Browsing by Author "Colak H.B."

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    A case of rhabdomyolysis induced acute renal failure secondary to statin-fibrate-derivative combination and occult hypothyroidism
    (Dustri-Verlag Dr. Karl Feistle, 2005) Kursat S.; Alici T.; Colak H.B.
    Rhabdomyolysis is a syndrome characterized by muscle necrosis and the release of intracellular muscle contents into the systemic circulation. We hereby report a patient proved to be a case of unrecognized hypothyroidism presenting with rhabdomyolytic acute renal failure precipitated by the combined use of statin and fenofibrate. A 63-year-old woman was referred to our department because of fatigue, diffuse muscle pain and oliguria. On the basis of pathogenesis, clinical and laboratory examination the diagnoses of acute renal failure secondary to the statin-fibrate-derivative combination induced rhabdomyolysis and auto-immune thyroiditis induced hypothyroidism were made. Although saline, furosemide and sodium bicarbonate infusions enabled diuresis and have led to a rapid recovery of renal function and normalization of blood pressure in five days (creatinine level decreased from 4.5 mg/dl to 1.2 mg/dl), only thyroid replacement therapy (0,1 mg thyroxine) that begun after the exclusion of adrenal insufficiency resulted in complete resolution of rhabdomyolysis. This prompted the diagnosis of background, clinically silent rhabdomyolysis aggrevated by the statin-fibrate-derivative combination. To our knowledge this case illustrates the first example of rhabdomyolytic acute renal failure induced by a statin-fibrate-derivative combination with underlying hypothyroidism which was responsible for the basal clinically unobservable rhabdomyolysis. ©2005 Dustri-Verlag Dr. K. Feistle.
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    Chylous ascites and chylothorax due to membranous nephropathy [2]
    (Dustri-Verlag Dr. Karl Feistle, 2007) Colak H.B.; Alici T.; Tekce H.; Öz D.; Erol A.; Aras F.; Kursat S.
    [No abstract available]
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    The relationship between depression - Malnutrition and echocardiographic-blood pressure parameters in chronic hemodialysis patients
    (2008) Kursat S.; Colak H.B.; Toraman A.; Ekmekci C.; Tekce H.; Alici T.
    Aims: The aim is to research the relationship between the degree of depression - malnutrition and inadequate volume control. Methods: The mean age of the 52 patients was 55 ± 14.6 years. Malnutrition score [subjective global assessment (SGA)] and depression score [Taiwanese Depression Questionnaire (TDQ)] of each chronic hemodialysis (CHD) patient were calculated. Then an echocardiographic assessment was carried out with the same device 1 day before the second HD session of the week. The 24 h blood pressure monitoring was performed 1 day before the second HD session of the week. Results: TDQ scores (TDQS) were ≥19 in 41 and <19 in 11 patients. TDQS was found to be significantly high in women (p = 0.01) who were older than 40 years (p = 0.03) and who have low family income (p = 0.03). TDQS was found to be significantly correlated with HD duration (p = 0.034), vena cava inferior collapse index (p = 0.02), malnutrition score (p = 0.011), residual renal function (ml/day) (p = 0.03), level of albumin (p = 0.0009), and iron (p = 0.015). A positive correlation was detected between TDQS and the ratio of mean nighttime blood pressure/ mean daytime blood pressure (p = 0.005, r = 0.394). Depression score was found to be significantly different between normal geometry and left ventricular hypertrophy (eLVH), concentric remodeling and eLVH, and concentric LVH and eLVH. Conclusions: The results show that lesser degrees of nocturnal dip and eLVH are associated with increased degrees of depression, implying that hypervolemia is strongly associated with depression and might be a component of strong relationships involving malnutrition, inflammation, and atherosclerosis in CHD patients. © Springer Science+Business Media B.V. 2008.
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    Relationship of insulin resistance in chronic haemodialysis patients with inflammatory indicators, malnutrition, echocardiographic parameters and 24 hour ambulatory blood pressure monitoring
    (2010) Kurat S.; Colak H.B.; Toraman A.; Tekçe H.; Ulman C.; Bayturan O.
    Objective. The relationship between malnutrition, echocardiographic parameters, 24 h ambulatory blood pressure (ABP) parameters and decreased insulin sensitivity index (ISI-S) in chronic haemodialysis patients was investigated. Material and methods. ISI-S and inflammatory indicators were measured. The nutritional state was assessed by malnutrition score. Echocardiography and 24 h ABP were performed 1 day before the second haemodialysis session of the week. Results. ISI-S was inversely correlated with the night-time mean blood pressure (BP)/day-time mean BP ratio (p 0.021) and malnutrition score (p < 0.01). High-sensitivity C-reactive protein, night-time mean BP/day-time mean BP and vena cava collapse index were independent risk factors affecting ISI-S (p < 0.001; β 0.412, p 0.025; β 0.204, p < 0.001; β 0.465). Conclusions. The decrease in ISI-S along with the hypervolaemia suggests that volume overload is a contributory factor in the pathogenesis of insulin resistance in patients with chronic renal failure. This study indicates that, in addition to the traditional cardiovascular risk factors in these patients, insulin resistance can be regarded as a risk factor, but not an independent one, mainly a reflection of the underlying culprit, hypervolaemia. © 2010 Informa Healthcare.