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Introduction: Human Immunodeficiency virus is a chronic infection that attacks the immune system of the human body, particularly CD4 T lymphocytes. Combined antiretroviral therapies are highly effective in virological suppression of human immunodeficiency virus infection. It has been shown that some retroviral therapies have a higher nephrotoxicity potential. As a result of renal injury, serum creatinine increases, and the estimated glomerular filtration rate is reduced. The aim of our study was to assess changes in kidney function during a 24-month period in HIV-positive patients who were begun on combined antiretroviral therapy. Material-method: A total of 127 HIV positive patients were enrolled. The patients were divided into five groups; patients who received no therapy were designated as Group 1; those that received Dolutegravir/Abacavir/Lamivudine combination as Group 2; those that received Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide Fumarate combination as Group 3; those that received Emtricitabine/Tenofovir Disoproxil Fumarate/Dolutegravir combination as Group 4; and those that received Emtricitabine/Tenofovir Disoproxil Fumarate/Raltegravir combination as Group 5. We compared the effects of these drugs on estimated glomerular filtration rate during a 24-month follow-up period. Results: At the 24th month of therapy, a significant difference was observed between the eGFR levels of the study groups (p:0.05). Serum creatinine level was significantly higher in Groups 4 and 5 compared to the other groups (p

Introduction We aimed to investigate the relationship between Vitamin D level and quality of life in patients undergoing peritoneal dialysis as renal replacement therapy. Methods 50 peritoneal dialysis patients aged between 18 and 73 years were included in this study. KDQOL-36 questionnaire was applied to rate the quality of life of the patients. This questionnaire consisted of 36 questions divided into five subscales. The patients were divided into two groups according to serum vitamin D levels. Patients with a serum 25(OH) D level < 20 ng/mL were identified as vitamin D deficiency group and those with a serum 25(OH)D level >= 20 ng/mL were identified as normal vitamin D group. Results The patients had a mean age of 41.16 +/- 16.05 years, 56% of them were females. The mean 25(OH) D levels of patients with 25 (OH) D levels < 20 ng/mL and those with >= 20 ng/mL were 10.50 +/- 4.62 ng/mL and 25.55 +/- 4.11 ng/mL, respectively. We found that all subscales of KDQOL-36 were lower with statistically significance in the group with Vitamin D (Vit-D) deficiency. Hemoglobin level was detected as independent risk factor for Symptom and problem list subscales and SF-12 physical component summary subscale (PCS) (P = 0.029, P = 0.047). Vit-D deficiency was detected as independent risk factors for kidney disease burden subscale and PCS (P = 0.035, P = 0.019). Hypertension was detected as independent risk factor for kidney disease burden subscale (P = 0.015). Conclusion Our study is the first to investigate the relationship between serum Vit-D level and quality of life by KDQOL-36 scale in peritoneal dialysis patients. We revealed that patients with low Vit-D levels had worse quality of life in all subscales.

WOS:000648071100001 PMID: 33955313 Introduction We have aimed to investigate the relationship between use of angiotensin-converting-enzyme inhibitor (ACEI) or angiotensin-receptor-blocker (ARB) drugs and acute hypoxemic respiratory failure (AHRF) and in-hospital mortality in hypertensive Covid-19 patients. Material and method Consecutive 1345 patients diagnosed with Covid-19 between April and October 2020 who met inclusion criteria were divided into two groups based on presence and absence of AHRF and mortality. The groups were compared regarding epidemiological, clinical, radiological, laboratory findings and treatments methods. The patient groups ACEI, ARB and other antihypertensive drugs (non-ACEI/ARB) were compared regarding same parameters. Results Median age was 68 (60-76) years in the patient group including 805 (59.9.1%) females. Of the patients, 475 (35.3%), 644 (47.9%) and 226 (16.8%) were using ACEIs, ARBs and non-ACEI/ARB, respectively. AHRF and in-hospital mortality developed in 1053 (78.3%) and 290 (21.6%) patients, respectively. Age, gender, coronary artery disease, diabetes mellitus (DM), neutrophil, lymphocyte, creatinine, D-dimer, C-reactive protein (CRP), ACEI, beta blocker and aspartate transaminase (AST) found statistically significant in the univariable logistic regression performed to identify independent predictors of mortality were included multivariable logistic regression model. Age (OR: 1.066, 95%CI: 1.049-1.083; p < .001), DM (OR: 1.682, 95%CI: 1.238-2.286; p = .001), neutrophil (OR: 1.041, 95%CI: 1.007-1.077; p = .019), creatinine (OR: 1.178, 95%CI: 1.048-1.325; p = .006), CRP (OR: 1.008, 95%CI: 1.006-1.010; p < .001), ACEI (OR: 0.718, 95%CI: 0.521-0.988; p = .042), AST (OR: 1.005, 95%CI: 1.001-1.010; p = .010) were found associated with in-hospital mortality. Conclusion In our study, it was not detected clinically significant difference between three groups with regard to their relation with in-hospital mortality.

Objective: The aim of this study is to examine and evaluate the clinical findings and affecting factors related to graft and patient survival in kidney transplant patients at Dicle University Hospital. Method: 72 patients who underwent kidney transplantation at Dicle University Medical Faculty Hospital between January 2012 and September 2019 were included in the study. Demographic characteristics of patients, transplantation types, clinical and laboratory findings, pre-transplant dialysis types, renal failure etiologies, post-transplant complications, average patient and graft survival times and patient characteristics at the time of diagnosis, laboratory values, and treatment modalities were investigated. Results: In this study, the data collected from 72 patients who had kidney transplantation and 68 donors was analysed. The mean age of the patients was 32,7±13,8 years. 31 of patients were female, 41 were male. 56 of the transplants were performed living donors and 12 from cadavers. 9 patients died. The mean of patient survival was 94±3,4 months. Graft loss occured in 15 patients. The mean of graft survival was 86±4,3 months. Acute rejection occured in 10 patients. Chronic allograft nephropathy occured in 19 patients. Chronic allograft nephropathy was found more frequently in patients with acute rejection (p=0.017). In addition, graft loss was more common in patients with chronic allograft nephropathy (p=0.002). The dialysis duration was less than 12 months, and the BMI of the recipient was below 30 had a positive effect on patient survival. Conclusion: Recipient obesity and long-term dialysis programs reduce patient survival. In addition, prevention of rejection has a positive effect on patient and graft survival. Amaç: Bu çalışmanın amacı Dicle Üniversitesi Hastanesi’nde böbrek nakli yapılan hastalarda greft ve hasta sağkalımına ilişkin klinik bulguları ve etki eden faktörleri incelemek ve değerlendirmektir. Yöntemler: Çalışmaya Ocak 2012- Eylül 2019 tarihleri arasında Dicle Üniversitesi Tıp Fakültesi Hastanesi’nde böbrek nakli yapılan 72 hasta dahil edildi. Çalışmaya dahil edilen hastaların demografik özellikleri, nakil tipleri, klinik ve laboratuvar bulguları, nakil öncesi diyaliz tipleri, böbrek yetmezliği etyolojileri, nakil sonrası gelişen komplikasyonlar, ortalama hasta ve greft sağkalım süreleri ve bu süreleri etkileyen tanı anındaki hasta özellikleri, laboratuvar değerleri, tedavi modaliteleri araştırıldı. Bulgular: Çalışmamızda böbrek nakli yapılan 72 hastanın ve 68 vericinin verileri analiz edildi. Hastaların ortalama yaşı 32,7±13,8 yıldı. 31 kadın, 41 erkek hasta vardı. Nakillerin 56’sı canlıdan, 12’si kadavradan yapılmıştı. Ortalama hasta sağkalımı 94±3,4 aydı. 15 hastada greft kaybı gelişmişti. 9 hasta eksitus olmuştu. Ortalama greft sağkalımı 86±4,3 aydı. 10 hastada akut rejeksiyon gelişmişti. 19 hastada kronik allograft nefropatisi gelişmişti. Kronik allograft nefropatisi, akut rejeksiyon gelişen hastalarda (p=0,017) daha sık saptandı. Ayrıca kronik allograft nefropatisi gelişen hastalarda greft kaybı daha sık olmaktaydı (p=0,002). Alıcının diyaliz süresinin ≤12 ay ve BKİ≤30 olması hasta sağkalımını olumlu etkilemişti. Sonuç: Alıcı obezitesi ve uzun süreli diyaliz programları hasta sağkalımını azaltmaktadır. Ayrıca rejeksiyonun önlenmesinin, hasta ve greft sağkalımına olumlu etkisi olmaktadır.

WOS:000614471900004 Background and Aims: Cancer patients are admitted to intensive care units (ICU) due to primary diseases, treatment-related conditions or comorbid diseases. Acute kidney injury (AKI) and infections appear to be factors affecting mortality and morbidity in ICU follow-up. Therefore, in our study, we investigated the effect of AKI and inflammation-based parameters on mortality in cancer patients admitted to the ICU. Materials and Methods: In this study, 386 patients diagnosed with malignancy hospitalized between 2010 and 2014 in Dicle University Medical Faculty Internal Medicine ICU were included. The study was designed retrospectively. The demographic characteristics and clinical information of the patients were obtained from the files. Subsequently, patients were classified as non-survivors (group 1) and survivors (group 2). Both groups were compared in terms of the presence and stage of AKI by KDIGO definition, neutrophil / lymphocyte ratio (NLR) and platelet / lymphocyte ratio (PLR). Results: Creatinine, CRP, neutrophil counts were found to be significantly higher and albumin, hemoglobin, platelet and lymphocyte counts were found to be lower in group 1 (n=276) compared to group 2 (n=110). Length of ICU was longer in group 2 patients. There was a positive correlation between mortality and KDIGO stages and NLR. Mortality rate was increased 1.9 fold in KDIGO stage 1, 2.3 fold in stage 2, 2.4 fold in stage 3 and 1.5 fold if NLR>5. There was no statistically significant relationship between PLR and mortality. Conclusion: The presence of AKI and elevated inflammation-based parameters were associated with mortality in oncologic patients admitted to the ICU.

INTRODUCTION: Sepsis is an important cause of mortality and morbidity, and inflammatory response and oxidative stress play major roles underlying its pathophysiology. Here, we evaluated the effect of intraperitoneal etanercept administration on oxidative stress and inflammation indicators in the kidney and blood of experimental sepsis-induced rats. METHODS: Twenty-eight adult Sprague Dawley rats were classified into Control (Group 1), Sepsis (Group 2), Sepsis+Cefazolin (Group 3), and Sepsis+Cefazolin+Etanercept (Group 4) groups. Kidney tissue and serum samples were obtained for biochemical and histopathological investigations and examined for the C reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), triggering receptor expressed on myeloid cells (TREM), and malondialdehyde (MDA) levels. RESULTS: The levels of TNF-α, TREM, and MDA in serum and kidney samples were significantly higher in rats from sepsis group than in rats from control group (p < 0.05). Group 3 showed a significant reduction in serum levels of TNF-α, CRP, and TREM as compared with Group 2 (p < 0.05). Serum TNF-α, CRP, TREM, and MDA levels and kidney TNF-α and TREM levels were significantly lower in Group 4 than in Group 2 (p < 0.05). Serum TNF-α and TREM levels in Group 4 were significantly lower than those in Group 3, and histopathological scores were significantly lower in Group 3 and Group 4 than in Group 2 (p < 0.05). Histopathological scores of Group 4 were significantly lower than those of Group 3 (p < 0.05). CONCLUSIONS: Etanercept, a TNF-α inhibitor, may ameliorate sepsis-induced oxidative stress, inflammation, and histopathological damage.

WOS:000513527600001 PMID: 32029697 Background: The main cause of mortality among chronic kidney disease (CKD) patients is cardiovascular disease (CVD). Epicardial adipose tissue (EAT) is considered to be novel cardiovascular risk factor. We assessed EAT in non-dialyzed stage 5 CKD patients and explored the association of EAT with body composition as determined by multi-frequency BIA. Material/Methods: The present included 70 stage 5 CKD patients who had not undergone dialysis and 40 healthy control subjects. EAT thickness was assessed by echocardiography. Hydration status and body composition were evaluated by multi-frequency bioelectrical impedance analysis. Results: Stage 5 CKD patients had significantly higher EAT thickness than healthy subjects (6.56±1.18 vs. 4.05±1.45, p