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Analysis of glomerular filtration rate, serum cystatin C levels, and renal resistive index values in cirrhosis patients

Üstündağ, Yücel | Samsar, Ufuk | Açıkgöz, Şereften | Çabuk, Mehmet | Kıran, Sibel | Külah, Eyüp | Aydemir, Selim

Article | 2007 | Clinical Chemistry and Laboratory Medicine45 ( 7 ) , pp.890 - 894

Background: The aim of this study was to evaluate the relation of glomerular filtration rate (GFR) to serum cystatin C levels, renal resistive index (RRI), serum creatinine and creatinine clearance in patients with different stages of cirrhosis. Methods: The study sample was 25 cirrhotic patients (10 females and 15 males; mean age 57.3±2.04 years), 10 in the compensated stage without ascites and 15 in the decompensated stage with new-onset ascites. None had azotemia nor were on diuretic treatment. The control group comprised 25 healthy adults (11 female and 14 men; mean age 56.56±1.91 years). Serum cystatin C, RRI, serum creatinine . . .and creatinine clearance were measured. GFR was determined by technetium99m- diethylene triamine pentaacetic acid renal scintigraphy. Results: Cirrhosis cases had lower mean scintigraphic GFR than controls (64.5±4.03 vs. 87.96±4.16 mL/min, p<0.05). Serum cystatin C and RRI were significantly higher in the cirrhotic group compared to controls (1.16±0.09 mg/L and 0.68±0.01 vs. 0.86±0.03 mg/L and 0.64±0.01, respectively; p<0.05). Subgroup comparative analysis showed that only two parameters, scintigraphic GFR and serum cystatin C, were significantly different between compensated and decompensated cirrhotics (75.62±4.9 mL/min and 0.89±0.07 mg/L vs. 57.23±5.14 mL/min and 1.34±0.13mg/L, respectively; p<0.05). Scintigraphic GFR showed significant correlation with cystatin C, but not with serum creatinine or creatinine clearance (r=-0.877, p<0.05) in decompensated patients. No correlation was observed between scintigraphic GFR and RRI or between serum cystatin C and RRI in all subjects. A receiver operator characteristics curve showed that cystatin C at a cutoff value of 1.01 mg/L can significantly differentiate patients with GFR <70 mL/min with 80% sensitivity and 80% specificity. Conclusions: Serum cystatin C, but not serum creatinine or RRI measurement, correlates with GFR in each stage of liver failure and has a significant diagnostic advantage in detecting lower GFR in such cases. © 2007 by Walter de Gruyter Daha fazlası Daha az

Disseminated tuberculosis in a non immun compromised patient with a complicated diagnosis

Sahin H. | Isik H. | Uygun Ilikhan S. | Tanriverdi H. | Bilici M.

Article | 2015 | Respiratory Medicine Case Reports14 , pp.1 - 3

Tuberculosis (TB) has become a global emergency worldwide. The long time period between the exposure to TB bacillus and the onset of symptoms cause a delay in diagnosis. Herein, we report a case of 64-year-old female patient suffering from dyspepsia, anorexia, weight loss and abdominal pain for the last 8 months. Physical examination, ascites fluid evaluation, chest radiography, ultrasonographic and tomographic scans, histopathological analysis of the lymphadenopathy (LAP) and endometrial tissue revealed TB. A fourfold antituberculous treatment with isoniazid, pyrazinamide, rifampicin and ethambutol was prescribed for two months and . . . for four months maintenance therapy with isoniazid and rifampicin was given. On the fourth month of the medical treatment the patient clinically recovered. Since the diagnosis of TB is difficult, high grade suspicion, combination of the radiologic, microbiologic and histopathological examinations are needed to achieve a diagnosis. © 2014 The Authors Daha fazlası Daha az

MELD-sodium score and its prognostic value in malignancy-related ascites of pancreatic and gastric cancer

Engin H. | Bilir C. | Üstündağ Y.

Article | 2013 | Supportive Care in Cancer21 ( 4 ) , pp.1153 - 1156

https://dx.doi.org/10.1007/s00520-012-1640-3 https://hdl.handle.net/20.500.12628/6598

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