Tutal, Emre

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https://hdl.handle.net/20.500.14411/7924
Name Variants
Emre, Tutal
E., Tutal
T., Emre
Tutal,E.
T.,Emre
E.,Tutal
Tutal, Emre
Job Title
Profesör Doktor
Email Address
emre.tutal@atilim.edu.tr
Main Affiliation
Internal Medical Sciences
Status
Former Staff
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Scholarly Output

3

Articles

3

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1/0

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0

Supervised PhD Theses

0

WoS Citation Count

6

Scopus Citation Count

6

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1

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1

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0

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0

WoS Citations per Publication

2.00

Scopus Citations per Publication

2.00

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1

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0

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Ankara Üniversitesi Tıp Fakültesi Mecmuası1
Clinical Transplantation1
Hemodialysis International1
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Author: Bal, Zeynep

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Now showing 1 - 2 of 2
  • Thumbnail Image
    Article
    Citation - WoS: 6
    Citation - Scopus: 6
    Effect of Nutritional Support on Nutritional Status and Inflammation in Malnourished Patients Undergoing Maintenance Hemodialysis
    (Wiley, 2021) Demirci, Bahar Gurlek; Carrero, Juan Jesus; Tutal, Emre; Bal, Zeynep; Sezer, Siren
    Introduction Protein energy wasting/malnutrition is a strong predictor of morbidity and mortality in patients on maintenance hemodialysis (MHD). We aimed to compare the effects of oral and/or intradialytic parenteral nutrition (IDPN) support on nutritional and inflammatory parameters in malnourished patients with MHD. Methods This is an observational study of 56 malnourished patients on MHD. We offered combined oral nutritional support (ONS) and IDPN for 12 months to all patients. Depending on patient choices for treatment, they were classified into four groups: group 1 (ONS only), group 2 (IDPN only), group 3 (both ONS and IDPN), and group 4 (patients who refused artificial nutrition support and only followed dietary advice). Normalized protein catabolic rate (nPCR), malnutrition inflammation score (MIS), and body composition (fat mass [FM], muscle mass [MM]) were assessed monthly. Findings The mean serum albumin levels of groups 2 and 3 significantly increased with the intervention, whereas that of group 4 significantly decreased. The mean nPCR levels of groups 2 and 3 significantly increased. Group 3 had the most significant positive change in serum albumin and nPCR levels. Mean serum C-reactive protein (CRP) levels of groups 1, 2, and 3 decreased, whereas those of group 4 increased. A increment in CRP was only identified in group 3. The MIS of groups 1, 2, and 3 significantly decreased whereas that of group 4 significantly increased. The increment % in FM was 1.1, 1.9, 9.1, and -2.9 for groups 1, 2, 3, and 4, respectively, and that in MM was -0.6, 4.4, 6.9, and -7.9 for groups 1, 2, 3, and 4, respectively. Discussion Compared to monotherapy or nutritional counseling, the choice of ONS plus IDPN is associated with improved nutritional status and decreased inflammation in malnourished patients on MHD. Nonetheless, interventional studies must be conducted to confirm these observations.
  • Thumbnail Image
    Article
    Hemodiyaliz Hastalarında Sevelamer Vasküler Sertliği Düzeltmekte ve Serum Ürik Asit Düzeyini Azaltmaktadır
    (2024) Demirci, Bahar Gürlek; Tutal, Emre; Bal, Zeynep; Erkmen, Mehtap; Sezer, Siren
    Amaç: Sevelamer, pleotropik etkisi ile prebiyotik olarak etki gösterebilir. Bu çalışmanın amacı sevelamerin ürik asit, HbA1c, lipid profili ve arteryel sertlik progresyonu üzerine etkisinin gösterilmesidir. Gereç ve Yöntem: Hemodiyalize giren ve aynı fosfor bağlayıcıyı (FB) 3 yıl kullanan 151 hasta çalışmaya dahil edildi. Hastalar kullandıkları FB’ye göre sevelamer bazlı FB (grup 1) ve kalsiyum bazlı FB (grup 2) olarak 2 gruba ayrıldı. Üç yıllık takipte biyokimyasal parametreler kayıt edildi. Arteryel sertlik başlangıçta ve 3. yılın sonunda aortik nabız dalga hızı (PWv) ölçümü ile belirlendi. Bulgular: Üç yıllık takipte ortalama ürik asid düzeyleri grup 1’de azalmışken grup 2’de stabil kaldı. Grup 1’deki hastaların %22,4’ünde ortalama ürik asid düzeylerinde 2 mg/dL’den fazla azalma saptandı. Diyabetik hastalarda HbA1c düzeyleri grup 1’de grup 2’ye göre daha düşüktü. PWv düzeyleri çalışmanın başında her 2 grup için de benzerdi. Ancak 3. yılın sonunda PWv düzeyleri grup 1’de grup 2’ye göre daha düşük saptandı. Sonuç: Sevelamer pleiotropik etki ile ürik asit düzeyini, düşük yoğunluklu lipoprotein-kolesterolü, HbA1c düzeyini azaltarak, fazla kalsiyum alımını engelleyerek kardiyovasküler riski azaltmaktadır. Hemodiyalize giren hastalarda sevelamer, kalsiyum bazlı fosfor bağlayıcılara göre arteryel sertlik progresyonunu da azaltarak kardiyovasküler risk profilini düzeltir.