Researcher:
Çamkıran, Volkan

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Doctor

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Volkan

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Çamkıran

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Çamkıran, Volkan

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2017 - 20206

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    Acute effects of salt on blood pressure are mediated by serum osmolality
    (Wiley, 2018) Afsar, Baris; Siriopol, Dimitrie; Kuwabara, Masanari; Rodriguez-Iturbe, Bernardo; Lanaspa, Miguel A.; Covic, Adrian; Johnson, Richard J.; N/A; Kanbay, Mehmet; Aslan, Gamze; Dağel, Tuncay; Çamkıran, Volkan; İncir, Said; Faculty Member; Doctor; Doctor; Doctor; Faculty Member; School of Medicine; N/A; N/A; N/A; School of Medicine; N/A; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; 110580; N/A; N/A; N/A; 175430
    It is classically thought that it is the amount of salt that is critical for driving acute blood pressure responses. However, recent studies suggest that blood pressure responses, at least acutely, may relate to changes in serum osmolality. Here, we test the hypothesis that acute blood pressure responses to salt can be altered by concomitant water loading. Ten healthy patients free of any disease and medication underwent 4 interventions each a week apart in which they took 300 mL of lentil soup with no salt (visit 1), lentil soup with 3 g salt (visit 2), or lentil soup with 3 g salt and 500 mL water (visit 3) or 750 mL water (visit 4). At each visit, hourly blood measurements and blood pressure measurements (baseline, 1st, 2nd, 3rd, and 4th hour) were performed and plasma osmolarity, sodium and copeptin levels were measured. Patients receiving the 3 g salt showed a 6 mOsm/L change in osmolality with a 2.5 mmol/L change in plasma sodium and 10 mm Hg rise in systolic blood pressure at 2 hours. When the same patients drank salty soup with water, the changes in plasma osmolarity, plasma sodium, and blood pressure were prevented. The ability to raise blood pressure acutely with salt appears dependent on changes in plasma osmolality rather than the amount of salt. Our findings suggest that concurrent intake of water must be considered when evaluating the role of salt in blood pressure.
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    Female and urban participants demonstrate an adverse trend in overall mortality in Turkey - and a report on the TARF survey 2016
    (Aves, 2017) Karadeniz, Yusuf; Can, Günay; Özbek, Mehmet; Hayıroğlu, Mert İ.; Kaya, Adnan; Uzun, Okan; Keskin, Muhammed; Karakoyun, Süleyman; Çamkıran, Volkan; Doctor; Koç University Hospital; N/A
    Objective: This study is an examination of 1) overall mortality trend in the Turkish Adult Risk Factor (TARF) study stratified by sex and place of residence, and 2) brief report on main aspects of the 2016 survey.Methods: The period of last 18 years was divided into 2 for trend analysis of data. Required information on deaths was obtained. Baseline age >=40 years at the beginning of each period was the inclusion criterion. Cox regression analyses were performed.Results: Among over 2500 participants in each, deaths were recorded in 281 and 334 individuals in Periods 1 and 2, respectively, and baseline mean age was 54.6 years and 56.4 years, respectively, in each period. Age-adjusted hazard ratio for mortality in Period 2 remained virtually the same for rural males, rose to borderline significance for urban males and rural females (p=0.06, p=0.09), and increased 1.72-fold for urban females (p=0.006), as compared to Period 1. Whereas males gained an average of 3.8 years of survival in the later period compared with the earlier period, females gained only 1.8 years. This narrowed the difference in mean age at death in favor of women from 2.5 years to 0.5 year. of 1144 participants to be surveyed in the TARF 2016, 48 were lost to follow-up, 695 were examined, and 39 participants were ascertained to be deceased. In 362 cases, verbal information was obtained regarding health status.Conclusion: Gain in survival in Turkish women has distinctly stagnated compared with men, and hazard of death has risen significantly for women and urban residents in the past decade, suggesting interaction between female sex and urban residence. Both phenomena require recognition and adoption of appropriate measures. / Amaç: 1) TEKHARF Çalışması'nda kaydedilen genel mortalite eğiliminin cinsiyet ve kır-kent yerleşimine katmanlanarak açıklanması, 2) 2016 takip taramasının ana unsurları hakkında kısa bilgi paylaşılması.Yöntemler: Son 18 yıllık dönem eğilim analizleri için ikiye bölündü. Ölüm konusunda gerekli bilgi alındı. Yaşın her iki dönem başında 40 ve üzerinde olması, örneklemin dahil edilme ölçütüydü. Cox regresyon analizi uygulandı.Bulgular: İlk ve son dönemde, başlangıçtaki ortalama yaş 54.6 ve 56.4 yıl iken, her bir dönemde 2500'ü aşkın katılımcıda 281 ve 334 ölüm kaydedildi. Ölüm için yaş-ayarlı mortalite ikinci dönemde, ilk döneme göre, kırsal kesim erkeklerinde aynen süregiderken, kentli erkekler ile kırsal bölge kadınlarında (p=0.06-0.09) yükseldi. Kentli kadınlarda ise, HR ilk döneme kıyasla son dönemde 1.72-kat arttı (p=0.006). İlk döneme kıyasla son dönemde erkeklerin 3.8 yıllık sağ kalım kazanmasına karşılık, kadınlarda kazanç 1.8 yıldı. Bu da, kadın lehine 2.5 yıl olan ortalama ölüm yaş farkını 0.5 yıla daralttı. TEKHARF 2016 takibinde izlenecek 1144 kişilik örneklemden 48'i takipten kayıp sayıldı; 695'i muayene edildi ve 39 katılımcının öldüğü belirlendi; 362 kişi hakkında da sözel bilgi edinildi.Sonuç: Türk erkeklerine kıyasla, kadınlarda sağ kalım kazancı son on yılda net biçimde duraklamış olduğu gibi, ölüm riski -kadın ve kentlilik arasında etkileşimi düşündürür biçimde- kadınlarda ve kent sakinlerinde anlamlı olarak yükselmiştir. Her iki gözlem açıkça kabul görüp kapsamlı önlem alınması gereğini ortaya koymaktadır.
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    Understanding vascular age: are clinical scoring systems useful for early vascular aging syndrome prediction ?
    (Adis Int Ltd, 2020) Apaydın, Ziya; Can, Mehmet Mustafa; Elçik, Deniz; N/A; N/A; N/A; N/A; Kılıç, Alparslan; Baydar, Onur; Elçioğlu, Betül Cengiz; Çamkıran, Volkan; Doctor; Doctor; Doctor; Doctor; N/A; N/A; N/A; N/A; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; N/A; N/A; N/A
    Introduction Early vascular aging syndrome (EVAS) is defined as increased arterial stiffness compared to age and sex matched patients, EVAS is measured by pulse wave velocity (PWV). Aim In our study we aim to identify in patients with high risk of EVAS using the CHADS2, CHA2DS2-VASc, and CHA2DS2-VASc-HS scores. Methods The CHADS2, CHA2DS2-VASc-HS and CHADS2VASC scoring systems are advised to determine management strategies in patients with nonvalvular atrial fibrillation. As they contain similar risk factors for the development or presence of EVAS, we believed that this risk scoring system could also be used to predict EVAS. This study was designed as a retrospective observational study. 2108 consecutive patients who had undergone 24-h blood pressure monitoring and measured PWV levels were included in the study. The patients were divided into the two groups according to corrected Pwv values. Results CHADS2, CHA2DS2-VASc, and CHA2DS2-VASc-HS scores were positively correlated with PWV values (r =0.251, p < 0.001; r = 0.457, p < 0.001; and r = 0.385, p < 0.001, respectively). CHA2DS2-VASc-HS score was statistically better than CHA2DS2, CHA2DS2-VASc score to predict early vascular aging syndrome (p < 0.001). For the prediction of EVAS, the cut-off value of CHA2DS2-VASc-HS score was >= 1.5 with a sensitivity of 49% and a specificity of 50 % (AUC 0.605; 95% [CI] 0.58-0.63) in the ROC curve analyses. Conclusions The CHA2DS2-VASc-HS scoring system might be used in daily clinical practice to calculate the total risk assessment of EVAS. This score is relatively simple to use and time-saving technique.
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    PublicationOpen Access
    Female and urban participants demonstrate an adverse trend in overall mortality in Turkey – and a report on the TARF survey 2016
    (Turkish Society of Cardiology, 2017) Altan Onat, Altan; Can,Günay; Keskin, Muhammed; Uzun, Ahmet Okan; Yüksel, Hüsniye; Çamkıran, Volkan; Koç University Hospital
    Objective: This study is an examination of 1) overall mortality trend in the Turkish Adult Risk Factor (TARF) study stratified by sex and place of residence, and 2) brief report on main aspects of the 2016 survey. Methods: The period of last 18 years was divided into 2 for trend analysis of data. Required information on deaths was obtained. Baseline age >= 40 years at the beginning of each period was the inclusion criterion. Cox regression analyses were performed. Results: Among over 2500 participants in each, deaths were recorded in 281 and 334 individuals in Periods 1 and 2, respectively, and baseline mean age was 54.6 years and 56.4 years, respectively, in each period. Age-adjusted hazard ratio for mortality in Period 2 remained virtually the same for rural males, rose to borderline significance for urban males and rural females (p=0.06, p=0.09), and increased 1.72-fold for urban females (p=0.006), as compared to Period 1. Whereas males gained an average of 3.8 years of survival in the later period compared with the earlier period, females gained only 1.8 years. This narrowed the difference in mean age at death in favor of women from 2.5 years to 0.5 year. Of 1144 participants to be surveyed in the TARF 2016, 48 were lost to follow-up, 695 were examined, and 39 participants were ascertained to be deceased. In 362 cases, verbal information was obtained regarding health status. Conclusion: Gain in survival in Turkish women has distinctly stagnated compared with men, and hazard of death has risen significantly for women and urban residents in the past decade, suggesting interaction between female sex and urban residence. Both phenomena require recognition and adoption of appropriate measures.
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    PublicationOpen Access
    The effect of urine pH and urinary uric acid levels on the development of contrast nephropathy
    (Karger Publishers, 2019) Afşar, Barış; Sağ, Alan A.; Siriopol, Dimitrie; You, Zhiying; Garcia, Miguel L.; Covic, Adrian; Cherney, David Z. I.; Johnson, Richard J.; Aslan, Gamze; Çamkıran, Volkan; Erden, Nihan; Yılmaz, Sezen Güçlü; İncir, Said; Kanbay, Mehmet; Doctor; Undergraduate Student; Faculty Member; Faculty Member; School of Medicine; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; 110580
    Background: hyperuricemia may cause acute kidney injury by activating inflammatory, pro-oxidative and vasoconstrictive pathways. In addition, radiocontrast causes an acute uricosuria, potentially leading to crystal formation. We therefore aimed to investigate the effect of urine acidity and urine uric acid level on the development of contrast-induced nephropathy (CIN) in patients undergoing elective coronary angiography. Methods: we enrolled 175 patients who underwent elective coronary angiography. CIN was defined as a >25% increase in the serum creatinine levels relative to basal values 48-72 h after contrast use. Prior to coronary angiography and 48-72 h later, serum uric acid, urea, creatinine, bicarbonate levels, and spot uric acid to creatinine ratio (UACR) were measured. Results: of the 175 subjects included, 29 (16.6%) developed CIN. Those who developed CIN had a higher prevalence of diabetes, higher UACR (0.60 vs. 0.44, p = 0.014), higher contrast volume, and lower serum sodium level. With univariate analysis of a logistic regression model, the risk of CIN was found to be associated with diabetes (p = 0.0016, OR = 3.8 [95% CI: 1.7-8.7]), urine UACR (p = 0.0027, OR = 9.6 [95% CI: 2.2-42.2]), serum sodium (p = 0.0079, OR = 0.8 [95% CI: 0.77-0.96]), and contrast volume (p = 0.0385, OR = 1.8 [95% CI: 1.03-3.09]). In a multiple logistic regression model with stepwise method of selection, diabetes (p = 0.0120, OR = 3.2 [95% CI: 1.3-8.1]) and UACR (p = 0.0163, OR = 6.9 [95% CI: 1.4-33.4]) were the 2 risk factors finally identified. Conclusions: we have demonstrated that higher urine UACR is associated with the development of CIN in patients undergoing elective coronary angiography.
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    PublicationOpen Access
    Tenth categories of total and HDL cholesterol fail to independently predict death risk in middle-aged Turkish adults
    (Turkish Society of Cardiology, 2017) Altan Onat, Altan; Can,Günay; Keskin, Muhammed; Uzun, Ahmet Okan; Yüksel, Hüsniye; Çamkıran, Volkan; Koç University Hospital
    Objective: The aim of this study was to delineate in detail the longitudinal association of total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) levels with overall mortality in middle-aged partici pants of the biennial Turkish Adult Risk Factor study.Methods: Baseline lipid variables were analyzed in sex-specific deciles. A baseline age of 45 to 84 years as an inclusion criterion led to the enrollment of 2121 men and women. Cox regression analyses were performed. Results: Deaths were recorded in 237 and 306 women and men, respectively, during a mean 8.85 +/- 4.4 years of follow-up. Afte r adjustment for age, smoking status, lipid-lowering and antihypertensive drug usage, prevalent diabetes, and coronary heart disease, and using the lowest decile as referent, neither TC (p trend=0.94 and 0.96, respectively), nor HDL-C categories (p trend=0.20 and 0.31, respectively) were significantly predictive of mortality in either gender. TC deciles exhibited a gender difference insofar as hazard ratios in females tended to be reciprocal to those in males in deciles 2 through 5. Conclusion: The findings on TC deciles may be attributed to a comparatively higher death rate in the female (compared with male) bottom decile, reflecting the autoimmune process-induced elevated risk in the lowest decile. Observations on HDLC confirmed presumed pro-inflammatory conversion in levels >50 mg/dL. These results have important clinical implications.