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Chronic Kidney Disease affects approximately 10% of the world’s adult population: it is within the top 20 causes of death worldwide, and its impact on patients and their families can be devastating. World Kidney Day and International Women’s Day in 2018 coincide, thus offering an opportunity to reflect on the importance of women’s health and specifically their kidney health, on the community, and the next generations, as well as to strive to be more curious about the unique aspects of kidney disease in women so that we may apply those learnings more broadly. Girls and women, who make up approximately 50% of the world’s population, are important contributors to society and their families. Gender differences continue to exist around the world in access to education, medical care, and participation in clinical studies. Pregnancy is a unique state for women, offering an opportunity for diagnosis of kidney disease, but also a state where acute and chronic kidney diseases may manifest, and which may impact future generations with respect to kidney health. There are various autoimmune and other conditions that are more likely to impact women with profound consequences for child bearing, and on the fetus. Women have different complications on dialysis than men, and are more likely to be donors than recipients of kidney transplants. In this editorial, we focus on what we do and do not know about women, kidney health, and kidney disease, and what we might learn in the future to improve outcomes worldwide.

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OBJECTIVE: It was evaluated the sufficiency of YouTube videos related with kidney transplantation as a source of information in this study. MATERIAL and METHODS: A search was made on YouTube web site on 01.09.2015 with the “kidney transplantation” keyword. Videos were evaluated by two nephrology specialists experienced in kidney transplantation. Scores (between 0 and 10) for “reliability”, “quality”, “usefulness” were given to each video content during expert evaluation. Chi-square, Mann-Whitney U, and Kruskal-Wallis analyses were carried out for the evaluation of the acquired data using SPSS 20.0. RESULTS: It was determined that 10% of the videos included in the study contained misleading information. It was determined that the videos which have received the highest number of views were on herbal products, surgical intervention and religious knowledge videos respectively (p<0.05). When the distribution of evaluated score averages with regard to the source uploading the video was considered, statistically significant differences were determined in all areas (p<0.05). CONCLUSION: Even though there is information on YouTube related with kidney transplantation, there are also videos that include misleading and unprofessional information. It is thought that healthcare professionals have significant responsibilities for ensuring that videos with reliable content are available in social media

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OBJECTIVE: Anemia is a common problem in chronic renal failure. Recent studies have shown that there is a close relationship between fluctuations in hemoglobin values and increased mortality. Therefore, treatment of anemia and providing stable hemoglobin (Hb) levels with erythropoiesisstimulating agent (ESA) is important in the management of chronic renal failure. Hence, ESA usage and relationship between ESA type and Hb variability were investigated in hemodialysis patients. MATERIAL and METHODS: 130 patients treated at a hemodialysis center were monitored monthly for one year. The mean age was 60±7 years, mean weight was 72±13 kg, and mean dialysis duration was 5 ±2 years (F/M: 64/66). Hb stability was defined as continuous ESA usage at maintenance dosage and Hb levels being at the target level (Hb≥11g/dl) for last 12 months. Hb variability and ESA dose change was accepted as decrease of Hb levels under 11 g/dl during maintenance dosage use and increasing ESA to starting dosage. In our study, annual mean values of monthly prescribed ESA rates, types of ESA and weekly dosages, and changes in ESA dosages due to monthly changes in hemoglobin (Hb) levels were examined. The relation between ESA type and Hb variability was investigated. RESULTS: During a one-year period, the number of patients who did not use ESA (Hb levels always >12 g/dl) was 5 (%3.8) and the number of patients who used ESA for different periods was 125 (%96.2). The mean number of patients using ESA monthly was 71 (57%). 32 (45%) patients used short acting, 31 (44%) used medium acting (darbepoetin) and 8 (11%) used long acting ESA (methoxy polyethylene glycol-epoetin beta). 26 patients (21%) used ESA at the starting dose and 45 (36%) at the maintenance dose. One third of the 71 patients (36.6%) were using ESA at the starting dose and two thirds (63.4%) were on the maintenance dose. Mean weekly short acting ESA dose was 9666±2376 IU in the starting dose group and 5400±1142 IU in the maintenance group. Mean weekly darbepoetin dose was 46.6±10,3 mcg in the starting dose group and 26.4±4,9 mcg in the maintenance group. There were no Hb changes in 33 patients (26.4%) but 92 (73.6%) had Hb variability during one year. During one year, the Hb level dropped under 11 g/dl once in 32 patients (35%), twice in 39 patients (42%), three times in 16 patients (17%) and four times in 5 (6%) patients and the ESA dose was increased to the starting dose. Number of monthly Hb changes was higher in the short acting ESA than the medium and long acting ESA groups. CONCLUSION: Our results revealed that monthly ESA usage rate and weekly ESA dosage were lower than in western countries. During the one year period, there was Hb variability in three in four of the patients and ESA dosages were changed. The number of monthly Hb variability cases was found to be lower in the medium and long acting ESA groups. The most important reason of Hb variability was monthly dose change or discontinuation of ESA, due to the limits in the application of ESA.

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Oral sodyum fosfat (OSP), maliyet ve kullanım kolaylığı açısından kolonoskopi hazırlığında sıkça kullanılır. Kolonoskopi hazırlığında kullanılan OSP ve sodyum fosfat içeren enemalar nedeniyle akut böbrek yetmezliği ortaya çıkabilir. 55 yaşında 5 yıldır bilinen tip 2 diabetes mellitus ve esansiyel hipertansiyonu olan, işlem öncesinde böbrek fonksiyon testleri normal olan kadın hastaya kolonoskopi yapılmış. Kolonoskopi hazırlığı için, 2 adet purgatif ve sodyum fosfat içeren enema verilmiş. Hasta, kolonoskopiden 1 gün sonra acil servise idrar yapamama şikayeti ile başvurdu. Renal biyopsi yapıldı, akut fosfat nefropatisi ile uyumlu saptandı. Kronik böbrek yetmezliği, OSP kullanımı için kontrendikedir. Yaş, kadın cinsiyeti, elektrolit dengesizliği ve OSP’nin uygunsuz kullanımı akut fosfat nefropatisinin riskini arttırır. Kolonoskopi hazırlığı için OSP kullanan, böbrek fonksiyon testlerinde bozulma ile değerlendirilen hastalarda akut fosfat nefropatisi akılda tutulmalıdır

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OBJECTIVE: Rapidly progressive glomerulonephritis is associated with rapid deterioration of kidney function. We aimed to evaluate patients followed-up with the diagnosis of rapidly progressive glomerulonephritis. MATERIAL and METHODS: This retrospective study included 28 patients who were compared for remission status and baseline serum creatinine levels. RESULTS: We evaluated 20 male and 8 female patients with a mean age of 46.68 ±15.94 years. Patients with higher baseline serum creatinine had significantly lower hemoglobin (p=0.01), platelet counts (p=0.01) and calculated e- GFR at last hospital visit (p=0.03) compared to patients with lower baseline serum creatinine. At discharge, the number of dialysis-dependent patients was significantly higher in the patients with higher baseline serum creatinine than the patients with lower baseline serum creatinine (p=0.01). Patients who had achieved remission had significantly lower percentage of cellular crescents (p= 0.009) and sclerotic glomeruli (p= 0.04) than patients who did not achieve remission. Dead patients were more likely to have a lymphocyte count of < 1000 cells/mm3 (p=0.009). CONCLUSION: Patients with high baseline serum creatinine levels were more likely to have lower hemoglobin levels and platelet counts. High baseline serum creatinine level and high percentage of cellular crescents and sclerotic glomeruli were related to worse renal prognosis. Patients with lower lymphocyte counts had higher mortality rates.