Effect of Dual Blockade of Renin-Angiotensin Aldosterone System on Proteinuria in Patients with Diabetic Nephropathy and Advanced Azotemia

Purpose: To investigate the dual effect of angiotensin blockade by irbesartan and enalapril on proteinuria in diabetic patients with azotemia.Methods: Patients with diabetes of > 5 years duration, proteinuria at a nephrotic level and serum creatinine > 1.5 mg/dL were enrolled in the study. Forty-five enrolled patients were divided into three groups, those receiving enalapril , irbesartan, or enalapril plus irbesartan, respectively, over a period of 24 weeks. Urinary protein excretion and serum level of albumin, creatinine, potassium were measured before and after treatmentResults: In patients receiving enalapril, irbesartan, and both drugs concomitantly, mean urinary protein excretion level decreased significantly at the end of 6 months from 6.46 ± 4.66 to 3.36 ± 1.60, 5.89 ± 5.34 to 3.22 ± 1.72 and 5.99 ± 3.77 to 2.10 ± 2.22 g/day, respectively (p = 0.001). Decrease in proteinuria in the group receiving the combined therapy was more significant than the other two groups (p = 0.025). During the period of therapy, serum albumin increased and mean arterial pressure decreased significantly (p = 0.02 and p = 0.002, respectively) but serum creatinine and potassium and creatinine clearance values showed insignificant increases (p = 0.28 and p = 0.57, respectively).Conclusion: The combined use of enalapril and irbesartan, in patients with diabetic nephropathy associated with azotemia, is more effective in decreasing proteinuria without causing any substantial increase in serum potassium levels. The combined use of these two drugs shows a more pronounced anti-proteinuric effect.Keywords: Angiotensin-converting enzyme inhibitor, Angiotensin receptor blocker, Diabetic nephropathy, Azotemia, Proteinuria, Aldosterone, Renin, Blood pressur

Renal complications of lipodystrophy: A closer look at the natural history of kidney disease

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/144612/1/cen13732_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/144612/2/cen13732.pd

Modelling and analysing of electricity transmission infrastructure of Ankara, Turkey: A case study on the critical line scenarios

The use of electricity has been increasing constantly from past to now and there is a need of reliable transmission and distribution systems in order to provide continuous and balanced energy. Besides, traditional energy management systems have been forced to change as a result of increases in the usage of renewable energy resources and the efficiency of demand-side on the market. In this respect, power systems should be planned and operated, properly and the balance of generation-consumption should be ensured within the nominal voltage limits. In this study, initially, the current status of electricity infrastructure in Turkey is evaluated. Afterwards, the electricity transmission infrastructure of Ankara that is the capital city of Turkey is modelled by Digsilent program. The critical line scenarios are implemented on the electricity transmission infrastructure model developed. These scenarios are based on the period of maximum and minimum electricity demand and the effects of demand response in this period. As a result of grid analyses performed, several findings has been obtained about the impacts of different line scenarios on the transmission system, the optimization of grid voltage profile and the role of demand response on voltage regulation

Load and short-circuit analyses of the electricity transmission system for industry regions in Ankara

In recent years, the increasing electricity demand leads energy operators to new grid investments. On the other hand, electricity grids are constantly extending and include different kinds of generation and consumption sources. In addition, the operating conditions of lines and equipments in the electricity transmission system are changed in consequence of increasing distributed generation resources on the grid. For these reasons, it is required to plan and analyze properly in power system establishments. In this study, the electricity transmission infrastructure of industry regions in Ankara, Turkey is modeled. The usage of large powerful loads, the constantly increasing electricity demand and the increment in microgrid applications are the main reasons for the preference of these industrial areas. In the stage of modeling the electricity transmission system, the actual data of grid, lines, substations and generation plants are used in the DigSilent program. The different case studies depended on load and short-circuit analyses are implemented on the developed grid model. As a result of the conducted case studies, the recent generation and consumption situations, the impacts of microgrids on the existing system and the possible grid reactions for the increasing demand and demand response in future years are evaluated in an effective manner

Statistical Scenarios for Demand Forecast of a High Voltage Feeder: A Comparative Study

The electricity demand forecasting has gained remarkable concern in energy market operation and planning with the emergence of deregulation in the power industry. Power system operators benefit from accurate demand forecasts by supporting investment decisions more objectively. As a crucial requirement, this paper focuses on hourly demand forecasts of a high voltage feeder. Moving average (MA), weighted moving average (WMA), autoregressive moving average (ARMA) and autoregressive integrated moving average (ARIMA) models have been used for creating statistical demand scenarios at 1-h, 2-h, 3-h and 4-h intervals. Many constructive comparisons have been conducted among MA, WMA, ARMA and ARIMA models comprehensively. Besides, the best statistical model employed in each hourly demand scenario provides the robust improvement percentage with respect to the persistence model

Treatment Results of Patients With Lupus Nephritis: A Single Center’s Experience

Objective: Lupus nephritis (LN) is a type of organ involvement of systemic lupus erythematosus (SLE) that leads to disease-related morbidity and mortality. Lack of good treatments for LN continues to be problematic. Many different treatment protocols are applied in treatment centers. Not every treatment protocol is successful. Moreover, patients who reached remission may present with exacerbations. In this study, we aimed to evaluate the treatment results of our patients and investigate their remission rates as well as factors that affect remissions.Materials and Methods: We retrospectively investigated the results of 41 patients who were diagnosed with lupus nephritis after kidney biopsy in the Nephrology and Immunology-Rheumatology departments of Atatürk University Medical Faculty Training Hospital between January 2000 and December 2008. Demographic information, clinical history and laboratory results were collected from each patient’s records. The relationships among clinical, laboratory, demographic parameters and remissions were investigated. The patients were grouped in terms of urine protein levels; patients with urine protein 0.05). We compared class 3 LN patients at the 6th and 12th months according to treatment protocols. Azathioprin or mycophenolate mophetil were significantly better at placing urine protein levels in remission as compared to cyclophosphamide (p<0.05).Conclusion: According to our study, no relationship was found between basal clinical and laboratory parameters and patient remission. Response rates of our LN patients were similar to those in the literature. However, complete remission is still a problem in LN. The results of the protocols used in the treatment of LN show similarities. Although there are some data suggesting that MMF used in recent years is effective, it should be supported by prospective multicenter studies. It is important to note that it is difficult to achieve complete remission in LN patients

Statistical scenarios for demand forecast of a high voltage feeder: A comparative study

The electricity demand forecasting has gained remarkable concern in energy market operation and planning with the emergence of deregulation in the power industry. Power system operators benefit from accurate demand forecasts by supporting investment decisions more objectively. As a crucial requirement, this paper focuses on hourly demand forecasts of a high voltage feeder. Moving average (MA), weighted moving average (WMA), autoregressive moving average (ARMA) and autoregressive integrated moving average (ARIMA) models have been used for creating statistical demand scenarios at 1-h, 2-h, 3-h and 4-h intervals. Many constructive comparisons have been conducted among MA, WMA, ARMA and ARIMA models comprehensively. Besides, the best statistical model employed in each hourly demand scenario provides the robust improvement percentage with respect to the persistence model