Background and Aim. Long hospital days in intensive care unit (ICU) due to life-threatening diseases are increasing in the world. The primary goal in ICU is to decrease length of stay in order to improve the quality of medical care and reduce cost. The aim of our study is to identify and categorize the factors associated with prolonged stays in ICU.Materials and Method. We retrospectively analyzed 3925 patients. We obtained the patients’ demographic, clinical, diagnostic, and physiologic variables; mortality; lengths of stay by examining the intensive care unit database records.Results. The mean age of the study was 61.6 ± 18.9 years. The average length of stay in intensive care unit was 10.2 ± 25.2 days. The most common cause of hospitalization was because of multiple diseases (19.5%). The length of stay was positively correlated with urea, creatinine, and sodium. It was negatively correlated with uric acid and hematocrit levels. Length of stay was significantly higher in patients not operated on than in patients operated on (p<0.001).Conclusion. Our study showed a significantly increased length of stay in patients with cardiovascular system diseases, multiple diseases, nervous system diseases, and cerebrovascular diseases. Moreover we showed that when urea, creatinine, and sodium values increase, in parallel the length of stay increases.

Introduction: In subclinical hypothyroidism (SH), serum lipid and lipoprotein concentrations are frequently changed. Compared with the healthy population, the levels of oxidized low-density lipoprotein cholesterol are higher, and the levels of high-density lipoprotein cholesterol are lower. In patients with SH, the mechanism of atherosclerosis may beattributed to the lipid abnormalities. There is evidence showing that oxidation plays an important role during the process of atherosclerosis. Inthis study, we evaluated the activity of paraoxonase (PON) and arylesterase (ARE) in patients with SH and investigated their relation with oxidative stress. Methods: The study enrolled 25 patients with SH and 20 sex- and age-matched healthy controls. The patient group and the control group were compared in terms of the activity of PON and ARE and the oxidative stress index. Results: Between 2 groups, no significant difference was found in terms of age, sex, serum levels of total cholesterol, low-density lipoprotein, and high-density lipoprotein. In the SH group, the activity of PON was significantly lower than that observed in the control group ( P < 0.05). Arylesterase activity also was significantly lower in the group with SH, compared with the control group ( P < 0.05). Oxidative stress index was found to be significantly higher in the patient group, compared with the healthy subjects ( P < 0.01). Oxidative stress index showed a strong positive correlation with the levels of thyroid stimulating hormone in all cases ( r = 0.60, P < 0.01). Conclusions: The activity of PON and ARE were significantly decreased, and oxidative stress was increased in patients with SH. Lower activities of these 2 biomarkers indicate increased oxidative damage in SH. Atherosclerosis in SH can be attributed to increased oxidative stress.

Aim The association of increased resistin levels in chronic kidney disease with diabetic nephropathy has not yet been clarified. Our aim was to analyze the relationship between serum resistin levels and various diabetic microvascular complications in patients. Methods A total of 83 patients were enrolled in this cross-sectional study. The subjects were divided into 3 groups: 27 patients with type 2 diabetes mellitus (T2DM) having no diabetic retinopathy (DRP) or microalbuminuria and having normal renal function were included in Group-1, 28 patients with T2DM having DRP and normal renal function in Group-2, and 28 patients with T2DM with DRP and microalbuminuria and an estimated glomerular filtration rate (eGFR) of<60 ml/min/1.73 m² in Group-3. Serum resistin levels were analyzed by enzyme-linked immunosorbent assay. Results The mean age of the patients [46 female (55.4%)] was 54.8±9.1 years. The resistin level in Group-3 was significantly higher than in Group-1 and Group-2 (p<0.001).However the resistin level was not different between Group-1 (without microvascular complications) and Group-2 (with microvascular complications). The resistin level was found to be correlated negatively with eGFR (r=−0.459; p<0.001) and albumin (r=−0.402; p<0.001), and positively with high-sensitivity C-reactive protein (hs-CRP) (r=0.366; p=0.001). In multivariate analysis, it was observed that eGFR and hs-CRP were independent determinants of plasma resistin level. Conclusion The main determinants of resistin level in patients with T2DM are the level of renal function and inflammation rather than presence of microvascular complications, obesity and insulin resistance.

In this study, we aimed to examine the impact of fasting during the month of Ramadan on autosomal dominant polycystic kidney disease (-ADPKD) patients with normal to near-normal glomerular filtration rate (GFR). This was a prospective observational study of patients with ADPKD, the majority of whom had normal or near-normal GFR. Patients were divided into two groups: the fasting group (FG) and the nonfasting group (NFG). Assessments in the NFG were performed 1 week before and 1 month after Ramadan, while FG patients were assessed on the last day of fasting in addition to the abovementioned visits. The following parameters were checked at each visit: blood pressure (BP), weight, sodium, potassium, blood urea nitrogen (BUN), creatinine, calcium, phosphorus, glucose, lipid profile, bicarbonate, urine density, 24-hour urine volume, 24-hour urine protein, GFR, neutrophil gelatinase-associated lipocalin (NGAL), and kidney injury molecule-1 (KIM-1). Kidney function tests were carried out on the 7th day of fasting in the FG for the identification of early kidney damage. Of the overall group of 54 patients, 23 were in FG (19 female) and 31 were in NFG (18 female). There were no significant differences between the two groups in terms of age, gender, ADPKD duration, and presence of hypertension. The mean estimated glomerular filtration rate (eGFR) values of FG and NFG were 86.4 ± 18.5 and 66.1 ± 36.5 mL/min/1.73m2, respectively. During the follow-up period, no significant changes occurred in BP, weight, creatinine, 24-hour urine volume, NGAL, KIM-1, or GFR in either group (p > 0.05), while 24-hour urinary protein was significantly decreased in FG (p < 0.001). A fasting duration of ~ 17 hours a day did not affect renal function negatively in patients with early-stage chronic kidney disease due to ADPKD. Also, no significant changes occurred in acute renal failure markers. .

AAbstract Background/aim: Hospital-acquired acute kidney injury (HA-AKI) may commonly develop in Covid-19 patients and is expected to have higher mortality. There is little comparative data looking for the effect of HA-AKI on mortality of chronic kidney disease (CKD) patients and a control group of general population suffering from Covid-19. HA-AKI development was assessed in a group of stage 3-5 CKD patients and control group without CKD among adult patients hospitalized for Covid-19. The role of AKI development on the outcome (in-hospital mortality and admission to the intensive care unit [ICU]) of patients with and without CKD was compared. Among 621 hospitalized patients (age 60 [IQR:47-73]), women: 44.1%), AKI developed in 32.5% of the patients, as stage 1 in 84.2%, stage 2 in 8.4% and, stage 3 in 7.4%. AKI developed in 48.0 % of CKD patients, whereas in 17.6% of patients without CKD. CKD patients with HA-AKI had the highest mortality rate of 41.1 % compared to 14.3 % of patients with HA-AKI but no CKD (p<0.001). However, patients with AKI+non-CKD had similar rates of ICU admission, mechanical ventilation, and death rate as patients with CKD without AKI. Adjusted mortality risk of the AKI+non-CKD group (HR: 9.0, 95%CI:1.9-44.2) and AKI+CKD group (HR: 7.9, 95%CI:1.9-33.3) were significantly higher than non-AKI+non-CKD group. AKI frequently develops in hospitalized patients due to Covid-19 and is associated with high mortality. HA-AKI has worse outcome whether it develops in patients with or without CKD, but the worst outcome was seen in AKI+CKD patients.