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    Association of fetuin - A levels with carotid intima media thickness and valvular calcification in hemodialysis and peritoneal dialysis patients
    (2013) Solak Y.; Inal A.; Atalay H.; Kayrak M.; Biyik Z.; Türkmen K.; Yeksan M.
    Background: Fetuin-A is a negative acute-phase reactant which prevents vascular calcification. Coronary artery disease (CAD) is the most important cause of mortality in patients undergoing renal replacement therapy (RRT). The key element of cardiovascular disease (CVD) seen in end-stage renal disease patients who are on dialysis treatment is accelerated calcific atherosclerosis. There are a limited number of studies in which HD and PD is compared in terms of fetuin-A level. OBJECTIVE: We aimed to investigate the association of serum fetuin-A level with valvular calcification and predictors of CAD in hemodialysis (HD) and peritoneal dialysis (PD) patients. MATERIAL and METHODS: 39 HD (24 males, 15 females) and 39 PD (25 males, 14 females) patients were included in the study. We determined carotid artery intima media thickness (CIMT) and evaluated heart valve calcification via echocardiography. We also measured serum fetuin-A level, CRP, ferritin, fibrinogen and serum albumin level. According to fetuin-A level, patients were stratified into quartiles. RESULTS: Fetuin-A level was significantly lower in HD patients when compared with that of PD patients (28.6±5.934 ng/ml, 32±4.8 ng/ml respectively p<0.001). There was a significant negative correlation between CIMT and fetuin-A level. CIMT was found to be lower in PD patients than in HD patients. We found a positive correlation between fetuin-A and dialysis adequacy and albumin level. There was a negative correlation of fetuin-A with age, fibrinogen, ferritin and CRP. Fetuin-A level was lower in patients with aortic calcification. Conclusion: Fetuin-A level was found to be lower in HD patients. Fetuin-A may be a novel marker for CVD in patients undergoing RRT.
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    Spontaneous retroperitoneal hemorrhage presenting as hemoperitoneum secondary to renal cyst rupture in a peritoneal dialysis patient with acquired cystic kidney disease
    (Medknow Publications, 2015) Biyik Z.; Solak Y.; Gaipov A.; Ozbek O.; Esen H.; Turk S.
    Spontaneous retroperitoneal hemorrhage (SRH) is a rare and potentially fatal condition. Acquired cystic kidney disease (ACKD) may cause SRH in hemodialysis patients. However, presentation of retroperitoneal hematoma as hemoperitoneum in peritoneal dialysis (PD) patients is exceedingly rare. We report a 44-year-old male PD patient who presented with hemoperitoneum secondary to retroperitoneal hematoma. The reason of SRH was rupture of the cysts of ACKD. The patient underwent unilateral nephrectomy with subsequent disappearance of hemoperitoneum. The importance of this case lies in the fact that the patients who have been receiving dialysis for a long time should be under surveillance in terms of ACKD development and potential associated complications such as cyst hemorrhage and malignancy.
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    Utility of double filtration plasmapheresis in acute antibody mediated renal allograft rejection: Report of three cases
    (2011) Solak Y.; Atalay H.; Polat I.; Anil M.; Türkmen K.; Biyik Z.; Yeksan M.
    Plasmapheresis is an extracorporeal procedure, which is often employed to rapidly lower circulating titers of autoantibodies, immune complexes or toxins. There are two types of plasmapheresis namely, regular plasmapheresis (RPP) by centrifugation and membrane filtration, and double filtration plasmapheresis (DFPP) which is a special form of membrane filtration in which two membranes called as plasma separator and plasma fractionator are employed to filter macromolecules more selectively. DFPP have several advantages over RP. Despite widespread utilization of DFPP in the setting of ABO blood group incompatible kidney transplantation, there is no report regarding DFPP in patients with antibody mediated acute renal allograft rejection who are good candidates for beneficial effects of DFPP. Here we report three renal transplant recipients in whom DFPP was applied as a component of anti-rejection treatment regimen.