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author:("afshar, Baris")
1.  Microalbuminuria, Kidney Function, and Daily Physical Activity 
The present study was carried out to investigate independent relationship between daily physical activity, microalbuminuria, and kidney function. The demographic characteristics and laboratory parameters were recorded for all patients. The determination of daily activities was carried out by Nottingham Extended Activities of Daily Living Scale (NEADLS) which was performed for each patient in an interview. Totally 139 patients were enrolled. In the whole group NEADLS score was correlated with age (rho: −0.759, P < 0.0001), clinical systolic blood pressure (rho: −0.212, P: 0.018), blood urea nitrogen (rho: −0.516, P < 0.0001), creatinine (rho: −0.501, P < 0.0001), uric acid (rho: −0.308, P < 0.0001), albumin (rho: 0.382, P < 0.0001), total cholesterol (rho: −0.194, P: 0.022), LDL-cholesterol (rho: −0.230, P: 0.008), hemoglobin (rho: 0.256, P: 0.002), creatinine clearance (rho: 0.565, P < 0.0001), 24-hour urinary protein excretion (rho: −0.324, P < 0.0001), and 24-hour urinary albumin excretion (UAE) (rho: −0.483, P < 0.0001). The multivariate linear regression of independent factors corelated with logarithmically converted NEADLS score (as a dependent variable) has shown that age (P < 0.0001), presence of coronary artery disease (P: 0.011), hemoglobin (P: 0.020), 24-hour creatinine clearance (P: 0.004), and 24-hour urinary albumin excretion (P < 0.0001) were independently corelated with NEADLS score. In conclusion, both UAE and kidney function were independently associated with daily physical activity.
PMCID: PMC3888721  PMID: 24455256
2.  The Impact of Different Anthropometric Measures on Sustained Normotension, White Coat Hypertension, Masked Hypertension, and Sustained Hypertension in Patients with Type 2 Diabetes 
Endocrinology and Metabolism  2013;28(3):199-206.
Many studies have aimed to determine whether body mass index (BMI), waist circumference (WC), or waist to hip ratio (WHR) best predicts hypertension in diabetic patients, with conflicting results. However, no study has examined the specific relationship between these anthropometric parameters with sustained normotension (SNT), white coat hypertension (WCHT), masked hypertension (MHT), and sustained hypertension (SHT) based on office and ambulatory blood pressure (BP) measurements in these patients.
Patients with newly diagnosed type 2 diabetes underwent the following procedures: history taking, measurements of anthropometric parameters, office and ambulatory BP measurements, physical examination, laboratory analysis, and random and 24-hour urine analysis.
In total, there were 65 dippers and 37 nondipper patients. None of the anthropometric parameters were different between the dippers and the nondippers. There were 25 patients with SNT, 32 with WCHT, seven with MHT, and 38 with SHT. A comparison of anthropometric parameters between these four groups of patients showed that WC (P=0.016) and WHR (P=0.015) were different among all groups. According to regression analysis, only BMI was independently related with MHT (odds ratio [OR], 1.373, P=0.022), whereas only WC has been associated with SHT (OR, 1.321, P=0.041).
Among anthropometric parameters, only WC and WHR were different in SNT, WCHT, MHT, and SHT in newly diagnosed patients with type 2 diabetes.
PMCID: PMC3811700  PMID: 24396679
Body mass index; Conicity index; Diabetes; Hypertension; Waist circumference
3.  The Relationship Between Erythropoietin Resistance and Antibody Response to Hepatitis B Vaccine in Hemodialysis Patients 
Nephro-urology Monthly  2013;5(3):806-812.
Seroconversion following Hepatitis B virus (HBV) vaccine in hemodialysis (HD) patients has been shown to be suboptimal. Nutritional and immunological factors were shown to influence the seroconversion related to HBV vaccination in HD patients. Resistance to erythropoiesis stimulating agents (ESA) for correction of anemia has also been shown to be associated with nutrition and inflammation in these patients.
The aim of the current study was to analyze the relationship between anti-HBs response and erythropoietin (EPO) resistance in HD patients.
Patients and Methods
Demographics, clinical characteristics, laboratory parameters and the data about vaccination status were obtained from dialysis charts and vaccination registries retrospectively. To calculate the EPO resistance ESA hypo responsiveness index (EHRI) was used. The EHRI was calculated through deviding the weekly dose of EPO by per kilogram of body weight divided by the hemoglobin level. Patients were divided into non-seroconversion (anti-HBs titers were < 10 IU/L) and seroconversion groups (anti-HBs titers were ≥ 10 IU/L) after completion of the four-dose vaccination schedule.
In total 97 patients were enrolled. For the entire group, stepwise linear regression analysis revealed that square root transformed anti-HBs levels were independently associated with age (P = 0.016), blood urea nitrogen (P = 0.019), high sensitive C-Reactive Protein (P = 0.009), and square root transformed EHRI (P = 0.019). Logistic regression analysis have also demonstrated that blood urea nitrogen (P = 0.002), creatinine (P = 0.046), albumin (P = 0.01) and square root transformed EHRI (P = 0.011) were independently related to seroconversion.
EPO resistance was negatively associated with anti-HBs levels and seroconversion. More studies are needed to highlight the underlying mechanisms regarding EPO resistance and response to HBV vaccination in HD patients.
PMCID: PMC3830906  PMID: 24282790
Erythropoietin; Hepatitis B; Renal Dialysis; Vaccines
4.  Do We Have to Shift Three Doses of Hepatitis B Vaccine Instead of Four Doses in Chronic Renal Failure: Think Before Action 
Hepatitis Monthly  2013;13(3):e8037.
PMCID: PMC3651844  PMID: 23675386
Dialysis; Hepatitis B Vaccines
5.  Relationship between Uric Acid and Subtle Cognitive Dysfunction in Chronic Kidney Disease 
American Journal of Nephrology  2011;34(1):49-54.
Elevated serum uric acid has been associated with cognitive dysfunction and vascular cognitive impairment in the elderly. Serum uric acid is also commonly elevated in chronic kidney disease (CKD), but its relationship with cognitive function in these patients has not been addressed.
Subjects with CKD (defined as eGFR <60/ml/min/1.73 m2) were evaluated for cognitive dysfunction using the validated Standardized Mini-Mental State Examination (SMMSE). Individuals with dementia, depression or other psychiatric disorders were excluded, as were subjects on uric acid-lowering therapy or with serious illnesses such as severe anemia or active or ongoing cardiovascular or cerebrovascular disease.
247 subjects were enrolled. SMMSE scores showed stepwise deterioration with increasing quartile of serum uric acid (26.4; 26.1; 25.5; 25.3, score range 20–30, p = 0.019). Post-hoc analysis demonstrated that there was no linear trend and only groups 1 and 4 were different with respect to SMMSE scores (p = 0.025). Stepwise multivariate linear regression revealed that age, educational status, presence of cerebrovascular disease, and serum uric acid were independently related to SMMSE scores.
Serum uric acid levels are independently and inversely associated with mild cognitive dysfunction in subjects with CKD.
PMCID: PMC3121541  PMID: 21659739
Cognitive function; Chronic kidney disease; Uric acid

Results 1-5 (5)