Person: ERSOY, ALPARSLAN
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ERSOY
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ALPARSLAN
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Publication The effect of smoking on endothelial dysfunction in autosomal dominant polycystic kidney disease patients with preserved renal function(Taylor & Francis, 2021-06-23) Gül, Cuma Bülent; Yıldız, Abdülmecit; Sağ, Saim; Oruç, Ayşegül; Ersoy, Alparslan; Güllülü, Sümeyye; YILDIZ, ABDULMECİT; ORUÇ, AYŞEGÜL; ERSOY, ALPARSLAN; GÜLLÜLÜ, NAZMİYE SÜMEYYE; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kardiyoloji Anabilim Dalı.; 0000-0002-0342-9692; AAH-4002-2021; HIG-9032-2022; CPX-5894-2022; EXG-3181-2022Background In autosomal dominant polycystic kidney disease (ADPKD), endothelial dysfunction (ED) is common and occurs much earlier than kidney function impairment. The impact of smoking on ED in ADPKD patients has not been previously studied. The aim of this study was to investigate the potential contribution of smoking habits to ED and subclinical atherosclerosis in these patients. Methods This case-control study included 54 ADPKD patients with preserved renal function and 45 healthy control subjects. ED was assessed using ischemia-induced forearm flow-mediated dilatation (FMD). Carotid intima-media thickness (CIMT) was measured from 10 mm proximal to the right common carotid artery. Clinical demographic characteristics and laboratory data were recorded for the patients and control group. Regression analysis was used to determine independent associations of ED and CIMT. Results FMD was significantly lower in the ADPKD patients (19.5 +/- 5.63 vs. 16.56 +/- 6.41, p = .018). Compared with nonsmoker ADPKD patients, smoker patients had significantly lower FMD values (18.19 +/- 6.52 vs. 13.79 +/- 5.27, p = .013). In multiple regression analysis, age (beta = -0.294, 95% CI: -0.392: -1.96, p = .001) for FMD and smoking (beta = 1.328, 95% CI: 0.251, 2.404, p = .017) for CIMT were independent predictors. Conclusions Patients with ADPKD had more impaired endothelial function and subclinical atherosclerosis compared with control subjects. Smoking may increase the risk of subclinical atherosclerosis in ADPKD patients.Publication Screening for fabry disease in patients who underwent renal biopsy and identification of a novel mutation(Aves, 2021-04-01) Oruç, Ayşegül; Yıldız, Abdulmecit; Akgür, Suat; Aydın, Mehmet Fethullah; Ersoy, Alparslan; Yavuz, Mahmut; Dilek, Kamil; Güllülü, Mustafa; ORUÇ, AYŞEGÜL; YILDIZ, ABDULMECİT; AKGÜR, SUAT; Aydın, Mehmet Fethullah; ERSOY, ALPARSLAN; YAVUZ, MAHMUT; DİLEK, KAMİL; GÜLLÜLÜ, MUSTAFA; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; 0000-0002-0342-9692; 0000-0002-5665-7402; AAJ-8220-2020; AAH-4002-2021; HIG-9032-2022; EJA-1761-2022; CPX-5894-2022; EHM-7377-2022; EUF-5229-2022; JGS-9425-2023Background: The X-linked Fabry disease (FD) with lysosomal storage of globotriaosylceramide (Gb3) due to alpha-galactosidase deficiency contributes to nephropathy consisting of proteinuria and renal failure eventually. Early initiation of the enzyme replacement therapy promises favorable renal outcomes. With the importance of early diagnosis, we screened FD among proteinuric patients in whom biopsy findings revealed Fabry nephropathy.Methods: Patients with light microscopic biopsy findings of vacuolated cells, focal and/or segmental glomerular sclerosis, tubular atrophy, and interstitial fibrosis were not associated with particular etiology, the presence of acro-paresthesia, angiokeratomas, and cornea verticillata, stroke history younger than 50 years, family history of renal failure with no cardiovascular risk factors were screened. Fifty-three of 308 consecutive adult patients (45.34 +/- 15.23 years old, 60.1% male) who underwent renal biopsy because of proteinuria were enrolled in the study. Screening for FD was performed by assessing alpha-Gal A activity in dried blood spots (DBS) for males and by genetic testing for females.Results: Fifty-three patients (39.94 +/- 11.97 years, 69.8% male) who underwent renal biopsy were screened. Laboratory findings revealed mean serum creatinine of 1.44 +/- 1.06 mg/dL, mean estimated glomerular filtration rate of 78.31 +/- 39.89 mL/min/1.73 m(2), and mean proteinuria of 4.32 +/- 3 g/day, whereas the females genetic screening was negative. Two of 37 males had low enzyme activity (<0.1 micmol/L/h) and confirmed FD by genetic analysis in whom one had a novel mutation of GLA gene (c.(1047G>A) p.(Trp349*)).Conclusion: It is worth noting that FD screening in patients with proteinuria, in whom vacuolated cells, mesangial expansion, glomerulosclerosis, interstitial fibrosis, and tubular atrophy of unknown etiology, are present in the renal biopsy either with or without a family history of kidney disease.Publication Association between resistance to cinacalcet and parathyroid gland hyperplasia in kidney transplant recipients with persistent hypercalcemia(Avicenna Organ Transplant Center, 2020-01-01) ORUÇ, AYŞEGÜL; Ersoy, Alparslan; ERSOY, ALPARSLAN; Yıldız, Abdülmecid; Gül, Özen Öz; ÖZ GÜL, ÖZEN; Kocaeli, Ayşen Akkurt; Erturk, E.; ERTÜRK, ELİF; Ersoy, C.; ERSOY, CANAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji Anabilim Dalı.; 0000-0002-0342-9692; JQI-3400-2023; AAI-1005-2021; JFB-3910-2023; AAH-4002-2021; KFR-7347-2024Background: Persistent hypercalcemia and hyperparathyroidism after successful kidney transplantation can be detrimental in some recipients and should be ameliorated.Objective: To point out the concerns regarding resistance to cinacalcet in kidney transplant recipients with persistent hypercalcemia.Methods: 14 renal transplant recipients who received cinacalcet treatment because of persistent hypercalcemia were included in the study. Serum creatinine, estimated glomerular filtration rate (eGFR), calcium, phosphorus, and intact parathyroid hormone (PTH) levels at the baseline and throughout the treatment, and ultrasonography and parathyroid scintigraphy findings were recorded.Results: Cinacalcet treatment was initiated after a mean +/- SD of 20.7 +/- 19.7 months of transplantation and maintained for 16.9 +/- 7.9 months. Serum calcium levels were significantly decreased with the cinacalcet treatment. There were no significant changes in serum creatinine, eGFR, phosphorus, and PTH levels. In all participants, serum calcium levels were increased from 9.8 +/- 0.6 to 11.1 +/- 0.6 mg/dL (p<0.001) within 1 month of cessation of cinacalcet. 7 recipients with adenoma-like hyperplastic glands underwent parathyroidectomy (PTx) due to failure with cinacalcet.Conclusion: Cinacalcet may be an appropriate treatment for a group of recipients with hypercalcemia without adenoma-like hyperplastic glands or who had a contraindication for surgery. Recipients with enlarged parathyroid gland may resist to cinacalcet-induced decrease in serum PTH, although the concomitant hypercalcemia may be corrected.Publication The comparison spondin 2 levels in primary glomerular diseases(Wolters Kluwer Medknow Publications, 2020-09-01) Kahvecioglu, Serdar; UEstundag, Yasemin; Ayar, Yavuz; Gül, Cuma Bulent; Esen, Selin Aktürk; Dogan, İbrahim; Oruç, Aysegül; Ersoy, Alparslan; ERSOY, ALPARSLAN; Yıldız, Abduelmecit; Oruç, Aysegül; ORUÇ, AYŞEGÜL; Bursa Uludağ Üniversitesi/Tıp Fakültesi; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; 0000-0003-2467-9356; AGF-0767-2022; AAH-5054-2021; AAH-4002-2021; GSE-0029-2022; A-7063-2018Spondin 2 (SPON2) plays an important role in multiple processes and is a member of the Spondin 2/F-spondin family of extracellular matrix proteins. We investigated serum SPON2 levels and its correlation with renal functions and urine protein excretion in different glomerular diseases. The cohort included 97 consecutive adults with persistant proteinuria (>300 mg/day) with the diagnosis of focal segmental glomerulosclerosis (FSGS), membranous glomerulonephritis (MN), IgA nephropathy (IgAN), membranoproliferative glomerulonephritis (MPGN), and AA amyloidosis and the control groups with 15 polycystic kidney disease (PKD) and 32 healthy people. Serum SPON2 levels in MN (64.6 ng/mL), FSGS (47.8 ng/mL), IgAN (52.6 ng/mL), MPGN (54.6 ng/mL), and AA amyloidosis (60.7 ng/mL) groups were higher than those of the control (26.4 ng/mL) and nonglomerular disease groups (PKD) (15.3 ng/mL). Only serum SPON2 levels were correlated with serum uric acid and triglyceride levels in patients with glomerular disease. This is the first study to show that serum SPON2 levels are similar in different glomerular diseases and that there is no correlation between SPON2 and proteinuria grade.Publication Conventional amphotericin b associated nephrotoxicity in patients with hematologic malignancies(Cureus, 2021-07-17) Gürsoy, Vildan; Özkalemkaş, Fahir; Özkocaman, Vildan; Yeğen, Zafer Serenli; Pınar, İbrahim Ethem; Ener, Beyza; Akalın, Halis; Kazak, Esra; Ali, Rıdvan; Ersoy, Alparslan; ÖZKALEMKAŞ, FAHİR; ÖZKOCAMAN, VİLDAN; PINAR, İBRAHİM ETHEM; ENER, BEYZA; AKALIN, EMİN HALİS; ALİ, RIDVAN; ERSOY, ALPARSLAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Hematoloji Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Nefroloji Bilim Dalı.; 0000-0001-9907-1498 ; 0000-0002-4803-8206; DLR-8474-2022 ; JIR-6730-2023 ; JGM-6601-2023 ; AAG-8523-2021 ; AAU-8952-2020; AAG-8459-2021; GXD-8209-2022; CPX-5894-2022Introduction: Amphotericin B (AmB-d) is one of the most effective therapeutic options against frequently life-threatening systemic fungal infections in patients with hematologic malignancies. However, significant adverse effects including nephrotoxicity associated with its use limit its more widespread use. The objectives of our study were to determine the incidence of AmB-d associated nephrotoxicity, to evaluate clinical and epidemiological characteristics of patients, and to support the notion that conventional amphotericin B remains a valid therapeutic option among hematologic patients with proper patient selection.Materials and methods: A total of 110 patients with hematologic malignancies were admitted to our Hematology Unit between January 2014 and November 2017 who required anti-fungal therapy during intensive systemic chemotherapy. The incidence of AmB-d associated nephrotoxicity, side effect profile, time to nephrotoxicity, and clinical and epidemiological characteristics associated with treatment success were assessed retrospectively.Results: Of the 110 patients receiving AmB-d, 70 (63.6%) were male and 40 (36.4%) were female. The mean age of participants was 44 years. The most common diagnosis was acute myeloid leukemia (n=53, 48.2%), and the most common chemotherapy protocol was 7 + 3 remission-induction (cytarabine 100 mg/m(2) days 1-7, Idarubicin 12 mg/m(2) days 1-3; n=24, 21.8%). In 56.4% of the patients, antifungal therapy was given empirically. In 40 patients (36.4%), nephrotoxicity was observed following antifungal treatment, and only four patients had stage 3 renal failure. The mean duration of time to nephrotoxicity from initiation of amphotericin B was four days (min: 2, max: 31). All patients were found to receive at least one additional potential nephrotoxic treatment during the antifungal treatment process.Conclusion: AmB-d is associated with a significant risk of nephrotoxicity. In most hematological patients, antifungal treatment is initiated empirically, and patients received prolonged courses of treatment. Therefore, it is plausible to initiate such treatment with AmB-d, when one considers the already high treatment costs in this patient group as well as the fact that AmB-d offers similar efficacy to antifungal agents at a lower cost. AmB-d may be recommended as a first-line agent in this patient group with the introduction of newer and more costly antifungal agents when needed, on the basis of the fact that these patients can be closely monitored in a hospital setting, reversible nature of nephrotoxicity upon discontinuation, and rare occurrence of severe renal failure requiring dialysis.Publication The relationship between lymphocyte subsets, nutritional status and tuberculin reactivity in continuous ambulatory peritonel dialysis and hemodialysis patients(Oxford University Press, 2021-05) Usta, Mehmet; Ersoy, Alpaslan; Ayar, Yavuz; Budak, Ferrah; ERSOY, ALPARSLAN; BUDAK, FERAH; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Bölümü; 0000-0001-7625-9148; JXD-1615-2024; IZP-9398-2023Background and Aims: Skin test anergy is common in patients with uremia and during maintenance hemodialysis treatment. However, up to date only one study concerning skin test in peritoneal dialysis patients has focused on the issue. Our cross-sectional controlled study was conducted to analyze the correlation of purifed protein derivative (PPD) test response with demographical features, nutritional parameters and the distribution of peripheral blood lymphocyte subsets in peritoneal dialysis and hemodialysis patients. Method: Stable 30 hemodialysis (HD) patients (16 men, 14 women) and 30 continuous ambulatory peritoneal dialysis (PD) patients (17 men, 13 women) were included. Thirty healthy cases (15 men, 15 women) with a mean age of 32.4±9.4 constituted the control group. Results: In the HD group, 14 patients (46.6%) were PPD positive, and ın the PD group 16 patients (53.3%) were PPD positive. In the PPD-positive HD patients 64.2% (9/14), and in the PPD-positive PD patients 62.4% (10/16) had an induration of 10 mm or greater. In the control group, 21 of 30 patients (70%) were PPD positive. Comparison of both HD and PD groups with the control group showed signifcant diferences in PPD reactivity (p<0.01). Albumin levels were signifcantly high in the control groups (p<0.01), and cholesterol levels were signifcantly high in the PD and the control groups (p<0.05). Transferrin levels were signifcantly high in the PD (p<0.01). The lymphocyte counts were signifcantly high in the control group compared to the HD patients (p<0.05). The lymphocyte subset percentages CD19 were high in the control groups (p<0.05), and CD16/56 was signifcantly high in the PD groups (p<0.05). All the parameters were also similar between PPD-positive and -negative same groups. Conclusion: The prevalence of PPD positivity was lower in the PD and HD groups. The PPD test responses were not related to the peripheral lymphocyte counts, subsets and malnutrition parameters.Publication Comparison of endoscopic and pathological findings of the upper gastrointestinal tract in transplant candidate patients undergoing hemodialysis or peritoneal dialysis treatment: A review of literature(BMC, 2020-10-22) Usta, Mehmet; Ersoy, Alparslan; Ayar, Yavuz; Ocakoğlu, Gökhan; Yüzbaşıoğlu, Bilgehan; Erdem, Emrullah Düzgün; Erdoğan, Ömer; ERSOY, ALPARSLAN; OCAKOĞLU, GÖKHAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Nefroloji Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0002-0710-0923; AAH-5180-2021; AAH-5054-2021Background: Dyspepsia is a common disorder in kidney transplant recipients, and the risk of post-transplant complications is increased in candidates with upper gastrointestinal disease. We evaluated gastrointestinal lesions of kidney transplant candidates on dialysis.Methods: In this study, endoscopic and pathological findings in hemodialysis (HD) and peritoneal dialysis (PD) patients with gastrointestinal symptoms on the waiting list were compared.Results: The most common non-ulcerous lesions in the endoscopic examination were gastritis (62.3%), erosive gastritis (38.7%), duodenal erosion or duodenitis (18.9%) and esophagitis (13.2%). The ulcerous lesion was present in only 3 patients. Gastroesophageal reflux disease, ulcerated lesion and non-ulcerated lesion rates were similar in both dialysis groups. Histopathological examination revealedHelicobacter pylori(HP) positivity in 28.3% of patients. HP positivity rate was significantly higher in PD patients than in HD patients (38.7% vs. 13.6%,p = 0.046). Chronic gastritis (75.5%) was the most common pathological finding. HP positivity rate was 37.5% in patients with chronic gastritis, but HP was negative in patients without chronic gastritis. In multivariate analysis, male gender, urea and albumin levels were associated with the presence of pathological chronic gastritis. The presence of gastritis, total cholesterol and ferritin levels were found significant for HP positivity. A total cholesterol > 243 mg/dL was significantly related to an increased risk of the presence of HP positivity.Conclusions: Gastrointestinal lesions and HP infection are common in dialysis patients. Dialysis modality may affect the frequency of some lesions. It may be useful to have an endoscopic examination before entering the transplant waiting list for all candidates.Publication Effect of parathyroidectomy timing in kidney transplant recipients on graft function(Başkent Üniversitesi, 2021-04-01) Oruc, Aysegul; Ersoy, Alparslan; Yildiz, Abdulmecit; Gul, Ozen Oz; Ersoy, Canan; Oruc, Aysegul; ORUÇ, AYŞEGÜL; Ersoy, Alparslan; ERSOY, ALPARSLAN; Yildiz, Abdulmecit; YILDIZ, ABDULMECİT; Gul, Ozen Oz; ÖZ GÜL, ÖZEN; Ersoy, Canan; ERSOY, CANAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; 0000-0002-0342-9692; 0000-0002-1332-4165; AAH-8861-2021; AAH-4002-2021Objectives: Persistent hyperparathyroidism can have a deleterious effect on graft function in kidney transplant recipients, although serum calcium, phosphorus, and parathyroid hormone levels tend to normalize after successful transplant. Parathyroidectomy can result in sustained amelioration of persistent hyperparathyroidism despite graft failure risk and unfavorable graft outcomes. Data on this issue are limited and conflicting. Here, we evaluated the effects of parathyroidectomy on graft function in kidney transplant recipients.Materials and Methods: This retrospective study included 249 adult kidney transplant recipients (121 deceased-donor/128 living-donor; 142 males/107 females; mean age of 39.3 +/- 11.6 y; mean follow-up of 46.5 +/- 23.5 mo). Participants were grouped as those without (n = 222), those with pretransplant (n = 12), and those with posttransplant (n = 15) parathyroidectomy. Graft outcomes and serum calcium, phosphorus, and parathyroid hormone levels were studied.Results: Serum calcium levels at baseline and at 1, 3, 6, and 12 months and parathyroid hormone levels at baseline and at 6 and 12 months were higher and serum phosphorus levels at 3, 6, and 12 months were lower in the posttransplant parathyroidectomy group versus the other groups (P <.001). We observed no significant differences between groups regarding serum calcium, phosphorus, and parathyroid hormone levels at last visit. Estimated glomerular filtration rates at 3, 6, and 12 months and at last visit in the pretransplant parathyroidectomy group were higher than in those without parathyroidectomy (P <.05) and higher at 6 and 12 months than in the posttransplant parathyroidectomy group (P <.05). No significant differences regarding graft loss and patient mortality were observed among the 3 groups (P >.05).Conclusions: Parathyroidectomy resulted in sustained decreased levels of serum calcium and parathyroid hormone. We observed no graft failure risk associated with parathyroidectomy in our study. Parathyroidectomy before transplant is advantageous with better graft function.Publication The perspectives of dialysis patients about the Covid-19 pandemic and differences between the modalities(Wiley, 2021-06-07) Oruç, Ayşegül; Aktaş, Nimet; Doğan, İbrahim; Akgür, Suat; Ocakoğlu, Gökhan; Ersoy, Alparslan; ORUÇ, AYŞEGÜL; OCAKOĞLU, GÖKHAN; ERSOY, ALPARSLAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0002-0342-9692; AAH-4002-2021; AAH-5180-2021; CPX-5894-2022The novel coronavirus disease was declared as a pandemic and CKD is an important risk factor for morbidity and mortality. Dialysis has additional contributions on transmission risk so prompt preventive strategies were implemented for dialysis patients. We aimed to evaluate pandemic-related perceptions and concerns of dialysis patients and differences between dialysis modalities. An anonymous survey for assessing concerns, knowledge, and attitudes about the pandemic was sent online to a total of 339 patients on maintenance dialysis at four tertiary dialysis centers in Turkey. A total of 309 patients (54.9 +/- 15.1 years, 51.6% females, 55.7% in-center HD, 44.3% peritoneal dialysis) enrolled. The anonymous online survey was conducted at the end of April 2020. HD patients were more concerned about transmission risk (p = 0.002) and risks associated with the dialysis treatment environment and the transport methods (p < 0.001). The total concern score was significantly higher in the HD group (2.60 +/- 0.93 vs. 1.65 +/- 0.54, p < 0.001). The knowledge about the pandemic and prevention methods and the attitudes of prevention were similar between the groups (p = 0.161 and 0.418, respectively). The compliance rate of personal preventive strategies was 98.1%. Considering changing the current dialysis modality due to the pandemic was higher in the HD group (p < 0.001). Although the preventive strategies were performed properly in the HD centers, HD patients were more concerned about the Covid-19 outbreak compared with PD. Our results support home dialysis treatments for modality decisions with patients' positive perspective of PD over HD during the pandemic.Publication Morning blood pressure surge in early autosomal dominant polycystic kidney disease and its relation with left ventricular hypertrophy(Oxford Univ Press, 2018-05-01) Yıldız, Abdulmecit; Sağ, Saim; Gül, Cuma; Can, Fatma; Oruç, Aysegül; Aydın, Mehmet; Bedir, Ömer; Akgür, Suat; Ayar, Yavuz; Güllülü, Sürneyye; Güllülü, Mustafa; Ersoy, Alparslan; YILDIZ, ABDULMECİT; Can, Fatma; ORUÇ, AYŞEGÜL; AYDIN, MEHMET AKİF; Bedir, Ömer; AKGÜR, SUAT; Ayar, Yavuz; GÜLLÜLÜ, NAZMİYE SÜMEYYE; GÜLLÜLÜ, MUSTAFA; ERSOY, ALPARSLAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Dahiliye Bölümü; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Bölümü; 0000-0003-2467-9356; 0000-0002-0342-9692; 0000-0002-5665-7402; 0000-0003-4607-9220; 0000-0002-5665-7402; AGF-0767-2022; GSE-0029-2022; AAH-5054-2021; AAH-4002-2021; O-9948-2015; HIG-9032-2022; IBQ-9926-2023; AAJ-8220-2020; IVE-3975-2023; EJA-1761-2022; EWD-8403-2022; JGS-9425-2023