AA Amiloidozlu Hastalarda Serum FGF-23 Düzeyi Subklinik Aterosklerozun Göstergesi midir?

Objective: Amyloid A (AA) amyloidosis is the most prevalent form of systemic amyloidosis, and is a serious condition characterized by protein-misfolding. Cardiovascular involvement is known to be a significant manifestation of the disease and common carotid artery intima-media thickness (CIMT) assessment is one of the well-recognized tools for identification of subclinical atherosclerosis. It was reported that FGF-23 may be a significant factor associated with atherosclerosis development in patients with AA amyloidosis, as well as being an independent risk factor for increased CIMT. In this study, we aimed to investigate whether elevated FGF-23 levels might be associated with CIMT levels in AA amyloidosis patients. Method: We studied 63 patients with AA amyloidosis and 29 aged-matched healthy controls. All subjects’ demographic data were recorded and the following parameters were measured: erythrocyte sedimentation rate, C-reactive protein, creatinine, urea, albumin, calcium, phosphate, parathyroid hormone, FGF-23, eGFR, CIMT, blood pressure and BMI. Results: CIMT levels were significantly higher in AA amyloidosis patients compared to the control group (p<0.001). However, serum FGF-23 levels were similar (p=0.110). CIMT was correlated with patient age (r=0.471, p<0.001), but serum FGF-23 was not associated with CIMT in patients with amyloidosis (r=0.031, p=0.807). Conclusion: Although our results suggest a lack of association between FGF-23 levels and CIMT in patients with AA amyloidosis.Amaç: Amiloidoz proteinlerin anormal katlantı oluşturması ile karekterize hayatı tehdit eden bir hastalıktır, Amyloid-associated (AA) amiloidoz sistemik amiloidozun en yaygın formudur. Kardiyovasküler tutulum amiloidozun en önemli klinik tezahürüdür ve karotis intima media kalınlığının ölçümü (KIMK) subklinik aterosklerozu tespit etmek için iyi tanımlanmış yöntemlerden birisidir. FGF-23 AA amiloidozda KIMK’dan bağımsız olarak subklinik ateroskleroz ile ilişkili olabileceği bildirilmiştir. Bu çalışmada amacımız, AA amiloidozlu hastalarda KIMK ile yükselmiş serum FGF-23 ile ilişkisinin olup olmadığına bakmaktı. Yöntem: Çalışmaya 63 AA amiloidozlu hasta ve 29 sağlıklı kontrol dahil ettik. Tüm olguların demografik verileri, eritrosit sedimantasyon hızı, Crp, kreatinin, üre, albumin, kalsiyum, fosfat, parathormon, FGF-23, eGFR, KIMK, kan basıncı ve vücut kitle indeksleri kayıt edildi. Bulgular: Karotis intima media kalınlığı AA amiloidozlu hastalarda kontrol grubuna göre anlamlı derecede fazlaydı (p<0.001). Bununla birlikte serum FGF-23 seviyesi iki grup arasında farklı değildi (p =0.110). KIMK yaş ile köreleydi (r=0.471, p<0.001), fakat serum FGF-23 seviyesi amiloidozlu hastalarda KIMK ile körele değildi (r=0.031, p=0.807). Sonuç: Bizim çalışmamızda, AA amiloidozlu hastalarda KIMK ile Serum FGF-23 seviyesi arasında bir korelasyon tespit edilememiştir

The longitudinal evolution of post-COVID-19 outcomes among hemodialysis patients in Turkey

Introduction: Hemodialysis (HD) patients have increased risk for short-term adverse outcomes of COVID-19. However, complications and survival at the post-COVID-19 period have not been published extensively.Methods: We conducted a national, multicenter observational study that included adult maintenance HD patients recovered from confirmed COVID-19. A control HD group without COVID-19 was selected from patients in the same center. We investigated the characteristics and outcomes in the follow-up of HD patients and compare them with the non-COVID-19 group.Results: A total of 1223 patients (635 patients in COVID-19 group, 588 patients in non-COVID-19 group) from 47 centers were included in the study. The patients' baseline and HD characteristics were almost similar. The 28th-day mortality and mortality between 28th day and 90th day were higher in the COVID-19 group than non-COVID-19 group (19 [3.0%] patients vs. none [0%]; 15 [2.4%] patients vs. 4 [0.7%] patients, respectively). The presence of respiratory symptoms, rehospitalization, need for home oxygen therapy, lower respiratory tract infection, and arteriovenous (AV) fistula thrombosis was significantly higher in the COVID-19 group in both the first 28 days and between 28 and 90 days. In the multivariable analysis, age (odds ratio [OR] [95% CI]: 1.029 [1.004-1.056]), group (COVID-19 group vs. non-COVID-19 group) (OR [95% CI]: 7.258 [2.538-20.751]), and vascular access type (tunneled catheter/AV fistula) (OR [95% CI]: 2.512 [1.249-5.051]) were found as independent parameters related to 90-day mortality.Conclusion: In the post-COVID-19 period, maintenance HD patients who have had COVID-19 have increased rehospitalization, respiratory problems, vascular access problems, and high mortality compared with the non-COVID-19 HD patients

The relationship between severity of interstitial fibrosis and anemia in patient with primary glomerulonephritis: The data from TSN-Gold working group

...ERA EDT