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Aim In resistant infections and septic patients, the choice of colistin in the selection of antibiotic therapy is important in the treatment response. Kidney damage is common after antibiotic use. In our study, we evaluated the clinical and laboratory data of the patients who developed nephrotoxicity after the use of colistin, followed in the intensive care unit of our hospital. Material and Methods The clinical and laboratory characteristics and treatment results of 148 patients (54 nephrotoxic patients) with infection who were followed up in the intensive care unit (ICU) of our hospital evaluated. Results The group that developed nephrotoxicity was older [70.5 (40–91), p

Background This study was designed to investigate the effect of calcineurin inhibitors (CNIs), cyclosporine (CsA), and tacrolimus (Tac) on anthropometrics in kidney transplant recipients. Methods 111 of 128 adult kidney transplant recipients who received post-transplant CNIs were included in this retrospective study. Anthropometrics were recorded in the pre-transplant and post-transplant 4-year follow-up periods (1st, 3rd, 6th, 12th, 24th, 36th and 48th months). Results Compared to pre-transplant values, significant increases in body weight and body mass index (between 3rd and 48th months), waist and hip circumferences (between 1st and 48th months), waist-to-hip ratio (between 1st and 3rd or 6th months) and neck circumference (between 1st and 12th or 24th months) were observed in both CsA and Tac groups. A significant increase was noted in post-transplant body fat percentage values for the 3rd to 24th months in the CsA group, whereas for the 24th to 48th months in both CsA and Tac groups. Hip circumferences percentage changes from the pre-transplant period to the 1st, 12th and 24th months were significantly higher in CsA than in the Tac group. At each time point, there was no significant difference in percentage changes for other anthropometric parameters between the CsA and Tac groups. De novo diabetes mellitus developed in 8.3% of the CsA group and 19.1% of the Tac group. Conclusions After a successful kidney transplant, anthropometric measurements increase in most recipients. Although the effect of calcineurin inhibitor type on weight gain is unclear, a regression analysis showed that CNI type was not a risk factor for the development of obesity in the 48th month. However, it is helpful to be cautious about its dyslipidemic effect in patients using CsA and the potential hazards of using Tac in patients with a diabetic predisposition.

Coronavirus disease 2019 (COVID-19) has a higher mortality in the presence of chronic kidney disease (CKD). However, there has not been much research in the literature concerning the outcomes of CKD patients in the post-COVID-19 period. We aimed to investigate the outcomes of CKD patients not receiving renal replacement therapy.In this multicenter observational study, we included CKD patients with a GFR 60 ml/min/1.73 mThere were 173 patients in the COVID-19 group and 207 patients in the control group. Most patients (72.8%) were treated as inpatient in the COVID-19 group (intensive care unit hospitalization: 16.7%, acute kidney injury: 54.8%, needing dialysis: 7.9%). While there was no significant difference between the baseline creatinine values of the COVID-19 group and the control group (1.86 and 1.9, p = 0.978, respectively), on the 1st month, creatinine values were significantly higher in the COVID-19 group (2.09 and 1.8, respectively, p = 0.028). Respiratory system symptoms were more common in COVID-19 patients compared to the control group in the 1st month and 3rd month follow-ups (p 0.001). Mortality at 3 months after the diagnosis of COVID-19 was significantly higher in the COVID-19 group than in the control group (respectively; 5.2% and 1.4%, p:0.037). Similarly, the rate of patients requiring dialysis for COVID-19 was significantly higher than the control group (respectively; 8.1% and 3.4%, p: 0.045).In CKD patients, COVID-19 was associated with increased mortality, as well as more deterioration in kidney function and higher need for dialysis in the post-COVID-19 period. These patients also had higher rate of ongoing respiratory symptoms after COVID-19.

Background The histopathological classification of ANCA-GN divides patients into four groups based on signs of glomerular injury. However, this classification did not consider age-related glomerulosclerosis. In this study, we aimed to compare the prediction of renal survival between Berden's ANCA-GN histopathological classification and ANCA-GN histopathological classification modified with age-related glomerulosclerosis. Methods Between January 2004 and December 2019, 65 patients diagnosed with ANCA-GN were enrolled. Demographic, laboratory, and histopathologic findings were retrospectively analyzed. Renal survival analyzes were compared according to classical and modified ANCA-GN histopathological classifications. The multivariate Cox regression analysis for the factors affecting renal survival was performed. Results In Berden's ANCA-GN histopathological classification, 15 patients were in the focal group, 21 in the crescentic, 21 in the sclerotic, and 8 in the mixed group. The ANCA-GN histopathological classification model generated statistically significant predictions for renal survival (p = 0.022). When the histopathological classification was modified with age-related glomerulosclerosis, 8 of the 9 patients previously classified in the sclerotic group were classified in the mixed and 1 in the crescentic groups. Modification of histopathological classification with age-related glomerulosclerosis increases the statistical significance in renal survival analysis (p = 0.009). The multivariate Cox regression analysis showed that the disease-related global sclerotic glomeruli percentage and serum creatinine level were the significant independent factors. Conclusion Modification of Berden's ANCA-GN histopathological classification model with age-related glomerulosclerosis may increase the statistical significance of the histopathological classification model.

Aim:Acute kidney injury (AKI) is still an important cause of morbidity and mortality. Several factors are effective in its frequency, etiology, prognosis and mortality. In our study, we aimed to demonstrate the etiology and prognostic factors of AKI.Methods:A total of 272 patients diagnosed with AKI, who were hospitalized in the nephrology department between January 2011 and December 2015, were included in the study. In addition to the demographic characteristics of patients, clinical and laboratory findings were evaluated retrospectively.Results:Forty-seven point four percent of patients were female and 52.6% were male. The mean age of the patients was 61.6 years, the mean length of hospital stay was 13.3 days, the number of hemodialysis sessions was 1.24 and the mortality rate was 4.8%. The need and number of hemodialysis sessions were significantly higher in older patients (>65 years). The need and number of hemodialysis sessions were higher in the renal AKI group (48.7%, 1.9). The length of hospital-stay was longer and mortality rate was higher in patients with renal AKI compared to the other groups (16.4 days, 8.8%). Mortality rate, length of hospital-stay, and number of hemodialysis sessions were found to be increased significantly in patients with infection (42%).Conclusion:Etiology and accompanying infection in AKI are the most important factors affecting mortality. In addition, anemia and advanced age increase the length of hospital stay and the need for hemodialysis.

Objective: Non-peptide vasopressin receptor antagonists (vaptans) are effective at increasing sodium in euvolemic and hypervolemic states and appear safe. We aimed to evaluate the efficacy of tolvaptan in euvolemic or hypervolemic hyponatremic patients. Methods: The study included 9 hyponatremic (serum sodium level

Aim Skin test anergy is common in patients with uremia and during maintenance hemodialysis treatment. However, up to date only one study concerning skin test in peritoneal dialysis patients has focused on the issue. Our cross-sectional controlled study was conducted to analyze the correlation of purified protein derivative (PPD) test response with demographical features, nutritional parameters and the distribution of peripheral blood lymphocyte subsets in peritoneal dialysis and hemodialysis patients Patients and methods Stable 30 hemodialysis (HD) patients (16 men, 14 women) and 30 continuous ambulatory peritoneal dialysis (PD) patients (17 men, 13 women) were included. Thirty healthy cases (15 men, 15 women) with a mean age of 32.4 ± 9.4 constituted the control group. Results In the HD group, 14 patients (46.6%) were PPD positive, and ın the PD group 16 patients (53.3%) were PPD positive. In the PPD-positive HD patients 64.2% (9/14), and in the PPD-positive PD patients 62.4% (10/16) had an induration of 10 mm or greater. In the control group, 21 of 30 patients (70%) were PPD positive. Comparison of both HD and PD groups with the control group showed significant differences in PPD reactivity (p p p p p p p Conclusion The prevalence of PPD positivity was lower in the PD and HD groups. The PPD test responses were not related to the peripheral lymphocyte counts, subsets and malnutrition parameters.

Objectives: Renal artery stenosis (RAS) is among the most common causes of secondary hypertension. Prevalence of RAS are seen in end-stage renal disease (ESRD) patients with hypertension between 1-10%. In our study, we evaluated the data of patients with RAS who were followed up with medical treatment and stenting. Methods: In our study, patients who were thought to have renal artery stenosis (RAS) with renal artery doppler ultrasonography were scanned with contrast-enhanced Magnetic Resonance Angiography (MRA). Fifty-three patients (10 received medical therapy, 43 applied invasive procedure) who diagnosed with RAS evaluated. Results: Follow-up times were 15 (12-84) months in patients who received medical therapy, and 12 (10-96) months in patients who treated with invasive therapy (p = 0.583). Median ages were 56 (19-74) years in medical treatment group, and 60 (15-77) years in invasive therapy group (p = 0.955). Compared with the beginning of treatment, diastolic hypertension was decreased of 12.5% in invasive treatment group opposite medical therapy group (p = 0.040), so eGFR was increased of 5.94% in invasive treatment group. Conclusions: In recent years, several studies about survival in patients with RAS was observed that there was no significant difference between the medical and invasive treatment. Clinical, laboratory, and individual characteristics should be considered in treatment choice.

BACKGROUND AND AIMS Coronavirus disease 2019 (COVID-19), which started in China in December 2019 and spread all over the world, is more progressive in patients who are elderly and with chronic diseases. Especially, kidney involvement affects the survival of patients. In this study, we analysed COVID-19 patients who developed acute kidney injury treated in our unit, retrospectively. METHOD The clinical and laboratory data of 610 patients who were hospitalized due to COVID-19 pandemic between 1 June 2020 and 30 June 2021 in the intensive care and other clinics of our hospital were evaluated from the records, retrospectively. A total of 140 patients were diagnosed with AKI according to the criteria of Kidney Disease Global Outcomes (KDIGO). The patients were divided into two groups as KDIGO stages 1 and 2 and 3. RESULTS The median age in both groups was 70 (35–92) and 73 (35–90) years. Approximately 70% of them were >65 years old. Almost all of the patients had hypertension. Most of the patients were using angiotensin converting enzyme inhibitors (ACE inh) or angiotensin receptor blockers (ARB) (84%). AKI was present at the time of admission (61.9%) in the KDIGO 1 group and at the time of hospitalization (64.3%) in the KDIGO 2, 3 groups. The mortality rate was higher in stage 2–3 AKI patients (35.7%). Ferritin and fibrinogen levels were high in the KDIGO 2, 3 group, while lymphocyte levels were low. CONCLUSION AKI can be seen at the time of admission and during treatment in patients who are hospitalized and treated due to COVID-19. COVID-19 is more mortal in patients with advanced AKI.

Introduction: We aimed to study the characteristics of peritoneal dialysis (PD) patients with coronavirus disease-19 (COVID-19), determine the short-term mortality and other medical complications, and delineate the factors associated with COVID-19 outcome. Methods: In this multicenter national study, we included PD patients with confirmed COVID-19 from 27 centers. The baseline demographic, clinical, laboratory, and radiological data and outcomes at the end of the first month were recorded. Results: We enrolled 142 COVID-19 patients (median age: 52 years). 58.2% of patients had mild disease at diagnosis. Lung involvement was detected in 60.8% of patients. Eighty-three (58.4%) patients were hospitalized, 31 (21.8%) patients were admitted to intensive care unit and 24 needed mechanical ventilation. Fifteen (10.5%) patients were switched to hemodialysis and hemodiafiltration was performed for four (2.8%) patients. Persisting pulmonary symptoms (n = 27), lower respiratory system infection (n = 12), rehospitalization for any reason (n = 24), malnutrition (n = 6), hypervolemia (n = 13), peritonitis (n = 7), ultrafiltration failure (n = 7), and in PD modality change (n = 8) were reported in survivors. Twenty-six patients (18.31%) died in the first month of diagnosis. The non-survivor group was older, comorbidities were more prevalent. Fever, dyspnea, cough, serious-vital disease at presentation, bilateral pulmonary involvement, and pleural effusion were more frequent among non-survivors. Age (OR: 1.102; 95% CI: 1.032–1.117; p: 0.004), moderate-severe clinical disease at presentation (OR: 26.825; 95% CI: 4.578–157.172; p < 0.001), and baseline CRP (OR: 1.008; 95% CI; 1,000–1.016; p: 0.040) were associated with first-month mortality in multivariate analysis. Discussion/Conclusions: Early mortality rate and medical complications are quite high in PD patients with COVID-19. Age, clinical severity of COVID-19, and baseline CRP level are the independent parameters associated with mortality.

BACKGROUND AND AIMS There is not enough data on the post-COVID-19 (coronavirus disease 2019) period for peritoneal dialysis (PD) patients affected from COVID-19. We aimed to compare the clinical and laboratory data retrospectively obtained in the follow-up of PD patients after COVID-19 with a control PD group. METHOD This study, supported by the Turkish Society of Nephrology, is a national multicenter retrospectively case–control study involving adult PD patients with confirmed COVID-19, using data collected from 21 April 2021 to 11 June 2021. A control PD group was also formed from each PD unit, from patients with similar characteristics but who did not have COVID-19. Patients in the active period of COVID-19 were not included. Data at the end of the first month and within the first 90 days, as well as other outcomes, including mortality, were investigated. RESULTS A total of 223 patients (COVID-19 group: 113, control group: 110) from 28 centers were included. The duration of PD in both groups was similar [median (IQR):3.0 (1.88–6.0) years and 3.0 (2.0–5.6)], but the patient age of the COVID-19 group was lower than the control group [50 (IQR:40–57) years and 56 (IQR:46–64) years, P CONCLUSION Mortality in the first 90 days after COVID-19 in PD patients with COVID-19 is not different from the control PD group. However, some of these patients continue to experience significant problems, especially respiratory system symptoms, malnutrition, and hypervolemia.

BACKGROUND AND AIMS Haemodialysis (HD) patients are at increased risk for adverse short-term consequences of COVID-19. In this study, we investigated the characteristics of chronic HD patients in the post-COVID-19 period and compared them with the control group. METHOD We conducted a national multicentre observational study involving adult chronic HD patients recovering from COVID-19. The control HD group was selected from patients with similar characteristics who did not have COVID-19 in the same center. SARS-CoV-2 RT-PCR negative patients and patients in the active period of COVID-19 were not included. RESULTS A total of 1223 patients (635 COVID-19 groups, 588 control groups) were included in the study from the data collected from 47 centres between 21 April 2021 and 11 June 2021. The patients' baseline demographics, comorbidities, medications, HD characteristics and basic laboratory tests were quite similar between the groups (Table 1). 28th-day mortality and between 28th day and 90th day mortality were higher in the COVID-19 group than in the control group [19 (3.0%) patients and 0 (0%) patients; 15 (2.4%) patients and 4 (0.7%) patients, respectively]. Presence of respiratory symptoms, rehospitalization, need for home oxygen therapy, lower respiratory tract infection and A-V fistula thrombosis were significantly higher in the COVID-19 group in the first 28 days of illness and between 28 and 90 days. Mortality was significantly associated with preexisting COVID-19, age, current smoking, use of tunneled HD catheter, persistence of respiratory symptoms, rehospitalization, need for home oxygen support, presence of lower respiratory tract infection within 28 days and persistence of respiratory symptoms. CONCLUSION In the post-COVID-19 period, mortality, rehospitalization, respiratory problems and vascular access problems are higher in maintenance HD patients who have had COVID-19 compared to control HD patients. Table 2. Comparative presentation of patients data on the 28th day and between 28 and 90 day COVID-19 groupN = 635 Control groupN = 588 28th-day results, n(%) Death* 19(3.0) 0(0) Any respiratory symptoms* 152(23.9) 11(1.9) Rehospitalization for any reason* 52(8.2) 24(4.1) Need for home oxygen support * 26(4.1) 2(0.3) Lower respiratory tract infection* 65(10.2) 8(1.4) AV fistula thrombosis* 13(2.0) 2(0.3) Other thromboembolic events * 15(2.4) 4(0.7) Need for HD catheter placement* 21(3.3) 9(1.5) 28th day-90. day resultsa n(%) N:616 N:588 Death* 15(2.4) 4(0.7) Any respiratory symptoms* 45(7.3) 10(1.7) Rehospitalization for any reason* 44(7.1) 18(3.1) Need for home oxygen support* 12(1.9) 2(0.3) AV fistula thrombosis* 9(1.5) 1(0.2) Other thromboembolic events* 9(1.5) 2(0.3) Need for HD catheter placement 13(2.1) 10(1.7) HD: haemodialysis, AV: arteriovenous. *P

Introduction: There are not enough data on the post-CO-VID-19 period for peritoneal dialysis (PD) patients affected from COVID-19. We aimed to compare the clinical and laboratory data of PD patients after COVID-19 with a control PD group. Methods: This study, supported by the Turkish Society of Nephrology, is a national, multicenter retrospective case-control study involving adult PD patients with confirmed COVID-19, using data collected from April 21, 2021, to June 11, 2021. A control PD group was also formed from each PD unit, from patients with similar characteristics but without COVID-19. Patients in the active period of COVID-19 were not included. Data at the end of the first month and within the first 90 days, as well as other outcomes, including mortality, were investigated. Results: A total of 223 patients (COVID-19 group: 113, control group: 110) from 27 centers were included. The duration of PD in both groups was similar (median [IQR]: 3.0 [1.88-6.0] years and 3.0 [2.0-5.6]), but the patient age in the COVID-19 group was lower than that in the control group (50 [IQR: 40-57] years and 56 [IQR: 46-64] years, p < 0.001). PD characteristics and baseline laboratory data were similar in both groups, except serum albumin and hemoglobin levels on day 28, which were significantly lower in the COVID-19 group. In the COVID-19 group, respiratory symptoms, rehospitalization, lower respiratory tract infection, change in PD modality, UF failure, and hypervolemia were significantly higher on the 28th day. There was no significant difference in laboratory parameters at day 90. Only 1 (0.9%) patient in the COVID-19 group died within 90 days. There was no death in the control group. Respiratory symptoms, malnutrition, and hypervolemia were significantly higher at day 90 in the COVID-19 group. Conclusion: Mortality in the first 90 days after COVID-19 in PD patients with COVID-19 was not different from the control PD group. However, some patients continued to experience significant problems, especially respiratory system symptoms, malnutrition, and hypervolemia. © 2022 S. Karger AG, Basel. Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.

Introduction: Hemodialysis (HD) patients have increased risk for short-term adverse outcomes of COVID-19. However, complications and survival at the post-COVID-19 period have not been published extensively.Methods: We conducted a national, multicenter observational study that included adult maintenance HD patients recovered from confirmed COVID-19. A control HD group without COVID-19 was selected from patients in the same center. We investigated the characteristics and outcomes in the follow-up of HD patients and compare them with the non-COVID-19 group.Results: A total of 1223 patients (635 patients in COVID-19 group, 588 patients in non-COVID-19 group) from 47 centers were included in the study. The patients' baseline and HD characteristics were almost similar. The 28th-day mortality and mortality between 28th day and 90th day were higher in the COVID-19 group than non-COVID-19 group (19 [3.0%] patients vs. none [0%]; 15 [2.4%] patients vs. 4 [0.7%] patients, respectively). The presence of respiratory symptoms, rehospitalization, need for home oxygen therapy, lower respiratory tract infection, and arteriovenous (AV) fistula thrombosis was significantly higher in the COVID-19 group in both the first 28 days and between 28 and 90 days. In the multivariable analysis, age (odds ratio [OR] [95% CI]: 1.029 [1.004-1.056]), group (COVID-19 group vs. non-COVID-19 group) (OR [95% CI]: 7.258 [2.538-20.751]), and vascular access type (tunneled catheter/AV fistula) (OR [95% CI]: 2.512 [1.249-5.051]) were found as independent parameters related to 90-day mortality.Conclusion: In the post-COVID-19 period, maintenance HD patients who have had COVID-19 have increased rehospitalization, respiratory problems, vascular access problems, and high mortality compared with the non-COVID-19 HD patients.

IgG4 related disease is an immune-mediated chronic inflammatory disease. It is a multisystemic disease that can lead to retroperitoneal fibrosis with involvement of the pancreas, glands, thyroid, lymph nodes, etc. and characterized histopathologically by lymphoplasmocytic cell infiltration. We evaluated a patient diagnosed with IGG4 related disease impaired kidney function.

ObjectiveCoronavirus disease 2019 (Covid 19) started in China in December 2019 and spread all over the world, is more progressive in patients who are elderly and with chronic diseases. Especially kidney involvement affects the survival of patients. In this study, we analyzed Covid 19 patients who developed acute kidney injury treated in our unit, retrospectively.MatherialsThe clinical and laboratory data of 610 patients who hospitalized due to Covid 19 pandemic between 01.06.2020 and 30.06.2021 in the intensive care and other clinics of our hospital evaluated from the records, retrospectively. One hundred-fourty patients diagnosed with AKI according to the criteria of KDIGO (Kidney Disease Global Outcomes). The patients divided into two groups as KDIGO stage 1 and 2, 3.ResultsThe median age in both groups was 70 (35-92) and 73 (35-90) years. Approximately seventy percent of them were over 65 years old. Almost all of the patients had hypertension. Most of the patients were using angiotensin converting enzyme inhibitors (ACE inh) or angiotensin receptor blockers (ARB) (84%). AKI was present at the time of admission (61.9%) in the KDIGO 1 group and at the time of hospitalization (64.3%) in the KDIGO 2, 3 group. The mortality rate was higher in stage 2-3 AKI patients (35.7%). Ferritin and fibrinogen levels were high in the KDIGO 2, 3 group, while lymphocyte levels were low.ConclusionAKI can be seen at the time of admission and during treatment in patients who are hospitalized and treated due to Covid 19. Covid 19 is more mortal in patients with advanced AKI.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a disease that affects many organs, especially the lung, and may lead to multiorgan failure. Studies describing neurological dysfunctions involving the central and peripheral nervous systems have emerged. In our study, we aimed to evaluate the neurological signs and symptoms in hospitalized patients with COVID-19. METHODS: The data of 290 patients admitted to our center (ward and intensive care unit) who received a diagnosis of COVID-19 were analyzed retrospectively. Patients' demographic, clinical and laboratory data, and their neurological diseases, symptoms, and complications were compared. RESULTS: Male sex, heart disease, chronic obstructive pulmonary disease and having a history of neurological disease were associated with increased mortality in patients with COVID-19. Seizures and altered consciousness were also found to be more common in patients who died. In addition, lower platelet counts (P=0.001), higher C-reactive protein levels (P

Abstract Aim: This study investigated the effect of mycophenolate mofetil (MPA) treatment instead of azathioprine (AZA) on renal function after kidney transplantation. Methods: Thirteen of all recipients were taking a cyclosporine-based regimen and serum creatinine levels were above 1.5 mg/dL. In 13 patients, MPA treatment was started instead of AZA. Renal functions were evaluated for 12 months after MPA treatment. Results: Serum creatinine levels increased from 2.11±0.48 mg/dL to 2.16±0.72 mg/dL at 12th months. This increase was not statistically significant. Serum creatinine levels decreased in 5 of 13 patients. Conclusion: In selected patients, conversion from AZA to MPA may slow down the rate of deterioration in graft functions.

Background and Aims Skin test anergy is common in patients with uremia and during maintenance hemodialysis treatment. However, up to date only one study concerning skin test in peritoneal dialysis patients has focused on the issue. Our cross-sectional controlled study was conducted to analyze the correlation of purifed protein derivative (PPD) test response with demographical features, nutritional parameters and the distribution of peripheral blood lymphocyte subsets in peritoneal dialysis and hemodialysis patients. Method Stable 30 hemodialysis (HD) patients (16 men, 14 women) and 30 continuous ambulatory peritoneal dialysis (PD) patients (17 men, 13 women) were included. Thirty healthy cases (15 men, 15 women) with a mean age of 32.4±9.4 constituted the control group. Results In the HD group, 14 patients (46.6%) were PPD positive, and ın the PD group 16 patients (53.3%) were PPD positive. In the PPD-positive HD patients 64.2% (9/14), and in the PPD-positive PD patients 62.4% (10/16) had an induration of 10 mm or greater. In the control group, 21 of 30 patients (70%) were PPD positive. Comparison of both HD and PD groups with the control group showed signifcant diferences in PPD reactivity (p Conclusion The prevalence of PPD positivity was lower in the PD and HD groups. The PPD test responses were not related to the peripheral lymphocyte counts, subsets and malnutrition parameters.

Background and Aims The aim of this study was to evaluate the short-term effects of omega-3 polyunsaturated fatty acids (n-3 PUFA) supplementation on glycemic control and renal function in type 2 diabetic patients with chronic kidney disease. Method Twenty-five diabetic patients received medication containing 2 g/day n-3 PUFA orally in addition to standard treatments. Their estimated glomerular filtration rates (eGFR) were Results After three months of supplementation, the changes in serum creatinine, uric acid, eGFR and urinary albumin excretion levels did not reach statistical significance. There was no difference between serum glucose, HbA1C and lipid profile values before and after the n-3 PUFA supplementation in patients. Only serum albumin significantly increased from 4.10±0.26 to 4.28±0.31 g/dL (p=0.016), and systolic blood pressure decreased from 121.4±14.5 to 116.6±14.9 mmHg (p=0.001). Conclusion Short-term n-3 PUFA supplementation did not affect renal function and glycemic control in patients with type 2 diabetes with chronic kidney disease.

Background/aim: Hospital-acquired acute kidney injury (HA-AKI) may commonly develop in Covid-19 patients and is expected to have higher mortality. There is little comparative data investigating the effect of HA-AKI on mortality of chronic kidney disease (CKD) patients and a control group of general population suffering from Covid-19. Materials and methods: HA-AKI development was assessed in a group of stage 3-5 CKD patients and control group without CKD among adult patients hospitalized for Covid-19. The role of AKI development on the outcome (in-hospital mortality and admission to the intensive care unit [ICU]) of patients with and without CKD was compared. Results: Among 621 hospitalized patients (age 60 [IQR: 47-73]), women: 44.1%), AKI developed in 32.5% of the patients, as stage 1 in 84.2%, stage 2 in 8.4%, and stage 3 in 7.4%. AKI developed in 48.0 % of CKD patients, whereas it developed in 17.6% of patients without CKD. CKD patients with HA-AKI had the highest mortality rate of 41.1% compared to 14.3% of patients with HA-AKI but no CKD (p < 0.001). However, patients with AKI+non-CKD had similar rates of ICU admission, mechanical ventilation, and death rate to patients with CKD without AKI. Adjusted mortality risks of the AKI+non-CKD group (HR: 9.0, 95% CI: 1.9-44.2) and AKI+CKD group (HR: 7.9, 95% CI: 1.9-33.3) were significantly higher than that of the non-AKI+non-CKD group. Conclusion: AKI frequently develops in hospitalized patients due to Covid-19 and is associated with high mortality. HA-AKI has worse outcomes whether it develops in patients with or without CKD, but the worst outcome was seen in AKI+CKD patients. Turkish Society of Nephrology for the organization We thank Turkish Society of Nephrology for the organization and funding of the study. We also would like to express our gratitude to the patients whose records were used in this study, without which this research would not be possible.

BackgroundAcute kidney injury (AKI) is common in coronavirus disease-2019 (COVID-19) and the severity of AKI is linked to adverse outcomes. In this study, we investigated the factors associated with in-hospital outcomes among hospitalized patients with COVID-19 and AKI.MethodsIn this multicenter retrospective observational study, we evaluated the characteristics and in-hospital renal and patient outcomes of 578 patients with confirmed COVID-19 and AKI. Data were collected from 34 hospitals in Turkey from March 11 to June 30, 2020. AKI definition and staging were based on the Kidney Disease Improving Global Outcomes criteria. Patients with end-stage kidney disease or with a kidney transplant were excluded. Renal outcomes were identified only in discharged patients.ResultsThe median age of the patients was 69 years, and 60.9% were males. The most frequent comorbid conditions were hypertension (70.5%), diabetes mellitus (43.8%), and chronic kidney disease (CKD) (37.6%). The proportions of AKI stages 1, 2, and 3 were 54.0%, 24.7%, and 21.3%, respectively. 291 patients (50.3%) were admitted to the intensive care unit. Renal improvement was complete in 81.7% and partial in 17.2% of the patients who were discharged. Renal outcomes were worse in patients with AKI stage 3 or baseline CKD. The overall in-hospital mortality in patients with AKI was 38.9%. In-hospital mortality rate was not different in patients with preexisting non-dialysis CKD compared to patients without CKD (34.4 versus 34.0%, p = 0.924). By multivariate Cox regression analysis, age (hazard ratio [HR] [95% confidence interval (95%CI)]: 1.01 [1.0–1.03], p = 0.035], male gender (HR [95%CI]: 1.47 [1.04–2.09], p = 0.029), diabetes mellitus (HR [95%CI]: 1.51 [1.06–2.17], p = 0.022) and cerebrovascular disease (HR [95%CI]: 1.82 [1.08–3.07], p = 0.023), serum lactate dehydrogenase (greater than two-fold increase) (HR [95%CI]: 1.55 [1.05–2.30], p = 0.027) and AKI stage 2 (HR [95%CI]: 1.98 [1.25–3.14], p = 0.003) and stage 3 (HR [95%CI]: 2.25 [1.44–3.51], p = 0.0001) were independent predictors of in-hospital mortality.ConclusionsAdvanced-stage AKI is associated with extremely high mortality among hospitalized COVID-19 patients. Age, male gender, comorbidities, which are risk factors for mortality in patients with COVID-19 in the general population, are also related to in-hospital mortality in patients with AKI. However, preexisting non-dialysis CKD did not increase in-hospital mortality rate among AKI patients. Renal problems continue in a significant portion of the patients who were discharged.

Degerli meslektaslarimiz dunyayi etkileyen pandemi surecinde, onun kiskacinda olaganustu gunler geciriyoruz. Bu surecte saglik calisanlarinin fedakarligi yadsinamaz. Degerlerin yitirildigi bir donemde meslegini hayati ile ozdeslestiren, gecesi gunduzu olmayan, fedakarligin ust seviyede oldugu, kimi zaman kuru bir tesekkurun cok goruldugu arkadaslarimiza bizlerde bir katkida bulunmak istedik.Olaganustu, farkli bir sey mi yaptik. Tabiiki hayir. Amacimiz meslege yeni baslayan arkadaslarimizin kolay okuyabilecegi, cok sikmadan ozet bulabilecekleri bilgileri paylasmakti. Bu surecte hayatini kaybeden meslektaslarimizi ve hastalarimizi rahmet ve minnetle aniyorum.

Background: we aimed to present the demographic characteristics, clinical presentation, and outcomes of our multicenter cohort of adult KTx recipients with COVID-19.Methods: we conducted a multicenter, retrospective study using data of patients hospitalized for COVID-19 collected from 34 centers in Turkey. Demographic characteristics, clinical findings, laboratory parameters (hemogram, CRP, AST, ALT, LDH, and ferritin) at admission and follow-up, and treatment strategies were reviewed. Predictors of poor clinical outcomes were analyzed. The primary outcomes were in-hospital mortality and the need for ICU admission. The secondary outcome was composite in-hospital mortality and/or ICU admission.Results: one hundred nine patients (male/female: 63/46, mean age: 48.412.4years) were included in the study. Acute kidney injury (AKI) developed in 46 (42.2%) patients, and 4 (3.7%) of the patients required renal replacement therapy (RRT). A total of 22 (20.2%) patients were admitted in the ICU, and 19 (17.4%) patients required invasive mechanical ventilation. 14 (12.8%) of the patients died. Patients who were admitted in the ICU were significantly older (age over 60 years) (38.1% vs 14.9%, p=0.016). 23 (21.1%) patients reached to composite outcome and these patients were significantly older (age over 60years) (39.1% vs. 13.9%; p=0.004), and had lower serum albumin (3.4g/dl [2.9-3.8] vs. 3.8g/dl [3.5-4.1], p=0.002), higher serum ferritin (679 mu g/L [184-2260] vs. 331 mu g/L [128-839], p=0.048), and lower lymphocyte counts (700/mu l [460-950] vs. 860 /mu l [545-1385], p=0.018). Multivariable analysis identified presence of ischemic heart disease and initial serum creatinine levels as independent risk factors for mortality, whereas age over 60 years and initial serum creatinine levels were independently associated with ICU admission. On analysis for predicting secondary outcome, age above 60 and initial lymphocyte count were found to be independent variables in multivariable analysis. Conclusion: over the age of 60, ischemic heart disease, lymphopenia, poor graft function were independent risk factors for severe COVID-19 in this patient group. Whereas presence of ischemic heart disease and poor graft function were independently associated with mortality., NA

Background Maintenance hemodialysis (MHD) patients are at increased risk for coronavirus disease 2019 (COVID-19). The aim of this study was to describe clinical, laboratory, and radiologic characteristics and determinants of mortality in a large group of MHD patients hospitalized for COVID-19. Methods This multicenter, retrospective, observational study collected data from 47 nephrology clinics in Turkey. Baseline clinical, laboratory and radiological characteristics, and COVID-19 treatments during hospitalization, need for intensive care and mechanical ventilation were recorded. The main study outcome was in-hospital mortality and the determinants were analyzed by Cox regression survival analysis. Results Of 567 MHD patients, 93 (16.3%) patients died, 134 (23.6%) patients admitted to intensive care unit (ICU) and 91 of the ones in ICU (67.9%) needed mechanical ventilation. Patients who died were older (median age, 66 [57–74] vs. 63 [52–71] years, p = 0.019), had more congestive heart failure (34.9% versus 20.7%, p = 0.004) and chronic obstructive pulmonary disease (23.6% versus 12.7%, p = 0.008) compared to the discharged patients. Most patients (89.6%) had radiological manifestations compatible with COVID-19 pulmonary involvement. Median platelet (166 × 103 per mm3 versus 192 × 103 per mm3, p = 0.011) and lymphocyte (800 per mm3 versus 1000 per mm3, p p = 0.001) on admission were lower in patients who died. Age (HR: 1.022 [95% CI, 1.003–1.041], p = 0.025), severe-critical disease clinical presentation at the time of diagnosis (HR: 6.223 [95% CI, 2.168–17.863], p p = 0.009), ferritin levels on admission (HR; 1.057 [95% CI, 1.006–1.111], p = 0.028), elevation of aspartate aminotransferase (AST) (HR; 3.909 [95% CI, 2.143–7.132], p 3 per mm3) during hospitalization (HR; 1.864 [95% CI, 1.025–3.390], p = 0.041) were risk factors for mortality. Conclusion Hospitalized MHD patients with COVID-19 had a high mortality rate. Older age, presence of heart failure, clinical severity of the disease at presentation, ferritin level on admission, decrease in platelet count and increase in AST level during hospitalization may be used to predict the mortality risk of these patients.

Background Dyspepsia is a common disorder in kidney transplant recipients, and the risk of post-transplant complications is increased in candidates with upper gastrointestinal disease. We evaluated gastrointestinal lesions of kidney transplant candidates on dialysis. Methods In this study, endoscopic and pathological findings in hemodialysis (HD) and peritoneal dialysis (PD) patients with gastrointestinal symptoms on the waiting list were compared. Results The most common non-ulcerous lesions in the endoscopic examination were gastritis (62.3%), erosive gastritis (38.7%), duodenal erosion or duodenitis (18.9%) and esophagitis (13.2%). The ulcerous lesion was present in only 3 patients. Gastroesophageal reflux disease, ulcerated lesion and non-ulcerated lesion rates were similar in both dialysis groups. Histopathological examination revealed Helicobacter pylori (HP) positivity in 28.3% of patients. HP positivity rate was significantly higher in PD patients than in HD patients (38.7% vs. 13.6%, p = 0.046). Chronic gastritis (75.5%) was the most common pathological finding. HP positivity rate was 37.5% in patients with chronic gastritis, but HP was negative in patients without chronic gastritis. In multivariate analysis, male gender, urea and albumin levels were associated with the presence of pathological chronic gastritis. The presence of gastritis, total cholesterol and ferritin levels were found significant for HP positivity. A total cholesterol > 243 mg/dL was significantly related to an increased risk of the presence of HP positivity. Conclusions Gastrointestinal lesions and HP infection are common in dialysis patients. Dialysis modality may affect the frequency of some lesions. It may be useful to have an endoscopic examination before entering the transplant waiting list for all candidates.

Encapsulating peritoneal sclerosis (EPS) is a serious complication for patients with chronic kidney disease (CKD) who were treated with long-term peritoneal dialysis (PD). The risk of EPS was increased after kidney transplantation. In our study we evaluated risk factors for EPS patients after kidney transplantation who were treated before with PD.In our study, between January 2008 and August 2015, 47 PD patients (12 had EPS) who underwent kidney transplantation were analyzed. Age, gender, time of PD treatment, human leukocyte antigen (HLA) matching, cold ischemia time, kidney function (serum urea, creatinine, etc), comorbidities, immunosuppressive therapy, clinical features, and outcomes of PD patients were retrospectively evaluated in both groups.Mean age was 42 (range, 25-60) years in EPS patients, versus 43 (range, 22-77) years without EPS (P = .798). Distribution of gender was similar in both groups (P = .154). The C-reactive protein levels (P .001), number of patients with peritonitis (P = .001), length of time on PD (P .001), and serum ferritin levels (P = .020) were higher in EPS patients. The immunosuppressive therapy was changed; tamoxifen and steroids were used after diagnosis in EPS patients. HLA matching was higher in the non-EPS group (P = .006). EPS was more often seen in patients who were treated with continuous ambulatory peritoneal dialysis (CAPD; 75%; P = .036). EPS was more often detected in cadaveric transplant recipients (83.3%; P = .024). High peritoneal transmittance rate was more identified in EPS (+) patients (P = .001). EPS was more often seen in patients who were treated with icodextrin-based regimens in PD before transplantation (91.7%; P = .037). The length of time on PD and high ferritin levels increased EPS 1.08 and 1.01, respectively (P = .036 and .049, respectively), in multivariate analysis.The length of time on PD, type of PD, PD regimens with icodextrin, episodes of peritonitis, and peritoneal transmittance in patients with CKD affect the development of EPS after transplantation.

Aim: Amyloid A amyloidosis is a rare complication of chronic inflammatory conditions. Most patients with amyloid A amyloidosis present with nephropathy and it leads to renal failure and death. We studied clinical characteristics and survival in patients with amyloid A amyloidosis. Methods: A total of 81 patients (51 males, 30 females) with renal biopsy proven amyloid A amyloidosis were analyzed retrospectively. The patients were divided into good and poor outcomes groups according to survival results. Results: Most of the patients (55.6%) had nephrotic range proteinuria at diagnosis. Most frequent underlying disorders were familial Mediterranean fever (21.2%) and rheumatoid arthritis (10.6%) in the good outcome group and malignancy (20%) in the poor outcome group. Only diastolic blood pressure in the good outcome group and phosphorus level in the poor outcome group was higher. Serum creatinine levels increased after treatment in both groups, while proteinuria in the good outcome group decreased. Increase in serum creatinine and decrease in estimated glomerular filtration rate of the poor outcome group were more significant in the good outcome group. At the time of diagnosis 18.5% and 27.2% of all patients had advanced chronic kidney disease (stage 4 and 5, respectively). Median duration of renal survival was 65 +/- 3.54 months. Among all patients, 27.1% were started dialysis treatment during the follow-up period and 7.4% of all patients underwent kidney transplantation. Higher levels of systolic blood pressure [hazard ratios 1.03, 95% confidence interval: 1-1.06, p = 0.036], serum creatinine (hazard ratios 1.25, 95% confidence interval: 1.07-1.46, p = 0.006) and urinary protein excretion (hazard ratios 1.08, 95% confidence interval: 1.01-1.16, p = 0.027) were predictors of end-stage renal disease. Median survival of patients with organ involvement was 50.3 +/- 16 months. Conclusion: Our study indicated that familial Mediterranean fever constituted a large proportion of cases and increased number of patients with idiopathic amyloid A amyloidosis. Additionally, it was observed that patient survival was not affected by different etiological causes in amyloid A amyloidosis. Resumo Objetivo: A amiloidose AA é uma complicação rara de condições inflamatórias crônicas. A maior parte dos pacientes com amiloidose AA apresenta nefropatia, que leva à insuficiência renal e à morte. Estudaram-se as características clínicas e a sobrevida em pacientes com amiloidose AA. Métodos: Analisaram-se retrospectivamente 81 pacientes (51 homens, 30 mulheres) com amiloidose AA comprovada por biópsia renal. Os pacientes foram divididos em grupos de desfecho bom e ruim de acordo com os resultados de sobrevida. Resultados: A maior parte dos pacientes (55,6%) tinha proteinúria na faixa nefrótica no momento do diagnóstico. Os distúrbios subjacentes mais frequentes foram a febre familiar do Mediterrâneo (FFM, 21,2%) e a artrite reumatoide (10,6%) no grupo de desfecho bom e a malignidade (20%) no grupo de desfecho ruim. Somente a pressão arterial diastólica no grupo de desfecho bom e o nível de fósforo no grupo de desfecho ruim foram mais elevados. Os níveis séricos de creatinina aumentaram após o tratamento em ambos os grupos, enquanto a proteinúria diminuiu no grupo de desfecho bom. O aumento na creatinina sérica e a diminuição na TFGe do grupo de desfecho ruim foram mais significativos no grupo de desfecho bom. No momento do diagnóstico, 18,5% e 27,2% de todos os pacientes tinham doença renal crônica avançada (estágios 4 e 5, respectivamente). A duração média da sobrevida renal foi de 65 ± 3,54 meses. Entre todos os pacientes, 27,1% iniciaram tratamento de diálise durante o período de seguimento e 7,4% de todos os pacientes foram submetidos a transplante renal. Níveis elevados de pressão arterial sistólica [taxas de risco (HR) 1,03, intervalo de confiança (IC) de 95%: 1 a 1,06, p = 0,036], creatinina sérica (HR 1,25, IC 95%: 1,07 a 1,46, p = 0,006) e excreção urinária de proteínas (HR 1,08, IC 95%: 1,01 a 1,16, p = 0,027) foram preditores de doença renal terminal. A mediana da sobrevida de pacientes com comprometimento de órgãos foi de 50,3 ± 16 meses. Conclusão: O presente estudo indicou que a FFM constituiu uma grande proporção de casos e crescente quantidade de pacientes com amiloidose AA idiopática. Adicionalmente, observou-se que a sobrevida do paciente não foi afetada pelas diferentes causas etiológicas na amiloidose AA.

Aim: Uric acid levels increase in chronic renal failure especially due to protein metabolism. In this study, we aimed to compare uric acid clearance who are also nephrotoxic in patients with end-stage renal disease. Methods: Sixty-one chronic peritoneal dialysis (PD) patients and fifty-one chronic hemodialysis (HD) patients included in the study. Duration of PD and HD, uric acid levels, age and gender of the patients evaluated. Uric acid levels in PD patients and HD patients compared. Results: The mean ages of PD and HD patients were 56.77 ±13.58 and 57.25 ± 16.45 years, respectively (p=0.864). The number of male patients was more in the PD group and female in the HD group (p=0.959). The duration of dialysis was 3.25 in PD, 3.75 in HD (p=0.925). The mean uric acid levels were 5.54 ± 1.13 mg/dL in PD patients, and 5.76 ±1.52 mg/dL in HD patients (p=0.389). Conclusion: Dialysis is used to remove toxins in end-stage renal disease. Uric acid levels may be elevated in patients with end-stage renal disease. There is no difference in uric acid clearance in PD and HD patients.

Objectives: Malnutrition is a common problem in chronic renal disease patients during pre-dialysis and dialysis, leading to increased cardiovascular diseases and mortality. This study aimed to evaluate the efficacy of supplemental protein supplementation on malnutrition in peritoneal dialysis patients. Methods: Eighty-four stable adult peritoneal dialysis patients included in this study. In addition to the standard diets, oral nutritional product (372 calories, 61 g protein, 30 g glutamine, and 30 g arginine/100 g powder sachet twice a day) gave to patients. Before the study and after three months from the supportive therapy; anthropometric measurements with serum urea, creatinine, total protein, albumin, cholesterol, KtV, body mass index was analyzed. Results: The mean age of peritoneal dialysis patients was 60 (46-78) years. Serum urea levels from 96 ± 44 to 109 ± 42 mg/dL (p = 0.007), total protein levels from 5.85 ± 0.68 to 6.18 ± 0.66 g/dL (7.8%, p = 0.007), albumin levels increased from 3.02 ± 0.27 to 3.32 ± 0.34 g/dL (11.7%, p = 0.003) increased significantly after an average of 0.43 g/kg protein and 178 cal/day energy support. Conclusions: Albumin is an indicator of malnutrition related mortality. Therefore, using of protein nutritional products in addition to standard treatment may be beneficial for malnourished peritoneal dialysis patients.

Spondin 2 (SPON2) plays an important role in multiple processes and is a member of the Spondin 2/F-spondin family of extracellular matrix proteins. We investigated serum SPON2 levels and its correlation with renal functions and urine protein excretion in different glomerular diseases. The cohort included 97 consecutive adults with persistant proteinuria (>300 mg/day) with the diagnosis of focal segmental glomerulosclerosis (FSGS), membranous glomerulonephritis (MN), IgA nephropathy (IgAN), membranoproliferative glomerulonephritis (MPGN), and AA amyloidosis and the control groups with 15 polycystic kidney disease (PKD) and 32 healthy people. Serum SPON2 levels in MN (64.6 ng/mL), FSGS (47.8 ng/mL), IgAN (52.6 ng/mL), MPGN (54.6 ng/mL), and AA amyloidosis (60.7 ng/mL) groups were higher than those of the control (26.4 ng/mL) and nonglomerular disease groups (PKD) (15.3 ng/mL). Only serum SPON2 levels were correlated with serum uric acid and triglyceride levels in patients with glomerular disease. This is the first study to show that serum SPON2 levels are similar in different glomerular diseases and that there is no correlation between SPON2 and proteinuria grade. WOS:000596487500004 2-s2.0-85096728103 PubMed: 33229764

OBJECTIVES Lymphocele is a well-known postoperative surgical complication after kidney transplant. In this study, our aim was to analyze incidence, risk factors, and outcomes of posttransplant lymphocele in a large cohort. MATERIALS AND METHODS This observational study included 395 consecutive patients (219 males and 176 females) who underwent kidney transplant procedures from 183 living and 212 deceased donors in our center between January 2007 and 2014. A lymphocele was diagnosed with ultrasonography. RESULTS The incidence of lymphoceles in our cohort was 31.9% (n = 126). There were no significant dif-ferences with regard to body mass indexes, age of donors, deceased donor ratios, acute rejection episodes, and history of abdominal surgery between those with and without lymphoceles. The pre-transplant serum albumin levels (3.29 ± 0.67 vs 3.48 ± 0.69 g/dL; P = .009) in the lymphocele group and diabetes mellitus ratios (15.9% vs 4.5%; P < .001) in the nonlymphocele group were lower than levels shown in the other group. The lymphocele ratio in patients who received cyclosporine was higher than that shown in patients who did not received it (37.5% vs. 27.4%; P = .032). There was no difference in lymphocele incidence between patients who were taking and those who were not taking mammalian target of rapamycin inhibitors, mycophenolate mofetil, or mycophenolate sodium. In regression analysis, presence of diabetes mellitus, transplant from deceased donors, older age of donors, and lower albumin levels were independent risk factors for posttransplant lymphocele occurrence. CONCLUSIONS Posttransplant lymphocele was a relatively common surgical complication in our cohort. We concluded that diabetes mellitus, use of kidneys from deceased donors, older donor age, and hypoalbuminemia were independent risk factors for lymphocele development.

Background/PurposeGlomerulonephritis is among the most important group of diseases causing end-stage renal disease (ESRD). The prevalence of glomerulonephritis varies depending on age, sex, geographical features, etc. In the present study, we evaluated the clinical and laboratory parameters of patients who underwent renal biopsy.MethodsIn this retrospective study, demographic and clinical characteristics, specific diagnoses of glomerular diseases, and biopsy findings of all patients in whom native renal biopsy was performed in our hospital between January 2009 and December 2014 were analyzed.ResultsA total of 384 patients were divided into two groups as primary glomerular diseases (PGD) and secondary glomerular diseases (SGD). Some 37.1% of patients with PGD and 49.2% of patients with SGD were female. The mean age was 43.8 ± 14.1 years in the PGD group and 47.3 ± 16.1 years in the SGD group (p = 0.044). Nephrotic syndrome in the PGD group and unexplained renal dysfunction in the SGD group were observed more frequently at the time of admission. In the SGD group, biopsy findings (crescents, sclerosis, vascular involvement, etc.) were dominant and more pronounced (p

Aim: Focal segmental glomerulosclerosis (FSGS) is one of the most common glomerulonephritis (GNP) worldwide. Despite treatment, it may progress to end-stage renal disease. In the present study, we compared clinical and histopathological data on FSGS with primary and secondary GNP retrospectively. Methods: We retrospectively analyzed data on clinical and laboratory findings, treatment response, and risk factors associated with mortality in patients, who had been diagnosed with FSGS and other GNP via renal biopsy between January 2009 and December 2014. The average follow-up time was 22 (8-76) months. Results: FSGS and primary GNP were more frequently seen in males than in females (55.9% vs. 65.3%, p=0.033). Nephrotic syndrome was more common in patients with FSGS (41.2%) and primary GNP (57.7%), while chronic renal disease was more frequent in patients with secondary GNP (35%). In FSGS, the complete remission rate was 54.4%. 63.2% of patients had continued to receive treatment. According to the biopsy findings, interstitial inflammation and fibrosis were observed in 100% and 98.5% of patients with FSGS, respectively (p=0.010 and p

Aim: Visfatin is a cytokine released from adipose tissue, especially in enflammation. In our study, we tried to show the relationship of visfatin levels with chronic renal failure (CRF) as an enflammatory marker. Methods: We included 50 CRF patients (28 male, 22 female) who attended Uludağ University Nephrology Clinic and 31 healthy volunteers (13 male, 18 female). Visfatin levels and biochemical parameters, such as parathyroid hormone (PTH), lipid parameters, albumin, C-reactive protein (CRP), creatinine, urea, immunoglobulins, etc. were examined. Results: In CRF patients, visfatin levels were found to be significantly increased (p

OBJEcTIVE: Amyloidosis is a chronic disease associated with proteinuria and can progress to renal failure. The diagnosis and treatment of the underlying cause is therefore important. In this study at a university hospital, the diagnosis of amyloidosis patients with renal biopsies was evaluated retrospectively. MATERIAL and METhODS: 69 (42 males, 27 females, mean age: 51.7 ± 14.8 years) patients were diagnosed with amyloidosis with renal biopsy. Indications for biopsy was nephrotic syndrome in 42 patients (60.9%), nephritic syndrome in 27 (39.1%) and renal dysfunction with proteinuria in 31 (44.9%). RESULTS: The most common causes of secondary amyloidosis were Familial Mediterranean Fever in 17 of the 62 patients, chronic inflammatory diseases in 17 patients and chronic infection in 13 patients. No cause was determined in 12 patients. Multiple myeloma was present in 5 patients with primary amyloidosis. At the time of diagnosis with amyloidosis, 19 patients were stage 1, 15 stage 2, 5 stage 3A, 12 stage 3B, 10 stage 4 and 8 stage 5. The baseline hemoglobin, serum albumin, creatinine, sodium, potassium, calcium, phosphorus, AST, ALT, PTH, SAA, CRP levels, average daily urinary protein excretion and baseline GFR values were not significantly different in primary and secondary amyloidosis patients. The treatment was medical in 62.3% of the patients, dialysis in 31.9% and renal transplantation in 5.8%.

Aim. The aim of this study was to evaluate risk factors affecting graft and patient survival after transplantation from deceased donors. Methods. We retrospectively analyzed the outcomes of 186 transplantations from deceased donors performed at our center between 2006 and 2014. The recipients were divided into two groups: Group I (141 recipients without graft loss) and Group II (45 recipients with graft loss). Kaplan-Meier, log-rank test, and Cox proportional hazard regressions were used. Results. The characteristics of both groups were similar except renal resistive index at the last follow-ups. When graft survival and mortality at the first, third, and fifth years were analyzed, tacrolimus (Tac)-based regimens were superior to cyclosporine (CsA)-based regimens (P

TEKER, FATIH/0000-0003-4693-6587 WOS: 000360363200008 The main reason for the increased risk of thromboembolism in pregnancy is hypercoagulability, which has likely evolved to protect women from the bleeding challenges of miscarriage and childbirth. Women are at a 4- to 5-fold increased risk of thromboembolism during pregnancy and the postpartum period compared with when they are not pregnant. Risk factors include a history of thrombosis, inherited and acquired thrombophilia, maternal age greater than 35, certain medical conditions, and various complications of pregnancy and childbirth. In this report, a case of a 25-year-old woman diagnosed with deep vein thrombosis in the fourth week of the postpartum period is presented. After the investigating the reasons of deep vein thrombosis, heterozygote factor V Leiden mutation and heterozygote activated protein c resistance were detected. This case is presented in order to emphasize that hereditary risk factors must be investigated, especially in young patients, although the patient already had an acquired risk factor such as pregnancy.

Aim: We analyzed the results of upper gastrointestinal endoscopy performed between November 2011 and January 2013 in the endoscopy unit at Bayburt State Hospital. Methods: Endoscopic analyses were done with a PENTAX EPK 100P equipment. The results were assessed retrospectively. Results: A total of 1008 patients (664 women, 344 men) aged between 17 and 88 (mean: 50±18) years have undergone upper gastrointestinal endoscopy. 186 (18.4%) patients were diagnosed with pangastritis, 81 - with esophagitis (8%), 68 - with antral gastritis (6.7%), 67 - with duodenal ulcer (6.6%), 57 - with gastric ulcer (5.6%), 35 - with alkaline reflux gastritis (3.6%), 21 - with duodenitis (2.1%), 5 - with gastric cancer (0.5%), 4 - with esophagial cancer (0.4%), 4 - with gastric polyp (0.4%) and 3 patients were diagnosed with esophagial ulcer (0.3%). Conclusion: Lesions were most commonly observed in the stomach. Gastritis, esophagitis, duodenal and gastric ulcer were frequently observed in our city. (The Medical Bulletin of Haseki 2013; 51: 116-9)

Resumo Objetivo A amiloidose AA e uma complicacao rara de condicoes inflamatorias cronicas. A maior parte dos pacientes com amiloidose AA apresenta nefropatia, que leva a insuficiencia renal e a morte. Estudaram‐se as caracteristicas clinicas e a sobrevida em pacientes com amiloidose AA. Metodos Analisaram‐se retrospectivamente 81 pacientes (51 homens, 30 mulheres) com amiloidose AA comprovada por biopsia renal. Os pacientes foram divididos em grupos de desfecho bom e ruim de acordo com os resultados de sobrevida. Resultados A maior parte dos pacientes (55,6%) tinha proteinuria na faixa nefrotica no momento do diagnostico. Os disturbios subjacentes mais frequentes foram a febre familiar do Mediterrâneo (FFM, 21,2%) e a artrite reumatoide (10,6%) no grupo de desfecho bom e a malignidade (20%) no grupo de desfecho ruim. Somente a pressao arterial diastolica no grupo de desfecho bom e o nivel de fosforo no grupo de desfecho ruim foram mais elevados. Os niveis sericos de creatinina aumentaram apos o tratamento em ambos os grupos, enquanto a proteinuria diminuiu no grupo de desfecho bom. O aumento na creatinina serica e a diminuicao na TFGe do grupo de desfecho ruim foram mais significativos no grupo de desfecho bom. No momento do diagnostico, 18,5% e 27,2% de todos os pacientes tinham doenca renal cronica avancada (estagios 4 e 5, respectivamente). A duracao media da sobrevida renal foi de 65 ± 3,54 meses. Entre todos os pacientes, 27,1% iniciaram tratamento de dialise durante o periodo de seguimento e 7,4% de todos os pacientes foram submetidos a transplante renal. Niveis elevados de pressao arterial sistolica [taxas de risco (HR) 1,03, intervalo de confianca (IC) de 95%: 1 a 1,06, p = 0,036], creatinina serica (HR 1,25, IC 95%: 1,07 a 1,46, p = 0,006) e excrecao urinaria de proteinas (HR 1,08, IC 95%: 1,01 a 1,16, p = 0,027) foram preditores de doenca renal terminal. A mediana da sobrevida de pacientes com comprometimento de orgaos foi de 50,3 ± 16 meses. Conclusao O presente estudo indicou que a FFM constituiu uma grande proporcao de casos e crescente quantidade de pacientes com amiloidose AA idiopatica. Adicionalmente, observou‐se que a sobrevida do paciente nao foi afetada pelas diferentes causas etiologicas na amiloidose AA.