Diabetic nephropathy: diagnosis, prevention and treatment [Diyabetik nefropati: tani, onleme ve tedavisi]

Diabetic Nephropathy (DN) is a microvascular complication seen in both type 1 and 2 Diabetes Mellitus (DM) and worldwide incidince is increasing. Hemodynamic, metabolic and genetic factors are responsible take part in the pathogenesis. First finding is microalbuminuria (30-300 mg/day or 20-200 µ/min.). Screening for microalbuminuria should be performed once a year, starting 5 years after diagnosis in type 1 DM and at diagnosis in type 2 DM patients. Hyperglycemia, hypertension, smoking, high dietary protein, hyperlipidemia, sex, race, obesity and genetic tendency were identified as independent risk factors in the development and progression of DN. Good glycemic control (HbA1c < 7%), treating hypertension (< 130/80 mmHg or < 125/75 mmHg if proteinuria > 1.0 g/day), treating dyslipidemia (LDL cholesterol [Med-Science 2016; 5(4.000): 1068-73

Vitamin D and pro-inflammatory cytokine IFN-γ and the anti-inflammatory cytokines IL-4 and IL-10 in Peritoneal Dialysis Patients

Several clinical trials in patients with chronic disease have found that active vitamin D usage lowers pro-inflammatory cytokines. The aim of this study was evaluate whether supplementation of cholecalciferol in peritoneal dialysis patients with vitamin D deficiency would lead any chance in the pro-inflammatory cytokine IFN-γ and the anti-inflammatory cytokines IL-4 and IL-10, and pentraxin 3 and peripheral blood mononuclear cell subpopulations (CD3, CD4, CD8, CD45)and CD4/CD8 ratio. We analyzed fasting blood samples from 31 continuous peritoneal dialysis patients (14 males, 16 females, mean age 48,6±14,8 yrs) for serum 25-hydroxyvitamin D [25(OH)D)] and specific plasma cytokine concentrations (interferon-gamma [IFN-γ], interleukin [IL]-4, and IL-10), pentraxine 3, CD3, CD4, CD8 and CD45 before and after cholecalciferol replacement. Before and after cholecalciferol replacement mean 25 (OH) level was 6,1±2,1 ng/dL and 39,7±10,9 ng/dL respectively (p [Med-Science 2017; 6(3.000): 393-7

Extrapulmonary tuberculosis in ten hemodialysis patients: a single center experience

Tuberculosis (TB) infection is increasing all over the world especially among immunocompromised patients including end stage renal disease (ESRD) patients. Symptoms and signs are non-spesific and involvement is generally extra-pulmonary in ESRD patients. We presented ten ESRD patients with TB. Six of our cases presented with TB lymphadenitis, two with Potts disease, one with breast TB and one with lung TB and Wegeners granulomatosis. The diagnosis of TB is based on the finding of an acid fast bacilli-positive smear, positive culture of Mycobacterium tuberculosis, and typical histopathologic findings. Anti-TB therapy with isoniazid, rifampin, pyrazinamide and ethambutol combinations are generally successful. Non- spesific constitutional symptoms and unexplained deterioration of general health in ESRD patients should attract attention of clinicians about TB infections. [Med-Science 2016; 5(4.000): 1016-8

Etodolac induced acute interstitial nephritis and autoimmune hemolytic anemia

In spite of the widespread use of non-steroidal anti-inflammatory drugs (NSAIDs) such as etodolac, induction of drug-dependent antibodies that cause hemolytic anemia and acute tubulointerstitiel nephritis are rarely reported. Currently, there is no way of identifying individuals who are at risk to develop this kind of complications. In patients who present with acute immune hemolysis and acute renal failure, it is important that a careful history of medication be obtained, potential sensitizing medications be identified. In this article we describe a patient with acute autoimmune hemolytic anemia and acute renal failure related with etodolac. [Med-Science 2016; 5(4.000): 1030-2

Correlation between vitamin D status and Wechsler Adult Intelligence Scale's comprehension subtest in patient with end-stage renal diseases

WOS: 000379514000214

Investigation of cognitive functions with Wechsler Adult Intelligence Scale's comprehension subtest and Mini-Mental State Examination in patients with end-stage renal diseases

WOS: 000364786400232