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1. A model for acute kidney injury in severe burn patients

Author

Cem Aydogan, Emre Karakaya, Cihat Burak Sayin, Ebru H. Ayvazoglu Soy, Mehmet Haberal, Sait Can Yücebaş, Omar Alshalabi, Aydincan Akdur, and Emin Turk

Subjects
Adult, medicine.medical_specialty, Resuscitation, Burn injury, medicine.medical_treatment, Critical Care and Intensive Care Medicine, 030207 dermatology & venereal diseases, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Oliguria, Internal medicine, Medicine, Humans, Medical history, Renal replacement therapy, Retrospective Studies, Creatinine, business.industry, Acute kidney injury, 030208 emergency & critical care medicine, General Medicine, Acute Kidney Injury, medicine.disease, Renal Replacement Therapy, chemistry, Emergency Medicine, Surgery, medicine.symptom, business, Burns, Kidney disease
Abstract

Introduction In patients with severe burns, morbidity and mortality are high. One factor related to poor prognosis is acute kidney injury. According to the AKIN criteria, acute kidney injury has 3 stages based on urine output, serum creatinine level, and renal replacement therapy. In this study, we aimed to create a decision tree for estimating risk of acute kidney injury in patients with severe burn injuries. Methods We retrospectively evaluated 437 adult patients with ≥20% total burn surface area injury who were treated at the Baskent University Ankara and Konya Burn Centers from January 2000 to March 2020. Patients who had high-voltage burn and previous history of kidney disease were excluded. Patient demographics, medical history, mechanism of injury, presence of inhalation injury, depth of burn, laboratory values, presence of oliguria, need for renal replacement therapy, central venous pressure, and prognosis were evaluated. These data were used in a “decision tree method” to create the Baskent University model to estimate risk of acute kidney injury in severe burn patients. Results Our model provided an accuracy of 71.09% for risk estimation. Of 172 patients, 78 (45%) had different degrees of acute kidney injury, with 26 of these (15.1%) receiving renal replacement therapy. Our model showed that total burn surface area was the most important factor for estimation of acute kidney injury occurrence. Other important factors included serum creatinine value, burn injury severity score, hemoglobin value, neutrophil-to-lymphocyte ratio, and platelet count. Conclusion The Baskent University model for acute kidney injury may be helpful to determine risk of acute kidney injury in burn patients. This determination would allow appropriate treatment to be given to high-risk patients in the early period, reducing the incidence of acute kidney injury.

Published
2020

3. Post-transplantation Anemia Predicts Cardiovascular Morbidity and Poor Graft Function in Kidney Transplant Recipients

Author

M.E. Uyar, Emre Tutal, Mehmet Haberal, F. N. Özdemir Acar, Siren Sezer, Cihat Burak Sayin, and B. Gurlek Demirci

Subjects
Adult, Male, medicine.medical_specialty, Anemia, Renal function, Pulse Wave Analysis, Ventricular Function, Left, Muscle hypertrophy, Ventricular Dysfunction, Left, Vascular Stiffness, Internal medicine, Humans, Medicine, Kidney transplantation, Transplantation, medicine.diagnostic_test, business.industry, Graft Survival, Complete blood count, Middle Aged, Prognosis, medicine.disease, Kidney Transplantation, Transplant Recipients, Surgery, Cardiovascular Diseases, Echocardiography, Erythropoietin, Arterial stiffness, Cardiology, Kidney Failure, Chronic, Female, Hypertrophy, Left Ventricular, business, medicine.drug
Abstract

We aimed to investigate whether low post-transplantation-period hemoglobin levels are predictive of cardiovascular morbidity in terms of left ventricular (LV) hypertrophy and vascular stiffness and to determine the contributing factors of post-transplantation anemia in kidney transplant (KT) recipients.One hundred fifty (mean age, 38.9 ± 10.8 y; 113 male) KT recipients with functioning grafts were enrolled in the study. All subjects underwent clinical and laboratory evaluations (24-hour urinary protein loss, complete blood count) and transthoracic echocardiography to assess LV systolic function. Arterial stiffness was measured by means of carotid-femoral pulse-wave velocity (PWV). Mean hemoglobin levels were analyzed at the 1st, 6th, 12th, and 24th months after transplantation. Patients were divided into 2 groups according to presence of anemia: patients with anemia (group 1; n = 120) and normal (group 2; n = 30).PWV values (6.8 ± 1.9 m/s vs 6.4 ± 1.1 m/s in groups 1 and 2, respectively; P = .002) and LV mass index (LVMI; 252.1 ± 93.7 g/m(2) vs 161.2 ± 38.5 g/m(2) groups 1 and 2, respectively; P = .001) were significantly higher in group 1. Estimated glomerular filtration rate and (64 ± 28.5 m/min vs 77.8 ± 30 m/min in groups 1 and 2, respectively; P = .001) LV systolic function (57.2 ± 5.8% vs 77.8 ± 30% in groups 1 and 2, respectively; P.005) were significantly lower in group 1. In regression analysis, LV systolic function and LVMI were predictors of post-transplantation hemoglobin levels.Post-transplantation anemia contributes to cardiovascular morbidity by deteriorating LV function and increasing PWV and is therefore associated with poor prognosis for graft survival. Early correction of post-transplantation anemia, especially with the use of erythropoietin, may be beneficial for both graft and recipient survivals.

Published
2015
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4. Transplantation - clinical II

Author

Handan Ozdemir, Himanshu V Patel, Tingli Wang, Izumi Yamamoto, Anna Perri, Eva Svobodova, Alberto Mella, Alexander Kildushevsky, Ole Øyen, Nicolas Congy-Jolivet, Sergio Luis-Lima, Yuangao Zou, Hideki Fuji, Tolga Yildirim, Norihiko Goto, Marian Klinger, Leonídio Dias, Won Seok Yang, Lanlan Wang, Tatjana Cvetkovic, Barbara Assenzio, Filiz Bakar, Samantha Mantovani, Halil Yazici, Vijay Thanaraj, Priyadarshini S Shah, Solbjørg Sagedal, Francesca Sidoti, Anupma Kaul, Giordano Zampi, Dharmendra Bhadauria, Moncef Mokni, Tatjana Jevtovic Stoimenov, Tine Thurison, Alessia Di Nauta, Christos S. Katsouras, Franca Sinesi, Denisa Mendonça, Jude Yagan, Atsushi Miki, Giorgos Spanos, F. Zalamea Jarrin, Maria Cristina Di Vico, Francesca Greco, Marco Ballestri, Veena R Shah, Takashi Yokoo, António Castro Henriques, Pranjal R Modi, Vito Fanelli, Andrey Vatazin, Jiri Fronek, Siren Sezer, Anna Teresa Mazzeo, Takayuki Yamamoto, Karen Stopper, Jerzy Chudek, Antonij Slavcev, Deepak Shankar Ray, Takaaki Kimura, Claudio Musetti, Christina Dörje, Lidija Orlić, Osman Ilhan, Rahmi Yilmaz, Francesca Damiano, Mehmet Gokhan Caglayan, Marcel Naik, Ken Kitamura, Maarten B. Rookmaaker, Arjan D. van Zuilen, Pablo Raffaele, Trond Jenssen, Yosu Luque, Masato Fujisawa, Katerina K. Naka, Giuseppe Paolo Segoloni, Ioannis Gkirdis, Leonardo Caroti, Maarten Naesens, Klemens Budde, Rossana Cavallo, Nanna von der Lippe, Ilaria Mastromauro, A. Azzebi, Rigas Kalaitzidis, Fredrik B. Brekke, António Cabrita, Sławomir Zmonarski, Flavio Vincenti, Alessandro De Vincenzi, Hela Ghezaiel, Vasilis Koutlas, Elena Cremaschi, Dorota Kamińska, Mark A. J. Devonald, Kostas C. Siamopoulos, Mahmut Altindal, Mehtap Ekmen Uyar, Dobrin Svinarov, Abdulrahman Housawi, Sanjin Rački, Wissal Sahtout, Ramazan Cetinkaya, Emre Tutal, Luísa Lobato, Mehmet Sukru Sever, Umberto Maggiore, Momir Mikov, Dorry L. Segev, Inés Beired Val, Stefania Bussolino, Fernando Gil Catalinas, Steffen Thiel, Anna Kotsia, Olesja Rissling, Halil Ermis, Borelli K. Zlatkov, Adam Varga, Efrat Harel, Eva Pokorna, P. Chudoba, Saliha Uyanık, Kostas Pappas, Maria Vittoria Mauro, Viktorija Dragojevic-Simic, Alexey Zulkarnaev, Vural Taner Yilmaz, Mikiko Yoshikawa, Luciana Mascia, Aureliusz Kolonko, Yasunaru Sakuma, Manoj R Gumber, Jens Bollerslev, Maria Boratyńska, Kathy Denesyk, Lionel Rostaing, Fabrizio Fop, Carlo Massimetti, Tak Mao Chan, Jamal Rizvi, Predrag Vlahovic, Anna Maria Degli Antoni, Yasuo Takeuchi, Bård Waldum, Pieter Evenepoel, Dai Kohguchi, Aurelio Rodríguez-Hernández, Marcin Protasiewicz, Yudo Tannno, Samira Ben Amor, Sofia Pedroso, Rusudana Kantaria, Nikola Stefanović, Renzo Bonofilgio, Kristin Godang, Hans-H. Neumayer, Aydin Turkmen, Bosiljka Devcic, Oktawia Mazanowska, Tomasz Dawiskiba, Zeynep Bal, Donatella Vizza, J. Portoles Perez, Maggie Ming Yee Mok, Veronika Fedulkina, Josefina Santos, Byung Ha Chung, Altagracia Bello Ovalle, Lampros Lakkas, Jean-Luc Taupin, Anis Belarbia, Anil Chandraker, Andrea Ranghino, Sharmas Vali, Yaeni Kim, Yong-Soo Kim, Dorota Bartoszek, Sakuma Yasunaru, Mirosław Banasik, Malgorzata Kaminska, Cheol Whee Park, Jonathan Visentin, Fulvia Giaretta, Nobuo Tsuboi, Nathan T. James, Tiziana Cena, Tri Q. Nquyen, Giovanni Piotti, Huseyin Kocak, Armando Torres, Milagros Sierra Carpio, Gabriela Pimentel Guzmán, O. Lafuente Covarrubias, B. Sanchez Sobrino, Yuliya V Smedbraaten, Morten W. Fagerland, Pankaj R Shah, Amin Amro, Maria Granito, Davide Diena, Hargovind L Trivedi, Kenan Keven, Hyuk Y Kwon, Bei Cai, Alena Parikova, Ercan Turkmen, Jean J. Filipov, Marc-Olivier Timsit, Alastair Ferraro, Nicoline M.H. Veldhuijzen, Ibrahim Aliosmanoglu, Koji Nanmoku, R K Sharma, Neven Vavic, Anders Hartmann, Nilgun Aysuna, Geir Mjøen, Barbara Sandor, Gianni Cappelli, Louise Moist, José-Carlos Oliveira, Salima Kejji, Alena Verflova, Haralampos Harisis, Babak J. Orandi, Cristina Izzo, Andras Toth, Ana González-Rinne, Ivana Mikolašević, Mehmet Haberal, Petra Reinke, Akimitsu Kobayashi, Marion Rabant, Agnieszka Sas, Giulia Ligabue, Soumava Gupta, Dmytro Khadzhynov, Soon Bae Kim, Fatih Yılmaz, Gunilla Høyer-Hansen, Fotios Zarzoulas, Semra Bozfakioglu, O. Guliyev, Mehtap Erkmen Uyar, Yasuyuki Nakada, Zeynep Kendi Celebi, Alejandro Jiménez-Sosa, Christophe Legendre, Haralampos Pappas, José Davide, Sandro Feriozzi, Keitaro Yokoyama, Mustafa Arici, Esteban Porrini, Niraj M. Desai, Dany Anglicheau, Enrico Eugenio Minetti, Shunji Narumi, Federica Civiletti, Bahar Gurlek Demirci, Pierre Merville, Pablo Klin, Natalia Negrín-Mena, Roberta Fenoglio, Pratik Das, Marco Quaglia, Abdelatif Achour, Martina Pavletic Persic, Turan Colak, Hallvard Holdaas, Hyun Seon Kim, Charlie Martinez, Nemanja Jacimovic, Sung H Son, Carlo Buzio, Francesco Fontana, Giorgos Tzeltzes, Anders Åsberg, Andrea Kantor, Sébastien Lepreux, Ana Aldea-Perona, Laure-Hélène Noël, Takafumi Yamakawa, Daniela Perugini, Magdalena Szotowska, Ichiro Ohkido, Antonio Gil Paraíso, Aruna V Vanikar, Nurhan Ozdemir Acar, Manuela Guedes de Almeida, Bo Ying Choy, Charles S. Craik, Antoine Bello, Andrzej Wiecek, Bang-Gee Hsu, Massimo Rittà, Cristina Giraldi, Björn Meijers, Gwendaline Guidicelli, Henri Kreis, Chul Woo Yang, Augusto Vaglio, Marit Elizabeth Von Düring, Kouji Nannmoku, Riccardo Magistroni, Yunus Erdem, Katrien De Vusser, Marta Artamendi Larrañaga, Hiroyasu Yamamoto, Luigi Biancone, Giorgos Nakas, Rita Marcela Fortunato, Enma Huarte Loza, Nemanja Rancic, Andrea Airoldi, Katarzyna Koscielska-Kasprzak, Francesca Leone, Kazunari Yoshida, R. Llopez Carratala, Miyeon Kim, Andrea Cossarizza, Gabriele Guglielmetti, G. Tognarelli, Burak Sayin, José Manuel González-Posada, Jin Kong, Bulent Altun, Ingrid Os, Anne Theakstone, Shantanu Bhattacharjya, Piotr Kuczera, Gian Domenico D Fabbri, Lionel Couzi, Yosra Guedri, Nurhan Ozdemir, Cristina Costa, Chung Hee Baek, Emil P. Dimitrov, Ester Gallo, Dirk Kuypers, Hermann Hernandez Vargas, Massimo Gai, Rohit Rungta, Jun-Seok Kim, Piero Stratta, Takashi Yagisawa, Cihat Burak Sayin, Antonio Amoroso, Faisal Rehman, Maria Zanazzi, P. Dominguez Apiñaniz, Teresa Papalia, Franco Brescia, Vesna Lukenda, Ruben Poesen, Gea Imperato, P. Carta, Davide Medica, Alessandra Palmisano, S. Karsten Alvarez, Rozenn Clément, Jelena Katic, F Ersoy, Vladimir Hanzal, Safa Nouira, Manisha Sahay, K. Kalmár-Nagy, Michele Battista, Eun J Whang, Kalman Toth, Andrew A. House, Anna Varberg Reisæter, Hyung Jin Cho, Evangelia Dounousi, Irini Tzalavra, Sabri Ferdaws, Gultekin Suleymanlar, Limei Luo, Ayhan Dinckan, Ilaria Deambrosis, Begum Erdemir, Akinori Nukui, Thomas Schachtner, Karsten Midtvedt, Cecilia Dall Anesse, Ewelina Sikora-Grabka, Domingo Marrero, Ming-Che Lee, Vivek B Kute, Lourdes Pérez-Tamajón, Ana Coloma Lopez, Maria Messina, Ozgur Akin Oto, Lorraine Kwan, Robert A. Montgomery, Aris Bechlioulis, Olga Balafa, Isabel Fonseca, Aida Larti, Magdalena Krajewska, Akira Kurosawa, Toshihisa Iwabuchi, Janka Slatinska, Teppei Ohyama, Agnieszka Hałoń, Daisuke Ishii, Dag Olav Dahle, Su-Kil Park, Soumaya Ben Abdelkrim, Won Y Choi, Fatma Nurhan Ozdemir Acar, Sanda Mrabet, Lorenzo Di Maria, Saliha Yildirim, Oliver Staeck, Aleksandra Kovacevic, Elisa Buti, Yasar Caliskan, Lampros K. Michalis, Makoto Tsujita, Paweł Madej, Michalis Mitsis, Eduardo Salido, Ondrej Viklicky, Kiranmai Ismal, Yoshihiko Watarai, Dimitris Evangelou, Hege Pihlstrøm, Dorsaf Zellama, Chul Soo Yoon, Radmila Veličković Radovanović, Thomas Bachelet, Duck Jong Han, Paolo Gigliotti, Shinichi Nishi, Danilo Lofaro, Nassim Kamar, Fabian Halleck, Charlotte Ng, Erik H. Strøm, Aki Mafune, Sara De Biasi, Selami Kocak Toprak, António Castro-Henriques, Fabiola Pagani, Alaattin Yildiz, Marcin Adamczak, Pablo Bridoux, Marina Colic, Anara Amanova, Kyeong Woo Nho, Anna V. Reisæter, Bum Soon Choi, Hugo Sanabria, Enrique Ramalle Gómara, Ayse Serra Artan, Walther H. Boer, Takahisa Hiramitsu, Narayan Prasad, Albane Sartorius, Juan De Francesco, Daniele Cagna, Jorge Malheiro, Himmet Bora Uslu, Alun Williams, Vincenzo Cantaluppi, Yunying Shi, La Salete Martins, Pål-Dag Line, Péter Szakály, and Takaaki Kobayashi

Subjects
Transplantation, medicine.medical_specialty, Nephrology, business.industry, Medicine, business, Surgery
Published
2012
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5. Graft function and arterial stiffness: can bioimpedance analysis be useful in renal transplant recipients?

Author

Siren Sezer, Mehmet Haberal, Turan Colak, F. N. Özdemir Acar, B. Gurlek Demirci, Cihat Burak Sayin, and O. Guliyev

Subjects
Adult, Male, medicine.medical_specialty, Body water, Renal function, Blood Pressure, Pulse Wave Analysis, Kidney, Vascular Stiffness, Body Water, Internal medicine, medicine.artery, Extracellular fluid, medicine, Electric Impedance, Humans, Kidney transplantation, Antihypertensive Agents, Transplantation, business.industry, Graft Survival, Middle Aged, medicine.disease, Kidney Transplantation, Surgery, medicine.anatomical_structure, Blood pressure, Echocardiography, Pulmonary artery, Hypertension, Cardiology, Arterial stiffness, Body Composition, Kidney Failure, Chronic, Female, business
Abstract

Objective We aimed to determine the total body water (TBW) by means of bioimpedance analysis (BIA) and to analyze the association of TBW, graft function, and arterial stiffness by means of pulse-wave velocity (PWV) and echocardiographic measurements in renal transplant (RT) recipients. Methods Eighty-two RT recipients (mean age, 38.7 ± 11.5 y; 58 male) who were using ≥1 antihypertensive treatment were enrolled in the study. Biochemical parameters, 24-hour urinary protein loss, estimated glomerular filtration rate (eGFR), transthoracic echocardiography, bioimpedance analysis according to systolic blood pressure, TBW, lean tissue index (LTI), extracellular water (ECW), intracellular water (ICW), lean tissue mass (LTM), phase angle (Phi50) levels, and renal resistive index (RRI) were evaluated. Results TBW and ECW were significantly correlated with systolic blood pressure. Urinary protein loss, pulmonary artery pressure, frequency of overhydration, systolic blood pressure, TBW, LTI, ECW, ICW, LTM, and Phi50 values were significantly higher in patients with estimated glomerular filtration rate (eGFR) 15–49 mL/min but similar in patients with eGFR 50–70 mL/min. Conclusions Hypertensive RT recipients have increased TBW, LTI, ICW, FTI, LTM, and Phi50 values. Graft function is positively correlated with systolic blood pressure and BIA parameters. Therefore, hypertensive RT recipients should be closely followed with the use of BIA for an early diagnosis of loss of graft function.

Published
2014

6. Post-transplant C-reactive protein predicts arterial stiffness and graft function in renal transplant recipients

Author

Mehmet Haberal, Turan Colak, B. Gurlek Demirci, Emre Tutal, Cihat Burak Sayin, and Siren Sezer

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Renal function, Pulse Wave Analysis, Cohort Studies, Vascular Stiffness, Internal medicine, medicine, Humans, Dialysis, Transplantation, Proteinuria, biology, business.industry, C-reactive protein, Graft Survival, Middle Aged, medicine.disease, Prognosis, Kidney Transplantation, Post transplant, Transplant Recipients, C-Reactive Protein, Cross-Sectional Studies, Renal transplant, Cardiovascular Diseases, biology.protein, Arterial stiffness, Cardiology, Kidney Failure, Chronic, Surgery, Female, medicine.symptom, business
Abstract

The aim of this study was to evaluate the renal and cardiovascular outcomes of post-transplant c-reactive protein (CRP) levels.One hundred fifty renal transplant recipients (113 men; median age, 38.9 ± 10.8 years) were cross-sectionally analyzed. Mean pre-transplant and post-transplant CRP levels were analyzed by the 1(st), 3(rd), 6(th), 12(th), and 24(th) months of transplantation. Patients were divided into 3 groups according to mean post-transplantation CRP levels: group 1 (CRP20 mg/L and fluctuating levels; n = 34), group 2 (CRP, 6-20 mg/L; n = 40), and group 3 (CRP6 mg/L; n = 76). Arterial stiffness was measured by means of carotid femoral pulse-wave velocity (PWv) by use of the SphygmoCor system.Patients in group 1 had significantly lower estimated glomerular filtration rate (eGFR) (P = .000) and left ventricular systolic function and higher duration of dialysis before transplantation, pulse-wave velocity (PWv), proteinuria, and left ventricular mass index when compared with the other two groups. In regression analysis, eGFR and PWv were detected as the predictors of post-transplantation CRP levels.Fluctuating and high stable (20 mg/L) post-transplant CRP levels predict eGFR, proteinuria, left ventricular mass index, and PWv after transplantation. Thus, CRP levels may be a useful marker to anticipate graft survival and cardiovascular morbidity in renal transplant recipients.

Published
2014

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