Background: We wished to investigate potential causes of dialysis-induced hypotension (DIH), including the attenuated cardiovascular response to sympathetic system activation during exercise and myocardial dysfunction. Methods: This study included 26 end-stage renal disease (ESRD) patients with DIH, 30 ESRD patients without DIH (Non-DIH), and 30 control subjects. Each patient was evaluated with echocardiography and a symptom-limited treadmill stress test. The chronotropic index (CRI), heart rate recovery (HRR), systolic blood pressure response to exercise (SBP response), and tissue Doppler systolic myocardial velocities were calculated. Results: The HRR and velocities were reduced in dialysis patients compared to controls; however, they were similar in patients with and without DIH. Patients with DIH had the lowest CRI compared to theNon-DIH group (0.62 ± 0.15 vs. 0.73 ± 0.17, p = 0.020) and controls (0.62 ± 0.15 vs. 0.86 ± 0.11, p < 0.001). Similarly, patients with DIH had the lowest SBP response values compared to the Non-DIH (34.88 ± 15.01 vs. 55.67 ± 25.42, p = 0.002) and controls (34.88 ± 15.01 vs. 59.70 ± 23.04, p < 0.001). Conclusion: Patients with DIH have inadequate sympathetic activity of the cardiovascular system during exercise and impaired left ventricular systolic function. Both factors could contribute to the development of hypotension during hemodialysis.

Amaç: Amiloidoz amyloid fibrillerin dokularda birikmesi ile oluşur, çeşitli lokal ve sistemik semptomların oluşmasına neden olur. Amyloid A amyloidozis (AA amyloidozis) sistemik amiyloidozun en sık görülen tipidir. Çalışmalar, azalmış serum fetuin-A (SF-A) seviyesi son dönem böbrek hastalarında artmış morbitite ve mortaliteyle birlikte olduğunu göstermiştir. Amacımız AA amiloidozlu hastalarda yüksek SF-A düzeylerinin ortak karotis intima-media kalınlığı (IMT) ile ilişkili olup olmadığını araştırmaktı. Yöntemler: Çalışmaya 63 AA amiloidozlu olgu ve 29 sağlıklı kontrol dahil ettik. İki grubun demografik verilerini, biyokimasal parametrelerini, SF-A seviyelerini ve karotis IMT değerlerini karşılaştırdık. Aynı zamanda AA amiloidozlu hastalarda karotis intima-media kalınlığı ile SF-A düzeyleri arasındaki ilişkiyi araştırdık. Bulgular: Kontrol grubu ile karşılaştırıldığında AA amiloidozlu hastalarda karotis IMT'nin anlamlı derecede artığını tespit ettik(p<0,001). Kontrol grubu ile hasta grubu arasındaki SF-A seviyeleri benzerdi (p=0,11). Karotis IMT ile SF-A düzeyi arasında herhangi bir korelasyon yoktu(r=0,074, p=0,565). Sonuç: Çalışmamızda AA amiloidozlu hastaların SF-A seviyesinde değişiklik yoktu. Aynı zamanda karotis intima-media kalınlığı ile SF-A düzeyi arasında herhangi bir korelasyon yoktu.

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Background Although several renal biopsy registry reports have been published worldwide, there are no data on primary glomerular disease trends in Turkey. Methods Three thousand eight-hundred fifty-eight native kidney biopsy records were assessed in the Turkish Society of Nephrology Primary Glomerulopathy Working Group (TSN-GOLD) Registry. Secondary disease and transplant biopsies were not recorded in the registry. These records were divided into four periods, before 2009, 2009 to 2013, 2013-2017, and 2017-current. Results A total of 3858 patients (43.6% female, 6.8% elderly) were examined. Nephrotic syndrome was the most common biopsy indication in all periods (58.6%, 53%, 44.1%, 51.6%, respectively). In the whole cohort, IgA nephropathy (IgAN) (25.7%) was the most common PGN with male predominance (62.7%), and IgAN frequency steadily increased through the periods (× 2 = 198, p < 0.001). MGN was the most common nephropathy in the elderly (> 65 years), and there was no trend in this age group. An increasing trend was seen in the frequency of overweight patients (× 2 = 37, p < 0.0001). Although the biopsy rate performed with interventional radiology gradually increased, the mean glomeruli count in the samples did not change over the periods. Conclusions In Turkey, IgAN is the most common primary glomerulonephritis, and the frequency of this is increasing.