Researcher:
Vehbi, Sezan

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Undergraduate Student

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Sezan

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Vehbi

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Vehbi, Sezan

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20222

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    Immune checkpoints inhibitors and its link to acute kidney injury and renal prognosis
    (Springer) Siriopol, Dimitrie; Covic, Adrian; Perazella, Mark A.; N/A; Kanbay, Mehmet; Yıldız, Abdullah Burak; Vehbi, Sezan; Hasbal, Nuri Barış; Kesgin, Yavuz Erkam; Celayir, Özde Melisa; Selçukbiricik, Fatih; Faculty Member; Undergraduate Student; Undergraduate Student; Faculty Member; Researcher; Other; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; N/A; School of Medicine; N/A; N/A; N/A; N/A; N/A; N/A; Koç University Hospital; 110580; N/A; N/A; 143778; 327622; N/A; 202015
    Background Immunotherapy with immune checkpoint inhibitors (ICPi) may cause acute kidney injury (AKI) and their use is increasing. Materials and methods This is a single-center retrospective cohort study of patients receiving ICPi drugs for solid organ malignancies. ICPi-related AKI, the need for renal replacement therapy during or following ICPi treatment, and the associated mortality was studied. Results Two hundred thirty five patients were included in the final analysis. Patients with (N = 40) and without (n = 195) AKI had similar age, sex, type of ICPi, baseline serum creatinine levels, comorbidities and mortality; while patients with AKI were more likely to be receiving a nephrotoxic agent or be treated for genitourinary malignancy. 18 patients had ICPi-related AKI; 7 of these patients underwent kidney biopsy, which showed acute interstitial nephritis while the remaining 11 were diagnosed on clinical parameters. 18 (45%) patients recovered kidney function after AKI. No differences were observed between patients with and without kidney function recovery, although patients without recovery had a numerical, but not statistically significant, higher mortality. Patients with biopsy-confirmed ICPi-induced AKI had an increased risk of mortality, as compared with the rest of the population-HR 1.83, 95% CI 1.22-2.74, p = 0.003. Conclusion Use of nephrotoxic drugs and the location of malignancy appear to be common drivers of AKI in patients receiving ICPis for solid organ malignancy. Whether nephrotoxic agents or urinary tract obstruction may favor ICPi-related autoimmunity should be further studied.
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    Assessment of hypertension in obstructive sleep apnea by ambulatory blood pressure monitoring: a systematic review and meta-analysis
    (Lippincott Williams and Wilkins (LWW), 2022) Siriopol, Dimitrie; Kanbay, Asiye; Yıldız, Abdullah Burak; Vehbi, Sezan; Özgü, Özde; Yağ, Burak; Kanbay, Mehmet; Undergraduate Student; Undergraduate Student; Undergraduate Student; Undergraduate Student; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; N/A; N/A; N/A; N/A; 110580
    Among obstructive sleep apnea (OSA) patients, there exists a high prevalence of hypertension. Determining the optimal blood pressure (BP) monitoring modality in this population will lead to a better understanding of hypertension profiles and a more accurate diagnosis of hypertension. PubMed, Ovid/Medline, Web of Science, Scopus, Cochrane Library, and CINAHL databases were screened, and the relevant articles regarding BP monitoring in OSA patient population were selected. Studies evaluating both ambulatory (ABPM) and office BP measurements were selected to be analyzed for the hypertension diagnosis specificity of ABPM measurement in OSA patients compared with office measurements. If reported, additional information regarding white-coat, masked hypertension, and circadian BP pattern prevalence was included. A cumulative analysis of five studies revealed a prevalence of hypertension based on BP to be 44%, whereas a cumulative analysis of four studies revealed a prevalence of hypertension based on ABPM to be 66%. Excluding a study with the nighttime assessment of hypertension reduced the cumulative prevalence of hypertension in OSA patients to 59%. The cumulative prevalence of Studies demonstrated the prevalence of masked and white-coat hypertension to be 34 and 9%, respectively. As a higher prevalence of hypertension was detected by ABPM and nighttime measurement, it can be deduced that ABPM is more sensitive in determining OSA patients with hypertension, and that nighttime ABPM further increases this sensitivity. The presence of masked and white-coat hypertension in OSA patients underlines the importance of correct hypertension diagnosis as it affects further management in this population with increased cardiovascular risk.
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    An update review on hemodynamic instability in renal replacement therapy patients
    (Springer) Covic, Andreea; Burlacu, Alexandru; Covic, Adrian; N/A; Yıldız, Abdullah Burak; Vehbi, Sezan; Kanbay, Mehmet; Undergraduate Student; Undergraduate Student; Faculty Member; School of Medicine; Koç University Hospital; N/A; N/A; 110580
    Background: Hemodynamic instability in patients undergoing kidney replacement therapy (KRT) is one of the most common and essential factors influencing mortality, morbidity, and the quality of life in this patient population. Method: Decreased cardiac preload, reduced systemic vascular resistance, redistribution of fluids, fluid overload, inflammatory factors, and changes in plasma osmolality have all been implicated in the pathophysiology of hemodynamic instability associated with KRT. Result: A cascade of these detrimental mechanisms may ultimately cause intra-dialytic hypotension, reduced tissue perfusion, and impaired kidney rehabilitation. Multiple parameters, including dialysate composition, temperature, posture during dialysis sessions, physical activity, fluid administrations, dialysis timing, and specific pharmacologic agents, have been studied as possible management modalities. Nevertheless, a clear consensus is not reached. Conclusion: This review includes a thorough investigation of the literature on hemodynamic instability in KRT patients, providing insight on interventions that may potentially minimize factors leading to hemodynamic instability.
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    PublicationOpen Access
    Kidney replacement therapy patients with COVID-19 in the vaccine era: what do we need to know?
    (Oxford University Press (OUP), 2022) Vehbi, Sezan; Yıldız, Abdullah Burak; Kanbay, Mehmet; Faculty Member; School of Medicine; N/A; N/A; 110580
    Kidney disease is one of the most important factors affecting the prognosis of patients with coronavirus disease 2019 (COVID-19). Patients on kidney replacement therapy (KRT; dialysis and kidney transplant recipients) are vulnerable to severe complications of COVID-19. As the pandemic evolves and preventive strategies, availability of healthcare facilities, treatment approaches and vaccination strategies change, studies are needed on COVID-19 epidemiology and outcomes in KRT patients that contribute to vaccination regimens, treatment protocols and immunosuppressive therapies of KRT patients with COVID-19. In their registry-based study, Quiroga et al. analyzed COVID-19 KRT patients in Spain across six pandemic waves in order to evaluate dynamic treatment approaches and outcomes as well as the efficacy of vaccination.