We aimed to investigate the factors affecting the development of atherosclerosis and the role of calcification inhibitors fetuin-A, matrix-Gla protein (MGP), osteoprotegerin (OPG) in atherosclerosi...

Various risk scores such as COVID‐GRAM Critical Illness Risk Score (COVID‐GRAM), quick COVID‐19 Severity Index (qCSI), and systemic immune‐inflammation index (SII) have been developed to determine critical illness in hospitalized patients. None of these risk scoring systems was evaluated in HD patients who indeed carry the highest risk of developing critical illnesses. We aimed to evaluate, in hemodialysis (HD) patients with COVID‐19, the performance of these scoring systems for the need of intensive care unit (ICU) and mortality. The qCSI, COVID‐GRAM, and SII scores of the patients at admission to hospital were calculated and grouped according to the scoring results. The primary outcome of the study was mortality and need of ICU. Critical illness was described as a composition of admission to the ICU, invasive ventilation, or death. It was determined that when the qCSI is over 6.5, the need for ICU increased 13.8 times and mortality increased 21.3 times. When the COVID‐GRAM score is >157, the ICU need increased 14.7 times and the mortality increased 33.7 times. We found that the need for ICU increased 4.2 times and mortality increased 3.1 times when the SII score was >1145. These tests, which can be easily calculated, could be used to estimate the risk of developing critical illness among COVID‐19 HD patients. Estimating the risk of critical illness could help to reduce mortality in HD patients.

Aim: Vascular calcification is a common complication in CKD. Studies conducted in patients with end-stage renal disease (ESRD) showed that calcification in vascular structures is an important component of the atherosclerosis process. GLA rich protein (GRP) has been suggested as a potential marker for vascular calcification. We investigated the relationship between GRP levels, carotid intima media thickness and inflammatory parameters in patients with predialysis stage 3, 4 and 5 CKD. Material and Methods: A total of 106 patients aged ≥ 18 years with CKD stage 3, stage 4 and non-dialysis stage 5 and 25 healthy volunteers were enrolled in the study. Patients with obesity, uncontrolled hypertension, coronary artery disease, with active cancer or liver disease, malignant hematologic disorders, acute renal failure, acute or chronic infections were excluded. As the control group, healthy volunteers without any known illness, regular drug use, smoking, alcohol use, and obesity were recruited. Results: Patients were divided into two groups as those with CIMT below 0.90 mm and those with CIMT 0.90 mm and above. There was no significant difference between the two groups in terms of the presence of HT and DM. While the CRP values of the group with high CIMT were found to be significantly higher (p=0.005), the GLA rich protein levels of this group were found to be significantly higher (p=0.019). Conclusion: In our study, it was determined that there was a positive correlation between GRP levels and CIMT in patients with predialysis CKD, and GRP levels were higher in patients with CIMT above 0.90 mm. These findings suggest that GRP levels can be used as a cardiovascular event biomarker in patients with CKD.

Objective: The aim of our study was to examine the factors associated with mortality in patients who underwent percutaneous endoscopic gastrostomy (PEG) and identify biomarkers that may guide clinical practice. Methods: This retrospective observational study included adults who underwent PEG placement in our center. Demographic data, date of PEG placement, inpatient ward, PEG indication, time from admission to PEG placement, post-PEG complications, and outcome (discharge/mortality) were recorded. Logistic regression analysis was performed to identify factors associated with 90-day and 6-month mortality. Results: Of 100 patients included in the study, 52% were men and the median age was 73 years. The most common indication for PEG was malignancy (n=25, 25%). The most common minor complication was minor peristomal bleeding and peristomal infection requiring tube removal The most common major complication was aspiration pneumonia. Thirty-eight patients (38.0%) died within 90 days and 52 patients (52.0%) died within 6 months of PEG placement. The odds of 90-day mortality were 57.5% lower per 1-unit increase in total serum protein level (odds ratio [OR]: 0.425, 95% CI: 0.230–0.888; p=0.021), 1.6% higher per 1-unit increase in serum CRP (OR: 1.016, 95% CI: 1.006–1.027; p=0.003), and 13.6 times higher in patients with aspiration pneumonia (OR: 13.631, 95% CI: 2.997–61.988; p=0.001). For 6-month mortality, a 1-unit increase in serum albumin level was associated with 81.4% lower odds (OR: 0.186, 95% CI; 0.081–0.430; p<0.001) and aspiration pneumonia with 22 times higher odds (OR: 21.984, 95% CI: 2.412–200.342; p=0.006). Conclusion: Aspiration pneumonia, low total serum protein and albumin levels, and high CRP level were associated with higher mortality.

Introduction Effective palliative care reduces unnecessary hospital admissions and intensive care length of stay. The present study aimed to investigate the parameters associated with mortality in patients receiving palliative care support. Material and methods This prospective observational...