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Kanbay M.,Istanbul Medeniyet University | Bayram Y.,Fatih University | Solak Y.,Nephrology Clinic | Sanders P.W.,University of Alabama at Birmingham
Journal of the American Society of Hypertension | Year: 2013

Potassium and sodium share a yin/yang relationship in the regulation of blood pressure (BP). BP is directly associated with the total body sodium and negatively correlated with the total body potassium. Epidemiologic, experimental, and clinical studies have shown that potassium is a significant regulator of BP and further improves cardiovascular outcomes. Hypertensive cardiovascular damage, stroke, and stroke-related death are accelerated by salt intake but might be curbed by increasing dietary potassium intake. The antihypertensive effect of potassium supplementation appears to occur through several mechanisms that include regulation of vascular sensitivity to catecholamines, promotion of natriuresis, limiting plasma renin activity, and improving endothelial function. In the absence of chronic kidney disease, the combined evidence suggests that a diet rich in potassium content serves a vasculoprotective function, particularly in the setting of salt-sensitive hypertension and prehypertension. © 2013 American Society of Hypertension. All rights reserved.

Aydin H.,Zonguldak State Hospital | Guven F.M.K.,Zonguldak State Hospital | Yildiz G.,Nephrology Clinic | Bakir M.,Cumhuriyet University | And 2 more authors.
European Review for Medical and Pharmacological Sciences | Year: 2014

AIM: Crimean-Congo hemorrhagic fever is a potentially fatal viral disease in humans caused by CCHF virus. We aimed to demonstrate change in serum levels of matrix metallopeinase/tissue matrix metalloproteinase inhibitor (MMP/TIMP) associated with CCHF. PATIENTS AND METHODS: Blood specimens were collected in acute and convalescence periods from the patients presented to Cumhuriyet University Hospital, Department of Emergency and Infection Diseases with presumed as CCHF between May 2010 and September 2010. Fortyone age and gender matched healthy individuals had not any viral, bacterial, acute or chronic disease were enrolled as the controls. Blood specimens were centrifuged at 4000 rpm for 5 min with in "Hettich universal 32" centrifuge. Serum samples obtained were kept at -80°C. All the specimens were brought to room temperature during the study and MMP-1, 2, 7, 9, 10 and TIMP-1 tests were studied at one time using "RayBiotech" brand kit in "Grifols" brand "Triturus" model ELISA device. Acute, convalescence and control groups were compared in terms of the serum levels of MMP-1, 2, 7, 9, 10 and TIMP-1. RESULTS: There was a statistically significant increase in serum levels of MMP-1, 7, 9, 10 and TIMP-1 in the convalescence period (p < 0.05) compared to the controls, while the increase in levels of MMP-2 was not statistically significant (p > 0.05). In acute period of CCHF, mean TIMP-1 levels of severe patients was significantly lower than that of the non-severe patients (207913 ± 31051 versus 231300 ± 13267, respectively, p = 0.023). CONCLUSIONS: High serum levels of MMP and TIMP in CCHF disease were found to decrease as progressed to convalescence from the acute period. It is thought MMP and TIMP plays a significant role in pathogenesis of CCHF.

Loizou C.P.,Intercollege | Loizou C.P.,Cyprus University of Technology | Kasparis T.,Cyprus University of Technology | Lazarou T.,Nephrology Clinic | And 2 more authors.
Computers in Biology and Medicine | Year: 2014

The objective of this study was to investigate differences in intima-media thickness (IMT) and diameter (D) measurements of the common carotid artery (CCA) in ultrasound imaging in normal subjects and renal failure disease (RFD) patients. Manual measurements by two experts and automated segmentation measurements (based on snakes and active contour models (ACM)) were carried out on 73 normal subjects, and 80 RFD patients. Statistical analysis was carried out using the Wilcoxon rank-sum test at p<0.05. Results demonstrated that the mean IMT and D measurements were significantly higher for the RFD group versus the normal group. Moreover, there was no significant difference between the manual and automated measurements. The ACM segmentation was slightly more accurate than segmentation based on snakes. Further work is needed to validate these findings on a larger group of subjects. © 2014 Elsevier Ltd.

Kanbay A.,Istanbul Medeniyet University | Inonu H.,Gazi University | Solak Y.,Nephrology Clinic | Erden A.,Kayseri Training and Research Hospital | And 6 more authors.
European Journal of Internal Medicine | Year: 2014

Background and aims Obstructive sleep apnea (OSA) is now considered as an independent risk factor for cardiovascular (CV) disease. Although uric acid is increasingly being implicated in CV morbidity and mortality, no study attempted to determine independent role of uric acid in CV morbidity of OSA patients. We aimed to assess the role of serum uric acid as a potential mechanism of CV morbidity in a nonselected cohort of OSA patients. Methods This was a cohort study in which patients who had undergone a formal sleep study for diagnosis of OSA were recruited. Included patients were grouped according to apnea-hypopnea index (AHI) as mild, moderate and severe OSA. Patients with AHI < 5 served as control group. Patients were interrogated as to cardiovascular morbid conditions which included prior history and an established diagnosis of coronary artery disease, cerebrovascular accident, congestive heart failure due to coronary artery disease and arrhythmias. Results 436 OSA patients included (72 controls, 97 with mild, 75 with moderate, and 192 with severe OSA). The severe group also had higher serum uric acid level compared with the control and other OSA groups. Linear regression showed that the Ln uric acid was positively associated with Ln AHI score. In unadjusted logistic regression, severe OSA was associated with higher odds of a cardiovascular event, OR = 2.81 (1.307-6.041), p = 0.0081 while the other categories of sleep apnea were not. However, severe OSA was no longer significant after adjusting for age, gender, diabetes mellitus status, hypertension status, BMI, and smoking, OR = 1.882 (0.826-4.287), p = 0.1322. Uric acid was significantly higher in those who had a cardiovascular event even in the mild, moderate and severe OSA groups. Conclusion Hyperuricemia is strongly associated with cardiovascular disease in OSA patients. This strong relationship persists even after controlling for well-known traditional risk factors for cardiovascular disease. © 2014 European Federation of Internal Medicine.

Taranu T.,Grigore T. Popa University of Medicine and Pharmacy | Florea L.,Nephrology Clinic | Florea L.,Grigore T. Popa University of Medicine and Pharmacy | Paduraru D.,Grigore T. Popa University of Medicine and Pharmacy | And 3 more authors.
Romanian Journal of Morphology and Embryology | Year: 2014

Morphological alterations of peritoneum in chronically dialyzed patients involve fibrosis and angiogenesis as pathogenic mechanisms. The aim of this retrospective study was to evaluate morphological changes of peritoneum in chronic peritoneal dialysis (PD) at 4, 8, 12, and 14 years. Peritoneal changes were investigated in 110 patients with end stage renal failure, which were included in a PD program. Intraoperative biopsies were grouped in four study Groups (A: 1–48 months, B: 49–96 months, C: 97–144 months, and D: 145–168 months), and were processed histologically and stereologically. Mesothelial denudation was found in percentage volumes of 5.49% – Group A, 16.10% – Group B, 16.68% – Group C and 19.88% – Group D. Reduplication of the basement membrane was observed in patients with over five years of PD. Interstitial stromal fibrosis recorded percentage volumes of 25.49% (Group A), 26.10% (Group B), 35.85% (Group C) and 56.63% for the patient with 14 years of PD. Subendothelial hyalinizing vasculopathy was recorded in percentage volumes of 2.22%, 6.63%, 9.16% up to 9.20%. Vascular permeability reduction was recorded as decreasing percentage volumes from 22.59% to 12.81%, 7.77% and 7.37%. Perivascular inflammation was marked in the serosa of the patients in Group A (4.55%). Calcifications recorded percentage volumes of 1.63% at eight years, 3.74% at 12 years and 4.03% at 14 years of PD. Peritoneal morphological changes appear at 3–4 years of PD and progressively aggravate with long-term PD. © 2014, Editura Academiei Romane. All rights reserved.

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