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Item Secondary Hyperparathyroidism Is Associated with Pulmonary Hypertension in Older Patients with Chronic Kidney Disease and Proteinuria(2015) Genctoy, Gultekin; Arikan, Serap; Gedik, Olcay; 0000-0002-5145-2280; 0000-0001-5752-3812; 25537827; AAJ-5551-2021; AAM-4084-2021; AAJ-1289-2021Hyperparathyroidism is associated with pulmonary vascular calcification and pulmonary hypertension (PH) in a chronic kidney failure dog model, and increased prevalence of PH and a PH-hyperparathyroidism relationship in pre-dialysis chronic kidney disease (CKD) and hemodialysis patients are reported. This study investigated the prevalence of PH and relationships between PH and metabolic abnormalities in patients with stage 1-4 proteinuria CKD. One-hundred and ninety patients (mean age 61 +/- A 17.4, 116 males) with proteinuria CKD and no coronary diseases, congestive heart failure, smoking history, and pulmonary diseases were enrolled. Estimated glomerular filtration rate was 39.7 +/- A 23 ml/min. CKD etiology was diabetes mellitus in 52 (27.3 %), chronic glomerulonephritis or tubulointerstitial nephritis in 56 (29.4 %), hypertension in 36 (19 %), and other etiologies (nephrolithiasis, obstructive nephropathy, and amyloidosis) in 46 (25.3 %) patients. Echocardiography was performed, and systolic pulmonary artery pressure (PAP) and left ventricular ejection fraction were determined. Laboratory tests examined lipid parameters, serum albumin, urea, creatinine, calcium, phosphorus, C-reactive protein, parathyroid hormone, ferritin, and hemoglobin levels. PH (PAP > 35 mmHg) was detected in 68 patients (35.9 %). Patients with PH were older (68 +/- A 12.3 vs. 52.1 +/- A 16.7, p = 0.03), had lower ejection fractions (51.3 +/- A 13.4 vs. 60.8 +/- A 9.1 %, p = 0.003), lower hemoglobin (11.3 +/- A 1.5 vs. 12.1 +/- A 1.9, p = 0.05), and higher parathyroid hormone (218 +/- A 159.3 vs. 127.7 +/- A 67.4 pg/ml, p = 0.05) levels. The remaining parameters were similar between groups. Older age, lower ejection fraction, and secondary hyperparathyroidism may contribute to PH in stage 1-4 proteinuria CKD.Item Urinary N-Acetyl-Beta-D Glucosaminidase Activity is Associated with Inflammation and Proteinuria in Diabetic and Non-Diabetic Patients with Different Stages of Chronic Kidney Disease(2015) Genctoy, Gultekin; Arikan, Serap; 0000-0002-5145-2280; 0000-0001-5752-3812; AAJ-5551-2021; AAM-4084-2021OBJECTIVE: Clinical studies have demonstrated that tubulointerstitial rather than glomerular pathology correlates with the degree and progression of renal impairment. Urinary n-acetyl-betaD- glucosaminidase (NAG) is a biomarker of tubular damage, shown to be elevated in patients with glomerulonephritis and acute kidney injury. However, it has not been assessed longitudinally in chronic kidney disease (CKD). The aim of the present study was to determine urinary NAG activity and its possible associations with metabolic and inflammatory parameters in CKD. MATERIAL and METHODS: A total of 72 patients (mean age: 64.5 +/- 15.7) with stage 1-5 CKD were included. Of the 72 patients 23 (32%) had diabetic nephropathy and 49 (68%) had different types of primary glomerular diseases. Fasting blood samples were collected to analyse complete blood count, urea, creatinine, albumin, lipid parameters, C-reactive protein, uric acid and parathyroid hormone. 24-hour urine was collected to determine protein excretion. Urinary NAG and creatinine levels were analysed from the first morning urine samples. The NAG index (urinary NAG/ creatinine) was used to exclude dilutional errors. RESULTS: Mean eGFR was 38.3 +/- 21.7 ml/min. The urinary NAG index was significantly higher in stage 3 compared to stage 2 (32.1 +/- 23.5 vs. 7.5 +/- 3.3 U/gr-creatinine; p=0.002) and lower in stage 5 compared to stage 3 CKD (8.2 +/- 7.6 vs. 32.1 +/- 23.5; p=0.017). The urinary NAG index was positively correlated with 24-hour urine protein excretion (r=0.43; p=0.0001) and serum CRP (r=0.549; p=0.04) and negatively correlated with hemoglobin levels (r-0.394; p=0.004). CONCLUSION: The present study demonstrated that urinary NAG correlates with systemic inflammation and proteinuria and may be associated with progression of CKD.Item Clinical Profile and Renal Ultrasound Characteristics of Children With Nutcracker Syndrome in Turkey(2022) Basaran, Edibe Gozde; Yilmaz, Aysun Caltik; Gungor, Ozlem; Tayfur, Asli Celebi; Buyukkaragoz, Bahar; https://orcid.org/0000-0003-0774-4419; 35060485; AAD-1877-2021Objective We aimed to evaluate the clinical profile and radiological findings of children with nutcracker syndrome (NCS) and to assess the association between the parameters. Methods A retrospective analysis of the clinical, laboratory and radiological parameters of children diagnosed with NCS between January, 2011 and October, 2017 was done. Results Of a total of 29 patients [19 girls, 65.5%] with NCS, having a mean (SD) age of 10.8 years, 72.4% had BMI <-2SD. Approximately half of the patients (51.7%) were asymptomatic. Left flank pain was commonest (9/29; 31%) symptom, followed by macroscopic hematuria (4/29; 13.8%). Isolated proteinuria was seen in 9 children. There was no significant difference between the symptomatic and asymptomatic patients in terms of Doppler ultrasonography findings. All patients were followed up conservatively, 5 received enalapril therapy for moderate proteinuria. Conclusion NCS should be considered in children, especially with low BMI, presenting with orthostatic proteinuria and hematuria, with or without left flank pain after ruling out the common causes.Item Prevalence of Proteinuria in School-Aged Turkish Children, and Its Association with Obesity and Hypertension(2017) Kazanci, Nafia Ozlem; Gul, Ali; Ozer, Samet; Yilmaz, Resul; Sonmezgoz, Ergun; Kasap, Tuba; Takci, Sahin; Unuvar, Seyma; Onder, Yalcin; Citil, RizaAim: In kidney diseases, renal damage may be mild and initially asymptomatic. Proteinuria, a marker of kidney injury, directly contributes to chronic tubulointerstitial damage. We investigated the prevalence of proteinuria (POP) in school-aged children in Turkey. Materials and Methods: The cluster sampling method was used to calculate the required size of the study group for this cross-sectional study. Urine samples were randomly obtained to determine urinary protein/creatinine ratio (Upr/Ucr) from 1374 children aged 6 to 18 years. POP was also specifically assessed in hypertensive and obese children. Results: The mean age of the subjects was 11.68 +/- 3.43 years. The children were from rural (23.9%) and urban (76.1%) regions of Tokat, Turkey. Upr/Ucr >= 0.20 was detected in 92 children, corresponding to a POP rate of 6.7%, without any statistically significant difference between girls and boys. Among 141 obese children, 16 (11.3%) and 76 of 1233 non-obese children (6.2%) had proteinuria (p<0.05). Children with hypertension had a POP of 7.5% compared to the 6.7% of those without hypertension (p>0.05). Conclusion: Among school-aged Turkish children POP was 6.7%. POP was higher in obese than in non-obese children. But there was no association between POP and hypertension. While screening programs allow the early detection of renal disease, further cohort studies are required to be able to suggest urinary screening programs.Item Proteinuria in preeclampsia: is it important?(2018) Okten, Sabri Berkem; Ozkara, Atilla; Kaya, Aski Ellibes; Basbug, Alper; Dogan, Ozan; Caglar, Mete; Kumru, Selahattin; 0000-0001-7473-761X; 30084477Objectives: Our aim is to evaluate the laboratory results arid proteinuria levels of preeclamptic women arid their relationships to maternal and fetal outcomes. Material and methods: One hundred preeclamptic pregnant women who gave birth in our clinic between 2013 and 2015 were included in our study retrospectively. The data collected from the patients included gestational week, age, gravidity, parity, abortus history, blood pressure, biochemical parameters, delivery method, maternal hospitalization time, cesarean indication, complications, blood products required, plasmapheresis use and dialysis need. The details about the newborns were recorded retrospectively. The relationships between preeclampsia signs and maternal and neonatal outcomes were analyzed. The protein amounts were analyzed via 24-hour collected urine analyses and spot urine analyses. Results: A statistically significant positive correlation was observed between neonatal intensive care unit needs and proteinuria levels. Fetal growth restriction, respiratory distress syndrome and sepsis were observed as the level of proteinuria increased, but the result was not statistically significant. Eclampsia was observed only in patients with massive proteinuria, and it was statistically significant. An increase in cesarean sections, placental abruptions, antihypertensive drug needs and blood product replacement rates was observed as the amount of proteinuria increased in preeclamptic women, but the results were not statistically significant. Conclusions: The severity of preeclampsia cannot be determined by the level of proteinuria. However, when massive proteinuria is detected, the clinician should be more cautious about maternal and fetal complications.