Browsing by Author "Merhametsiz, Ozgur"
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Article Citation Count: 27Predicting the outcome of COVID-19 infection in kidney transplant recipients(Bmc, 2021) Oto, Ozgur Akin; Ozturk, Savas; Turgutalp, Kenan; Arici, Mustafa; Alpay, Nadir; Merhametsiz, Ozgur; Yildiz, AlaattinBackgroundWe aimed to present the demographic characteristics, clinical presentation, and outcomes of our multicenter cohort of adult KTx recipients with COVID-19.MethodsWe conducted a multicenter, retrospective study using data of patients hospitalized for COVID-19 collected from 34 centers in Turkey. Demographic characteristics, clinical findings, laboratory parameters (hemogram, CRP, AST, ALT, LDH, and ferritin) at admission and follow-up, and treatment strategies were reviewed. Predictors of poor clinical outcomes were analyzed. The primary outcomes were in-hospital mortality and the need for ICU admission. The secondary outcome was composite in-hospital mortality and/or ICU admission.ResultsOne hundred nine patients (male/female: 63/46, mean age: 48.412.4years) were included in the study. Acute kidney injury (AKI) developed in 46 (42.2%) patients, and 4 (3.7%) of the patients required renal replacement therapy (RRT). A total of 22 (20.2%) patients were admitted in the ICU, and 19 (17.4%) patients required invasive mechanical ventilation. 14 (12.8%) of the patients died. Patients who were admitted in the ICU were significantly older (age over 60years) (38.1% vs 14.9%, p=0.016). 23 (21.1%) patients reached to composite outcome and these patients were significantly older (age over 60years) (39.1% vs. 13.9%; p=0.004), and had lower serum albumin (3.4g/dl [2.9-3.8] vs. 3.8g/dl [3.5-4.1], p=0.002), higher serum ferritin (679 mu g/L [184-2260] vs. 331 mu g/L [128-839], p=0.048), and lower lymphocyte counts (700/mu l [460-950] vs. 860 /mu l [545-1385], p=0.018). Multivariable analysis identified presence of ischemic heart disease and initial serum creatinine levels as independent risk factors for mortality, whereas age over 60years and initial serum creatinine levels were independently associated with ICU admission. On analysis for predicting secondary outcome, age above 60 and initial lymphocyte count were found to be independent variables in multivariable analysis.Conclusion Over the age of 60, ischemic heart disease, lymphopenia, poor graft function were independent risk factors for severe COVID-19 in this patient group. Whereas presence of ischemic heart disease and poor graft function were independently associated with mortality.Article Citation Count: 1The results of SGLT-2 inhibitors use in kidney transplantation: 1-year experiences from two centers(Springer, 2023) Sözener, Ulaş; Ozler, Tuba Elif; Demir, Mehmet Emin; Sozener, Ulas; Uyar, Murathan; Ercan, Zafer; Turkmen Sariyildiz, Gulcin; Surgical SciencesPurposeSodium-glucose co-transporter-2 inhibitor (SGLT-2i) administration is associated with some concerns in regard to the increased risk of genital and urinary tract infections (UTI) in kidney transplant recipients (KTR). In this study, we present the results of SGLT-2i use in KTR, including the early post-transplant period.MethodsParticipants were divided into two groups: SGLT-2i-free diabetic KTR (Group 1, n = 21) and diabetic KTR using SGLT-2i (Group 2, n = 36). Group 2 was further divided into two subgroups according to the posttransplant prescription day of SGLT-2i; < 3 months (Group 2a) and >= 3 months (Group 2b). Groups were compared for development of genital and urinary tract infections, glycated hemoglobin a1c (HgbA1c), estimated glomerular filtration rate (eGFR), proteinuria, weight change, and acute rejection rate during 12-month follow-up.ResultsUrinary tract infections prevalence was 21.1% and UTI-related hospitalization rate was 10.5% in our cohort. Prevalence of UTI and UTI-related hospitalization, eGFR, HgbA1c levels, and weight gain were similar between the SGLT-2i group and SGLT-2i-free group, at the 12-month follow-up. UTI prevalence was similar between groups 2a and 2b (p = 0.871). No case of genital infection was recorded. Significant proteinuria reduction was observed in Group 2 (p = 0.008). Acute rejection rate was higher in the SGLT-2i-free group (p = 0.040) and had an impact on 12-month follow-up eGFR (p = 0.003).ConclusionSGLT-2i in KTR is not associated with an increased risk of genital infection and UTI in diabetic KTR, even in the early posttransplant period. The use of SGLT-2i reduces proteinuria in KTR and has no adverse effects on allograft function at the 12-month follow-up.