Anti-phospholipase A2 Receptor Antibody Measurement in Patients with Idiopathic Membranous Nephropathy Diagnosed by Renal Biopsy

Objective: Our study is a cross-sectional study that aims to evaluate the presence and levels of anti-phospholipase A2 receptor (PLA2R) antibodies in healthy volunteers and idiopathic membranous nephropathy (IMN) patients and to assess the relationship between these levels and clinical parameters. Methods: Serum anti-PLA2R antibody levels, complete blood count, urea, creatinine (Kre), total protein,albumin, low-density lipoprotein (LDL)-cholesterol, triglycerides (TG), high-density lipoprotein (HDL)-cholesterol, total cholesterol, C-reactive protein (crp), sedimentation, proteinuria were measured from 71 IMN patients and 48 healthy volunteers. Results: Of the values compared between the two groups, the urea, creatinine, and modified diet renal disease (MDRD) were similar, total protein, albumin, LDL-cholesterol, TG, total cholesterol, HDL-cholesterol, and complete urinalysis protein values were statistically significantly high in the patient group, as expected in nephrotic syndrome (p\u3c0.01). The anti-PLA2Rantibody levels measured using enzyme-linked immunosorbent assay (ELISA) in patient and control groups were found to be negative. The anti-PLA2R level was found to be 0.104 (0.093-0.129) ng/ml in the IMN group, while it was 0.141 (0.117-0.177) ng/ml in the control group (P=0,001). Although the P value was significant, the anti-PLA2R antibody level was found to be high in the control group and was outside the reference range of the kit. Conclusion: There is a need to conduct more sensitive studies with a higher number of patients in order to distinguish between primary and secondary nature and to investigate the presence of anti-PLA2R in IMNpatients, which constitute the majority of nephrotic syndromes in adults. Antibody titer levels were observed to be low and it was revealed that the measurement range of the antibody kit used in the study should be more sensitive

Bilateral Renal Mass-Renal Disorder: Tuberculosis

A 30-year-old woman has presented complaining of weakness and fatigue to her primary care physician. The renal sonography is a routine step in the evaluation of new onset renal failure. When the renal masses have been discovered by sonography in this setting, the functional imaging may be critical. We reported a case about bilateral renal masses in a young female patient with tuberculosis and renal insufficiency. Magnetic resonance (MR) has revealed the bilateral renal masses in patient, and this patient has been referred to our hospital for further management. The patient’s past medical and surgical history was unremarkable

Urinary angiotensinogen level is correlated with blood pressure level and proteinuria in patients with masked hypertension

Urinary angiotensinogen (UAGT) level is an index of the intrarenal-renin angiotensin system status and is significantly correlated with blood pressure (BP) and proteinuria in patients with hypertension (HT). We aimed to investigate the possible relationship between UAGT levels and albuminuria in masked hypertensives. A total of 96 nondiabetic treated hypertensive patients were included in this study. The patients were divided into two groups: masked hypertensives (office BP <140/90 mmHg and ambulatory BP ≥130/80 mmHg) and controlled hypertensives (office BP <140/90 mmHg and ambulatory BP <130/80). The mean UAGT/UCre level and urinary albumin–creatinine ratio (UACR) of masked hypertensives were higher than those of controlled hypertensives (7.76 μg/g vs 4.02 μg/g, p < 0.001 and 174.21 mg/g vs 77.74 mg/g, p < 0.001, respectively). A significant positive correlation was found between UAGT/UCre levels and ambulatory systolic BP and diastolic BP levels in patients with masked HT, but this was not found with office SBP or DBP levels. Importantly, UAGT/UCre levels showed a significant positive correlation with UACR in both groups, but correlation of the UAGT levels with UACR was more pronounced in masked hypertensives (r = 0.854, p < 0.001 vsr = 0.512, p < 0.01). As a result, UAGT level was increased in patients with masked HT, which was associated with an elevation in albuminuria. Overproduction of the UAGT may play a pivotal role in development of proteinuria

Can we predict patients that will not benefit from invasive mechanical ventilation? A novel scoring system in intensive care: the IMV mortality prediction score (IMPRES)

KUCUK, Ahmet Oguzhan/0000-0002-6993-0519; Kirakli, Cenk/0000-0001-6013-7330; KUCUK, Mehtap PEHLIVANLAR/0000-0003-2247-4074; Aksoy, Iskender/0000-0002-4426-3342WOS: 000504051300010PubMed: 31655511Background/aim: The present study aimed to define the clinical and laboratory criteria for predicting patients that will not benefit from invasive mechanical ventilation (IMV) treatment and determine the prediction of mortality and prognosis of these critical ill patients. Materials and methods: The study was designed as an observational, multicenter, prospective, and cross-sectional clinical study. It was conducted by 75 researchers at 41 centers in intensive care units (ICUs) located in various geographical areas of Turkey. It included a total of 1463 ICU patients who were receiving invasive mechanical ventilation (IMV) treatment. A total of 158 parameters were examined via logistic regression analysis to identify independent risk factors for mortality; using these data, the IMV Mortality Prediction Score (IMPRES) scoring system was developed. Results: The following cut-off scores were used to indicate mortality risk: 8, very high risk. There was a 26.8% mortality rate among the 254 patients who had a total IMPRES score of lower than 2. The mortality rate was 93.3% for patients with total 1M PRES scores of greater than 8 (P < 0.001). Conclusion: The present study included a large number of patients from various geographical areas of the country who were admitted to various types of ICUs, had diverse diagnoses and comorbidities, were intubated with various indications in either urgent or elective settings, and were followed by physicians from various specialties. Therefore, our data are more general and can be applied to a broader population. This study devised a new scoring system for decision-making for critically ill patients as to whether they need to be intubated or not and presents a rapid and accurate prediction of mortality and prognosis prior to ICU admission using simple clinical data