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Öğe ADULT MINIMAL CHANGE DISEASE IN TURKEY: THE RESULTS OF TURKISH SOCIETY OF NEPHROLOGY GLOMERULAR DISEASES WORKING GROUP(Oxford Univ Press, 2020) Yilmaz, Murvet; Sipahioglu, Murat; Dervisoglu, Erkan; Aydemir, Nihal; Uzun, Sami; Istemihan, Zulal; Unsai, Oktay[Abstract Not Available]Öğe CHARACTERISTICS AND SURVIVAL RESULTS OF PERITONEAL DIALYSIS PATIENTS SUFFERING FROM COVID-19 IN TURKEY: A MULTICENTER NATIONAL STUDY(Karger, 2022) Gursu, Meltem; Ozturk, Savas; Arici, Mustafa; Sahin, Idris; Goekcay Bek, Sibel; Yilmaz, Murvet; Koyuncu, SumeyraBackground: We aimed to study the characteristics of peritoneal dialysis (PD) patients with Coronavirus disease-19 (COVID-19), determine the short-term mortality and other medical complications, and delineate the factors associated with COVID-19 outcome.Methods: In this multicenter national study, we included PD patients with confirmed COVID-19 from 27 centers. The baseline demographic, clinical, laboratory, and radiological data and outcomes at the end of the first month were recorded.Results: We enrolled 142 COVID-19 patients (median age:52 years). 58.2% of patients had mild disease at diagnosis. Lung involvement was detected in 60.8% of patients. 83 (58.4%) patients were hospitalized, 31 (21.8%) patients were admitted to intensive care unit and 24 needed mechanical ventilation. 15 (10.5%) patients were switched to hemodialysis and hemodiafiltration was performed for four (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. 26 patients (18.31%) died in the first month of diagnosis. The non-survivor group was older, 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 baseline CRP (OR:1.008; 95%CI; 1.000-1.016; p:0.040) were associated with first-month mortality in multivariate analysis.Conclusions: 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.Öğe Demographic, clinical and laboratory characteristics of adult-onset minimal change disease in Turkey: Turkish Society of Nephrology-Glomerular Diseases (TSN-GOLD) Working Group(Springer, 2023) Aydin, Zeki; Yilmaz, Murvet; Sipahioglu, Murat; Dervisoglu, Erkan; Aydemir, Nihal; Uzun, Sami; Istemihan, ZulalPurpose In our study, diagnostic and demographic characteristics of patients diagnosed with minimal change disease (MCD) by biopsy, clinical and laboratory findings in our country were investigated. Methods Data were obtained from the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) Working Group database. Demographic characteristics, indications for biopsy, diagnosis of the glomerular diseases, comorbidities, laboratory and biopsy findings of all patients were recorded. The data presented are cross-sectional and includes application data for the biopsy period. Results Of 3875 patients, 233 patients with MCD (median age 35.0 years) were included in the study, which constitutes 6.0% of the total glomerulonephritis database. Renal biopsy was performed in 196 (84.1%) patients due to nephrotic syndrome. Median serum creatinine was 0.7 (0.6-1.0) mg/dl, mean eGFR was 104 +/- 33 ml/min/1.73 m(2) and median proteinuria 6000 mg/day. The number of patients under the age of 40 years was 139 (59.7%) (Group A), and the number of patients aged 40 years and over was 94 (40.3%) (Group B). Compared to Group A, global sclerotic glomeruli (24 vs. 43, p < 0.001) interstitial inflammation (15 vs. 34, p < 0.001), interstitial fibrosis (20 vs. 31, p = 0.001, vascular changes (10 vs. 25, p < 0.001) and tubular atrophy (18 vs. 30, p < 0.001) were found to be significantly higher in Group B. There was no difference in immunofluorescent staining properties between the two groups. Conclusion Our data are generally compatible with the literature. Chronic histopathological changes were more common in patients aged 40 years and older than younger patients. Studies investigating the effects of these different features on renal survival are needed.Öğe Evaluation of Outcomes of Peritoneal Dialysis Patients in the Post-COVID-19 Period: A National Multicenter Case-Control Study from Turkey(Karger, 2023) Ozturk, Savas; Gursu, Meltem; Arici, Mustafa; Sahin, Idris; Eren, Necmi; Yilmaz, Murvet; Koyuncu, SumeyraIntroduction: There are not enough data on the post-CO-VID-19 period for peritoneal dialysis (PD) patients affected from COVID-19. We aimed to compare the clinical and laboratory data of PD patients after COVID-19 with a control PD group. Methods: This study, supported by the Turkish Society of Nephrology, is a national, multicenter retrospective case-control study involving adult PD patients with confirmed COVID-19, using data collected from April 21, 2021, to June 11, 2021. A control PD group was also formed from each PD unit, from patients with similar characteristics but without COVID-19. Patients in the active period of COVID-19 were not included. Data at the end of the first month and within the first 90 days, as well as other outcomes, including mortality, were investigated. Results: A total of 223 patients (COVID-19 group: 113, control group: 110) from 27 centers were included. The duration of PD in both groups was similar (median [IQR]: 3.0 [1.88-6.0] years and 3.0 [2.0-5.6]), but the patient age in the COVID-19 group was lower than that in the control group (50 [IQR: 40-57] years and 56 [IQR: 46-64] years, p < 0.001). PD characteristics and baseline laboratory data were similar in both groups, except serum albumin and hemoglobin levels on day 28, which were significantly lower in the COVID-19 group. In the COVID-19 group, respiratory symptoms, rehospitalization, lower respiratory tract infection, change in PD modality, UF failure, and hypervolemia were significantly higher on the 28th day. There was no significant difference in laboratory parameters at day 90. Only 1 (0.9%) patient in the COVID-19 group died within 90 days. There was no death in the control group. Respiratory symptoms, malnutrition, and hypervolemia were significantly higher at day 90 in the COVID-19 group. Conclusion: Mortality in the first 90 days after COVID-19 in PD patients with COVID-19 was not different from the control PD group. However, some patients continued to experience significant problems, especially respiratory system symptoms, malnutrition, and hypervolemia.
