Objective: In recent years, paracetamol has been shown to have toxic effects on the kidneys. Sialic acid (SA), an important component of the cell membranes, increases in many pathological conditions. This study aimed to investigate the effects of different doses of paracetamol on the kidney tissue and serum total SA (TSA) and lipid-bound SA (LSA) levels.
Materials and Methods: A total of 5 different groups were formed, with 8 rats in each group; 20 and 500 mg/kg/intraperitoneal paracetamol was applied to the groups once daily for 1 and 3 days, respectively. Renal pathology was evaluated with hematoxylin and eosin. TSA/LSA levels and urea/creatinine levels were measured from the blood samples taken from the rats.
Results: TSA levels were significantly higher in the groups in which paracetamol was administered in a single dose and 500 mg/kg dose for 3 days than control (p<0.05 and p<0.001). LSA levels were significantly higher in the groups that received 1 and 3 doses of 500 mg/kg/day and 3 doses of 20 mg/kg than control (p<0.05, p<0.001, and p<0.05).
Conclusion: SA levels may be a specific marker for kidney damage because of the increase in the SA levels in direct proportion to this level of renal degeneration.
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Objective: Kitāb al-Ḥāwī fī al-Ṭibb, also known as Liber Continens, is one of the most renowned and influential works of the Eastern and Western world written during the medieval times. Written by Abū Bakr Muḥammad b. Zakariyyā al-Rāzī (AD 865-925), who is known as Rhazes in the Western world, Kitāb al-Ḥāwī fī al-Ṭibb has great importance for the history of medicine. Indeed, it contains many valuable quotations from other ancient authors whose works could not endure the present day and Rhazes’ own comments on them. The purpose of this study is to present the fragments of Rhazes’ Kitāb al-Ḥāwī fī al-Ṭibb with quotes from the different works of Archigenes of Apamea, a famous physician living in Rome at the time of emperor Trajan (AD 98-117), in English. The quotes and comments deal with diseases of the kidney, urinary tract, and other related topics.
Materials and Methods: The tenth book of Kitāb al-Ḥāwī entitled fī amrāḍ al-kulā wa majārī al-bawl wa ghayrihā is on diseases of the kidneys, urinary tract, and others. First, quotations from Archigenes were identified in Arabic and Latin texts of al-Hāwī. Then, these fragments were compared with each other and translated into English.
Results: The fragments from Archigenes contains subjects such as kidney pain, hematuria, kidney stones, diabetes, and probable gonorrhea.
Conclusion: The fragments recorded in Kitāb al-Ḥāwī/Liber Continens on diseases of the urogenital system and written by Archigenes of Apamea are discussed and brought to English literature, to the best of our knowledge, for the first time, through this limited study.
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Objective: Atrial fibrillation (AF) is one of the most common and cumulatively important cardiac arrhythmias. Prevalence
of AF is much higher in patients with chronic kidney disease (may be up to 27%). We aimed to study the prevalence and
clinical features of AF in hemodialysis centers.
Materials and Methods: Patients who had been under chronic in-center hemodialysis for at least 6 months and were ≥18
years of age were included in this cross-sectional study conducted at five hemodialysis centers across İstanbul between
May 2017 and July 2017. Medical history, clinical (including medications and echocardiography), and laboratory data were
obtained using a standardized study form.
Results: The data of 632 prevalent patients undergoing in-center hemodialysis (mean age 62.7±13.9 years, males 350 and
females 282) were included in the analysis. AF was present in 92 (14.5%) of the patients. The prevalence of AF was lowest
in patients <55 years of age and showed an increasing trend with age. While age, coronary artery disease, heart failure, and
cerebrovascular events were associated with the presence of AF; left ventricular hypertrophy, diabetes and hypertension
were not. Overall, 78% of patients with AF were using either single or a combination of antithrombotic agents. Less than
10% of AF patients were receiving warfarin. The rates of antiplatelet agents and warfarin use were not different between
patients with a CHA2DS2-VASc score of ≥2 or less.
Conclusion: AF is highly prevalent in patients undergoing hemodialysis, and warfarin was used in nearly 5% of the patients
with AF undergoing hemodialysis in this study, which suggests that the current knowledge is unconvincing to proceed
for the treatment with anticoagulation. Further studies are needed to guide the management for prevention of strokes in
patients with AF undergoing dialysis.
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Objective: Chronic kidney disease (CKD) and diabetes mellitus (DM) both have an increased risk of cardiovascular disease
(CVD). Based on estimated glomerular filtration rate values, both CVD and CKD have powerful and independent relationships even after adjusting for known CVD risk factors, history of CVD events, and proteinuria. However, there are limited
data about the individual effects of the underlying etiology of CKD on CVD. This study aims to evaluate the cardiovascular
status (CVS) of patients with diabetic and non-diabetic stage 3, 4, and 5 CKD with non-invasive methods.
Materials and Methods: A total of 187 patients who had stage 3-5 CKD were grouped on the basis of whether they had
DM or not. The non-invasive cardiovascular markers such as pulse wave velocity, carotid intima media thickness, central
systolic and diastolic pressures, and central pulse pressures were evaluated in these patients.
Results: A total of 187 patients with CKD were recruited for this study. Of them, 46 (25%) had diabetic CKD (mean age,
57.7±9.2 years) and 141 (75%) had non-diabetic CKD (mean age, 56.8±12.4 years). Clinical systolic blood pressure, clinical
pulse pressure, central systolic blood pressure, central pulse pressure, cardiac output, and pulse wave velocity were significantly higher in patients with CKD who had DM.
Conclusion: The impaired renal function and DM have additive effects on the development of peripheral arterial calcification. The CVS of patients with CKD and DM is worse than that of patients with CKD who were not diabetic; therefore, extra
effort must be given for diabetic CKD patients.
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Novel, targeted anticancer therapies have increased survival rates in patients. However, the incidence, severity, and pattern of their toxicities are different from those of traditional chemotherapies. The high prevalence of chronic kidney disease
in the general population and the increased incidence of cancer highlight the need for nephrology consultation regarding
this issue. Here, we review the incidence, mechanisms, and management of adverse renal effects associated with major
molecular, targeted cancer therapies. Early diagnosis and prompt intervention in case of adverse renal events are crucial
for the proper management of patients with cancer treated with targeted agents.
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We aimed to present five patients presenting with hypertension and diagnosed as renal artery stenosis. Five patients with
renal artery stenosis were studied retrospectively. Two of our cases were diagnosed as fibromuscular dysplasia, other
cases were diagnosed as Takayasu arteritis and Moyamoya disease, and one of them had congenital vascular abnormality.
Renovascular hypertension is one of the most important causes of secondary hypertension in children, and renal artery
stenosis constitutes a significant proportion of renovascular disease. We must consider renal artery stenosis in children
presenting with resistant hypertension.
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Acute kidney injury (AKI) is an initial clinical diagnosis in patients with rapid renal function deterioration. Underlying etiologies of AKI include primary kidney diseases, such as acute glomerular and vasculitic diseases, tubulointerstitial nephritis
(TIN); systemic insults, such as ischemia and toxins; and obstructive nephropathy. Acute TIN is a common cause of AKI and
may be caused by systemic autoimmune conditions, such as immunoglobulin G4-related diseases (IgG4-RD). To date, only
one case demonstrates the association of IgG4-RD and AA amyloidosis. Here we report an IgG4-related TIN (IgG4-TIN) and
AA amyloidosis in a patient who presented with gross hematuria, proteinuria, and AKI. IgG4-TIN should be considered as a
potential cause of AKI as well as chronic kidney disease regarding its long-term inflammatory effects on the kidney.
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Hafnia alvei is a rare bacterium that is generally reported to be an opportunistic infectious agent in adults. There are a
limited number of identified pediatric cases in the literature. This article reports H. alvei as the causative agent of urinary
tract infection in a healthy 8-year-old girl with no underlying disease. The patient recovered with a 10-day oral trimethoprim/sulfamethoxazole treatment. The aim of this study was to review the characteristics of this rare microorganism, as a
causative agent of urinary tract infection, for clinicians.
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Objective: Patient access to information support to supplement their understanding of laboratory and test parameters remains challenging because of medical and scientific terminology. These challenges have led to the exploration of new and efficient ways of approaching educational and information support for patients with long-term conditions (LTCs) such as chronic kidney disease (CKD). This study aims to explore the perspectives on educational support surrounding CKD laboratory investigations from a sample of the Renal Patient Support Group (RPSG).
Materials and Methods: The research team conducted five polls from January 2018 to July 2018 via the RPSGs “closed” social media platform to help understand the importance of healthcare scientist’s educational support for laboratory tests and investigations. The target of this study was to seek 1,000 responses from 8,000 members of this social media platform.
Results: A total of 574 RPSG members participated in polls, representing a 7% response rate. Seventy-seven percent (mean: 23; SD: 5.48) of the respondents agreed that access to a healthcare scientist in primary care would be advantageous. When asked about what technology solutions are available via general practitioner (GP)/transplant unit, a portal allowing access to medical records and laboratory results scored highest with 26% (mean: 25.3; SD: 5.02) respondents selecting this choice. Assessing a remote healthcare scientist via a computer or application was selected by 33% (mean: 17.8; SD: 4.21) of the respondents. CKD patients get confused regarding laboratory investigations accessed by a mix of healthcare professionals. Healthcare scientists should educate patients about laboratory investigations.
Conclusions: The polls conducted added value to an important topic of healthcare scientist involvement in educating CKD patients about laboratory investigations. Currently, there is more scope for healthcare scientists to provide support to CKD patients with smarter education regarding laboratory investigations and parameters.
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Objective: Large solitary renal cysts (SRC) may result in renal ischemia. Renalase, a protective enzyme against ischemic renal injury, has an effective role in controlling blood pressure (BP). Therefore, we aimed to investigate the relationships among pre- and postoperative serum angiotensinogen, epinephrine, renalase/epinephrine ratio, and BP in patients who underwent laparoscopic cyst decortication.
Materials and Methods: We included 20 patients with large SRC and 16 healthy individuals in this prospective study. Cysts were diagnosed by ultrasonography and characterized using computed tomography. Blood and urine samples were collected during pre- and postoperative periods. In addition, 12-hour ambulatory BP values were recorded. Serum angiotensinogen, renalase, and epinephrine levels were measured by the enzyme-linked immunosorbent assay method.
Results: There was no statistically significant difference in angiotensinogen and renalase levels between patient and control groups (p=0.205, p=0.163, respectively), but preoperative renalase/epinephrine ratio was significantly higher in patients (p=0.006) than in the control group. In addition, renalase/epinephrine ratio was significantly lower in the postoperative period (p=0.018). Univariate and multivariate logistic regression analyses demonstrated that a higher renalase/epinephrine ratio was associated with the presence of SRC (p=0.028, p=0.016, respectively).
Conclusion: A high renalase/epinephrine ratio may be associated with the presence of large SRC. We think that renalase may be a biomarker in the management of SRC and decision making in surgical procedures. Association of renalase with large SRC should be explored in future studies.
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