Evaluation of the Relationship Between Diabetic Nephropathy, Hemogram Parameters, and Uric Asid

Aim:Inflammation plays an important role in the development of diabetic nephropathy (DNP). In our study, we aimed to analyze the relationship between the mean platelet volume (MPV), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), uric acidlymphocyte ratio (UALR), and uric acid level with early diagnosis of DNP and DNP progression.Methods:Our cross-sectional study, which is a type of observational study, included patients diagnosed with type 2 diabetes mellitus and followed in the internal medicine and nephrology clinics of our hospital. Patients were divided into four groups: Group 1: estimated glomerular filtration rate (eGFR) >60 mL/min/1.73 m2 and albuminuria 60 mL/min/1.73 m2 and albuminuria: 30-300 mcg/day; Group 3: eGFR >60 mL/min/1.73 m2 and albuminuria >300 mcg/day; and Group 4: eGFR 300 mcg/day. Thirty-six patients were included in group 1, 38 patients in group 2, 35 patients in group 3, and 40 patients in group 4. Mean platelet volume, NLR, PLR, UALR, and uric acid levels were compared among the groups.Results:A total of 149 patients were included in the study; 57.7% were female, and the mean age was 55.2±9.2 years. Significant differences were found among the groups in terms of MPV, PLR, NLR, and UALR (p<0.001, p=0.023, p≤0.001, p<0.001, respectively). There was a negative correlation between eGFR and MPV (r=-0.218, p=0.008). While there was no relationship between eGFR and platelet values, a relationship was obtained when platelets were compared with lymphocytes (r=-0.263, p=0.002). There was a weak relationship between eGFR and neutrophil levels (r=-0.188, p=0.026), but a stronger relationship was found when neutrophil and lymphocyte values were rationed (r=-0.414, p<0.001).Conclusion:Mean platelet volume, PLR, NLR, UALR, and uric acid levels, especially MPV, can be used in the development and progression of DNP

Bilateral Ischemic Optic Neuropathy Developed under Interferon Therapy

Introduction. Interferon is a glycoprotein produced by assigned cells of immune system. It has been used in many different diseases. Although flu-like syndrome, myalgia, rash, hypotension, thrombocytopenia and peripheral neuropathy due to interferon use are encountered frequently, ocular side effects are rare, generally mild and transient. Case Report. 47-year-old female patient, presented with a mass lesion in right renal pelvis. Right radical nephrectomy was applied and the histopathological examination was consistent with papillary renal cell carcinoma. Interferon alpha treatment was started subcutaneously at the dose of 5 MIU/3 times in a week. Four weeks after the interferon therapy, suddenly bilateral visual loss developed. We discussed the diagnosis, followup, and treatment of the patient who developed irreversible ischemic optic neuropathy and had no previous known primary systemic disease to cause this condition. Conclusion. We suggest that patients should be screened for risk factors causing optic ischemic neuropathy, before interferon therapy. Although there was no adequate information in the literature for the followup, patients should be monitorized before, 1 month after, and 2 months after the treatment. And if there is no complication, we suggest that they should be followed up at 3-month intervals

Bilateral Ischemic Optic Neuropathy Developed under Interferon Therapy

Introduction. Interferon is a glycoprotein produced by assigned cells of immune system. It has been used in many different diseases. Although flu-like syndrome, myalgia, rash, hypotension, thrombocytopenia and peripheral neuropathy due to interferon use are encountered frequently, ocular side effects are rare, generally mild and transient. Case Report. 47-year-old female patient, presented with a mass lesion in right renal pelvis. Right radical nephrectomy was applied and the histopathological examination was consistent with papillary renal cell carcinoma. Interferon alpha treatment was started subcutaneously at the dose of 5 MIU/3 times in a week. Four weeks after the interferon therapy, suddenly bilateral visual loss developed. We discussed the diagnosis, followup, and treatment of the patient who developed irreversible ischemic optic neuropathy and had no previous known primary systemic disease to cause this condition. Conclusion. We suggest that patients should be screened for risk factors causing optic ischemic neuropathy, before interferon therapy. Although there was no adequate information in the literature for the followup, patients should be monitorized before, 1 month after, and 2 months after the treatment. And if there is no complication, we suggest that they should be followed up at 3-month intervals

Case Report of a Patient with Goodpasture's Syndrome Who Relapsed While on Hemodialysis

Goodpasture's syndrome is a rare autoimmune disease in which anti-glomerular basement membrane antibodies damage the glomerular and alveolar basement membrane. Its relapse is very rare, compared to other pulmonary-renal syndromes. Herein, we present an unusual case of Goodpasture's syndrome, which recurred despite immunosuppressive treatment. After the initial treatment with corticosteroid and cyclophosphamide pulses, plasmapheresis, alveolar hemorrhage ended, and the anti-glomerular basement membrane antibody finding became negative, but hemodialysis had to be continued. After 8 months of hemodialysis, anti-glomerular basement membrane antibodies were re-detected, and hemoptysis occurred a month later. Then, plasmapheresis, intravenous immunoglobulin, and methylprednisone were given in addition to azathioprine treatment; however, the serum anti-glomerular basement membrane antibody positivity persisted

Inflammation, Left Ventricular Mass Index and Chronic Renal Failure in Diabetic Patients

Aim: The aim of this study was to determine the relationship between left ventricular hypertrophy (LVH) and inflammatory markers in patients with type 2 Diabetes Mellitus (T2DM) with diabetic nephropathy at different stages

Podocyte Injury in Autosomal Dominant Polycystic Kidney Disease

Background/Aims: Autosomal dominant polycystic kidney disease (ADPKD) is a tubulointerstitial disease. Different degrees of glomerular affection in ADPKD may affect the further course of disease in which it may hypothetically be secondary to the result of glomerular involvement causing podocyte injury. Our aim was to compare urinary excretion of podocin and podocalyxin, which are biomarkers of podocyte injury, and to assess their relationship with proteinuria and renal function in ADPKD. Methods: Fifty-six patients with ADPKD and 28 volunteers were enrolled to study. Podocin, podocalyxin protein levels, and proteinuria were measured in urine. Patients were categorized based on their estimated glomerular filtration rate (eGFR). Results: Patients with ADPKD had higher podocin and podocalyxin levels compared to the control group. The levels of podocin and podocalyxin were higher in ADPKD patients both with eGFR >= 60 mL/min/1.73 m(2) and with eGFR = 60 mL/min/1.73 m(2). Podocin and podocalyxin were negatively correlated with eGFR and positively correlated with urine protein to creatinine ratio in ADPKD patients. Conclusion: Urine biomarkers of podocytes injury were significantly higher in ADPKD patients even in the early stage of the disease than in the control group. It should be clarified whether these biomarkers can provide new prognostic parameters for disease surveillance