The reliability and success of peritoneal dialysis during the COVID-19 pandemic.

We evaluated the symptoms, changes in laboratory findings during the novel coronavirus disease (COVID-19) pandemic, and the effect of depression in patients with peritoneal dialysis (PD). This is an observational and cross-sectional study. All patients were asked to fill the clinical assessment form and Beck depression and anxiety inventory. Also, the last two laboratory evaluations during this period were examined. A total of 123 patients performing PD were included. None of the patients were diagnosed with COVID-19. In the total study population, parathyroid hormone (PTH), serum albumin, phosphorus and ferritin levels significantly elevated at the end of 97 ± 31 days. PTH and phosphorus levels remained stable in remote monitoring automated PD (RM-APD) group (p = 0.4 and p = 0.5), they tended to increase in continuous ambulatory PD group and significantly increased in automated PD group (p = 0.09 and p = 0.01 for PTH and p = 0.06 and p = 0.001 for phosphorus, respectively). Moderate to severe depression was associated with dyspnoea, weight gain more than 5 kg, fatigue, palpitation and increased anxiety. PD is a reliable and successful form of dialysis and can be safely administered even if hospital access is restricted. Also, RM-APD may be a better choice because of providing more stable bone-mineral metabolism. Moreover, evaluating depression and anxiety is essential for the accurate clinical assessment.

Hypervolemia and high tumor necrosis factor-α: An interesting finding during the first six months' posttransplant period in kidney transplant recipients with good renal function.

Renal transplantation is the treatment of choice for the end-stage renal disease. Hypervolemia and inflammation are commonly overlooked. We investigated whether hyper-volemia develops in kidney transplant recipients with estimated glomerular filtration rate (eGFR) >70 mL/min and if there is there any correlation between inflammatory cytokines and hypervolemia in the 1st month and at six months after transplantation. We measured serum tumor necrosis factor-α (TNF-α), interleukin (IL)-1, IL-6, and body composition indices in 11 healthy volunteers and 19 kidney transplant recipients (KTRs) with eGFR >70 mL/min at one month and six months posttransplant. At baseline, body mass index (BMI) and fat tissue index (FTI) were significantly higher and overhydration improved (P = 0.006) at 6th month in KTRs. There was no difference in BMI, FTI, lean tissue index (LTI), and serum levels of IL-1 and IL-6 in controls and KTRs at six months posttransplant. Volume overload and serum TNF-α levels were significantly lower in controls than KTRs. There was positive correlation between volume overload and serum TNF-α levels in KTRs. Compared to baseline, parameters including volume overload, BMI, and FTI were found to be improved at six months' posttransplant in KTRs. Interestingly, volume overload and high levels of serum TNF-α continued at least six months after transplantation.

Expression of p53, Ki67, epidermal growth factor receptor, transforming growth-factorα, and p21 in primary and secondary hyperparathyroidism.

BACKGROUND: Secondary hyperparathyroidism (SH) is major problem in chronic renal failure. There are studies to examine proliferation and apoptosis associated biomarkers expressions in parathyroid lesions to reveal specific features. In this study, we evaluated the expression of some growth factors and their receptors in parathyroid gland of patients with SH or primary hyperparathyroidism (PH). MATERIALS AND METHODS: A total of 49 patients had been operated for PH and 26 for SH. Parathyroid tissue samples were evaluated histopathologically and immunohistochemically using antibodies to human p53, KI-67, anti-human p21, antitransforming growth factor (TGF) α, CPP32 (caspase 3), and epidermal growth factor receptor (EGFR). RESULTS: Adenoma was higher in PH compared with SH as 48/49 and 3/26, respectively (P = 0.000). Parathyroid hyperplasia was found in 23/26 patients with SH and 1/49 patient with PH. In parathyroid tissue there were no difference between PH and SH for p53, Ki-67, caspase, EGFR expressions; while there were significantly difference for TGFα (P = 0.047) and borderline significant difference for p21 (P = 0.06) expressions. CONCLUSION: Adenoma was priority present in PH patients, hyperplasia was present in SH. There were no differences between primary and SH or adenoma and hyperplasia for expressions of cycline-dependent kinase inhibitor p21, p53, EGFR, Ki67, caspase; while TGFα expression was found to be different.