Türkmen, Kultigin; Erdur, Fatih Mehmet; Dalmaz, Mahmut; Yeksan, Mehdi; Akkus, Idris; Türk, Suleyman

OBJECTIVE: Recombinant human erythropoietin (r-HuEPO) was found to be associated with increased blood pressure in hemodialysis (HD) patients. Plasma endothelin-1(ET-1) was reported to be increased during treatment with r-huEPO in HD patients. Prostacyclin (PGI2) was found to be associated with the reduction in vascular resistance. We aimed to determine the role of ET-1 and PGI2 on r-huEPO-induced hypertension in HD patients. MATERIAL and METHODS: 43 HD patients (19 females, 24 males) were randomly assigned to groups. Group 1 (n= 15) consisted of patients receiving r-HuEPO-a subcutaneously after each dialysis session for 6 to 42 months. Group 2 (n= 15, control group) consisted of patients who did not receive any r-huEPO and group 3 (n= 13) consisted of patients who received r-huEPO-a subcutaneously after each dialysis session for 12 weeks. Plasma ET-1,2 and 6-keto-PGF1-a were measured. RESULTS : There were no differences in terms of ET-1,2 and 6-keto-PGF1-a, systolic and diastolic BP and hematocrit levels in group 1 and group 2 patients. However, in group 3 patients, hematocrit, plasma ET1,2 and 6-keto PGF1-a levels were significantly elevated after 12 weeks of rHuEPO treatment. CONCLUSION: We showed that ET-1.2 and 6-keto-PGF1-a levels were found to be significantly increased with 12 weeks of rHu-EPO therapy in HD patients.

Türkmen, Kultigin; Fatih, M. Ehmet Erdu R.; Erikoglu, Mehmet; Gaipov, Abduzhappar; Çolak, Bayram; Tekin, Ahmet; Yeksan, Mehdi; Selçuk, Nedim Yilmaz; Türk, Sleyman; Tavli, Sakir

BJECTIVE: Renal transplantation (RTx) is the best therapeutic modality for end-stage renal disease patients. We report 8 years single-centre experience on cadaveric and living donor RTx in terms of demographic features along with graft functions, posttransplant medical complications, patients-graft survivals. MATERIAL and METHODS: We enrolled 66 RTx (female/male: 36/30) patients including 40 cadaveric and 26 living donors. At admission age, gender, causes of renal failure, dialysis typeduration, type of RTx, induction and maintenance immunosuppressive modalities, rejection episodes, biochemistry-hemogram parameters at 1, 6, 12, 24 and 60 months after transplantation and medical complications were obtained from the medical records. RESULTS: Mean recipient age was 41 +/- 11.6 years. Mean transplant duration was 32.2 +/- 31.4 months, and the mean creatinine values was 1.4 +/- 0.9 mg/dl. The most commonly used immunosuppressive protocol was corticosteroid+tacrolimus+mycophenolate mofetil. Delayed graft function, chronic allograft nephropathy and acute rejection were observed in 27.3%, 25.7% and 13.6% of patients, respectively. 1-and 5-year patient survival rates were 100% and 100% for living donor patients and 85% and 85% for cadaveric patients, respectively. 1- and 5-year graft survival rates were 100% and 100% for living donor RTx patients, and 80% and 80% for cadaveric RTx patients, respectively. The most common medical complications were new onset diabetes mellitus and dyslipidemia. The most common early and late infection was urinary tract infection. CONCLUSION: RTx is the best renal replacement therapy in terms of patient-graft survival. However, patients should be closely moniterized for metabolic complications.