Researcher:
Demiray, Atalay

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Master Student

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Atalay

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Demiray

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Demiray, Atalay

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2021 - 202318

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    Uric acid in metabolic syndrome: does uric acid have a definitive role?
    (Elsevier, 2022) N/A; N/A; N/A; Çöpür, Sidar; Demiray, Atalay; Kanbay, Mehmet; Resercher; Master Student; Faculty Member; School of Medicine; Graduate School of Health Sciences; School of Medicine; 368625; N/A; 110580
    increased serum uric acid (SUa) levels are commonly seen in patients with metabolic syndrome and are widely accepted as risk factors for hypertension, gout, non-alcoholic fatty liver disease, chronic kidney disease (CKD), and cardiovascular diseases. although some ambiguity for the exact role of uric acid (Ua) in these diseases is still present, several pathophysiological mechanisms have been identified such as increased oxidative stress, inflammation, and apoptosis. accumulating evidence in genomics enlightens genetic variabilities and some epigenetic changes that can contribute to hyperuricemia. Here we discuss the role of Ua within metabolism and the consequences of asymptomatic hyperuricemia while providing newfound evidence for the associations between Ua and gut microbiota and vitamin D. increased SUa levels and beneficial effects of lowering SUa levels need to be elucidated more to understand its complicated function within different metabolic pathways and set optimal target levels for SUa for reducing risks for metabolic and cardiovascular diseases.
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    Deciphering nutritional interventions for podocyte structure and function
    (Academic Press Ltd-Elsevier Science Ltd, 2021) Afşar, Barış; Afşar, Rengin Elsürer; Covic, Adrian; N/A; N/A; Demiray, Atalay; Kanbay, Mehmet; Master Student; Faculty Member; Graduate School of Health Sciences; School of Medicine; N/A; 110580
    Despite increasing awareness and therapeutic options chronic kidney disease (CKD) is still and important health problem and glomerular diseases constitute and important percentage of CKD. Proteinuria/albuminuria is not just a marker; but it also plays a direct pathogenic role in renal disease progression of CKD. Glomerular filtration barrier (GFB) which consists of fenestrated endothelial cells, fused basal membrane and interdigitating podocyte foot process and filtration slits between foot process is the major barrier for proteinuria/albuminuria. Many glomerular diseases are characterized by disruption of GFB podocytes, foot process and slit diaphragm. Many proteinuric diseases are non-specifically targeted by therapeutic agents such as steroids and calcineurin inhibitors with systemic side effects. Thus, there is unmet need for more efficient and less toxic therapeutic options to treat glomerular diseases. In recent years, modification of dietary intake, has been gained to treat pathologic processes introducing the concept of 'food as a medicine'. The effect of various nutritional products on podocyte function and structure is also trending, especially in recent years. In the current review, we summarized the effect of nutritional interventions on podocyte function and structure.
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    Cardiorenal metabolic consequences of nighttime snacking: is it an innocent eating behavior?
    (Springernature, 2022) Tuttler, Kathherine R.; N/A; Kanbay, Mehmet; Çöpür, Sidar; Demiray, Atalay; Faculty Member; Researcher; Master Student; School of Medicine; School of Medicine; Graduate School of Health Sciences; 110580; 368625; N/A
    Purpose of Review Health consequences of nighttime eating, as a publicly discussed eating behavior type, have been speculated lately. Nighttime eating has been linked to various metabolic outcomes including hyperlipidemia, hypertriglyceridemia, hyperglycemia, weight gain, elevated blood pressure, obesity, and metabolic syndrome, and cardiorenal outcomes such as atherosclerosis, a decline in eGFR, and proteinuria. Recent Findings Although the exact underlying pathophysiological mechanism is not yet clear, multiple hypotheses including disrupted circadian rhythm, altered hormonal levels, and decline in cellular regeneration have been proposed. In this review, we aim to evaluate the growing literature on nighttime eating behavior in terms of metabolic and cardiorenal outcomes, pathophysiological basis, and potential therapeutic alternatives.
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    Substitution of sugar-sweetened beverages for other beverages: Can it be the next step towards healthy aging?
    (Springernature, 2021) Afsar, Barış; Ortiz, Alberto; Covic, Adrian; N/A; Kanbay, Mehmet; Demiray, Atalay; Ertuğlu, Lale Aslıhan; Yıldız, Abdullah Burak; Faculty Member; Master Student; Undergraduate Student; Undergraduate Student; School of Medicine; Graduate School of Health Sciences; School of Medicine; School of Medicine; 110580; N/A; N/A; N/A
    Purpose of Review With the prolongation of life expectancy, the gap between lifespan and "health span," the disease-free lifespan, has been widening due to the massive burden of age-related chronic diseases and research on healthy aging has been gaining momentum. A growing body of evidence suggests that diet is a strong determinant of healthy aging and consumption of sugar-sweetened beverages (SSB), a major source of added sugars, predicts poor health outcomes in the aging population, including cardiovascular disease, diabetes, and cancer. Evidence further supports a link between sugar-sweetened beverages-triggered pathological processes and biologic factors of aging, including inflammaging, oxidative stress, and alterations in intestinal microbiota. At present, substitution of sugar-sweetened beverages with healthier alternative beverage remains the most robust strategy to limit the deleterious effects of sugar-sweetened beverages on health worldwide and may help achieve healthy longevity. The purpose of this review is to provide an overview of mechanisms by which sugar-sweetened beverages consumption may impact the physiological aging process and how a simple intervention of beverage replacement may promote healthy aging. Recent Findings Recent findings indicate that SSB are associated with accelerated aging phenotype and activate various adverse biological processes such as chronic inflammation, oxidative stress, insulin resistance, and gut dysbiosis. Summary Replacing SSB with healthier beverages may be a reasonable option to reduce the burden of chronic disease in the aging population and even prolong life and healthspan.
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    Association between lipoprotein (a) level and chronic cardio-renal syndrome in patients with coronary artery disease
    (Wiley, 2021) N/A; N/A; N/A; N/A; N/A; N/A; Ural, Dilek; Cünedioğlu, Berkay Ömer; Yurtseven, Ece; Demiray, Atalay; Aytekin, Saide; Aytekin, Vedat; Faculty Member; Undergraduate Student; Teaching Faculty; Master Student; N/A; Doctor; Faculty Member; School of Medicine; School of Medicine; School of Medicine; Graduate School of Health Sciences; N/A; N/A; School of Medicine; Koç University Hospital; 1057; N/A; 176021; N/A; N/A; 140946
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    Effect of sodium-glucose cotransporter 2 inhibitors on hemoglobin and hematocrit levels in type 2 diabetes: a systematic review and meta-analysis
    (Springer, 2022) Tapoi, Laura; Ureche, Carina; Afsar, Baris; Cherney, David Z., I; Covic, Adrian; N/A; Kanbay, Mehmet; Demiray, Atalay; Tanrıöver, Cem; Çevik, Enes; Faculty Member; Master Student; Undergraduate Student; Undergraduate Student; School of Medicine; Graduate School of Health Sciences; School of Medicine; School of Medicine; 110580; N/A; N/A; N/A
    Background Sodium-glucose cotransporter 2 inhibitors (SGLT2i) improve outcomes of patients with type 2 diabetes at high cardiovascular risk and chronic kidney disease. Recent studies showed an increase in hemoglobin and hematocrit after SGLT2i treatment. Materials and methods We did a systematic review and meta-analysis of randomized, double-blind, placebo-controlled studies of SGLT2i in patients with type 2 diabetes. We searched through PubMed/Medline, Web of Science, Embase (Elsevier), and the Cochrane Central Register of Controlled Trials (Wiley) from January 2010 to January 2021. Results We included seventeen randomized, double-blind, placebo-controlled studies. The total number of evaluated patients was 14,748. The treatment arm consisted of canagliflozin, dapagliflozin, empagliflozin and ipragliflozin. SGLT2i therapy significantly increased hemoglobin levels when compared to placebo (MD 5.60 g/L, 95% CI 3.73-7.47 g/L, P < 0.00001, considerable heterogeneity-I-2 = 94%). Each SGLT2i also led to a significant increase in the hematocrit level when compared to placebo (MD 1.32%, 95% CI 1.21-1.44, P < 0.00001, considerable heterogeneity-I-2 = 99%). Conclusions SGLT2i led to significant increases in hemoglobin and hematocrit levels when compared to placebo. In addition to their cardiovascular effect, SGLT2i also increases hemoglobin and hematocrit levels.
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    Fatty kidney: a possible future for chronic kidney disease research
    (Wiley, 2022) Sag, Alan A.; Covic, Adrian; Ortiz, Alberto; Tuttle, Kathherine R.; N/A; Çöpür, Sidar; Kanbay, Mehmet; Demiray, Atalay; Researcher; Faculty Member; Undergraduate Student; School of Medicine; School of Medicine; School of Medicine; 368625; 110580; N/A
    Background Metabolic syndrome is a growing twenty-first century pandemic associated with multiple clinical comorbidities ranging from cardiovascular diseases, non-alcoholic fatty liver disease and polycystic ovary syndrome to kidney dysfunction. A novel area of research investigates the concept of fatty kidney in the pathogenesis of chronic kidney disease, especially in patients with diabetes mellitus or metabolic syndrome. Aim To review the most updated literature on fatty kidney and provide future research, diagnostic and therapeutic perspectives on a disease increasingly affecting the contemporary world. Materials and Method We performed an extensive literature search through three databases including Embase (Elsevier) and the Cochrane Central Register of Controlled Trials (Wiley) and PubMed/Medline Web of Science in November 2021 by using the following terms and their combinations: 'fatty kidney', 'ectopic fat', 'chronic kidney disease', 'cardiovascular event', 'cardio-metabolic risk', 'albuminuria' and 'metabolic syndrome'. Each study has been individually assessed by the authors. Results Oxidative stress and inflammation, Klotho deficiency, endoplasmic reticulum stress, mitochondrial dysfunction and disruption of cellular energy balance appear to be the main pathophysiological mechanisms leading to tissue damage following fat accumulation. Despite the lack of large-scale comprehensive studies in this novel field of research, current clinical trials demonstrate fatty kidney as an independent risk factor for the development of chronic kidney disease and cardiovascular events. Conclusion The requirement for future studies investigating the pathophysiology, clinical outcomes and therapeutics of fatty kidney is clear.
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    The use of healthy eating index 2015 and healthy beverage index for predicting and modifying cardiovascular and renal outcomes
    (Springernature, 2022) Afşar, Barış; Ortiz, Alberto; N/A; Ertuğlu, Lale Aslıhan; Demiray, Atalay; Kanbay, Mehmet; Undergraduate Student; Master Student; Faculty Member; School of Medicine; Graduate School of Health Sciences; School of Medicine; Koç University Hospital; N/A; N/A; 110580
    Purpose of Review With the wide recognition of the importance of dietary patterns rather than isolated nutrient groups on health outcomes, numerous diet quality indices have been designed to evaluate the overall food intake quality in the last two decades. Recent Findings The newest version of the Healthy Eating Index (HEI), HEI-2015, is a diet quality index that measures adherence to the recommendations of the 2015-2020 Dietary Guidelines for Americans. While the key nutrient groups are included in most diet quality indices, differences in other components and the scoring system differentiate HEI. The Healthy Beverage Index (HBI) was recently introduced. Previous literature has confirmed the association of the older versions of HEI with metabolic syndrome, inflammatory markers, and negative health outcomes including cardiovascular disease, type 2 diabetes mellitus, chronic kidney disease, and all-cause mortality. Summary This review presents the existing evidence on the association of HEI-2015 and HBI with health markers and long-term outcome, provides guidance on their use, and identifies persisting challenges such as the development of simple, unified, and objective tools to characterize healthy diets in routine clinical practice.
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    Sodium and ultrafiltration profiling in hemodialysis: a long-forgotten issue revisited
    (2021) Basile, Carlo; Afşar, Barış; Covic, Adrian; N/A; Ertuğlu, Lale Aslıhan; Demiray, Atalay; Kanbay, Mehmet; Undergraduate Student; Master Student; Faculty Member; School of Medicine; Graduate School of Health Sciences; School of Medicine; Koç University Hospital; N/A; N/A; 110580
    Sodium and ultrafiltration profiling are method of dialysis in which dialysate sodium concentration and ultrafiltration rate are altered during the course of the dialysis session. Sodium and ultrafiltration profiling have been used, commonly simultaneously, to improve hemodynamic stability during hemodialysis. Sodium profiling is particularly effective in decreasing the incidence of intradialytic hypotension, while ultrafiltration profiling is suggested to decrease subclinical repeated end organ ischemia during dialysis. However, complications such as increased interdialytic weight gain and thirst due to sodium excess have prevented widespread use of sodium profiling. Evidence suggest that different sodium profiling techniques may lead to different clinical results, and preferring sodium balance neutral sodium profiling may mitigate adverse effects related to sodium overload. However, evidence is lacking on the long-term clinical outcomes of different sodium profiling methods. Optimal method of sodium profiling as well as the utility of sodium/ultrafiltration profiling in routine practice await further clinical investigation.
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    Glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors for diabetes after solid organ transplantation
    (WILEY, 2021) Porrini, Esteban; Hornum, Mads; Afsar, Baris; Ortiz, Alberto; Covic, Adrian; Rossing, Peter; N/A; Ertuğlu, Lale Aslıhan; Demiray, Atalay; Kanbay, Mehmet; Undergraduate Student; Master Student; Faculty Member; N/A; School of Medicine; Graduate School of Health Sciences; School of Medicine; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; N/A; 110580
    Post-transplant diabetes mellitus (PTDM) is a common complication of solid organ transplantation and a major cause of increased morbidity and mortality. Additionally, solid organ transplant patients may have pre-existent type 2 diabetes mellitus (T2DM). While insulin is the treatment of choice for hyperglycemia in the first weeks after transplantation, there is no preferred first line agent for long-term management of PTDM or pre-existent T2DM. Glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium-glucose cotransporter 2 (SGLT2) inhibitors improve glycemic control, lower body weight, and blood pressure, are recommended after lifestyle and metformin as initial therapy for diabetic patients with cardiovascular or kidney comorbidities regarding their cardiorenal benefits. Furthermore, the mechanisms of action of GLP-1RA may counteract some of the driving forces for PTDM, as calcineurin-induced beta cell toxicity as per preclinical data, and improve obesity. However, their use in the treatment of PTDM is currently limited by a paucity of data. Retrospective observational and small exploratory studies suggest that GLP-1RA effectively improve glycemic control and induce weight loss in patients with PTDM without interacting with commonly used immunosuppressive agents, although randomized-controlled clinical trials are required to confirm their safety and efficacy. In this narrative review, we evaluate the risk factors and pathogenesis of PTDM and compare the potential roles of GLP-1RA and SGLT2 inhibitors in PTDM prevention and management as well as in pre-existent T2DM, and providing a roadmap for evidence generation on newer antidiabetic drugs for solid organ transplantation.