Introduction. Acute kidney injury (AKI) pathogenesis is complex. Findings of gentamicin nephrotoxicity are seen in 30% of the AKI patients. Vitamin D has proven to be effective on renin expression, inflammatory response, oxidative stress, apoptosis, and atherosclerosis. We aimed to investigate the effect of vitamin D in an experimental rat model of gentamicin-induced AKI. Methods. Thirty nonuremic Wistar albino rats were divided into 3 groups: Control group, 1 mL saline intramuscular (im) daily; Genta group, gentamicin 100 mg/kg/day (im); Genta + vitamin D, gentamicin 100 mg/kg/day (im) in addition to 1α, 25 (OH)2D3 0.4 mcg/kg/day subcutaneously for 8 days. Blood pressures and 24-hour urine were measured. Blood urea and creatinine levels and urine tubular injury markers were measured. Renal histology was semiquantitatively assessed. Results. Urea, creatinine and urine neutrophil gelatinase-associated lipocalin, and kidney injury molecule-1 were all increased in Genta group indicating AKI model. Systolic blood pressure decreased, but urine volume and glutathione increased in Genta + Vit D group compared to Control group. Histological scores indicating tubular injury increased in Genta and Genta + Vit D groups. Conclusions. Vitamin D does not seem to be effective on histological findings although it has some beneficial effects via RAS system and a promising effect on antioxidant system.
Infections are a major cause of morbidity and mortality in the elderly. Improvements in health care prevention including vaccinations and treatment have led to an increase in the birth life expectancy. The vaccines that are now recommended for people over 60 are influenza, herpes zoster and a vaccine combining tetanus toxoid, reduced diphtheria toxoid, and pneumococcal vaccine. Our aim was to estimate the prevelance of vaccination among diabetic patients attending in Tepecik Training Hospital and in Ege University Faculty of Medicine. Patients and Methods: Individuals at or over the age of 60 who were attending to Tepecik Training Hospital and at Ege University Faculty of Medicine. Department of Internal Medicine was targeted from February to May 2014. Our data are collected from the patients face to face by questionnaire. Results: A total of 274 elderly patients with a mean ± SD (range) age of 72 ± 6 (62-93) years were questioned. The vaccination ratios were determined as 34% (93) for influenza, 9.5% (26) for pneumococcal, 10.6% (27) for tetanus vaccine. The patients were divided in two groups as diabetics and non-diabetics. The influenza vaccination rate is 38.1% in diabetic patients, rate of 31.8% in non-diabetic patients, the pneumococcal vaccine rate is 13.4% in diabetic patients, rate of 7.39% in non-diabetic patients. The tetanus vaccination rate is 9.28% in diabetic patients, rate of 11.36% in non-diabetic patients. No statistically significant difference between two groups was determined.
Acute renal failure (ARF) is a clinical situation that renal functions deteriorate suddenly within hours to days. Postrenal causes are responsible for a small part of ARF. In this article, we presented a case gone to left nephrectomy priorly, with a right ureter stone led to complete obstruction, ARF, and treated by ureterorenoscopy (URS). A seventy year old male patient was sent to Emergency Department because of anuria for 48 hours. In ultrasonographic exam; there wasn't hydronephrosis of right kidney. A right lower ureter stone was seen in the non-contrast spiral abdominal computed tomography. The lower ureter stone was removed by URS and JJ catheter was replaced. He was discharged with normal renal function tests. In conclusion, postrenal ARF must be ruled out in patients with acute anuria, especially zero urine, even if hydronephrosis delinea. If postrenal ARF is diagnosed and treated quickly, the outcomes will be excellent.
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