death. Acute admission rate was 1.15/year for Monday to Friday and 0.85/year for the weekend (P<0.001). Admissions specifically for peritonitis were slightly lower at the weekend (25.0 vs 26.5 per 100 patient years, P=0.004). Compared with technique survival following admission with peritonitis on a Wednesday, Monday was associated with an increased risk (hazard ratio 1.18, 95% CI 1.01 - 1.38, P=0.04) an association that persisted adjusting for age, comorbidity, ethnicity and including death as a technique failure event (hazard ratio 1.20, 95% CI 1.02 - 1.40 P=0.027). View larger version: In this window In a new window Download as PowerPoint Slide
    Full-text · Article · May 2014 · Nephrology Dialysis Transplantation
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    ABSTRACT: Background: Coagulation abnormalities have been reported in familial Mediterranean fever (FMF) patients with amyloidosis and nephrotic syndrome; but there is not enough data about the continuity of the thrombogenic activity in FMF patients in clinical remission. The purpose of this study was to assess thrombin activatable fibrinolysis inhibitor (TAFI) levels and its relationship with fibrinolytic activity and also evaluate relationships between mutations and clinical signs in attack-free patients without amyloidosis. Methods: Seventy-nine FMF patients and 40 healthy adults were included. The study group was divided into five groups as follows: first group, homozygote M694V; second group, homozygote M680I; third group, M694V in one allele, the other allele have other mutations or not; fourth group, other mutations; and fifth group, no mutation. Results: Serum TAFI levels were significantly increased in patients compared with healthy individuals (116.64 ± 21.8 vs. 78.48 ± 19.7 μg/mL, p < 0.001) and a positive correlation was detected between TAFI antigen level and erythrocyte sedimentation rate and C-reactive protein levels (r = 0.247, p = 0.029 and r = 0.252, p = 0.032, respectively). Mean fibrinogen and TAFI levels were significantly higher in Group 1 than the other groups (p = 0.04 and p = 0.001, respectively) and in Group 3 it was higher than Groups 2, 4 and 5 (p = 0.04 and p = 0.001, respectively). Conclusions: High level of TAFI antigen in attack-free period of FMF disease shows ongoing subclinical inflammation and hypercoagulability. Clinicians should be careful about thrombosis even in patients at clinical remission. Also, genetic tests must be considered to predict clinical outcome and to reduce complications of FMF disease.
    Full-text · Article · Mar 2014 · Renal Failure
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    ABSTRACT: Despite the developments in modern medicine, acute renal injury is still a challenging and common health problem. It is well known that ischaemia and reperfusion takes place in pathological mechanisms. Efforts to clarify the pathophysiology and interventions to improve outcomes are essential. Our study aimed to investigate whether the prophylactic use of paricalcitol is beneficial in renal ischaemia/reperfusion (I/R) injury. Twenty-four Wistar albino rats were assigned randomly to four groups. Right nephrectomies were performed at the time of renal arterial clamping. Sham surgery was performed on the rats in group 1. For the rats in group 2, the left renal artery was clamped for 45 minutes. The rats in group 3 received paricalcitol for seven days (0.2μg/kg/day); following this, a right nephrectomy and left renal arterial clamping were not performed. The rats in group 4 received paricalcitol for seven days (0.2μg/kg/day); following this, a right nephrectomy and left renal arterial clamping for 45 minutes were performed. Tissue thiobarbituric acid reactive substances (TBARS), superoxide dismutase, sulfhydryl groups as well as nitric oxide metabolites, serum urea and creatinine levels were measured for all four groups. In group 4, there were some improvements in terms of TBARS, nitrite, nitrate, superoxide dismutase and creatinine levels. In the histopathological evaluation, paricalcitol therapy improved tubular necrosis and medullar congestion but there was no significant difference in terms of tubular cell swelling, cellular vacuolisation or general damage. Immunohistopathological examination revealed lower scores for vascular endothelial growth factor in the group 4 rats than in group 2. Paricalcitol therapy improved renal I/R injury in terms of serum and histopathological parameters. These potential beneficial effects need to be further investigated.
    No preview · Article · Oct 2013 · Annals of The Royal College of Surgeons of England
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    ABSTRACT: Aim: We aimed to investigate the QT dispersion and corrected QT (QTc) dispersion which are suggested as the signals of ventricular arrhythmias, in patients on maintenance CAPD and to evaluate the correlation between iron stores and these electrocardiographic parameters. Materials and method: Fifty-eight patients on maintenance CAPD and 19 healthy age- and sex-matched adults without cardiac disease were included. The PD patients were divided into two groups according to whether their computerized measurements of QTc dispersion were longer than 65 ms. Results: Although QT interval was statistically significantly shorter in control group (34 ± 28 vs. 43 ± 34 ms; p < 0.05), there was no significant difference in regards to the QTc, QT dispersion and QTc dispersion between two groups. PD patients with QTc dispersion longer than 65 ms had higher levels of serum ferritin (p = 0.038) and transferrin saturation (TSAT; p = 0.022) than the others. QTc dispersion were positively correlated with ferritin (r = 0.469, p < 0.01) and TSAT (r = 0.430, p < 0.01) in CAPD patients. Conclusion: Although prolonged QTc, QT dispersion and QTc dispersion were suggested as the markers of ventricular arrhythmias we did not find any significant difference in regards to these parameters between control patients and CAPD patients. But the high body iron stores in these patients increase the risk of increased QT dispersion. The concern over iron overload in dialysis patients is not only because of its oxidative toxicity, but also its precipitation of arrhythmias, which may be measured by the surrogate marker of QTc dispersion.
    No preview · Article · Sep 2013 · Renal Failure

Publication Stats

708 Citations
253.04 Total Impact Points

Institutions

  • 2005-2014
    • Ankara Numune Training and Research Hospital
      Engüri, Ankara, Turkey
  • 2012
    • Ulucanlar Eye Education and Research Hospital
      Engüri, Ankara, Turkey
  • 2011
    • Haydarpasa Numune Research and Teaching Hospital
      İstanbul, Istanbul, Turkey
  • 2010
    • Ankara University
      • Department of Nephrology
      Engüri, Ankara, Turkey
  • 2005-2008
    • Ministry of Health, Turkey
      Engüri, Ankara, Turkey
  • 2007
    • Fatih University
      • Department of Nephrology
      İstanbul, Istanbul, Turkey
    • Ankara Güven Hospital
      Engüri, Ankara, Turkey