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During the unprecedented COVID-19 pandemic, there is insufficient information about the psychological effects and factors that will affect the mental health status of hemodialysis (HD) patients. We aimed to evaluate the psychological effects of the COVID-19 pandemic on HD patients. There is an observational study in secondary-level healthcare services in eastern Turkey. There were a total of 176 respondents. Sociodemographic data of the participants were obtained from the files. All participants were measured with the Fear of COVID-19 Scale (FVC-19S) the depression anxiety and stress scale (DASS-21). There were significant differences between FVC-19S, depression, and anxiety in the age groups (p [Med-Science 2022; 11(2.000): 622-7]

The most common hereditary kidney illness, disease of autosomal dominant polycystic kidney disease (ADPKD), is associated with numerous cysts that induce kidney size enlargement. The most common extrarenal symptom of ADPKD is liver cysts. A condition in which patients have >20 cysts in the liver is defined as polycystic liver disease (PLD). The goal of this study was to find out how often PLD was in ADPKD patients and whether there was an association between the incidence of PLD and age, sex, and clinical manifestations using magnetic resonance imaging (MRI) results. In this study, the abdominal MRI results of 32 patients with ADPKD who underwent abdominal MRI at Hospital X between January 01, 2020 and September 30, 2021 were retrospectively evaluated by 2 radiologists. Twenty-nine (90.6%) patients had a minimum 1 cyst in the liver, whereas 12 (37.5%) patients had PLD. The women had a greater rate in of PLD than males, and a statistical difference had been observed (p = 0.033). PLD incidence was found to increase with age. The mean ages of patients with and those without PLD were 46.3 and 35.9 years, respectively, and between the foregoing mean age values, a significant difference was detected (p = 0.003). Furthermore, there was no difference between the patients with and those without PLD in terms of the clinical indicators of ADPKD, including total kidney volume and mean rate of glomerular filtration. In conclusion, the incidence of PLD in ADPKD patients was found to be high in our study, and the presence of PLD was not associated with the clinical findings of ADPKD. For this reason, we think that it may be beneficial to perform liver imaging at the time of diagnosis of ADPKD and in their routine follow-up. [Med-Science 2022; 11(1.000): 239-42]

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INTRODUCTION[|]Secondary hyperparathyroidism (SHPT) and anemia are the primary and most common complications in patients receiving hemodialysis (HD). Neutrophil gelatinase-associated lipocalin (NGAL) is a new marker to assess iron deficiency and manage iron therapy for HD patients. The aim of this study was to determine any association between serum NGAL level and anemia without iron deficiency in patients with SHPT on chronic HD.[¤]METHODS[|]Total of 61 SHPT patients on chronic HD were enrolled in the study and divided into 3 groups: mild SHPT group (n=17), moderate SHPT group (n=21), and severe SHPT group (n=23). Hemogram, biochemical assays, and level of ferritin, high sensitivity C-reactive protein (hs-CRP), and NGAL were evaluated in all groups.[¤]RESULTS[|]Serum NGAL level was significantly higher and hemoglobin (Hb) level was significantly lower in severe SHPT patients compared with both mild and moderate SHPT patients. Furthermore, in severe SHPT group, serum NGAL level was significantly positively correlated with serum parathyroid hormone (r=0.79; p=0.00) and hs-CRP (r=0.52; p=0.01) level and negatively correlated with serum Hb (r=-0.56; p=0.00) level.[¤]DISCUSSION AND CONCLUSION[|]SHPT was important factor affecting anemia in HD patients. Even when iron deficiency anemia is excluded in patients with SHPT, there was significant negative correlation between serum NGAL and Hb.[¤]

Diabetic Nephropathy (DN) is a microvascular complication seen in both type 1 and 2 Diabetes Mellitus (DM) and worldwide incidince is increasing. Hemodynamic, metabolic and genetic factors are responsible take part in the pathogenesis. First finding is microalbuminuria (30-300 mg/day or 20-200 µ/min.). Screening for microalbuminuria should be performed once a year, starting 5 years after diagnosis in type 1 DM and at diagnosis in type 2 DM patients. Hyperglycemia, hypertension, smoking, high dietary protein, hyperlipidemia, sex, race, obesity and genetic tendency were identified as independent risk factors in the development and progression of DN. Good glycemic control (HbA1c < 7%), treating hypertension (< 130/80 mmHg or < 125/75 mmHg if proteinuria > 1.0 g/day), treating dyslipidemia (LDL cholesterol [Med-Science 2016; 5(4.000): 1068-73]

Tuberculosis (TB) infection is increasing all over the world especially among immunocompromised patients including end stage renal disease (ESRD) patients. Symptoms and signs are non-spesific and involvement is generally extra-pulmonary in ESRD patients. We presented ten ESRD patients with TB. Six of our cases presented with TB lymphadenitis, two with Potts disease, one with breast TB and one with lung TB and Wegeners granulomatosis. The diagnosis of TB is based on the finding of an acid fast bacilli-positive smear, positive culture of Mycobacterium tuberculosis, and typical histopathologic findings. Anti-TB therapy with isoniazid, rifampin, pyrazinamide and ethambutol combinations are generally successful. Non- spesific constitutional symptoms and unexplained deterioration of general health in ESRD patients should attract attention of clinicians about TB infections. [Med-Science 2016; 5(4.000): 1016-8]

In spite of the widespread use of non-steroidal anti-inflammatory drugs (NSAIDs) such as etodolac, induction of drug-dependent antibodies that cause hemolytic anemia and acute tubulointerstitiel nephritis are rarely reported. Currently, there is no way of identifying individuals who are at risk to develop this kind of complications. In patients who present with acute immune hemolysis and acute renal failure, it is important that a careful history of medication be obtained, potential sensitizing medications be identified. In this article we describe a patient with acute autoimmune hemolytic anemia and acute renal failure related with etodolac. [Med-Science 2016; 5(4.000): 1030-2]

Purpose: The aim of this study was to evaluate changes in corneal biomechanical properties following hemodialysis using an ocular response analyzer (ORA) in non-diabetic end stage renal disease. Materials and Methods: We included one eye of 50 non-diabetic chronic renal failure patients (25 females and 25 males) with a mean age of 56.94 ± 9.95 years (range 36-80 years) in this cross-sectional study. Corneal compensated intraocular pressure (IOPcc), corneal hysteresis (CH) and the corneal resistance factor (CRF) were measured for included the eye of each participant using an ORA before and after hemodialysis. Central corneal thickness (CCT), blood pressure, plasma osmolality and plasma colloid osmotic pressure were also measured before and after the hemodialysis session. A paired samples t-test and Pearson's correlation analysis were carried out for statistical analysis. Results: The mean CCT, IOPcc, CH and CRF of the patients before hemodialysis were 550.20±19.64 µm, 16.84±3.20 mmHg, 10.68±2.41 mmHg and 11.36±2.50 mmHg, respectively. The mean CCT, IOPcc, CH and CRF of the patients after hemodialysis were 547.30±19.83 µm, 15.61±2.77 mmHg, 11.38±2.91 mmHg and 11.37±2.96 mmHg, respectively. The mean plasma osmolality, plasma colloid oncotic pressure and mean arterial pressure (MAP) of the patients before hemodialysis were 309.12±9.10 mOsm/L, 23.86±1.49 mmHg and 99.74±12.84 mmHg, respectively. The mean plasma osmolality, plasma colloid oncotic pressure and mean arterial pressure (MAP) of the patients after hemodialysis were 293.74±8.82 mOsm/L, 28.72±2.19 mmHg and 87.53±10.98 mmHg, respectively. Significant changes occurred in IOPcc, CH, mean arterial pressure, serum osmolality and plasma colloid oncotic pressure (p values of 0.006, 0.036, <0.001, <0.001 and <0.001, respectively). There was no significant difference in the CRF or CCT values before and after hemodialysis (p values of 0.980 and 0.084, respectively). There were significant moderate correlations between differences in IOPcc and CH (r=-0.369, p=0.008) and MAP and CH (r=0.355, p=0.011). Conclusion: Hemodialysis did not alter CCT and CRF but caused a significant IOP decrease and CH increase in non-diabetic chronic renal failure patients that need be taken into account during the evaluation of IOP in hemodialysis patients. [ABSTRACT FROM AUTHOR]

Background/aims: Much is known about the gastric tissue damage that is associated with hypovolemic stress, but gastrointestinal bleeding due to gastric injury and further gastric injury due to hypovolemia have not been evaluated in previous research. The aim of this study was to assess oxidative gastric tissue damage specifically linked to hypovolemia in patients with upper gastrointestinal bleeding., Methods: The study included 30 patients who presented with acute upper gastrointestinal bleeding and 30 controls. Each patient's history and laboratory findings were recorded, and multiple biopsies of the gastric antrum were obtained at diagnostic endoscopy on admission (day 1) and five days later. A set of antral biopsies was also collected from each control subject. Each tissue specimen was analyzed for levels of glutathione peroxidase, superoxide dismutase and catalase activity, and level of malondialdehyde., Results: First day glutathione peroxidase, superoxide dismutase and catalase levels were significantly lower and malondialdehyde levels were higher than on the 5th day, and 1st day and 5th day levels were significantly different from controls (p<0.05). A moderate level of correlation was detected between catalase and hemoglobin (r:-0.59) and hematocrit (r:-0.61) and between malondialdehyde and systolic blood pressure (p:0.58), hematocrit (r:0.45) and hemoglobin (r:0.49)., Conclusions: In this study, gastric tissue oxidative markers showed antral oxidative changes to be significantly correlated with patients' hemodynamics. Oxidative stress may not be a clinical condition but it obviously shows gastric tissue damage and may explain many of the patients' additional diagnosis of gastric erosions. Interestingly, the oxidative change does not completely recover even on the 5th day.