Independent association between serum sclerostin levels and carotid artery atherosclerosis in prevalent haemodialysis patients.

Background: Sclerostin is a soluble inhibitor of the Wnt signalling pathway and has been shown to be associated with decreased bone turnover and vascular and/or valvular calcification in patients with chronic kidney disease. Common carotid artery intima-media thickness (CIMT) assessment and common carotid artery (CCA) plaque identification with ultrasound imaging are well-recognized tools for the identification and monitoring of atherosclerosis. The aim of the present study was to investigate whether the circulating levels of sclerostin might be associated with carotid artery atherosclerosis in prevalent haemodialysis patients.

Serum sclerostin levels, arteriovenous fistula calcification and 2-years all-cause mortality in prevalent hemodialysis patients.

Background: Bone and mineral abnormalities, and cardiovascular calcification are associated with increased cardiovascular mortality in patients with chronic kidney disease (CKD). Recent studies have implicated Wnt signaling pathway in the pathogenesis of bone metabolism and vascular calcification. Sclerostin is a soluble inhibitor of Wnt signaling pathway and has been shown to be associated with decreased bone turnover and vascular calcification in CKD patients.

Urinary sodium excretion and ambulatory blood pressure findings in patients with hypertension.

Use of ambulatory blood pressure (BP) monitoring (ABPM) allows for identification of dipping, nondipping, extreme dipping, and reverse dipping of BP. Using office BP and ABPM, hypertension subtypes can be identified: sustained normotension (SNT), white-coat hypertension, masked hypertension, and sustained hypertension. The comparison of hemodynamic parameters and salt intake has not been investigated among these patient groups.

Prevalence of severe carotid artery stenosis and its association with echocardiographic parameters in maintenance hemodialysis patients.

Objectives: We aimed to determine the prevalence of significant carotid stenosis in maintenance hemodialysis patients and to identify biochemical and echocardiographic predictors of significant carotid stenosis in those patients.

Study Design: One hundred and seventeen maintenance hemodialysis patients were included in this study. Echocardiography biochemical tests and carotid artery Doppler ultrasonography were performed in all patients.

Body shape index and mortality in hemodialysis patients.

Objective: The relationship between various anthropometric parameters and mortality in hemodialysis (HD) patients is conflicting. Recently a new anthropometric parameter emerged, namely, body shape index (BSI). BSI is based on waist circumference (WC) but is independent of height, weight, and body mass index in predicting mortality in the general population.

Are there any seasonal changes of cognitive impairment, depression, sleep disorders and quality of life in hemodialysis patients?

Objective: Cognitive impairment, depression, sleep disorders and impaired quality of life are very common in hemodialysis (HD) patients. However, whether there are any seasonal changes of cognitive impairment, depression, sleep disorders and quality of life in HD patients is not known.

Methods: The laboratory parameters, depressive symptoms, health-related quality of life, sleep quality (SQ) and cognitive function, were measured twice.

The relationship between serum total testosterone and 24-hour urinary sodium excretion in never-treated stage 1 essential hypertensive patients.

Objectives: To study the relationship between serum total testosterone (TT) and 24-hour urinary sodium excretion in newly diagnosed stage 1 essential hypertensive patients with normal renal function.

Study Design: In total, 80 never-treated stage 1 hypertensive patients were included. All patients provided medical history and underwent physical examination, blood pressure measurement, 12-lead electrocardiography, routine urine analysis, biochemical analysis, 24-hour urine collection to measure urinary sodium and protein excretion, and creatinine clearance calculation.

Which anthropometric parameter is best related with urinary albumin excretion and creatinine clearance in type 2 diabetes: body mass index, waist circumference, waist-to-hip ratio, or conicity index?

Objective: We analyzed the relationships between body mass index (BMI), waist circumference (WC), waist-to-hip ratio, and conicity index and 24-hour urinary albumin excretion rate (UAER) and creatinine clearance.

Design: Cross-sectional study.

Setting: Patients presenting to a state hospital.

Plasma fibroblast growth factor-23 levels are independently associated with carotid artery atherosclerosis in maintenance hemodialysis patients.

Fibroblast growth factor-23 (FGF-23) has been suggested to play a role in vascular calcification in chronic kidney disease. Common carotid artery intima-media thickness (CIMT) assessment and common carotid artery (CCA) plaque identification using ultrasound are well-recognized tools for identification and monitoring of atherosclerosis. The aim of this study was to test that elevated FGF-23 levels might be associated with carotid artery atherosclerosis in maintenance hemodialysis (HD) patients.

Serum fibroblast growth factor-23 (FGF-23) levels are independently associated with left ventricular mass and myocardial performance index in maintenance haemodialysis patients.

Background: Fibroblast growth factor-23 (FGF-23) is a phosphorus-regulating substance. Circulating FGF-23 levels increase markedly in dialysis patients and are independently associated with increased risk of mortality. Given the fact that cardiovascular disease is the leading cause of death in dialysis patients, the aim of this study was to test if elevated FGF-23 levels might be associated with left ventricular mass index (LVMI) and left ventricular index of myocardial performance (MPI) in maintenance haemodialysis patients.

Simple renal cysts and circadian blood pressure: are they related to each other in patients with hypertension?

Previous studies have shown that the presence of simple renal cysts was related to hypertension. However, the relationship between simple renal cysts and circadian blood pressure was not studied before. Our study population comprised of newly diagnosed patients with essential hypertension.

Association among serum fetuin-A level, coronary artery calcification, and bone mineral densitometry in maintenance hemodialysis patients.

Patients with end-stage renal disease have a very high prevalence and extent of arterial calcification. A number of studies suggest that similar pathophysiologic mechanisms are responsible for development and progression of calcification of atherosclerotic plaque and bone formation. Fetuin-A is a potent calcification inhibitor and is expressed in bone, with not-yet well-defined functions.

Serum levels of MMP-9 and TIMP-1 in primary hypertension and effect of antihypertensive treatment.

Background: Matrix metalloproteinases, a family of proteolytic enzymes are thought to be involved in extracellular matrix accumulation during development of hypertensive target organ disease. The present study was designed to compare hypertensive patients with normotensive individuals with respect to serum levels of matrix metalloproteinase (MMP)-9 and tissue inhibitor of metalloproteinase (TIMP)-1 and to search for the effect of antihypertensive treatment on the serum enzyme levels.

Methods: Thirty-three patients with stage 1 primary hypertension and sixteen age- and sexmatched control subjects were enrolled into the study.

Concomitant amyloidosis, renal papillary carcinoma and ipsilateral pelvicalyceal urothelial carcinoma in a patient with familial Mediterranean fever.

We report a case of a 58-year-old man with a history of long standing familial Mediterranean fever (FMF) and AA amyloidosis, who developed renal papillary carcinoma and renal pelvic urothelial carcinoma simultaneously. Although the association between chronic inflammatory states like FMF and AA amyloidosis has been well established, the relationship between amyloidosis and solid tumors is not defined as clearly. Furthermore, to the best of our knowledge, co-existence of two different types of kidney malignancy with amyloidosis in a patient with FMF has not been reported.

Effect of renin angiotensin system blockade on pentraxin 3 levels in type-2 diabetic patients with proteinuria.

Background And Objectives: Long pentraxin 3 (PTX3) is a multimeric inflammatory mediator. Increased serum PTX3 levels have been reported among end-stage renal disease patients. Moreover, PTX3 has been suggested to represent a novel mortality risk factor, and elevated PTX3 levels have been shown to accompany increased albuminuria among patients with chronic kidney disease (CKD).

The interleukin-10 promoter genotype predicts diastolic dysfunction in maintenance hemodialysis patients.

Interleukin-10 (IL-10) predominantly acts as an anti-inflammatory factor. Polymorphisms in the IL-10 gene promoter determine quantitative cytokine production. Doppler echocardiography and tissue Doppler imaging (TDI) are superior to conventional echocardiography to evaluate diastolic dysfunction.

Association of serum lipid profile and arteriovenous fistula thrombosis in maintenance hemodialysis patients.

Background: Vascular access thrombosis represents a major cause of morbidity in the hemodialysis population. The role of serum lipid profile in access thrombosis is not sufficiently established. The aim of this study was to investigate the association between serum lipid profile and native arteriovenous fistula (AVF) thrombosis.

Enterococcal endocarditis associated with crescentic glomerulonephritis.

Glomerulonephritis secondary to infective endocarditis (IE) is an uncommon diagnosis and is usually associated with cardiac valvular infection by blood-culture-positive bacteria. We report a case of necrotizing glomerulonephritis associated with culture-positive endocarditis caused by Enterococcus faecalis. The patient presented with renal abnormalities and was further investigated by renal biopsy.

Magnetic resonance imaging of the rotator interval in patients on long-term hemodialysis: correlation with the range of shoulder motions.

Objective: To assess the rotator interval of patients on long-term hemodialysis with magnetic resonance imaging (MRI) for the presence of adhesive capsulitis and to correlate these findings with shoulder motions.

Methods: Seventeen shoulders in 16 patients (mean age, 53.8 years) on hemodialysis (range of duration, 4-28 years) who had pain and limited range of shoulder motion underwent MRI.

A rare complication of hemodialysis catheters: superior vena cava syndrome.

Central venous catheters in hemodialysis patients may result in superior vena cava (SVC) syndrome. With the increasing use of these catheters, the SVC syndrome will probably be more common among hemodialysis patients. This report describes 3 cases of SVC syndrome due to central venous catheters that developed in hemodialysis patients with previous multiple catheter placements.

Sonographic evaluation of entheseal sites of the lower extremity in patients undergoing hemodialysis.

Purpose: To evaluate the entheseal sites of the lower extremities in patients on hemodialysis using the Glasgow Ultrasound Enthesitis Scoring System (GUESS) and to correlate the findings with the duration of hemodialysis and patient scores.

Methods: Forty-nine patients who were on hemodialysis for at least 2 years were grouped according to duration of hemodialysis. Total GUESS scores; total enthesophyte, erosion, and bursitis scores; and tendon thicknesses were calculated, compared between groups, and correlated with duration of dialysis.

A case of Kaposi's sarcoma following treatment of membranoproliferative glomerulonephritis and a review of the literature.

Kaposi's sarcoma (KS) is an unusual tumor principally affecting the skin of the lower extremities. Although the association between KS and renal transplant has been well documented, there are a few KS cases in the literature associated with membranoproliferative glomerulonephritis or other glomerular diseases. This report presents a patient with membranoproliferative glomerulonephritis (MPGN) who developed KS following treatment with long-term medium dose glucocorticoid and short-term additional immunosuppressives.

A novel immunosuppressive agent, sirolimus, in the treatment of Kaposi's sarcoma in a renal transplant recipient.

Renal transplant recipients are susceptible to Kaposi's sarcoma (KS) because of treatment with immunosuppressive drugs. Sirolimus, a new immunosuppressive agent, has been successfully used for immune-suppression in kidney transplant recipients. Several studies have shown the potential role of sirolimus to inhibit progression of KS in kidney-transplant recipients.

Combined organ failure with combination antihyperlipidemic treatment: a case of hepatic injury and acute renal failure.

Objective: To report a case of acute hepatic injury and acute renal failure secondary to rhabdomyolysis associated with fluvastatin-gemfibrozil combination therapy for hyperlipidemia.

Case Summary: A 56-year-old woman with a history of hyperlipidemia presented with fatigue, weakness in her lower extremities, and red-colored urine. One month prior, she had started combination therapy of fluvastatin 80 mg/day and gemfibrozil 1200 mg/day.