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Irritable bowel syndrome (IBS) is a frequently seen functional bowel disease. Although not lifethreatening, it impairs quality of life and leads to economic losses. IBS symptoms are widespread in dialysis patients. Psychopathological disorders are known to increase in both IBS and dialysis patients. The purpose of this study was to investigate the prevalence of IBS, IBS-related factors, and psychopathological disorders in patients.One hundred fifty patients followed-up in hemodialysis (HD) or peritoneal dialysis (PD) programs were included in this prospective study. Patients were divided into groups with and without diagnoses of IBS based on the Rome-III diagnostic criteria. The Symptom Check List Revised (SCL90-R) test was then applied to the patients. Patients with and without IBS were compared according to the scores obtained from the questionnaire.IBS was determined in 59 (39.3%) of the dialysis patients. The prevalence of IBS was significantly higher in women (P = .030). The presence of coronary artery disease (CAD) and use of erythropoietin (EPO) were significantly higher in patients with IBS (P = .029, P = .031). Somatization, obsessive-compulsive disorder, interpersonal sensitivity, depression, anxiety, phobic anxiety, psychoticism, and additional items were also higher in patients with IBS. Subscale scores for somatization, depression, and additional parameters in dialysis patients with IBS were above the threshold values for screening.IBS is common in dialysis patients. The presence of CAD or use of EPO were frequently observed in dialysis patients with IBS, and psychopathologies in depression, somatization, and additional subparameters were also higher in these patients.

Aim: The aim of this study is to determine the prevalence of Chronic renal disease (CKD) in the patients known with gout arthritis. Method:A total of 162 patients with gout arthritis diagnosed between 2014 and 2017 were included in the study. Our work is a retrospective study. Glomerular filtration rate was calculated by Modification of Renal Disease (MDRD) method. Results: The mean age of the patients was found as 59,64 ± 14,54 (18-93). The majority of patients are male. Mean uric acid levels of the patients were found to be 9.07 mg / dL ± 1.75 (4-14.7). Among these individuals with gout arthritis, % 39,5 (64) had CKD stage 3-5, %46,9 (76) had hypertension, %18,5 (30) had diabetes mellitus, %14,2 (23) had coronary artery disease. 33.3% of the patients had CKD stage 2. Nephrolithiasis was detected in 22 of 85 ultrasound patients. The use of diuretics was detected in 36 of the patients. The consultation rate requested by the dietician was 41,4%. Conclusions: Hyperuricemia and hypertension are high in CKD. Diuretics used in the treatment of hypertension and edema may trigger gout arthritis. Similar to other studies in our study, the prevalence of CKD in gout arthritis was found high.

PubMed ID: 30251011 Purpose: Renal infarction is a clinical condition which is caused by renal artery occlusion and leads to permanent renal parenchymal damage. In the literature, there are generally case reports on this subject, and few studies that include a large group of patients. Therefore, we aimed to present the data of a large group of patients who were diagnosed with acute renal infarction in our country in this retrospective study. Methods: The data of patients who were diagnosed with acute renal infarction according to clinical and radiological findings in Turkey in the last 3 years were examined. For this purpose, we contacted with more than 40 centers in 7 regions and obtained support from clinically responsible persons. Demographic data of patients, laboratory data at the time of diagnosis, tests performed for etiologic evaluation, given medications, and patients’ clinical status during follow-up were obtained from databases and statistical analysis was performed. Results: One-hundred and twenty-one patients were included in the study. The mean age was 53 ± 1.4 (19–91) years. Seventy-one (58.7%) patients were male, 18 (14.9%) had diabetes, 53 (43.8%) had hypertension, 36 (30%) had atrial fibrillation (AF), and 6 had a history of lupus + antiphospholipid syndrome (APS). Forty-five patients had right renal infarction, 50 patients had left renal infarction, and 26 (21.5%) patients had bilateral renal infarction. The examinations for the ethiologies revealed that, 36 patients had thromboemboli due to atrial fibrillation, 10 patients had genetic anomalies leading to thrombosis, 9 patients had trauma, 6 patients had lupus + APS, 2 patients had hematologic diseases, and 1 patient had a substance abuse problem. Fifty-seven (57%) patients had unknown. The mean follow-up period was 14 ± 2 months. The mean creatinine and glomerular filtration rate (GFR) values at 3 months were found to be 1.65 ± 0.16 mg/dl and 62 ± 3 ml/min, respectively. The final mean creatinine and GFR values were found to be 1.69 ± 0.16 mg/dl and 62 ± 3 ml/min, respectively. Conclusions: Our study is the second largest series published on renal infarction in the literature. More detailed studies are needed to determine the etiological causes of acute renal infarction occurring in patients. © 2018, Springer Nature B.V.

C3glomerulopati (C3G), kompleman aktivasyonunun anormal kontrolü ile oluşan bir grupböbrek hastalığını kapsayan yakın zamanda tanımlanmış bir hastalıktır. C3Gglomerullerde immunoglobulin birikiminin trace ve yokluğu ile dominant olarak komplemanC3 birikimi ile karakterizedir. C3G C3 glomerulonefrit (C3GN) ve Dens DepositHastalığı (DDD) diye iki grup hastalıktan oluşmaktadır. DDD ve C3GN nadirgörülmektedir ve her iki hastalık hem çocuklarda hemde erişkinlerde görülmektedir.C3G spesifik tedavisinde, plazmaferez, immünsüpresif tedavi ve kompleman inhibitörleriniiçermektedir., C3glomerulopathy is a recently defined disease that encompasses a group of kidneydiseases caused by abnormal control of complement activation. C3G is characterizedbydeposition of dominant complement C3 with absence/traces of immunoglobulinsin the glomeruli. C3G may be classified intodense deposit disease (DDD) and C3 glomerulonephritis (C3GN). DDD andC3GN are rare forms of glomerulonephritis that affect both children and adults.In treatment C3G include on specific treatment, plasma therapy, immunsupressiveand complement inhibition.

WOS: 000412950500025, PubMed ID: 28573371, Primary glomerulopathies are those disorders that affect glomerular structure, function, or both in the absence of a multisystem disorder. We aimed to evaluate the frequency of MEFV gene mutation to show possible coexistence of FMF in patients diagnosed with biopsy-proven primary glomerulonephritis (GN). A total of 64 patients with biopsy-proven primary GN were included in the study. MEFV gene mutations examined retrospectively. The mean age of patients was 39.6 +/- 13.4 (range 18-69), 35 of patients were female and 29 of patients were male. Of the 64 patients, 17 were mesangial proliferative glomerulonephritis (MsPGN), 15 were IgA nephropathy (IgAN), 12 were membranous glomerulonephritis (MGN), 11 were focal segmental glomerulosclerosis (FSGS), three were membranous proliferative glomerulonephritis (MPGN), three were immune complex glomerulonephritis (ICGN), two were minimal change disease (MCD), and one was IgM nephropathy (IgMN). MEFV gene mutation was detected in 35.9% (23) of these patients. The most frequently detected mutations were E148Q and M694V. Twelve cases (18.75% of GN patients) with MEFV gene mutation were diagnosed as FMF phenotype I. The frequency of MEFV gene mutation was detected at a high rate of 35.9%. Further studies with larger populations are needed to clarify the importance of these mutations on clinical progression of glomerulonephritis.

Objective: Tumor lysissyndrome (TLS) is a clinical picture that occurs with the rapid destruction oftumor cells and with life-threatening metabolic disorders. The aim of our studyis to evaluate the etiologic causes, diagnosis and treatment of TLS cases. Method: The study wasconducted between January 2015 and December 2017 in KahramanmarasNecip Fazıl city Hospital.[HT1] Atotal of 32 patients diagnosed with TLS were included in the study. Laboratoryvalues of patients were scanned (blood urea nitrogen, creatinine, potassium,phosphorus, calcium, serum uric acid, lactate dehydrogenase) and diagnoses,chemotherapy and treatments were noted.Results: Of the 32 patientswho were included in the study, 17 were male and 15 were female. The averageage of the patients was found as 62,06 ± 12,10 (35-86) years. Hematologicmalignancy was detected in the etiology of11 of the TLS cases and solid tumor was detected in 21 of the TLS cases. Atotal of 12 (37.5%) patients had spontaneous TLS (5 in haematologicalmalignancy and 7 in solid tumor). Hyperpotassaemia 50%, hypocalcaemia 46.9%,hyperphosphatemia, hyperuricemia and acute kidney damage was present in allpatients. Mortality rate was found as 40.6%.Conclusions: Inour study, spontaneous TLS was detected at a high rate. In addition, themortality rate was also high. Early diagnosis and urgent treatment should beplanned to avoid mortalities., Amaç: Tümör lizis sendromu (TLS), tümörhücrelerinin hızlı bir şekilde yıkılmasıyla ortaya çıkan ve yaşamı tehditedebilen metabolik bozukluklarla seyreden klinik bir tablodur. Çalışmamızdaki amaç TLS olguların etyolojik nedenleri, tanı ve tedavilerini değerlendirmektir.Yöntem: Çalışma Ocak 2015 ile Aralık 2017tarihleri arasında Kahramanmaras Necip Fazıl Şehir [HT1] hastanesindeyapıldı. Çalışmaya, TLS tanısı konan toplam 32 hasta alındı. Hastalarındosyaları taranarak laboratuvar değerleri (kan üre azotu, kreatinin, potasyum,fosfor, kalsiyum, serum ürik asit, laktat dehidrogenaz), tanıları, aldıklarıkemoterapi ve tedavileri not edildi.Bulgular: Çalışmaya alınan toplam 32 hastanın17’si erkek, 15’i bayandı. Hastaların ortalama yaşları 62,06±12,10 (35-86) olaraksaptandı. TLS olgularının 11’nin etiyolojisinde hematolojik malignensi, 21’indeise solid tümör saptandı. Toplam 12 (37,5%) hastada spontan TLS (5’ihematolojik malignensi ve 7’si solid tümör) tespit edildi. Hiperpotasemi 50%oranında, hipokalsemi 46,9% oranında, hiperfosfatemi, hiperürisemi ve akutböbrek hasarı ise hastaların tümünde mevcuttu. Mortalite oranı 40,6% olaraksaptandı.Sonuç: Çalışmamızda spontan TLS yüksek orandasaptandı. Ayrıca mortalite oranıda yüksekti. Mortaliteden kaçınmak için erkentanı ve acil tedavi planlanmalıdır.

WOS: 000393291900003, OBJECTIVE: The aim of this study was to determine the incidence of peritonitis in patients with continuous ambulatory peritoneal dialysis (CAPD)-related peritonitis, microorganisms causing peritonitis and the clinical course of patients during the 15-year study period. MATERIAL and METHODS: A total of 61 patients (26 male, 35 female) with CAPD-related peritonitis treated in our hospital between 2000-2014 were enrolled into this study. RESULTS: During the study period, 103 episodes of peritonitis were observed, with a mean incidence of 0.29 episodes per patient year. Overall, 58.3% of the episodes were due to gram-positive organisms, 7.8% due to gram-negative organisms and 30.1% were culture negative. The treatment was successful in 96.1% of the episodes, and removal of the Tenckhoff catheter was required in 4 patients. It was observed when the distribution of the causative organisms over the years were examined that the number of CAPD peritonitis and the rate of culture-negative episodes decreased after the year 2008. CONCLUSION: In our center, the main causes of peritonitis were gram-positive microorganisms. During follow-up, the incidence of peritonitis and the rate of culture-negative episodes decreased but there was no change in the gram stain characteristics of organisms. Reducing the incidence of CAPD-related peritonitis could be possible by providing intensive training to patients and strict monitoring.

WOS: 000376969600002, PubMed ID: 29900931, Objectives: This study aims to evaluate the carotid intima-media thickness (CIMT) in patients diagnosed with familial Mediterranean fever (FMF) and investigate whether there is a relationship between glutathione-S-transferase (GST) gene polymorphisms and CIMT. Patients and methods: Sixty FMF patients (17 males, 43 females; mean age: 31.43 +/- 11.36 years; range 18 to 45 years) and 60 healthy controls (22 males, 38 females; mean age: 29.8 +/- 5.82 years; range 18 to 40 years) were enrolled in this study. Polymerase chain reaction-restriction fragment length polymorphism methods were carried out to assess GST polymorphisms. CIMT was measured by carotid ultrasonography. Biochemical parameters were also evaluated using biochemical methods. Results: Right and left CIMT of FMF patients were statistically significantly higher than that of control group (CIMT right p=0.001 and CIMT left: p=0.033). There was no significant association in terms of GST polymorphisms between FMF and control groups. No significant association was observed between GST polymorphisms and CIMT. Low density lipoprotein, erythrocyte sedimentation rate, and fibrinogen levels were significantly higher in the patient group (p0.05). Conclusion: Although no significant association was observed between GST polymorphisms and CIMT in FMF patients and controls, CIMT was statistically significantly higher in FMF patients compared to controls., Scientific Research Project Fund of Cumhuriyet University [T-515], This work is supported by the Scientific Research Project Fund of Cumhuriyet University under the project number "T-515".

Renal tubular acidosis (RTA) is metabolic acidosis disorder with a normal anion gap that occurs resulting from bicarbonate reabsorption or disorder in the hydrogen excretion from the kidney. A variety of tests are required to be administered in a stepwise fashion for the diagnosis and characterization of RTA. Correct diagnosis involves careful evaluation, including exclusion of other entities causing acidosis. The patients were treated with potassium and bicarbonate supplementation. A fifty-one years old female patient presented to the emergency department with quadriparesis dependent on hypokalemia and vitamin D deficiency, was diagnosed with distal renal tubular acidosis (dRTA) combined with Sjogren's Syndrome (SS). We submitted this case in order to draw attention to the presentation of the RTA with SS.

WOS: 000433009400011, PubMed ID: 29544394, Purpose: We investigated the influence of the vitamin D receptor gene Taql (rs731236), Apal (rs7975232), and Fokl (rs2228570) polymorphisms in arteriovenous fistula failure in hemodialysis patients. Methods: This study was carried out with 54 patients who experienced two or more fistula failures in the late period after arteriovenous fistula operation and 58 control patients with no history of arteriovenous fistula failure in 3years or longer. The polymerase chain reaction-restriction fragment length polymorphism method was used to determine the vitamin D receptor Taql, Fokl, and Apal polymorphisms. Results: For vitamin D receptor gene Taql and Fokl polymorphisms, no significant association was found between the two groups (p>0.05). However, a statistically significant association was determined for Apal polymorphism between the two groups (p = 0.02). In patients, Apal AA, AC, and CC genotype frequencies were found as 21 (38.9%), 32 (59.3%), and I (1.8%), respectively. However, genotype frequencies of AA, AC, and CC in the control group were 29 (50%), 22 (37.9%), and 7 (12.1%), respectively. In all three polymorphisms, no significant difference was found between the two groups in terms of allele frequencies (p>0.05). Conclusion: Vitamin D receptor Apal AC genotype may be a possible cardiovascular risk factor for the development of arteriovenous fistula failure.

WOS: 000426502700016, Aim: The purpose is to evaluate the relationship between Restless legs syndrome (RLS) and 25-Hydroxy D [25 (OH) D] vitamin level among hemodialysis patients. Material and Method: Hemodialysis patients, in Cumhuriyet University Faculty of Medicine Department of Nephrology were included in this study. Patients were asked about the diagnosis criteria of the International RLS study group and their laboratory examinations along with 25 (OH) D vitamin levels were assessed. Results: Seventy-five patients, 40 of whom were female, were included in the study. The average age of patients was 57.8 (19-84). Average 25 (OH) vitamin D levels of 75 patients in total were found to be 12.6 +/- 6.27 (3-30). Five patients had 25 (OH) D vitamin insufficiency and 70 had 25 (OH) D vitamin deficiency. Thirty-three patients were diagnosed with RLS and their average vitamin D levels were 10.76 +/- 4.56; the D levels of 42 patients not diagnosed with RLS were found to be 14.18 +/- 7.02. A significant relationship was determined between the patients diagnosed with RLS and their vitamin D levels (p=0.018). Discussion: A significant relationship was determined between RLS and 25 (OH) vitamin D level among hemodialysis patients. The fact that frequency of RLS was higher among hemodialysis patients compared to the general population may be related to low levels of 25 (OH) D vitamin.

WOS: 000425163400008, OBJECTIVE: Occult hepatitis B (OHB) virus infection is defined as the presence of hepatitis B virus (HBV) DNA in the liver tissue or serum of subjects seronegative for hepatitis B surface antigen. OHB leads to the potential risk of transmission in dialysis service. Routine HBV vaccine in dialysis patients is recommended. However, HBV vaccine response rates are lower than the community. The aim of this study was to determine the prevalence of OHB in hepatitis B vaccinated dialysis patients. MATERIAL and METHODS: This study was performed at the Nephrology Department, Faculty of Medicine, Cumhuriyet University, between 1st January -31st December 2014. Sera from 200 dialysis patients with negative HbsAg were investigated for HBV DNA using the polymerase chain reaction (PCR). RESULTS: The mean age of the patients was 59.57 +/- 14.89 (18-91) years; 179 of them were on hemodialysis and 21 were on peritoneal dialysis. Of the patients included in the study, anti-HBs positivity was present in 135 (67.5%) and anti-HBs negativity in 65 (32.5%). The OHB prevalence was 1.5% (n=3). CONCLUSION: In our study, the OHB prevalence was 1.5%. We assume that HBV infection would be reduced further by routinely applying HBV PCR tests for all patients who start dialysis and by taking precautions against transmission., Cumhuriyet University, The study was carried out with Cumhuriyet University Scientific Research Projects support.

Kalıtımsal hipoürisemiye genellikle ksantinüri ve herediter renal hipoürisemi yol açmaktadır. Hipoürisemi serum ürik asit seviyesinin 2mg/dl’den düşük olması olarak tanımlanmaktadır. Ksantinüri her yaşta, nadir görülen ve otozomal resesif geçen bir hatalıktır. Ksantin ve hipoksantin, enzim veya kofaktör eksikliği sonucu ürik asite dönüşümü olmaz ve kanda birikir, ayrıca idrar ile atılımı artar. Serum ve idrarda ürik asit seviyesi çok düşük saptanmaktadır. Biz bu makalede,hipoürisemi saptanan ve ksantinüri tanısı konulan yetmiş yediyaşında kadınhasta litaratüreşliğinde tartışıldı., Xanthinuria and hereditary renal hypouricemia usually leads to hereditary hypouricemia. Hypouricemia is defined as having serum uric acid level lower than 2 ml/dl. Xanthinuria is an autosomal recessive disease that can be occasionally seen in all ages. As a result of enzyme or cofactor deficiency, xanthine and hypoxanthine do not convert to uric acid and accumulate in the blood and increase the excretion in urine. The level of uric acid is detected very low either in serum or in urine. In this study, a case of a seventy-seven-year-old female patient in which hypouricemia was detected and who had the diagnosis of xanthinuria was discussed.

Pulmonary renal syndrome is a rare but serious complication of systemic vasculitis. The majority the cases are antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis. In this case, a 58 years old female case having aworsening clinical picture of probable urinary infection and acute renal failure was presented. By means of proteinuria, pyuria, hematuria and unexplained acute renal failure, we review the relevant literature on pulmonary renal syndrome associated with granulomatosis with polyangiitis (GPA) with negative serum ANCA serology. This report demonstrates the difficulty of diagnosing granulomatosis with polyangiitis (GPA) until renal biopsy was done while initial diagnostic serological negative ANCA testing.

Cytomegalovirus (CMV) is a DNA virus belonging to herpesviridea family. CMV infections are seen at all age groups all through the world. Its seroprevalence is 50% in developed countries and 40- 100% in developing countries. In seropostive cases, the disease develops as result of reactivation following a treatment with immunosuppressive.Hemolytic uremic syndrome (HUS) is defined by the triad of mechanical hemolytic anemia,thrombocytopenia and renal impairment. Atypical HUS (aHUS) defines non Shigatoxin- HUSand a primary disease due to a disorder in complement alternative pathway regulation.In the present paper, a 60 years old case undergoing plasma exchange for aHUS and found to have CMV pneumonia during follow-up is presented.

WOS: 000388039500001, Influenza viruses are members of the Orthomyxoviridae family, of which influenza A, B, and C viruses constitute three separate genera. Arterial thrombosis associated with H1N1 influenza A virus infection has rarely been reported. A Turkish man aged 28 years was admitted to our emergency department with dyspnea, bilateral lower extremity insensitivity, and cold. He reported symptoms of fever, myalgia, and cough, which he had had for fifteen days before being admitted to our hospital. The patient was tested for pandemic influenza A (H1N1) virus using polymerase chain reaction (PCR) tests, which were positive. Abdominal computerized tomography with contrast revealed a large occlusive thrombus within the infrarenal aorta.

WOS: 000378888900021, PubMed ID: 27118566, We aimed to investigate the associations of fractalkine receptor (CX3CR1) V249I, T280M and CCR5-59029 A/G gene polymorphisms in chronic renal failure (CRF) subjects undergoing hemodialysis and to evaluate possible associations of these polymorphisms with hypertension (HT), diabetes mellitus (DM) and atherosclerosis (AS). A total of 225 CRF subjects undergoing hemodialysis and 201 healthy controls were enrolled in the study. CRF subjects were divided into three major subgroups according to comorbidities including HT (n = 127), DM (n = 65) and AS (n = 33). Genotyping was done using polymerase chain reaction-restriction fragment length polymorphism method. The II genotype and I allele frequencies of CX3CR1 V249I polymorphism were found significantly more frequent in CRF subjects, CRF subjects with DM and CRF subjects with AS compared with controls (p < 0.05 for all comparisons). G allele frequency of CCR5 polymorphism was found significantly more prevalent in CRF subjects with DM than that of controls. Further, GG genotype and G allele frequencies of CCR5 polymorphism were significantly more prevalent in CRF subjects with AS compared with controls (p < 0.05). We also explored these polymorphisms among CRF subjects with and without following comorbidities: HT, DM, AS. We found significant association between CRF subjects with HT and without HT in terms of genotype and allele frequencies of V249I polymorphism (p < 0.05). CX3CR1 T280M polymorphism was not found significantly different in none of the comparisons. These data demonstrate possible associations between CX3CR1 V249I and CCR5-59029 A/G polymorphisms and/or HT, DM and AS in CRF subjects.

AMAÇ: Akut dekompanse kalp yetersizliği (ADKY) tedavisinde ultrafiltrasyon ve diüretikleri karşılaştıran çalışmalarda çelişkili sonuçlar elde edilmiştir. Çalışmamızda ADKY nedeniyle yatırılan, sol ventrikül sistolik disfonksiyonu üzerine sağ ventrikül fonksiyon bozukluğunun süperpoze olduğu (biventriküler kalp yetmezliği) hasta grubunda intravenöz diüretik tedavisi ile ultrafiltrasyonu, etkinlik ve güvenilirlik açısından karşılaştırdık.GEREÇ ve YÖNTEMLER: Çalışmamıza ultrafiltrasyon grubuna 10, diüretik grubuna 20 olmak üzere toplam 30 hasta alındı ve hastalar 3 ay takip edildi. BULGULAR: Taburcu olurken; ultrafiltrasyon ve diüretik grupları arasında kilo kaybı, toplam sıvı kaybı ve serum kreatinin düzeyindeki değişiklik açısından istatistiksel olarak anlamlı bir fark bulunmadı. Klinik olarak sağlanan dekonjesyon oranı, her iki grupta benzerdi. Ekokardiyografik parametrelerdeki, diğer biyokimyasal parametrelerdeki değişim, nörohormonal aktivasyonu değerlendirmek için bakılan serum renin ve aldosteron düzeylerindeki değişim de gruplar arasında farklı bulunmadı. İstenmeyen olaylar değerlendirildiğinde; hemodiyalize geçme ultrafiltrasyon grubunda %20, diüretik grubunda %5 oranında, kardiyak arrest ve ölüm ise ultrafiltrasyon grubunda %40, diüretik grubunda %10 oranında görüldü. Hastaların 1 ay ve 3 ay sonraki kilo değişimi, kreatinin ve elektrolit düzeyleri de benzer bulundu.sONUÇ: Sağ ve sol kalp yetersizliğinin birlikte olduğu hastalara uygulanan ultrafiltrasyon ve diüretik tedavilerinin, kilo kaybı, toplam sıvı kaybı, klinik olarak dekonjesyonun sağlanması, böbrek ve kardiyak fonksiyonlarında değişim, renin ve aldosteron düzeylerindeki değişim yönünden birbirine üstünlüğü gösterilemedi. Hemodiyalize geçme, kardiyak arrest ve ölümün ultrafiltrasyon grubunda daha fazla saptanmasına rağmen, istatistiksel değerlendirme yapılamadığından, ultrafiltrasyonun güvenilirliği değerlendirilememiştir. Ultrafiltrasyonun tedavide rutin uygulamaya girmesi için daha kapsamlı çalışmalara ihtiyaç vardır, OBJECTIVE: Studies comparing ultrafiltration and diuretics in management of ADHF have shown controversial results. In this study, we compared the efficacy and safety of intravenous diuretic therapy and ultrafiltration in patients admitted with acute decompensated heart failure (ADHF) who had right ventricular dysfunction superimposed on left ventricular systolic dysfunction. MATERIAL and METHODs: A total of 30 patients of whom 10 were in the ultrafiltration group and 20 were in the diuretic group were enrolled in this study and followed for 3 months. REsULTs: At discharge, there were no significant differences between the ultrafiltration and diuretic groups in terms of weight loss , total fluid loss, and changes in serum creatinine. The clinical decongestion rates were similar in the two groups. Moreover, echocardiographic and biochemical parameters and alterations in renin and aldosterone levels, as measured to assess neurohormonal activation, had overlapping results between the two groups. When unwanted events were analyzed, transition to hemodialysis was seen in 20% of the patients in the ultrafiltration group and 5% of the patients in the diuretic group. The frequency of cardiac arrest and death were 40% in the ultrafiltration group and 10% in the diuretic group. Weight change, creatinine, and electrolyte levels of the patients at 1 and 3 months were also similar.CONCLUsION: Despite the high frequency of hemodialysis transition, cardiac arrest, and death in the ultrafiltration group, safety of ultrafiltration could not be assessed because of inability to perform statistical analyses. Further studies are needed to investigate the practical uses of ultrafiltration in routine clinical practice

WOS: 000410618200027, Aim: To evaluate demographic,clinical and laboratory characteristics. causes, MEFV gene mutations, and mortality rates of patients with secondary amyloidosis. Material and Method: 61 patients who had been diagnosed with secondary amyloidosis by renal and rectal biopsy between 2007 and 2013 in the nephrology clinic of Cumhuriyet University. Faculty of Medicine, were included in the study. Demographic characteristics, causes of secondary amyloidosis, MEFV gene mutations, end-stage renal failure (ESRF), renal transplantation, and mortality rates were examined retrospectively. Results: In etiological terms, Familial Mediterranean Fever (FMF) occurrence was 62.2% (38), bronchiectasis and emphysema 9.8% (6), tuberculosis 4.9% (3), coexistence of FMF and ankylosing spondylitis 3.2% (2), coexistence of FMF and rheumatoid arthritis 1.60,6 (1), coexistence of FMF and systemic lupus erythematosus (SLE) 1.6% (1), osteomyelitis 1.6% (1). septic arthritis 1.6% (1), Crohn's disease 1.6% (1), colon cancer 1.6% (1), coexistence of bronchiect-axis and tuberculosis 1.6% (1), rheumatoid arthritis 1.6% (1), and idiopathic cases 6.5% (4). Proteinuria was determined at nephrotic level among 68% (32) of 47 patients who had secondary amyloidosis. MEFV gene mutation of 45 patients with secondary amyloidosis was assessed. Most patients had M694V gene mutation. Surprisingly, we detected heterozygous 61480 mutation in 3 cases. 12 cases died; of these, 9 had ESRF. Five cases with ESRF underwent renal transplantation. Discussion: We found FMF as the most common cause for secondary AA amyloidosis in this study. Further studies should be done with larger or multicenter cohorts.

WOS: 000379533500009, PubMed ID: 27105876, Fabry disease (FD) is a progressive, X-linked inherited disorder of glycosphingolipid metabolism due to deficient or absent lysosomal alpha-galactosidase A (AGALA) activity. FD and familial Mediterranean fever (FMF) have typical clinical similarities, and both diseases may progress to end-stage renal diseases. In this study, we aimed to determine the prevalence of FD in patients with FMF from Central Anatolia of Turkey. The study group consisted of 177 FMF patients, followed up by the Adult and Pediatric Nephrology Clinic of Cumhuriyet University Hospital. Screening for AGALA activity was performed by the dry blood spot method. Mutation analysis for GLA gene was carried out for patients having an AGALA enzyme activity value lower than the normal reference value. Low AGALA activity was detected in 23 (13 %) patients. Heterozygous GLA gene mutation c.[937G > T] p.[D313Y] was detected in one female patient (0.56 %). The patient was a 53-year-old female with proteinuria and who had undergone left nephrectomy; her glomerular filtration rate (GFR) by scintigraphy was found to be 70 ml/min. She had M694V mutation and no clinical manifestation of FD. In our study, the prevalence rate of FD was found as 0.56 % in FMF patients. The similarities between the symptoms of FMF and FD might lead to a diagnostic dilemma in physicians at countries where FMF is observed frequently. Although the prevalence of FD is rare, physicians should keep in mind that FD has an ambiguous symptomology pattern of FMF.

Introduction: Hemolytic uremic syndrome HUS is a clinical syndrome characterized by non-immune microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. In this study, we aimed to evaluate patients diagnosed with HUS in our clinic. Method: Patients who were diagnosed with HUS as clinic and laboratory between August 2012 and October 2017 were included in our nephrology clinic. Biochemistry, haemogram, ANA, anti-Ds DNA, p-ANCA, c-ANCA, anti-GBM antibody, C3, C4 of patients were studied. In some cases, ADAMTS13 was studied and renal biopsy was performed. The demographic features, clinics, and treatments of our cases were reviewed. Results: A total of 18 patients were enrolled in the study, the average age of the patients was 48.3 21-82 and 10 of the cases were female and 8 of the cases were male. Among the etiologic causes of HUS in patients; the complement factor B mutation, complement factor H polymorphism, breast cancer, herbal medicine, infections and idiopathic were detected. Primer glomerulonephritis was detected in 6 cases of renal biopsy. Conclusion: Clinical and laboratory remission was obtained in 13 patients. End-stage renal failure developed in 3 of our patients.

Background: Renal involvement in malignant patients may lead to kidney disease indirectly for a number of reasons, including direct metastasis or dehydration, hyperuricemia, and tumor lysis syndrome. We aimed to evaluate malignant patients who developed kidney disease in our study. Method: This study was performed in malignant patients who applied to the Kahramanmaras Necip Fazil City hospital between 2015-2017. Blood urea nitrogen, serum creatinine, uric acid, sodium, potassium, calcium, phosphorus, glucose, complete urine output and hemogram were noted in patients with kidney disease. Results: A total of 688 cancer patients were included in the study. 53.6% of the patients were female and 46.2% were male. The average age of the patients was found as 60.23±13.25 21-94 . Acute kidney injury was detected in %17,1. When the patients diagnosed with kidney disease were evaluated; serum uric acid levels were higher in 46.2% of patients, calcium-level was low in 7.7% of patients and high in 3.6% of patients, serum potassium level was high in 21.1% of patients, phosphorus level was high in 42.9% and serum sodium level was low in 17.2% of patients. According to Kidney Disease Improve Global Outcomes, the acute renal injury was detected in 42.4% of stage-I, 25.4% of stage II, and 32.2% of stage-III. 33 of 118 patients with acute renal injury died. Conclusion: In our study, the incidence of acute renal injury was 17.1% in the cancer patients. The mortality rate was higher in the patients with the acute renal injury.

Recent research has suggested that serum tumor markers can give valuable prognostic information in gastric cancer. In this study, we examined the relationship between preoperative serum carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, CA 72-4, and alfa fetoprotein (AFP) levels on clinicopathologic significance in gastric cancer patients. Preoperative plasma levels of CEA, CA 19-9, CA 72-4, and AFP were retrospectively examined in 95 patients who underwent surgical resection for gastric cancer, and the prognostic value of the tumour markers were estimated. The percentage of CA 19-9, CA 72-4, CEA, and AFP-positive cases were 41%, 32.6%, 24.2%, and 8.4%, respectively. CEA was more frequently positive in the patients with liver metastases (P=0.02). CA 19-9 was more frequently positive in patients with lymph node (P=0.005), peritoneal (P=0.01), and serosal (P=0.03) involvement. CA 72-4 was more frequently positive in patients with lymph node (P=0.01), peritoneal (P=0.03), and liver (P=0.01) involvement. Low 3-year cumulative survival was associated significantly with elevated serum levels of CEA (P=0.001), CA 19-9 (P=0.001), CA 72-4 (P=0.001), and AFP (P=0.01). In multivariate analysis, age, tumor stage, and CA 72-4 were the only independent prognostic factors. Being positive for CA 72-4 was associated with a 3.8-fold higher risk of death (95% confidence intervals: 1.3, 10.9). Our results suggest that high preoperative serum levels of CA 72-4 in gastric cancer patients are associated with a higher risk of death due to gastric cancer.

WOS: 000437362500014, PubMed ID: 30185366, Antiphospholipid syndrome (APS) is a disorder characterized by antiphospholipid antibody positivity, arterial or venous thrombosis, and fetal loss. In APS, renal as well as vascular and glomerular involvement is observed. Systemic lupus erythematosus and other connective tissue diseases should be excluded to diagnose primary APS. Immunoglobulin M (IgM) nephropathy is characterized by single or dominant IgM deposition in glomerular mesangium. It often presents with hematuria and proteinuria. In a 45-year-old female patient admitted to our clinic with diabetes mellitus and proteinuria, fundus examination did not reveal diabetic retinopathy but a high anticardiolipin IgM and venous thrombosis in the upper extremity were observed. Renal biopsy revealed IgM nephropathy. The patient was diagnosed with primary APS and IgM nephropathy. Cyclophosphamide and steroid treatment was started. Her proteinuria decreased as a result of the treatment. Although, it is reported in the literature that primary APS coexists with other glomerulonephritis, we did not detect coexistence of primary APS and IgM nephropathy.

Background: The purpose of this study was to investigate the relationship between the genetic mutations, which are frequently detected and known to cause familial Mediterranean fever (FMF) disease, with ABO blood groups.Methods: There were 271 patients with FMF diagnosis and 271 healthy control subject enrolled in the study. The medical files of each case were screened retrospectively and demographic characteristics, genetic mutations, and ABO blood groups were recorded.Results: No statistically significant difference was detected between the two groups with respect to their gender and age (p>0/05). When patient and healthy control groups were compared based on ABO blood groups, the study groups were observed to differ significantly with respect to B blood group (p=0.008). In the patient group, a considerable relationship could not have been found when the gene mutations were compared based on blood groups, either for E148Q (n=64) and M694V (n=142) genes (p>0.05). However, a considerable difference was observed for V726A (n=58) gene; B blood group was more frequently observed among those who were detected to have V726A mutation (p=0.022).Conclusions: In present study cohort, blood type B was more frequent among FMF patients. We observed that there could be a significant association between V726A mutation and ABO blood groups.

Amaç. Huzursuz bacak sendromu (HBS) bacaklarda huzursuzluk hissi, yanma ile kendini gösteren istirahat ve geceleri daha sık olan bacakları hareket ettirme isteği ile karakterize bir rahatsızlıktır. Bu durum hemodiyaliz hastalarında sıktır ve uykusuzluğa neden olabilir. Biz çalışmamızda uyku kalitesinde bozukluk ile HBS arasındaki ilişkiyi incelemeyi amaçladık. Yöntem. Çalışmaya hemodiyaliz programında olan hastalar alındı. Hastalara Uluslar arası huzursuz bacak çalışma grubu tanı kriterleri kullanıldı ve uyku kalitesi bozukluğu için Pittsburg uyku kalitesi indeksi kullanıldı. Hastaların tümünde hemogram, PTH, kalsiyum, fosfor, kreatinin, demir, serum demir bağlama kapasitesi ve ferritin değerleri değerlendirildi. Bulgular. Çalışmaya 112 hemodiyaliz hastası alındı. Hastaların yaş ortalaması 56,8 ± 16,2 idi. Hastaların %61,6’sında uyku kalitesinde bozukluk ve %66,1’inde HBS tespit edildi. Uyku kalite bozukluğu ile HBS arasında anlamlı bir ilişki (p, Aim. Restless legs syndrome (RLS) an ilness characterized by discomfort in the legs, rest manifested by burning and a desire to move the legs more often at night. This situation is common in hemodialysis patients and can cause insomnia. In our study, we aimed to investigate the relationship between the RLS and quality of sleep disorders. Methods. The study enrolled patients who were receiving hemodialysis. The international restless legs study group criteria were used for patients and the Pittsburg sleep quality index was used for sleep disturbance. In all patients, complete blood count, PTH, calcium, phosphorus, creatinine, iron, serum iron binding capacity and ferritin levels were evaluated. Results. The study enrolled 112 hemodialysis patients. The mean age of patients was 56.8 ± 16.2. In patients 61.6% the disorder in sleep quality was detected and in 66.1% the RLS was detected. A significant relationship between quality of sleep disorders and RLS (p

WOS: 000324403100019, PubMed ID: 24021031, Gitelman's syndrome (GS) is a rare disease with autosomal recessive trait, characterized by hypokalemia, hypomagnesemia, metabolic alkalosis, hypocalciuria and hyperkinemic hyperaldosteronism. While muscle weakness, tetany, stomachache, nausea and fever are very common, it could sometimes be completely asymptomatic as is the case in our patient. It is generally benign, but some severe complications like growth retardation and, though rare, paralysis and cardiac arrest could also be seen. A 57-year-old male patient sent to our hospital for further examination because of hypokalemia was diagnosed with GS as a result of clinical and laboratory assessments. Potassium and magnesium replacement was started. We are presenting our case seeing that GS is not a syndrome to be overlooked as it bears a risk of severe complications, although it might be asymptomatic until advanced ages.

Hindawi Limited, Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease and is responsible for 8-10% of patients with end-stage renal failure. The major extrarenal complications of ADPKD are cardiovascular abnormalities. Interrupted aortic arch (IAA) is a lethal congenital cardiac abnormality seen with a frequency of 3/1000000 births and is defined as a segment of the arcus aorta being atresic. In the literature, there are no any reports showing that polycystic kidney disease and interrupted aortic arch occur together. In this study, we present a rare case in which the patient has polycystic kidney disease and IAA together and discuss whether IAA is a complication of ADPKD. © 2013 Ayşe Şeker Koçkara et al., Şeker Koçkara, A.; Department of Nephrology, Cumhuriyet University Medical School, 58140 Sivas, Turkey; email: doctrayse@gmail.com

BioMed Central Ltd., Background: Hemolytic uremic syndrome is characterized by acute renal failure, thrombocytopenia, and Coombs-negative hemolytic anemia. In C3 mesangial proliferative glomerulonephritis, an increase in mesangial cell proliferation without thickening in the glomerular capillary wall can be seen under light microscopy, but the definitive diagnosis is made with the immunohistologic demonstration of isolated C3 deposits in the mesangium. C3 glomerulonephritis may be detected in childhood; however, in this case report we describe the first case of isolated C3 glomerulonephritis together with atypical hemolytic uremic syndrome in an adult patient. Case presentation: Here we present a case of a 27-year-old white man with anuria who was hospitalized after being diagnosed as having hemolytic uremic syndrome accompanied by acute renal failure. Renal biopsy results revealed C3 glomerulonephritis. There was a complete recovery of renal function after hemodialysis, and prednisolone and plasma exchange treatment. Conclusions: C3 glomerulopathy is distinct from atypical hemolytic uremic syndrome although both diseases are due to abnormal control of the alternative complement pathway. In atypical hemolytic uremic syndrome activation of complement occurs on glomerular or microvascular endothelium causing a thrombotic microangiopathy; in most cases, no electron-dense deposits are seen on electron microscopy and glomerular C3 is not detected on immunofluorescence. © 2016 The Author(s)., Huzmeli, C.; Department of Nephrology, Cumhuriyet University, Faculty of MedicineTurkey; email: chuzmeli@hotmail.com