Hemodiyaliz hastalarında okült viral B Hepatit sıklığı ve Hepatit C enfeksiyonunun okült viral B Hepatit sıklığı üzerine etkisi

Hepatit B virüs (HBV) enfeksiyonu hemodiyaliz hastalarında önemli bir sorun olmaya devam etmektedir. Bu duruma okült HBV enfeksiyonunun katkısı olduğu düşünülmektedir. Bu çalışmada amaç; hemodiyaliz hastalarında okült HBV enfeksiyonun sıklığını saptamak ve Hepatit C enfeksiyonun (HCV) okült HBV enfeksiyonu sıklığına katkısının olup olmadığını saptamaktır. Çalışmaya hepatit B yüzey antijeni (HBsAg) negatif 138 adet hemodiyaliz hastası alındı. Bu hastaların 84?ü serum anti HCV pozitif ve 54?ü negatifti. Hastaların %15.2?inde (21/138) serum HBV DNA pozitif olarak tespit edildi. HCV enfeksiyonu olan hemodiyaliz hastalarının 12?inde (%14.2) ve HCV enfeksiyonu olmayan hemodiyaliz hastalarının 9?unda (%16.6) serum HBV DNA pozitif saptandı. Okült HBV enfeksiyonu saptanan hemodiyaliz hastaları ile saptanmayan hastaların yaş, cinsiyet, hemodiyaliz süreleri, serum AST-ALT düzeyleri ve HBV serolojileri bakımından bir farklılık saptanmadı (p>0.05). Sonuç olarak, bizim çalışmamıza göre hemodiyaliz hastalarında HCV enfeksiyonu varlığı okült HBV enfeksiyonu için bir risk faktörü değildir. Hepatitis B (HBV) infections continue to occur in adult hemodialyis units. Occult HBV infection (serum hepatitis B surface antigen (HBsAg) negative but HBV DNA positive) may be a contributory factor in these patients. This study was designed to investigate (1) the prevalence and clinical impact of occult HBV infection in hemodialysis patients (2) to compare the prevalence of occult HBV infection between HCV positive and HCV negative hemodialysis patients. We included 138 patients who were on chronic hemodialysis. Eighty four patients were serum anti HCV positive and fifty four patients were negative. Serum HBV DNA testing was performed by polymerase-chain reaction (PCR). We also recorded general characteristics of the patients, duration of hemodialysis, serum AST and ALT levels. Nine (16.6 %) of the 54 HCV negative hemodialysis patients were HBV DNA positive. Twelve (14.2%) of the 84 anti HCV positive patients were HBV DNA positive. Hemodialysis duration; demographic features and biochemical parameters were not significantly different in patients with and without occult HBV infection in both HCV positive and negative hemodialysis patients (p>0.05). Anti HCV positivity is not a contributory factor for occult HBV infection in hemodialysis patients. None of the parameters help to distinguish patients with occult HBV infection from those who are serum HBV DNA negative

Expanding congenital abnormalities of the kidney and urinary tract (CAKUT) genetics: basonuclin 2 (BNC2) and lower urinary tract obstruction

his work was supported by FIS PI16/02057, PI19/00588, PI19/00815, DTS18/00032, REDinREN RD016/0009 Fondos FEDER, ERA-PerMed-JTC2018 (KIDNEY ATTACK AC18/00064 and PERSTIGAN AC18/00071), Sociedad Española de Nefrología, FRIAT, and Comunidad de Madrid B2017/BMD-3686 CIFRA2 and Rio Hortega to MV Perez-Gome

Air pollution and kidney disease: Review of current evidence

Along with amazing technological advances, the industrial revolution of the mid-19th century introduced new sources of pollution. By the mid-20th century, the effects of these changes were beginning to be felt around the world. Among these changes, health problems due to environmental air pollution are increasingly recognized. At the beginning, respiratory and cardiovascular diseases were emphasized. However, accumulated data indicate that every organ system in the body may be involved, and the kidney is no exception. Although research on air pollution and kidney damage is recent, there is now scientific evidence that air pollution harms the kidney. In this holistic review, we have summarized the epidemiology, disease states and mechanisms of air pollution and kidney damage

The role of endothelial glycocalyx in health and disease

The endothelium is the largest organ in the body and recent studies have shown that the endothelial glycocalyx (eGCX) plays a major role in health and disease states. The integrity of eGCX is vital for homoeostasis and disruption of its structure and function plays a major role in several pathologic conditions. An increased understanding of the numerous pathophysiological roles of eGCX may lead to the development of potential surrogate markers for endothelial injury or novel therapeutic targets. This review provides a state-of-the-art update on the structure and function of the eGCX, emphasizing the current understanding of interorgan crosstalk between the eGCX and other organs that might also contribute to the pathogenesis of kidney diseasesM.K. gratefully acknowledges use of the services and facilities of the Koc University Research Center for Translational Medicine, funded by the Republic of Turkey, Ministry of Developmen

The prevalence of pandemic anxiety, anxiety and depression during the covid-19 pandemic in Turkey

Background: This prevalence study involved participants from various cities in Turkey was conducted in April 2020, during the coronavirus pandemic in Turkey, with a view to evaluate the pandemic-related anxiety, generalized anxiety, and depression in the society. Method: The study was conducted with 1267 people in more than 70 cities in Turkey. The study data were obtained by means of online data collection forms, due to the risks posed by the contagious COVID-19 disease in face to face interviews. The Demographic Properties Form, the Utkan Pandemic Anxiety (UPA) scale, the Generalized Anxiety Disorder (GAD-7) scale, and the Beck Depression Inventory for Primary Care (BDI-PC) were utilized as data collection tools. Results: The average value for the UPA scale for the sample was calculated as 10.5 +/- 0.257 points, for the GAD-7 scale as 5.5 +/- 0.153 points, and for the BDI-PC as 3.8 +/- 0.095 points. The cut-off threshold for the UPA scale was exceeded by 34%, for the GAD-7 scale by 25.7%, and for the BDI-PC by 30.9% of the sample. Conclusion: It was concluded that the level of pandemic-related anxiety in the community was high, that the level of generalized anxiety and depression had increased in comparison to pre-pandemic times, and that women had a higher risk of pandemic-related anxiety, generalized anxiety, and depression, because they were a group at risk, and also due to the effect of media surveillance and reports

Investigating the Factors Affecting Depression By Using Structural Equation Modeling

The objective of the research was to study the factors affecting depression in general population. Materials and Methods. A total of 1,291 individuals at the age of 15-68 years participated in this cross-sectional study. The Demographic Information Form, the Beck Depression Inventory for Primary Care and the Generalized Anxiety Disorder Scale were used as data collection tools. The data obtained were evaluated in the SPSS 23 package program. Missing data were validated for extreme values, and, then, tested for normality and homogeneity. Testing for the research model was implemented by structural equation modeling using the AMOS program. Results. The following goodness-of-fit values were determined for the revised model predicting the factors influencing depression: χ2 = 535.62, χ2/df = 4.74, the normed fit index = 0.95, the Tucker-Lewis index = 0.95, the comparative fit index = 0.96, the goodness-of-fit index = 0.95, the adjusted goodness-of-fit index = 0.94, the root-mean-square error of approximation = 0.05, the root mean square residual = 0.12, which were within acceptable limits. According to our model, the generalized anxiety disorder-7 (t = 15.923; p < 0.001), gender (t = -5.866; p < 0.001), age (t = -8.193; p < 0.001) and marital status (t = -6.107; p < 0.001) had a significant effect on depression. However, there was no significant relationship between depression score and educational status, place of residence, family type, and smoking. Conclusions. In this model of our study, generalized anxiety disorder was found to have the greatest effect on depression, followed by age, marital status, and gender, respectively

Intravenous fluid therapy in accordance with kidney injury risk: when to prescribe what volume of which solution

Acute kidney injury; Colloid solution; Intravenous fluid therapyLesión renal aguda; Solución coloidal; Fluidoterapia intravenosaLesió renal aguda; Solució col·loïdal; Fluidoteràpia intravenosaAcute kidney injury (AKI) is common in hospitalized patients while common risk factors for the development of AKI include postoperative settings, patients with baseline chronic kidney disease (CKD) or congestive heart failure. Intravenous (IV) fluid therapy is a crucial component of care for prevention and treatment of AKI. In this narrative review, we update the approach to IV fluid therapy in hospitalized patients including the timing of fluid prescription, and the choice of fluid type, amount and infusion rate along with the potential adverse effects of various crystalloid and colloid solutions, addressing specifically their use in patients with acute kidney disease, CKD or heart failure, and their potential impact on the risk of hospital-acquired AKI

The chaos of hypertension guidelines for chronic kidney disease patients

Three major guidelines deal with blood pressure thresholds and targets for antihypertensive drug therapy in chronic kidney disease (CKD) patients: the 2012 Kidney Disease: Improving Global Outcomes Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease; the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults; and the 2018 ESC/ESH Guidelines for the Management of Arterial Hypertension. However, a careful reading of the three guidelines leaves the practicing physician confused about the definition of CKD, how hypertension and secondary hypertension should be diagnosed in CKD patients and what the blood pressure thresholds, targets and compelling indications of antihypertensive drug therapy should be for this population. Current guidelines refer to different CKD populations and propose different definitions of hypertension, different thresholds to initiate antihypertensive therapy in CKD patients and different BP targets compelling antihypertensive drug use. The different bodies producing guidelines should work together towards a unified definition of CKD, a unified concept of hypertension and unified BP thresholds and targets for hypertensive drug therapy for CKD patients. Otherwise they risk promoting confusion and therapeutic nihilism among physicians and patientsResearch by the authors was supported by FIS CP14/00133, PI16/02057, PI18/01366, PI19/00588, PI19/00815, DTS18/00032, ERA-PerMed-JTC2018 (KIDNEY ATTACK AC18/00064 and PERSTIGAN AC18/00071), ISCIII-RETIC REDinREN RD016/0009 Fondos FEDER, FRIAT, Sociedad Española de Nefrología, Comunidad de Madrid B2017/BMD-3686 CIFRA2-C

Chronodisruption: A poorly recognized feature of CKD

Multiple physiological variables change over time in a predictable and repetitive manner, guided by molecular clocks that respond to external and internal clues and are coordinated by a central clock. The kidney is the site of one of the most active peripheral clocks. Biological rhythms, of which the best known are circadian rhythms, are required for normal physiology of the kidneys and other organs. Chronodisruption refers to the chronic disruption of circadian rhythms leading to disease. While there is evidence that circadian rhythms may be altered in kidney disease and that altered circadian rhythms may accelerate chronic kidney disease (CKD) progression, there is no comprehensive review on chronodisruption and chronodisruptors in CKD and its manifestations. Indeed, the term chronodisruption has been rarely applied to CKD despite chronodisruptors being potential therapeutic targets in CKD patients. We now discuss evidence for chronodisruption in CKD and the impact of chronodisruption on CKD manifestations, identify potential chronodisruptors, some of them uremic toxins, and their therapeutic implications, and discuss current unanswered questions on this topicThis work was funded by FIS CP14/00133, PI16/02057, PI18/01366, PI19/00588, PI19/00815, DTS18/00032, ERA-PerMed-JTC2018 (KIDNEY ATTACK AC18/00064 and PERSTIGAN AC18/00071, National Institute of Health (2R01AI063331), ISCIII-RETIC REDinREN RD016/0009 Fondos FEDER, FRIAT, Sociedad Española de Nefrología, Comunidad de Madrid B2017/BMD-3686 CIFRA2-CM, Miguel Servet MS14/00133 to MDSN and ABS. IIS-Fundacion Jimenez Diaz Biobank, part of the Spanish Biobanks Platform (PT17/0015/0006). The APC was funded by PI19/0081