A Rare Cause of Drug-Induced Skin Rash and Eosinophilia

Allopurinol is a well-known drug to treat hyperuricemia in patients with chronic kidney disease, gout, or tumor lysis syndrome. The most common side effects are nausea, vomiting, elevated liver enzyme, pancreatitis, and skin rashes. Drug reaction with eosinophilic and systemic symptoms (DRESS) syndrome is a rare but life-threating complication of allopurinol treatment. Here, we present a 60-year-old male patient admitted with skin rashes, stomatitis, dyspnea, jaundice, elevated liver enzymes, acute renal failure, and eosinophilia, who was diagnosed with allopurinol-related DRESS syndrome

Outcomes of renal transplants from spousal donors: 25 years of experience at our center

Objectives: Many transplantation teams have attempted renal transplants from living unrelated kidney donors, as well as from cadaveric and living related kidney donors. In this study, we evaluated the results for renal transplants from spousal donors at our center

Does pregnancy increase graft loss in female renal allograft recipients?

Although many transplanted women who were previously infertile can conceive during the posttransplant period, maternal and fetal complications are likely. We evaluated the effect of pregnancy after renal transplantation in this study

Lower serum prohepcidin levels associated with lower iron and erythropoietin requirements in hemodialysis patients with chronic hepatitis C

Background: Patients with chronic HCV infection have increased liver iron. Recently identified protein hepcidin synthesized in the liver, is thought to be a key regulator for iron homeostasis and is induced by infection and inflammation. Lower erythropoietin and iron supplementation requirements were previously reported in HD patients with HCV infection. We investigated the association of prohepcidin with inflammation and iron parameters in HD patients with and without chronic HCV infection

BK Virus Nephropathy in Renal Transplant Recipients: A Single Centre Experience

Introduction: BK virus nephropathy is an important cause of allograft failure in renal transplant recipients that is linked to highly potent immunosuppressive theraphy. We aimed to exhibit experience of our centre with BK virus nephropathy

Reduction of uric acid levels with allopurinol treatment improves endothelial function in patients with chronic kidney disease

Background: Endothelial dysfunction (ED) is a key event in the development of atherosclerotic cardiovascular disease (CVD) in patients with chronic kidney disease (CKD). Association of hyperuricemia with CVD has been previously reported in the non-uremic population. In this prospective study, we aimed to evaluate the effects of treatment of hyperuricemia with allopurinol on ED and changes in the serum reactive oxygen species in patients with CKD. Methods: In this study, 19 (13 male) hyperuricemic (UA > 7 mg/dl) nondiabetic CKD patients without any comorbidity, aged < 60 years with creatinine clearance (CrCl) between 20 and 60 ml/min were evaluated. Endothelial functions were assessed by ischemia-induced forearm vasodilatation method (EDD). Oxidative stress was evaluated by measuring the serum oxidized LDL (ox-LDL), advanced oxidation protein products (AOPP) and nitrotyrosine (NT) levels. After measuring all these tests at baseline, allopurinol therapy was commenced for 8 weeks. After 8 weeks of allopurinol treatment, all measurements were repeated. Then, allopurinol treatment was ceased and same measurements were also repeated 8 weeks after ceasing of the treatment. Results: Serum creatinine, total cholesterol, albumin, hs-CRP, CrCl and proteinuria levels of the patients were similar among three study periods. After allopurinol therapy, the mean serum UA and NT levels significantly reduced as compared to baseline. At the 8th week after cessation of allopurinol treatment, serum UA levels were significantly increased. After allopurinol therapy, EDD value increased from 5.42 +/- 8.3% at baseline to 11.37 +/- 9% (p < 0.001). At the 8th week after ceasing allopurinol treatment, EDD returned to baseline values (5.96 +/- 8%, p < 0.001). Conclusion: Treatment of hyperuricemia with allopurinol improve ED in patients with CKD. However, mechanism responsible for this beneficial effect seems to be apart from antioxidant effects of allopurinol

Treatment and Outcome of Idiopathic Focal Segmental Glomerulosclerosis: Immunosuppressive Agents or Renin Angiotensin System Inhibitors

OBJECTIVE: We compared the efficacy and safety of 12 months of three different treatment regimens

A Case of Focal Segmental Glomerulosclerosis Accompanied By Truncus Arteriosus: Effectiveness of Angiotensin Receptor Antagonist and Cyclosporine A

Although glomerular injury has been recognized as a prominent complication of cyanotic congenital heart disease (CCHD), the nephrotic syndrome is rarely observed. A 23-year-old male with CCHD presented with edema in the eyelids and ankles since three months. He was cyanotic at birth and was diagnosed as having persistent truncus arteriosus and atrial septal defect. On admission, blood pressure was 130/90 mmHg and heart rate 76/minute. Laboratory findings revealed 5 g/day proteinuria, hemoglobin 17.1 g/dL, hematocrit 55.5%, serum creatinine 1.8 mg/dL, total protein 4.1 g/dL, serum albumin 2.2 g/dL and hypoxemia. Renal biopsy was performed and showed global sclerosis and focal segmental glomerulosclerosis (FSGS). Phlebotomy was performed and prednisolone 1 mg/kg/day and losartan 100 mg/day were started. After three months, cyclosporine A (CsA) (5 mg/kg/ day) was added to the treatment with a proteinuria level of 5.9 g/day. On the eight month of treatment proteinuria was reduced to 1.9 g/day with a serum creatinine level of 1.5 mg/dL, and albumin 3 g/dL. In this rare case, partial remission which was achieved by CsA and angiotensin receptor antagonist showed the important role of glomerular hyperfiltration in the development of CCHD-associated FSGS. When the secondary FSGS causes were ruled out, CCHD should be kept in mind and echocardiographic assessment should be performed