Türker Emre

Objective: The hemoglobin–albumin–lymphocyte–platelet (HALP) score reflects nutritional-inflammatory status and is a prognostic marker in several malignancies. Its potential association with renal recovery in newly diagnosed multiple myeloma (MM) remains unclear. We investigated the relationship between baseline HALP score and renal recovery in patients with newly diagnosed MM. Methods: We retrospectively evaluated 133 consecutive patients with newly diagnosed MM. Renal response analyses were restricted to 56 patients meeting prespecified baseline eGFR criteria. Renal recovery was defined by modified International Myeloma Working Group (IMWG) criteria using the last available follow-up eGFR. The median follow-up was 15 months (interquartile range [IQR], 6.5-20.75). The HALP score was evaluated using group comparisons, receiver operating characteristic (ROC), correlation, and logistic regression analyses. Results: In the renal outcome cohort (n = 56), 37 (66.1%) achieved renal recovery and 19 (33.9%) experienced nonrecovery. The median HALP score did not differ significantly between the recovery and nonrecovery groups (27.66 [IQR, 20.85–45.95] vs 22.82 [IQR, 9.90–54.94]; P = .364). HALP score discrimination for renal recovery was limited (area under the curve [AUC], 0.575; 95% CI, 0.435–0.706; P = .422). An exploratory cutoff of >18.91 yielded a sensitivity of 81.1% and specificity of 47.4%. HALP ≥18.91 was not significantly associated with renal recovery in univariable analysis (odds ratio [OR], 3.12; 95% CI, 0.91–10.64; P = .069) but showed a significant association after multivariable adjustment (OR, 4.32; 95% CI, 1.13–16.58; P = .033). The HALP score did not correlate with ΔeGFR (r = −0.058; P = .671). Conclusions: The continuous HALP score showed limited discrimination for renal recovery. However, an exploratory threshold of ≥18.91 was associated with recovery after multivariable adjustment. Given the modest sample size, wide CI, and nonsignificant ROC analysis, this threshold-based finding requires confirmation in larger independent cohorts.

Background/Objectives: This study investigated the prevalence and clinical significance of glomerular capillary C4d staining in native kidney biopsies and its association with renal outcomes in patients with biopsy-proven glomerular diseases. Methods: This single-center, retrospective study reviewed adult native kidney biopsy cases performed between November 2022 and November 2024 and included 173 patients with biopsy-proven glomerular disease who underwent immunohistochemical C4d staining. Results: C4d positivity was detected in 38.2% of biopsies, most frequently in membranous nephropathy (74.2%), followed by AA amyloidosis (63.6%) and lupus nephritis (63.6%). General characteristics were similar between C4d-negative and C4d-positive patients; however, the C4d-positive group had higher baseline LDL and proteinuria levels and lower albumin levels. At 6 months, the proportion of patients who achieved proteinuria levels <1 g/day and <0.5 g/day was significantly lower in the C4d-positive group compared to the C4d-negative group. The two groups did not differ regarding glomerular filtration rate and the need for renal replacement therapy. Older age and C4d positivity were independently associated with a lower likelihood of achieving proteinuria <0.5 g/day at 6 months. Conclusions: Glomerular capillary C4d positivity was associated with a more pronounced proteinuric phenotype and a reduced likelihood of early proteinuria remission. These findings support the clinical relevance of glomerular capillary C4d staining in relation to early proteinuria remission; however, larger prospective studies incorporating standardized semiquantitative C4d assessment and long-term follow-up are required before C4d can be considered a validated prognostic biomarker.

Peritoneal dialysis (PD) is a well-established kidney replacement therapy that offers greater treatment flexibility and better preservation of residual kidney function than conventional hemodialysi...

Background: Cognitive impairment is a common and clinically significant complication in patients undergoing peritoneal dialysis, a vulnerable population with multiple comorbidities. However, its underlying determinants remain incompletely understood. Vascular calcification, as a marker of systemic vascular pathology, has been suggested to be associated with cognitive dysfunction. This study aimed to evaluate the relationship between intracranial and valvular calcification and cognitive dysfunction in peritoneal dialysis patients. Methods: This single-center cross-sectional study included patients receiving peritoneal dialysis. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Intracranial and valvular calcifications were determined based on imaging findings. Clinical, demographic, and laboratory parameters were analyzed. Logistic regression analysis was used to identify factors associated with cognitive dysfunction, and receiver operating characteristic (ROC) analysis was performed to assess discriminative performance. Results: A total of 95 patients were included. Patients with cognitive dysfunction were older and more frequently female. In univariate analysis, age, female sex, and mitral valve calcification were significantly associated with cognitive dysfunction. After multivariable adjustment, only age (OR: 1.06, p = 0.02) and female sex (OR: 3.4, p = 0.03) remained independently associated. ROC analysis showed limited discriminative performance (AUC: 0.63). Conclusions: Calcification parameters were associated with cognitive dysfunction in unadjusted analyses but did not remain independent predictors after adjustment. Age was the strongest factor associated with cognitive dysfunction, while female sex was also independently associated with increased risk. These findings suggest that calcification burden may reflect cumulative vascular aging and comorbidity rather than serving as a standalone predictor of cognitive impairment.

Introduction: During the COVID-19 pandemic, mRNA vaccines which developed using a novel technology distinct from conventional vaccines, were widely administered. They are known to induce more pronounced immune reactions compared to classical vaccines. We investigated whether mRNA and inactivated vaccines accelerate the progression of chronic kidney disease. Methods: A total of 140 patients with CKD followed at Bursa City Hospital were retrospectively analyzed. Serum creatinine and glomerular filtration rate (GFR) values were recorded over three periods: pre-vaccination (−24 months), vaccination period, and post-vaccination (+24 months). GFR was calculated using the CKD-EPI formula. Due to the dependent nature of pre- and post-vaccination comparisons, the paired t -test was used for parametric data and the Wilcoxon signed-rank test for non-parametric data. Statistical significance was set at p < 0.05. Results: In the overall patient group and in the subgroup receiving only inactivated vaccines, a statistically significant difference in serum creatinine levels was observed between the pre- and post-vaccination periods; however, no statistically significant change was detected in GFR. In the subgroup of patients who received only the BioNTech (mRNA) vaccine, no statistically significant changes were observed in either serum creatinine or GFR. Conclusion: In our study, we concluded that mRNA and inactivated vaccines did not accelerate the progression of chronic kidney disease.

Aim To diagnose earlier kidney failure, we investigated renal functions with diffusion-weighted imaging (DWI). Methods We evaluated the DWI of 62 patients with chronic kidney disease (CKD) and compared it with creatinine clearance provided by daily urine collection. The apparent diffusion coefficient (ADC) values were compared with the five stages of CKD. Results For each stage of CKD, the ADC values were found to be significantly different (p < 0.01) and allowed the differentiation of stage 1 of the disease from the other stages. Conclusion Renal ADC values show a significant correlation with the clinical stages of CKD. DWI may detect renal failure prior to a rise in creatinine.