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Background: In our study, diagnostic and demographic characteristics of patients diagnosed with minimal change disease (MCD) by biopsy, clinical and laboratory findings in our country were investigated.Methods: Data were obtained from the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) Working Group database. Demographic characteristics, indications for biopsy, diagnosis of the glomerular diseases, comorbidities, laboratory and biopsy findings of all patients were recorded. The data presented is cross-sectional and includes application data for the biopsy period.Results: Of 3875 patients, 233 patients with MCD (median age 35.0 years) were included in the study, which constitutes 6.0% of the total glomerulonephritis database. Renal biopsy was performed in 196 (84.1%) patients due to nephrotic syndrome. Median serum creatinine was 0.7(0.6-1.0)mg/dl, mean eGFR was 104±33ml/min/1.73m2 and median proteinuria 6000 mg/day. The number of patients under the age of 40 years was 139 (59.7%) (Group A), and the number of patients aged 40 years and over was 94 (40.3%) (Group B). Compared to Group A, global sclerotic glomeruli (24 vs. 43,pConclusion: Our data are generally compatible with the literature. Chronic histopathological changes were more common in patients aged 40 years and older than younger patients. Studies investigating the effects of these different features on renal survival are needed.

© 2022, The Author(s), under exclusive licence to Springer Nature B.V.Cardiovascular disease (CVD) incidence is high in patients with chronic kidney disease (CKD) and is the most frequent cause of mortality in this population. Advanced age, hypertension, uremic toxins, endothelial dysfunction, atherosclerosis, hyperhomocysteinemia, oxidative stress, and inflammation are among the leading causes of increased CVD in advanced stages of CKD. Although defined as a decrease in muscle strength associated with aging, sarcopenia is also prevalent in CKD patients. Sarcopenia causes physical disability, low quality of life, and mortality. Regular exercise and nutritional supplementation may slow the progression of sarcopenia. Recent studies have shown that sarcopenia increases the risk of CVD and mortality in people with or without kidney disease. This review discusses the relationship between sarcopenia and CVD in light of the current literature.

© 2022 International Society for Apheresis and Japanese Society for Apheresis.Introduction: Polycystic kidney disease (PKD) is responsible for 5%–10% of end-stage renal disease. We examined the relationship between renal and extrarenal findings, disease severity, and the level of consciousness of PKD patients. Methods: Patients were asked to answer the questionnaire about PKD. Disease severity was determined according to estimated glomerular filtration rate, and disease awareness was assessed by adapting the Disease Perception Scale to PKD. Awareness of patients was evaluated comparatively with chronic kidney disease stage, age, region, and symptoms. Results: One out of five patients does not know that this disease is inherited. Mean awareness scores of the patients decreased significantly with increasing age. Awareness scores were significantly higher in patients with flank pain, hematuria, and urinary tract stones. Conclusion: Although PKD is the most common hereditary kidney disease, the rate of patients' knowledge on this subject is low. Increased awareness might lead to better treatment in those patients.

Background: Polyomavirus BK virus infection is a significant complication of renal transplantation and is an important cause of allograft loss. Today, despite the innovations in the pharmaceutical industry, a curative treatment against the BK virus has not been developed. The management is not standardized and is generally based on reported experience from transplantation centers. However, the literature on the subject with large samples is limited. Therefore, we designed a study to present our countrywide experience with BK virus nephropathy (BKVN) in renal transplant recipients. Methods: Our study was conducted with thirty kidney transplant centers from all provinces of Turkey. Only cases with BKVN proven by allograft biopsy were included in our study. Demographic characteristics and laboratory values of the patients were obtained from the archives and electronic databases of the centers. Results: A total of 13.857 patients from 30 transplantation centers were screened. 207 BKVN cases proven by allograft biopsy were identified and included in the study. The mean age was 46.4±13.1, and 146 (70.5%) patients were male. Twenty-six patients did not receive any induction therapy, 144 patients received anti-T lymphocyte globulin (ATLG), and 37 patients received basiliximab after transplantation. 23.6% of the patients had acute rejection history in the first six months of renal transplantation. all were treated with pulse steroids, and 46 were also treated with ATLG. The mean time to diagnosis of BKVN was 15.8±22.2 months after transplantation. At the time of diagnosis, the patients’ mean creatinine level was 1.8±0.7 mg/dl, and the mean estimated glomerular filtration rate was 45.8±19.6 ml/min. While BKVN was solely reported in 181 cases, there were cellular rejection findings in 21 biopsy specimens and humoral rejection in 4 biopsy specimens. In addition of dose reduction or discontinuation of immunosuppressive drugs, eighteen patients were treated with cidofovir, 11 patients with leflunomide, 17 patients with quinolones, 15 patients with intravenous immunoglobulin (IVIG), five patients with cidofovir+IVIG, and 12 patients with leflunomide+IVIG. None of the patients who received leflunomide and leflunomide+IVIG had allograft loss. Allograft loss was observed in 12 (15%) of 78 patients treated with antivirals or immunomodulators. Allograft loss occurred in 32 patients (15%) during follow-up out of 207 patients with BKVN. Five patients were retransplanted, and none developed BKVN during the follow-up. Conclusions: BKVN is still a significant cause of allograft loss in kidney transplantation, which has not been fully elucidated. Leflunomide appears to be an effective treatment in these patients.

Background: Peritoneal dialysis is a frequently used renal replacement treatment option in patients with end-stage renalfailure, and it is emphasized several times that it should be started as the first treatment in the literature. However, for manydifferent reasons, sometimes the treatment is stopped and switched to hemodialysis. In this study, we aimed to examinethe reasons and factors affecting the transition to hemodialysis in our unit.Methods: Fifty-five patients who were – transferred to hemodialysis – regularly attending the Peritoneal Dialysis Unit ofErciyes University Nephrology Department were included in our study. Biochemical analysis, peritoneal equalization test(PET), dialysis adequacy (kt/V), and creatinine clearance of these patients were recorded regularly. Regular cardiac exami-nations and ambulatory blood pressure measurements were also performed. The reasons for the transition from perito-neal dialysis to hemodialysis were also noted in detail.Results: The mean age of the patients was 54.02 ± 11.41 years, and 27 (62.8%) of the patients were male. While the shortestperiod spent on peritoneal dialysis was 13 months, the longest was 191 months. The most common type of permeabilityin PET analysis of the patients was observed as high-average. The most common reason for the transition to hemodialysiswas inadequate dialysis. Using univariate and multiple regression models, factors that predict the duration of stay in peri-toneal dialysis were examined. We found that the urine volume, total kt/V, and the number of peritonitis could be effectivein predicting this period.Conclusion: Peritoneal dialysis is a renal replacement option that has advantages such as patient comfort, preservation ofthe kidney’s remaining work, and social life. The reasons for the transition should be examined in detail, and the necessaryinterventions to prolong the time in peritoneal dialysis should be evaluated.

Sodium phosphate-based enema preparations are low-volume, hyperosmotic agents commonly used in bowel preparation for sigmoidoscopy/colonoscopy and surgical operation. Although generally safe and well tolerated in adults, severe metabolic complications have been reported with use. The patient in this case report was admitted to the general surgery department with complaints of nausea, vomiting, and abdominal pain after oral sodium phosphate solution. After clinical evaluation, hemodialysis was started for acute kidney injury (AKI). Clinicians should be alert using sodium phosphate solution for bowel cleansing before sigmoidoscopy/colonoscopy and surgical operation, in terms of acute kidney damage and electrolyte imbalance.

Background and Aims: Thirst, is the main driver for fluid consumption. Abundant water intake is advised for patients with autosomal dominant polycystic kidney disease (ADPKD). However, daily routines may limit water intake. There is no established tool to quantify the drivers of water intake in ADPKD patients. The aim of this study was to modify and validate a thirst distress scale (TDS) to identify the factors that influence water intake in ADPKD patients. Methods The TDS-heart failure questionnaire was first modified to TDS-PKD to adapt to patients with ADPKD to assess (a) the intensity of thirst, (b) the consequences if the quench for thirst is not satisfied enough and (c) the disturbing effects of thirst on quality of life. Then, the TDS-PKD questionnaire was translated to Turkish using the guidelines of the World Health Organization. An electronic survey with the SurveyMonkey platform was used to collect data. Thirst intensity was evaluated using a visual analog scale (VAS). Results The questionnaire was filled in by 186 ADPKD patients, of which 126 were on tolvaptan therapy. The TDS-PKD questionnaire showed good internal consistency, with a Cronbach's alpha value of 0.859. According to the exploratory factor analysis, a three-factor structure was obtained. Three factors explained 60.7% of the total variance. There was a positive and statistically significant correlation between the total TDS and VAS scores (r = 0.589, p

Aim: Fistula occlusion is one of the most common causes of hospitalization and mortality in hemodialysis patients. While there are many factors that affect the preoperative success of the fistula, we examined the effect of calcium and phosphorus values from electrolytes. Materials and methods: A total of 100 patients were included in the study. The effectiveness of the preoperative calcium x phosphorus (Ca x P) value of these patients to fistula success in the first 4 weeks was examined. Results: Calcium and phosphorus values of the blood values taken before the fistula was opened, there was a significant difference between the two groups (8.7 +/- 0.7 vs. 9.3 +/- 0.9, p = 0.001, and 3.4 +/- 0.9 vs. 5.2 +/- 1.4, p = 0.001). The difference in the Ca x P value, which is the hypothesis of our study, was found to be quite significant between the two groups (34.1 +/- 8.9 vs. 48.5 +/- 13.7, p < 0.001). Conclusion: Ca x P value was found to be significantly higher in preoperative fistula success and can be a simple and reliable parameter in the evaluation of fistula success.

Background Tunneled catheters can be used as an alternative vascular access in patients with limited health expectancy,vascular access problems and several comorbidities. We aimed to present a patient with venous stenosis related- reversible acute Budd-Chiari syndrome after catheter malposition. Case presentation After changing of tunneled catheter insertion, 36-year old man was admitted to our hospital with sudden onset of nausea, fever, chills and worsening general condition In computed tomography (CT) imaging, a hypodense thrombus was observed in which the distal end of the catheter is at the level of drainage of the hepatic veins in the inferior vena cava and that blocked hepatic vein drainage around the catheter. The catheter was removed and a new catheter was inserted in the same session. Because patient’s general condition was good and without fever, he was discharged with advices on the 9th day of hospitalization. Conclusion Although catheter malposition and thrombosis are not a common complication, clinicians should be alert of these complications.

BACKGROUND AND AIMS Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease with diffuse cysts in both kidneys and is responsible for 5–10% of end-stage renal disease Levy and Feingold (Estimating prevalence in single-gene kidney diseases progressing to renal failure. Kidney Int. 2000;58(3):925). Recently, tolvaptan, which can improve kidney survival, was approved for the management of the disease (Drug Approval Package: Jynarque (tolvaptan) Otsuka Pharmaceutical Development & Commercialization, Inc. application Number: 204 441, Approval Date: 04/23/2018). We examined the relationship between renal and extrarenal findings, disease severity and the level of consciousness of patients with ADPKD patients. METHOD About 516 patients who applied to nephrology clinics of seven different centers in Turkey were asked to answer the questionnaire about ADPKD that consisted of 38 questions. Disease severity was determined according to e-GFR, and disease awareness was assessed on a four-point scale by adapting the Disease Perception Scale to ADPKD. Awareness of patients was evaluated comparatively with chronic kidney disease stage, age, region and symptoms. RESULTS One out of five patients does not know that this disease is inherited. Mean awareness scores of the patients decreased significantly with increasing age. The average awareness score of the Central Anatolia region was significantly higher compared to other regions. Awareness scores were significantly higher in patients with flank pain and urinary tract stones. CONCLUSION To the best of our knowledge, this is the first study about ADPKD awareness. Although ADPKD is the most common hereditary kidney disease, the rate of patients’ knowledge on this subject is low. Awareness levels may vary according to age, regional differences or symptoms. Increased awareness might lead to better treatment and improved survival in those patients.

BACKGROUND AND AIMS Abundant water intake is advised for patients with autosomal dominant polycystic kidney disease (ADPKD) Meijer and Casteleijn (Riding the waves: evidence for a beneficial effect of increased water intake in autosomal dominant polycystic kidney disease patients? Nephrol Dialysis Transpl. 2014;29(9):1615–1617). Thirst, which can be defined as a sensation of dryness in the mouth and throat associated with a desire for liquids, is the main driver for fluid consumption Fitzsimons (Thirst. Physiol Rev 1972;52(2):468–561). However, daily routines may limit water intake. There is no established tool to quantify the drivers of water intake in ADPKD patients. In this study, it was aimed to develop and validate a thirst distress scale (TDS) to quantify the factors of water intake in ADPKD patients. METHOD The TDS-heart failure questionnaire was first (i) translated to Turkish using the approach recommended by the guidelines of the World Health Organization and finally (ii) modified to adapt to patients with ADPKD with totally 12 questions assessing (a) what may affect water intake, (b) what limit water intake and (c) what disturbing effects thirst may have on quality of life. The guidelines of the World Health Organization were used to translate the questionnaire to Turkish. An electronic survey with SurveyMonkey platform was used to collect data on thirst with TDS-PKD and thirst intensity (visual analog scale, VAS). Internal consistency of the TDS-PKD was evaluated with Cronbach’s alpha. Exploratory factor analysis was conducted to reveal the validity and the factor structure of the questions in the questionnaire. RESULTS The questionnaire was filled in by 154 ADPKD patients, of which 116 were on tolvaptan therapy. The time taken to answer the questions was about 4 min. The TDS-PKD questionnaire showed good internal consistency with a Cronbach's alpha value of 0.867. According to the exploratory factor analysis, a three-factor structure was obtained, meaning that there are three constructs about thirst in the TDS-PKD. Three factors explained 62.57% of the total variance. Factor one consisted of questions 1–7, factor two 8–10 and factor three 11–12. All three factors were significantly associated with thirst intensity (r = 0.505, r = 0.244 and r = 197, respectively). The average score of TDS-PDK was 40.2 ± 10.5, and the average VAS score was 8.5 ± 0.7. CONCLUSION The TDS-PKD questionnaire is a valid and reliable tool for evaluating the thirst distress in ADPKD patients.

Onder, M Ercument/0000-0002-1488-616X; Altay, Berkan/0000-0003-0297-6501; Orhan, Kaan/0000-0001-6768-0176 WOS:000545324000029 PubMed: 32275899 Purpose: The main disadvantage of distraction osteogenesis is the prolonged treatment protocol. Recently, oxytocin (OT) has been found to have anabolic effects on bone metabolism. In this experimental study, the effects of OT on the mandibular distraction gap in rabbits at 2 different distraction rates were evaluated. Materials and Methods: This experimental study was conducted on 28 male New Zealand white rabbits. The animals were divided into 3 experimental groups and 1 control group. Group A (control group, n = 7) consisted of animals with distraction at a rate of 1 mm/day, and group B (n = 7) consisted of animals with a distraction rate of 2 mm/day; groups A and B received postoperative saline solution injection. Group C (n = 7) consisted of animals with distraction at a rate of 1 mm/day, and group D (n = 7) consisted of animals with a distraction rate of 2 mm/day; postoperative OT injection was performed in groups C and D. Results: Both histomorphologic and micro-computed tomography evaluations showed increased bone healing in the OT-treated groups. Conclusions: On the basis of the evaluation of both the histomorphometric and micro-computed tomographic data, systemic OT administration was found to increase new bone formation and bone healing with distraction osteogenesis. (C) 2020 American Association of Oral and Maxillofacial Surgeons Scientific Research Projects Coordination Unit of Kirikkale UniversityKirikkale University [2018/13] This work was supported by the Scientific Research Projects Coordination Unit of Kirikkale University. Project number 2018/13.

IgA nephropathy (IgA-N) is the most common glomerulonephritis type globally. IgA-N is usually accepted as a kidney disease; however, IgA-N has been reported with infections, autoimmune diseases, and malignancies in the literature. In this report, we present a case of a 33-year-old man diagnosed with IgA nephropathy first and then with B-cell acute lymphoblastic leukemia (B-ALL). He was admitted to our hospital with complaints of nausea, vomiting, fatigue, and headache. Laboratory investigations revealed increased levels of blood urea nitrogen and creatinine, hypercalcemia, anemia, and thrombocytopenia. Kidney biopsy was performed, and IgA nephropathy was detected. Atypical lymphocytes and erythroblasts were present in the peripheral blood smear. Bone marrow biopsy was performed and demonstrated B-ALL. Kidney function tests normalized after 1 month of chemotherapy, including steroid treatment with intravenous fluid administration. In conclusion, it has been speculated that IgA nephropathy is associated with B-ALL.

Purpose Because of the increase in globalization, clinicians all over the world are confronted the questions about safety of Ramadan fasting. However, there is no clear information about whether there is an obstacle for fasting patients with chronic disease. Hence, in the present study, we aimed to investigate the effects of Ramadan fasting on kidney and the factors affecting this relationship in patients with chronic kidney disease. Methods This study involving 117 patients [36 females, 81 males; mean age, 60 (46.0-70.0) years] with stage 2-3 chronic kidney and fasting. Patients were evaluated every 10 days for acute kidney injury (AKI) in Ramadan month. And, patients with acute kidney injury and patients without AKI were grouped. Results When the patients were evaluated for AKI, we observed that in 27 patients had acute kidney injury. While patients without AKI fasted for more days (p < 0.001), urea levels and frequency of hypertension were higher in the group with AKI (p = 0.019;p = 0.025 respectively). We also performed univariate and multiple binary logistic regression analysis to identify the risk factors of AKI. Hypertension and number of fasting day were found to be predictive of AKI (p = 0.02;p < 0.001 respectively). Conclusions We found a significant relationship between hypertension, the number of fasting days and acute kidney injury. Patients with chronic kidney damage and hypertension should be evaluated more carefully, informed about the importance of hydration after fasting and should be followed frequently for AKI.

Onder, M Ercument/0000-0002-1488-616X WOS:000549448200007 Zygomatic implants for toothless, atrophic posterior maxilla are effective treatment options and it is known that graft use has a positive effect on the zygomatic implant stability with this treatment option. The aim of this study was to evaluate the stress values and their distribution at zygomatic implant-supported prosthetic infrastructure in augmented and non-augmented models. In this study, the three-dimensional finite element method was used and 2 zygomatic implants (47.5 x 4.0 mm), 2 conventional implants (13 x 3.75 mm) and atrophic maxilla with augmented and non-augmented maxillary sinus with prosthetic infrastructure, were modelled. A vertical load of 150 N was applied onto the maxillary model at 4 different regions (#9, #12, #14 and #15). The von Mises stress, which is produced as a result of loading of zygomatic implants and prosthetic infrastructure has been evaluated in augmented and non-augmented models. The highest von Mises stress value for the prosthetic infrastructure was determined in the non-augmented model as a result of the loading to region #9 (MPa 222,886). Consequently, grafting procedures will increase bone support and reduce stresses in the prosthetic substructure, especially in posterior loads in the maxilla with low bone density.

Autosomal dominant polycystic kidney disease (ADPKD), characterized by the development of multiple cysts in the kidneys and other organs, is the most common hereditary renal disorder and the fourth leading cause of end-stage renal disease. In adults with a positive family history, the diagnosis of ADPKD is made based on the radiologic evidence of bilateral, fluid-filled renal cysts. Furthermore, initial symptoms including pain, increased thirst, polyuria, nocturia, and increased urinary frequency may lead to the diagnosis of ADPKD. An easily accessible, applicable, and cost-effective biomarker is needed to predict the clinical course of ADPKD due to its progressive pattern. Urine is an easily obtainable and widely used test specimen for diagnosis and follow-up in several renal diseases. Thus, the aim of the present study was to review and assess new urinary biomarkers and urinary findings in ADPKD.

Introduction: Mucociliary clearance (MC) is a critical defense mechanism for the protection of the entire respiratory system. Nasal colonization of some pathogens and chronical nasal infections are important risk factors for peritonitis. Any disturbance in the MC causes stasis of secretions and secondary infections. Objective: The aim of the study was to evaluate the patients with chronic kidney disease (CKD) receiving continuous ambulatory peritoneal dialysis (CAPD) in terms of nasal MC. More specifically, the goal is to investigate the possible correlation between the nasal MC and peritonitis. Methods: Forty CAPD patients and 39 healthy volunteers were involved in the study. The nasal MC was evaluated with the saccharin test, in which a 1 mm diameter saccharin particle was carefully placed on the antero-medial surface of inferior nasal concha. The time taken by the subjects from the placement of particle to the perception of the sweet taste was taken as mucociliary clearance time (MCT). The groups were compared in terms of MCT. The patient group was evaluated in terms of a peritonitis history, and the correlations with MC were analyzed. Results: Patient group with CKD consisted of 16 females and 24 males with a mean age of 32.4 years; healthy individuals in the control group consisted of 17 women and 22 men with a mean age of 33.3 years. There was not a significant difference in terms of mean MC time in patients with CKD when compared with the individuals in the control group. The comparison between the mean MCT in the patients who had a history of peritonitis and patients without peritonitis was statistically significant (p

Secondary and tertiary hyperparathyroidism is an important problem of chronic kidney disease. Brown tumor is a benign, unusual, reactive lesion as a result of disturbed bone remodeling, from long-standing increase in parathyroid hormone level. Brown tumors may cause morbidity due to pressure symptoms on neural structures and spontaneous bone fractures. Herein, we presented a peritoneal dialysis patient with tertiary hyperparathyroidism under calcand calcitriol treatment for 4 years due to refusing of the parathyroidectomy operation. She admitted to hospital for sudden onset back pain with difficulty in gait and walking, and imaging studies showed an expansile mass lesion in the thoracic spine. She was operated for mass and diagnosed with brown tumor. After operation, she lost the ability of walking than become paraplegic and she underwent rehabilitation program. Preventive measures including calcitriol and cinacalcet may cause a modest decrease in parathyroid hormone levels but it should be remembered for the development of bone complications such as brown tumor formation in patients with moderate elevated PTH levels, especially those with tertiary hyperparathyroidism. Parathyroidectomy should be performed without delay in these cases.

To evaluate the accuracy of US in calculating renal volumes and renal resistive index (RRI) that was obtained using a new method in patients with autosomal dominant polycystic kidney disease (ADPKD). In this prospective study, US and MRI were performed in 57 patients with ADPKD (31 female and 26 male; age range, 19–79 years) between August 2017 and May 2018. The volumes determined using US and MRI were compared. The ellipsoid formula was re-evaluated using different multipliers. RRI was obtained 1.5–2 cm distal to the outlet of main renal arteries. The relationship between mean RRI, renal function tests, and kidney volumes and difference between mean RRI of ADPKD patients with and without renal failure were investigated using a two-sided independent samples t test and Pearson correlation test. Interobserver agreements for volume assessments and RRI measurements were determined. By changing the ellipsoid formula, a very good agreement was found (ICC 0.970 for the right kidney and ICC 0.973 for the left kidney). The mean RRI in the right renal artery was 0.61 ± 0.07 and in the left renal artery 0.63 ± 0.06. The mean RRI of ADPKD patients with renal failure was significantly higher than that of patients without renal failure (p = 0.005). There was a significant correlation between mean RRI and renal function tests. The accuracy of the US in calculating renal volumes increases by adapting the ellipsoid formula. RRI may be used for the management of ADPKD independently of volumes. •The accuracy of ultrasonography for renal volume measurement increases by changing the classical ellipsoid formula. •Renal resistive index measured by color Doppler ultrasonography is helpful for the management of autosomal dominant polycystic kidney disease. •The role of Doppler US in autosomal dominant polycystic kidney disease should increase as a result of our findings.

This study was supported by Scientific Research Project Unity of Kirikkale University., The mechanism of osseointegration is related to many factors, including the quality of the bone, the biocompatibility and surface characteristics of the implant material, the surgical technique, and functional loading. The purpose of this study was to investigate the effects of hyaluronic acid gel on the osseointegration of implants placed in defined areas of the mandible in rabbits. Hyaluronic acid is known to have an osteoinductive effect during regeneration of bony defects, and we thought that it might also have a favourable effect on osseointegration, a specialised mechanism to heal bone. Ten New Zealand rabbits aged 10 weeks and weighing 2.5-3.0 kg were used, and sites for implants that were far enough from the apices of the teeth in the mandibular molar area were chosen. Two cavities were prepared in each rabbit, one (anterior) for the control implant, and one (posterior) for the implant with hyaluronic acid gel (Medical Instinct GmbH, Bovenden). New bone and the osteoid matrix content around the dental implants were evaluated histologically and histomorphometrically two months after the operation, and no significant difference was found between the two groups. (C) 2018 The British Association of Oral and Maxillofacial Surgeons., Scientific Research Project Unity of Kirikkale University

Background and Objectives: Cyst pressure induces renin-angiotensin-aldosterone system activation and kidney hypoxia in autosomal dominant polycystic kidney disease (ADPKD). Lipopolysaccharide-induced Toll-like receptor activation causes metabolic disturbances that are triggered by increased succinate levels and hypoxia inducible factors, which results in inflammation via IL-1β activation. Since we aimed to investigate the role of both inflammation and hypoxia in the clinical course of ADPKD, via succinate levels from sera samples, HIF-1α gene expression from whole blood and urine samples and IL-1βgene expression from whole blood were measured. Methods: One hundred ADPKD patients and 100 matched healthy controls were enrolled to this cross-sectional study. Twenty-four-hour ambulatory blood pressure monitoring was conducted in all participants. Blood, serum, and urine samples were taken after 12-h fasting for the measurement of biochemical parameters and succinate levels. Whole blood and urine samples were used for HIF-1α and IL-1β geneexpression by using quantitative real-time PCR. Results: There were significant differences in whole blood HIF-1α, IL-1β geneexpression, and serumsuccinate levels between the ADPKD patients and the control subjects. Whole blood HIF-1αgene expression, IL-1β geneexpression, and serumsuccinate levels were also significantly different in ADPKD patients with hypertension in comparison with normotensive ones (p < 0.05). Serum succinate levels and blood IL-1β geneexpression were increased in ADPKD patients with high levels of HIF-1α geneexpression (p = 0.018 and p = 0.029, respectively). Conclusions: Increased age,low eGFR, and HIF-1α and IL-1β geneexpressions were also independently associated with hypertension in ADPKD patients. Inflammation and hypoxia are both relevant factors that might be associated with hypertension in ADPKD.

Background Several factors play a role in the pathogenesis of pruritus in uremic patients. The pathophysiology is complex and many factors have been identified in these patients. The aim of this study was to investigate the presence, severity, and possible causes of pruritus in patients with peritoneal dialysis (PD) . Methods Eighty patients, who received continuous ambulatory peritoneal dialysis (CAPD) treatment, were included in this study. Biochemical measurements, parathormone, C-reactive protein (CRP), and vitamin B12 levels of all the patients were recorded. Furthermore, substance P (SP) levels were measured by ELISA methods. Patients were examined by a dermatologist and pruritus degrees were queried using the visual analog score (VAS) with skin dryness. Results In generalized linear model analysis, total urea clearance and SP independently predicted VAS scores. SP was significantly predictive in ROC analysis in identifying the VAS score in patients with peritoneal dialysis. The sensitivity and specificity of SP were 80% and 67% (cut-off > 364), respectively, with an area under the ROC curve of 0.757 (95% CI 0.650-0.865, p < 0.001). SP also was significantly predictive in ROC analysis in identifying xerosis in PD patients. Conclusion Pruritus was proportional to the amount of substance P and total urea clearance was another reason affecting pruritus in peritoneal dialysis patients.

Objective: Coronavirus disease 2019 (COVID-19) has been declared a pandemic by the World Health Organization. Many studies have examined their psychological effects. However, during these periods when the new case of COVID-19 patients decreased, their psychological effects were not sufficiently reported. Our aim was to investigate the anxiety and depressive symptom levels of healthcare workers (HCW) during the periods when the increase in the number of cases slowed down in the COVID-19 epidemic. Materials and Methods: A cross-sectional a questionnaire consisted of Beck Depression Inventory and Beck Anxiety Inventory was applied to 143 people working in a university hospital. General information such as age, gender, marital status, study history in the COVID-19 pandemic, history of chronic disease, and whether there are other HCW at home was collected and compared. Results: The median value of beck anxiety score was 6. The median value of Beck depression score varies by gender (p=0.015). Median value of Beck depression score varies according to marital status (p=0.011). The median value of Beck anxiety score varies according to gender (p=0.008). The median value of Beck anxiety score varies according to occupational groups (p=0.003). A significant link was obtained between Beck depression groups and marital status (p

INTRODUCTION Arteriovenous fistula (AVF) stenosis is one of the most important clinical problems in hemodialysis patients. The histopathological findings of neointimal hyperplasia and impaired angiogenesis have been well established in stenotic AVFs. Soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) has been implicated in pathological angiogenesis. Thus, we aimed to investigate the association between sVEGFR-1 and AVF stenosis in hemodialysis patients. METHODS This prospective cohort study included 70 patients with end-stage renal disease. Forty-five patients were included in the final analysis, and the median follow-up period was 36 months. Venous stenosis was detected by physical examination and documented by fistulography. Blood samples were analyzed a day before the fistula operation, and serum levels of sVEGFR-1 were measured. FINDINGS The median sVEGFR-1 level was higher in the stenosis group than in the nonstenosis group (17 pg/mL [89.5%] vs. 5 pg/mL [19.2%], respectively; P 30 kg/m2 ) had the shortest stenosis-free survival (20 months [9.35-30.65]). Multivariate Cox analysis showed that sVEGFR-1, serum creatinine, and parathyroid hormone levels were associated with AVF stenosis risk. Kaplan-Meier survival curves showed that patients with less than the median value of sVEGFR-1 (

Endothelins including its most abundant isoform, endothelin-1 (ET-1), are peptides acting as vasoconstrictors when binding to ETA and ETB receptors, and, in addition to their distinct roles in normal physiology, endothelins have a central role in the pathophysiology of many diseases including cardiovascular and renal diseases. Endothelin-1 (ET-1), the most potent vasoconstrictor in the cardiovascular system, regulates basal vascular tone and glomerular hemodynamics. ET-1 is involved also in vascular and cardiac hypertrophy, inflammation, and in the development and progression of cardiovascular diseases - e.g. essential hypertension, atherosclerosis, coronary artery disease, congestive heart failure, pulmonary arterial hypertension and cerebrovascular disease and renal diseases - e.g. acute renal failure, polycystic kidney disease and chronic kidney disease. Not surprisingly, the ET system has become a target for therapeutic interventions that now include a few already established and some new promising agents. In this narrative review, we summarize physiologic properties of the ET system, focusing especially on ET-1, and its role in the pathophysiology of ET system activated diseases, and discuss the potentials of therapeutic interventions targeting the ET system in cardiovascular and renal diseases. While ET receptor antagonists have already revolutionized the management of idiopathic pulmonary arterial hypertension, so far, this class of drugs have failed as medication for congestive heart failure. Clinical trials continue to explore new applications of endothelin receptor antagonists in treatment-resistant hypertension and chronic kidney disease and have shown some benefits in the latter group by reducing proteinuria; however, they have not been approved yet. We conclude that larger clinical trials are needed to validate the use of ET receptor antagonists in ET system activated diseases.

Background and Aims Minimal change disease (MCD) is the most common cause of the nephrotic syndrome (NS) in children. Although there are many data regarding the course, response to treatment, and outcomes in pediatric patients, only a few series have examined these issues in adults. The aim of the study was to delineate the demographic and clinical properties of MCD of adult population in our country. Method All over the country, a total of 47 centers entered data between May 2009 and May 2019 to the database created by of Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) Working Group. Demographic and clinical characteristics and biopsy findings recorded to the database were analyzed. Results In total, 258 patients were compatible with the pathological diagnosis of MCD. Mean age was 36.16±15.44 years and 53.88% were male. At diagnosis, 66.7% patients presented with pretibial edema,15.9% with hypertension. Microscopic hematuria occured in 18.2% patients. Only 24 patients (9.3%) presented with a decrease in renal function (serum creatinine greater than 1.3 mg/dl). The mean daily proteinuria was 6.3 g, and serum albumin was 2.6 mg/dl. The most frequent indication for biopsy was NS (86.4%). On kidney biopsy, the mean number of glomeruli was 18.08±11.11. Mezangial proliferation and mezangial IgM were present in 27.5% and 22.5%, respectively. Only in 3.5% of the included patients, electron microscopic studies were performed. Conclusion This study describes the characteristics of a cohort of adult patients with MCD. MCD in adults may sometimes present concurrently with hematuria, hypertension, and acute kidney injury.

This study aimed to investigate the relationship between fluid and sodium excretion and blood pressure, echocardiographic parameters, and arterial stiffness in peritoneal dialysis (PD) patients and to evaluate the effect of sodium excretion on patients’ survival. This study was conducted as a single-centered, prospective study in the Department of Nephrology in Erciyes University. The patients included in the study were followed up for 3 years. Seventy PD patients were included in the study. We recorded demographic characteristics, biochemical parameters, urine and peritoneal ultrafiltration volumes, peritoneal equalization tests, ambulatory blood pressure measurements, and echocardiographic measurements. We measured the amount of total sodium excretion of the patients and arterial stiffness using pulse wave velocity (PWV). Patients were divided into two groups based on the amount of total sodium excretion: low group and high group. We compared these groups in terms of cardiac and biochemical parameters. When demographic data and biochemical values were compared, there was no significant difference between the two groups. NT-proBNP level, systolic blood pressure, and mean arterial pressure were significantly higher in the low group (p: 0.02, p: 0.031, p: 0.05, respectively). Net ultrafiltration was significantly higher in the high group (p: 0.03), was also found to be high in patients with high sodium excretion (p: 0.001). Negative correlations were found between sodium excretion and net ultrafiltration, NT-Pro BNP, and PWV. At the end of the 3-year follow-up, the survival rate was shorter and the mortality rate was higher in the low group (p: 0.042). Fluid status in PD patients can affect arterial stiffness both directly and through hypertension. Correction of hypervolemia has the potential to not only prevent hypertension and left ventricular hypertrophy, but also to improve arterial stiffness, a well-known cardiovascular risk factor. The mortality rate was higher in PD patients with low total sodium excretion. Therefore, these patients should be followed more closely to ensure volume control.

Background Neointimal hyperplasia is the main cause of arteriovenous fistula (AVF) failure. Hypoxia-inducible factors (HIFs) factors are associated with neointimal hyperplasia. Thus, we investigated the association between HIF-2 alpha (HIF-2 alpha) and AVF maturation in end-stage kidney disease (ESKD) patients. Methods This prospective cohort study was conducted in 21 voluntary healthy subjects and 50 patients with ESKD who were eligible for AVF creation. Inclusion criteria were being ESKD patients without a history of AVF surgery and dialysis. Eight patients excluded from the study due to having unavailable veins six patients were excluded due to acute thrombosis after surgery. One patient lost to follow-up. A total of 35 patients were included in final analysis. The blood samples were collected a day before the AVF surgery for biochemical parameters and HIF-2 alpha measurement. HIF-2 alpha levels were measured by the ELISA method. Results Compared with healthy subjects, ESKD patients had a significantly higher level of HIF-2 alpha. [1.3 (1.0-1.9) vs 2.2 (1.6-3.0)] (P = .002). Patients were divided into two groups after the evaluation of AVF maturation, as the mature group (n = 19) and the failure group (n = 16). Serum HIF-2 alpha level was 1.7 (1.1-1.8) in the mature group; however, it was 3.1 (2.8-3.3 in failure group (P .001). Multiple logistic regression analyses showed that HIF-2 alpha independently predicted AVF maturation. The ROC curve analysis showed that HIF-2 alpha > 2.65 predicted AVF maturation failure with the 87% sensitivity and 94% specificity [AUC:0.947, 95% CI (0.815-0.994),P .001]. Conclusions HIF-2-alpha levels were higher in ESKD patients than healthy subjects. HIF-2-alpha could be a marker of AVF maturation failure.

The main objective of this analysis was to evaluate (1) implant survival, (2) biologic complications, and (3) demographics associated with zygomatic implants placed according to the zygomatic anatomy-guided approach (ZAGA). This retrospective multicenter study reviewed data from the charts of 82 consecutive patients who had received 182 zygomatic implants. Patients were fully edentulous (62.2%), partially edentulous (22.0%), or had failing dentition (15.9%). Most patients (87.5%) did not have previous sinusitis and 11.3% had been previously treated for it. Additionally, about half of the patients (53.8%) did not present periodontal pathology, and one-third (36.3%) did, but were subsequently treated. Most implants (93.8%) were loaded immediately, i.e., within 48 h of placement. Implants were followed for 10.5 &plusmn, 7.2 months, and all were recorded as surviving and stable at last follow-up. Post-operative complications were infrequent and included sinusitis (10.1%) and peri-implant hyperplasia (0.8%). The low complication rate and 100% implant survival and stability indicate that zygomatic implants offer a viable treatment option when performing graftless restoration of severely resorbed maxilla, including immediate loading protocols.

Autosomal-dominant polycystic kidney disease (ADPKD) is associated with oxidative stress and hypertension development before renal function decline and cardiovascular disease development. Oxidative stress-responsive kinase-1 (OSR-1) participates in the signaling regulating Na+ transport during oxidative stress and also plays a role in the regulation of cell volume and blood pressure. Therefore, we aimed to investigate the potential role of OSR-1 in ADPKD patients. Eighty ADPKD patients, 80 healthy controls, and 80 non-ADPKD patients with hypertension were enrolled in this cross-sectional study. Twenty-four-hour ambulatory blood pressure monitoring was conducted in all participants. Blood samples were taken after 12-h fasting for the measurement of biochemical parameters and OSR-1 gene expression. Vascular dysfunction was assessed using ischemia-induced forearm flow-mediated vasodilation (FMD). Briefly, of the 80 ADPKD patients, 41(51%) were male, and 53(66%) of them were hypertensive. The mean age of the 80 controls was 35.3 +/- 12.6 years, and 37(46%) of them were male. The mean age of the 80 non-ADPKD patients with hypertension was 44.6 +/- 11.9 years, and 38(47.5) of them were male. There were significant differences in serum OSR-1 gene expression between the ADPKD patients and the control subjects. Serum OSR-1 gene expression was also significantly increased in hypertensive ADPKD patients in comparison with both normotensive ADPKD counterparts and non-ADPKD hypertensive subjects. Serum OSR-1 gene expression was increased in patients with ADPKD than healthy subjects. Low estimated glomerular filtration rate (eGFR), OSR-1 gene expression, total kidney volume (TKV), and high-density lipoprotein (HDL) were also independently associated with hypertension in ADPKD patients.

The introduction of dental implants has resulted in many new developments in modern dentistry. The long-term clinical success of dental implants among other factors depends on understanding the interaction between bones and implants under various conditions and locations [1–3].

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.

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by multisystem involvement. The renal involvement of SLE may present with hematuria, proteinuria or acute kidney dysfunction. It is well established that pregnancy may trigger the disease activation in patients with SLE. Lupus nephritis (LN) may be diagnosed during pregnancy in very few patients. Preeclampsia is a pregnancy-related disorder characterized by maternal hypertension, proteinuria, and edema and is sometimes complicated by renal dysfunction, which usually occurs in the last trimester of pregnancy. However preeclampsia rarely occurs within 48 h of postpartum. In this report, we present the case of a 20-year-old patient with oliguria, proteinuria, edema, and hypertension who was diagnosed with preeclampsia starting at the 35th week of her first pregnancy. Acute kidney failure developed in the postpartum period after emergency cesarian delivery. Crescentic and diffuse LN was revealed by renal biopsy. While SLE is a risk factor for preeclampsia, LN should be considered in kidney failure in the third trimester or postpartum period.

WOS: 000429609000006 Objective: The aim of this study is to compare the stress distribution of three different implant macro design applied with allogeneic cancellous bone rings using three dimensional finite element analyses. Material and Methods: Finite element models of maxilla and mandible that augmented with allogeneic bone ring graft with implants were created. Vertical force of 100 N and oblique force of 100 N at 45 degrees angle were applied to three different (variable thread, cylindrical, standard thread) macro design implants. Results: Stress concentrations in the conjunction of neck of the implant and allogeneic bone ring were higher than other areas. The highest calculated values of Von Misses stresses were observed in standard thread implant with oblique loading in mandible model. In all models the highest stress values were greater for oblique loading compare to vertical loading. Discussion: Implant macro designs shows different distributions to implanted bone or graft. It should be considered when choosing an implant in the cases augmented with allogeneic cancellous bone ring. Kirikkale University Scientific Research Project Department [2015/104] This study supported by Kirikkale University Scientific Research Project Department. Project No: 2015/104.

Renal amyloid A (AA) amyloidosis is one of the systemic etiologies of nephrotic syndrome (NS) in adults. Chronic inflammatory conditions including rheumatoid arthritis, familial periodic fever syndromes, spondyloarthropathies, and chronic bacterial infections such as tuberculosis and chronic osteomyelitis are the common causes of secondary AA amyloidosis. In this case report, we reported a patient presented with nephrotic syndrome and secondary AA amyloidosis due to chronic hepatitis B infection in the absence of any glomerulonephritis.

Onder, M Ercument/0000-0002-1488-616X; ATIL, Fethi/0000-0002-8286-4819 WOS: 000415085100107 PubMed: 29095728 Bisphosphonates that constrain bone resorption have a direct effect on osteoclast function. In this experimental study, the effects of low-dose local alendronate injections on the distraction gap (DG) in rabbit mandible at 2 different rates were evaluated. The experimental study was conducted on 20 male, New Zealand white rabbits. The animals were divided into 3 experimental groups and 1 control group. Group 1 consisted of animals with distraction at the rate of 1 mm/day, receiving postoperative local low-dose alendronate local injections into the DG. Group 2 consisted of animals with distraction at the rate of 2 mm/day, receiving postoperative 0.75 mu g/kg of alendronate local injections into the DG. Group 3 consisted of animals with distraction at the rate of 2 mm/day, receiving postoperative 0.2 mL local saline injections into the DG. Group 4 consisted of animals with distraction at the rate of 1 mm/day, receiving postoperative 0.2 mL local saline injections into the DG. All the injections were performed immediately postoperatively and for all groups at 1, 2, 3, and 4 weeks following surgery. The distraction zones were evaluated using dual-energy X-ray absorptiometry and histological analysis. Histologically, bone healing was found to be significantly accelerated in Groups 1 and 4 compared with Groups 2 and 3 (P