Background and Objectives: Rhabdomyolysis is a disorder in which skeletal muscle tissues are damaged, resulting in the escape of their internal substances into the blood circulation. Acute kidney injury (AKI) is a serious complication of rhabdomyolysis that necessitates early recognition to ensure effective clinical management. The objective of this research was to create a practical scoring tool for forecasting AKI in patients experiencing rhabdomyolysis due to trauma or excessive exercise. Materials and Methods: A novel scoring system, termed the growth differentiation factor-15-trauma-creatine kinase acute kidney injury score (GDF-TRACK-AKI score), was established. The model integrates serum levels of growth differentiation factor-15 (GDF-15), creatine kinase (CK), and occurrence of rhabdomyolysis associated with trauma. Clinical and biochemical data were prospectively collected, and the model’s predictive performance was evaluated using receiver operating characteristic ROC curve analysis. Results: Among patients with rhabdomyolysis, those who developed AKI had significantly higher GDF-TRACK-AKI scores (median: 3.00 (IQR: 2.00)) compared to patients without AKI (median: 0.48 (IQR 0.89); p < 0.001). Serum CK and GDF-15 levels were also markedly elevated in the AKI group (p < 0.001). ROC analysis identified a cut-off value of 2.5, providing 67% sensitivity and 98% specificity. Patients with scores ≥ 2 demonstrated a significantly increased risk of AKI. Conclusions: Designed as a practical and dependable tool, the GDF-TRACK-AKI score facilitates prompt identification of kidney injury in patients whose rhabdomyolysis is linked to either trauma or vigorous activity. The integration of trauma history with GDF-15 and CK biomarker data improves risk stratification precision and supports timely treatment decisions. To verify its practical utility and prognostic capabilities, the GDF-TRACK-AKI score should undergo additional evaluation across expansive and demographically varied clinical populations.

Background and Objectives: Circadian fluctuations in blood pressure, particularly the non-dipping pattern characterized by the absence of a nocturnal decline, are associated with an increased risk of microvascular complications. The retina, as a highly sensitive microvascular tissue, offers a valuable window into systemic hemodynamic alterations. However, the literature lacks detailed structural analyses that evaluate all retinal regions by segmenting nighttime into specific time intervals. Notably, the early morning period (04:00–08:00), during which stress hormones such as cortisol and catecholamines rise physiologically, leads to increased blood pressure that may significantly affect retinal microcirculation. This prospective study aims to assess retinal microvascular structures in dipper and non-dipper individuals using structural optical coherence tomography and to investigate their relationship with blood pressure parameters by dividing nighttime into distinct time segments. Materials and Methods: A total of 60 participants were classified as dipper (n = 26) or non-dipper (n = 34) based on 24 h ambulatory blood pressure monitoring results. Structural optical coherence tomography was used to evaluate superficial and deep capillary plexus densities in the foveal, parafoveal, and perifoveal regions, along with the area and perimeter of the foveal avascular zone (FAZ) and flow density (FD). Blood pressure values, including systolic, diastolic, mean arterial, and pulse pressure, were recorded during two nighttime intervals (00:00–04:00 and 04:00–08:00), and correlations with retinal parameters were analyzed. Results: No significant differences were observed in retinal microvascular parameters between the dipper and non-dipper groups. Deep capillary densities, particularly in the parafoveal and perifoveal regions, showed significant positive correlations with serum total protein, albumin, and very low-density lipoprotein (VLDL) levels. Furthermore, systolic and mean arterial pressures measured during the 04:00–08:00 interval demonstrated significant positive correlations with deep retinal vascular densities. The FAZ perimeter was negatively correlated with pulse pressure variability, while FD showed a negative correlation with mean arterial pressure variability. Conclusions: This prospective study is among the first to investigate the effects of circadian blood pressure patterns on retinal microvascular structures by segmenting nighttime into specific intervals and employing comprehensive structural optical coherence tomography across the entire retina. The findings suggest that retinal microvascular structure may be associated with fluctuations in blood pressure. Analyses of blood pressure measurements between 04:00 and 08:00 may offer supplementary insights into the evaluation of retinal microvascular structure.

Aim: This study evaluated the distribution of anti-rheumatic drug treatments in rheumatoid arthritis (RA) patients with chronic kidney disease (CKD) across different renal stages. Material and Method: A cross-sectional analysis included 72 RA patients with CKD (estimated glomerular filtration rate 3 months). Demographic characteristics, disease duration, laboratory results, current RA medications, and renal replacement therapy status were recorded. Additionally, the presence of extra-articular manifestations, comorbidities (including hypertension, diabetes mellitus, hyperlipidemia, coronary artery disease, cerebrovascular disease, osteoporosis, and malignancy were obtained from the electronic patient files), history of prior infections, underlying etiology of CKD, and availability of renal biopsy reports were retrospectively extracted from hospital electronic medical records. Patients were stratified by CKD renal stage (3, 4, 5). Results: Mean age was 66.7±11.8 years; 73.6% were female. Hypertension (84.7%) and diabetes (33.3%) were prevalent comorbidities. CKD etiology was undetermined in 65% of patients. Overall, 97.2% received conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), 12.5% biologic disease-modifying antirheumatic drugs (bDMARDs), and 51.4% glucocorticoids. Hydroxychloroquine was the most common csDMARDs (76.4%), while methotrexate use differed significantly by CKD renal stage (stage 3: 27.7%; stage 4: 9.1%; stage 5: 0%; p=0.028). Among bDMARDs, rituximab (stage 3 only), TNF inhibitors (all stages), and tocilizumab (stage 4) were used. Etanercept was preferred in dialysis-dependent patients. Conclusion: CKD stage significantly influences RA treatment selection. Methotrexate is avoided in stage 5 CKD, while hydroxychloroquine remains the predominant csDMARD. Leflunomide and sulfasalazine use in advanced CKD exceeds prior reports. Individualized therapy, adjusted for renal function and comorbidities, is essential. Larger prospective studies are needed to validate these findings.

The liver performs most peripheral thyroid hormone metabolism, and thyrotropin (TSH) secretion normally rises overnight. This rise is blunted in non-thyroi

Metabolic dysfunction-associated steatotic liver disease (MASLD) affects roughly 30% of adults globally, rising to 55%-70% in type 2 diabetes mellitus (T2DM) and 60%-75% in obesity. The 2023 multi-society Delphi consensus placed MASLD within metabolic medicine, yet most guidance still approaches the condition from a hepatology standpoint and gives little attention to endocrine clinical workflows. PubMed/MEDLINE, Scopus, and Web of Science were searched from January 2018 to March 2026, combining legacy and updated nomenclature with 3 keyword domains (endocrine/ metabolic context, noninvasive fibrosis assessment, and pharmacological agents), with priority given to multisociety guidelines and randomized controlled trials with histological endpoints. Metabolic dysfunction-associated steatotic liver disease shares bidirectional pathways with T2DM, obesity, polycystic ovary syndrome, and thyroid dysfunction, placing endocrine clinics in a natural first-contact position. Non-invasive fibrosis triage with fibrosis-4 index followed by transient elastography or the Enhanced Liver Fibrosis test fits routine endocrine workflows; semaglutide, tirzepatide, pioglitazone, and resmetirom now have phase 2 or 3 histological data for metabolic dysfunction-associated steatohepatitis resolution or fibrosis improvement. Treatment prioritization across dominant endocrine- metabolic phenotypes is offered as a conceptual framework rather than a validated algorithm. Endocrine clinics are an underused setting for earlier identification of MASLD-related hepatic risk; non-invasive fibrosis assessment is feasible in selected high-risk patients, and the dominant metabolic comorbidity profile can guide treatment choices. The frameworks offered here are practical proposals, not replacements for society recommendations, and require prospective implementation studies in endocrine outpatient cohorts, including Turkish and regional populations. Cite this article as: Yakut M, Berber K. Metabolic dysfunction–associated steatotic liver disease in endocrine practice: risk assessment, fibrosis stratification, and treatment considerations. Endocrinol Res Pract. Published online September 1, 2026. doi: 10.5152/erp.2026.26984.