Relationship of salusin-alpha and salusin-beta levels with atherosclerosis in patients undergoing haemodialysis

CONCLUSION Patients undergoing haemodialysis have higher Sal-beta and Sal-alpha levels, and their higher Sal-beta/Sal-alpha ratio, in comparison with healthy controls, might have cardiovascular risk implications

Hemodiyaliz Hastalarında COVID-19 Toraks Bilgisayarlı Tomografi Bulgularının Değerlendirilmesi

Aim: Coronavirus disease 2019 (COVID-19) is an unprecedented cause of pandemics affecting all segments of society. It is not known whether hemodialysis patients form a different patient group in terms of susceptibility to COVID-19 infection or severe disease. In this study, thorax computed tomography (CT) findings were evaluated in hemodialysis patients diagnosed with COVID-19 infection during the pandemic period. Material and Methods: CT findings of 32 hemodialysis patients diagnosed with COVID-19 with real-time polymerase chain reaction or thorax CT examination were evaluated retrospectively. Radiological findings were classified as ground glass, consolidation, mixed type involvement (ground glass and consolidation), crazy paving appearance, interlobular septal thickening, nodule, halo-reverse halo finding, air bronchogram finding, subpleural curvilinear opacities and tree-in-bud views. Results: A total of 32 patients were included in the study. Twenty-one (65.6%) of the patients were male and 11 (34.4%) were female. The mean age was 67.5±8.5 years. All patients had chronic kidney failure. Thorax CT examination revealed ground-glass opacities in 14 (43.8%) patients, consolidation in 3 (9.4%) patients, and mixed type involvement (ground-glass opacities and consolidation) in 15 (46.9%) patients. The accompanying CT findings were pleural effusion in 23 (71.9%) patients, subpleural curvilinear opacities in 13 (40.6%) patients, bronchial wall thickening in 11 (34.4%) patients, lymphadenopathy in 7 (21.9%) patients, bronchiectasis in 4 (12.5%) patients and pleural thickening in 4 (12.5%) patients. Conclusion: When hemodialysis patients are infected with COVID-19 infection, they differ significantly from other COVID-19 patients in terms of symptoms, clinical course, and prognosis, as well as imaging findings.Amaç: Koronavirüs hastalığı 2019 (coronavirus disease 2019, COVID-19) toplumun her kesimini etkileyen benzeri görülmemiş bir pandemi sebebidir. Hemodiyaliz hastalarının, COVID-19 enfeksiyonuna ya da şiddetli hastalığa yatkınlık açısından farklı bir hasta grubunu oluşturup oluşturmadıkları bilinmemektedir. Bu çalışmada pandemi döneminde COVID-19 enfeksiyonu tanısı alan hemodiyaliz hastalarında toraks bilgisayarlı tomografi (BT) bulguları değerlendirilmiştir. Gereç ve Yöntemler: Gerçek zamanlı polimeraz zincir reaksiyonu veya toraks BT incelemesi ile COVID-19 tanısı konulan 32 hemodiyaliz hastasının BT bulguları geriye dönük olarak değerlendirildi. Radyolojik bulgular; buzlu cam, konsolidasyon, karışık tip tutulum (buzlu cam ve konsolidasyon), kaldırım taşı görünümü, interlobüler septal kalınlaşma, nodül, halo-ters halo bulgusu, hava bronkogram bulgusu, subplevral kürvilineer opasiteler ve tomurcuklanmış ağaç görünümleri olarak sınıflandırıldı. Bulgular: Çalışmaya toplam 32 hasta dahil edildi. Hastaların 21’i (%65,6) erkek, 11’i (%34,4) kadındı. Yaş ortalaması 67,5±8,5 yıl idi. Tüm hastalarda kronik böbrek yetmezliği mevcuttu. Toraks BT incelemesinde hastaların 14'ünde (%43,8) buzlu cam görünümü, 3'ünde (%9,4) konsolidasyon ve 15'inde (%46,9) karışık tip tutulum (buzlu cam görünümü ve konsolidasyon) görüldü. Eşlik eden BT bulguları 23 (%71,9) hastada plevral effüzyon, 13 (%40,6) hastada subplevral kürvilineer opasiteler, 11 (%34,4) hastada bronşiol duvar kalınlaşması, 7 (%21,9) hastada lenfadenopati, 4 (%12,5) hastada bronşektazi ve 4 (%12,5) hastada plevral kalınlaşma idi. Sonuç: Hemodiyaliz hastaları COVID-19 enfeksiyonuna yakalandıklarında semptom, klinik seyir ve prognostik açıdan olduğu gibi görüntüleme bulguları açısından da diğer COVID-19 hastalarından önemli farklılıklar göstermektedir

Atherosclerosis in geriatric patients known to be healthy

Background: The aim of the present study is to determine the presence of atherosclerosis in geriatric patients who are known to be healthy and examine sociodemographic and laboratory parameters affecting the presence of atherosclerosis.Method: 90 healthy volunteers including 66(73.3%) non-geriatric ones and 24(26.7%) geriatric ones were included in the study. It was analyzed whether there was a correlation between the two groups in terms of the parameters of gender, age average, alcohol consumption, smoking, carotid intima-media thickness (CA-IMT), and pulse wave velocity (PWV). Sociodemographic and laboratory parameters of the volunteers with and without atherosclerosis in the geriatric group were examined. Results: Among geriatric volunteers (Group 1), 13(54.2%) were male; whereas, among non-geriatric volunteers (Group 2), 41(62.1%) were male. CA-IMT was determined to be higher in Group 1 (averagely 0.80±0.12 mm) than Group 2 (averagely 0.62±0.14 mm) (p:<0.001). PWV was significantly higher in Group 1 (averagely 10.32±1.44 m/s) than Group 2 (6.26±1.09 m/s) (p:<0.001). After PWV or CA-IMT examination, atherosclerosis findings were determined in 12 healthy geriatric volunteers (50%) in Group 1.Conclusion: It should be remembered that even though atherosclerosis can be frequently observed in geriatric individuals who are known to be healthy, it may also go unnoticed. Determination of atherosclerosis with noninvasive methods will be helpful in preventing complications that might be caused by atherosclerosis.

Periton ve hemodiyaliz hastalarında kardiak aritmiler ve kalp hızı değişkenliği

Bu çalısmada Holter-EKG monitörizasyonu kullanılarak benzer yas, cinsiyet, diyabet ve diyaliz süresine sahip hemodiyaliz (HD) ve periton diyaliz (PD) hastalarını kardiyak aritmi varlıgı ve kalp hızı degiskenligi açısından karsılastırmayı amaçladık. HD hasta grubunda ventriküler erken vuruları PD hasta grubuna göre anlamlı olarak daha sıktı. Kalp hızı degiskenligi parametreleri ise HD grubunda daha belirgin daha düsük saptandı. Ekokardiyografik olarak HD hastaların sol atrium çapı ve sol ventrikül kitle indeksi PD grubuna göre daha yüksekti. Çoklu analizlerde; yas ve HD tedavisi altında olmak ventriküler erken vuruların belirleyicileri olarak saptandı. SDNN belirleyicisi olarak PD yaklasımı olarak degerlendirildi. Bu sonuçlar ısıgında periton diyalizi yaklasımı günlük ve aralıklı yapılıyor olması üremik hastalardaki otonom disfonksiyonu iyilestirmede HD yaklasımına göre daha etkindir. HD hastalarındaki otonom disfonksiyonunu düzeltmek, dolayısıyla gelecekteki kardiyovasküler mortaliteyi azaltmak amacıyla hemodiyaliz seansının süresini uzatmakla mümkün olabilir

Early Switch to Mammalian Target of Rapamycin Inhibitors Is a Sustainable Treatment Approach in Renal Transplant Recipients: 7-Year Results

Conclusion. Switching to m-TORi in the early posttransplant period is a safe and sustainable treatment approach

Acute Phosphate Nephropathy

Oral sodium phosphate (OSP) is frequently used in colonoscopy preparation for both cost and ease of use. Acute renal failure may occur due to these OSP-and sodium phosphate-containing enemas used in colonoscopy preparation. A 55-year-old female patient with type 2 diabetes mellitus and essential hypertension, known for 5 years, and normal renal function tests, underwent colonoscopy. For colonoscopy preparation, she used two OSP containing purgatives and sodium phosphate containing enema. The patient presented to the emergency service with a complaint of being unable to urinate 1 day after colonoscopy. Renal biopsy was performed and acute phosphate nephropathy was reported. Chronic renal failure is a contraindication to the use of OSP. Old age, female sex, electrolyte imbalance and inappropriate use of OSP increase the acute phosphate nephropathy risk. Acute phosphate nephropathy should be kept in mind in patients who undergo colonoscopy, use OSP for the preparation, and present with impaired renal function

Acute Phosphate Nephropathy

Oral sodium phosphate (OSP) is frequently used in colonoscopy preparation for both cost and ease of use. Acute renal failure may occur due to these OSP-and sodium phosphate-containing enemas used in colonoscopy preparation. A 55-year-old female patient with type 2 diabetes mellitus and essential hypertension, known for 5 years, and normal renal function tests, underwent colonoscopy. For colonoscopy preparation, she used two OSP containing purgatives and sodium phosphate containing enema. The patient presented to the emergency service with a complaint of being unable to urinate 1 day after colonoscopy. Renal biopsy was performed and acute phosphate nephropathy was reported. Chronic renal failure is a contraindication to the use of OSP. Old age, female sex, electrolyte imbalance and inappropriate use of OSP increase the acute phosphate nephropathy risk. Acute phosphate nephropathy should be kept in mind in patients who undergo colonoscopy, use OSP for the preparation, and present with impaired renal function