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Objective: The objective of this study is to investigate the diagnostic utility of microRNAs (miRNAs) for distinguishing between urine samples from patients with Diabetic Kidney Disease (DKD) and those with Focal Segmental Glomerulosclerosis (FSGS). Methods: In this multicentric, cross-sectional investigation, we enrolled patients diagnosed with DKD, individuals with primary biopsy-proven FSGS, and healthy controls. The top 5 miRNAs (hsa-mir-21, hsa-mir-30a, hsa-mir-193a, hsa-mir-196a, hsa-mir-200a) were selected to quantify miRNAs in urine samples. Isolation of targeted miRNAs was performed from urinary exosomes, and the quantitative profile of the isolated miRNAs was measured by RT-qPCR. The ΔΔCt method was implemented to calculate the fold differences between disease and control samples. Results: Thirteen DKD patients, 11 FSGS patients, and 14 healthy controls were included in this study. Hsa-mir-21 and hsa-mir-30a exhibited distinct regulation in both groups, with upregulation observed in FSGS and downregulation in DKD (hsa-mir-21 in DKD (0.668 ± 0.25, p < 0.0005) and FSGS (2.267 ± 1.138, p < 0.0077); hsa-mir-30a in DKD (0.874 ± 0.254, p = 0.079) and FSGS (1.378 ± 0.312, p < 0.0006)). Hsa-mir-193a exhibited significant dysregulation in DKD (1.017 ± 0.413, p < 0.029) but not in FSGS (4.18 ± 1.528, p = 0.058). Hsa-mir-196a and hsa-mir-200a showed upregulation in patient groups (hsa-mir-196a in DKD (1.278 ± 0.527, p = 0.074) and FSGS (2.47 ± 0.911, p < 0.0003); hsa-mir-200a in DKD (1.909 ± 0.825, p = 0.082) and FSGS (1.301 ± 0.358, p < 0.008)). Conclusion: Specific miRNAs, particularly miR-21, miR-30a, miR-196a, and miR-200a, might play a role in the pathogenesis of kidney diseases and could potentially serve as biomarkers to distinguish between FSGS and DKD patients. [ABSTRACT FROM AUTHOR]

Background: Patients with chronic diseases such as chronic kidney disease (CKD) have been reported to have more adverse outcomes during the coronavirus disease 2019 (COVID-19) pandemic. There are insuficient data on the outcomes of patients with primary glomerular diseases (PGD) afer COVID-19. Methods: We designed a national multicenter observational study that included adult patients with biopsy-proven PGD who survived COVID-19. A control group was created from the same centers, including PGD patients without COVID-19. The clinical and laboratory data of the patients at baseline, frst, and third months afer COVID-19 were recorded. Results: A total of 129 patients from 21 centers were included (COVID-19 group, n = 77). Baseline characteristics were almost similar except the ratio of active disease in the non-COVID-19 group was signifcantly higher than in the COVID-19 group. No patients died during the frst and third months. Respiratory symptoms were signifcantly higher in the COVID-19 group than in the non-COVID-19 group in the frst month (7.8% vs. 0%, P = .039). All other follow-up outcomes, including initiation of chronic kidney replacement therapy and initiation of new immunosuppressive treatment, and the laboratory data were not diferent between the groups in the frst and third months. Conclusion: Primary glomerular disease patients in the post-COVID-19 period had more respiratory symptoms than non-COVID-19 PGD patients, but outcomes, including death and initiation of kidney replacement therapy, were not diferent in the frst and third months post COVID-19. [ABSTRACT FROM AUTHOR]

Objective: The autosomal dominant polycystic kidney disease is the most common genetic cause of chronic kidney disease. In this context, it was aimed to investigate the demographical, clinical, and laboratory findings of, and the treatment methods implemented on, patients with autosomal dominant polycystic kidney disease, along with the factors that can be associated with kidney survival. Methods: Hospital records of autosomal dominant polycystic kidney disease patients, who were followed up by our nephrology clinic, were analyzed retrospectively. Demographical, clinical, and laboratory findings, treatments, and kidney survival of patients were recorded. Kidney survival of patients who were either lost to follow-up or followed by another center was learned through phone calls. Results: The data of 300 patients with a diagnosis of autosomal dominant polycystic kidney disease, 157 of whom were women and 143 men of whom were men, were analyzed within the scope of the study. Been diagnosed at a younger age, female gender, having a high estimated glomerular filtration rate at initial admission, and use of renin–angiotensin system blockers were determined to be significant in better kidney survival. Moreover, the use of renin–angiotensin system blockers was also determined to be significant for longer kidney survival in patients with less than 1 g/day proteinuria. Conclusion: It was concluded as a result of the study that early diagnosis and treatment management of autosomal dominant polycystic kidney disease patients are of paramount importance. Additionally, the results of the study suggest that the use of renin–angiotensin system blockers in hypertensive patients with autosomal dominant polycystic kidney disease may be a factor for better kidney survival. [ABSTRACT FROM AUTHOR]

Anemia is an important cause of morbidity and mortality in chronic kidney disease (CKD). Previous studies have shown the curative effects of altitude on anemia in hemodialysis (HD) and non-hemodialysis CKD. This study examined the effect of altitude on erythropoietin stimulating agent (ESA), İntravenous (IV) iron requirement in HD patients. This retrospective observational study was conducted between January and June 2023. The study group was divided into two groups according to altitude: HD patients living in Van Province (1,730 meters, 5,765 feet) in the high-altitude group (HAG) and HD patients living in Istanbul Province (sea level) in the low-altitude group (LAG). In addition to hemoglobin (Hgb) and ferritin levels, ESA and IV iron doses were recorded at monthly visits for six months. These values of the HAG and LAG were compared. A total of 184 patients were included in the study (HAG: 108 patients and LAG: 79 patients). HD patients living at high altitudes had statistically significantly higher Hgb and ferritin values compared to low altitudes (HAG: 11.5 g/dL, 749 pg/L vs. LAG: 11.3 g/dL; 543 pg/L; p=0.04, p< 0.001, respectively). In addition, ESA (HAG: 53 IU/kg/week, 12000 IU/month vs. LAG: 100.6 IU/kg/week, 24000 IU/month; p<0.001) and IV iron (HAG: 208.3±151 mg/month vs. LAG:364.9±300.8 mg/month; p=0.002) dose was significantly lower. HD patients living at high altitude needed lower doses of ESA and IV iron to reach higher Hgb values than patients living at lower altitude. [ABSTRACT FROM AUTHOR]

This article discusses the issue of medication nonadherence in kidney transplant recipients and its negative impact on graft survival. It emphasizes the importance of identifying and monitoring at-risk patients for nonadherence to immunosuppressive drugs. The article explores various risk factors for nonadherence and different methods for diagnosing and monitoring it. It also suggests interventions such as clinical pharmacist care and educational behavioral interventions to improve medication adherence. A study using the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS) found a relatively high rate of nonadherence, particularly in patients using tacrolimus. Early diagnosis and treatment, along with the involvement of clinical pharmacists, may help improve medication adherence and prevent graft dysfunction. [Extracted from the article]

Patient selection and preparation for kidney transplantation may pose clinical challenges. A 35-year-old male patient was presented with chest wall tumoral lesions on the day when he was matched with a deceased-donor kidney. Apart from the tumoral lesions, his medical, surgical, and immunologic evaluations were quite favorable to proceed with the operation. Pre-operative thorax surgery and orthopedics consultations were asked for cytopathological evaluation to rule out a possible malignancy. However, considering the cold ischemia time of the donated kidney, there was not enough time to plan and wait for the pathological evaluation of the biopsy. On chest tomography imaging, the expansile tumoral lesions had a lytic–cystic character with well-defined borders. High parathyroid hormone and alkaline phosphatase levels of the patient suggested Brown tumor the most likely diagnosis and we chose to proceed with the operation. Post-operative biopsy findings supported our clinical diagnosis. We herein share the role of clinical evaluation and imaging studies for differential diagnosis of tumoral lesions in kidney transplantation candidates. [ABSTRACT FROM AUTHOR]

Introduction: There are many differences between hemodialysis (HD) and peritoneal dialysis (PD) treatments, including their impact on the psychological status of the patients. In this study, our aim was to compare the psychological statuses of HD and PD patients during the social isolation period due to the COVID-19 pandemic. Methods: We conducted this cross-sectional study on adult HD and PD patients when the curfew measures were in effect. We used an electronic form composed of 3 sections to collect data. In the first section, we collected data on the demographics and clinical and laboratory parameters of the patients. The second and third sections consisted of the Hospital Anxiety and Depression Scale (HADS) and the Impact of Event Scale-Revised (IES-R) questionnaires, respectively. Results: The HD (n = 116) and PD (n = 130) groups were similar regarding age and sex, and they had similar HADS anxiety scores. HADS depression scores were higher in PD patients (p = 0.052). IES-R scores were significantly higher in PD patients in comparison to HD patients (p = 0.001). Frequencies of abnormal HADS-anxiety (p = 0.035) and severe psychological impact (p = 0.001) were significantly higher in PD patients. Discussion/Conclusion: During the social isolation period due to the COVID-19 pandemic, HD patients had better mood profiles than PD patients. A more stable daily routine, an uninterrupted face-to-face contact with health-care workers, and social support among patients in the in-center dialysis environment might be the cause of the favorable mood status. PD patients might need additional psychological support during those periods. [ABSTRACT FROM AUTHOR]