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Objective: There is not enough information in the literature conducted about the importance of serum uric acid levels in hypertensive emergency patients. Our study aims to investigate the role of serum uric acid levels in patients admitted to the emergency department due to high blood pressure.Materials and methods: Hypertensive emergency with acute target organ damage with blood pressure 180/110 mmHg and above (group I), hypertensive urgency patients without acute target organ damage with blood pressure of 180/110 mmHg and above (group II), and the patients with uncontrolled hypertension with systolic blood pressure between 140-180 mmHg and diastolic blood pressure between 90-110 mmHg (group III). Results: One hundred twenty-four hypertensive patients (80 female, 44 male) were included. 33 patients (26.6%) were in group I, 19 (15.3%) in group II and 72 (58.1%) in group III. When compared in terms of serum uric acid level, it was found that there was a statistically significant difference between the groups (p = 0.001). The average serum uric acid level of patients in group I was higher compared to other groups (p, Amaç: Hipertansif acil hastalarda serum ürik asit düzeylerinin önemi konusunda yapılan literatürde yeterli bilgi yoktur. Çalışmamız, yüksek tansiyon nedeniyle acil servise başvuran hastalarda serum ürik asit düzeylerinin rolünü araştırmayı amaçlamaktadır.Gereç ve yöntemler: Kan basıncı 180/110 mmHg ve üzerinde akut hedef organ hasarı olan hipertansif acil (grup I), kan basıncı 180/110 mmHg ve üzerinde olan akut hedef organ hasarı olmayan hipertansif acil hastalar (grup II) ve 140-180 mmHg arasında sistolik kan basıncı ve 90-110 mmHg arasında diyastolik kan basıncı olan kontrolsüz hipertansiyonu olan hastalar (grup III).Bulgular: Yüz yirmi dört hipertansif hasta (80 kadın, 44 erkek) dahil edildi. Grup I'de 33 (% 26.6), grup II'de 19 (% 15.3) ve grup III'te 72 (% 58.1) hasta yer aldı. Serum ürik asit düzeyi açısından karşılaştırıldığında gruplar arasında istatistiksel olarak anlamlı fark olduğu bulundu (p = 0,001). Grup I'deki hastaların ortalama serum ürik asit düzeyi diğer gruplara göre yüksekti (p

Objective: Hepcidin is a peptide with anti-microbial properties that is largely synthesized in the liver and has important roles in iron homeostasis, with serum levels elevated in chronic inflammatory conditions, including chronic kidney disease (CKD). Our aim was to discuss on the role of vitamin D in regulation of hepcidin and anemia of CKD. Methods: The study group included 103 patients with CKD and 59 healthy individuals. The serum concentration of hepcidin was measured using ELISA, and the association to the following factors was evaluated: age, sex, body mass index, renal functions (estimated glomerular filtration rate, eGFR), drug history, serum biochemistry, complete blood count, iron and total iron binding capacity, ferritin, vitamin D, high sensitive C-reactive protein, C-reactive protein, and the erythrocyte sedimentation rate. Results: The mean age of the CKD group was 58.63 ± 11.8 years (with 16, 26, 27, 19, and 15 patients; respectively in each chronic kidney disease stage, from I through V and nine on haemodialysis, six on peritoneal dialysis). The mean hepcidin concentration was higher in the chronic kidney disease (30.3±24.7 ng/ml) than control (17.8 ± 8.4ng/ml) group (p

Giriş: Hastaneye yatırılan hastalarda akut böbrek hasarı (ABH) sık olarak görülmektedir (%1,92). ABH’lı hastalarda serum düzeltilmiş ve iyonize kalsiyum düzeylerinin acil hemodiyalizi öngörmedeki etkisi bilinmemektedir. Bu çalışmada acil serviste ABH tanısı alan hastalarda serum düzeltilmiş ve iyonize kalsiyum düzeylerini karşılaştırmayı amaçladık.Yöntem: Çalışmamız retrospektif olarak planlandı. Grup 1: En az bir kez acil hemodiyaliz seansı alan ABH hastaları. Grup 2: Hemodiyalize girmeyen AKIN evre 1-3 olan hastalar. Hastaların başvuru anında serum düzeltilmiş ve iyonize kalsiyum, kreatinin ve albümin değerleri incelendi. Çalışmanın tüm verileri SPSS 19.0 ile kaydedildi. İstatistiksel anlamlılık için p, Introduction: Acute kidney injury (AKI) is common in hospitalized patients (1.92%). The effect of serum corrected and ionized calcium levels in predicting emergency hemodialysis in patients with AKI is unknown. In this study, we aimed to compare serum corrected and ionized calcium levels in patients who were diagnosed with AKI in the emergency service.Methods: Our study was planned retrospectively. Group 1: Patients with AKI who underwent at least one session of emergency hemodialysis. Group 2: The patients with AKIN stage 1-3 who did not undergo hemodialysis. Serum corrected and ionized calcium, creatinine and albumin values of the patients at the time of admission were analyzed. All data of the study were recorded by SPSS 19.0. For statistical significance, p

Background and objectives Delayed graft function (DGF) may increase the risk for kidney graft dysfunction. Renal resistive index (RRI) in Doppler ultrasonography is useful in measuring blood flow changes in kidneys which is indicative of tubulointerstitial damage. Most of the diseases in DGF etiology are related to tubulointerstitium and arteries of the kidneys. In this study, we investigated whether there is a relationship between delayed graft function and renal resistive index in kidney transplant recipients (KTR). Materials and methods Patients who underwent kidney transplantation were included in this retrospective study. KTR were divided into two groups as DGF (+) and DGF (-). Comparison of RRI values of DGF (+) and DGF (-) groups according to the measurements at different times. Results The findings showed that both RRI measurements (post-transplant in the first week and the end of the first year) of the DGF (+) group were higher than DGF (-) group (p=0.001 and p=0.003, respectively). The interaction of measurements and DGF did not have an effect on RRI (p>0.05). Conclusion The value of RRI in the DGF (-) group was lower than DGF (+) group in the first week after kidney transplantation.

Objective Older adults with co‐morbidities have been reported to be at higher risk for adverse outcomes of coronavirus disease 2019 (COVID‐19). The characteristics of COVID‐19 in older patients and its clinical outcomes in different kidney disease groups are not well known. Methods Data were retrieved from a national multicentric database supported by Turkish Society of Nephrology, which consists of retrospectively collected data between 17 April 2020 and 31 December 2020. Hospitalised patients aged 18 years or older with confirmed COVID‐19 diagnosis suffering from stage 3‐5 chronic kidney disease (CKD) or on maintenance haemodialysis (HD) treatment were included in the database. Non‐uraemic hospitalised patients with COVID‐19 were also included as the control group. Results We included 879 patients [388 (44.1%) female, median age: 63 (IQR: 50‐73) years]. The percentage of older patients in the CKD group was 68.8% (n = 188/273), in the HD group was 49.0% (n = 150/306) and in the control group was 30.4% (n = 70/300). Co‐morbidities were higher in the CKD and HD groups. The rate of presentation with severe‐critical disease was higher in the older CKD and HD groups (43.6%, 55.3% and 16.1%, respectively). Among older patients, the intensive care unit (ICU) admission rate was significantly higher in the CKD and HD groups than in the control group (38.8%, 37.3% and 15.7%, respectively). In‐hospital mortality or death and/or ICU admission rates in the older group were significantly higher in the CKD (29.3% and 39.4%) and HD groups (26.7% and 30.1%) compared with the control group (8.6% and 17.1%). In the multivariate analysis, in‐hospital mortality rates in CKD and HD groups were higher than control group [hazard ratio (HR): 4.33 (95% confidence interval [CI]: 1.53‐12.26) and HR: 3.09 (95% CI: 1.04‐9.17), respectively]. Conclusion Among older COVID‐19 patients, in‐hospital mortality is significantly higher in those with stage 3‐5 CKD and on maintenance HD than older patients without CKD regardless of demographic characteristics, co‐morbidities, clinical and laboratory data on admission.

Background/aim: Hospital-acquired acute kidney injury (HA-AKI) may commonly develop in Covid-19 patients and is expected to have higher mortality. There is little comparative data investigating the effect of HA-AKI on mortality of chronic kidney disease (CKD) patients and a control group of general population suffering from Covid-19. Materials and methods: HA-AKI development was assessed in a group of stage 3-5 CKD patients and control group without CKD among adult patients hospitalized for Covid-19. The role of AKI development on the outcome (in-hospital mortality and admission to the intensive care unit [ICU]) of patients with and without CKD was compared. Results: Among 621 hospitalized patients (age 60 [IQR: 47-73]), women: 44.1%), AKI developed in 32.5% of the patients, as stage 1 in 84.2%, stage 2 in 8.4%, and stage 3 in 7.4%. AKI developed in 48.0 % of CKD patients, whereas it developed in 17.6% of patients without CKD. CKD patients with HA-AKI had the highest mortality rate of 41.1% compared to 14.3% of patients with HA-AKI but no CKD (p < 0.001). However, patients with AKI+non-CKD had similar rates of ICU admission, mechanical ventilation, and death rate to patients with CKD without AKI. Adjusted mortality risks of the AKI+non-CKD group (HR: 9.0, 95% CI: 1.9-44.2) and AKI+CKD group (HR: 7.9, 95% CI: 1.9-33.3) were significantly higher than that of the non-AKI+non-CKD group. Conclusion: AKI frequently develops in hospitalized patients due to Covid-19 and is associated with high mortality. HA-AKI has worse outcomes whether it develops in patients with or without CKD, but the worst outcome was seen in AKI+CKD patients. Turkish Society of Nephrology for the organization We thank Turkish Society of Nephrology for the organization and funding of the study. We also would like to express our gratitude to the patients whose records were used in this study, without which this research would not be possible.

Background and objectives As the stage progresses in chronic kidney disease (CKD), the risk of contrast-induced nephropathy (CIN) also increases. Serum albumin level is the strongest predictor of CIN development in patients with CKD. It is widely known that females of age 75 are at risk for the development of CIN. Our study aims to investigate the impact of age, gender, serum creatinine, and albumin levels on the development of CIN in patients who were admitted to the emergency department and have had contrast-enhanced computerized tomography (CECT) for diagnosis. Materials and methods The study was planned retrospectively. Patients who applied to the emergency department between January 1, 2018, and January 1, 2020, and had CECT were included in the study. A 25% or 0.5 mg/dL increase in serum basal creatinine level within 72 hours following the implementation of contrast agent was accepted as CIN. The patients were divided into two groups: CIN (+) and CIN (-). Results One-hundred twenty-two patients (53 female and 69 male), whose average age was 72.27± 12, were included in the study. Forty-five of the patients were found to be CIN (+) and 77 CIN (-). There was no significant difference between the groups (p> 0.05) in terms of age. It was found that the serum creatinine level during admission to the emergency department was the determinant for the development of CIN (p = 0.024). In addition, it was observed that serum albumin levels during the admission had no impact on the development of CIN (p = 0.326). When the serum albumin values of female and male patients diagnosed with CIN measured at the first admission to the emergency service were compared, the mean values were found to be lower in male patients (p = 0.027). Conclusion Serum creatinine and albumin levels, age, and gender parameters should be considered in terms of the risk of CIN development in patients who are admitted to the emergency department and given contrast agents.

Here in this report a 31 year old pregnant woman with positive serum antiglobulin test against anti-D antierythrocyte antibodies who was treated succesfully with double filtration plasmapheresis (DFPP) is presented. The DFPP was started in the early stage of pregnancy together with intravenous immunoglobulin therapy and the antierythrocyte antibody titer of the patient was successfully maintained in a stable level below 1:64 dilution. She delivered successfully on the 30th week of gestation. The favorable outcome of this patient implies that DFPP is an effective and safe treatment modality in pregnant women with red cell alloimmunization.

Suttonella indologenes is a Gram-negative, aerobic coccobacillus of Cardiobacteriaceae family and its natural habitat is the mucous membranes of the upper respiratory system. The literature includes limited number of case reports concerning fatal endocarditis due to infection in the prosthetic heart valves caused by the aforementioned microorganism. However, there is no information on extracardiac involvement due to this microorganism. Here, we present a peritonitis case caused by Suttonella indologenes in a patient receiving continuous ambulatory peritoneal dialysis.

Background and objectives: Uremic encephalopathy is the most important complication of renal failure and urgent dialysis treatment is required. Parathormone (PTH) contributes to the etiopathogenesis of uremic encephalopathy. PTH is a hormone that acts in the calcium balance in the organism. The aim of our study was to investigate the effect of serum adjusted and ionized calcium on the development of uremic encephalopathy in patients with acute renal injury (acute kidney injury network (AKIN) stage 3). Materials and Methods: Our study was supported by Canakkale Onsekiz Mart University Scientific Research Projects Unit (ID:1278). Three groups were formed for the study. The first group was acute renal failure AKIN stage 3 (N: 23), the second group was AKIN stage 3, and the patients who had emergency hemodialysis (N: 17) and the third group (N: 9) had AKIN stage 3 hemodialysis due to uremic encephalopathy. In these patient groups, 25-hydroxy vitamin D, PTH, calcium, albumin, urea, creatinine, and blood-gas-ionized calcium were observed in their serum during the first application. Calcium, albumin, urea, creatinine, and ionized calcium in blood gas were also examined in serum at 24th and 72th hours. Data were analyzed using SPSS version 19.0. Kruskal&ndash, Wallis test and Mann&ndash, Whitney U test were applied for the variables that did not comply with normal distribution. p &lt, 0.005 was accepted statistically. Results: A statistically significant difference was found between the measurement creatinine values at the 24th and 72th hours of admission in AKIN stage 3 patients who applied to the emergency department (p = 0.008). A statistically significant difference was found in the measured calcium values (p = 0.013). A statistically significant difference was found in the measured ionized calcium values (p = 0.035). Conclusions: In our study, the effect of ionized calcium level on uremic encephalopathy in serum creatinine, calcium, and blood gas in patients presenting with acute renal injury, AKIN stage 3, was significant, but studies with new and large groups are needed.

Aim To investigate the efficacy of adalimumab treatment in an experimental rat sclerosing encapsulated peritonitis (SEP) model. Methods The study involved 40 Wistar albino rats divided into four groups: chlorhexidine (CH) group, control group, CH + adalimumab group, and CH + resting group. The control group received normal saline intraperitoneally (i.p.). Other groups received 0.1% CH gluconate, 15% ethanol, and normal saline mixture i.p. for three weeks in order to induce SEP. CH + adalimumab group received 5 mg/kg adalimumab i.p. at the beginning of week 4 and week 6, while CH + resting group was followed-up for three weeks without applying any procedure after the onset of SEP. Rats in groups CH and control group were sacrificed on day 21, and rats in group CH + adalimumab and CH + resting were sacrificed on day 42. All groups were evaluated for peritoneal thickness, inflammation, vascularization, and fibrosis. Results CH + adalimumab group showed a significant decrease in peritoneal thickness, fibrosis score, and vascular score compared with CH group and CH + resting group. Conclusion Adalimumab can prevent SEP development.

Objective Serum leptin levels of chronic kidney disease patients have been detected higher than normal population. The aim of this study was to investigate the effects of serum leptin levels on thrombocyte aggregation in peritoneal dialysis patients. Methods Fourty three peritoneal dialysis patients were included in the study. Thrombocyte aggregation was calculated from the whole blood subsequently the effects of different concentrations of human recombinant leptin on thrombocyte aggregations were investigated. Four test cells were used for this process. While leptin was not added into the first test cell, increasing amounts of leptin was added into the second, third and fourth test cells to attain the concentrations of 25, 50 and 100 ng/ml respectively. Results Thrombocyte aggregation was inhibited by recombinant leptin in peritoneal dialysis patients. Thrombocyte aggregation mean values were found statistically significantly higher in first test cell when compared to leptin groups in peritoneal dialysis patients. For leptin groups we could not find any statistically significant differences for thrombocyte aggregation mean values between any of the groups. Conclusion Further studies with larger number of peritoneal dialysis patients are required to prove the action of leptin on thrombocyte aggregation.

WOS: 000393291900012 OBJECTIVE: Cinacalcet reduces parathyroid hormone levels by increasing the sensitivity of the parathyroid gland to calcium. in this study, we firstly aimed to evaluate the efficacy of cinacalcet in Turkish hemodialysis patients. MATERIAL and METHODS: 4483 hemodialysis patients were screened and 469 patients who had used cinacalcet were included in the study. the patients were divided into 4 groups according to drug usage durations (Group 1: 3 months, Group 2: 6 months, Group 3: 9 months and Group 4: 12 months). the patients' Parathormone, Ca, P and CaxP levels at the 3rd, 6th, 9th and 12th months were compared to the start of treatment and previous months. RESULTS: the levels of Parathormone, Ca, P and CaxP significantly decreased compared to their initial levels in all groups (from 1412 pg/ml to 1222 pg/mL for Parathormone, p< 0,001) in the 3rd month. However, this reduction was not continued in the subsequent months (Parathormone: 1381 pg/ml for the 12th month). CONCLUSION: Cinacalcet may not provide adequate benefit in control of hyperparathyroidism in Turkish hemodialysis patient population.