The novel coronavirus disease was declared as a pandemic and CKD is an important risk factor for morbidity and mortality. Dialysis has additional contributions on transmission risk so prompt preventive strategies were implemented for dialysis patients. We aimed to evaluate pandemic‐related perceptions and concerns of dialysis patients and differences between dialysis modalities. An anonymous survey for assessing concerns, knowledge, and attitudes about the pandemic was sent online to a total of 339 patients on maintenance dialysis at four tertiary dialysis centers in Turkey. A total of 309 patients (54.9 ± 15.1 years, 51.6% females, 55.7% in‐center HD, 44.3% peritoneal dialysis) enrolled. The anonymous online survey was conducted at the end of April 2020. HD patients were more concerned about transmission risk (p = 0.002) and risks associated with the dialysis treatment environment and the transport methods (p < 0.001). The total concern score was significantly higher in the HD group (2.60 ± 0.93 vs. 1.65 ± 0.54, p < 0.001). The knowledge about the pandemic and prevention methods and the attitudes of prevention were similar between the groups (p = 0.161 and 0.418, respectively). The compliance rate of personal preventive strategies was 98.1%. Considering changing the current dialysis modality due to the pandemic was higher in the HD group (p < 0.001). Although the preventive strategies were performed properly in the HD centers, HD patients were more concerned about the Covid‐19 outbreak compared with PD. Our results support home dialysis treatments for modality decisions with patients' positive perspective of PD over HD during the pandemic.

Persistent hyperparathyroidism can have a deleterious effect on graft function in kidney transplant recipients, although serum calcium, phosphorus, and parathyroid hormone levels tend to normalize after successful transplant. Parathyroidectomy can result in sustained amelioration of persistent hyperparathyroidism despite graft failure risk and unfavorable graft outcomes. Data on this issue are limited and conflicting. Here, we evaluated the effects of parathyroidectomy on graft function in kidney transplant recipients. This retrospective study included 249 adult kidney transplant recipients (121 deceased-donor/128 living-donor; 142 males/107 females; mean age of 39.3 ± 11.6 y; mean follow-up of 46.5 ± 23.5 mo). Participants were grouped as those without (n = 222), those with pretransplant (n = 12), and those with posttransplant (n = 15) parathyroidectomy. Graft outcomes and serum calcium, phosphorus, and parathyroid hormone levels were studied. Serum calcium levels at baseline and at 1, 3, 6, and 12 months and parathyroid hormone levels at baseline and at 6 and 12 months were higher and serum phosphorus levels at 3, 6, and 12 months were lower in the posttransplant parathyroidectomy group versus the other groups (P < .001). We observed no significant differences between groups regarding serum calcium, phosphorus, and parathyroid hormone levels at last visit. Estimated glomerular filtration rates at 3, 6, and 12 months and at last visit in the pretransplant parathyroidectomy group were higher than in those without parathyroidectomy (P < .05) and higher at 6 and 12 months than in the posttransplant parathyroidectomy group (P < .05). No significant differences regarding graft loss and patient mortality were observed among the 3 groups (P > .05). Parathyroidectomy resulted in sustained decreased levels of serum calcium and parathyroid hormone. We observed no graft failure risk associated with parathyroidectomy in our study. Parathyroidectomy before transplant is advantageous with better graft function.

Introduction: We aimed to study the characteristics of peritoneal dialysis (PD) patients with coronavirus disease-19 (COVID-19), determine the short-term mortality and other medical complications, and delineate the factors associated with COVID-19 outcome. Methods: In this multicenter national study, we included PD patients with confirmed COVID-19 from 27 centers. The baseline demographic, clinical, laboratory, and radiological data and outcomes at the end of the first month were recorded. Results: We enrolled 142 COVID-19 patients (median age: 52 years). 58.2% of patients had mild disease at diagnosis. Lung involvement was detected in 60.8% of patients. Eighty-three (58.4%) patients were hospitalized, 31 (21.8%) patients were admitted to intensive care unit and 24 needed mechanical ventilation. Fifteen (10.5%) patients were switched to hemodialysis and hemodiafiltration was performed for four (2.8%) patients. Persisting pulmonary symptoms (n = 27), lower respiratory system infection (n = 12), rehospitalization for any reason (n = 24), malnutrition (n = 6), hypervolemia (n = 13), peritonitis (n = 7), ultrafiltration failure (n = 7), and in PD modality change (n = 8) were reported in survivors. Twenty-six patients (18.31%) died in the first month of diagnosis. The non-survivor group was older, comorbidities were more prevalent. Fever, dyspnea, cough, serious-vital disease at presentation, bilateral pulmonary involvement, and pleural effusion were more frequent among non-survivors. Age (OR: 1.102; 95% CI: 1.032–1.117; p: 0.004), moderate-severe clinical disease at presentation (OR: 26.825; 95% CI: 4.578–157.172; p < 0.001), and baseline CRP (OR: 1.008; 95% CI; 1,000–1.016; p: 0.040) were associated with first-month mortality in multivariate analysis. Discussion/Conclusions: Early mortality rate and medical complications are quite high in PD patients with COVID-19. Age, clinical severity of COVID-19, and baseline CRP level are the independent parameters associated with mortality.

Background/PurposeGlomerulonephritis is among the most important group of diseases causing end-stage renal disease (ESRD). The prevalence of glomerulonephritis varies depending on age, sex, geographical features, etc. In the present study, we evaluated the clinical and laboratory parameters of patients who underwent renal biopsy.MethodsIn this retrospective study, demographic and clinical characteristics, specific diagnoses of glomerular diseases, and biopsy findings of all patients in whom native renal biopsy was performed in our hospital between January 2009 and December 2014 were analyzed.ResultsA total of 384 patients were divided into two groups as primary glomerular diseases (PGD) and secondary glomerular diseases (SGD). Some 37.1% of patients with PGD and 49.2% of patients with SGD were female. The mean age was 43.8 ± 14.1 years in the PGD group and 47.3 ± 16.1 years in the SGD group (p = 0.044). Nephrotic syndrome in the PGD group and unexplained renal dysfunction in the SGD group were observed more frequently at the time of admission. In the SGD group, biopsy findings (crescents, sclerosis, vascular involvement, etc.) were dominant and more pronounced (p < 0.001). In the PGD group, responsiveness to the therapy was higher than in the SGD group (p < 0.001). Mortality rates were 2.27% in the PGD group and 18.3% in the SGD group. According to the multivariate analysis, the increase of creatinine level after treatment (odds ratio 1.49) and presence of SGD (odds ratio 7.74) were independent risk factors for patient death (p < 0.001).ConclusionThe present study showed important data about the etiology, clinical findings, follow ups, and prognosis of PGD and SGD among adults in our center. We observed that mortality was higher in patients with SGD.背景 / 目的腎小球腎炎是導致末期腎病 (ESRD) 的最重要疾病,其盛行率與年齡、性別、及地域特性有關。在本研究中,我們在接受腎臟組織活檢的腎小球疾病患者間,對相關的臨床及檢驗特徵進行了調查。方法在本回溯性研究中,對象為於 2009 年 1 月至 2014 年 12 月期間,在本院接受自身腎臟組織活檢的病人。我們對其人口學與臨床特徵、腎小球疾病診斷、及活檢結果進行了分析。結果調查對象為 384 位原發性腎小球疾病 (PGD) 或次發性腎小球疾病 (SGD) 患者。在 PGD 及 SGD 組別中,女性比例分別佔 37.1% 及 49.2%,平均年齡分別為 43.8 ± 14.1 歲及 47.3 ± 16.1 歲 (p = 0.044)。入院時,PGD 組以腎病症候群較常見,SGD 組則以原因不明之腎臟功能障礙較常見。在 SGD 組間,活檢結果較多樣化 (新月形、硬化、血管病變等) 且較明顯 (p < 0.001)。治療反應比率以 PGD 組高於 SGD 組 (p < 0.001),死亡率分別為 PGD 組的 2.27% 及 SGD 組的 18.3%。多變項分析顯示,治療後肌酸酐的增加 (OR 1.49)、及 SGD 的存在 (OR 7.74) 是病人死亡的獨立危險因子 (p < 0.001)。結論對於本中心的 PGD 與 SGD 成年患者,本研究提供了成因、臨床表現、追蹤、及預後等方面的重要數據,並觀察到 SGD 患者的死亡率較高