ANCA-associated glomerulonephritis (ANCA-GN) is a leading cause of pauci-immune crescentic GN. Recent evidence indicates that complement activation, marked by C3 deposition in glomeruli, may contribute to more severe renal injury and influence renal outcomes. We aim to evaluate the clinical, histopathological, and prognostic implications of C3 deposition in ANCA-GN. We retrospectively analyzed 195 patients with biopsy-proven ANCA-GN from the Turkish Society of Nephrology Glomerular Diseases registry from 2002 to 2022. Patients were classified as C3-positive or C3-negative according to kidney biopsy immunofluorescence findings. Clinical characteristics, histopathologic lesion profiles, and follow-up outcomes (remission, relapse, and survival) were compared between the two groups. Of 195 patients, 54 (27.7%) had C3 deposition. The C3-negative group was more likely to exhibit PR3-ANCA positivity, whereas the C3-positive group was strongly associated with the presence of MPO-ANCAs (22.2% vs. 77.8%; p = 0.001). Compared with C3-negative patients, C3-positive patients had higher levels of proteinuria (2026 mg/day vs. 1790 mg/day; p = 0.049) and lower HDL levels (30 mg/dL vs. 37 mg/dL; p = 0.009). Fibrocellular crescents were more common in C3-positive patients than in C3-negative patients (p < 0.001). Immune complex deposits, including IgG (26.4% vs. 3.5%; p < 0.001), IgA (14.8% vs. 0.7%; p < 0.001), IgM (25.0% vs. 3.5%; p < 0.001), and C1q (13.7% vs. 0.8%; p < 0.001) were significantly greater in the C3-positive group. However, no significant difference was detected in overall survival (85.8% for C3-negative patients vs. 88.9% for C3-positive patients; p = 0.249). Similarly, the remission (62.1% vs. 59.4%; p = 0.786) and relapse rates (14.8% vs. 11.1%; p = 0.532) did not differ between the groups. In ANCA-GN, glomerular C3 deposition is associated with an MPO-ANCA serotype, greater proteinuria, and more severe renal histology (including immune-complex deposition and more fibrocellular crescents), indicating more pronounced complement activation and tissue injury. However, C3 deposition did not predict worse patient or renal survival in our cohort. Not applicable.

Background: Kidney transplantation is the most preferred type of renal displacement therapy for end stage renal disease (ESRD) patients. More patients developed ESRD. The most important source is the donations from unrelated spouses. In this study, we aimed to compare the transplantation data obtained from the spouses of the patients with the transplantation data obtained from other relatives. Methods: The data including 167 living kidney transplantations performed between January 2006 and December 2019 were retrospectively collected. The patients were divided into two groups; spousal donor group (n: 53) and living-related donor group (n: 114). Results: There was no significant difference in delayed graft function in both groups. There were no patients with acute rejection proven by biopsy or considered biochemically in the spousal donor group. With regard to 3-year results in the living-related donor group the patient survival rate was 100%, while it was 98.2% in terms of graft survival. Conclusions: In conclusion, similar patient and graft survival rates between spousal donor kidney transplantation and living-related kidney transplantation has made spousal donor kidney transplantation, with possible problems in terms of tissue compatibility, an acceptable alternative to donor supply.

Background: Finerenone is associated with a lower, yet clinically relevant, risk of hyperkalemia compared with steroidal mineralocorticoid receptor antagonists in diabetic kidney disease (DKD) trials. However, real-world data on hyperkalemia and its associated factors are lacking. Methodology: FINE-TURK is a national, observational cohort of DKD patients who were initiated on finerenone. Eligible adults were included; demographic, clinical, and laboratory data were evaluated. The primary outcome (PO) was hyperkalemia risk signal (potassium ≥ 5.0 mEq/L), and the secondary outcome (SO) was clinically meaningful hyperkalemia (potassium ≥ 5.5 mEq/L). Multivariate logistic regression (LR) was used to define features associated with both PO and SO. LR, random forest (RF), gradient boosting, and CatBoost classifiers were used to define important features associated with the PO. Results: 699 patients were included. 259 (37.1%) reached the PO, and 51 (7.3%) reached the SO. Baseline potassium and estimated glomerular filtration rate (eGFR) were the most important variables associated with both outcomes and were consistently identified as the top features across all models. Thiazide use, presence of diabetic retinopathy, and diabetes duration were also associated with the PO. LR demonstrated the highest recall; random forest achieved the highest precision in performance. Discussion: Real-world data suggest that the risk of clinically meaningful hyperkalemia is similar to that in the clinical trials. In parallel with the safety analysis of clinical trials, baseline potassium and eGFR were consistently the most important factors associated with hyperkalemia risk.

Renal Anatomi Orçun ALTUNÖREN Garip BEKFİLAVİOĞLU Renal Fizyoloji Ceren ÖNAL Bülent ALTUN Öykü ve Fizik İnceleme Tekin AKPOLAT Klirens Kavramı ve Glomerüler Filtrasyon Hızı Ölçüm Metotları Ebru SEVİNÇ OK İdrar Analizi ve Yorumlanması Çiğdem MENGÜŞ Ahmet Uğur YALÇIN Renal Görüntüleme Kenan TURGUTALP Caner ÖZER Renal Biyopsi ve Temel Patolojik İncelemeler Gökhan TEMİZ İlter BOZACI İdrar Miktarı Değişiklikleri (Poliüri, Oligüri, Anüri) Aydın ÜNAL İşeme Bozuklukları (Noktüri-Pollaküri-Dizüri-İdrar İnkontinansı) Murat Hayri SİPAHİOĞLU Sümeyra KOYUNCU Hematüriye Yaklaşım Cenk GÖKALP Soner DUMAN Proteinüriye Yaklaşım Serkan AKTÜRK Fatih DEDE Hücre Dışı Sıvı Volümü Düzenlenmesi ve Bozuklukları Seyhun KÜRŞAT Su ve Sodyum Metabolizması Bozuklukları Tevfik ECDER Potasyum Metabolizması ve Bozuklukları Bülent TOKGÖZ Cihan UYSAL Kalsiyum Metabolizması ve Bozuklukları Engin ONAN Özkan GÜNGÖR Fosfor Metabolizması ve Bozuklukları Aysel GÜRKAN TOÇOĞLU Savaş SİPAHİ Magnezyum Metabolizması ve Bozuklukları Eyüp KÜLAH Asit-Baz Dengesi Zeki AYDIN Metabolik Asidoz Özant HELVACI Galip GÜZ Metabolik Alkaloz Aykut SİFİL Solunumsal Asit-Baz Bozuklukları Halil AYDAR Garip ŞAHİN Karma Asit-Baz Bozuklukları Meltem SEZİŞ DEMİRCİ Gökhan ATAY Glomerüler Hastalıkların Patogenezi ve Sınıflaması Serhan TUĞLULAR Primer Glomerüler Hastalıkların Epidemiyolojisi Egemen CEBECİ Nefritik Sendrom İzzet Hakkı ARIKAN Nefrotik Sendrom Ferruh ARTUNÇ Minimal Değişim Hastalığı Meltem GÜRSU Membranöz Nefropati Savaş ÖZTÜRK İmmünglobülin A Nefropatisi Zerrin BİCİK BAHÇEBAŞI Fokal Segmental Glomerüloskleroz Abdülmecit YILDIZ Membranoproliferatif Glomerülonefrit ve C3 Glomerülopatisi Ahmet Burak DİRİM Yaşar ÇALIŞKAN Hızlı İlerleyen Glomerülonefritler Hayriye SAYARLIOĞLU Enfeksiyon İlişkili Glomerülonefritler Beyza ALGÜL DURAK Emre TUTAL İnce Bazal Membran Hastalığı Kamil DİLEK Diğer Glomerülonefritler Necmi EREN Serkan BAKIRDÖĞEN Lupus Nefriti Mustafa GÜLLÜLÜ Diğer Bağ Dokusu Hastalıkları ve Böbrek Didem TURGUT Diabetes Mellitus Epidemiyolojisi, Tanısı, Patogenezi, Kliniği ve Tedavisi Kültigin TÜRKMEN İsmail BALOĞLU Diyabetik Böbrek Hastalığı Neriman Sıla KOÇ Mustafa ARICI Gebelikte Böbrek Fizyolojisi Kübra KAYNAR Gebelikte Böbrek İlişkili Sorunlar Dilek TORUN Böbrek Hastalıklarında Gebelik Saime PAYDAŞ Üriner Sistem Enfeksiyonlarına Yaklaşım Faruk Hilmi TURGUT Kan Basıncı Kontrolü ve Hipertansiyon Fizyopatolojisi Ercan TÜRKMEN Nurol ARIK Primer Hipertansiyon ve Tedavisi Şükrü ULUSOY Gülsüm ÖZKAN Renovasküler Hipertansiyon Hadim AKOĞLU Endokrin Hipertansiyon Ayşa HACIOĞLU Züleyha KARACA Diğer Sekonder Hipertansiyon Nedenleri Ali Rıza UÇAR Halil YAZICI Hipertansif Aciller Kürşad ÖNEÇ Ülver BOZTEPE DERİCİ Ozmotik Diüretikler Özgür Akın OTO Tiazid ve Benzeri Diüretikler Ayça İNCİ Loop Diüretikleri Fatma AYERDEN EBİNÇ Diğer Diüretikler Yasemin COŞKUN YAVUZ Akuaretikler İrem PEMBEGÜL Kistik Böbrek Hastalıkları İsmail KOÇYİĞİT Eray EROĞLU Kalıtsal Tübüler Hastalıklar Ramazan ÇETİNKAYA Fabry Hastalığı Nurhan SEYAHİ Şeyda GÜL ÖZCAN Alport Hastalığı Ali Kemal KADİROĞLU Akut İnterstisyel Nefrit Ali GÜREL Ayhan DOĞUKAN Kronik İnterstisyel Nefrit Hakan AKDAM FMF ve Amiloidoz Harun AKAR Paraproteinemiler ve Miyelom Böbreği Vecihi BATUMAN Ürolojik Testler ve Değerlendirilmesi Aydın GÜÇLÜ Vezikoüreteral Reflü Funda SAĞLAM Böbrek Taş Hastalıkları Neslihan TEZCAN Rüya MUTLUAY Üriner Sistem Obstrüksiyonu Funda SARI Akut Böbrek Hasarının Tanımı ve Epidemiyolojisi Belda DURSUN Akut Böbrek Hasarında Klinik ve Komplikasyonlar Yelda GÜN Yavuz YENİÇERİOĞLU Akut Böbrek Hasarı Tedavisi Abdülmecit YILDIZ Alp İKİZLER Ezilme (Crush) Sendromu Mehmet Şükrü SEVER Trombotik Mikroanjiyopatiler Tuncay ŞAHUTOĞLU Ekrem KARA Yoğun Bakım Ünitesinde Akut Böbrek Hasarı ve Hemodinamik Destek Özlem USALAN Orhan ÖZDEMİR Yoğun Bakım Ünitesinde Renal Replasman Tedavileri Cuma Bülent GÜL Hepatitler ve Böbrek Alper AZAK Hepatorenal Sendrom Sinan KAZAN Sena ULU Kardiyorenal Sendrom: Patogenez ve Tanı Bülent HÜDDAM Kardiyorenal Sendrom: Tedavi İlter BOZACI Erhan TATAR Ürik Asitin Sistemik Hastalıklar ve Hipertansiyon Gelişimindeki Rolü Sidar ÇOPUR Mehmet KANBAY Gut ve Ürik Asit Nefropatisi Ender HÜR Aysun TORAMAN Kronik Böbrek Hastalığının Epidemiyolojisi ve Fizyopatolojisi...

Mantar zehirlenmelerinin mortalitesi yüksektir, sıklıkla amanita türlerine bağlı gelişir. Elli sekiz yaşında kadın hasta üç gün önce mantar yeme öyküsü ve bulantı, kusma, idrar miktarında azalma şikayetleriyle başvurdu. Değerlendirme sonucunda mantar zehirlenmesine bağlı rabdomiyoliz zemininde akut böbrek, karaciğer ve kardiak hasar olarak değerlendirildi. Hastaya medikal destek tedavi yanı sıra hemodiyaliz ve plazmaferez tedavisi uygulandı, izleminde klinik ve laboratuvar olarak tam düzelme sağlandı. Bu olgu raporunda mantar zehirlenmesinin geniş klinik spektrumu ve ölümcül potansiyeli açısından taşıdığı önemi vurgulamayı amaçladık.

Purpose: Nutrition is severely impaired in individuals with renal impairment, and transplant often ameliorates this condition. In this study, we aimed to evaluate the controlling nutritional status (CONUT) score of kidney transplant (KT) recipients. Materials and methods: Using the data from the nephrology transplant unit, we analyzed 188 patients whose data on the constituents of the CONUT score were available. We included KT individuals with at least one lymphocyte count and total cholesterol and albumin concentrations. This data has been used to calculate the CONUT score. The decrease of lymphocyte counts and total cholesterol was determined with 0, 1, 2, and 3 points, and the reduction of albumin was assigned with 0, 2, 4, and 6 points in agreement with disease severity. Patients were classified according to this score: normal, light, moderate, and severe. Results: There were 138 patients in normal, 54 in light, and three in each moderate and severe group. The CONUT score was good for regular-weight patients both before and after transplantation. All laboratory findings revealed significant differences between CONUT groups (p< 0.05). The logistic regression analysis model, including cholesterol, WBC, and calcium, showed that these three parameters have a predictive value of 80%. Conclusion: After transplantation, the number of patients in the underweight group decreased when normal weight and obesity increased. However, some patients’ nutrition was not ameliorated. The CONUT score may be a useful tool for monitoring transplant patients’ nutritional status.