This study aimed to evaluate the potential clinical value of the Naples Prognostic Score (NPS) in predicting rapid 12-month kidney function decline (RKFD) in predialysis stage 3–4 chronic kidney disease (CKD) patients. A retrospective analysis was conducted using data from 404 CKD patients who were consecutively enrolled at two centers between December 2023 and September 2024. All included patients had at least 12 months of follow-up available for outcome assessment. Participants were categorized based on the presence or absence of RKFD, defined as an absolute decrease in eGFR of > 5 mL/min/1.73 m² over 12 months. Clinical, laboratory, and nutritional–inflammatory parameters were compared between groups. Multivariable logistic regression and receiver operating characteristic (ROC) curve analyses were performed to evaluate the predictive performance of NPS. RKFD occurred in 105 participants (26.0%). Individuals with RKFD exhibited significantly impaired inflammatory and nutritional markers (higher neutrophil-to-lymphocyte ratio [NLR], lower lymphocyte-to-monocyte ratio [LMR], reduced serum albumin, and lower total cholesterol). NPS was independently associated with RKFD (OR = 7.86 per 1-point increase; 95% CI: 5.22–12.60; p < 0.001) and demonstrated high discriminative performance (AUC = 0.912; optimism-corrected AUC = 0.913). NPS was independently associated with short-term RKFD in patients with stage 3–4 CKD. Its discriminative performance in this cohort suggests potential clinical relevance for identifying patients at increased risk of early kidney function deterioration, although confirmation in externally validated prospective studies is required.

Serum uric acid (SUA) level has been associated with the progression of chronic kidney disease (CKD), but the role of the SUA/creatinine (SUA/Cre) ratio remains unclear. This study aimed to evaluate whether the SUA/Cre ratio is superior to isolated SUA as a marker for CKD. A retrospective observational study including 524 participants was conducted to compare SUA and SUA/Cre ratio in groups with and without CKD. Participants were categorized into 3 groups according to CKD stage: no CKD (n = 84), CKD stage 1-2 (n = 124), and CKD stage 3-4 (n = 316). Multivariate and receiver operating characteristic (ROC) analyses were performed to assess the association of SUA and SUA/Cre ratio with the presence of CKD. According to the ROC curve, SUA level showed a stronger correlation than the SUA/Cre ratio (area under the curve [AUC] = 0.768 vs AUC = 0.261; p < .001). Although both the SUA/Cre ratio and SUA level were associated with renal dysfunction, SUA was found to be a better marker of CKD.

Background/Objectives: The Naples Prognostic Score (NPS) is a composite index of nutritional and inflammatory status that has demonstrated prognostic value across various critical illnesses. This study aimed to evaluate the prognostic significance of NPS in patients with acute pancreatitis (AP). Methods: In this retrospective cohort study, 452 patients diagnosed with AP between January 2024 and March 2026 were classified as mild (MAP), moderately severe (MSAP), or severe (SAP) according to the revised Atlanta classification. NPS was calculated from admission serum albumin, total cholesterol, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio. Results: Of the 452 patients, 276 (61.1%) had MAP, 124 (27.4%) had MSAP, and 52 (11.5%) had SAP. NPS was significantly higher in SAP patients than in MAP and MSAP patients (for both comparisons; p < 0.001). ROC analysis showed an AUC of 0.758 (95% CI: 0.693–0.824) for predicting SAP, with an optimal cut-off of NPS ≥ 3 yielding a sensitivity of 80.8% and a specificity of 61.3%. Patients were stratified into low (0–2) and high (3–4) NPS groups. High NPS was significantly associated with SAP (χ² = 33.044, p < 0.001), with a negative predictive value of 96.1%. In multivariable analysis, high NPS was an independent predictor of SAP (OR: 4.346, 95% CI: 2.018–9.362; p < 0.001). Conclusions: NPS, calculated from four routine laboratory parameters available at admission, is a simple, rapid, and independent predictor of disease severity in AP and may support early risk stratification in the emergency setting.

Malnutrition is prevalent in patients with cirrhosis and is linked to negative clinical outcomes. However, research on the prognostic nutritional index (PNI) and the burden of hospitalization over one year in stable outpatients remains limited. This study aimed to assess the relationship between PNI and liver-related hospitalization outcomes, as well as 12-month mortality, in outpatients with cirrhosis. In this retrospective single-center study, 125 adult patients with stable cirrhosis were analyzed, focusing on baseline demographic, clinical, laboratory, and 12-month follow-up data. Logistic regression was employed to evaluate the incidence of hospitalization in the entire cohort, while Poisson regression assessed hospital admission counts among patients with complete follow-up, and linear regression investigated the total length of stay for hospitalized patients.The results indicated that lower PNI values were significantly correlated with an increased likelihood of hospitalization and a higher frequency of hospital admissions within one year. In multivariable analysis, PNI remained an independent predictor of hospitalization (odds ratio [OR] = 0.655, 95% confidence interval [CI]: 0.530–0.809, p < 0.001) and admission frequency (incidence rate ratio [IRR] = 0.90, 95% CI: 0.848–0.955, p < 0.001), while no significant association was found with the length of hospital stay. Each 5-unit increase in PNI corresponded to substantially lower odds of hospitalization (OR = 0.121, 95% CI: 0.042–0.347) and a reduced admission rate (IRR = 0.59, 95% CI: 0.444–0.794). Additionally, PNI exhibited significant negative correlations with the Model for End-Stage Liver Disease–Sodium (MELD-Na) and Child–Turcotte–Pugh scores (all p < 0.001). PNI also demonstrated strong predictive validity for 12-month cirrhosis-related mortality, with an area under the curve (AUC) of 0.873 (95% CI: 0.802–0.943) and an optimal cut-off value of 38.5. Patients with a PNI ≤38.5 experienced significantly reduced 12-month survival (log-rank p < 0.001). These findings suggest that PNI may serve as a straightforward and accessible marker for nutritional assessment and early risk stratification in stable outpatients with cirrhosis.

Giriş ve Amaç: Şiddetli akut solunum yolu sendromu koronavirüsü-2’nin neden olduğu COVID-19 ilk olarak Çin’in Hubei Eyaletinin Wuhan şehrinde 2019 Aralık ayında ortaya çıkan bir hastalıktır. Dünya Sağlık Örgütü, salgının dünyada yayılması ile 11 Mart 2020 tarihinde COVID-19 salgınını pandemi ilan etti. Pandemi ilanı, hem ülkemizde hem de diğer ülkelerde normal sağlık hizmetleri ve COVID-19 pandemisiyle mücadelenin aynı anda aksatılmadan yürütülmesini zorunlu kıldı. Biz de pandemi ilanıyla başlayan pandemi döneminin Antalya Eğitim ve Araştırma Hastanesi Gastroenteroloji servisi hasta yatışlarının sayısal olarak, yatış süreleri, yatırılan servis (acil/poliklinik) tanı dağılımları açısından nasıl etkilendiğini görmek için bu çalışmayı planladık. Gereç ve Yöntem: Çalışmamıza Nisan - Kasım 2020 tarihleri ile 2019 yılının aynı aylarında gastroenteroloji servisine yatan hastaları dahil ettik. Hastaların bilgileri ve tanıları hastane bilgi yönetim sisteminde kayıtlı olan elektronik dosyalarından alındı. Çalışmamıza toplam 1321 hasta dahil edildi. Çalışmaya katılanların 646’sı (%49) pandemi öncesi dönemde, 675’i (%51) pandemi döneminde yatan hastalardı. Bulgular: Yatırılan hasta sayısı olarak her iki dönem arasında fark yoktu (p: 0.113). Yatış süresi pandemi döneminde pandemi öncesi döneme göre daha kısaydı (pandemi öncesi dönem 6.4 ± 5.5 gün vs. pandemi dönemi 5.7 ± 4.9, p: 0.028). Hastalar her iki dönemde de daha çok acil servisten yatırılmışlardı (pandemi öncesi dönem %74.6 vs pandemi dönemi %78 p: 0.210). Tanı dağılımına bakıldığında hastalar pandemi öncesi 31 farklı tanı ile, pandemi sonrası 30 farklı tanı ile yatırılmıştı. Her iki dönemde de en sık üst gastrointestinal sistem kanaması ile yatırılmışlardı. Pandemi öncesi dönemde 134 (%20.3) ve pandemi döneminde de 129 (%18.8) hasta üst gastrointestinal sistem kanaması nedeniyle servise yatırılmıştı. Her iki dönem arasında bu tanı açısından anlamlı fark yoktu (p: 0.488). Sonuç: COVID-19 pandemisi 3. basamak gastroenteroloji servis hasta yatışlarını sayısal olarak, yatırıldıkları servis ve tanı dağılımı açısından etkilememiştir. Yatış süresini ise kısaltmıştır.