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Introduction: Immunoglobulin A nephropathy (IgAN) is the most common form of glomerulonephritis worldwide with a strong autoimmune component. 40% of diagnosed cases end up with end-stage kidney disease within 20 years of diagnosis. IgAN also affects tissues that can produce mucosal secretions, such as the nasopharynx, and causes mucosal infections in patients with IgAN. Metabolomics analysis allows us to analyze the differentiation in metabolite levels in biofluids such as urine and serum. Our aim was to evaluate the disease from a different perspective, including saliva, and assess the metabolomic differences between healthy people and IgAN patients and evaluate the correlation between urinary and salivary metabolomics in IgAN patients. Method: This study was based on two groups: healthy control and IgAN patients groups. Stimulated salivary and spot urine samples were collected from both groups. Collected samples were subjected to full metabolome analysis in a liquid chromatography-mass spectrometry (LC-MS/MS) device. In addition, general demographic information of subjects, serum urea, serum creatinine, urine creatinine, urine proteinuria, and estimated glomerular filtration rate (eGFR) levels of subjects were gathered for statistical analysis. Results: Sixteen IgAN patients participated in the study. Four of 16 patients were male, and the mean age of the IgAN group was 45.31±6.65 years. Ten healthy controls participated in the study. Four of 10 controls were male, and the mean age of the healthy control group was 41.36±6.57 years. The IgAN patients had meaningfully increased serum creatinine and urine proteinuria levels compared with the healthy controls (p=0.009 and p=0.006). GFR levels were found to be significantly decreased in IgAN patients (p=0.006). However, there were no significant differences in serum urea and urine creatinine levels (p=0.610 and p=0.111). Conclusion: These are the results of our preparatory work. Further analysis will be conducted. [ABSTRACT FROM AUTHOR]

Introduction: In Turkey, one out of every 7 people has kidney disease, and the number of patients receiving kidney replacement therapy (KRT) is increasing. The thoughts of kidney healthcare providers (KHPs) play a significant role in the decision-making process in the patient's choice of dialysis modality. In this study, we evaluated the thoughts and attitudes of KHPs in Turkey regarding the dialysis modality. Method: An online survey was conducted to investigate the demographic characteristics of KHPs and the variables influencing modality recommendations. The prepared survey was distributed to KHPs in every region of Turkey between March 15 and June 15, 2023. The distribution of the data was analyzed using the Shapiro-Wilk and Pearson chi-square tests. Results: A total of 102 physicians and 42 nurses completed the survey (F: 82, M: 62, mean age 45+/- 8.6 years). The current patients of the respondents are predominantly treated with in-center hemodialysis (90.3%) and to a lower percentage (9.7%) with peritoneal dialysis. According to the participants, the major role in the decision of the dialysis modality belongs to the nephrologist (54.9%). The preference for referring patients to in-center hemodialysis was no caregiver (76.4%), low socio-economic status (69%), more than one chronic disease (57.6%), and low education level (56.3%). In the question "If you needed a dialysis modality, which method would you prefer?", the participants answered "Home hemodialysis" (45.8%), "Peritoneal dialysis" (43.8%) and "In-center hemodialysis" (10.4%). 66.8% of the respondents believed that they had insufficient knowledge about home hemodialysis. Conclusion: The results indicate that KHPs prefer home hemodialysis, although most of their patients are treated with in-center hemodialysis. Most KHPs consider themselves incompetent in home hemodialysis. Education, training, and new regulations regarding dialysis modalities are needed. [ABSTRACT FROM AUTHOR]

The avoidance of financial gain in the human body is an international ethical standard that underpins efforts to promote equity in donation and transplantation and to avoid the exploitation of vulnerable populations. The avoidance of financial loss due to donation of organs, tissues, and cells is also now recognized as an ethical imperative that fosters equity in donation and transplantation and supports the well-being of donors and their families. Nevertheless, there has been little progress in achieving financial neutrality in donations in most countries. We present here the findings of an international ethics working group convened in preparation for the 2023 Global Summit on Convergence in Transplantation, held in Santander, Spain, which was tasked with formulating recommendations for action to promote financial neutrality in donation. In particular, we discuss the potential difficulty of distinguishing interventions that address donation-related costs from those that may act as a financial incentive for donation, which may inhibit efforts to cover costs. We also outline some practical strategies to assist governments in designing, implementing, and evaluating policies and programs to support progress toward financial neutrality in donation., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Trafficking in human organs, cells, and tissues has long been a source of concern for health authorities and professionals, and several international ethical guidance documents and national laws have affirmed the prohibition of trade in these substances of human origin (SoHOs). However, despite considerable attention to the issue of organ trafficking, this remains a substantial and widespread problem internationally. In contrast, trafficking in cells, tissues, and medical products derived from SoHOs has received comparatively little attention, and the extent and nature of such trafficking remain largely unknown. Consequently, as part of the 2023 Global Summit on Convergence in Transplantation held in Santander, Spain, an ethics working group was assigned the task of formulating actionable recommendations to support the prevention of trafficking in all SoHOs. In reporting on this work, we review factors that may influence the persistent trafficking of SoHOs, explore the potential difficulties associated with the collection and reporting of data about suspected trafficking activities, and argue that more practical and consistent guidance, training, and regulatory frameworks are needed internationally to support effective reporting, sharing of data, and collaborative responses to suspected trafficking cases. We also discuss the importance of psychosocial evaluation of living donors as a strategy to detect and prevent organ trafficking and strive to advance the implementation of this well-established recommendation by outlining minimum standards for psychosocial evaluation of living donors., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)