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  • 1
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    P0440EPIDEMIOLOGICAL AND CLINICAL CHARACTERSTICS OF IGA NEPHROPATHY PATIENTS IN TURKEY: TSN-GOLD WORKING GROUP
    Oxford University Press (OUP) ; 2020
    In:  Nephrology Dialysis Transplantation Vol. 35, No. Supplement_3 ( 2020-06-01)
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    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 35, No. Supplement_3 ( 2020-06-01)
    Abstract: According to the data of the Turkish Society of Nephrology-Glomerular Diseases Working Group (TSN-GOLD Working Group), IgA nephropathy is the most common primary glomerular disease in Turkey. The purpose of this study was to investigate the epidemiological and clinical data of IgA nephropathy patients in Turkey. Method 4399 patients with primary glomerular diseases from 47 centers who were followed up between May 2009 and May 2019 were included in the study conducted by TSN-GOLD Working Group. 524 patients were excluded due to lack of pathological data. Among the remaining patients, demographic, clinical and laboratory data of 994 patients with IgA nephropathy were analyzed. Results The median age of the patients was 37 (28-47) years, and 37.3% of them were female. The laboratory and clinical data at the time of diagnosis is presented in Figure-1, and biopsy indications are described in Figure-2. The median number of glomeruli was 16 (IQR: 3.5-4.3), sclerotic glomeruli was 2 (IQR: 1-5), and segmental sclerotic glomeruli was 1 (IQR: 1-2). Exudative changes, subendothelial and subepithelial deposition were present in 566 patients (56.9%), 46 patients (4.6%) and in 38 patients (3.8%), respectively. 662 (66.1%) and 611 of the patients (61.4%) had tubular atrophy and interstitial fibrosis in varying degrees, respectively. 672 (%67.6) and 416 patients (%41.9) had interstitial inflammation and vascular changes, respectively. In immunofluorescence staining, 18%, 30.1%, 4.4%, 68% of the patients had IgG, IgM, C1q and C3 positivity, respectively. Crescentic glomeruli were detected in 227 patients (3.3 ± 3.1 glomeruli). Patients with crescentic glomeruli had significantly higher proteinuria and lower eGFR than the patients without [2203 mg/day (15-26078) vs 1807 mg/day (15-29112); p=0.001; 55.3 ml/min/1.73 m2 (3.72-141.9) vs 72 ml/min/1.73 m2 (3.84-150.81); p & lt;0.001, respectively]. Oxford classification was applied to 544 patients. Endocapillary hypercellularity (E1), mesengial hypercellularity (M1), tubular atrophy and interstitial fibrosis (T1 and T2), segmental sclerosis (S1) were present in 126 (13%), 425 (42.8%), 306 (30.8%) and 325 patients (%32.7), respectively. Proteinuria levels were higher in patients with endocapillary hypertrophy, mesengial hypercellularity, tubular atrophy-interstitial fibrosis and segmental sclerosis. eGFR levels were lower in patients with endocapillary hypertrophy, tubular atrophy-interstitial fibrosis and segmental sclerosis (Figure-3). Conclusion In this study we found that, the most common presentation of IgA nephropathy patients in our country was asymptomatic urinary abnormalities followed by nephritic and nephrotic syndrome. Higher proteinuria and lower eGFR values in patients with crescentic glomeruli, support the adoption of crescentic lesions in the new Oxford classification (MEST-C) to predict more precise outcome of IgA nephropathy patients. The high number of patients to whom the Oxford classification was applied provided us with the opportunity to examine the clinical reflections of pathological features. Evaluation of the follow-up data of the patients will give us the possibility to reveal the effect of initial clinical and pathological features on clinical findings and renal outcome.
    Type of Medium: Online Resource
    ISSN: 0931-0509 , 1460-2385
    URL: Article
    DOI: 10.1093/ndt/gfaa142.P0440
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
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  • 2
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    P0448CHARACTERISTICS OF PRIMARY GLOMERULAR DISEASE PATIENTS WITH HEMATURIA IN TURKEY: THE DATA FROM TSN-GOLD WORKING GROUP
    Oxford University Press (OUP) ; 2020
    In:  Nephrology Dialysis Transplantation Vol. 35, No. Supplement_3 ( 2020-06-01)
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    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 35, No. Supplement_3 ( 2020-06-01)
    Abstract: Hematuria is one of the most common laboratory findings in nephrology practice. In different regions of the world, the etiologic causes differ. To date, there is no enough data regarding the clinical and histopathologic characteristics of primary glomerular diseases (PGD) patients with hematuria in our country. Method Data were obtained from national multicenter (47 centers) data entered into the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) database between May 2009 and June 2019. The data of all PGD patients over the age of 16 years who were diagnosed with renal biopsy and had hematuria data were included in the study. The biopsy samples were processed using a light microscopy and immunofluorescence examination. Demographic characteristics such as age, sex, indications for biopsy, primary glomerular diseases, comorbidities, laboratory and biopsy findings of all patients were also recorded. Hematuria was defined as the presence of at least 5 red blood cells/hpf. Results Data of 3394 patients were included to the study after the exclusion of patients with secondary glomerulonephritis and patients with missing biopsy findings. While 1699 (50.1%) patients had hematuria, 1695 (49.9%) patients did not have hematuria. Demographic, laboratory, and histopathological characteristics of patients with and without hematuria are given in Table. Patients with hematuria had statistically higher systolic blood pressure (SBP), serum blood urea nitrogen, creatinine, albumin, levels and urine pyuria, however, these patients had statistically lower age, body mass index, presence of hypertension and diabetes, eGFR, 24-hour proteinuria, serum total, HDL and LDL-cholesterol and C3 levels when compared with patients without hematuria. Figure depicted the etiologic causes of patients with and without hematuria. According to histopathological findings, number of global sclerotic glomeruli, cellular and fibrocellular crescents, the levels of mesangial proliferation, endocapillary proliferation, exudative changes in glomeruli, severe tubular atrophy, interstitial inflammation, subendothelial deposition, moderate and severe IgA and C3 deposition were found to be significantly higher and the levels of basal membrane thickening, interstitial fibrosis, subepithelial deposition, severe IgG staining were found to be significantly lower in patients with hematuria. Conclusion This is the first multicenter national report regarding the demographic and histopathologic data of PGD patients with or without hematuria. Hematuria, a feature of nephritic syndrome, was found at a higher than expected in the PGDs presenting with nephrotic syndrome in our national database.
    Type of Medium: Online Resource
    ISSN: 0931-0509 , 1460-2385
    URL: Article
    DOI: 10.1093/ndt/gfaa142.P0448
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
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  • 3
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    #3266 PROGNOSTIC FACTORS IN RENAL AND PATIENT SURVIVAL IN ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODY ASSOCIATED VASCULITIS
    Oxford University Press (OUP) ; 2023
    In:  Nephrology Dialysis Transplantation Vol. 38, No. Supplement_1 ( 2023-06-14)
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    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 38, No. Supplement_1 ( 2023-06-14)
    Abstract: The most important determinant of renal and patient survival in anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) is early initiation immunosuppressive (IS) therapy. Other factors associated with survival are age and renal function and/or renal involvement at diagnosis. The prognosis is poor in patients with AAV who do not receive IS treatment. The effect of plasma exchange (PE). in patients who underwent plasmapheresis with IS treatment has been questioned in recent studies. Renal histology is a predictor of long-term risk of renal failure in patients with crescentic glomerulonephritis, and prognostic histological scorings have been developed. In this study, we investigated clinical and pathological risk factors that may affect patient and renal survival in patients with AAV. Method Data of 225 AAV patients diagnosed by renal biopsy in the age range of 16-85 years in 30 centers were used which were obtained from the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) Working Group database. Patients who did not have regular follow-up for at least 3 months, patients with immunocomplex glomerulonephritis, and patients with rapidly progressive glomerulonephritis who were positive for anti-GBM antibodies were excluded from the study. Patients with negative ANCA (n: 17) and unknown ANCA results (n: 28) were included in the study according to their renal biopsy findings. Results The mean age of the study population was 52,1±15,2 years and 126 (56%) were male. After renal biopsy, 154 patients (85.1%) received only cyclophosphamide and steroid treatment as initial IS treatment, 23 patients (12.6%) also received PE. When the clinical results of the patients were evaluated, end-stage renal disease (ESRD) was detected in 50 (22.2%) patients, while 36 (16%) patients died. When the factors affecting the development of ESRD were evaluated with the logistic regression analysis model, it was shown that the low albumin level of the patients at the time of diagnosis and the percentage of interstitial fibrosis (IF) & gt;25% in renal pathology were more effective for the development of ESRD (p = 0.02, p = 0.01). When the factors affecting the survival of the patients were evaluated with the logistic regression analysis model, we demonstrated that there was no significant effect of PE and IF & gt;25% in renal pathology; age [HR = 1.035 (1.001-1.069)] and patients with lower albumin value [HR = 0.488 (0.241-0.987)] were found to be more risky in terms of death (p = 0.041, p = 0.046) (Table 1). Conclusion In this study, the serum albumin level of the patient at the time of biopsy was determinant in renal and patient survival in AAV. IF & gt;25% in renal pathology was effective in renal survival, but it was not found to be effective in patient survival. Plasma exchange did not provide additional benefit to standard treatment. Prospective and multicenter studies with a larger number of patients are needed to confirm our findings.
    Type of Medium: Online Resource
    ISSN: 0931-0509 , 1460-2385
    URL: Article
    DOI: 10.1093/ndt/gfad063a_3266
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
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  • 4
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    #3476 CHARACTERISTICS AND SURVIVAL DATA OF PATIENTS WITH PRIMARY FOCAL SEGMENTAL SEGMENTAL GLOMERULOSCLEROSIS: TSN-GOLD MULTI-CENTER STUDY
    Oxford University Press (OUP) ; 2023
    In:  Nephrology Dialysis Transplantation Vol. 38, No. Supplement_1 ( 2023-06-14)
    Details
    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 38, No. Supplement_1 ( 2023-06-14)
    Abstract: We aimed to investigate the characteristics and survival data of biopsy-proven primary focal segmental glomerulosclerosis (FSGS) in adult patients across Turkey. Method Patients with primary FSGS were included by retrospectively scanning the database of the Turkish Society of Nephrology Glomerular Diseases Study Group (TSN-GOLD). Demographic and laboratory data of the patients at baseline, sixth month, first year, and third year were recorded. Patients with secondary FSGS, missing data were excluded. Results The study included 1668 patients with primary FSGS who met the criteria. 1386 patients were included. The mean age of the patients was 41.16±13.88 years, and 712 patients (51.4%) were male. The total follow-up period from the biopsy date was 37.63±40.45 (IQR:1-249) months. The mean blood pressure of the patients, respectively; 130.43±17.63/81.47±10.85 mmHg, serum creatinine 1.29±1.28 mg/dl, e-GFR: 86.10±42.70 ml/min/1.73 m2, serum albumin: 3.41±0.92 g/dl and proteinuria amount was 4687±4658 g/day. Microscopic hematuria was detected in 40.2% of the patients. The rate of admission with nephrotic syndrome was .45.7%. In light microscopy, the mean glomeruli count was 17.36±10.58, with 3.32±4.08 global sclerosis and 0.08±065 glomeruli had segmental sclerosis. Mesangial proliferation was found in 53.1% of the patients and interstitial inflammation was found in 69.7% of the patients. Interestingly, the most common immunoglobulin staining was IgM (19.3%) in the immunofluorescent microscope. The rate of receiving immunosuppressive therapy was 36%. A positive correlation was found in terms of serum creatinine, albumin, and proteinuria in the 3-year follow-up (p & lt;0.001). In the univariate analysis, the group with e-GFR & lt;60 ml/min/1.73 m2 was older, hypertensive, uremic, anemic, had more interstitial fibrosis/tubular atrophy and less interstitial inflammation and mesangial proliferation (p & lt;0.001). In terms of quantitative proteinuria, Patients with proteinuria & gt;3.5 g/day were more hypertensive, hyperlipidemic, hypoalbuminemic and anemic (p & lt;0.05). Conclusion Our study presented important data on the status of patients with national primary FSGS. Approximately one-third of patients receive immunosuppressive therapy. The most important factors determining the prognosis of primary FSGS are the initial nephrotic proteinuria and the degree of renal function.
    Type of Medium: Online Resource
    ISSN: 0931-0509 , 1460-2385
    URL: Article
    DOI: 10.1093/ndt/gfad063c_3476
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
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  • 5
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    Systemic Lupus Erythematosus Presenting with Renal Vein Thrombosis: A Case Report
    AVES YAYINCILIK A.Ş. ; 2014
    In:  Turkish Nephrology Dialysis Transplantation Vol. 23, No. 2 ( 2014-5-6), p. 172-174
    Details
    In: Turkish Nephrology Dialysis Transplantation, AVES YAYINCILIK A.Ş., Vol. 23, No. 2 ( 2014-5-6), p. 172-174
    Type of Medium: Online Resource
    ISSN: 1300-7718
    Uniform Title: Systemic Lupus Erythematosus Presenting with Renal Vein Thrombosis: A Case Report
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.5262/tndt.2014.1002
    DOI: 10.5262/tndt
    DOI: 10.5262/tndt.2014.1002.20
    Language: Unknown
    Publisher: AVES YAYINCILIK A.Ş.
    Publication Date: 2014
    detail.hit.zdb_id: 3142917-8
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  • 6
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    P0377THE RELATIONSHIP BETWEEN SEVERITY OF INTERSTITIAL FIBROSIS AND ANEMIA IN PATIENT WITH PRIMARY GLOMERULONEPHRITIS: THE DATA FROM TSN-GOLD WORKING GROUP
    Oxford University Press (OUP) ; 2020
    In:  Nephrology Dialysis Transplantation Vol. 35, No. Supplement_3 ( 2020-06-01)
    Details
    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 35, No. Supplement_3 ( 2020-06-01)
    Abstract: Anemia is one of the most important complications in chronic renal disease and inadequate erythropoietin production is the most important reason for anemia. Fibrosis of renal interstitium may be associated with inadequate synthesis of erythropoietin and anemia. In our study, we investigated the relationship between the severity of interstitial fibrosis (IF) in patients with primary glomerulonephritis (PGN) and anemia parameters. Method A total of 2794 patients who were recorded to the database of the Turkish Society of Nephrology, Glomerular Diseases (TSN-GOLD) Working Group between May 2009 and June 2019 were included in our national multicenter (44 centers) study. Patients aged 16 years or more with documented biopsy were included in the study. Patients were divided into four groups according to IF severity. IF was not detected in the interstitial area, was defined as none, if fibrosis was present in less than 25% of the area, defined as mild, if fibrosis was present in 25-50%, defined as moderate and if more than 50%, defined as severe. Anemia was defined as hemoglobin & lt;12 g/dl in adult female patients and & lt;13 g/dl in adult male patients, according to Clinical Practice Guidelines for anemia of CKD published by The Kidney Disease: Improving Global Outcomes Foundation. The relationship between IF severity and anemia parameters at the time of biopsy was investigated. Results In the study, 57% of the patients were male and their mean age was 41.0 ± 14.3 years. The mean eGFR was 82.7 ± 36.9 ml / min / 1.73 m2 and the hemoglobin level was 13.1 ± 1.9 g/dl. General characteristics of patients with and without anemia are given in Table 1. While 41.1% of patients had no IF, 41.2% had mild, 14.1% had moderate and 3.5% had severe IF. When the patients were divided into four groups according to the severity of IF, the mean hemoglobin and hematocrit levels were significantly different between the groups (Figure 1). Anemia was present in 960 patients (34.4%) (Figure 2). Anemia rate was significantly higher in the patients with IF than patients without IF (36.8% vs 30.9%, p = 0.001). Anemia rate was %25.1 in patients with eGFH≥60 ml/min/1.73m2 and 56% in patients with eGFR & lt;60 ml/min/1.73m2. Gender, serum albumin, eGFR, proteinuria, presence of diabetes, presence of nephrotic syndrome, and presence of IF were the independent variables in the regression analysis of hemoglobin-related factors (Table 2). Conclusion Approximately one-third of PGN patients had anemia at the time of biopsy and the frequency of anemia increases in patients with IF. The presence of IF is an independent risk factor associated with the development of anemia in PGN. The elucidation of the etiopathogenesis of anemia in PGN patients may play an important role in the follow-up and treatment of patients. Studies on IF can play a critical role.
    Type of Medium: Online Resource
    ISSN: 0931-0509 , 1460-2385
    URL: Article
    DOI: 10.1093/ndt/gfaa142.P0377
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
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  • 7
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    Colistin and Acute Renal Failure: A Centre’s Experience
    AVES YAYINCILIK A.Ş. ; 2014
    In:  Turkish Nephrology Dialysis Transplantation Vol. 23, No. 3 ( 2014-9-2), p. 196-201
    Details
    In: Turkish Nephrology Dialysis Transplantation, AVES YAYINCILIK A.Ş., Vol. 23, No. 3 ( 2014-9-2), p. 196-201
    Type of Medium: Online Resource
    ISSN: 1300-7718
    Uniform Title: Colistin and Acute Renal Failure: A Centre’s Experience
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.5262/tndt.2014.1003
    DOI: 10.5262/tndt
    DOI: 10.5262/tndt.2014.1003.04
    Language: Unknown
    Publisher: AVES YAYINCILIK A.Ş.
    Publication Date: 2014
    detail.hit.zdb_id: 3142917-8
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  • 8
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    Urinay neutrophil gelatinase-associated lipocalin as a biomarker in different renal problems
    The Scientific and Technological Research Council of Turkey (TUBITAK-ULAKBIM) - DIGITAL COMMONS JOURNALS ; 2020
    In:  TURKISH JOURNAL OF MEDICAL SCIENCES Vol. 50, No. 6 ( 2020-10-22), p. 1566-1572
    Details
    In: TURKISH JOURNAL OF MEDICAL SCIENCES, The Scientific and Technological Research Council of Turkey (TUBITAK-ULAKBIM) - DIGITAL COMMONS JOURNALS, Vol. 50, No. 6 ( 2020-10-22), p. 1566-1572
    Abstract: Background/aim: Neutrophil gelatinase-associated lipocalin (NGAL) is used previously to estimate the etiology, severity, and clinical outcomes of acute kidney injury (AKI). However, the role of urinary NGAL (uNGAL) in the postrenal setting is not clear. In our study, we aimed to discover the cut-off value of uNGAL that can be used in the differential diagnosis of underlying AKI etiologies.Materials and methods: In this prospective cross-sectional study, we examined 82 subjects in four groups: patients that had (1) postrenal AKI; (2) AKI other than postrenal etiologies; (3) stable chronic kidney disease; and (4) healthy subjects. A renal function assessment was carried out by measuring serum creatinine (sCr) and uNGAL at the time of diagnosis [0th min (T0)] . We followed the study group for three months. Results: At the time of diagnosis, sCr (T0) was highest in the postrenal AKI and AKI groups in contrast to stable chronic kidney disease patients and healthy subjects (P 〈 0.001), as expected. T0 median uNGAL was highest in the postrenal group (P 〈 0.001). Area under curve (AUC) of uNGAL to estimate postrenal AKI presence was 0.957 (95% CI, 0.897–1.000; P 〈 0.001). The cut-off point of uNGAL was 42.625 ng/mL for this estimation. Conclusion: Patients with AKI must be classified according to the underlying etiologies as soon as possible. uNGAL may be useful to estimate the etiologies, and whether the problem is acute or chronic in the course. In postrenal kidney problems, to plan the urgency of the urologic procedures, it is crucial.
    Type of Medium: Online Resource
    ISSN: 1303-6165
    URL: Article
    DOI: 10.3906/sag-2002-130
    Language: Unknown
    Publisher: The Scientific and Technological Research Council of Turkey (TUBITAK-ULAKBIM) - DIGITAL COMMONS JOURNALS
    Publication Date: 2020
    detail.hit.zdb_id: 2046475-7
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  • 9
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    Occult Adrenal Insufficiency in Renal Amyloidosis Patients
    Galenos Yayinevi ; 2021
    In:  Medeniyet Medical Journal ( 2021)
    Details
    In: Medeniyet Medical Journal, Galenos Yayinevi, ( 2021)
    Abstract: Objective: Systemic amyloidosis may affect many organs, and may cause endocrinologic problems which may result in adrenal insufficiency. However, assessment of adrenocortical reserve is challenging in amyloidosis patients with renal involvement. We aimed to evaluate adrenocortical reserve with various methods of cortisol measurement to determine any occult clinical condition. Methods: Patients with renal amyloidosis and healthy subjects were evaluated in this cross-sectional study. Basal cortisol, corticosteroid-binding globulin (CBG), and albumin levels were measured. Serum free cortisol (cFC) level was calculated. Cortisol response tests performed after ACTH stimulation test (250 μg, intravenously) were evaluated, and free cortisol index (FCI) was calculated. Results: Twenty renal amyloidosis patients, and 25 healthy control subjects were included in the study. Patients and control subjects had similar median serum baseline cortisol levels [258 (126-423) vs 350 (314-391) nmol/L, p=0.169)] whereas patients’ stimulated cortisol levels at the 60th minute were lower [624 (497-685) vs 743 (674-781) nmol/L, p=0.011)] . The 60th-minute total cortisol levels of 8 of the 20 (40%) amyloidosis patients were 〈 500 nmol/L, but only three of these 8 patients had stimulated FCI 〈 12 nmol/mg suggesting an adrenal insufficiency (15%). Conclusion: ACTH stimulation test and cortisol measurements should be considered in renal amyloidosis patients with severe proteinuria to avoid false positive results if only ACTH stimulation test is used. It will be appropriate to evaluate this group of patients together with estimated measurements as FCI.
    Type of Medium: Online Resource
    ISSN: 2149-2042
    Uniform Title: Renal Amiloidoz Hastalarında Gizli Adrenal Yetmezlik
    URL: Article
    DOI: 10.5222/MMJ.2021.93902
    Language: Unknown
    Publisher: Galenos Yayinevi
    Publication Date: 2021
    detail.hit.zdb_id: 3035195-9
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  • 10
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    The relation between serum cathepsin D level and carotid intima-media thickness in nondiabetic hypertensive patients
    The Scientific and Technological Research Council of Turkey (TUBITAK-ULAKBIM) - DIGITAL COMMONS JOURNALS ; 2016
    In:  TURKISH JOURNAL OF MEDICAL SCIENCES Vol. 46 ( 2016), p. 13-17
    Details
    In: TURKISH JOURNAL OF MEDICAL SCIENCES, The Scientific and Technological Research Council of Turkey (TUBITAK-ULAKBIM) - DIGITAL COMMONS JOURNALS, Vol. 46 ( 2016), p. 13-17
    Type of Medium: Online Resource
    ISSN: 1300-0144 , 1303-6165
    URL: Article
    DOI: 10.3906/sag-1410-55
    Language: Unknown
    Publisher: The Scientific and Technological Research Council of Turkey (TUBITAK-ULAKBIM) - DIGITAL COMMONS JOURNALS
    Publication Date: 2016
    detail.hit.zdb_id: 2046475-7
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