Volume status and arterial blood pressures are associated with arterial stiffness in hemodialysis patients

Background: Arterial stiffness is a strong predictor of mortality in hemodialysis patients. In this study, we aimed to investigate possible relations of arterial stiffness with volume status determined by bioimpedance analysis and aortic blood pressure parameters. Also, effects of a single hemodialysis session on these parameters were studied

Immunosuppressive Agents in the Treatment of Membranoproliferative Glomerulonephritis

INTRODUCTION: Treatment of membranoproliferative glomerulonephritis (MPGN) is often unrewarding with approximately 60% of patients progressing to end-stage renal failure within 10 years. In our study, we compared the efficacy of CS alone versus low dose CS + another immunosuppressive agent retrospectively. MATERIAL an

Otozomal dominant polikistik böbrek hastalığında ürogenital kistlerin semen parametreleri üzerine etkisi var mı ?

WOS: 000374928100006OBJECTIVE: Autosomal dominant polycystic kidney disease (ADPKD) is a systemic disease with cysts in many organs including the urogenital tract. The aim of the study was to evaluate the relationship between urogenital cysts, semen pathologies and infertility in ADPKD. MATERIAL and METHODS: Male ADPKD patients aged 18-60 with creatinine clearance years higher than 60 ml/min were included. All patients had magnetic resonance imaging of the urinary system and pelvis, scrotal Doppler ultrasonography and sperm analysis. The results were compared with those of a healthy control group. RESULTS: 27 patients and 17 volunteers were included. Seminal vesicle and prostate cysts were detected in four (15%) and six (22%) patients, respectively. Five of the 23 married patients (21%) had infertility and this rate was higher than in the control group (p=0.044). The ratio of sperms with normal morphology and progressive motility was lower, and the rate of hypospermia, oligozoospermia, azospermia, asthenozoospermia and teratozoospermia were higher in the patient group. There was no significant difference between patients with/without urogenital cysts regarding seminal pathologies. CONCLUSION: Seminal abnormalities and infertility are more frequent in patients with ADPKD. Defects in spermatogenesis and sperm motility may be related to urogenital cysts as well as ciliary pathologies. There is a need for further studies evaluating the role of urogenital cysts in semen pathologies.AMAÇ: Otozomal dominant polikistik böbrek hastalığı (ODPBH) ürogenital sistemle birlikte birçok organda kist oluşumuna neden olabilen sistemik bir hastalıktır. Çalışmada, ODPBH olan bireylerde ürogenital kistler ile semen patolojileri ve infertilite ilişkisi değerlendirilmiştir. GEREÇ ve YÖNTEMLER: Çalışmaya 18-60 yaşları arasında, kreatinin klirensi 60 ml/dakika/1.73 m2’nin üzerinde, ODPBH olan erkekler dahil edildi. Tüm hastalara üriner sistem ve pelvik manyetik rezonans(MR) inceleme, skrotal Doppler ultrasonografi ve semen analizi yapıldı. Sonuçlar sağlıklı kontrol grubu ile karşılaştırıldı. BULGULAR: Yirmiyedi hasta ve 17 gönüllü çalışmaya dahil edildi. Seminal vezikül kisti 4(%15), prostat kisti 6 (%22) hastada tespit edildi. Kontrol grubundan daha sık olarak, evli olan 23 hastanın 5’inde (%21) infertilite mevcuttu (p=0.044). Normal morfolojili sperm oranları ve ileri motilite daha düşük, hipospermi, oligozoospermi, azospermi, asthenozoospermi ve teratozoospermi oranları hasta grubunda daha yüksekti. Ürogenital kisti olan/olmayan hastalarda semen patolojileri açısından anlamlı fark yoktu. SONUÇ: Seminal anormallikler ve infertilite ODPBH olanlarda daha sıktır. Spermatogenez ve sperm motilite defektleri siliar patolojiler gibi urogenital kistlerle ilişkili olabilir. Ürogenital kistlerin semen patolojilerindeki rolünü değerlendirmek için ileri çalışmalara ihtiyaç vardır

Influence of conversion from calcineurin inhibitors to everolimus on fibrosis, inflammation, tubular damage and vascular function in renal transplant patients

Conversion from calcineurin inhibitor (CNI) to mTOR inhibitors may reduce and even halt the progression of chronic allograft dysfunction (CAD) which is the most important cause of renal allograft loss. We aimed to investigate the effects of conversion from CNI to everolimus on parameters of fibrosis, inflammation, glomerulotubular damage and vascular functions in renal transplant recipients

HCV POZİTİF RENAL TRANSPLANT HASTALARINDA POSTTRANSPLANT DİYABET GELİŞİMİ RİSKİ ARTMIŞ MIDIR?

HCV POZİTİF RENAL TRANSPLANT HASTALRINDAPOSTTRANSPLANT DİYABET GELİŞİMİ RİSKİ ARTMIŞ MIDIR?Abdullah Şumnu1, Erol Demir2, Ozan Yeğit3, .mmü Korkmaz3, Yaşar Çalışkan2, Nadir Alpay4,Halil Yazıcı2, Aydın Türkmen21İstanbul Medipol Üniversitesi, Nefroloji2İstanbul Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Nefroloji Bilim Dalı3İstanbul Tıp Fakültesi, İç Hastalıkları Anabilim Dalı4Kırklareli Devlet Hastanesi, NefrolojiGiriş: Artan kanıtlar HCV enfeksiyonunun posttransplant diyabet gelişimi ileilişkisini g.stermektedir. Biz de kendi merkez verilerimiz üzerinden bu ilişkiyiaraştırdık.Yöntem: İ.T.F. Nefroloji Bilim Dalı Transplantasyon Polikliniği tarafından takipedilen ve pretransplant d.nemde diyabeti olmayan toplam 289 hastanın (95HCV, 194 non-HCV) dosyaları retrospektif olarak taranarak posttransplantdiyabet gelişimi a.ısından değerlendirildi. Veriler SPSS 20.0 istatistik veritabanına aktarıldı.Sonuçlar: Hastaların yaş ortalaması 44.3Å}11.3; %41’i kadın %59’u erkek idi.Ortalama takip süresi 119Å}73 ay iken, kalsin.rin inhibit.rü (KNİ) kullanımsüresi ise 102Å}67 ay idi. HCV ve non-HCV grupları arasında yaş, cinsiyet, don.r(canlı, kadavra), b.brek yetersizliği etyolojisi, KNİ kulanma yüzdesi (iki gruptada yaklaşık %95) a.ısından fark yok iken HCV hastalarının takip süresi (163’ekarşı 97 ay) ve dolayısıyla KNİ kullanım ayı (132’ye karşı 89 ay) non-HCVhastalara g.re daha yüksekti. Bununla birlikte non-HCV grubunda takrolimuskullanım oranı HCV grubuna g.re anlamlı olarak daha yüksekti (%55’e karşı%13). Posttransplant diyabet gelişim oranı HCV grubunda %12 (12 hasta) ikennon-HCV grubunda ise %3.5 (7 hasta) bulundu (p = 0.005).Tartışma: Her ne kadar takip süresi anlamlı olarak daha fazla olsa da,posttransplant diyabet gelişim riski siklosporine g.re daha fazla olan takrolimuskullanım yüzdesinin belirgin olarak daha düşük olduğu HCV grubunda diyabetgelişiminin anlamlı olarak daha fazla bulunması literatür ile uyumlu olarak HCVenfeksiyonun diyabet gelişimindeki muhtemel rolünü desteklemektedir

Cardiac Biomarkers and Noninvasive Predictors of Atherosclerosis in Chronic Peritoneal Dialysis Patients

Background: We investigated the relationship among serum cardiac biomarkers including N-terminal pro-brain natriuretic peptide (NT-pro-BNP), cardiac troponin T (cTnT), uric acid and high-sensitive C-reactive protein (hs-CRP) and noninvasive predictors of atherosclerosis including carotid intima-media thickness (IMT), aortic stiffness (pulse wave velocity (PWV)) and transthoracic coronary flow reserve (CFR) in peritoneal dialysis (PD) patients. Methods: 37 PD patients were included in the study. We measured (1) carotid IMT, (2) PWV and augmentation index (Alx), and (3) CFR. Simultaneous measurements of serum NT-pro-BNP, cTnT, uric acid and hs-CRP were also performed. Associations among these variables were analyzed. Results: cTnT was significantly associated with carotid IMT (r = 0.747, p = 0.01 ng/ml) significantly had higher carotid IMT and PWV values. Only the aortic PWV significantly correlated with residual renal function (r = -0.574, p = 0.004). Conclusions: Serum cTnT appeared to be a useful clinical biomarker for evaluating noninvasive predictors of atherosclerosis in chronic PD patients. Arterial stiffness as determined by PWV is also correlated with residual renal function. Copyright (c) 2012 S. Karger AG, Base

Immunological parameters associated with the severity of COVID-19 pneumonia in kidney transplant recipients

Purpose An outbreak of a novel respiratory disease due to coronavirus species was emerged in 2019 and named as Coronavirus Disease-2019 (COVID-19). Clinical and immunological factors affecting the course of COVID-19 in kidney transplant recipients (KTR) are not well-known. Methods In this prospective observational study, we presented 20 KTR with COVID-19 pnemonia and examined the factors predicting the severity of COVID-19. A total of 10 KTR without COVID-19 was used as control group. Lymphocyte subsets were determined by flow cytometry. In 13/20 patients, immunophenotyping was repeated 1 week later. Results Mean age of the patients was 50 +/- 9 years. Patients were classified as mild-moderate (oxygen saturation: SO2 > 90%) and severe disease groups (SO2 <= 90%). Serum albumin and hemoglobin were lower and CRP, fibrinogen and peak d-dimer were higher in severe group. Peak CRP was inversely associated with nadir SO2 (r = - 0.68, p = 0.001). Neutrophil/lymphocyte ratio was higher in severe group (p = 0.01). CD3 + and CD4 + cells were lower and NK cell percentage (CD16 + 56 +) was higher in severe group. Percentage of spontaneously activated CD8 cells (CD8 + CD69 +) was higher in severe group. In comparison of KTR with and without COVID-19, CD8 + cells were lower but NK cell percentage was higher in KTR with COVID-19. Conclusion In this pilot study, increased NK cells, activated CD8 + cells and decreased CD3 + and CD4 + cells were associated with severity of COVID-19 in KTR. Peripheral immunophenotyping of lymphocyte subtypes may provide prognostic information about the clinical course of COVID-19 in KTR