The effect of non-albumin proteinuria on renal outcomes in patients with biopsy proven diabetic nephropathy.

OBJECTIVE: We aimed at investigating the effect of non-albumin proteinuria on renal outcomes in patients with biopsy-proven diabetic nephropathy. PATIENTS AND METHODS: The files of all patients who underwent kidney biopsy between January 2010 and January 2020 were reviewed retrospectively. Non-albumin proteinuria was calculated by subtracting albumin from total protein in 24-hour urine samples. The patients were divided into 2 groups, according to the presence of composite kidney outcomes. RESULTS: The study included 23 patients with diabetic nephropathy. The kidney endpoint was achieved in 34.8% (n=8) of the patients. Hypertension, duration of diabetes mellitus, creatinine level at the date of biopsy, microalbuminuria and non-albumin proteinuria were found to be independent predictors for composite kidney outcome (p=0.002, p=0.007, p=0.004, p=0.006, and p=0.001, respectively). CONCLUSIONS: NAP was found to be an independent risk factor for doubling the serum creatinine level from the date of biopsy, for starting hemodialysis or peritoneal dialysis, for kidney transplantation, and kidney-related death.

A new parameter predicting steroid response in idiopathic IgA nephropathy: a pilot study of pan-immune inflammation value.

OBJECTIVE: In this pilot study, we aimed at investigating the predictive power of pan-immune inflammation value (PIV) on response rates at 6 months in idiopathic IgA nephropathy (IgAN) patients who started steroids. PATIENTS AND METHODS: The study was conducted with patients diagnosed with idiopathic IgAN and treated with 3-6 months of conservative treatment and steroid therapy started because proteinuria was above 1 g/day. Patients with proteinuria lower than 0.3 g/day, no macroscopic hematuria, and no hematuria detected in 3 consecutive urinalyses for 6 months were considered to be patients in remission. PIV was calculated by [neutrophil count (103 µL)*platelet count (103 µL)*monocyte count (103 µL)]/lymphocyte count (103 µL)]. Patients were compared according to their remission status in terms of PIV. RESULTS: The mean PIV was significantly higher in patients in the non-remission group than in patients in the remission group (1,869.2±1,781.9 to 574.1±364.5, respectively). The best cut-off for PIV was 752.6 to predict non-remission with a 75% sensitivity and 71.4% specificity. CONCLUSIONS: Our study showed that PIV is a reliable marker for predicting steroid response at the 6th month in patients with idiopathic IgAN.

Relationships Between Metabolic Syndrome, Microalbuminuria, and C-Reactive Protein in Turkish Kidney Transplant Recipients.

AIM: The aims of this study were to report the prevalence of metabolic syndrome (MS) in a cohort of Turkish kidney transplant recipients and to define the relationships between MS, microalbuminuria and C-reactive protein (CRP), which are cardiovascular risk factors, in kidney transplant setting. METHODS: This cross sectional study included 170 adult renal transplantation recipients with a mean follow-up of 53.1 ± 49.9 months. The diagnosis of MS was made according to the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria. Microalbuminuria was defined as a urinary albumin/creatinine ratio of 30-300 mg/g. CRP levels ≥6.0 were classified as high CRP. RESULTS: Mean age was 39.3 ± 11 years. The prevalence of MS was 45.8% (n = 78). The prevalence of microalbuminuria was not different in patients with MS compared to those without MS (39.7% vs 37%, P = .428). In multivariate logistic regression analyses, systolic blood pressure (SBP) (odds ratio 1.68; 95% confidence interval [CI] 1.12-2.52; P = .011) and high fasting glucose (odds ratio 2.82; 95% confidence interval [CI] 1.16-6.86; P = .022) were significantly associated with microalbuminuria. When patients with MS and high CRP were compared with patients with normal CRP and without MS, microalbuminuria did not differ between the groups (P = .213). CONCLUSION: The prevalence of MS in our kidney recipient cohort was found to be increased compared to general population. MS was not related to increased prevalence of microalbuminuria, even when combined with high CRP. Microalbuminuria was associated with elevated SBP and hyperglycemic status.