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Introduction. The aim was to evaluate the effect of therapeutic plasma exchange (TPE) and eculizumab on hematological and renal survival in atypical hemolytic uremic syndrome (aHUS), and additionally, to examine the reliability of discontinuation of eculizumab treatment.

Introduction: Patients on hemodialysis, especially with diabetes, face elevated cardiovascular events. A major contributor to complications associated with diabetes is advanced glycation end products (AGEs). Removing these compounds is challenging in traditional hemodialysis. Medium‐cut‐off (MCO) membranes potentially remove toxins without significant albumin loss. This study explored how MCO membranes impact AGEs levels in uncontrolled diabetic patients undergoing hemodialysis. Methods: Sixteen patients received MCO membrane dialysis, while others used high‐flux (HF) membranes. After 12 sessions, the dialyzers were switched, totaling 24 sessions. Blood samples at trial initiation (T0), session 12 (T1) and session 24 (T2) tested for CML, Pentosidine, laboratory parameters. Results: Switching dialyzers showed increased albumin with MCO‐to‐HF and decreased with HF‐to‐MCO, albeit nonsignificant (p = 0.5/p = 0.1). Patients on MCO had lower albumin levels than HF (p = 0.03/p = 0.6, respectively). Hemodialysis with MCO demonstrated lower levels of CML/Pentosidine compared to HF (p = 0.09/p = 0.9 for CML; p = 0.04/p = 0.3 for Pentosidine). Transitioning to HF led to elevated levels (p = 0.4/p = 0.09 for CML; p = 0.3/p = 0.07 for Pentosidine). Conclusion: MCO dialysis in diabetic individuals notably reduces AGE levels. [ABSTRACT FROM AUTHOR]

Introduction. IgA nephropathy (IgAN) is a heterogeneous disease with highly variable clinical and histopathological features. We investigated the effects of Oxford classification and clinical features on renal survival in patients with IgAN.

Introduction. More than 50% of glomerular crescent formation is required for a diagnosis of crescentic glomerulonephritis in a kidney biopsy. Although treatment protocols have been established for diffuse crescentic glomerulonephritis, there is no standard treatment for patients with fewer crescents in renal biopsies. In this study the importance of crescent percentage and clinical features on renal survival independent of underlying disease was investigated.

Background: Limited data in the literature is comparing early‐start peritoneal dialysis (PD), urgent‐start hemodialysis (HD) with the jugular central venous catheter (CVC), and conventional‐start PD. Methods: This retrospective study was conducted with 148 patients with early‐start PD, 104 patients with conventional‐start PD, and 100 patients with urgent‐start HD. Early‐start PD was defined as catheter break‐in time between 3 and 14 days. Results: The occurrence of dialysate‐leakage was similar between PD groups (p = 0.1). Bleeding at the catheter site was detected in 8 (2.3%) patients with CVC. There was no significant difference in catheter dysfunction and revision. PD groups had statistically similar peritonitis rates (p = 0.5). 19% (19/100) of patients suffered CVC‐related bloodstream infection and one patient died due to septic shock. Technique survival was significantly higher at early‐start PD than the conventional‐start PD at 6 months (p = 0.02). Conclusion: Initiating early‐start PD is comparable with conventional‐start PD, and it may be an alternative dialysis modality to avoid bloodstream infections in suitable patients. [ABSTRACT FROM AUTHOR]

Introduction: Of the most remarkable molecules associated with atherosclerosis and the cardiovascular outcome are S100A12 (10,379.5 Da) and soluble receptor for advanced glycation end products (sRAGE‐42,803 Da) in the hemodialysis (HD) population. We designed a study investigating the effects of the medium cut‐off (MCO) dialyzers focusing on S100A12 and sRAGE in HD patients compared with low‐flux and high‐flux dialyzers. Methods: This single‐site, prospective, observational study comprises age and sex‐matched HD groups (low‐flux, high‐flux, and MCO). Blood samples were drawn at baseline (predialysis and postdialysis) and the sixth month (predialysis). Results: Groups had similar demographic features and laboratory parameters. Baseline S100A12 levels of the groups were similar [34.3 (±66.5), 30.9 (±42.7), and 40.6 (±29.6); p = 0.13]. Compared to their baseline, the sixth‐month S100A12 levels were constant in low‐flux and high‐flux group and significantly lower in MCO group (p = 0.16, p = 0.33, and p = 0.004). Baseline sRAGE levels of the groups were similar at baseline [2.8 (±0.8), 2.7 (±0.6), and 2.6 (±0.7); p = 0.65], and the sixth‐month [2.9 (±0.5), 2.4 (±0.7), and 2.4 (±0.8); p = 0.24]. sRAGE levels remained constant in all groups [p = 0.84, p = 0.13, and p = 0.39]. S100A12/sRAGE ratio at baseline and sixth month was constant in low‐flux [22.3 (±63.7) and 18.1 (±24.8); p = 0.17] and high‐flux groups [11.9 (±15.3) and 13.1 (±5.8); p = 0.26], the ratio decreased significantly in MCO group [16.5 (±11.6) to 7.8 (±5.5); p = 0.03]. Conclusion: Our study suggests that prolonged use of MCO dialyzers is associated with better S100A12 and sRAGE levels. Long‐term studies with larger samples are needed to understand the effects of a better S100A12‐sRAGE profile provided by MCO dialyzers on HD patients' cardiovascular outcomes. [ABSTRACT FROM AUTHOR]

Background: Increasing peritoneal permeability with ultrafiltration and solute removal inadequacy is a challenging issue in peritoneal dialysis (PD). Decreasing permeability is less frequent but also results in diminished solute clearance. We evaluated the association between longitudinal high‐sensitive C‐reactive protein (hs‐CRP) values and the change in transport characteristics of the peritoneal membrane in PD patients. Methods: This is a retrospective, single‐center study of incident PD patients. An increase or decrease in peritoneal transport status is defined as two or more categories of a rise or decline in the peritoneal equilibration test (PET) from their baseline during follow‐up. The 4‐h dialysate/plasma creatinine ratio was used to classify transport characteristics. Hs‐CRP values were obtained from the routine annual examinations of the patients. Results: Baseline demographics, residual kidney function, frequency of high glucose‐containing dialysate, and icodextrin use were similar between the groups. Total episodes of peritonitis within the first 5 years of follow‐up were higher in stable transporters than in increased and decreased transporters (p = 0.009). Stable transporters' mean hs‐CRP values did not change within 5 years (Wilks' λ = 0.873, F (2.317, 180.740) = 2.210, p = 0.10). Increased and decreased transporters' hs‐CRP values significantly raised over the years (Wilks' λ = 0.422, F (1.979, 77.163) = 3.405, p = 0.04 and Wilks' λ = 0.558, F (3.673, 66.107) = 4.396, p = 0.001, respectively). Conclusions: Our study shows that the peritoneal membrane may change into different characteristics in many patients over time, despite very low peritonitis frequencies and similar baseline characteristics that may be significantly affected by systemic inflammation. [ABSTRACT FROM AUTHOR]

We evaluated the symptoms, changes in laboratory findings during the novel coronavirus disease (COVID‐19) pandemic, and the effect of depression in patients with peritoneal dialysis (PD). This is an observational and cross‐sectional study. All patients were asked to fill the clinical assessment form and Beck depression and anxiety inventory. Also, the last two laboratory evaluations during this period were examined. A total of 123 patients performing PD were included. None of the patients were diagnosed with COVID‐19. In the total study population, parathyroid hormone (PTH), serum albumin, phosphorus and ferritin levels significantly elevated at the end of 97 ± 31 days. PTH and phosphorus levels remained stable in remote monitoring automated PD (RM‐APD) group (p = 0.4 and p = 0.5), they tended to increase in continuous ambulatory PD group and significantly increased in automated PD group (p = 0.09 and p = 0.01 for PTH and p = 0.06 and p = 0.001 for phosphorus, respectively). Moderate to severe depression was associated with dyspnoea, weight gain more than 5 kg, fatigue, palpitation and increased anxiety. PD is a reliable and successful form of dialysis and can be safely administered even if hospital access is restricted. Also, RM‐APD may be a better choice because of providing more stable bone‐mineral metabolism. Moreover, evaluating depression and anxiety is essential for the accurate clinical assessment. [ABSTRACT FROM AUTHOR]

Objective: Glomerular diseases can result from many inherited or acquired disorders and could lead to chronic kidney disease. Glomerular disease frequency varies between countries. Glomerular diseases have a dynamic structure and may change over years. According to the data in Turkey, the most common glomerulonephritis is membranous nephropathy. But last published data belongs to 2014. The aim of this study is to determine the frequency of kidney biopsy proven glomerulonephritis (GN) in Turkey Methods: Retrospective observational study was conducted in Gazi University. We evaluated 1273 native kidney biopsies from 2008 to 2017. Renal disease were divided into five major categories: primary GN, secondary GN, tubulointerstitial nephropathies (TIN), vascular nephropathies (VN) and acute tubular necrosis (ATN). Results: 756 (59.4%) patients had primary GN, 353 (27.7%) patients had secondary GN, 101 (7.9%) patients had TIN, 32 (2.5%) patients had VN and 31 (2.4%) patients had ATN. While, the most frequent pathological diagnosis was focal segmental glomerulosclerosis (FSGS) (31.35%), followed by membranous GN (27.65%) in primary glomerulonephritis, amyloidosis (27.2%) was the most frequent pathological diagnosis followed by systemic lupus erythematosus (SLE) (20.68%) in secondary glomerulonephritis. FSGS is the most common kidney pathology until 50 years old (18-30 years old, 22% and 31-50 years old, 20%). Membranous glomerulonephritis (MGN) is the most common kidney pathology after the ages 50 years old (50-64 years old, 20% and >65 years old, 17%). Conclusion: FSGS is the most common primary GN in Turkish population and the frequency is gradually increasing. [ABSTRACT FROM AUTHOR]

Phosphate binder pill (PBP) burden is a significant problem in dialysis patients. Phosphate absorption through the paracellular pathway increases in relatively acidic pH. In this study, we evaluated the effect of factors contributing to duodenal pH—Helicobacter pylori (HP), proton pump inhibitors (PPIs), and NaHCO3 capsules—on PBP burden. We evaluated 255 dialysis patients with gastric biopsies and excluded patients with low Kt/V, gastrectomy, and parathyroidectomy. Patients were divided into groups and subgroups regarding HP existence, use of PPI, or NaHCO3 capsules. HP+ group had significantly higher PBP burden and PBP equivalent doses (P < 0.001; both). HP+ subgroup not using daily PPIs or NaHCO3 capsules had the highest PBP burden and PBP equivalent doses (P < 0.001; both). HP− subgroups had similar PBP and PBP equivalent doses (P = 0.446 and P = 0.382; respectively). HP colonization might affect the PBP burden in dialysis patients due to a decrease of duodenal pH. [ABSTRACT FROM AUTHOR]