Introduction: In December 2019, pneumonia cases emerging in China rapidly spread and became a global pandemic. The disease called COVID-19 threatens health and life in patients with comorbid disease, especially in patients with kidney failure. In this study, we aimed to evaluate the clinical findings, laboratory parameters, and prognosis of COVID-19 disease in end-stage renal patients undergoing hemodialysis treatment. Methods: We included the hemodialysis patients who have been diagnosed with COVID-19 disease and received inpatient treatment between 11 Match 2020 and 24 April 2020 in hospital. The demographic characteristics, comorbidities, symptoms, clinical course, laboratory parameters, and treatments were recorded. Findings: The study included 25 hemodialysis patients; 15 (60%) were female. The mean age was 60.5 AE 15 years. All patients had chest computed tomography findings compatible with COVID-19 disease. The findings were bilateral in 88% of patients. The real-time reverse transcriptasepolymerase chain reaction test was positive in 48% of the patients. The most common symptoms were dyspnea (56%) and fever (52%). The most common comorbid disease was hypertension (76%). Leukocytosis in 12% of the patients while 72% had lymphopenia. All patients had a high C-reactive protein value. 64% of patients required oxygen support and 32% intensive care. 28% developed a secondary infection. 76% (19/25) of the patients has been discharged with cure and 20% (5/25) died. The inpatient follow-up of a patient (4%) continues. Secondary infection development was significantly associated with oxygen demand (P = 0.027) and need for intensive care (P = 0.001). Discussion: The associated clinical symptoms of COVID-19 were similar in hemodialysis patients to those of patients without renal disease. However, it caused pneumonia in all hemodialysis patients. It was associated with a more severe disease and worse prognosis with a mortality rate of 20%. Our study suggests that COVID-19 disease has a significantly more severe course and worse prognosis in hemodialysis patients.

OBJECTIVE: Vitamin D insufficiency might have a role in numerous diseases including autoimmune disease, cancer, diabetes mellitus, hypertension and heart diseases. The relationship between vitamin D insufficiency and hyperuricemia has been shown previously but there are conflicting results in studies. MATErIAl and METhODS:A total of 1562 patients who had serum uric acid and vitamin D levels measured at the same time were enrolled. Patients who were on vitamin D replacement therapy, receiving calcium and/or allopurinol, or had gout and chronic kidney disease were excluded. rESulTS: Hyperuricemic patients had significantly lower levels of serum vitamin D level compared with normouricemic patients (p<0.001) whereas there was no difference between the groups in terms of serum calcium, phosphorus, parathormone and alkaline phosphatase. Severe deficiency (25(OH) vitamin D <10) was significantly more common among patients with hyperuricemia (p<0.001). When vitamin D levels were analyzed according to age, a significant inverse correlation between vitamin D and serum uric acid level was found in decades 7 and 8. Age, eGFR and vitamin D level below 20 appeared as independent associates of serum uric acid levels.COnCluSIOn: These data suggest that hyperuricemia associates with vitamin D deficiency. Further studies are needed to understand the mechanism underlying this association and its potential clinical implications. BulGulAr: Hiperürisemik hastaların serum vitamin D düzeyleri normoürisemik hastalara göre daha düşük olduğu görülmesine (p<0.001) karşın, gruplar serum kalsiyum, fosfor, parathormon ve alkalen fosfataz düzeyleri bakımından benzerdi. D vitamini düzeylerine göre değerlendirildiğinde ağır (vitamin D <10) düzeyde eksikliği olan hastaların daha çok hiperürisemik (p<0.001) grupta olduğu görüldü. Yaşa göre serum D vitamini ve ürik asit düzeyleri arasında anlamlı derecede negatif korelasyonun 7. ve 8. dekatlarda olduğu görüldü. Yaş, serum D vitamini düzeyinin <20 olması ve eGFR düzeyleri, serum ürik asit düzeyi ile anlamlı korelasyon gösterdiği görüldü.SOnuç: Çalışmamızda, hiperüriseminin D vitamini eksikliği ile ilişkili olduğu saptanmıştır. Bu ilişkiyi açıklayabilecek mekanizma ve bunun klinik açıdan etkilerine yönelik daha ileri çalışmalara ihtiyaç vardır.

Background The prognostic factors for COVID-19 in patients with chronic kidney disease (CKD) are uncertain. We conducted a study to compare clinical and prognostic features between hospitalized COVID-19 patients with and without CKD. Methods Fifty-six patients with stage 3–5 CKD and propensity score-matched fifty-six patients without CKD were included in the study. Patients were followed-up at least fifteen days or until death after COVID-19 diagnosis. The endpoints were death from all causes, development of acute kidney injury (AKI) or cytokine release syndrome or respiratory failure, or admission to the intensive care unit (ICU). Results All patients were reviewed retrospectively over a median follow-up of 44 days (IQR, 36–52) after diagnosis of COVID-19. Patients with CKD had higher intensive care unit admission and mortality rates than the patients without CKD, but these results did not reach statistical significance (16 vs. 19; p = 0.54 and 11 vs. 16, p = 0.269, respectively). The frequency of AKI development was significantly higher in predialysis patients with CKD compared to the other group (8 vs. 5; p < 0.001), but there was no significant difference between the groups in terms of cytokine release syndrome (13 vs. 8; p = 0.226), follow-up in the ICU (19 vs. 16; p = 0.541), and respiratory failure (25 vs. 22, p = 0.566). Multivariate logistic regression analysis revealed that respiratory failure and AKI were independent risk factors for mortality. Conclusion The mortality rates of COVID-19 patients with CKD had higher than COVID-19 patients without CKD. Also, AKI and respiratory failure were independently related to mortality.

CRS is associated with ED and atherosclerosis, as indicated by decreased FMD and increased CIMT in patients with CRS. Further studies are necessary to identify the exact pathophysiologic mechanisms responsible for our findings.

Background Amyloidosis is a protein-misfolding disease characterized by the deposition of aggregated proteins in the form of abnormal fibrils that disrupt tissue structure, ultimately causing disease. Amyloidosis is very frequent in untreated familial Mediterranean fever (FMF) patients and it is the most important feature that determines the prognosis of FMF disease. The mean platelet volume (MPV) in FMF has been previously studied. However, whether MPV level in FMF patients is lower or higher compared to healthy controls remains a topic of ongoing debate. In this study, we aimed to investigate MPV values and to assess the correlation between MPV and proteinuria in patients with AA amyloidosis and AA amyloidosis secondary to familial Mediterranean fever (AA-FMF) through a retrospective chart-review. Material/Methods This study was carried out on 27 patients with AA amyloidosis, 36 patients with AA amyloidosis secondary to FMF (a total of 63 patients with AA), and 29 healthy controls. There was no statistically significant difference between the AA patients and the control group (p=0.06) or between the AA-FMF group and the control group in terms of MPV values (p=0.12). Results We found a statistically significant negative correlation between MPV and thrombocyte count in all groups (p<0.05 for all groups), but there was no correlation between MPV and proteinuria levels in AA patients (p=0.091). Conclusions While similar results also exist, these findings are contrary to the majority of previous studies. Therefore, further controlled clinical prospective trials are necessary to address this inconsistency.