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Öğe Ace gene polymorphisms are ineffective on contrast induced nephropathy(Elsevier, 2022) Kilic, Ilhan; Palabiyik, Orkide; Taylan, Gokay; Sipahi, Tammam; Ustundag, SedatBackground: The renin-angiotensin system regulates the haemodynamics. ACE gene polymorphisms are known to influence serum angiotensin converting enzyme level. Contrast nephropathy develops after exposure to intravascular contrast media that influence vascular hemodynamics. ACE gene polymorpisms may have an enhancing role in contrast media related renal injury. The aim of the study: The aim of this study was to investigate the impact of ACE insertion/deletion (I/D) polymorphism in contrast-induced nephropathy (CIN) development. Methods: 194 patients with chronic kidney disease that were administered iodinated contrast media were examined. Patients were monitored for at least 7 days for CIN development after parenteral contrast exposure. Control and patient groups were divided in terms of CIN development status. Polymerase chain reaction was performed for the genotyping of the ACE gene polymorphism from DNAs that were isolated from peripheral blood of the patients. Results: 83 patients with CIN (34 women, 49 men) and 111 control patients without CIN (43 women, 68 men) were enrolled. Gender was not statistically different between the two groups (p = 0.75). The average age of the CIN group (71) was greater than that of the control group (68). No association was detected between ACE gene polymorphism (II, ID AND DD genotypes) and CIN in both patients and controls. Conclusion: ACE gene polymorphisms does not influence contrast induced nephropathy development.Öğe Atypical Presentation of Rectus Sheath Hematoma in a Hemodialysis Patient: Recurrent Abdominal Pain After Dialysis Sessions(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2017) Kilic, Ilhan; Kurultak, Ilhan; Ustundag, SedatRectus sheath hematoma is a rare but well-known cause of acute abdominal pain. Rectus sheath hematoma is largely misdiagnosed as seen rarely. As a fatal disorder it must be suspected especially in patients receiving anticoagulant therapy for any reason. Heparin exposure during hemodialysis sessions and uremic bleeding diathesis causes chronic hemodialysis patients to be vulnerable to rectus sheath hematoma. Rectus sheath hematoma may be mild and self-limiting but also be so severe that it threatens life because of hypotensive shock and anemia-related risks. The patient may present without symptoms, with abdominal pain or with hemodynamic shock. We present a case report describing a patient with recurrent abdominal pain due to rectus sheath hematoma exacerbating after hemodialysis sessions.Öğe Endocarditis and Calcific Uremic Arteriolopathy: Is it a Coincidence or an Association? Case Report(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2016) Kurultak, Ilhan; Kilic, Ilhan; Sezer, Betul; Tuncel, Sedat; Tastekin, Ebru; Ustundag, SedatThe uncommon complications regarding CKD tend to increase in clinical setting because of the chronic kidney disease (CKD) population has been expanding every passing day. Perhaps the most important one of these is calcific uremic arteriolopathy (CUA, calciphylaxis). Calcific uremic arteriolopathy is a clinical syndrome which includes systemic calcification of the small vessels, causes to ischemia, subcutaneous necrosis and it has high mortality and morbidity rates (1,2). There is a large body of data in literature about CUA although very little for its cardiac involvement. Herein we presented a case of calcific endocarditis with CUA and the review of the literature. According to our observation, parathyroidectomy was effective to provide clinical and radiological improvement in the presented case. The clinician should consider adding parathyroidectomy to conventional strategies immediately if the risk of such uncontrolled hyperparathyroidism is present.Öğe Investigation of VEGF and IL-8 Gene Polymorphisms in Patients with Differentiated Thyroid Cancer(Clin Lab Publ, 2016) Kilic, Ilhan; Guldiken, Sibel; Sipahi, Tammam; Palabiyik, Orkide; Akker, Mustafa; Celik, Ozlem; Soysal-Atile, NeslihanBackground: Differentiated thyroid carcinomas (DTC) account for most of the thyroid cancers. The emergence of DTC may be affected by various predisposing genetic alterations and environmental factors The aim of this study was to investigate the role of VEGF C936T and IL-8 A251T gene polymorphisms in the pathogenesis and metastasis of differentiated thyroid cancer. Methods: The study consisted of 101 patients DTC patients and 109 healthy controls. The parameters of the stage of cancer of the DTC patients at the time of diagnosis (TNM) were recorded. DNA was isolated from blood using a DNA isolation kit. VEGF C936T and IL-8 A251T gene polymorphisms were determined using the polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) methods. Distributions of gene polymorphisms were evaluated according to the Hardy-Weinberg principle. Results: The TT genotype from the VEGF C936T genotype distributions was higher in the control group than in the DTC group (p < 0.05). In contrast, the IL-8 A-251T genotype distributions were similar in both groups. No relationship was found between either cytokine gene polymorphism or the DTC stages. The frequency of IL-8 TT was higher in the DTC group with lymph gland metastasis (TT 92%) than in the group without lymph gland metastasis (TT 45.9%) (p < 0.05). Conclusions: We consider that the VEGF 936 TT genotype may play a protective role in the development of DTC and that the IL-8 A-251 TT genotype may contribute to the DTC lymph node metastasis. Therefore, these genotypes may hold a key to the evaluation of thyroid nodules and the metastasis of DTC.Öğe Quality of life and sleep, depression, family functioning, and marital adjustment in patients on hemodialysis and peritoneal dialysis(Wiley, 2024) Kilic, Evnur Kahyaci; Kilic, Ilhan; Gorgulu, Yasemin; Ustundag, SedatIntroduction: End-stage renal disease is different from other chronic diseases that the treatment method is as difficult. Our aim in this study was to compare marital adjustment, sexual functions and family functioning between hemodialysis (HD) and peritoneal dialysis (PD) patient. Method: A total of 21 HD and 27 PD patients were included. Beck Depression Inventory (BDI), Short Form-36 (SF-36), Pittsburgh Sleep Quality Index (PSQI), Arizona Sexual Experiences Scale (ASEX), Golombok-Rust Inventory for Sexual Satisfaction (GRISS), Marital Adjustment Test (MAT) and Family Assessment Device (FAD) were applied. Results: BDI scores were significantly higher in HD patients (p < 0.001). According to FAD problem solving (p < 0.001), communication (p = 0.00) and general functioning scores (p = 0.04) were higher in PD. The rate of poor sleep quality was 44.4% in the PD group, and 66.7% in HD group (p = 0.12). General health (p = 0.04), vitality (p < 0.001), mental health (p = 0.00) and social functioning (p = 0.00) scores were lower in HD patients. Conclusion: HD patients are at high risk for psychiatric disorders due to the treatment modality. These patients should be monitored carefully and consultation-liaison services should be increased.Öğe Relapsing Serratia peritonitis resulting in peritoneal catheter loss(Wolters Kluwer Medknow Publications, 2018) Kilic, Ilhan; Gungor, Kultural; Kurultak, Ilhan; Ustundag, SedatSerratia marcescens (SM) is an opportunistic Gram-negative bacterium. It can cause technique failure or severe sepsis despite being a rare agent causing peritonitis. We present a case of a 40-year-old woman with end-stage renal disease secondary to chronic glomerulo-nephritis on continuous ambulatory peritoneal dialysis (PD). She presented with severe abdominal pain and a cloudy peritoneal fluid. The fluid was cultured according to our unit protocol. The organism isolated was identified as SM; this was after the patient was treated for SM peritonitis one week earlier. The response to treatment with ceftazidime was poor despite being sensitive in vitro. The peritoneal catheter was removed due to rapid clinical deterioration. Piperacillin-tazobactam (PIP/TAZ) monotherapy was successfully administered subsequently. Eventually, she was transferred to hemodialysis (HD). SM is an uncommon cause of PD-related peritonitis. It may cause catheter loss and even death. In our case, the infection could be controlled only after catheter removal, and she was transferred to HD. Cephalosporins should rapidly be changed to PIP/TAZ when SM is isolated from the peritoneal fluid.Öğe The role of eNOS gene polymorphisms on contrast induced nephropathy development in chronic kidney disease patients(Wiley, 2023) Kilic, Ilhan; Palabiyik, Orkide; Kurultak, Ilhan; Sipahi, Tammam; Ustundag, SedatIntroduction Contrast nephropathy is a result of contrast media given through intravascular routes. Nitric oxide gene polymorphisms may alter the hemodynamic stability resulting in medullary ischemia Nitric oxide gene polymorphisms may have an enhancing role in contrast media related renal injury. The aim of this study was to investigate the role of eNOS intron 4a/b, T786C, and G894T gene polymorphisms on contrast-nephropathy risk. Methods Ninety-four chronic kidney disease patients with contrast nephropathy and 120 chronic kidney disease patients without contrast nephropathy were included. DNA isolation was performed and specific regions of DNA for eNOS G894T, T786C, and intron 4a/b genes were amplified by polymerase chain reaction technique. Results TT polymorphism of T786C gene and GG polymorphism of G894T gene were detected to be possibly protective from contrast induced nephropathy. Conclusion Endothelial nitric oxide synthase G894T gene polymorphisms, older age, and presence of diabetes mellitus may influence contrast nephropathy development.Öğe Scintigraphy as a Reliable Technique for Diagnosis and Follow-Up of Pleuroperitoneal Leakage in Peritoneal Dialysis Patients(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2016) Kilic, Ilhan; Kurultak, Ilhan; Aktas, Gul; Ustundag, Sedat; Sarikaya, AliMetabolic and mechanic complications can be seen due to peritoneal dialysis. Pleuroperitoneal leakage is rare but can be a life-threatening mechanic complication of peritoneal dialysis. Some techniques have been used to diagnose this entity. Radionuclide imaging can be used as a reliable technique in order to show the pleuroperitoneal passage and can be used to show the recovery. Herein we present the first case report in the literature about a patient with pleuroperitoneal shunt that was demonstrated scintigraphically during the leakage and after the resolution.
