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OBJECTIVE: Cardiac autonomic dysfunction (COD) is one of the important factors implicated in the pathogenesis of primary hypertension (HT). Heart rate variability (HRV) measurement has been used widely to determine the COD. We aimed to examine the HRV in primary hypertension and its relationships with end organ damage. MATERIAL and METHODS: Ninety adult patients and 28 healthy controls were included into the study. Heart rates (HRs) and HRV parameters were measured by monitoring with 24-hour Holter electrocardiographic records. Patients were assessed in terms of retinopathy, microalbuminuria and left ventricle hypertrophy. RESULTS: Primary hypertensive patients had significantly higher blood pressure (BP) values than those of the controls. Minimum HRs of all patients were significantly higher than controls, while HRV parameters showed significantly lower values in the patients compared to controls. The HRV parameters showed no significant correlations with retinopathy, left ventricle hypertrophy, microalbuminuria and cardiovascular risk factors. CONCLUSION: Lower HRV parameters in hypertensive patients probably suggests the presence of a COD. However, such a difference was not observed between the newly and previously diagnosed patients indicating that the HRV seems not to be influenced by antihypertensive treatment. [ABSTRACT FROM AUTHOR]

Aortic pulse wave velocity is currently the ‘gold standard' measure of arterial stiffness.In this study we aimed to investigatethe relationships betweenAortic pulse wave velocity and body mass index in hypertensive andnormotensiveobesesubjects.A total of109 obese subjects were divided into two groups according to arterial blood pressures andbody mass index. Subjects with a body mass index of 30.0-34.9 kg/m2 were defined as Class I, and =35.0 kg/m2 as Class II. Then Class I and II groups were divided into two groups according to blood pressures as normotensive-Class I, II and hypertensive-Class I, II.In the whole group (n:109) pulse wave velocity was significantly correlated with age, systolic blood pressure and diastolic blood pressure (r=0.229; p=0.017, r=0.301; p=0.001 and r=0.323; p=0.001, respectively). Pulse wave velocity was not significantly correlated with body mass index neither in the whole group nor in the Class I and Class II groups.These results suggest that in the patients with a body mass index of =30.0 kg/m2, increase ofpulse wave velocity is not associated with body mass index, but can be related with age, systolic and diastolic blood pressure. [ABSTRACT FROM AUTHOR]

Objectives In 1981, Peter A. Stewart published a paper describing his concept for employing Strong Ion Difference. In this study we compared the HCO3 levels and Anion Gap (AG) calculated using the classic method and the Stewart method. Methods Four hundred nine (409) arterial blood gases of 90 patients were collected retrospectively. Some were obtained from the same patients in different times and conditions. All blood samples were evaluated using the same device (ABL 800 Blood Gas Analyzer). HCO3 level and AG were calculated using the Stewart method via the website AcidBase.org. HCO3 levels, AG and strong ion difference (SID) were calculated using the Stewart method, incorporating the parameters of age, serum lactate, glucose, sodium, and pH, etc. Results According to classic method, the levels of HCO3 and AG were 22.4± 7.2 mEq/L and 20.1± 4.1 mEq/L respectively. According to Stewart method, the levels of HCO3 and AG were 22.6±7.4 and 19.9±4.5 mEq/L respectively. Conclusions There was strong correlation between the classic method and the Stewart method for calculating HCO3 and AG. The Stewart method may be more effective in the evaluation of complex metabolic acidosis. [ABSTRACT FROM AUTHOR]

Pulse wave velocity (PWV), augmentation index (Aix), and central aortic pressure (CAP) are arterial stiffness markers of endothelial dysfunction (ED). We investigated the relationship between arterial stiffness parameters and asymmetric dimethylarginine (ADMA; a marker of ED), in newly diagnosed patients with hypertension (n = 101; 61 females). These patients were investigated in accordance with the recommendations of hypertension guidelines. Arterial stiffness was measured, and serum ADMA and C-reactive protein (CRP; a marker of inflammation) levels were determined. In both women and men, there was no difference in terms of age, body mass index, systolic and diastolic blood pressures, PWV, CAP and the levels of ADMA, while Aix and CRP levels were significantly higher in women (P = .004, P = .046, respectively). In the whole group, ADMA levels correlated with Aix (Pearson r = .237, P = .024). Our findings provide further evidence of a link between arterial stiffness and ED in newly diagnosed patients with hypertension. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the effects of first, early morning and last measurements on daily average blood pressure during the ABPM. Previously done 525 ABPM were analyzed, retrospectively. 66.7% of these measures were in male patients. Mean age of all the patients was 43.3±16.1 years. Thirty-eight measurements per day every patient were planned. .The differences between the average of total measurements(n) and the average of n-1, n-2, n-3 which were calculated with the elimination of first, early morning and last measurements from total daily measurements were investigated. The mean of total average of all measurements (n) was 130.7±14.2/79.0±10.9 mmHg. The means of averages of first, early morning and last measurements were 140.5± 17.6/ 88.0±12.2, 134.3±18.3/ 81.9±13.4 and 135.2±19.4/ 82.9±13.5 mmHg respectively. The average of first, early morning and last measurements were statictically higher than the average of total measurements(n) realized during the day (p<0.001, for both systolic and diastolic values of each measure). Research results shows that, regarding both systolic and diastolic blood pressures, there were statistically significant differences between the average of total measurements(n) and the averages of n-1, n-2 and n-3 measurements which were calculated with the elimination of first, early morning and last measures from total daily measurements.( p<0.001 for all systolic and diastolic comparisons). The ones with systolic blood pressure < 140 mmHg (n=256) at the first measurement of monitoring were according hypertensive according to the total average (>135 mmhg, n=43, 16.8%), whereas hypertension ratio in the ones with systolic blood pressure > 140 mmHg (n=269) at the first measurement was (n=153, 56.9%). Research results suggest that, the first measurement > 140 mmHg increases the probability of hypertension by 3.4 times when compared with those whose first measurement being < 140 mmHg. [ABSTRACT FROM AUTHOR]

Hypertensive patients have strong evidence of endothelial dysfunction. Some novel endothelial dysfunction parameters such as pulse wave velocity (PWV), augmentation index (AIx), and central aortic pressure (CAP) have been investigated as predictive markers of atherosclerosis. It is well known that obesity has relationships with endothelial dysfunction and atherosclerosis. We aimed to investigate relationships between anthropometric measurements and arterial stiffness parameters in essentially hypertensive patients. The study population included 100 patients (56 females, 44 males) newly or formerly diagnosed as essentially hypertensive in an outpatient clinic. Arterial stiffness measurements, including PWV, AIx, CAP, and body mass index (BMI); waist circumference, hip circumference; waist/hip ratio; and triceps, biceps, subscapular, and suprailiac skinfold thicknesses were also applied to all the study patients. Then, the relationships between BMI, anthropometric measurements, and arterial stiffness parameters were investigated. The mean systolic arterial blood pressure of the study population was 135.85 ± 15.27 mm Hg and the mean diastolic arterial blood pressure of the study population was 84.17 ± 9.58 mm Hg. The parameters such as PWV, AIx, and CAP measured for arterial stiffness had correlations between BMI and different anthropometric measurements. The statistically significant correlations were present between PWV and triceps skinfold thickness (TST) ( r = 0.377, P < .001) and it was also seen when regression analysis was performed (PWV = 6.41 + [0.072 × TST]; R2 = 0.142, F[1-98] = 16.23, P < .001). Triceps skinfold thickness among these correlations may be used to estimate the carotid-femoral PWV, which is an indicator of subclinical organ damage due to hypertension. [ABSTRACT FROM AUTHOR]

Hypertensive patients have strong evidence of endothelial dysfunction. We aimed to explore the relationships between cardiovascular risk factors and arterial stiffness parameters in hypertensive patients. The study population included 109 hypertensive patients (63 females, 46 males). Arterial stiffness measures including pulse wave velocity, augmentation index, and central aortic pressure were applied. Augmentation index and central aortic pressure were found to be significantly higher ( P < .001 and P = .03, respectively) in women. The higher augmentation index and central aortic pressure values were observed in women than in men. These data offer new evidences for the role of sex hormones in the pathogenesis of atherosclerosis in women. [ABSTRACT FROM AUTHOR]

An increased incidence of hypertension (HT) in postmenopausal female population has been shown in previous studies and this has been ascribed to an association with altered status of estrogen (E2) and other female sex hormones. Hypertension is associated with certain target organ damage (TOD) and related clinical conditions. The aim of this study was to determine the relationship between microalbuminuria, left ventricular hypertrophy (LVH), retinopathy, and sex hormone status in newly diagnosed hypertensive women. A total of 66 hypertensive women (39 postmenopausal and 27 premenopausal) were included in the study. Along with the tests recommended in the HT guidelines, LVH, hypertensive retinopathy, and microalbuminuria were investigated in all the patients. Sex hormones (follicle stimulating hormone, luteinizing hormone, progesterone, and E2) of the patients were also measured. The results show that there was no statistically significant difference between the two groups in regard to TOD except microalbuminuria. The frequency of microalbuminuria in premenopausal group patients was higher than that of the postmenopausal group patients ( P = .038). This study suggests that TOD caused by HT is a very important health problem, seeming to be related with female sex hormones. [ABSTRACT FROM AUTHOR]

Since the effect of smoking on plasma leptin has been divergent in clinical trials, which might have occurred due to selection of heterogeneous study populations, we investigated whether there is such an association in a group of healthy, non-obese, young male adults. A total of 54 smokers (mean age: 21.1891.62; body mass index (BMI): 19.6090.85) and 26 non-smokers (mean age 21.6993.0; BMI: 21.5991.39) with similar daily physical activities and diet and without any documented disease were enrolled, and their plasma leptin levels were determined for the comparison between the two groups. The mean BMI and plasma leptin of smokers were significantly lower than in non-smokers. Plasma leptin in the smokers group correlated inversely with BMI and the amount of daily smoking. Below BMI 20 kg/m2 and between 20.0 and 20.9 kg/m2 the plasma leptin levels in smokers were significantly lower when compared to non-smokers. Plasma leptin is decreased in healthy, young non-obese male smokers independently of the amount of body fat. High amount of smoking is associated with lower serum leptin as well. [ABSTRACT FROM AUTHOR]

Blood gas analyses are needed to reveal any kind of acid-base imbalance in some patients. Traditionally, arterial punctures are performed to obtain the blood samples for blood gas analyses. Arterial puncture is not a completely safe procedure. It may cause serious problems including arterial thrombosis, arteriovenous fistula, pseudoaneurysms and hematoma. In this retrospective reviewing, it was aimed to yield novel formulations to predict the blood pH only from CtCO2 and HCO3 values which can easily be measured in venous blood samples obtained for other diagnostic and follow-up purposes. [ABSTRACT FROM AUTHOR]

Objective: The primary aim of this study was to compare the retinal vessel caliber (RVC) with both arterial stiffness (AS) parameters and nocturnal blood pressure dipping status (DS) in essential hypertension (EH). Materials and Methods: The retinal vessel diameter of 101 patients with EH and 31 sex- and age-matched healthy controls was measured using retinal fundus photography. Venous blood samples were obtained for biochemical tests and anthropometric measurements were also recorded. The AS parameters of carotid-femoral pulse wave velocity (cfPWV), augmentation index (AIx), and central aortic pressure (CAP) were assessed using a non-invasive TensioClinic arteriographic system (TensioMed Kft., Budapest, Hungary). DS was evaluated using 24-hour ambulatory blood pressure measurements. The baseline characteristics, AS parameters, and the nocturnal DS of hypertensive patients were statistically compared with those of healthy individuals according to RVC values. Results: The hypertensive group had significantly higher heart rates (p=0.023); AS parameters (PWV [p<0.001], CAP [p<0.001]); and fasting glucose (p=0.028), creatinine (p=0.046), triglyceride (p=0.045), uric acid (p=0.014) and microalbuminuria (p=0.004) values than the healthy controls. Although there was a significant positive linear correlation between the duration of hypertension and PWV (p=0.024), AIx (aortic) (p=0.005) and AIx (brachial) (p=0.013), no significant difference between the EH patients and the control subjects was observed in the AS parameters and nocturnal DS values according to the RVC value. Conclusion: The results of this study did not demonstrate a significant correlation between the RVC and the AS parameters and nocturnal DS in EH. Additional prospective studies are warranted to reach a consensus on the clinical significance of RVC measurements in EH. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) was linked to increased lifetime risk of cardiovascular disease. A low ankle–brachial index (ABI) is associated with accelerated atherosclerosis. The ABI value and the associated conditions in women with PCOS were searched in the present study. The ABI was measured using a handheld Doppler device and calculated using both standard and modified definitions. Women with PCOS (n = 103, mean age = 24.9 ± 5.9 years) had a mean ABI of 1.10 ± 0.10. A low ABI (≤0.9) was 2.9% and 14.6% using the standard and modified definitions, respectively. Mean ABI correlated negatively to body weight, BMI, waist circumference, waist-to-hip ratio, and hematocrit. Logistic regression analysis revealed higher waist-to-hip ratio as independently associated with a lower ABI. Frequency of ABI ≤0.9 in PCOS was lower than the general population. However, increased waist-to-hip ratio was a predictor of a lower ABI value. [ABSTRACT FROM PUBLISHER]

Abstract: Although several studies have indicated oxidative system abnormalities in patients with familial Mediterranean fever, it is still obscure whether proteinuria seen in this disease has an effect on the oxidative system. In the present study, oxidative system changes were investigated in familial Mediterranean fever with or without proteinuria. Plasma malondialdehyde levels in proteinuric and nonproteinuric patients were higher than those of the controls and they were also significantly higher in the patients with proteinuria compared to patients without proteinuria. The patients had significantly lower plasma glutathione peroxidase activities than the controls. Glutathione peroxidase activities did not show statistically significant differences between the patients with and those without proteinuria. A significant difference was not established for erythrocyte superoxide dismutase activities. These data suggest that there is an increase in lipid peroxidation in familial Mediterranean fever. Decreased plasma glutathione peroxidase activities seem to be responsible for increased plasma malondialdehyde levels in both patient groups. However, the fact that higher plasma malondialdehyde levels in proteinuric patients were observed compared to nonproteinuric patients in the presence of the unchanged plasma glutathione peroxidase activities in these groups suggests that the nephrotic state may have a contribution to this situation. [Copyright &y& Elsevier]

Background: Unconjugated bilirubin (UCB) plays a protective role in coronary artery disease. Red cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are inflammatory biomarkers and higher levels are related to atherosclerosis and adverse cardiovascular events. Aim: We aimed to investigate the relation between UCB levels and RDW, NLR, PLR in people with Gilbert's syndrome (GS). Materials and methods: We selected 2166 subjects (1082 with GS and 1084 healthy controls) from a database having 33,695 people. RDW, NLR and PLR were investigated in the subjects with GS and compared with the healthy controls. Linear regression analysis was used to evaluate the relation between variables. Results: NLR and PLR were higher in the subjects with GS compared to the controls (p < 0.001). RDW was similar in both groups (p = 0.318). UCB was negatively correlated with lymphocyte counts (p = 0.040), and positively correlated with RDW (p < 0.001) and PLR (p = 0.037) in the subjects with GS. There was no significant correlation between UCB and NLR (p = 0.078). RDW (p < 0.001) and lymphocyte counts (p = 0.030) were significantly associated with UCB levels in the regression analysis conducted in the subjects with GS. Conclusion: There is a negative association between UCB and NLR, PLR due to low amounts of lymphocyte counts, which causes increased risk of CVD. These results suggest that the cardio-protective effect of UCB is due to both anti-oxidative and anti-inflammatory ways indirectly. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the relationship between early stage hypertensive retinopathy (HTRP) and endothelial dysfunction (ED) in atherogenesis. MATERIAL and METHODS: A total of 99 subjects consisting of 73 patients diagnosed with Essential Hypertension (HT) and 26 healthy subjects were included to the study. Flow mediated dilatation (FMD) was performed to detect ED. Asymmetric dimethylarginine-ADMA was measured as a marker of ED and the hsCRP and sTWEAK levels were measured for microvascular inflammation. All patients were screened for retinopathy. RESULTS: The mean blood pressure of the hypertensive patients and the control subjects was 140.1±13.7/86.1±10.7 and 107.12±10.0/65.38±10.2 respectively. HTRP was positive in 60.3% (n=44) and negative in 39.7% (n=29) of the patients with hypertension. There was grade 1 retinopathy in 52.1% and grade 2 retinopathy in 8.2% of hypertensive patients. The hsCRP, sTWEAK and ADMA levels were significantly higher in hypertensive patients than in the control group (respectively, p=0,011, p=0,001, p=0,001). FMD levels were lower in the hypertensive group, as expected. FMD levels were lower in the retinopathy group when the hypertensive group with and without retinopathy and the control group compared. hsCRP, sTWEAK and ADMA levels were significantly higher in subjects with retinopathy. hsCRP, sTWEAK and ADMA levels were also significantly higher in subjects with retinopathy (p=0.039, p=0.001, p=0.001). CONCLUSION: ED is thought to play a role in HT etiology and is also important in the development of HT complications. It would be appropriate to evaluate hypertensive patients more carefully and perform the necessary laboratory tests to detect ED so that the proper treatment can be started (ACEI, exercise, lifestyle changes). [ABSTRACT FROM AUTHOR]

Arterial stiffness is currently the 'gold standard' measure of aortic (carotid-femoral) pulse wave velocity (PWV), which is an important independent predictor of risk of developing a cardiovascular event. Gilbert's syndrome is a congenital disorder characterized by intermittent and non-hemolytic elevation of indirect bilirubin levels due to the deficiency of the enzyme UDP-glucuronyl transferase in the liver and many prospective studies found an inverse relationship between bilirubin levels and cardiovascular events in these patients. We aimed to investigate serum bilirubin levels and arterial stiffness parameters in patients with Gilbert's syndrome in this study. A total of 53 cases, consisting of 26 patients with a diagnosis of Gilbert's syndrome and 27 healthy control subjects, were included in the study. Serum bilirubin levels, other routine blood chemistry, and arterial stiffness measurements were recorded. The mean ages of Gilbert's syndrome and the control group were 31.5 ± 9.7 and 36.8 ± 11.1 years, respectively. PWV measurements were significantly lower in Gilbert syndrome patients (6.68 and 7.3 m/s in patients and controls; respectively) ( P < .05). In correlation analysis in Gilbert's syndrome patients, PWV had a significant correlation with total and indirect bilirubin levels ( r = −0.370, P = .009/ r = −0.495, P = .003, respectively). Gilbert's syndrome patients have lower PWV measurements compared to healthy subjects, and the total and indirect bilirubin levels are also associated with PWV measurements. These findings may indicate the decreased atherosclerotic disease incidence in Gilbert's syndrome patients. [ABSTRACT FROM AUTHOR]

High levels of circulating Von Willebrand factor (vWf) and increased neutrophil to lymphocyte (N/L) ratio may reflect vascular inflammation in hypertensive patients. In present study, we aimed to investigate the effects of valsartan as an angiotensin II receptor antagonist and amlodipine as a calcium channel blocker on the vWf levels and N/L ratio in patients with essential hypertension. Patients were randomized to one of the following intervention protocols: calcium channel blocker (amlodipine, 5-10 mg/day) as group A ( n = 20 mean age = 51.85 ± 11.32 y) and angiotensine II receptor blocker (valsartan, 80-320 mg/day) as group B ( n = 26 mean age = 49.12 ± 14.12 y). Endothelial dysfunction and vascular inflammation were evaluated with vWf levels and N/L ratio in hypertensive patients before treatment and after treatment in the 12th week. No statistically significant differences were found among the groups in terms of age, sex, and body mass index (BMI). There was a significant decrease in vWf levels ( P < .001) and N/L ratio after treatment ( P = .04, P < .001, respectively) in both the groups. Von Willebrand factor levels and N/L ratio are very important markers having a role in vascular inflammation and antihypertensive treatment with amlodipine and valsartan may improve cardiovascular outcomes by decreasing these biomarkers. [ABSTRACT FROM AUTHOR]

Pentraxin 3 (PTX3) is a new candidate immunoinflammatory marker that has been reported to be associated with cardiometabolic risk factors. We aimed to investigate the effects of valsartan and amlodipine on the PTX3 and C-reactive protein (CRP) levels in patients with essential hypertension. Patients with a newly diagnosed essential hypertension were admitted to our internal medicine outpatient clinic. Patients were randomized to one of the following intervention protocols: calcium channel blocker (amlodipine, 5-10 mg/day) as group A ( n = 22; mean age ± standard deviation [SD]: 52 ± 11 year) and angiotensine II receptor blocker (valsartan, 80-320 mg/day) as group B ( n = 28; mean age ± SD: 50 ± 14 year). Endothelial dysfunction and systemic inflammation were evaluated with PTX3 and CRP. There was a significant decrease in the level of PTX3 after treatment in two groups ( P < .05). Although there was a significant decrease in the level of CRP after treatment in amlodipine group, there was no significant decrease in the levels of PTX3 and CRP after treatment in two groups. There were no significant differences in the systolic and diastolic blood pressure reduction between the two treatment groups. In the treatment of hypertension, prior knowledge of the level of plasma PTX3 could be important in antihypertensive drug choice. C-reactive protein and PTX3 are the markers that have role in vascular inflammation and are found associated with the prognosis of cardiovascular outcomes in many trials. In our study, PTX and CRP levels were decreased when compared to baseline levels. [ABSTRACT FROM AUTHOR]

Hypertension is a modifiable risk factor for cardiovascular diseases and is associated with several metabolic disorders like dyslipidemia. Higher levels of triglyceride and low-density lipoprotein (LDL) are quite strong factors for the development of cardiovascular diseases. In this study, we investigated the effects of valsartan and amlodipine on the lipid profile in patients with newly diagnosed essential hypertension. We observed a beneficial effect of amlodipine on the lipid profile with a significant reduction of LDL compared to valsartan. In the treatment of hypertension, prior knowledge of the plasma cholesterol levels can be important in antihypertensive drug choice. [ABSTRACT FROM AUTHOR]

Hypertension is a major challenge for public health. Appropriate antihypertensive treatment seem to provide a better life with lower morbidity and mortality rates. Another pathologic condition, osteoporosis, mainly affects postmenouposal women, and constitutes a growing body of risks after a particular age. As bone is a dynamic organ system that is directly related to calcium and phosphor metabolism, imbalance in these two parameters upon aging or menopause finally may lead to osteoporosis. Today, both osteoporosis and high blood pressure are major morbidities, especially in the elderly population. There are some intriguing results on the effects of antihypertensive agents on bone metabolism in the literature. In this study, we aimed to investigate the effects of widely used antihypertensive agents, valsartan and amlodipine on vitamin D levels in newly diagnosed hypertensive population. We found that amlodipine increased vitamin D levels significantly in patients with a newly diagnosed hypertension on a 12-week treatment duration compared to valsartan. [ABSTRACT FROM AUTHOR]

Background: Microalbuminuria (MA) is common in hypertensive population and is a marker for endothelial dysfunction and a predictor of increased cardiovascular risk. A great body of data shows the importance of MA as a strong predictor of renal and cardiovascular disease (CVD) risk in hypertensive population. Aim: In this study, we aimed to compare the anti-albuminuric effects of an angiotensin II receptor antagonist, valsartan, with a calcium channel blocker, amlodipine, in newly diagnosed hypertensive patients. Material and methods: Totally, 20 patients were recruited into the study. Patients were randomized to one of the following intervention protocols: An (a) angiotensin II receptor blocker (valsartan, 80-320 mg/day) or (b) calcium channel blocker (amlodipine, 5-10 mg/day), for 12 weeks immediately after baseline measurements. Ten patients were randomized into valsartan group and 10 patients into the amlodipine group. Twenty-four-hour urinary albumin excretion (UAE) levels of the patient groups were measured before treatment and on the 12th week. Results: Patients of the two groups were matched for age and body mass index. In the amlodipine group, baseline urine microalbumin levels were higher compared to valsartan group, although the difference was not statistically significant ( p = 0.082). At the 12th week, there was a significant decrease in urine microalbumin levels in the amlodipine group, but no significant change was observed in the valsartan group. Conclusion: Amlodipine seems to be superior to valsartan in decreasing UAE. To reduce cardiovascular risks, endothelial dysfunction, and microinflammation, these factors are taken into consideration while prescribing antihypertensive drugs in hypertensive patients. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma is among the most common solid organ tumors and cancer-related causes of death. It often has an asymptomatic behavior based on a chronic liver disease. To extend survival, detecting early-stage Hepatocellular carcinoma without distant metastases or intravascular thrombus is important in terms of treatment options. We here, present a 61-year-old male patient, who was previously diagnosed with Hepatocellular carcinoma due to chronic Hepatitis B virus infection, had liver resection due to early stage disease and experienced lung metastases, hepatic vein, portal vein, inferior vena cava and bilateral renal vein thrombosis in follow-up. According to our literature search, our case is the first case of bilateral renal vein thrombosis in patient with Hepatocellular carcinoma identified alive. During the investigation of cancer, the right time and the appropriate use of imaging techniques may allow early detection of any vascular thrombosis that can worsen the clinical situation and especially renal vein thrombosis which may be the reason of acute renal failure. [ABSTRACT FROM AUTHOR]