Efficacy of adalimumab therapy in experimental rat sclerosing encapsulated peritonitis model

Aim To investigate the efficacy of adalimumab treatment in an experimental rat sclerosing encapsulated peritonitis (SEP) model. Methods The study involved 40 Wistar albino rats divided into four groups: chlorhexidine (CH) group, control group, CH + adalimumab group, and CH + resting group. The control group received normal saline intraperitoneally (i.p.). Other groups received 0.1% CH gluconate, 15% ethanol, and normal saline mixture i.p. for three weeks in order to induce SEP. CH + adalimumab group received 5 mg/kg adalimumab i.p. at the beginning of week 4 and week 6, while CH + resting group was followed-up for three weeks without applying any procedure after the onset of SEP. Rats in groups CH and control group were sacrificed on day 21, and rats in group CH + adalimumab and CH + resting were sacrificed on day 42. All groups were evaluated for peritoneal thickness, inflammation, vascularization, and fibrosis. Results CH + adalimumab group showed a significant decrease in peritoneal thickness, fibrosis score, and vascular score compared with CH group and CH + resting group. Conclusion Adalimumab can prevent SEP development

Comparison of serum corrected and ionized calcium levels in patients with acute kidney injury

Introduction: Acute kidney injury (AKI) is common in hospitalized patients (1.92%). The effect of serum corrected and ionized calcium levels in predicting emergency hemodialysis in patients with AKI is unknown. In this study, we aimed to compare serum corrected and ionized calcium levels in patients who were diagnosed with AKI in the emergency service.Methods: Our study was planned retrospectively. Group 1: Patients with AKI who underwent at least one session of emergency hemodialysis. Group 2: The patients with AKIN stage 1-3 who did not undergo hemodialysis. Serum corrected and ionized calcium, creatinine and albumin values of the patients at the time of admission were analyzed. All data of the study were recorded by SPSS 19.0. For statistical significance, p lt;0.050 was accepted.Results: The mean serum corrected calcium levels were lower in group 1 than in group 2, and the difference was statistically significant (p lt;0.001). The mean ionized calcium levels in blood gas were lower in group 1 than in group 2, and the difference was statistically significant (p = 0.002).Conclusions: Serum corrected, and ionized calcium levels can be useful in predicting emergency hemodialysis in patients with AKI

Suttonella indologenes peritonitis in a patient receiving continuous ambulatory peritoneal dialysis

Suttonella indologenes is a Gram-negative, aerobic coccobacillus of Cardiobacteriaceae family and its natural habitat is the mucous membranes of the upper respiratory system. The literature includes limited number of case reports concerning fatal endocarditis due to infection in the prosthetic heart valves caused by the aforementioned microorganism. However, there is no information on extracardiac involvement due to this microorganism. Here, we present a peritonitis case caused by Suttonella indologenes in a patient receiving continuous ambulatory peritoneal dialysis

Comparison of serum corrected and ionized calcium levels in patients with acute kidney injury

Introduction: Acute kidney injury (AKI) is common in hospitalized patients (1.92%). The effect of serum corrected and ionized calcium levels in predicting emergency hemodialysis in patients with AKI is unknown. In this study, we aimed to compare serum corrected and ionized calcium levels in patients who were diagnosed with AKI in the emergency service.Methods: Our study was planned retrospectively. Group 1: Patients with AKI who underwent at least one session of emergency hemodialysis. Group 2: The patients with AKIN stage 1-3 who did not undergo hemodialysis. Serum corrected and ionized calcium, creatinine and albumin values of the patients at the time of admission were analyzed. All data of the study were recorded by SPSS 19.0. For statistical significance, p lt;0.050 was accepted.Results: The mean serum corrected calcium levels were lower in group 1 than in group 2, and the difference was statistically significant (p lt;0.001). The mean ionized calcium levels in blood gas were lower in group 1 than in group 2, and the difference was statistically significant (p = 0.002).Conclusions: Serum corrected, and ionized calcium levels can be useful in predicting emergency hemodialysis in patients with AKI

CHARACTERISTICS AND SURVIVAL RESULTS OF PERITONEAL DIALYSIS PATIENTS SUFFERING FROM COVID-19 IN TURKEY: A MULTICENTER NATIONAL STUDY

INTRODUCTION: We aimed to study the characteristics of peritoneal dialysis (PD) patients with coronavirus disease-19 (COVID-19), determine the short-term mortality and other medical complications, and delineate the factors associated with COVID-19 outcome. METHODS: In this multicenter national study, we included PD patients with confirmed COVID-19 from 27 centers. The baseline demographic, clinical, laboratory, and radiological data and outcomes at the end of the first month were recorded. RESULTS: We enrolled 142 COVID-19 patients (median age: 52 years). 58.2% of patients had mild disease at diagnosis. Lung involvement was detected in 60.8% of patients. Eighty-three (58.4%) patients were hospitalized, 31 (21.8%) patients were admitted to intensive care unit and 24 needed mechanical ventilation. Fifteen (10.5%) patients were switched to hemodialysis and hemodiafiltration was performed for four (2.8%) patients. Persisting pulmonary symptoms (n = 27), lower respiratory system infection (n = 12), rehospitalization for any reason (n = 24), malnutrition (n = 6), hypervolemia (n = 13), peritonitis (n = 7), ultrafiltration failure (n = 7), and in PD modality change (n = 8) were reported in survivors. Twenty-six patients (18.31%) died in the first month of diagnosis. The non-survivor group was older, comorbidities were more prevalent. Fever, dyspnea, cough, serious-vital disease at presentation, bilateral pulmonary involvement, and pleural effusion were more frequent among non-survivors. Age (OR: 1.102; 95% CI: 1.032–1.117; p: 0.004), moderate-severe clinical disease at presentation (OR: 26.825; 95% CI: 4.578–157.172; p < 0.001), and baseline CRP (OR: 1.008; 95% CI; 1,000–1.016; p: 0.040) were associated with first-month mortality in multivariate analysis. DISCUSSION/CONCLUSIONS: Early mortality rate and medical complications are quite high in PD patients with COVID-19. Age, clinical severity of COVID-19, and baseline CRP level are the independent parameters associated with mortality

Pregnancy and its outcomes in hemodialysis patients in Turkey

Background/aim: This study aimed to investigate pregnancy frequency and evaluate the factors affecting live births in hemodialysis (HD) patients. Materials and methods: Female HD patients whose pregnancy was retrospectively reported between January 1, 2014, and December 31, 2019. The duration of HD, primary disease, and the information on whether the pregnancy resulted in abortion, stillbirth, or live birth, whether the HD duration was prolonged after diagnosing the pregnancy and whether it accompanied preeclampsia were recorded. Results: In this study, we reached 9038 HD female patients' data in the study. A total of 235 pregnancies were detected in 145 patients. The mean age was 35.42 (35 +/- 7.4) years. The mean age at first gestation was 30.8 +/- 6.5 years. The average birth week was 32 (28 -36) weeks. A total of 53.8% (no = 78) of the patients had live birth, 51.7% (no = 70) had at least one abortion in the first 20 weeks, and 13.1% (no = 19) had at least one stillbirth after 20 weeks. The rate of patients' increased numbers of dialysis sessions during pregnancy was 71.7%. The abortion rate was 22.4% in those with increased HD sessions, whereas 79.3% in those not increased HD sessions (p < 0.001). Live birth frequency was 67.2% in the increased HD sessions group and 3.4% in those who did not differ in HD sessions (p < 0.001). Conclusion: For the first time, we reported pregnancy outcomes in HD female patients, covering all regions of Turkey. It has been observed that; increasing the number of HD sessions in dialysis patients will decrease fetal and maternal complications and increase live birth rates

Mortality analysis of COVID-19 infection in chronic kidney disease, haemodialysis and renal transplant patients compared with patients without kidney disease: A nationwide analysis from Turkey

© The Author(s) 2020.Background. Chronic kidney disease (CKD) and immunosuppression, such as in renal transplantation (RT), stand as one of the established potential risk factors for severe coronavirus disease 2019 (COVID-19). Case morbidity and mortality rates for any type of infection have always been much higher in CKD, haemodialysis (HD) and RT patients than in the general population. A large study comparing COVID-19 outcome in moderate to advanced CKD (Stages 3-5), HD and RT patients with a control group of patients is still lacking. Methods. We conducted a multicentre, retrospective, observational study, involving hospitalized adult patients with COVID-19 from 47 centres in Turkey. Patients with CKD Stages 3-5, chronic HD and RT were compared with patients who had COVID-19 but no kidney disease. Demographics, comorbidities, medications, laboratory tests, COVID-19 treatments and outcome [in-hospital mortality and combined in-hospital outcome mortality or admission to the intensive care unit (ICU)] were compared. Results. A total of 1210 patients were included [median age, 61 (quartile 1-quartile 3 48-71) years, female 551 (45.5%)] composed of four groups: Control (n = 450), HD (n = 390), RT (n = 81) and CKD (n = 289). The ICU admission rate was 266/ 1210 (22.0%). A total of 172/1210 (14.2%) patients died. The ICU admission and in-hospital mortality rates in the CKD group [114/289 (39.4%); 95% confidence interval (CI) 33.9-45.2; and 82/289 (28.4%); 95% CI 23.9-34.5)] were significantly higher than the other groups: HD = 99/390 (25.4%; 95% CI 21.3-29.9; P<0.001) and 63/390 (16.2%; 95% CI 13.0-20.4; P<0.001); RT = 17/81 (21.0%; 95% CI 13.2-30.8; P = 0.002) and 9/81 (11.1%; 95% CI 5.7-19.5; P = 0.001); and control = 36/450 (8.0%; 95% CI 5.8-10.8; P<0.001) and 18/450 (4%; 95% CI 2.5-6.2; P<0.001). Adjusted mortality and adjusted combined outcomes in CKD group and HD groups were significantly higher than the control group [hazard ratio (HR) (95% CI) CKD: 2.88 (1.52- 5.44); P = 0.001; 2.44 (1.35-4.40); P = 0.003; HD: 2.32 (1.21- 4.46); P = 0.011; 2.25 (1.23-4.12); P = 0.008), respectively], but these were not significantly different in the RT from in the control group [HR (95% CI) 1.89 (0.76-4.72); P = 0.169; 1.87 (0.81-4.28); P = 0.138, respectively]. Conclusions. Hospitalized COVID-19 patients with CKDs, including Stages 3-5 CKD, HD and RT, have significantly higher mortality than patients without kidney disease. Stages 3-5 CKD patients have an in-hospital mortality rate as much as HD patients, which may be in part because of similar age and comorbidity burden. We were unable to assess if RT patients were or were not at increased risk for in-hospital mortality because of the relatively small sample size of the RT patients in this study