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Öğe Comparison of dialysate and plasma NTproBNP in prediction of clinical outcomes of diabetic and nondiabetic peritoneal dialysis patients(DUSTRI-VERLAG DR KARL FEISTLE, 2018) Koz, Suleyman; Sahin, Idris; Kayatas, Mansur; Koz, Sema TulayBackground: Plasma level of N-terminal pro-brain natriuretic peptide (P-NTproBNP) is a useful marker in prediction of mortality in peritoneal dialysis (PD) patients. However, the predictive value of spent dialysate counterpart (D-NTproBNP) of plasma NTproBNP on mortality and dropout is not known. Materials and methods: Simultaneous P-NTproBNP and D-NTproBNP assays were performed after an overnight dwell in 44 scheduled ambulatory PD patients. Patients were followed for similar to 47 months. Deceased patients or patients who were transferred to hemodialysis were regarded as dropouts. Results: 14 patients (31.8%) dropped out at similar to 4 years (9 deaths and 5 transfers to hemodialysis). Diabetics, males, and patients with higher membrane permeability had higher dropout rates. Patients with P-and D-NTproBNP higher than median values had higher mortality and dropout rates (Kaplan-Meier test, log-rank Test p < 0.05). Odds ratios of D-NTproBNP for death and dropouts were (3.807 (0.907-15.971), p = 0.068) and (2.87 (1.009-8.138) p = 0.048), respectively; odds ratios of P-NTproBNP for death and dropouts were (4.652 (0.914-23.693), p = 0.064) and (2.67 (0.924-7.716), p = 0.07), respectively; in ROC analysis for death, AUC for P-and D-NTproBNP were 0.762 (0.578-0.946, p = 0.016) and 0.765 (0.590-0.940, p = 0.015), respectively. Exclusion of diabetic patients from the analyses resulted in significant changes in the predictive value P-and D-NTproBNP. Although death and dropout rates were still higher in nondiabetic patients with higher NTproBNP levels, the differences between groups lost statistical significance. Conclusion: Both P-NTproBNP and D-NTproBNP are significant predictors of outcomes of interest. Predictive value of NTproBNP might be different in diabetics and non-diabetic CAPD patients.Öğe Development and validation an HPLC-UV method for determination of esomeprazole and pirfenidone simultaneously in rat plasma: application to a drug monitoring study(Istanbul Univ, Fac Pharmacy, 2021) Dural, Emrah; Koz, Sema Tulay; Koz, SuleymanBackground and Aims: It has been observed that the combined treatment of esomeprazole and pirfenidone provides increased efficacy in the treatment of pulmonary fibrosis disease, recently. The aim of this study is to develop a simple, sensitive, and reliable high-performance liquid chromatography method to be used in drug monitoring to increase the effectiveness of esomeprazole and pirfenidone in treatment and to reduce their adverse effects. Methods: Separation was conducted with a C18 reverse-phase column (4.6 mm x 250 mm, 5 mu m) used as a mobile phase prepared with the phosphate buffer (10 mM KH2PO4 and 10 mM K2HPO4) and acetonitrile (60:40, v/v) by an isocratic flow (1 mL/min). Mobile phase pH was adjusted to 3.0. Ultraviolet detection was accomplished at 305 nm. The column oven was held at 35 degrees C to ensure an efficient analytical separation. Results: Analytical recovery of esomeprazole was between 92.43 and 105.36% and for pirfenidone it was found between 89.56 and 104.32%. Accuracy values of esomeprazole and pirfenidone were determined between (-2.90) - 4.22 and (-4.45) - 5.78, respectively. Precision (RSD%) was <= 7.89. The quantification limit was determined as 0.58 and 0.36 ng/mL. Plasma esomeprazole and pirfenidone levels were found as 0.87-8296.87 ng/mL (612.99 +/- 2212.20, mean +/- standard deviation) and 0.45-238.60 ng/mL (61.44 +/- 76.35, mean +/- standard deviation), respectively. Conclusion: Unexpectedly high RSD values were observed in both plasma (360.88%) and dose-rated results (89.61%) of esomeprazole, and pirfenidone were thought to be related to individual metabolism differences.Öğe Estimated Dialysate Magnesium Clearance in Peritoneal Dialysis Patients(WILEY-BLACKWELL, 2015) Koz, Suleyman; Sahin, Idris; Koz, Sema Tulay; Terzi, Zafer; Ataman, Engin; Akkus, Hadi…Öğe Expression of FGF-23 and FGFR1 is increased in uremic rat skin(Dustri-Verlag Dr Karl Feistle, 2023) Koz, Sema Tulay; Ozkaynak, Ozge; Koz, Suleyman; Aydin, Huseyin; Goze, O. FahrettinPurpose: Alterations in skin structure and function are very common in uremic patients, but still there is no unifying hypothesis for uremic skin disorders. Fibroblast growth factor-23 (FGF-23) deficiency has been linked to skin disorders in non-uremic animals. We aimed to study alterations in FGF-23 and fibroblast growth factor-23 receptor 1 (FGFR1) expression in uremic rat skins. Material and methods: Wistar albino rats were divided into two groups: sham group (SG, n = 8) and uremic group (UG, n = 8). Uremia was induced by reduction of the total kidney mass in the UG. Animals were sacrificed after 14 weeks of the follow-up. Results: Serum creatinine and blood urea nitrogen levels in the UG increased significantly, compared to the SG, at the end of the experiment (0.69 & PLUSMN; 0.08 vs. 0.3 & PLUSMN; 0.04 Mann-Whitney U test (MWU), p = 0,003 and 55.2 & PLUSMN; 8.9 vs. 29.6 & PLUSMN; 6.8 MWU, p = 0.002, respectively). Serum FGF-23 level in the UG was increased non -significantly, compared to the SG (53.5 & PLUSMN; 20.9 vs. 37.2 & PLUSMN; 9.7 MWU, p = 0.072), whereas serum 1,25(OH)2D3 level was significantly lower in the UG (149.4 & PLUSMN; 33.5 vs. 213.8 & PLUSMN; 43.8 MWU, p < 0.05). Expression of FGF-23 in UG skins, assessed by western blot, was significantly higher than that in the SG (186.3 & PLUSMN; 16.8 vs. 148.9 & PLUSMN; 25.9, MWU, p < 0.01). FGFR1 expression was increased in almost all parts of the uremic skin. Receptor expression was most dense at the epidermis and hair follicles. Normal skin appendages and cells either expressed no receptor, or expressed it very weakly. Conclusion: This study shows increased FGF-23 levels and FGFR1 expression in uremic rat skins. It deserves further study to fully place this finding in the pathophysiology and clinical picture of uremic skin diseases.
