Aim:Inflammation plays an important role in the development of diabetic nephropathy (DNP). In our study, we aimed to analyze the relationship between the mean platelet volume (MPV), ...neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), uric acidlymphocyte ratio (UALR), and uric acid level with early diagnosis of DNP and DNP progression.Methods:Our cross-sectional study, which is a type of observational study, included patients diagnosed with type 2 diabetes mellitus and followed in the internal medicine and nephrology clinics of our hospital. Patients were divided into four groups: Group 1: estimated glomerular filtration rate (eGFR) >60 mL/min/1.73 m2 and albuminuria <30 mcg/day; Group 2: eGFR >60 mL/min/1.73 m2 and albuminuria: 30-300 mcg/day; Group 3: eGFR >60 mL/min/1.73 m2 and albuminuria >300 mcg/day; and Group 4: eGFR <60 mL/ min/1.73 m2 and albuminuria >300 mcg/day. Thirty-six patients were included in group 1, 38 patients in group 2, 35 patients in group 3, and 40 patients in group 4. Mean platelet volume, NLR, PLR, UALR, and uric acid levels were compared among the groups.Results:A total of 149 patients were included in the study; 57.7% were female, and the mean age was 55.2±9.2 years. Significant differences were found among the groups in terms of MPV, PLR, NLR, and UALR (p<0.001, p=0.023, p≤0.001, p<0.001, respectively). There was a negative correlation between eGFR and MPV (r=-0.218, p=0.008). While there was no relationship between eGFR and platelet values, a relationship was obtained when platelets were compared with lymphocytes (r=-0.263, p=0.002). There was a weak relationship between eGFR and neutrophil levels (r=-0.188, p=0.026), but a stronger relationship was found when neutrophil and lymphocyte values were rationed (r=-0.414, p<0.001).Conclusion:Mean platelet volume, PLR, NLR, UALR, and uric acid levels, especially MPV, can be used in the development and progression of DNP.
Aim: The aim of this study was to determine the relationship between left ventricular hypertrophy (LVH) and inflammatory markers in patients with type 2 Diabetes Mellitus (T2DM) with diabetic ...nephropathy at different stages.
Methods: Our study was a cross-sectional study involving patients with various stage of T2DM. Patients with LVH were identified by 2D echocardiography. Plasma human tumor necrosis factor alpha (TNF-α), interleukin (IL)-1, IL-6, vaspin, vispatin and midkine were measured.
Results: A total of 59 T2DM patients (56% women) with a mean age of 56.1±8.8 years were included in the study. The mean left ventricular mass index was 129±30. LVH was detected in 62.7% of the patients. Patients with an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2 had a higher incidence of LVH than patients with an eGFR ≥60 mL/min/1.73 m2 (p=0.03). The TNF-α levels in patients with LVH with low eGFR was found to be statistically significantly higher than in patients without LVH (p=0.047). The level of vaspin was statistically significantly higher in patients with LVH (p=0.01).
Conclusion: LVH was found to be more frequent in patients with low eGFR, and from inflammatory markers, it was found to be associated only with TNF-α and vaspin.
Cardiorenal syndrome (CRS) is a general term that can
reflect different clinical conditions in which cardiac and renal
dysfunctions coexist. The main pathogenetic mechanisms
playing a role in heart ...failure (HF) and CRS are neurohumoral
adaptation, right ventricular dilatation and dysfunction and
systemic inflammation. Persistence of these factors cause
focal and segmental glomerulosclerosis, and tubulointerstitial
fibrosis in the renal parenchyma. Diuretics, beta blockers, reninangiotensin-
aldosterone system inhibitors, and vasodilators are
the main medical treatments besides conventional approach,
such as salt and water restriction and quitting smoking,
in HF treatment. Diuretic resistance is the main problem
emerging during diuretic treatments. Two renal replacement
treatments have become prominent for removal of excess
fluids via ultrafiltration in HF patients with diuretic resistance
extracorporeal ultrafiltration with hemodialysis and peritoneal
dialysis (PD). Herein, the role of these two ultrafiltration
modalities, especially peritoneal ultrafiltration (PUF) in the
treatment of HF is discussed. The main studies and advantages
of PUF in HF treatment were discussed. Moreover, effects of
PD on glomerular filtration rate, hospitalization and mortality
were investigated. In conclusion, PD is an alternative cheap,
practical and convenient therapy in reducing cardiac volume
burden in HF patients who do not respond well to standard
treatments and/or require frequent hospitalization.
Aim: Asymmetric dimethylarginine (ADMA) is associated with
increased coronary artery disease risk through endothelial dysfunction
in dialysis patients. We aimed to investigate the role of ...flow-mediated
dilatation (FMD), a non-invasive indicator of endothelial function, and
ADMA in mortality in peritoneal dialysis (PD) patients.
Methods: PD patients aged 18-80 years; with dialysis duration of at
least three months were included. FMD measurement and ADMA
levels were recorded. Outcome of the patients on the third year were
analyzed with binary logistic analyses.
Results: The mean age of the 55 patients was 53±15 years and the
mean follow-up duration was 36 months. Mean FMD and ADMA
levels were 10.6±6.4% and 81.8±48.0 mol/L, respectively. Eighteen
patients died during follow-up. Age, presence of diabetes mellitus
and ischemic heart disease, ultrafiltration amount and serum albumin
level were related with mortality while gender, weekly Kt/V and
ADMA levels were not. There was no significant relationship between
ADMA level and FMD (p=0.873). FMD was negatively correlated with
systolic and diastolic blood pressures (p=0.001, p<0.001, respectively).
Hypertension was found to be the most important single factor
determining FMD (p=0.037).
Conclusion: Estimating endothelial function by FMD or measuring
serum ADMA levels may not be useful for predicting mortality in PD
patients.
Amaç: Fokal segmental glomerüloskleroz (FSGS) Türkiye’ de ve dünyada sık görülen glomerülonefritlerdendir. Çalışmamızın amacı, merkezimizde erişkin yaş grubunda primer FSGS tanısıyla takip edilmekte ...olan hastaların tanı anı demografik ve klinik özelliklerini, biyopsi bulgularını ortaya koymaktır.
Yöntemler: Tek merkezli, retrospektif, kesitsel çalışmamıza kliniğimizde takip edilen böbrek biyopsi ile kanıtlanmış primer FSGS tanılı 99 erişkin hasta çalışmamıza dahil edildi. Sekonder FSGS tanılı hastalar dışlandı. Hastalara ait demografik ve klinik özellikleri, biyopsi bulguları incelendi.
Bulgular: Çalışmamıza dahil edilen 99 hastadan 59’u (%59,6) kadındı. Hastaların ortalama tanı yaşı 40,7±13,8 yıldı. Hastaların en sık biyopsi endikasyonu nefrotik sendromdu (%68,7), başvuru tahmini glomerüler filtrasyon hızı 78,9±35,8 mL/dk/1,73 m2’ydi. Serum albümin ortalamaları 3,2±0,9 gr/dL iken, proteinüri ortancaları 3485 (çeyrekler arası Aralık: 1739-7275) mg/gün olarak saptandı. İnterstisyel fibrozis hastaların %63,4’ünde, tübüler atrofi %74,7’sinde saptandı.
Sonuç: Fokal segmental glomerüloskleroz hastalarımızda başvuru şikayetleri ve klinik verileri ülke ve dünya literatürü ile uyumlu bulunmakla birlikte biyopsi anında hastaların yaklaşık yüzde kırkı azalmış böbrek fonksiyonlarıyla karşımıza çıkmaktadır. Yapılan biyopsilerde tübüler atrofi ve interstisyel fibrozisin yüksek oranda görülmesi nedeniyle FSGS düşünülen hastaların biyopsileri daha erken yapılmalıdır.
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