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Gursu M, Ozturk S, Arici M, Sahin İ, Bek S, Yılmaz M, Ozberk S, Karahisar Sirali S, Ural Z, Dursun B, Yuksel E, Uzun S, Sipahi S, Ahbap Dal E, Serra Ucar A, Altunoren O, Tunca O, Ayar Y, Gok Oguz E, Yilmaz Z, Kahvecioglu S, Asicioglu E, Oruc A, Riza Altiparmak M, Aydin Z, Huddam B, Esra Dolarslan M, Azak A, Bakirdogen S, Ugur Yalcin A, Karadag S, Sena Ulu M, Gungor O, Ari Bakir E, Riza Odabas A, Seyahi N, Yildiz A, Ateş K. MO696: Characteristics and Survival Results of Peritoneal Dialysis Patients Suffering from Covid-19 in Turkey: A Multicenter National Study. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac078.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Although existing data suggest an increased mortality rate, data about the course of coronavirus disease 2019 (COVID-19) in peritoneal dialysis (PD) patients, its short- and long-term effects on the patient and technique survival are limited. Moreover, specific factors associated with increased risk of death have not been clearly defined yet. Therefore, we aimed to study the characteristics of PD patients with COVID-19, determine the short-term mortality and other medical complications, and delineate the factors associated with COVID-19 outcome.
METHOD
This national multicenter study included all PD patients who had confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection based on positive reverse transcriptase–polymerase chain reaction testing of a nasopharyngeal swab recorded in this database from the attending 27 PD centers. The demographic data, comorbidities, medications used, PD-related data were recorded as well as clinical, laboratory and radiological findings of COVID-19 and outcomes at the end of the first month were recorded.
RESULTS
We enrolled 142 COVID-19 patients (median age: 52 years). A total of 58.2% of patients had mild disease at diagnosis, lung involvement was detected in 60.8% of patients. A total of 83 (58.4%) patients were hospitalized, 31 (21.8%) patients were admitted to intensive care unit and 24 needed mechanical ventilation. A total of 15 (10.5%) patients were switched to hemodialysis and hemodiafiltration was performed for 4 (2.8%) patients. Persisting pulmonary symptoms (n = 27), lower respiratory system infection (n = 12), rehospitalization for any reason (n = 24), malnutrition (n = 6), hypervolemia (n = 13), peritonitis (n = 7), ultrafiltration failure (n = 7) and in PD modality change (n = 8) were reported in survivors. During the 1 month from the diagnosis of COVID-19, 26 patients (18.31%) died. The non-survivor group was older and comorbidities were more prevalent. Fever, dyspnea, cough, serious-vital disease at presentation, bilateral pulmonary involvement and pleural effusion were more frequent among non-survivors. Age (OR:1.102; 95% CI: 1.032–1.117; P:0.004), moderate–severe clinical disease at presentation (OR:26.825; 95% CI: 4.578–157.172; P < 0.001) and CRP levels (OR:1.008; 95% CI; 1.000–1.016; P:0.040) were associated with increased first-month mortality in multivariate analysis.
CONCLUSION
Early mortality rate and medical complications are quite high in PD patients with COVID-19. Age, clinical severity of COVID-19 and baseline CRP level are the independent parameters associated with mortality.
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Affiliation(s)
- Meltem Gursu
- Turkey
- Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Bezmialem Vakıf University, Istanbul, Turkey
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Arikan H, Ozturk S, Tokgoz B, Dursun B, Seyahi N, Trabulus S, Islam M, Ayar Y, Gorgulu N, Karadag S, Gok M, Akcali E, Bora F, Aydın Z, Altun E, Ahbap E, Polat M, Soypacacı Z, Oguz EG, Koyuncu S, Colak H, Sahin İ, Dolarslan ME, Helvacı O, Kurultak I, Eren Z, Dheir H, Ogutmen MB, Taymez DG, Genek DG, Ozkurt S, Bakır EA, Yuksel E, Sahutoglu T, Oto OA, Boz G, Sengul E, Kara E, Tuglular S. Characteristics and outcomes of acute kidney injury in hospitalized COVID-19 patients: A multicenter study by the Turkish society of nephrology. PLoS One 2021; 16:e0256023. [PMID: 34375366 PMCID: PMC8354466 DOI: 10.1371/journal.pone.0256023] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 07/28/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Acute kidney injury (AKI) is common in coronavirus disease-2019 (COVID-19) and the severity of AKI is linked to adverse outcomes. In this study, we investigated the factors associated with in-hospital outcomes among hospitalized patients with COVID-19 and AKI. METHODS In this multicenter retrospective observational study, we evaluated the characteristics and in-hospital renal and patient outcomes of 578 patients with confirmed COVID-19 and AKI. Data were collected from 34 hospitals in Turkey from March 11 to June 30, 2020. AKI definition and staging were based on the Kidney Disease Improving Global Outcomes criteria. Patients with end-stage kidney disease or with a kidney transplant were excluded. Renal outcomes were identified only in discharged patients. RESULTS The median age of the patients was 69 years, and 60.9% were males. The most frequent comorbid conditions were hypertension (70.5%), diabetes mellitus (43.8%), and chronic kidney disease (CKD) (37.6%). The proportions of AKI stages 1, 2, and 3 were 54.0%, 24.7%, and 21.3%, respectively. 291 patients (50.3%) were admitted to the intensive care unit. Renal improvement was complete in 81.7% and partial in 17.2% of the patients who were discharged. Renal outcomes were worse in patients with AKI stage 3 or baseline CKD. The overall in-hospital mortality in patients with AKI was 38.9%. In-hospital mortality rate was not different in patients with preexisting non-dialysis CKD compared to patients without CKD (34.4 versus 34.0%, p = 0.924). By multivariate Cox regression analysis, age (hazard ratio [HR] [95% confidence interval (95%CI)]: 1.01 [1.0-1.03], p = 0.035], male gender (HR [95%CI]: 1.47 [1.04-2.09], p = 0.029), diabetes mellitus (HR [95%CI]: 1.51 [1.06-2.17], p = 0.022) and cerebrovascular disease (HR [95%CI]: 1.82 [1.08-3.07], p = 0.023), serum lactate dehydrogenase (greater than two-fold increase) (HR [95%CI]: 1.55 [1.05-2.30], p = 0.027) and AKI stage 2 (HR [95%CI]: 1.98 [1.25-3.14], p = 0.003) and stage 3 (HR [95%CI]: 2.25 [1.44-3.51], p = 0.0001) were independent predictors of in-hospital mortality. CONCLUSIONS Advanced-stage AKI is associated with extremely high mortality among hospitalized COVID-19 patients. Age, male gender, comorbidities, which are risk factors for mortality in patients with COVID-19 in the general population, are also related to in-hospital mortality in patients with AKI. However, preexisting non-dialysis CKD did not increase in-hospital mortality rate among AKI patients. Renal problems continue in a significant portion of the patients who were discharged.
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Affiliation(s)
- Hakki Arikan
- Department of Internal Medicine, Division of Nephrology, Marmara University School of Medicine, Istanbul, Turkey
| | - Savas Ozturk
- Department of Nephrology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Bulent Tokgoz
- Department of Internal Medicine, Division of Nephrology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Belda Dursun
- Department of Internal Medicine, Division of Nephrology, Pamukkale University Medical School, Denizli, Turkey
| | - Nurhan Seyahi
- Department of Nephrology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Sinan Trabulus
- Department of Nephrology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Mahmud Islam
- Division of Nephrology, Zonguldak Ataturk State Hospital, Zonguldak, Turkey
| | - Yavuz Ayar
- Division of Nephrology, Bursa City Hospital, Faculty of Medicine, University of Health Sciences, Bursa, Turkey
| | - Numan Gorgulu
- Department of Nephrology, Istanbul Bagcilar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Serhat Karadag
- Department of Nephrology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Mahmut Gok
- Department of Nephrology, Sultan 2.Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Esra Akcali
- Department of Nephrology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Feyza Bora
- Department of Internal Medicine, Division of Nephrology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Zeki Aydın
- Department of Nephrology, Kocaeli Darica Farabi Training and Research Hospital, University of Health Sciences, Kocaeli, Turkey
| | - Eda Altun
- Division of Nephrology, Golcuk Necati Celik State Hospital, Kocaeli, Turkey
| | - Elbis Ahbap
- Department of Nephrology, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
| | - Mehmet Polat
- Division of Nephrology, Nevsehir State Hospital, Nevsehir, Turkey
| | - Zeki Soypacacı
- Department of Nephrology, Ataturk Training and Research Hospital, University of Katip Celebi, Izmir, Turkey
| | - Ebru Gok Oguz
- Department of Nephrology, Diskapi Yildirim Beyazit Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Sumeyra Koyuncu
- Department of Internal Medicine, Division of Nephrology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Hulya Colak
- Division of Nephrology, Tepecik Education and Research Hospital University of Health Sciences, İzmir, Turkey
| | - İdris Sahin
- Department of Internal Medicine, Division of Nephrology, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Murside Esra Dolarslan
- Division of Nephrology, Trabzon Kanuni Education and Research Hospital, University of Health Sciences, Trabzon, Turkey
| | - Ozant Helvacı
- Division of Nephrology, Yenimahalle Research and Training Hospital, Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey
| | - Ilhan Kurultak
- Department of Nephrology, Trakya University Faculty of Medicine, Edirne, Turkey
| | - Zehra Eren
- Department of Nephrology, Alanya Alaaddin Keykubat University School of Medicine, Antalya, Turkey
| | - Hamad Dheir
- Department of Internal Medicine, Division of Nephrology, Sakarya University Medical Faculty Education and Research Hospital, Sakarya, Turkey
| | - Melike Betul Ogutmen
- Division of Nephrology, Haydarpasa Numune Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Dilek Guven Taymez
- Nephrology and Dialysis Department, Kocaeli State Hospital, Kocaeli, Turkey
| | - Dilek Gibyeli Genek
- Department of Nephrology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Sultan Ozkurt
- Department of Nephrology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Elif Ari Bakır
- Department of Nephrology, Bahcesehir University Hospital, Istanbul, Turkey
| | - Enver Yuksel
- Department of Nephrology, Gaziyasargil Training and Research Hospital, University of Health Sciences, Diyarbakir, Turkey
| | - Tuncay Sahutoglu
- Nephrology Unit, Sanliurfa Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey
| | - Ozgur Akin Oto
- Department of Internal Medicine, Division of Nephrology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Gulsah Boz
- Division of Nephrology, Kayseri City Training and Research Hospital, Kayseri, Turkey
| | - Erkan Sengul
- Division of Nephrology, Kocaeli Derince Education and Research Hospital, University of Health Sciences, Kocaeli, Turkey
| | - Ekrem Kara
- Department of Internal Medicine, Division of Nephrology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Serhan Tuglular
- Department of Internal Medicine, Division of Nephrology, Marmara University School of Medicine, Istanbul, Turkey
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Arıkan İH, Ozturk S, Tokgoz B, Dursun B, Seyahi N, Trablus S, Islam M, Ayar Y, Gorgulu N, Karadag S, Gok M, Akcali E, Bora F, Aydin Z, Altun E, Ahbap Dal E, Polat M, Soypacaci Z, Gok Oguz E, Koyuncu S, Colak H, Sahin İ, Dolarslan ME, Helvacı Ö, Kurultak I, Eren Z, Dheir H, OGUTMEN MELIKEBETUL, Guven Taymez D, Gibyeli Genek D, Ozkurt S, Ari Bakir E, Yuksel E, Sahutoglu T, Oto OA, Boz G, Erkan S, Kara E, Tuglular ZS. MO357ACUTE KIDNEY INJURY IN HOSPITALIZED COVID-19 PATIENTS: A MULTICENTRE STUDY BY TURKISH SOCIETY OF NEPHROLOGY. Nephrol Dial Transplant 2021. [PMCID: PMC8194783 DOI: 10.1093/ndt/gfab082.0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
Acute kidney injury (AKI) is common in coronavirus disease-2019 (COVID-19) and the severity of AKI is linked to adverse outcomes. In this study, we investigated the factors associated with in-hospital outcomes among hospitalized patients with COVID-19 and AKI.
Method
In this multicenter retrospective observational study, we evaluated the characteristics and in-hospital renal and patient outcomes of 578 patients with confirmed COVID-19 and AKI. Data were collected from 34 hospitals in Turkey from March 11 to June 30, 2020. AKI definition and staging were based on the Kidney Disease Improving Global Outcomes criteria. Patients with end-stage kidney disease or with a kidney transplant were excluded. Renal outcomes were identified only in discharged patients.
Results
The median age of the patients was 69 years, and 60.9% were males. The most frequent comorbid conditions were hypertension (70.5%), diabetes mellitus (43.8%), and chronic kidney disease (41.5%). The proportions of AKI stages 1, 2, and 3 were 54.0%, 24.7%, and 21.3%, respectively. 291 patients (50.3%) were admitted to the intensive care unit. Renal improvement was complete in 80.7% and partial in 17% of the patients who were discharged. Renal outcomes were worse in patients with AKI stage 3 or baseline CKD. The overall in-hospital mortality in patients with AKI was 38.9%. By multivariate Cox regression analysis, age (hazard ratio [HR] [95% confidence interval (95%CI)]: 1.01 [1.0-1.03], p = 0.035], male gender (HR [95%CI]: 1.47 [1.04-2.09], p = 0.029), diabetes mellitus (HR [95%CI]: 1.51 [1.06-2.17], p = 0.022) and cerebrovascular disease (HR [95%CI]: 1.82 [1.08-3.07], p = 0.023), serum lactate dehydrogenase (greater than two-fold increase) (HR [95%CI]: 1.55 [1.05-2.30], p = 0.027) and AKI stage 2 (HR [95%CI]: 1.98 [1.25-3.14], p = 0.003) and stage 3 (HR [95%CI]: 2.25 [1.44-3.51], p = 0.0001) were independent predictors of in-hospital mortality. The in-hospital mortality rates across AKI stages by age, gender, and diabetes mellitus were shown in the Figure.
Conclusion
Advanced-stage AKI is associated with extremely high mortality among hospitalized COVID-19 patients. Age, male gender, comorbidities, which are risk factors for mortality in patients with COVID-19 in the general population, are also related to in-hospital mortality in patients with AKI. Renal problems continue in a significant portion of the patients who were discharged.
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Affiliation(s)
- İzzet Hakkı Arıkan
- Marmara University School of Medicine, Deparment of Internal Medicine, Division of Nephrology, Istanbul, Turkey
| | - Savas Ozturk
- Haseki Training and Research Hospital, Department of Nephrology, Istanbul, Turkey
| | - Bulent Tokgoz
- Erciyes University School of Medicine, Deparment of Internal Medicine, Division of Nephrology, Kayseri, Turkey
| | - Belda Dursun
- Pamukkale University Medical School, Deparment of Internal Medicine, Division of Nephrology, Denizli, Turkey
| | - Nurhan Seyahi
- Istanbul University, Cerrahpasa Medical Faculty, Department of Nephrology, Istanbul, Turkey
| | - Sinan Trablus
- Istanbul University, Cerrahpasa Medical Faculty, Department of Nephrology, Istanbul, Turkey
| | - Mahmud Islam
- Zonguldak Ataturk State Hospital, Division of Nephrology, Zonguldak, Turkey
| | - Yavuz Ayar
- University of Health Science. Faculty of Medicine, Bursa City Hospital, Division of Nephrology, Bursa, Turkey
| | - Numan Gorgulu
- University of Health Sciences, Istanbul Bagcilar Training and Research Hospital, Department of Nephrology, Istanbul, Turkey
| | - Serhat Karadag
- Haseki Training and Research Hospital, Department of Nephrology, Istanbul, Turkey
| | - Mahmut Gok
- Sultan 2. Abdulhamid Han Training and Research Hospital, Department of Nephrology, Istanbul, Turkey
| | - Esra Akcali
- Mersin University Faculty of Medicine, Department of Nephrology, Mersin, Turkey
| | - Feyza Bora
- Akdeniz University Faculty of Medicine, Deparment of Internal Medicine, Division of Nephrology, Antalya, Turkey
| | - Zeki Aydin
- University of Health Sciences, Kocaeli Darica Farabi Training and Research Hospital, Department of Nephrology, Kocaeli, Turkey
| | - Eda Altun
- Golcuk Necati Celik State Hospital, Division of Nephrology, Kocaeli, Turkey
| | - Elbis Ahbap Dal
- Sisli Hamidiye Etfal Education and Research Hospital, Department of Nephrology, Istanbul, Turkey
| | - Mehmet Polat
- Nevsehir State Hospital, Division of Nephrology, Nevsehir, Turkey
| | - Zeki Soypacaci
- University of Katip Celebi, Ataturk Training and Research Hospital, Department of Nephrology, Izmir, Turkey
| | - Ebru Gok Oguz
- University of Health Sciences, Diskapi Yildirim Beyazit Education and Research Hospital, Department of Nephrology, Ankara, Turkey
| | - Sumeyra Koyuncu
- Erciyes University School of Medicine, Deparment of Internal Medicine, Division of Nephrology, Kayseri, Turkey
| | - Hulya Colak
- University of Health Sciences, Tepecik Education and Research Hospital, Division of Nephrology, Izmir, Turkey
| | - İdris Sahin
- Inonu University Faculty of Medicine, Deparment of Internal Medicine, Division of Nephrology, Malatya, Turkey
| | - Murside Esra Dolarslan
- University of Health Sciences,Trabzon Kanuni Education and Research Hospital, Division of Nephrology, Trabzon, Turkey
| | - Özant Helvacı
- Yildirim Beyazit University Yenimahalle Research and Training Hospital, Division of Nephrology, Ankara, Turkey
| | - Ilhan Kurultak
- Trakya University Faculty of Medicine, Department of Nephrology, Edirne, Turkey
| | - Zehra Eren
- Alanya Alaaddin Keykubat University School of Medicine, Deparment of Internal Medicine, Division of Nephrology, Antalya, Turkey
| | - Hamad Dheir
- Sakarya University Medical Faculty Education and Research Hospital, Deparment of Internal Medicine, Division of Nephrology, Sakarya, Turkey
| | - MELIKE BETUL OGUTMEN
- University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Division of Nephrology, Istanbul, Turkey
| | - Dilek Guven Taymez
- Kocaeli State Hospital, Nephrology and Dialysis Department, Kocaeli, Turkey
| | - Dilek Gibyeli Genek
- Mugla Sıtkı Kocman University, Faculty of Medicine, Department of Nephrology, Mugla, Turkey
| | - Sultan Ozkurt
- Eskisehir Osmangazi University Faculty of Medicine, Department of Nephrology, Eskisehir, Turkey
| | - Elif Ari Bakir
- Bahcesehir University Hospital, Department of Nephrology, Istanbul, Turkey
| | - Enver Yuksel
- University of Health Sciences, Gaziyaşargil Training and Research Hospital, Department of Nephrology, Diyarbakir, Turkey
| | - Tuncay Sahutoglu
- Sanliurfa Mehmet Akif Inan Training and Research Hospital, Nephrology Unit, Sanliurfa, Turkey
| | - Ozgur Akin Oto
- Istanbul University Istanbul Medical Faculty, Deparment of Internal Medicine, Division of Nephrology, Istanbul, Turkey
| | - Gulsah Boz
- Kayseri City Training and Research Hospital, Division of Nephrology, Kayseri, Turkey
| | - Sengul Erkan
- Health Science University, Kocaeli Derince Education and Research Hospital, Division of Nephrology, Kocaeli, Turkey
| | - Ekrem Kara
- Recep Uzmanı Tayyip Erdogan University, Faculty of Medicine, Deparment of Internal Medicine, Division of Nephrology, Rize, Turkey
| | - Z Serhan Tuglular
- Marmara University School of Medicine, Deparment of Internal Medicine, Division of Nephrology, Istanbul, Turkey
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4
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Sumnu A, Turkmen K, Cebeci E, Turkmen A, Eren N, Seyahi N, Oruc A, Dede F, Derici Ü, Basturk T, Şahin G, Sipahioglu M, Sahin GM, Tatar E, Dursun B, Sipahi S, Yılmaz M, Suleymanlar G, Ulu S, Gungor O, Kutlay S, Bahçebaşı ZB, Sahin İ, Kurultak I, Sevinc C, Yilmaz Z, Kazancioglu RT, Cavdar C, Candan F, Aydin Z, Oygar D, Gul B, Altun B, Paydas S, Uzun S, Istemihan Z, Ergul M, Dincer MT, Gullulu M, Piskinpasa S, Akcay OF, Unsal A, Koyuncu S, Gok M, Ozturk S. Characteristics of primary glomerular diseases patients with hematuria in Turkey: the data from TSN-GOLD Working Group. Int Urol Nephrol 2020; 53:945-954. [PMID: 33155086 DOI: 10.1007/s11255-020-02690-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 10/27/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Hematuria is one of the most common laboratory findings in nephrology practice. To date, there is no enough data regarding the clinical and histopathologic characteristics of primary glomerular disease (PGD) patients with hematuria in our country. METHODS 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. Demographic characteristics, laboratory and biopsy findings were also recorded. RESULTS Data of 3394 PGD patients were included in the study. While 1699 (50.1%) patients had hematuria, 1695 (49.9%) patients did not have hematuria. Patients with hematuria had statistically higher systolic blood pressure, 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-h proteinuria, serum total, HDL and LDL cholesterol, and C3 levels when compared with patients without hematuria. Hematuria was present 609 of 1733 patients (35.8%) among the patients presenting with nephrotic syndrome, while it was presented in 1090 of 1661 (64.2%) patients in non-nephrotics (p < 0.001). 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.
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Affiliation(s)
- Abdullah Sumnu
- Department of Nephrology, Medical Faculty, Medipol Mega Hastanesi, Medipol University, Göztepe Mahallesi Metin Sk. No: 4, Bağcılar, Istanbul, Turkey.
| | - Kultigin Turkmen
- Nephrology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Egemen Cebeci
- Nephrology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Aydin Turkmen
- Nephrology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Necmi Eren
- Nephrology Medical Faculty, Kocaeli University, İzmit, Kocaeli, Turkey
| | - Nurhan Seyahi
- Nephrology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Aysegul Oruc
- Nephrology, Medical Faculty, Uludag University, Bursa, Turkey
| | - Fatih Dede
- Nephrology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Ülver Derici
- Nephrology, Medical Faculty, Gazi University, Ankara, Turkey
| | - Taner Basturk
- Nephrology, Hamidiye Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Garip Şahin
- Nephrology, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Murat Sipahioglu
- Nephrology, Medical Faculty, Erciyes University, Kayseri, Turkey
| | - Gulizar Manga Sahin
- Nephrology, Sultan Abdulhamit Han Research and Training Hospital, Istanbul, Turkey
| | - Erhan Tatar
- Nephrology, Bozyaka Training and Research Hospital, Izmır, Turkey
| | - Belda Dursun
- Nephrology, Medical Faculty, Pamukkale University, Denizli, Turkey
| | - Savas Sipahi
- Nephrology, Medical Faculty, Sakarya University, Sakarya, Turkey
| | - Mürvet Yılmaz
- Nephrology, Bakirkoy Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | | | - Sena Ulu
- Nephrology, Medical Faculty, Afyon University, Afyon, Turkey
| | - Ozkan Gungor
- Nephrology, Medical Faculty, Sutcu İmam University, Kahramanmaras, Turkey
| | - Sim Kutlay
- Nephrology, İbni Sina Hospital, Medical Faculty, Ankara University, Ankara, Turkey
| | | | - İdris Sahin
- Nephrology, Medical Faculty, Inonu University, Malatya, Turkey
| | - Ilhan Kurultak
- Nephrology, Medical Faculty, Trakya University, Edirne, Turkey
| | - Can Sevinc
- Nephrology, Medical Faculty, Ataturk University, Erzurum, Turkey
| | | | | | - Caner Cavdar
- Nephrology, Medical Faculty, Dokuz Eylul University, Izmir, Turkey
| | - Ferhan Candan
- Nephrology, Medical Faculty, Cumhuriyet University, Sivas, Turkey
| | - Zeki Aydin
- Nephrology, Darica Farabi Training and Research Hospital, Darıca, Kocaeli, Turkey
| | - Deren Oygar
- Nephrology, Burhan Nalbantoglu State Hospital, Lefkosa, Cyprus
| | - Bulent Gul
- Nephrology, Bursa Yuksek Ihtisas Training and Research Hospital, Nilüfer, Bursa, Turkey
| | - Bulent Altun
- Nephrology, Medical Faculty, Hacettepe University, Ankara, Turkey
| | - Saime Paydas
- Nephrology, Medical Faculty, Cukurova University, Adana, Turkey
| | - Sami Uzun
- Nephrology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Zulal Istemihan
- Internal Medicine, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Metin Ergul
- Nephrology Medical Faculty, Kocaeli University, İzmit, Kocaeli, Turkey
| | - Mevlut Tamer Dincer
- Nephrology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Mustafa Gullulu
- Nephrology, Medical Faculty, Uludag University, Bursa, Turkey
| | - Serhan Piskinpasa
- Nephrology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | | | - Abdulkadir Unsal
- Nephrology, Hamidiye Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Sumeyra Koyuncu
- Nephrology, Medical Faculty, Erciyes University, Kayseri, Turkey
| | - Mahmut Gok
- Nephrology, Sultan Abdulhamit Han Research and Training Hospital, Istanbul, Turkey
| | - Savas Ozturk
- Nephrology, Haseki Training and Research Hospital, Istanbul, Turkey
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5
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Turgutalp K, Cebeci E, Turkmen A, Derici Ü, Seyahi N, Eren N, Dede F, Gullulu M, Basturk T, Manga Sahin G, Yılmaz M, Sipahi S, SAHIN G, Ulu MS, Tatar E, Gundogdu A, Turan Kazancioglu R, Sevinc C, Gungor O, Sahin İ, Kutlay S, Kurultak I, Aydin Z, Altun B, Dursun B, Yilmaz Z, Uzun O, Suleymanlar G, Candan F, Sezer S, Tanburoglu DB, Bicik Bahçebaşı Z, Guven Taymez D, Oygar D, Akcali E, Istemihan Z, Akcay OF, Dincer MT, Ergul M, Yenigun E, Turkmen K, Ozturk S. P0490IS THE SEVERITY OF GLOMERULAR IGG STAINING IN PATIENT WITH IGA NEPHROPATHY USEFUL FOR PREDICTING POOR RENAL PROGNOSIS? THE DATA FROM TSN-GOLD WORKING GROUP. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
In IgA nephropathy (IgAN), which is characterized by mesangial IgA accumulation, there is the formation of circulating autoantibodies against galactose deficient IgA1s (Gd-IgA1). IgG / Gd-IgA1 immunocomplexes accumulate in the glomerular mesangium and play a role in the pathogenesis of IgAN. Recent studies have suggested a relationship between glomerular IgG deposition and the severity of glomerular inflammation. However, detection of the presence and severity of IgG in routine immunofluorescence microscopy (IFM) may fail. This study aims to investigate whether IgG positivity detected by IFM is associated with poor renal prognostic indicators and whether renal prognosis can be predicted according to IgG positivity.
Method
4399 patients who were enrolled between May 2009-June 2019 in database of Turkish Society of Nephrology, Glomerular Diseases Working Group (TSN-GOLD) including 44 centers were evaluated. After exclusion criteria, 994 primary IgAN patients were included in the study. Glomerular IgG negative and positive patients were compared by means of Oxford classification scores, histopathological evaluations, proteinuria, creatinine, albumin, blood pressures. IgG positive patients were divided into subgroups according to the grade of the IFM positivity. The relationship between IgG positivity and poor prognosis criteria were evaluated.
Results
Demographic and biochemical findings of glomerular IgG positive and negative patients at the time of biopsy are shown in Table 1. No difference was found between the groups. There was no difference in the demographic and biochemical findings at the time of biopsy in IgG subgroup analyses (Table 2). There was no difference between the histopathological and Oxford MEST scores of the subgroups. Glomerular IgG positivity was not associated with diastolic blood pressure, systolic blood pressure, urea, uric acid, age, eGFR, albumin, proteinuria (p> 0.05 for all, r= -0.084, r= -0.102, r= -0.006, r=0.062, r= 0.014, r= -0.044, r= -0.061, r= -0.066, r= 0.150, respectively).
Conclusion
Glomerular IgG positivity detected by routine IFM in IgAN is not associated with poor renal prognostic indicators. It is difficult to predict renal prognosis by looking at the severity of IgG positivity at the baseline evaluation.
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Affiliation(s)
| | - Egemen Cebeci
- Haseki Training and Research Hospital, Department of Nephrology, Istanbul, Turkey
| | - Aydin Turkmen
- Istanbul University, Department of Nephrology, Istanbul, Turkey
| | - Ülver Derici
- Gazi University Faculty of Medicine, Department of Nephrology, Ankara, Turkey
| | - Nurhan Seyahi
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Nephrology, Istanbul, Turkey
| | - Necmi Eren
- Kocaeli University, Department of Nephrology, Kocaeli, Turkey
| | - Fatih Dede
- Health Sciences University, Ankara Numune Education and Research Hospital, Department of Nephrology, Ankara, Turkey
| | - Mustafa Gullulu
- Uludag University Faculty of Medicine, Department of Medicine, Bursa, Turkey
| | - Taner Basturk
- Health Sciences University, Sıslı Hamidiye Etfal Training and Research Hospital, Department of Nephrology, Istanbul, Turkey
| | - Gulizar Manga Sahin
- Istanbul Abdulhamid Han Training and Research Hospital, Department of Nephrology, Istanbul, Turkey
| | - Mürvet Yılmaz
- Health Sciences University, Bakirkoy Sadi Konuk Training and Research Hospital, Department of Nephrology, Istanbul, Turkey
| | - Savas Sipahi
- Sakarya University Medical Faculty Education and Research Hospital, Department of Nephrology, Istanbul, Turkey
| | - Garip SAHIN
- Eskisehir Osmangazi University, Department of Nephrology, Istanbul, Turkey
| | - Memnune Sena Ulu
- Afyon Health Sciences University, Department of Nephrology, Afyon, Turkey
| | - Erhan Tatar
- Health Sciences University, Izmir Bozyaka Training and Research Hospital, Department of Nephrology, Izmir, Turkey
| | - Ali Gundogdu
- Erciyes University, Department of Nephrology, Kayseri, Turkey
| | | | - Can Sevinc
- Atatürk University, Department of Nephrology, Erzurum, Turkey
| | - Ozkan Gungor
- Kahramanmaras Sutcu Imam University, Department of Nephrology, Kahramanmaraş, Turkey
| | - İdris Sahin
- Inonu University Faculty of Medicine, Department of Nephrology, Malatya, Turkey
| | - Sim Kutlay
- Ankara University, School of Medicine, Department of Nephrology, Ankara, Turkey
| | - Ilhan Kurultak
- Trakya University, Department of Nephrology, Edirne, Turkey
| | - Zeki Aydin
- Darica Farabi Training and Research Hospital, Department of Nephrology, Kocaeli, Turkey
| | - Bulent Altun
- Hacettepe University, Department of Nephrology, Ankara, Turkey
| | - Belda Dursun
- Pamukkale University, Department of Nephrology, Denizli, Turkey
| | - Zulfikar Yilmaz
- Dicle University, Department of Nephrology, Diyarbakır, Turkey
| | - Ozcan Uzun
- Dokuz Eylül University, Department of Nephrology, İzmir, Turkey
| | | | - Ferhan Candan
- Cumhuriyet University, Department of Nephrology, Sivas, Turkey
| | - Siren Sezer
- Atilim University Medicana International Hospital, Department of Nephrology, Ankara, Turkey
| | | | - Zerrin Bicik Bahçebaşı
- Kartal Lutfi Kirdar Training and Research Hospital, Department of Nephrology, Istanbul, Turkey
| | | | - Deren Oygar
- Lefkosa BND Training and Research Hospital, Department of Nephrology, Lefkosa, Cyprus
| | - Esra Akcali
- Mersin University, Department of Nephrology, Mersin, Turkey
| | - Zulal Istemihan
- Istanbul University, Department of Nephrology, Istanbul, Turkey
| | - Omer Faruk Akcay
- Gazi University Faculty of Medicine, Department of Nephrology, Ankara, Turkey
| | - Mevlut Tamer Dincer
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Nephrology, Istanbul, Turkey
| | - Metin Ergul
- Kocaeli University, Department of Nephrology, Kocaeli, Turkey
| | - Ezgi Yenigun
- Health Sciences University, Ankara Numune Education and Research Hospital, Department of Nephrology, Ankara, Turkey
| | - Kultigin Turkmen
- Necmettin Erbakan University, Meram School of Medicine, Department of Internal Medicine, Division of Nephrology, Konya, Turkey
| | - Savas Ozturk
- Haseki Training and Research Hospital, Department of Nephrology, Istanbul, Turkey
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6
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Turkmen A, Sumnu A, Cebeci E, Yazici H, Eren N, Seyahi N, Dilek K, Dede F, Derici Ü, Unsal A, SAHIN G, Sipahioglu M, Gok M, Tatar E, Dursun B, Sipahi S, Yılmaz M, Suleymanlar G, Ulu MS, Gungor O, Kutlay S, Bicik Bahçebaşı Z, Sahin İ, Kurultak I, Turkmen K, Yilmaz Z, Turan Kazancioglu R, Cavdar C, Candan F, Aydin Z, Oygar D, Gul CB, Arici M, Paydas S, Guven Taymez D, Kucuk M, Trablus S, Turgutalp K, Koc L, Sezer S, Duranay M, Bardak S, Altintepe L, Arikan IH, Azak A, Odabas AR, Manga Sahin G, Ozturk S. P0501THE EPIDEMIOLOGICAL FEATURES OF PIRMARY GLOMERULAR DISEASES IN TURKEY: THE MULTICENTER STUDY OF TURKISH SOCIETY OF NEPHROLOGY GLOMERULAR DISEASES (TSN-GOLD) WORKING GROUP. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
The largest data on the epidemiology of primary glomerular diseases (PGD) are obtained from the databases of countries or centers. Here, we presented the extended results of the Primary Glomerular Diseases Study of the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD)Working Group.
Method
The data of patients who underwent renal biopsy and diagnosed as primary glomerular disease were recorded in the database prepared for the study. Between May 2009 and May 2019, a total of 4399 patients from 47 centers were evaluated. Basal data of 3875 patients were analyzed after exclusion of those lacking light microscopy and immunofluorescence findings.
Results
The mean age was 41.5 ± 14.9 years. Of the patients, 1690 were female (43.6%) and 2180 (56.3%) were male. Nephrotic syndrome was the most common biopsy indication (51.7%). This was followed by asymptomatic urinary abnormalities (18.3%) and nephritic syndrome (17.8%). The most common PGH was IgA nephropathy (25.7%), followed by membranous nephropathy (25.6%) and FSGS (21.9%). The mean total number of glomeruli per biopsy was 17 ± 10. Mean baseline systolic blood pressure was 130 ± 20 mmHg and diastolic blood pressure was 81 ± 12 mmHg. Median proteinuria was 3300 (IQR: 1467-6307) mg / day, mean serum creatinine, estimated GFR and albumin values were 1.4 ± 1.5 mg / dl, 80.7 ± 39.1 ml / min and 3.2 ± 0.9 g / dl, respectively.
Conclusion
In Turkey, the incidence of IgA nephropathy patients have become more common than membranous nephropathy among PGD patients diagnosed with renal biopsy.
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Affiliation(s)
- Aydin Turkmen
- Istanbul University, Istanbul Faculty of Medicine, Nephrology, Istanbul, Turkey
| | - Abdullah Sumnu
- Medipol University Medical Faculty, Medipol Mega Hospital, Nephrology, İstanbul, Turkey
| | - Egemen Cebeci
- Haseki Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Halil Yazici
- Istanbul University, Istanbul Faculty of Medicine, Nephrology, Istanbul
| | - Necmi Eren
- Kocaeli University Medical Faculty, Nephrology, Kocaeli, Turkey
| | - Nurhan Seyahi
- Istanbul University, Cerrahpasa Faculty of Medicine, Nephrology, Istanbul, Turkey
| | - Kamil Dilek
- Uludag University, Medical Faculty, Nephrology, Bursa, Turkey
| | - Fatih Dede
- Ankara Numune Training and Research Hospital, Nephrology, Ankara, Turkey
| | - Ülver Derici
- Gazi University Medical Faculty, Nephrology, Ankara, Turkey
| | - Abdulkadir Unsal
- Hamidiye Sisli Etfal Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Garip SAHIN
- Eskisehir Osmangazi University, Medical Faculty, Nephrology, Eskisehir, Turkey
| | - Murat Sipahioglu
- Erciyes University, Medical Faculty, Nephrology, Kayseri, Turkey
| | - Mahmut Gok
- Sultan Abdulhamit Han Research and Training Hospital, Nephrology, Istanbul, Turkey
| | - Erhan Tatar
- Bozyaka Training and Research Hospital, Nephrology, Izmır, Turkey
| | - Belda Dursun
- Pamukkale University, Medical Faculty, Nephrology, Denizli, Turkey
| | - Savaş Sipahi
- Sakarya University, Medical Faculty, Nephrology, Sakarya, Turkey
| | - Mürvet Yılmaz
- Bakirkoy Sadi Konuk Training and Research Hospital, Nephrology, Istanbul, Turkey
| | | | | | - Ozkan Gungor
- Sutcu İmam University, Medical Faculty, Nephrology, Kahramanmaras, Turkey
| | - Sim Kutlay
- Ankara University, Medical Faculty, İbni Sina Hospital, Nephrology, Ankara, Turkey
| | | | - İdris Sahin
- Inonu University, Medical Faculty, Nephrology, Malatya, Turkey
| | - Ilhan Kurultak
- Trakya University, Medical Faculty, Nephrology, Istanbul, Turkey
| | - Kultigin Turkmen
- Necmettin Erbakan University, Meram Medicine Faculty, Nephrology, Konya, Turkey
| | - Zulfikar Yilmaz
- Dicle University, Medical Faculty, Nephrology, Diyarbakir, Turkey
| | | | - Caner Cavdar
- Dokuz Eylul University, Medical Faculty, Nephrology, Izmir, Turkey
| | - Ferhan Candan
- Cumhuriyet University, Medical Faculty, Nephrology, Sivas, Turkey
| | - Zeki Aydin
- Darica Farabi Training and Research Hospital, Nephrology, Kocaeli, Turkey
| | - Deren Oygar
- Burhan Nalbantoglu State Hospital, Nephrology, Lefkosa, Cyprus
| | - Cuma Bulent Gul
- Bursa Yuksek Ihtisas Training and Research Hospital, Nephrology, Bursa, Turkey
| | - Mustafa Arici
- Hacettepe University, Medical Faculty, Nephrology, Ankara, Turkey
| | - Saime Paydas
- Cukurova University, Medical Faculty, Nephrology, Adana, Turkey
| | | | - Mehmet Kucuk
- Okmeydanı Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Sinan Trablus
- Istanbul Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Kenan Turgutalp
- Mersin University, Medical Faculty, Nephrology, Mersin, Turkey
| | - Leyla Koc
- Taksim Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Siren Sezer
- Atilim University, Medicana International Hospital, Nephrology, Ankara, Turkey
| | - Murat Duranay
- Ankara Training and Research Hospital, Nephrology, Ankara, Turkey
| | - Simge Bardak
- Batman State Hospital, Nephrology, Batman, Turkey
| | | | | | - Alper Azak
- Balikesir Training and Research Hospital, Nephrology, Balikesir, Turkey
| | - Ali Riza Odabas
- Medeniyet University Medical School, Goztepe Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Gulizar Manga Sahin
- Sultan Abdulhamit Han Research and Training Hospital, Nephrology, Istanbul, Turkey
| | - Savas Ozturk
- Haseki Training and Research Hospital, Nephrology, Istanbul, Turkey
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7
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Eren N, Gursu M, Cebeci E, Turkmen A, Yeter HH, Seyahi N, Piskinpasa SV, Ersoy A, Basturk T, Manga Sahin G, Kocak Yucel FS, Genç AB, SAHIN G, Ulu MS, Soyhan M, Turkmen K, Ozberk S, Elcioğlu O, Altunoren O, Sahin İ, Kutlay S, Üstündağ S, Kalender B, Dede F, Altun B. P0440EPIDEMIOLOGICAL AND CLINICAL CHARACTERSTICS OF IGA NEPHROPATHY PATIENTS IN TURKEY: TSN-GOLD WORKING GROUP. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and Aims
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<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.
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Affiliation(s)
- Necmi Eren
- Kocaeli University, Faculty of Medicine, Division of Nephrology, Kocaeli, Turkey
| | - Meltem Gursu
- Bezmialem Vakif University, Faculty of Medicine, Division of Nephrology, Istanbul, Turkey
| | - Egemen Cebeci
- Haseki Training and Research Hospital, Division of Nephrology, Istanbul, Turkey
| | - Aydin Turkmen
- İstanbul University, İstanbul Medical Faculty, Division of Nephrology, Istanbul, Turkey
| | - Hasan Haci Yeter
- Gazi University, Faculty of Medicine, Division of Nephrology, Ankara, Turkey
| | - Nurhan Seyahi
- İstanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Division of Nephrology, Istanbul, Turkey
| | | | - Alpaslan Ersoy
- Uludağ University Faculty of Medicine, Division of Nephrology, Bursa, Turkey
| | - Taner Basturk
- Şişli Etfal Training and Research Hospital, Division of Nephrology, Istanbul, Turkey
| | - Gulizar Manga Sahin
- Sultan Abdülhamid Han, Training and Research Hospital, Division of Nephrology, Istanbul, Turkey
| | | | - Ahmed Bilal Genç
- Sakarya University, Faculty of Medicine, Division of Nephrology, Adapazari, Turkey
| | - Garip SAHIN
- Eskişehir Osmangazi University, Faculty of Medicine, Division of Nephrology, Eskisehir, Turkey
| | - Memnune Sena Ulu
- Afyon Saglik Bilimleri University, Faculty of Medicine, Division of Nephrology, Afyonkarahisar, Turkey
| | - Merve Soyhan
- Bozyaka Training and Research Hospital, Division of Nephrology, Izmir, Turkey
| | - Kultigin Turkmen
- Necmettin Erbakan Üniversity, Meram Medical Faculty, Division of Nephrology, Konya, Turkey
| | - Sumeyra Ozberk
- Erciyes University, Faculty of Medicine, Division of Nephrology, Kayseri, Turkey
| | - Omer Elcioğlu
- Bezmialem Vakif University, Faculty of Medicine, Division of Nephrology, Istanbul, Turkey
| | - Orcun Altunoren
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Division of Nephrology, Kahramanmaras, Turkey
| | - İdris Sahin
- Inonü University, Faculty of Medicine, Division of Nephrology, Malatya, Turkey
| | - Sim Kutlay
- Ankara University, Faculty of Medicine, Division of Nephrology, Ankara, Turkey
| | - Sedat Üstündağ
- Trakya University, Faculty of Medicine, Division of Nephrology, Edirne, Turkey
| | - Betul Kalender
- Kocaeli University, Faculty of Medicine, Division Of Nephrology, Kocaeli, Turkey
| | - Fatih Dede
- Ankara Numune Training and Research Hospital, Division of Nephrology , Ankara, Turkey
| | - Bulent Altun
- Hacettepe University, Faculty of Medicine, Division of Nephrology, Ankara, Turkey
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8
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Sumnu A, Turkmen K, Cebeci E, Turkmen A, Eren N, Seyahi N, Oruc A, Dede F, Derici Ü, Basturk T, SAHIN G, Sipahioglu M, Manga Sahin G, Tatar E, Dursun B, Sipahi S, Yılmaz M, Suleymanlar G, Ulu MS, Gungor O, Kutlay S, Bicik Bahçebaşı Z, Sahin İ, Kurultak I, Sevinc C, Yilmaz Z, Turan Kazancioglu R, Cavdar C, Candan F, Aydin Z, Oygar D, Gul CB, Altun B, Paydas S, Uzun S, Istemihan Z, Ergul M, Dincer MT, Gullulu M, Piskinpasa SV, Akcay OF, Unsal A, Koyuncu S, Gok M, Ozturk S. P0448CHARACTERISTICS OF PRIMARY GLOMERULAR DISEASE PATIENTS WITH HEMATURIA IN TURKEY: THE DATA FROM TSN-GOLD WORKING GROUP. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
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.
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Affiliation(s)
- Abdullah Sumnu
- Medipol University, Medical Faculty, Nephrology, Istanbul, Turkey
| | - Kultigin Turkmen
- Necmettin Erbakan University, Meram Medical Faculty, Nephrology, Konya, Turkey
| | - Egemen Cebeci
- Haseki Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Aydin Turkmen
- Istanbul University, Istanbul Medical Faculty, Nephrology, Istanbul, Turkey
| | - Necmi Eren
- Kocaeli University, Medical Faculty, Nephrology, Kocaeli, Turkey
| | - Nurhan Seyahi
- Istanbul University, Cerrahpasa Medical Faculty, Nephrology, Istanbul, Turkey
| | - Aysegul Oruc
- Uludag University, Medical Faculty, Nephrology, Bursa, Turkey
| | - Fatih Dede
- Ankara Numune Training and Research Hospital, Nephrology, Ankara, Turkey
| | - Ülver Derici
- Gazi University, Medical Faculty, Nephrology, Ankara, Turkey
| | - Taner Basturk
- Hamidiye Sisli Etfal Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Garip SAHIN
- Eskisehir Osmangazi University, Medical Faculty, Nephrology, Eskisehir, Turkey
| | - Murat Sipahioglu
- Erciyes University, Medical Faculty, Nephrology, Kayseri, Turkey
| | - Gulizar Manga Sahin
- Sultan Abdulhamit Han Research and Training Hospital, Nephrology, Istanbul, Turkey
| | - Erhan Tatar
- Bozyaka Training and Research Hospital, Nephrology, Izmır, Turkey
| | - Belda Dursun
- Pamukkale University, Medical Faculty, Nephrology, Denizli, Turkey
| | - Savas Sipahi
- Sakarya University, Medical Faculty, Nephrology, Sakarya, Turkey
| | - Mürvet Yılmaz
- Bakirkoy Sadi Konuk Training and Research Hospital, Nephrology, Istanbul, Turkey
| | | | | | - Ozkan Gungor
- Sutcu İmam University, Medical Faculty, Nephrology, Kahramanmaras, Turkey
| | - Sim Kutlay
- Ankara University, Medical Faculty, İbni Sina Hospital, Nephrology, Ankara, Turkey
| | | | - İdris Sahin
- Inonu University, Medical Faculty, Nephrology, Malatya, Turkey
| | - Ilhan Kurultak
- Trakya University, Medical Faculty, Nephrology, Edirne, Turkey
| | - Can Sevinc
- Ataturk University, Medical Faculty, Nephrology, Erzurum, Turkey
| | - Zulfikar Yilmaz
- Dicle University, Medical Faculty, Nephrology, Diyarbakir, Turkey
| | | | - Caner Cavdar
- Dokuz Eylul University, Medical Faculty, Nephrology, Izmir, Turkey
| | - Ferhan Candan
- Cumhuriyet University, Medical Faculty, Nephrology, Sivas, Turkey
| | - Zeki Aydin
- Darica Farabi Training and Research Hospital, Nephrology, Kocaeli, Turkey
| | - Deren Oygar
- Burhan Nalbantoglu State Hospital, Nephrology, Lefkosa, Cyprus
| | - Cuma Bulent Gul
- Bursa Yuksek Ihtisas Training and Research Hospital, Nephrology, Bursa, Turkey
| | - Bulent Altun
- Hacettepe University, Medical Faculty, Nephrology, Ankara, Turkey
| | - Saime Paydas
- Cukurova University, Medical Faculty, Nephrology, Adana, Turkey
| | - Sami Uzun
- Haseki Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Zulal Istemihan
- Istanbul University, Istanbul Medical Faculty, Internal Medicine, Istanbul, Turkey
| | - Metin Ergul
- Kocaeli University, Medical Faculty, Nephrology, Kocaeli, Turkey
| | - Mevlut Tamer Dincer
- Istanbul University, Cerrahpasa Medical Faculty, Nephrology, Istanbul, Turkey
| | - Mustafa Gullulu
- Uludag University, Medical Faculty, Nephrology, Bursa, Turkey
| | | | | | - Abdulkadir Unsal
- Hamidiye Sisli Etfal Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Sumeyra Koyuncu
- Erciyes University, Medical Faculty, Nephrology, Kayseri, Turkey
| | - Mahmut Gok
- Sultan Abdulhamit Han Research and Training Hospital, Nephrology, Istanbul, Turkey
| | - Savas Ozturk
- Haseki Training and Research Hospital, Nephrology, Istanbul, Turkey
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9
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Kurultak I, Gungor O, Ozturk S, Dirim AB, Eren N, Yenigun E, Ahbap Dal E, Dincer MT, Bora F, Akgur S, Sumnu A, Dursun B, Sipahi S, Çetinkaya H, Sahin İ, SAHIN G, Yılmaz M, Vatansever B, Aydin E, Ulu MS, Gundogan A, Üstündağ S, Sayarlioglu H, Kumru Şahin G, Elcioglu OC, Aydin Z, Selcuk NY, Onal C, Oruc M, Kucuk M, Aktas N, Derici Ü, Suleymanlar G. P0389THE PREVALENCE, CLINICAL AND PATHOLOGICAL CHARACTERISTICS OF PRIMARY FOCAL SEGMENTAL GLOMERULOSCLEROSIS IN TURKISH ADULTS: THE DATA FROM TSN-GOLD ( TURKISH SOCIETY OF NEPHROLOGY GLOMERULAR DISEASES) WORKING GROUP. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
Focal segmental glomerulosclerosis (FSGS) is one of the primary glomerulopathies which is the most common cause of end-stage renal disease among all primary glomerular diseases. In adults, nephrotic syndrome develops 10-35% due to FSGS. However, its frequency has been increasing in recent years. This study was aimed to present the data and the prevalence of primary FSGS patients in Turkey.
Method
These data were obtained from the National Multicenter (47 centers) Primary Glomerular Diseases registry system, which was entered into the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) database between May 2009 and June 2019. The presented data in this study is cross-sectional and includes the recorded data of the patients in the hospitalization period for the kidney biopsy. These demographic, clinic and pathological data of patients were evaluated with using statistically.
Results
Of the 3875 patients enrolled in the Primary Glomerular Diseases database, 850 (21.9%) had FSGS. The mean age of the patients was 47.1 ± 13.7 and 435 (52%) of patients were male. Two hundred and eighty one (33.1%) had hypertension and 93 (11%) had diabetes. Five hundred and four patients (59.3%) were diagnosed as nephrotic syndrome. At the time of diagnosis, the mean systolic blood pressure was 13.8 ± 18.6 mm Hg and the mean diastolic blood pressure was 81.4± 11.4 mm Hg. The laboratory findings at the time of diagnosis on following; serum creatinine 1.2 ± 0.04 mg / dl, albumin 3.3 ± 0.03 g / dl, and 24 hours urinary proteinuria amounts to 4743 ± 181 mg / day. Demographical and clinical data of the patients at the time of diagnosis were presented on Table 1. In pathological examination; the mean number of glomeruli was 16.8 ± 0.3, global sclerotic glomeruli were 3.1 ± 0.1, and segmental sclerotic glomeruli were 2.4 ± 0.1. Summary of Pathological Findings were presented on Table 2
Conclusion
It is very difficult to determine the absolute incidence and prevalence of primary FSGS. Incidence rates have been reported to range from 0.2 to 1.8 / 100,000 per year in the literature. In a United States study, the most common diagnosis in 2501 kidney biopsies was FSGS (35.9%). According to this database, the prevalence of FSGS in primary glomerular diseases in our country is 21.9%.
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Affiliation(s)
- Ilhan Kurultak
- Trakya University, Faculty of Medicine, Nephrology, Edirne, Turkey
| | - Ozkan Gungor
- Sutcu Imam University, Faculty of Medicine, Nephrology, Turkey
| | - Savas Ozturk
- Haseki Education and Research Hospital, Nephrology, Istanbul, Turkey
| | - Ahmet Burak Dirim
- Istanbul University, Faculty of Medicine, Nephrology, Istanbul, Turkey
| | - Necmi Eren
- Kocaeli University, Faculty of Medicine, Nephrology, Kocaeli, Turkey
| | - Ezgi Yenigun
- Ankara Numune Education and Research Hospital, Nephrology, Ankara, Turkey
| | - Elbis Ahbap Dal
- Hamidiye Sisli Etfal Education and Research Hospital, Nephrology, Istanbul, Turkey
| | | | - Feyza Bora
- Akdeniz University, Faculty of Medicine, Nephrology, Antalya, Turkey
| | - Suat Akgur
- Uludag University, Faculty of Medicine, Nephrology, Bursa, Turkey
| | - Abdullah Sumnu
- Medipol University, Faculty of Medicine, Nephrology, İstanbul
| | - Belda Dursun
- Pamukkale University, Faculty of Medicine, Nephrology, Denizli, Turkey
| | - Savaş Sipahi
- Sakarya University, Faculty of Medicine, Nephrology, Sakarya, Turkey
| | - Hakkı Çetinkaya
- Sultan Abdulhamid Han Education and Research Hospital, Nephrology, Istanbul, Turkey
| | - İdris Sahin
- Inonu University, Faculty of Medicine, Nephrology, Malatya, Turkey
| | - Garip SAHIN
- Eskisehir Osmangazi Universitesi, Faculty of Medicine, Nephrology, Eskişehir, Turkey
| | - Mürvet Yılmaz
- University of Halth Sciences, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Nephrology, Istanbul, Turkey
| | - Bulent Vatansever
- Izmir Bozkaya Education and Research Hospital, Nephrology, Izmir, Turkey
| | - Emre Aydin
- Dicle University, Faculty of Medicine, Nephrology, Urfa, Turkey
| | - Memnune Sena Ulu
- Afyon University, Faculty of Medicine, Nephrology, Afyon, Turkey
| | - Ali Gundogan
- Erciyes University, Faculty of Medicine, Nephrology, Kayseri, Turkey
| | - Sedat Üstündağ
- Trakya University, Faculty of Medicine, Nephrology, Edirne, Turkey
| | | | - Gizem Kumru Şahin
- Ankara University, Faculty of Medicine, Ibni-Sina Hospital, Nephrology, Ankara, Turkey
| | - Omer Celal Elcioglu
- Bezmialem Vakıf University, Faculty of Medicine, Nephrology, Istanbul, Turkey
| | - Zeki Aydin
- Darıca Farabi Education and Research Hospital, Nephrology, Kocaeli, Turkey
| | | | - Ceren Onal
- Hacettepe University, Faculty of Medicine, Nephrology, Ankara, Turkey
| | - Meric Oruc
- Kartal Dr. Lutfi Kırdar Education and Research Hospital, Nephrology, Istanbul, Turkey
| | - Mehmet Kucuk
- Okmeydanı Education and Research Hospital, Nephrology, Istanbul, Turkey
| | - Nimet Aktas
- Bursa Yuksek Ihtisas Education and Research Hospital, Nephrology, Bursa, Turkey
| | - Ülver Derici
- Gazi University, Faculty of Medicine, Nephrology, Ankara, Turkey
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10
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Gul CB, Kucuk M, Ozturk S, Demir E, Eren N, Sumnu A, Seyahi N, Gullulu M, Dede F, Derici Ü, Koc Y, SAHIN G, Oymak O, Manga Sahin G, Tatar E, Dursun B, Dheir H, Apaydin S, Suleymanlar G, Ulu MS, Altunoren O, Kutlay S, Mese M, Sahin İ, Ustundag S, Turkmen K, Yilmaz ME, Turan Kazancioglu R, Uzun O, Candan F, Aydin Z, Oygar D, Aktas N, Erdem Y, Paydas S, Guven Taymez D, Can B, Kıykım A, Koc L, Sezer S, Duranay M, Bardak S, Altintepe L, Kaya B, Azak A, Alisir Ecder S, Cavdar C, Selcuk NY. P0431TRENDS OF PRIMARY GLOMERULAR DISEASE IN TURKEY FROM 2009 TO 2017: A REGIONAL REGISTRY REPORT FROM TSN-GOLD WORKING GROUP. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
Several glomerular disease registries in Europe, and they shared their data; however, there was a lack of current data on trends of primary glomerulopathy in Turkey. Glomerular disease patterns can change geographical areas and populations decade by decade. Our aim is to present Turkey's primary glomerular disease pattern from 2009 to 2017.
Method
3878 native kidney biopsy records were assessed in the Turkish Society of Nephrology Glomerulopathy (TSN-GOLD) Working Group Registry. Secondary disease (lupus, etc.) and transplant biopsies do not enroll in the registry. These records divided into four periods, before 2009, 2009 to 2013, 2013 to 2017, and 2017 to current.
Results
A total of 3858 patients (M = 2173, K = 1685) were examined. There was no difference in the distribution of number of patients according to periods (Q1 = 968, Q2 = 960, Q3 = 968, Q4 = 962). Nephrotic syndrome was the most common biopsy indication in all quarters (58.6%, 53%, 44.1%, 51.6%, respectively). Glomerulopathy types; Membranous GN (29.9%, n = 290) was the first in Q1 and IgA nephropathy (17.7%, n = 172) was the second. IgA nephropathy (28.5%, n = 274) was the most common glomerulopathy in Q2, while Membranous GN (25.5%, n = 245) was the second most common. IgA nephropathy (29.9%, n = 285) was the most common glomerulopathy in Q3, followed by FSGS (22.9%, n = 222) and Membranous GN. In Q4, FSGS (26.8, n = 258) was the most common glomerulopathy, followed by IgA nephropathy (26.7%, n = 257) and Membranous GN (24.5%, n = 236) (Figure 1).
Conclusion
While biopsy indications did not change over the years, the incidence of FSGS and IgA nephropathy gradually increased.
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Affiliation(s)
- Cuma Bulent Gul
- Bursa Yuksek Ihtisas Training and Research Hospital, Nephrology, Bursa, Turkey
| | - Mehmet Kucuk
- Okmeydanı Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Savas Ozturk
- Haseki Training and Resarch Hospital, Nephrology, Turkey
| | - Erol Demir
- Istanbul University Medical School, Nephrology
| | - Necmi Eren
- Kocaeli Derince Training and Research Hospital, Nephrology
| | - Abdullah Sumnu
- Medipol Mega University Hospital, Nephrology, istanbul, Turkey
| | | | - Mustafa Gullulu
- Uludag University Medical Faculty Hospital, Nephrology, Bursa, Turkey
| | - Fatih Dede
- Ankara Numune Training and Research Hospital, Nephrology, ankara, Turkey
| | - Ülver Derici
- Gazi University Medical Faculty, Nephrology, Ankara, Turkey
| | - Yener Koc
- Sisli Hamidiye Training and Research Hospital, Nephrology, Turkey
| | - Garip SAHIN
- Osmangazi University, Nephrology, eskisehir, Turkey
| | - Oktay Oymak
- Erciyes University, Nephrology, Kayseri, Turkey
| | | | - Erhan Tatar
- Bozyaka Training and Research Hospital, Nephrology, Izmir, Turkey
| | | | - Hamad Dheir
- Sakarya Training and Research Hospital, Nephrology, Turkey
| | - Süheyla Apaydin
- Dr. Sadi Konuk training and reseasrch hospital, Istanbul, Turkey
| | | | - Memnune Sena Ulu
- Afyon Kocatepe University Medical School, nephrology, Afyonkarahisar, Turkey
| | - Orcun Altunoren
- Kahramanmaraş Sütçü İmam University, Nephrology, Kahramanmaras, Turkey
| | - Sim Kutlay
- Ibn Sina University Hospital, Nephrology, Ankara, Turkey
| | - Meral Mese
- Kartal Training and Research Hospital, Nephrology, Turkey
| | - İdris Sahin
- Inonu University Medical School, Nephrology, Turkey
| | | | - Kultigin Turkmen
- Necmettin Erbakan University Meram Medical School, Nephrology, Turkey
| | | | | | - Ozcan Uzun
- Dokuz Eylul University Medical school, Nephrology, Turkey
| | - Ferhan Candan
- Cumhuriyet University Medical School, Nephrology, Turkey
| | - Zeki Aydin
- Darıca Farabi Training and Research Hospital, Nephrology, Turkey
| | - Deren Oygar
- Lefkosa Burhan Nalbantoglu Hospital, Nephrology
| | - Nimet Aktas
- Bursa Yuksek Ihtisas Training and Research Hospital, Nephrology, Bursa, Turkey
| | - Yunus Erdem
- Hacettepe University Medical School, Nephrology, Turkey
| | | | | | - Basak Can
- Ok Meydanı Traing and Research Hospital, Nephrology
| | | | - Leyla Koc
- Taksim Traing and Research Hospital, Nephrology
| | - Siren Sezer
- Baskent University Medical School, Nephrology
| | | | | | | | - Burcu Kaya
- Marmara University Medical School, Nephrology, Turkey
| | - Alper Azak
- Balıkesir Traing and Research Hospital, Nephrology
| | | | - Caner Cavdar
- Dokuz Eylul University Medical School, Nephrology
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11
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Aydin Z, Turkmen K, Dede F, Yasar E, Ozturk S, Aydin M, Tatar E, SAHIN G, Manga Sahin G, Oto OA, Sumnu A, Eroglu E, Dincer MT, Dursun B, Eren N, Sevinc M, Guzel FB, Yalin SF, Kutlay S, Apaydin S, Berktas HB, Kazan S, Dheir H, Bora F, Basturk T, Sahin İ. P0395DEMOGRAPHIC AND CLINICAL CHARACTERISTICS OF RAPIDLY PROGRESSIVE GLOMERULONEPHRITIS IN TURKEY. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
Rapidly progressive glomerulonephritis (RPGN) is a clinical condition that develops due to different etiologic causes, characterized by a rapid and progressive decrease in renal function and progresses to end-stage renal failure in weeks to months if not treated. In our study, diagnostic and demographic characteristics of patients diagnosed with RPGN by biopsy, clinical and laboratory findings in our country were investigated.
Method
Data were obtained from national multicenter (47 centers) data entered into the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) Working Group database between May 2009 and June 2019. Demographic characteristics such as age, sex, indications for biopsy, diagnosis of the glomerular diseases, comorbidities, laboratory and biopsy findings of all patients were recorded. The data presented is cross-sectional and includes application data for the biopsy period. According to their types, RPGN patients were classified as type 1 (anti-GBM related), type 2 (immunocomplex related) and type 3 (immune-negative; “pauci-immune”).
Results
After exclusion of 46 patients with missing data, 200 patients (mean age 47.9 ± 16.7 years, 44% female) were included in the study which constitutes 5.2% of the total glomerulonephritis database (total number of patients: 3875). Hypertension was present in 62 patients (31.0%) and diabetes was present in 18 patients (9.0%). Renal biopsy was performed in 147 (73.5%) patients due to nephritic syndrome (RPGN included). 80.2% of the patients' biopsies were performed in nephrology clinics and 19.8% of them were performed in radiology clinics. ANCA positivity was found in 121 (60.5%) patients (proteinase 3-ANCA was positive in 55 and myeloperoxidase-ANCA positive in 66 patients). Type 1 RPGN was detected in 11 (5.5%), type 2 RPGN in 42 (21%) and type 3 RPGN in 147 (73.5%) patients. In 21 patients (10.5%), biopsy revealed RPGN with advanced chronic changes (fibrous global sclerotic glomeruli, advanced interstitial fibrosis and tubular atrophy). Mean serum creatinine was 4.2 ± 3.4 mg/dl, median glomerular filtration rate was 18 (10-37) ml/min and proteinuria 2100 (1229-3526) mg/day according to CKD-EPI formula. The mean number of glomeruli in the biopsies was 18.8 ± 10.6 and the number of crescentic glomeruli was 9.9 ± 7.7 (ratio: 52.7%) (Figure). The patients were divided into 3 groups according to their crescentic glomeruli ratios. The proportion of crescentic glomeruli is 10-50% in group 1, 50-80% in group 2, and >80% in group 3. The demographic, laboratory and histopathological characteristics of the groups are given in Figure. It was observed that urea and creatinine increased and calcium and hemoglobin decreased with increasing crescentic glomerular ratio.
Conclusion
Our study provides valuable demographic, clinical, laboratory and histopathological data about RPGN in our country. Our data are generally compatible with the literature. In our study, advanced chronic histopathological findings were prominent in the biopsy of 21 patients. Early biopsy should be performed to confirm the diagnosis of RPGN and to avoid unnecessary intensive immunosuppressive therapy. In addition to the treatments applied, detailed data, including patient and renal survival are needed.
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Affiliation(s)
- Zeki Aydin
- Darica Farabi Training and Research Hospital, Nephrology, Kocaeli, Turkey
| | - Kultigin Turkmen
- Necmettin Erbakan University, Meram Medical School, Nephrology, Turkey
| | - Fatih Dede
- Ankara Numune Training and Research Hospital, Nephrology, Ankara, Turkey
| | - Emre Yasar
- Gazi University Medical School, Nephrology, Ankara, Turkey
| | - Savas Ozturk
- Haseki Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Mehmet Aydin
- Uludag University Medical School, Nephrology, Bursa, Turkey
| | - Erhan Tatar
- Bozyaka Training and Research Hospital, Nephrology, Izmir, Turkey
| | - Garip SAHIN
- Osmangazi University Medical School, Nephrology, Eskisehir, Turkey
| | - Gulizar Manga Sahin
- Sultan Abdülhamid Han Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Ozgur Akin Oto
- Istanbul University Medical School, Nephrology, Istanbul, Turkey
| | - Abdullah Sumnu
- Medipol University Medical School, Nephrology, Istanbul, Turkey
| | - Eray Eroglu
- Erciyes University Medical School, Nephrology, Kayseri, Turkey
| | | | - Belda Dursun
- Pamukkale University Medical School, Nephrology, Denizli, Turkey
| | - Necmi Eren
- Kocaeli University Medical School, Nephrology, Kocaeli, Turkey
| | - Mustafa Sevinc
- Sisli Hamidiye Etfal Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Fatma Betul Guzel
- Sutcu Imam University Medical School, Nephrology, Kahramanmaraş, Turkey
| | - Serkan Feyyaz Yalin
- Dr Lutfi Kırdar Kartal Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - Sim Kutlay
- Ankara University Medical School, Nephrology, Ankara, Turkey
| | - Suheyla Apaydin
- Bakirkoy Dr Sadi Konuk Training and Research Hospital, Nephrology, Istanbul, Turkey
| | | | - Sinan Kazan
- Afyonkarahisar SBU Medical School, Nephrology, Afyonkarahisar, Turkey
| | - Hamad Dheir
- Sakarya University Medical School, Nephrology, Sakarya, Turkey
| | - Feyza Bora
- Akdeniz University Medical School, Nephrology, Antalya, Turkey
| | - Taner Basturk
- Sisli Hamidiye Etfal Training and Research Hospital, Nephrology, Istanbul, Turkey
| | - İdris Sahin
- Inonu University Medical School, Nephrology, Malatya, Turkey
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12
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Rahman A, Aydin S, Bayar MK, Sahin İ. Changes of ghrelin and brain natriuretic peptide levels in systemic vascular resistance after cardiopulmonary bypass. J Physiol Biochem 2008; 64:221-30. [DOI: 10.1007/bf03178845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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