Evaluation of renoprotective effect of calcium channel blockers in coronary angiography patients

Aim: To evaluate the effectiveness of contrast-induced acute kidney injury (CI-AKI) prophylaxis retrospectively, using calcium channel blockers (CCB) before and after contrast exposure and comparing them with patients using angiotensin converting enzyme inhibitors (ACEI), which has not been explored by many studies. Methods: The study was performed in Afyon Kocatepe University, Faculty of Medicine Research Hospital, Cardiology Department between January 2014 and June 2016. Eighty patients using dihydropyridine (amlodipine 10 mg), non-dihydropyridine (diltiazem 60 mg) CCB or ACEI in the form of monotherapy before coronary angiography were included. Results: In the CCB and ACEI group, CI-AKI development rates were 15.7% (n=8) and 24.1% (n=7), respectively (p = 0.383; Fisher's exact test). When the CCB group was evaluated as dihydropyridine and non-dihydropyridine subsets, CI-AKI development rates were found to be similar as well (p = 0.445; Fisher’s exact test) in each subset. Conclusion: In our study, we evaluated one of today's important dilemma; the methods related to the prophylaxis of CI-AKI. Our study shows that there is no difference in the development of CI-AKI between patients using the calcium channel blocker group drugs and ACEI as monotherapy. However, in our study, the mean age of patients using CCB was significantly higher than the group using ACEI

Do MEFV mutations influence arterial stiffness in FMF patients?

Background: Pulse wave velocity (PWV) is the most used technique to evaluate the arterial elasticity, which is an early indicator of atherosclerosis. We aimed to evaluate if MEFV Mutations influence arterial stiffness in patients with Familial Mediterranean fever (FMF) Methods: 70 patients diagnosed with FMF and 50 age-and sex-matched controls were included in the study. Genetic analysis of the patients was performed. After the measurement of PWV; the presence of AS was determined. Results: Mean PWV value and arterial stiffness frequency of FMF patients were significantly higher than the control group (p <0.001, p <0.001) respectively. In addition, FMF patients with M694Vmutations had higher PWV values and arterial stiffness frequency than those with other mutations. (p=0.045), (p=0.001). There were no differences within all genetic mutation types in terms of arterial stiffness frequency.Conclusions: As a result, due to subclinical inflammation in FMF patients, they have risk for cardiovascular complications. These patients especially those with M694Vmutations have to be followed more closely because of increased cardiovascular risk and PWV measurements may be a good tool to detect early development of atherosclerosis.

Spontaneous Perforation of Cirrhotic Acid After Observed Interesting Development: Case Report

Paracentesis which is used for cirrhotic acid treatment may cause renal dysfunction secondary to circulatory dysfunction when performed with high volume. In our clinic, spontaneous ascites perforation has developed in a patient hospitalized due to massive ascites and hepatorenal syndrome. In the follow-up period, dramatical decline was observed in creatinine values. In conclusion; it should be kept in mind that, a large amount of ascites drainage may be performed without increase in creatinine values during paracentesis taking into account the hemodynamic status of the patient

Spontaneous Perforation of Cirrhotic Acid After Observed Interesting Development: Case Report

Sirotik asit tedavisinde kullanılan parasentez, yüksek volümle yapıldığında dolaşım disfonksiyonu ve buna sekonder böbrek fonksiyon bozukluklarına neden olabilir. Kliniğimizde, masif asit ve hepatorenal sendrom nedeniyle takip ettiğimiz hastamızda spontan perforasyon gelişmesi takibinde, kreatinin değerlerinde dramatik bir düşme ve normal değerlerine gerileme gözlendi. Sonuç olarak; parasentez ile kreatinin değerlerinde yükselme olmadan da fazla miktarda asit mayisi direne edilebileceği, hastaların hemodinamik durumu da göz önüne alınarak, tedavi planlanırken akılda bulundurulmalıdır.Paracentesis which is used for cirrhotic acid treatment may cause renal dysfunction secondary to circulatory dysfunction when performed with high volume. In our clinic, spontaneous ascites perforation has developed in a patient hospitalized due to massive ascites and hepatorenal syndrome. In the follow-up period, dramatical decline was observed in creatinine values. In conclusion; it should be kept in mind that, a large amount of ascites drainage may be performed without increase in creatinine values during paracentesis taking into account the hemodynamic status of the patient

Insulin resistance

İnsülin direnci (İR), önemli bir morbidite nedenidir. Hareketsiz yaşam tarzı ve beslenme alışkanlığının yanında, genetik özellikler de rol oynamaktadır. İR, obezite, hipertansiyon ve hiperlipidemi ile ilişkisi nedeniyle ciddi önem taşımaktadır. Sağlıklı populasyonda % 25 oranında İR görülür. Bu direnç, öglisemiyi sağlayabilmek icin hiperinsülinemiyle karşılanmaya çalışılır. İR’nin gösterilmesi tip 2 diyabet ve/veya kardiyovasküler hastalık riskinin tanımlanması açısından klinik önem taşır. İR’nin ölçülmesinde HOMA ve QUICKI güvenilir metodlardır. Tedavi; diyet, egzersiz ve kilo kaybından oluşan yaşam tarzı değişikliğidir. Diyet ve egzersiz yeterli olmadığında ilaç tedavisi iyi bir seçenektir.Insulin resistance (IR) is an important cause of morbidity. Sedentary lifestyle, dietary habits and heredity plays role. IR becomes more important when its relationship with obesity, hypertension, and hyperlipidemia is considered. It can be seen in 25% of the healthy population. IR is tried to be tolerated with hyperinsulinemia to achieve euglycemia. It is clinially important to identify the type 2 diabetes risk and /or cardiovascular disease. HOMA and QUICKI are reliable methods to measure IR. Treatment is modulation of life style including diet. The medical treatment is a good option when diet and exercise do not work

A rare reason of hyponatremia: Cefaperazone-sulbactam

Hiponatremi , serum sodyum düzeyinin 136 mmol/L nin altında olması olarak tanımlanır. Hastanede yatan hastalarda en sık görülen elektrolit bozukluğudur. İlaçlar hiponatremi nedenlerinden biridir. Sefaperazon-sulbaktam, klinik pratikte sık kullanılan bir antibiyotiktir. Çeşitli yanetkileri bilinmekle beraber, hiponatremi çok nadir olarak görülür. Kliniğimizde takip ettiğimiz, Sefaperazon-Sulbaktam kullanımına bağlı gelişen hiponatremi olgusuyla, ilaç ilişkili hiponatremiye dikkat çekmeyi amaçladık. Açıklanamayan hiponatremi gelişen hastalarda, nadir de olsa, antibiyotik ilişkili hiponatremi akılda tutulmalıdır.Hyponatremia is defined as serum sodium level is lower than 136 mmol / L. It is the most common electrolyte disorder in hospitalized patients. Drug-induced hyponatraemia is one of the reasons. Cefoperazone-sulbactam is a commonly used antibiotic in clinical practice. Although its several side effects are known, hyponatremia is very rare. We aimed to draw attention to drug-associated hyponatraemia with a case developing hyponatremia due to use of Cefoperazone-sulbactam. Although it is rare; antibiotic associated hyponatremia should be kept in mind in patients developing unexplained hyponatremia

A rare reason of hyponatremia: Cefaperazone-sulbactam

Hiponatremi , serum sodyum düzeyinin 136 mmol/L nin altında olması olarak tanımlanır. Hastanede yatan hastalarda en sık görülen elektrolit bozukluğudur. İlaçlar hiponatremi nedenlerinden biridir. Sefaperazon-sulbaktam, klinik pratikte sık kullanılan bir antibiyotiktir. Çeşitli yanetkileri bilinmekle beraber, hiponatremi çok nadir olarak görülür. Kliniğimizde takip ettiğimiz, Sefaperazon-Sulbaktam kullanımına bağlı gelişen hiponatremi olgusuyla, ilaç ilişkili hiponatremiye dikkat çekmeyi amaçladık. Açıklanamayan hiponatremi gelişen hastalarda, nadir de olsa, antibiyotik ilişkili hiponatremi akılda tutulmalıdır.Hyponatremia is defined as serum sodium level is lower than 136 mmol / L. It is the most common electrolyte disorder in hospitalized patients. Drug-induced hyponatraemia is one of the reasons. Cefoperazone-sulbactam is a commonly used antibiotic in clinical practice. Although its several side effects are known, hyponatremia is very rare. We aimed to draw attention to drug-associated hyponatraemia with a case developing hyponatremia due to use of Cefoperazone-sulbactam. Although it is rare; antibiotic associated hyponatremia should be kept in mind in patients developing unexplained hyponatremia

Analysis of patients hospitalized in our clinic with the diagnosis of acute renal failure

Amaç: Akut böbrek yetmezliği, böbrek fonksiyonlarında hızlı bir azalmayla karakterize ve yüksek mortalite oranına sahip önemli bir klinik sendromdur. Akut böbrek yetmezliğinde mortalite, son yıllardaki yoğun bakım ve renal replasman tedavilerindeki gelişmeye rağmen yüksek kalmaya devam etmektedir. Bu çalışmada kliniğimizde ABY tanısıyla yatan hastaları değerlendirdik. Gereç ve Yöntem: Ocak 2011 ve Aralık 2012 arasında hastanemize Akut böbrek yetmezliği tanısıyla başvuran 145 hastayı retrospektif olarak inceledik. Hastaların kayıtlarından yaşı, Akut böbrek yetmezliği tipi, başvuru şekli, başvurudaki temel bulguları, etyolojisi, zeminde eşlik eden hastalıklar, uygulanan tedavi ve laboratuvar değerleri kaydedildi. Bulgular: Olguların etiyolojisi incelendiğinde en sık nedenler prerenal azotemi (%38,6) ve nefrotoksik ajan kullanımıydı (%30,3). Hastaların %72,6’sı nonoligürik %27,4’ü oligürik idi. Olguların %65,5’ine medikal tedavi uygulanırken %34,5’ine medikal tedaviye ek olarak hemodiyaliz tedavisi uygulandı. Hastaların %86,9’u tedavi sonucu iyileşirken, %13,1’i kaybedildi. Ölen hastaların %63,2’si medikal tedaviye ek olarak hemodiyaliz tedavisi alırken %36,8’i sadece medikal tedavi almıştı. Oligürik hastaların %67,5’i medikal tedavi ve hemodiyaliz, %32,5’i sadece medikal tedavi alırken nonoligürik hastaların %21,9’u medikal tedavi ve hemodiyaliz, %78,1’i sadece medikal tedavi aldı. Sonuç: Akut böbrek yetmezliği etiyolojisinde 40 yıl öncesine göre medikal nedenler ön plana çıkmaktadır. Ayrıca oligoanürik Akut böbrek yetmezliği hastalarında diyaliz gereksiniminin arttığı ve diyaliz tedavisi gereken hastalarda prognozun daha kötü olduğu gözlenmiştir. Bu yüzden bu hastaların daha yakından izlenmesi gerekmektedir.Objective: Acute renal failure, which is characterized by a speedy decrease in renal function, is an important clinical syndrome with a high mortality rate. In spite of advanced intensive care and renal replacement therapies in recent years, Acute renal failure mortality continues to remaining high . In this study, we evaluated patients hospitalized with ARF. Material and Methods: We reviewed 145 patients with a diagnosis of Acute renal failure between January 2011 and December 2012 in our hospital, retrospectively. From the records of the patients, age, Acute renal failure type, application form, application of the basic findings, etiology, concomitant diseases, treatment, and laboratory values were recorded. Results: The most common causes of Acute renal failure etiology in our hospital were prerenal azotemia (38.6%) and nephrotoxic agents (30.3%) . The 72.6%of patients were nonoliguric, while 27.4%were oliguric. Medical treatment was applied to 65.5%of patients and medical management together with hemodialysis therapy was administered to the rest of the patients. The improvement rate of patients was 869% while 13.1%of the patients were lost. The 63.2%of dying patients were treated with hemodialysis treatment in addition to medical treatment, while 36.8%had received medical treatment only. The 21.9%of nonoliguric patients had received hemodialysis and medical treat ment and 78.1%of them received only medical treatment. Conclusion: According to the etiology of Acute renal failure, medical reasons come to the forefront compared with 40 years ago. It is also observed that the need for dialysis in Acute renal failure patients with oligoanuria increased and the patients who require dialysis have worse prognosis. Therefore, these patients should be monitored more closely

Analysis of patients hospitalized in our clinic with the diagnosis of acute renal failure

Amaç: Akut böbrek yetmezliği, böbrek fonksiyonlarında hızlı bir azalmayla karakterize ve yüksek mortalite oranına sahip önemli bir klinik sendromdur. Akut böbrek yetmezliğinde mortalite, son yıllardaki yoğun bakım ve renal replasman tedavilerindeki gelişmeye rağmen yüksek kalmaya devam etmektedir. Bu çalışmada kliniğimizde ABY tanısıyla yatan hastaları değerlendirdik. Gereç ve Yöntem: Ocak 2011 ve Aralık 2012 arasında hastanemize Akut böbrek yetmezliği tanısıyla başvuran 145 hastayı retrospektif olarak inceledik. Hastaların kayıtlarından yaşı, Akut böbrek yetmezliği tipi, başvuru şekli, başvurudaki temel bulguları, etyolojisi, zeminde eşlik eden hastalıklar, uygulanan tedavi ve laboratuvar değerleri kaydedildi. Bulgular: Olguların etiyolojisi incelendiğinde en sık nedenler prerenal azotemi (%38,6) ve nefrotoksik ajan kullanımıydı (%30,3). Hastaların %72,6’sı nonoligürik %27,4’ü oligürik idi. Olguların %65,5’ine medikal tedavi uygulanırken %34,5’ine medikal tedaviye ek olarak hemodiyaliz tedavisi uygulandı. Hastaların %86,9’u tedavi sonucu iyileşirken, %13,1’i kaybedildi. Ölen hastaların %63,2’si medikal tedaviye ek olarak hemodiyaliz tedavisi alırken %36,8’i sadece medikal tedavi almıştı. Oligürik hastaların %67,5’i medikal tedavi ve hemodiyaliz, %32,5’i sadece medikal tedavi alırken nonoligürik hastaların %21,9’u medikal tedavi ve hemodiyaliz, %78,1’i sadece medikal tedavi aldı. Sonuç: Akut böbrek yetmezliği etiyolojisinde 40 yıl öncesine göre medikal nedenler ön plana çıkmaktadır. Ayrıca oligoanürik Akut böbrek yetmezliği hastalarında diyaliz gereksiniminin arttığı ve diyaliz tedavisi gereken hastalarda prognozun daha kötü olduğu gözlenmiştir. Bu yüzden bu hastaların daha yakından izlenmesi gerekmektedir.Objective: Acute renal failure, which is characterized by a speedy decrease in renal function, is an important clinical syndrome with a high mortality rate. In spite of advanced intensive care and renal replacement therapies in recent years, Acute renal failure mortality continues to remaining high . In this study, we evaluated patients hospitalized with ARF. Material and Methods: We reviewed 145 patients with a diagnosis of Acute renal failure between January 2011 and December 2012 in our hospital, retrospectively. From the records of the patients, age, Acute renal failure type, application form, application of the basic findings, etiology, concomitant diseases, treatment, and laboratory values were recorded. Results: The most common causes of Acute renal failure etiology in our hospital were prerenal azotemia (38.6%) and nephrotoxic agents (30.3%) . The 72.6%of patients were nonoliguric, while 27.4%were oliguric. Medical treatment was applied to 65.5%of patients and medical management together with hemodialysis therapy was administered to the rest of the patients. The improvement rate of patients was 869% while 13.1%of the patients were lost. The 63.2%of dying patients were treated with hemodialysis treatment in addition to medical treatment, while 36.8%had received medical treatment only. The 21.9%of nonoliguric patients had received hemodialysis and medical treat ment and 78.1%of them received only medical treatment. Conclusion: According to the etiology of Acute renal failure, medical reasons come to the forefront compared with 40 years ago. It is also observed that the need for dialysis in Acute renal failure patients with oligoanuria increased and the patients who require dialysis have worse prognosis. Therefore, these patients should be monitored more closely