Lipid accumulation product and visceral adiposity ındex: two new indices to predict metabolic syndrome in chronic kidney disease

OBJECTIVE

The aim of this study was to assess the ability of lipid accumulation product (LAP) and visceral adiposity index (VAI) to predict metabolic syndrome (MetS) in patients with chronic kidney disease (CKD). We also aimed to determine whether VAI and LAP indices are superior to traditional body indices such as body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR).

PATIENTS AND METHODS

This study was performed by retrospectively scanning the files of patients with stage 3-5 chronic renal failure who came for nephrology outpatient follow-up between January 2017 and December 2017. Metabolic syndrome was identified using the 2009 harmonized criteria. The receiver operating characteristic curve (ROC) was used to compare the area under the ROC curve (AUC) of each index.

RESULTS

247 patients were included in the analyses. The prevalence of MetS was 80.9%. LAP was determined as the optimal predictor in chronic kidney disease patients, with 0.864 AUC in females and 0.908 AUC in males. Optimal cut-off values for LAP were 33.5 in females and 36.6 in males. VAI was the second most optimal predictor, with 0.856 AUC in females and 0.888 AUC in males. Optimal cut-off values for VAI were 2.24 in females and 1.56 in males.

CONCLUSIONS

LAP and VAI are effective indices for the prediction of MetS in patients with chronic kidney disease; LAP is the best index for the determination of MetS in both men and women.

Spontaneous retroperitoneal hemorrhage presenting as hemoperitoneum secondary to renal cyst rupture in a peritoneal dialysis patient with acquired cystic kidney disease

Spontaneous retroperitoneal hemorrhage (SRH) is a rare and potentially fatal condition. Acquired cystic kidney disease (ACKD) may cause SRH in hemodialysis patients. However, presentation of retroperitoneal hematoma as hemoperitoneum in peritoneal dialysis (PD) patients is exceedingly rare. We report a 44-year-old male PD patient who presented with hemoperitoneum secondary to retroperitoneal hematoma. The reason of SRH was rupture of the cysts of ACKD. The patient underwent unilateral nephrectomy with subsequent disappearance of hemoperitoneum. The importance of this case lies in the fact that the patients who have been receiving dialysis for a long time should be under surveillance in terms of ACKD development and potential associated complications such as cyst hemorrhage and malignancy.

Community-acquired carbapenem-resistant Acinetobacter baumannii urinary tract infection just after marriage in a renal transplant recipient

Urinary tract infection (UTI) is common in renal transplant recipients and may worsen allograft and patient survival. Many risk factors such as age, female gender, immunosuppression, comorbidity, deceased-donor kidney transplantation, and uretheral catheterization are involved in development of UTI. Acinetobacter baumannii has rarely been reported as a causative agent for development of UTI. Here, we present an unusual case of a renal transplant recipient who developed community-acquired carbapenem-resistent A. baumannii UTI.