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    Diagnostic value of MAG3 scintigraphy and DMSA scintigraphy in renal parenchyma damage and acute pyelonephritis of children
    (Cukurova Univ, Fac Medicine, 2016) Kilicaslan, Buket; Alp, Handan; Yildirim, Mustafa; Inandi, Tacettin
    Purpose: In this study, we aimed to compare diagnostic value of MAG3 scintigraphy in renal parenchyma damage and acute pyelonephritis, in the first urinary tract infection in children, with DMSA scintigraphy. Material and Methods: Seventy patients who never diagnosed before but admitted with complaints of urinary tract infection for the first time, were included in this study. Before the treatment of all patients in the study were taken blood and urine samples, and leukocyte count, erythrocyte sedimentation rate, C-reactive protein concentration were determined. DMSA scintigraphy in detection of renal parenchyma damage was accepted as gold standard. In the detection of damage in renal parenchyma, positive and negative predictive value, selectivity and sensitivity of MAG3 scintigraphy were detected. Results: The fever, elevated leukocytes, C-reactive protein and sedimentation rate were found statistically significant in the detection of pyelonephritis. However, these values were not significant statistically in the demonstration of the severity of parenchyma damage. In the detection of damage in renal parenchyma, MAG3 scintigraphy had a sensitivity of 32.5 % and a specificity of 98.1 %. Conclusion: MAG3 scintigraphy can not replace DMSA scan to determine the renal parenchyma damage in childhood.
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    Platelet-to-lymphocyte ratio predicts mortality better than neutrophil-to-lymphocyte ratio in hemodialysis patients
    (Springer, 2016) Yaprak, Mustafa; Turan, Mehmet Nuri; Dayanan, Ramazan; Akin, Selcuk; Degirmen, Elif; Yildirim, Mustafa; Turgut, Faruk
    Purpose Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were established showing the poor prognosis in some diseases, such as cardiovascular diseases and malignancies. The risk of mortality in patients with end-stage renal disease (ESRD) was higher than normal population. In this study, we aimed to investigate the relationship between NLR, PLR, and all-cause mortality in prevalent hemodialysis (HD) patients. Methods Eighty patients were enrolled in study. NLR and PLR obtained by dividing absolute neutrophil to absolute lymphocyte count and absolute platelet count to absolute lymphocyte count, respectively. The patients were followed prospectively for 24 months. The primary end point was all-cause mortality. Results Mean levels of neutrophil, lymphocyte, and platelet were 3904 +/- 1543/mm(3), 1442 +/- 494/mm(3), 174 +/- 56 x 10(3)/mm(3), respectively. Twenty-one patients died before the follow-up at 24 months. Median NLR and PLR were 2.52 and 130.4, respectively. All-cause mortality was higher in patients with high NLR group compared to the patients with low NLR group (18.8 vs. 7.5 %, p = 0.031) and in patients with higher PLR group compared to patients with lower PLR group (18.8 vs. 7.5 %, p = 0.022). Following adjusted Cox regression analysis, the association of mortality and high NLR was lost (p = 0.54), but the significance of the association of high PLR and mortality increased (p = 0.013). Conclusion Although both NLR and PLR were associated with all-cause mortality in prevalent HD patients, only PLR could independently predict all-cause mortality in these populations.
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    Role of ultrasonographic chronic kidney disease score in the assessment of chronic kidney disease
    (Springer, 2017) Yaprak, Mustafa; Cakir, Ozgur; Turan, Mehmet Nuri; Dayanan, Ramazan; Akin, Selcuk; Degirmen, Elif; Yildirim, Mustafa
    Ultrasonography (US) is an inexpensive, noninvasive and easy imaging procedure to comment on the kidney disease. Data are limited about the relation between estimated glomerular filtration rate (e-GFR) and all 3 renal US parameters, including kidney length, parenchymal thickness and parenchymal echogenicity, in chronic kidney disease (CKD). In this study, we aimed to investigate the association between e-GFR and ultrasonographic CKD score calculated via these ultrasonographic parameters. One hundred and twenty patients with stage 1-5 CKD were enrolled in this study. The glomerular filtration rate was estimated by the Chronic Kidney Disease Epidemiology Collaboration equation. US was performed by the same radiologist who was blinded to patients' histories and laboratory results. US parameters including kidney length, parenchymal thickness and parenchymal echogenicity were obtained from both kidneys. All 3 parameters were scored for each kidney, separately. The sum of the average scores of these parameters was used to calculate ultrasonographic CKD score. The mean age of patients was 63.34 +/- 14.19 years. Mean kidney length, parenchymal thickness, ultrasonographic CKD score and median parenchymal echogenicity were found as 96.2 +/- 12.3, 10.97 +/- 2.59 mm, 6.28 +/- 2.52 and 1.0 (0-3.5), respectively. e-GFR was positively correlated with kidney length (r = 0.343, p < 0.001), parenchymal thickness (r = 0.37, p < 0.001) and negatively correlated with CKD score (r = -0.587, p < 0.001) and parenchymal echogenicity (r = -0.683, p < 0.001). Receiver operating characteristic curve analysis for distinction of e-GFR lower than 60 mL/min showed that the ultrasonographic CKD score higher than 4.75 was the best parameter with the sensitivity of 81% and positive predictivity of 92% (AUC, 0.829; 95% CI, 0.74-0.92; p < 0.001). We found correlation between e-GFR and ultrasonographic CKD score via using all ultrasonographic parameters. Also, our study showed that ultrasonographic CKD score can be useful for distinction of CKD stage 3-5 from stage 1 and 2. We suggested that the ultrasonographic CKD score provided more objective data in the assessment of CKD.