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Serum bilirubin may predict the progression of CKD in patients with type 2 diabetes and preserved kidney function.

Serum albumin is a major determinant of hospitalization in patients with end‐stage renal disease (ESRD). Previous reports generally use the Poisson model to evaluate the relationships between outcome and response variables. However, hospitalization data are often overdispersed, and few studies using appropriate methods exist in the literature.This retrospective cohort study included 426 patients with ESRD receiving hemodialysis treatment between 2014 and 2018. Using a negative binomial regression model with hierarchical multivariable adjustments, we investigated the relationship between serum albumin, hospital admissions, and total hospitalization days. Mean age and mean baseline serum albumin levels were 64.7 ± 11 years and 3.5 ± 0.5 g/dL, respectively. At least one hospitalization was identified in 402 (94%) patients. The incidence rate was 1.48 (95% CI, 1.41‐1.56) admissions per patient‐year during the follow‐up period of 5 years. A negative linear association was observed between serum albumin and hospitalization frequency. Hospitalization rates (95% CI) were 1.81 (1.65‐1.98), 1.44 (1.3‐1.59), 1.36 (1.22‐1.51), and 1.33 (1.2‐1.48) per patient‐year in serum albumin levels ≤3, 3.1 to ≤3.3, 3.4 to ≤3.7, and ≥3.8 g/dL, respectively. Case mix‐adjusted incidence rate ratio was 0.82 (95% CI, 0.70‐0.94), while it was robust to further adjustments for malnutrition and inflammation markers. Similar results were observed in hospitalization days and time to the first hospitalization. These findings, which result from the negative binomial model using overdispersed data, suggest that lower serum albumin is related to increased hospitalization rates and hospital days in incident hemodialysis patients.

Background: Urinary calculi are a common and severe problem, which are formed by urolithiasis or by the formation of calcium oxalate (CaOx) crystals in the kidneys. Many treatment options such as drugs, various herbal preparations, surgical removal of the stones, and extracorporeal shock wave lithotripsy have been applied for this condition. The aim of this study is to assess the effects of the drug amlodipine in an experimentally induced urolithiasis rat model. Materials and methods: The effect of 5 mg/kg amlodipine was studied in rats that were first treated with 1% ethylene glycol and 1% ammonium chloride for 21 days to induce urolithiasis. The weight differences and the levels of calcium, magnesium, and phosphate were measured in serum and urine. In addition, urine CaOx level was defined and histopathological analyses were performed on the kidneys. Results: Urolithiasis caused a significant increase in both serum and urine parameters compared with healthy rats. Urolithiasis plus amlodipine administration increased the levels of these same parameters. Urine CaOx level was high in urolithiasis rats and was also increased by urolithiasis plus amlodipine administration. The weight of the rats decreased in the urolithiasis plus amlodipine group when compared with the urolithiasis group. Histopathological examinations revealed extensive intratubular crystal depositions and degenerative tubular structures in the urolithiasis group and the amlodipine treatment group. Conclusion: We showed that amlodipine may increase susceptibility to urolithiasis by raising hyperoxaluria and hypercalciuria. Further studies should be performed to elucidate the urolithiasis activity of amlodipine and to confirm the data.

Objective White blood cell (WBC) count was used as a predictor in researches since it is a prognostic indicator and a substantial predictor of the development of cardiovascular disease (CVD). There have been very few reports looking at the association between WBC count and overall mortality in peritoneal dialysis (PD) patients. We intended to explore if the baseline total leukocyte count is linked to all-cause mortality, considering the association for linearity in PD patients. Material and methods The study comprised 204 incident PD patients who began treatment at the Nephrology Department of Health Sciences University, Kayseri Medical Faculty, Kayseri City Hospital between January 2009 and December 2017. The research period ended in January 2018. The link between baseline WBC count and all-cause mortality was studied using Cox proportional hazards models. Results The average age of the patients was 46.75 (8.49) years, and 48.5% were male. Diabetes and hypertension were prevalent in 59.8% and 76% of the population, respectively. The average WBC count was 9.37 (2.70) × 10 3 /µL. The mortality risk increased by 23% for every one-unit increase in the crude model. The hazard of death in the fully corrected model was 1.12 [95% confidence interval (CI): 1.02-1.23, p = 0.015]. In the models with WBC count stratified by tertiles, the mortality hazard of patients in tertile 2 was 2.38 (95% CI: 1.24-4.58, p = 0.009) and of patients in tertile 3 in the fully adjusted model was 2.64 (95% CI: 1.30-5.33, p = 0.007), compared with patients in tertile 1. Conclusion The initial WBC count may have a long-term impact on patient survival. Individuals with higher basal values or even an elevation in follow-up should therefore be strictly controlled, and all preventative measures should be made to lower the risk level.