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RESULTS: The quality of sleep was poor in 51.2% of the patients. These patients were relatively older than the patients with good quality of sleep (44.0±13.0 and 37.4±11.8 year respectively, p

Native kidney function can still contribute to the total renal function after preemptive renal transplantation, and the primary problems of native kidneys such as tubular disorders may persist or reappear in the post-transplantation period. Bartter syndrome is a rare hereditary tubulopathy characterized by renal salt wasting, hypokalemia, metabolic alkalosis, and normotensive hyperreninemic hyperaldosteronism. In this case report, we described a patient who presented with episodes of recurrent hypokalemia, hypomagnesemia, and metabolic alkalosis in the post-transplantation period, probably due to the tubular disorder of the native kidneys. The primary kidney disease had not been adequately investigated in the pre-transplant period, and Bartter syndrome was the most likely diagnosis. Identifying primary kidney disease in the pre-transplantation period is important for patient follow-up.

Gitelman syndrome is an autosomal recessive tubulopathy that is characterized by metabolic alkalosis, hypomagnesemia, hypocalciuria, secondary hyperreninemic hyperaldosteronism and low blood pressure. Acquired Gitelman syndrome is very rarely seen, and usually associated with autoimmune diseases or developing after kidney transplantation. Celiac disease is an enteropathy for which the etiology is not known and where environmental, immunologic and genetic factors may all contribute to the disease. Celiac disease may lead to hypokalemia. Here, we describe a case of Celiac disease and Gitelman syndrome that were both diagnosed during the investigation of hypokalemia.

oBjECTiVE: We aimed to evaluate the ECG findings in asymptomatic HD patients for CVD, and to determine related factors with these findings. MATEriAl and MethoDS: 545 maintenance HD patients treated at 10 different HD centers were included. The patients with angina pectoris, documented coronary artery disease, heart failure, and chronic obstructive pulmonary disease were excluded. The mean complete blood count, blood biochemical tests, and lipid profile obtained in the last three months were recorded. Standard 12-derivation ECG with 25 mm/sec speed was performed in all patients. rESUlTS: P-mitrale was found in 274 patients (50.2%), ischemic T wave alterations were found in 249 patients (45.6%), left ventricular hypertrophy was found in 90 patients (16.5%), arrhythmia was found in 88 patients (16.1%), and bundle branch block was found in 83 patients (15.3%). These abnormalities, especially ischemic T wave alterations and SVH, were determined more frequently in diabetic patients and patients with lower hemoglobin level. We did not observe any differential diagnostic attempts for these alterations in last three months. CoNClUSioN: ECG abnormalities are prevalent in asymptomatic HD patients. Surprisingly, whether these abnormalities result from cardiovascular disease or not has not been investigated by medical teams. We concluded that this behavior may due to the symptom-free condition, or perception of HD treatment as a routine treatment method. keY woRDS: Hemodialysis, Electrocardiography, Left ventricular hypertrophy, Bundle branch block doi: 10.5262/tndt.2011.1003.11 Yazisma Adresi: kenan TUrGUTAlP Mersin Universitesi, Ic Hastaliklari Anabilim Dali, Nefroloji Bilim Dali, Mersin, Turkiye Tel : 0 532 492 68 83 E-posta : k.turgutalp@hotmail.com Gelis Tarihi : 09.02.2011 Kabul Tarihi : 19.06.2011

A 49-year-old male presented with severe abdominal distension, massive ascites, generalized edema, and oliguria for one week. Physical examination on admission revealed a blood pressure of 100/60 mmHg, pulse 96/min., body temperature, 38°C and respiratory rate, 18/min. Cardiovascular examination was normal. Generalized edema, massive ascites, and reduced breathing sounds with bilaterally crackles at the lower lung fi elds were found. Petechial hemorrhages and severe pitting edema were found on bilateral lower extremity. INTRODUCTION

OBJECTIVE: Patients with malignancies may develop autoimmune and rheumatic manifestations as a result of generation of autoantibodies, paraneoplastic syndromes, direct invasion of joints and muscles by the tumour cells, or combination chemotherapy. We present a case with prostate cancer and acute kidney injury (AKI) mimicking rapidly progressive glomerulonephritis with a positive test result for anti-double-stranded deoxyribonucleic acid antibodies (Anti-dsDNA ab).