The relationship between uric acid levels and graft function in renal transplant patients who discontinued steroid therapy.

Introduction: High uric acid levels are commonly encountered in kidney transplant recipients, and can be associated with allograft dysfunction. Our study aims to examine the relationship between UA levels and graft function in patients discontinuing steroids.Methods: In this single-center-retrospective study, 56 patients discontinued steroid therapy from among 678 RT patients transplanted from living donors between 1999-2020 were included. The mean age of the study group was 45.8 +/- 8.8 years. Causes of steroid discontinuation, creatinine levels concurrent with uric acid levels before and after steroid discontinuation (mean 3.9 +/- 2.1 years), acute rejection numbers, demographics, durations of dialysis and transplantation, medications, laboratory data, human leukocyte antigen (HLA) mismatch numbers, blood-pressure (BP), body mass index, delayed acute rejection (DAR) numbers (3 months post-transplantation) were all recorded.Results: Creatinine and uric acid levels were seen to have increased after steroid discontinuation, there was a significant relationship between them (p0.001). Statistically significant correlation was found between increased creatinine levels after steroid discontinuation and graft survival with higher HLA mismatch; 39 (69.6%) patients with mismatch >= 2, and 17 patients with mismatch 2 (30.4%) (p=0.049) . No significant relationship was found between DAR numbers before and after steroid discontinuation, and creatinine levels after steroid discontinuation.Conclusion: Per model obtained as a result of multivariate linear analysis, hyperuricemia and HLA mismatch numbers (p= 0.048 and p= 0.044, respectively) are independent predictive factors for graft dysfunction in patients discontinuing steroids. Accordingly, negative effects of modeling should be kept in mind for long-term graft survival in patients who plan to continue with steroid-sparing regimens

New-onset type II diabetes mellitus, hyperosmolar non-ketotic coma, rhabdomyolysis and acute renal failure in a patient treated with sulpiride [5]

PubMed ID: 15735255[No abstract available

The role of neutrophil gelatinase-associated lipocalin (NGAL) in the determination of contrast-induced nephropathy in patients undergoing coronary angiography

OBJECTIVE: Contrast-induced nephropathy (CIN) is the acute kidney injury developing following the administration of contrast agent after all other reasons are excluded. We aimed to determine the role of NGAL in the urine for early diagnosis of contrast-induced nephropathy, as the disorder is an important reason of acute renal failure in cases subject to cardiac catheterization clinical practice, and the frequency is increasing.MATERIAL and METHODS: One hundred cases undergoing elective coronary angiography between the dates of January 1st 2011 and March 1st 2011 were included in the study. Urine samples of the patients were taken maximum 4 hours after the coronary angiography to check the urinary NGAL level.RESULTS: The creatinine level had increased 25% in 8 patients at the 48th hour following angiography and this was accepted as CIN. Using a cutoff value of 100 ng/ml, urinary NGAL levels were found to elevated in these 8 patients, consisting of 6 females and 2 males. All them had hypertension (HT) by itself or with other accompanying diseases.CONCLUSION: The CIN diagnosis can be made with the conventional method of measuring the level of creatinine in the blood 48 hours after surgery but using the urinary NGAL method can fasten the diagnosis and treatment and also can shorten hospital stays

dialysis: a multicenter study

Objectives: Fabry's disease is an X-linked inherited, rare, progressive, lysosomal storage disorder, affecting multiple organs due to the deficient activity of a-galactosidase A (alpha-Gal A) enzyme. The prevalence has been reported to be 0.15-1% in hemodialysis patients; however, the information on the prevalence in chronic kidney disease not on dialysis is lacking. This study aimed to determine the prevalence of Fabry's disease in chronic kidney disease.Methods: The patients older than 18 years, enclosing KDIGO 2012 chronic kidney disease definitions, not on dialysis, were enrolled. Dried blood spots on Guthrie papers were used to analyze alpha-Gal A enzyme and genetic analysis was performed in individuals with enzyme activity <= 1.2 lmol/L/h.Results: A total of 1453 chronic kidney disease patients not on dialysis from seven clinics in Turkey were screened. The mean age of the study population was 59.3 +/- 15.9 years. 45.6% of patients were female. The creatinine clearance of 77.3% of patients was below 60 mL/min/ 1.73 m(2), 8.4% had proteinuria, and 2.5% had isolated microscopic hematuria. The mean value of patients' alpha-Gal A enzyme was detected as 2.93 +/- 1.92 mu mol/L/h. 152 patients had low levels of alpha-Gal A enzyme activity (<= 1.2 mu mol/L/h). In mutation analysis, A143T and D313Y variants were disclosed in three male patients. The prevalence of Fabry's disease in chronic kidney disease not on dialysis was found to be 0.2% (0.4% in male, 0.0% in female).Conclusion: Fabry's disease should be considered in the differential diagnosis of chronic kidney disease with unknown etiology even in the absence of symptoms and signs suggestive of Fabry's disease