Factors affecting TST level in patients undergoing dialysis: a multicenter study

PMID = 3028919

The relationship between uric acid levels and graft function in renal transplant patients who discontinued steroid therapy.

Introduction: High uric acid levels are commonly encountered in kidney transplant recipients, and can be associated with allograft dysfunction. Our study aims to examine the relationship between UA levels and graft function in patients discontinuing steroids.Methods: In this single-center-retrospective study, 56 patients discontinued steroid therapy from among 678 RT patients transplanted from living donors between 1999-2020 were included. The mean age of the study group was 45.8 +/- 8.8 years. Causes of steroid discontinuation, creatinine levels concurrent with uric acid levels before and after steroid discontinuation (mean 3.9 +/- 2.1 years), acute rejection numbers, demographics, durations of dialysis and transplantation, medications, laboratory data, human leukocyte antigen (HLA) mismatch numbers, blood-pressure (BP), body mass index, delayed acute rejection (DAR) numbers (3 months post-transplantation) were all recorded.Results: Creatinine and uric acid levels were seen to have increased after steroid discontinuation, there was a significant relationship between them (p0.001). Statistically significant correlation was found between increased creatinine levels after steroid discontinuation and graft survival with higher HLA mismatch; 39 (69.6%) patients with mismatch >= 2, and 17 patients with mismatch 2 (30.4%) (p=0.049) . No significant relationship was found between DAR numbers before and after steroid discontinuation, and creatinine levels after steroid discontinuation.Conclusion: Per model obtained as a result of multivariate linear analysis, hyperuricemia and HLA mismatch numbers (p= 0.048 and p= 0.044, respectively) are independent predictive factors for graft dysfunction in patients discontinuing steroids. Accordingly, negative effects of modeling should be kept in mind for long-term graft survival in patients who plan to continue with steroid-sparing regimens

Impedance ratio: a novel marker and a powerful predictor of mortality in hemodialysis patients

WOS: 000378888900020PubMed ID: 27093965Impedance ratio (Imp-R) obtained by multifrequency bioimpedance analysis (BIA) has been shown to be associated with volume and nutrition status. In this prospective study, the predictive role of Imp-R for mortality in hemodialysis (HD) patients was investigated. Multifrequency (5-50-100-200 kHz) BIA was applied to 493 prevalent HD patients in March-April 2006. Imp-R was defined as the ratio of 200-5 kHz impedance values. Demographical, clinical and laboratory data at the time of the analysis were recorded. All-cause and cardiovascular (CV) mortality were assessed during 3 years of follow-up. Mean age was 57.7 +/- 13.9 years, HD duration 52.1 +/- 42.6 months and prevalence of diabetes 21.7 %. Imp-R was negatively correlated with nutritional markers including albumin, creatinine and hemoglobin levels. In addition, there was a positive correlation between Imp-R and age, ratio of extracellular water to total body water and high-sensitive C-reactive protein. Over a mean follow-up period of 27.9 +/- 11.1 months, 93 deaths (52 from CV reasons) were observed. In the multivariate analysis, Imp-R was significantly associated with all-cause and CV mortality after adjustments [HR 1.13, 95 % CI (1.04-1.23); p = 0.004 and HR 1.15, 95 % CI (1.03-1.27); p = 0.01, respectively]. The risk of all-cause mortality was 3.4 times higher in the fourth quartile of Imp-R (> 83.5 %) compared to the first Imp-R quartile (< 78.8 %) as reference. Cutoff value of Imp-R for all-cause mortality was 82.0 % with a sensitivity of 65.5 % and specificity of 64 %. Impedance ratio measured by multifrequency in standardized conditions BIA is an independent and powerful predictor of both all-cause and CV mortality in hemodialysis patients

New-onset type II diabetes mellitus, hyperosmolar non-ketotic coma, rhabdomyolysis and acute renal failure in a patient treated with sulpiride [5]

PubMed ID: 15735255[No abstract available

The role of neutrophil gelatinase-associated lipocalin (NGAL) in the determination of contrast-induced nephropathy in patients undergoing coronary angiography

OBJECTIVE: Contrast-induced nephropathy (CIN) is the acute kidney injury developing following the administration of contrast agent after all other reasons are excluded. We aimed to determine the role of NGAL in the urine for early diagnosis of contrast-induced nephropathy, as the disorder is an important reason of acute renal failure in cases subject to cardiac catheterization clinical practice, and the frequency is increasing.MATERIAL and METHODS: One hundred cases undergoing elective coronary angiography between the dates of January 1st 2011 and March 1st 2011 were included in the study. Urine samples of the patients were taken maximum 4 hours after the coronary angiography to check the urinary NGAL level.RESULTS: The creatinine level had increased 25% in 8 patients at the 48th hour following angiography and this was accepted as CIN. Using a cutoff value of 100 ng/ml, urinary NGAL levels were found to elevated in these 8 patients, consisting of 6 females and 2 males. All them had hypertension (HT) by itself or with other accompanying diseases.CONCLUSION: The CIN diagnosis can be made with the conventional method of measuring the level of creatinine in the blood 48 hours after surgery but using the urinary NGAL method can fasten the diagnosis and treatment and also can shorten hospital stays