The Frequency of Osteoporosis in Hemodialysis and Continuous Ambulatory Peritoneal Dialysis Patients According to PTH Levels after Active Vitamin D Therapy during the Two Years Period

Aim: Osteoporosis is a skeletal disorder that is characterized by low bone mass, micro-structuraldegeneration of bone and high risk of fracture. In this study our aim was to detect the frequencyof osteoporosis in hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD)patients according to Parathyroid Hormone (PTH) after vitamin D therapy during the two yearsperiod.Materials and method: 18 HD patients (12 male, 6 female) and 12 CAPD patients (8 male, 4female) undergoing to dialysis therapy in dialysis center of Medicine Faculty Hospital in DicleUniversity were enrolled to the study. The patients were evaluated with bone mineral densitywhich was measured by left heel quantitative ultrasound before and after the active vitamin Dtherapy. The blood samples were collected for biochemical analysis in the morning after 12hours fasting period before and after the active vitamin D therapy. Results: After the therapy T and Z scores bone mineral density and ALP values were increasedin the group that PTH values were between 120-250 pg/ml and more than 250 pg/ml. But theseparameters were decreased in the group that PTH were lower than 120 pg/ml. Osteoporosispercentage were 23 % in PTH value 250 pg/ml in the initial measurement. After the therapy these were 30 %, 0% and 20 % relatively.Conclusion: Before the treatment there was not a statistical difference between T score of 3groups. After the treatment there was a statistically significant difference. Especially T scorewas better after the therapy in the second group that PTH values were between 120-250 pg/ml

Immunosuppressive treatment results in patients with primary iga nephropathy in Türkiye: A nationwide study

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The frequency of osteoporosis in hemodialysis and continuous ambulatory peritoneal dialysis patients according to PTH levels after active vitamin D therapy during the two years period

Aim: Osteoporosis is a skeletal disorder that is characterized by low bone mass, micro-structural degeneration of bone and high risk of fracture. In this study our aim was to detect the frequency of osteoporosis in hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients according to Parathyroid Hormone (PTH) after vitamin D therapy during the two years period. Materials and method: 18 HD patients (12 male, 6 female) and 12 CAPD patients (8 male, 4 female) undergoing to dialysis therapy in dialysis center of Medicine Faculty Hospital in Dicle University were enrolled to the study. The patients were evaluated with bone mineral density which was measured by left heel quantitative ultrasound before and after the active vitamin D therapy. The blood samples were collected for biochemical analysis in the morning after 12 hours fasting period before and after the active vitamin D therapy. Results: After the therapy T and Z scores bone mineral density and ALP values were increased in the group that PTH values were between 120-250 pg/ml and more than 250 pg/ml. But these parameters were decreased in the group that PTH were lower than 120 pg/ml. Osteoporosis percentage were 23 % in PTH value 250 pg/ml in the initial measurement. After the therapy these were 30 %, 0 % and 20 % relatively. Conclusion: Before the treatment there was not a statistical difference between T score of 3 groups. After the treatment there was a statistically significant difference. Especially T score was better after the therapy in the second group that PTH values were between 120-250 pg/ml. © 2010 Düzce Medical Journal

Shear wave elastography findings in Immunoglobulin A Nephropathy patients: is it more specific and sensitive for interstitial fibrosis or interstitial fibrosis/tubular atrophy?

Background:Prediction of prognosis in Immunoglobulin A Nephropathy (IgAN) and taking appropriate precautions may reduce annual incidence of chronic kidney disease. This may be possible by close follow-up for the development and progression of interstitial fibrosis (IF) or interstitial fibrosis/tubular atrophy (IFTA) in IgAN patients. Aim:To investigate whether Young's elastic modulus (YM) which measured shear wave elastography (SWE) might be used for follow-up of IF or IFTA in IgAN patients. Methods:Prospective study was approved by Human Research Ethics Committee. Group 1 consisted of patients with IgAN. Group 2 consisted of healthy control participants. Young's elastic modulus which is a value of stiffness along with longitudinal stiffness was used to evaluate tissue elasticity. Specificity, sensitivity, positive predictive value (PPV) of YM for the presence of IF and IFTA were evaluated. Results:Group 1 consisted of 30 participants, and group 2 consisted of 32 participants. Sensitivity and specificity of SWE to diagnose presence of IF for YM > 15 kPa were 89% and 90%, respectively. PPV among the ones whom IF was diagnosed by YM >15 kPa was 91%. Sensitivity and specificity of SWE to diagnose presence of IFTA for YM > 15 were 65% and 51%, respectively. PPV among the ones whom IFTA was diagnosed by YM >15 kPa was 78.1%. Conclusions:YM which measured SWE is highly specific and sensitive in the diagnosis of IF, but not for IFTA in IgAN patients. Therefore, progression for IF in IgAN may be followed by SWE

Predicting the outcome of COVID-19 infection in kidney transplant recipients

BackgroundWe aimed to present the demographic characteristics, clinical presentation, and outcomes of our multicenter cohort of adult KTx recipients with COVID-19.MethodsWe conducted a multicenter, retrospective study using data of patients hospitalized for COVID-19 collected from 34 centers in Turkey. Demographic characteristics, clinical findings, laboratory parameters (hemogram, CRP, AST, ALT, LDH, and ferritin) at admission and follow-up, and treatment strategies were reviewed. Predictors of poor clinical outcomes were analyzed. The primary outcomes were in-hospital mortality and the need for ICU admission. The secondary outcome was composite in-hospital mortality and/or ICU admission.ResultsOne hundred nine patients (male/female: 63/46, mean age: 48.412.4years) were included in the study. Acute kidney injury (AKI) developed in 46 (42.2%) patients, and 4 (3.7%) of the patients required renal replacement therapy (RRT). A total of 22 (20.2%) patients were admitted in the ICU, and 19 (17.4%) patients required invasive mechanical ventilation. 14 (12.8%) of the patients died. Patients who were admitted in the ICU were significantly older (age over 60years) (38.1% vs 14.9%, p=0.016). 23 (21.1%) patients reached to composite outcome and these patients were significantly older (age over 60years) (39.1% vs. 13.9%; p=0.004), and had lower serum albumin (3.4g/dl [2.9-3.8] vs. 3.8g/dl [3.5-4.1], p=0.002), higher serum ferritin (679 mu g/L [184-2260] vs. 331 mu g/L [128-839], p=0.048), and lower lymphocyte counts (700/mu l [460-950] vs. 860 /mu l [545-1385], p=0.018). Multivariable analysis identified presence of ischemic heart disease and initial serum creatinine levels as independent risk factors for mortality, whereas age over 60years and initial serum creatinine levels were independently associated with ICU admission. On analysis for predicting secondary outcome, age above 60 and initial lymphocyte count were found to be independent variables in multivariable analysis.Conclusion Over the age of 60, ischemic heart disease, lymphopenia, poor graft function were independent risk factors for severe COVID-19 in this patient group. Whereas presence of ischemic heart disease and poor graft function were independently associated with mortality

COVID-19 Infection in Peritoneal Dialysis Patients: A Comparative Outcome Study with Patients on Hemodialysis and Patients without Kidney Disease

Objectives: There is limited data about coronavirus disease-19 (COVID-19) characteristics and results in peritoneal dialysis (PD) patients. This study aimed to investigate the characteristics and outcomes among PD patients and compare them with matched hemodialysis (HD) patients and a control group without kidney disease

Impact of hospital-acquired acute kidney injury on Covid-19 outcomes in patients with and without chronic kidney disease: a multicenter retrospective cohort study

Background/aim: Hospital-acquired acute kidney injury (HA-AKI) may commonly develop in Covid-19 patients and is expected to have higher mortality. There is little comparative data investigating the effect of HA-AKI on mortality of chronic kidney disease (CKD) patients and a control group of general population suffering from Covid-19. Materials and methods: HA-AKI development was assessed in a group of stage 3 & ndash;5 CKD patients and control group without CKD among adult patients hospitalized for Covid-19. The role of AKI development on the outcome (in-hospital mortality and admission to the intensive care unit [ICU]) of patients with and without CKD was compared. Results: Among 621 hospitalized patients (age 60 [IQR: 47 & ndash;73]), women: 44.1%), AKI developed in 32.5% of the patients, as stage 1 in 84.2%, stage 2 in 8.4%, and stage 3 in 7.4%. AKI developed in 48.0 % of CKD patients, whereas it developed in 17.6% of patients without CKD. CKD patients with HA-AKI had the highest mortality rate of 41.1% compared to 14.3% of patients with HA-AKI but no CKD (p < 0.001). However, patients with AKI+non-CKD had similar rates of ICU admission, mechanical ventilation, and death rate to patients with CKD without AKI. Adjusted mortality risks of the AKI+non-CKD group (HR: 9.0, 95% CI: 1.9 & ndash;44.2) and AKI+CKD group (HR: 7.9, 95% CI: 1.9 & ndash;33.3) were significantly higher than that of the non-AKI+non-CKD group. Conclusion: AKI frequently develops in hospitalized patients due to Covid-19 and is associated with high mortality. HA-AKI has worse outcomes whether it develops in patients with or without CKD, but the worst outcome was seen in AKI+CKD patients

Determinants of mortality in a large group of hemodialysis patients hospitalized for COVID-19

Background: Maintenance hemodialysis (MHD) patients are at increased risk for coronavirus disease 2019 (COVID-19). The aim of this study was to describe clinical, laboratory, and radiologic characteristics and determinants of mortality in a large group of MHD patients hospitalized for COVID-19