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BACKGROUND AND AIMS Haemodialysis (HD) patients are at increased risk for adverse short-term consequences of COVID-19. In this study, we investigated the characteristics of chronic HD patients in the post-COVID-19 period and compared them with the control group. METHOD We conducted a national multicentre observational study involving adult chronic HD patients recovering from COVID-19. The control HD group was selected from patients with similar characteristics who did not have COVID-19 in the same center. SARS-CoV-2 RT-PCR negative patients and patients in the active period of COVID-19 were not included. RESULTS A total of 1223 patients (635 COVID-19 groups, 588 control groups) were included in the study from the data collected from 47 centres between 21 April 2021 and 11 June 2021. The patients' baseline demographics, comorbidities, medications, HD characteristics and basic laboratory tests were quite similar between the groups (Table 1). 28th-day mortality and between 28th day and 90th day mortality were higher in the COVID-19 group than in the control group [19 (3.0%) patients and 0 (0%) patients; 15 (2.4%) patients and 4 (0.7%) patients, respectively]. Presence of respiratory symptoms, rehospitalization, need for home oxygen therapy, lower respiratory tract infection and A-V fistula thrombosis were significantly higher in the COVID-19 group in the first 28 days of illness and between 28 and 90 days. Mortality was significantly associated with preexisting COVID-19, age, current smoking, use of tunneled HD catheter, persistence of respiratory symptoms, rehospitalization, need for home oxygen support, presence of lower respiratory tract infection within 28 days and persistence of respiratory symptoms. CONCLUSION In the post-COVID-19 period, mortality, rehospitalization, respiratory problems and vascular access problems are higher in maintenance HD patients who have had COVID-19 compared to control HD patients. Table 2. Comparative presentation of patients data on the 28th day and between 28 and 90 day COVID-19 groupN = 635 Control groupN = 588 28th-day results, n(%) Death* 19(3.0) 0(0) Any respiratory symptoms* 152(23.9) 11(1.9) Rehospitalization for any reason* 52(8.2) 24(4.1) Need for home oxygen support * 26(4.1) 2(0.3) Lower respiratory tract infection* 65(10.2) 8(1.4) AV fistula thrombosis* 13(2.0) 2(0.3) Other thromboembolic events * 15(2.4) 4(0.7) Need for HD catheter placement* 21(3.3) 9(1.5) 28th day-90. day resultsa n(%) N:616 N:588 Death* 15(2.4) 4(0.7) Any respiratory symptoms* 45(7.3) 10(1.7) Rehospitalization for any reason* 44(7.1) 18(3.1) Need for home oxygen support* 12(1.9) 2(0.3) AV fistula thrombosis* 9(1.5) 1(0.2) Other thromboembolic events* 9(1.5) 2(0.3) Need for HD catheter placement 13(2.1) 10(1.7) HD: haemodialysis, AV: arteriovenous. *P

Purpose To investigate the frequency of hypogonadism and its relationship to inflammation and carotid intima-media thickness (CIMT) in male patients with predialysis chronic kidney disease (CKD). Methods A total of 105 patients with CKD, 55 (52.4%) as stage 3, 33 (31.4%) as stage 4 and 17 (16.2%) as stage 5, were enrolled into the study. Total testosterone (TT) and free testosterone (FT), interleukin 6 (IL-6), C-reactive protein (CRP) levels, and CIMT were measured. Results According to TT and FT, hypogonadism was detected in 18 (17.1%) and 22 (20.9%) patients, respectively. There was no difference in terms of TT and FT, CIMT, CRP and IL-6 between the stages of CKD. According to TT, the patients with hypogonadism had significantly higher CRP and high-density lipoprotein cholesterol (HDL-cholesterol) levels (p = 0.004 and p = 0.005, respectively). There was no significant difference in other parameters. According to FT, the patients with hypogonadism had significantly higher CRP (p = 0.017), and TT were negatively correlated with body mass index (BMI), waist circumference (WC), hip circumference, and CRP levels. FT was negatively correlated with age, waist circumference, systolic blood pressure, diastolic blood pressure (DBP) and CRP. Conclusions The frequency of hypogonadism was found around 17–21% among the patients with CKD. Despite similar IL-6 and CIMT levels, CRP was found to be higher in the patients with hypogonadism. We consider that further studies with larger populations are needed to elucidate the entity.

Despite plenty of restless legs syndrome (RLS) studies conducted with hemodialysis patients, it has been scarcely studied in patients with predialysis chronic kidney disease (CKD). In the present study, we aimed to investigate the frequency of RLS in patients with nondialysis chronic kidney disease and explore the relationship between RLS with sleep quality, depression, pulse wave velocity (PWV), and clinical parameters. This cross-sectional study included 259 stage 3–5 predialysis CKD patients. The diagnosis of RLS was defined according to the diagnostic criteria defined by the international RLS study group. Beck depression inventory (BDI) was employed to assess depression while Pittsburgh Sleep Quality Index (PSQI) was employed to assess sleep quality. 41 patients (16%) were diagnosed with RLS. BDI and PSQI scores of patients with RLS were significantly higher than those without RLS (p = 0.01, p = 0.03, respectively). Pulse wave velocity (PWV) was significantly lower in patients with RLS (8.0 ± 1.8) than those without RLS (8.6 ± 1.9) (p = 0.05). Decrease in PWV and increase in BDI score demonstrated by multivariate analysis were shown as independent predictors of RLS development (ExpB = 1.266, p = 0.02 and ExpB = 0.957, p = 0.007 and p = 0.04, respectively). RLS is a significant problem in predialysis CKD patients and depression, and poor sleep quality is typical in these patients. Arterial stiffness is lower in these patients and any factors related to the pathophysiology of RLS might play important roles in modulating atherosclerosis.

Introduction: Hemodialysis (HD) patients have increased risk for short-term adverse outcomes of COVID-19. However, complications and survival at the post-COVID-19 period have not been published extensively.Methods: We conducted a national, multicenter observational study that included adult maintenance HD patients recovered from confirmed COVID-19. A control HD group without COVID-19 was selected from patients in the same center. We investigated the characteristics and outcomes in the follow-up of HD patients and compare them with the non-COVID-19 group.Results: A total of 1223 patients (635 patients in COVID-19 group, 588 patients in non-COVID-19 group) from 47 centers were included in the study. The patients' baseline and HD characteristics were almost similar. The 28th-day mortality and mortality between 28th day and 90th day were higher in the COVID-19 group than non-COVID-19 group (19 [3.0%] patients vs. none [0%]; 15 [2.4%] patients vs. 4 [0.7%] patients, respectively). The presence of respiratory symptoms, rehospitalization, need for home oxygen therapy, lower respiratory tract infection, and arteriovenous (AV) fistula thrombosis was significantly higher in the COVID-19 group in both the first 28 days and between 28 and 90 days. In the multivariable analysis, age (odds ratio [OR] [95% CI]: 1.029 [1.004-1.056]), group (COVID-19 group vs. non-COVID-19 group) (OR [95% CI]: 7.258 [2.538-20.751]), and vascular access type (tunneled catheter/AV fistula) (OR [95% CI]: 2.512 [1.249-5.051]) were found as independent parameters related to 90-day mortality.Conclusion: In the post-COVID-19 period, maintenance HD patients who have had COVID-19 have increased rehospitalization, respiratory problems, vascular access problems, and high mortality compared with the non-COVID-19 HD patients.

Objective: Pulse wave velocity (PWV) is frequently used for arterial stiffness assessment in chronic renal disease (CRD). There are very few studies in the literature about the relationship between arterial stiffness and renal progression leading to mortality in CRD. Herein, we searched the relationship between arterial stiffness, and progression of kidney disease, leading to mortality in CRD patients. Methods: 194 stage 3-5 CRD patients were included in the study. The patients were followed at least four years. The primary endpoints were initiation a renal replacement treatment and death. PWV was measured using the Mobil-O-Graph NG arteriography device. Results: The study was completed with 194 patients within four years. During this period, out of 194 patients, 89 needed a renal replacement treatment (72 hemodialysis patients, 17 renal transplantation) and 15 died. Ninety of them are still being followed as predialysis CKD patient in the nephrology outpatient clinic. Increased PWV was detected as an independent predictive marker of mortality. Conclusion: Our study demonstrated that PWV might be an independent predictor of mortality. In this sense, monitoring the PWV and taking measures in this direction can reduce the effect of arterial stiffness on mortality., Amaç: Nabız dalga hızı (PWV), vasküler kalsifikasyon tanısında kullanılan elektron beam bilgisayarlı tomografi (EBCT) ile korelasyon gösterir ve kronik böbrek hastalığında (KBH) arteriyel sertlik değerlendirmesi için sıklıkla kullanılır. Literatürde KBH’ da arteriyel sertlik ile böbrek progresyonu ve mortalite arasındaki ilişki hakkında çok az çalışma vardır. Bu çalışmada KBH’da arteriyel sertlik ile böbrek hastalığının progresyonu ve mortalite arasındaki ilişkiyi araştırdık. Gereç ve Yöntem: Aralık 2014-Haziran 2015 tarihleri arasında nefroloji polikliniğine başvuran evre 3-5 kronik böbrek hastaları çalışmaya alındı. Hastalar en az dört yıl takip edildi. Birincil sonlanım noktaları bir renal replasman tedavisi başlanması (renal transplantasyon, hemodiyaliz veya periton diyalizi) ve ölümdür. Nabız dalga hızı (PWV) Mobil-O-Graph NG (Stemberg Germany Stolberg Germany) arteriograf cihazı kullanılarak ölçüldü. Bulgular: Çalışma 4 yıl boyunca düzenli kontrole gelen 194 hasta ile tamamlandı. Bu süre zarfında 194 hastanın 89’unda renal replasman tedavisi (72 hemodiyaliz, 17 renal transplantasyon) gerekti ve 15’i öldü. 90 hasta nefroloji polikliniğinde prediyaliz KBH’sı olarak izlenmektedir. Artan PWV, mortalitenin bağımsız bir prediktif belirteci olarak tespit edildi. Sonuç: Bu çalışmada, PWV’deki artışın mortalitenin bağımsız bir belirteci olduğunu bulduk. Bu anlamda, PWV’nin izlenmesinin ve bu yönde önlemler alınmasının arteriyel sertliğin mortalite üzerindeki etkisini azaltabileceğini gösterdik.

Introduction Chronic kidney disease (CKD) patients have more frequent sleep disorders and cardiovascular disease than normals. Since arterial stiffness as a risk factor of atherosclerosis can be evaluated with pulse wave velocity (PWV), we aimed to investigate the prevalance of sleep quality (SQ) and the relationship between SQ and risk factors of atherosclerosis and whether there is a relationship between SQ and PWV (the indicator of arterial stiffness) in predialysis CKD patients. Methods This cross-sectional study was carried out in CKD patients followed at the Nephrology Department in Konya, Turkey, between November 2014 and March 2015. A total of 484 CKD patients were screened. Of the 484 patients, 285 patients were excluded. The remaining 199 CKD patients without cardiovascular disease at stage 3, 4, and 5 (predialysis) were included in the final study. The SQ of the patients was evaluated by the Pittsburgh Sleep Quality Index (PSQI). PWV was measured by using a single-cuff arteriography device (Mobil-O-Graph PWA, a model pulse wave analysis device; IEM). Results A total of 199 predialysis CKD patients were included in the study, 73 of whom (36.7%) were ‘poor sleepers’ (global PSQI >5). Patients with poor SQ were older than those with good SQ (p = 0.077). SQ was worse in female patients compered to male patients (p = 0.001). SQ was worse in obese patients. As laboratory parameters, serum phosphorus, LDL cholesterol, and triglycerides levels correlated positively with SQ (respectively; r = 0.245, pConclusions Our study showed for the first time that there is a relationship between SQ and risk factors of atherosclerosis in predialysis CKD patients.