Background: This study aims to investigate the effects of different direct oral anticoagulants on experimental renal injury induced by temporary infrarenal aortic occlusion. Methods: A total of 35 male Wistar rats (250 to 350 g) were randomly allocated to any of the five groups: sham, ischemia-reperfusion, rivaroxaban, dabigatran, and apixaban groups. Sham group underwent median laparotomy. Ischemia-reperfusion group was given saline gavage for one week. Animals in the other groups received rivaroxaban (3 mg/kg), dabigatran (15 mg/kg), or apixaban (10 mg/kg) daily once for one week via oral gavage. The infrarenal abdominal aorta was clamped for 60 min, and reperfusion was maintained for 120 min in the ischemia-reperfusion, rivaroxaban, dabigatran, and apixaban groups. At the end of reperfusion, kidneys were harvested for biochemical and histopathological analysis. Results: Renal total antioxidant capacity was reduced, and total oxidant status, interleukin-1 beta, and tumor necrosis factor-alpha were elevated in the ischemia-reperfusion group, compared to the sham group (p<0.005). Histological damage scores were also higher in the ischemia-reperfusion group (p<0.005). Administration of direct oral anticoagulants caused an increase of total antioxidant capacity and reduction of total oxidant status, tumor necrosis factor-alpha, and interleukin-1 beta in the rivaroxaban, dabigatran, and apixaban groups compared to the ischemia-reperfusion group (p<0.005). Histological damage scores were lower in the rivaroxaban and dabigatran groups than the ischemia-reperfusion group scores (p<0.005). Conclusion: Direct oral anticoagulants reduce aortic clamping-induced renal tissue oxidation and inflammation. Rivaroxaban and dabigatran attenuate ischemia-reperfusion-related histological damage in kidneys.

To investigate the effects of adalimumab pretreatment on the lipopolysaccharide-mediated myocardial injury. Twenty-eight Wistar rats were randomized into four groups (n=7). Control (C) group animals were injected once a day with intraperitoneal (i.p) 0.9 % saline for two days. In the Adalimumab (Ada) group, adalimumab was injected at a dose of 10 mg/kg/ day (i.p) for two days. Lipopolysaccharide (Lps) group rats were injected with a dose of 5 mg/kg (i.p) lipopolysaccharide. Lipopolysaccharide + Adalimumab (Lps+Ada) group rats received adalimumab before the administration of lipopolysaccharide. The animals were sacrificed 24 h after the last injection and blood samples were obtained for determination of biochemical cardiac injury markers and circulating levels of TNF-α and interleukin-6 (IL-6). Hearts were harvested for histological examination. Endotoxin exposure resulted in significant increases in serum cardiac injury markers, serum cytokines and histological myocardial injury scores in the Lps group. The levels of circulating cytokines, cardiac injury markers and histological injury scores for myocardial necrosis, perivascular cell infiltration, and inflammation were significantly reduced in Lps+Ada as compared to Lps group (p<0.05). Adalimumab pretreatment reduces endotoxin-induced myocardial damage in rats. This beneficial effect is thought to be related to the reduction of cytokine release.

Lipopolysaccharides is well-known in the acute renal injury process. It causes widespread activation of inflammatory cascades. Tumor necrosis factor (TNF)-α and interleukin (Il)-6 are essential proinflammatory cytokines that can induce the production of other cytokines in host response. Adalimumab suppresses TNF-α, IL-1β, and IL-6. We aimed to evaluate whether adalimumab would prevent the toxicity of lipopolysaccharide on the rat renal tissue.

This study aimed to evaluate the impact of preprocedural neutrophil-to-albumin ratio (NAR) on survival among patients undergoing tunneled hemodialysis catheter (THC) placement. We retrospectively reviewed 60 consecutive patients who underwent right-internal-jugular THC placement between July 2021 and October 2023. Demographics, laboratory variables and survival were collected. NAR and neutrophil-percentage-to-albumin ratio (NPAR) were calculated. Cox regression and Kaplan - Meier analyses explored associations with mortality; receiver-operating-characteristic (ROC) curves defined optimal cutoffs. Mean age was 70 ± 12 years; 24 patients (40%) died, yielding one-year survival of 62.5%. On multivariate Cox regression analysis, after adjustment for all covariates, higher NAR remained an independent predictor of mortality (p 175.4 had markedly lower one-year survival than those below the threshold (30.2% vs 88.2%, p <0.001). Catheter patency at one year was 84.8%. Among patients receiving a tunneled hemodialysis catheter, elevated preprocedural NAR levels were associated with increased mortality. NAR, which is an easily and routinely measurable parameter, may serve as a prognostic biomarker in this patient population.

Background: In this study, our aim was to conduct a cost/effectiveness research by determining the cost , in the patients who are in the routine hemodialysis program with a hemodialysis catheter, according to type of the catheter and the number of the days in which the catheters can be used actively. Methods: Between 2013 and 2020,patients with temporary hemodialysis catheters (Group 1 , n:81) and patients tunneled hemodialysis catheters (Group 2, n:205) were identified by scanning the hospital archive. The number of days in which the catheters were actively used was calculated according to the next catheter insertion or replacement date. Then, the permanent and temporary catheter fees paid by the governmentdetermined, according to the current Health Practices Communique (SUT) pricing that learnt from the hospital accounting department. Catheter cost per day was determined using the SPSS 22 program. Results: In the analysis made according to demographic characteristics, no significant difference was found between the groups in terms of gender (p=0.129). When the mean age of the patients was examined, no difference was found between the groups (p=0.085). No statistical difference was found between the groups in comorbid conditions: diabetes, hypertension, and coronary artery disease (p=0.219, p=0.129, p=0.822). The patency period was significantly higher in group 2 (p