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Öğe Epidemiological features of primary glomerular disease in Turkey: a multicenter study by the Turkish Society of Nephrology Glomerular Diseases Working Group(BioMed Central Ltd, 2020) Türkmen, Aydın; Şumnu, Abdullah; Cebeci, Egemen; Yazıcı, Halil; Eren, Necmi; Seyahi, Nurhan; Dilek, Kamil; Dede, Fatih; Derici, Ülver Boztepe; Ünsal, Abdülkadir; Şahin, Garip; Sipahioǧlu, Murat Hayri; Gok, Mahmut; Tatar, Erhan; Dursun, Belda; Sıpahı, Savaş; Yılmaz, Mürvet; Süleymanlar, Gültekin; Ulu, Sena Memnune; Güngör, Özkan; Kutlay, Sim; Bahçebaşı, Zerrin Bicik; Şahin, Ídris; Kurultak, İlhan; Türkmen, Kültigin; Yılmaz, Zülfikar; Kazancıoğlu, Rümeyza Turan; Çavdar, Caner; Candan, Ferhan; Aydın, Zeki; Oygar, Düriye Deren; Gul, Cuma Bulent; Arici, Mustafa; Paydaş, Saime; Taymez, Dilek Güven; Küçük, Mehmet; Trablus, Sinan; Turgutalp, Kenan; Koç, Leyla; Sezer, Siren; Duranay, Murat; Bardak, Simge; Altıntepe, Lütfullah; Arikan, Izzet Hakki; Azak, Alper; Odabaş, Ali Rıza; Şahin, Gülizar Manga; Ozturk, SavasAbstract Background: The largest data on the epidemiology of primary glomerular diseases (PGDs) are obtained from the databases of countries or centers. Here, we present the extended results of the Primary Glomerular Diseases Study of the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) Working Group. Methods: Data of patients who underwent renal biopsy and received the diagnosis of PGD were recorded in the database prepared for the study. A total of 4399 patients from 47 centers were evaluated between May 2009 and May 2019. The data obtained at the time of kidney biopsy were analyzed. After the exclusion of patients without light microscopy and immunofluorescence microscopy findings, a total of 3875 patients were included in the study. Results: The mean age was 41.5 ± 14.9 years. 1690 patients were female (43.6%) and 2185 (56.3%) were male. Nephrotic syndrome was the most common biopsy indication (51.7%). This was followed by asymptomatic urinary abnormalities (18.3%) and nephritic syndrome (17.8%). The most common PGD was IgA nephropathy (25.7%) followed by membranous nephropathy (25.6%) and focal segmental glomerulosclerosis (21.9%). The mean total number of glomeruli per biopsy was 17 ± 10. The mean baseline systolic blood pressure was 130 ± 20 mmHg and diastolic blood pressure was 81 ± 12 mmHg. The median proteinuria, serum creatinine, estimated GFR, and mean albumin values were 3300 (IQR: 1467–6307) mg/day, 1.0 (IQR: 0.7–1.6) mg/dL, 82.9 (IQR: 47.0–113.0) mL/min and 3.2 ± 0.9 g/dL, respectively. Conclusions: The distribution of PGDs in Turkey has become similar to that in other European countries. IgA nephropathy diagnosed via renal biopsy has become more prevalent compared to membranous nephropathy. Keywords: Epidemiology, Glomerulonephritis, Kidney biopsy, Primary glomerular diseases; the Turkish Society of Nephrology glomerular diseases (TSN-GOLD) working group, Turkish Society of NephrologyÖğe Factors influencing disease recurrence and graft survival in patients who developed end-stage renal disease due to focal segmental glomerulosclerosis and underwent renal transplantation(Int College of Surgeons, 2021) Yılmaz, Vural Taner; Koçak, Hüseyin; Çetinkaya, Ramazan; Ülger, Burak Veli; Süleymanlar, GültekinAbstract Aim: The aim of our study was to determine the factors effecting disease recurrence and graft survival in patients who developed end-stage renal disease (ESRD) due to focal segmental glomerulosclerosis (FSGS) and underwent renal transplantation (Rtx). Methods: A total of 37 patients with FSGS (female/male: 10/27) who underwent Rtx in our transplant center between 2001 and 2014 were included in the study. The patients were diagnosed with FSGS by biopsy. Comparative analyses were performed in order to determine the factors effecting disease recurrence and graft survival. Plasmapheresis was performed with 40 mL/kg plasma. The diagnosis of the recurrence of FSGS and the acute rejections were also confirmed by biopsy. Results: Statistical analyses revealed that, recurrence rates were higher in Rtx recipients from deceased donor [deceased donor versus living donor, 2 (50.0%) versus 3 (9.1%), P = 0.024]. However, no correlation was found between recurrence and renal replacement treatment (RRT) methods, duration of RRT, preoperative or postoperative prophylactic plasmapheresis, the presence of preoperative nephrotic proteinuria, donor's or recipient's age or gender, kinship with donor, time interval between development of FSGS and ESRD, or performing native nephrectomy. Graft survival rates were higher in Rtx patients that were transplanted from living donor, first-degree relatives, and in patients without recurrence. Conclusion: In countries where organ donation is insufficient, living donors can be used with a low risk of recurrence for Rtx candidates with FSGS. Also, grafts from living donors, particularly from first-degree relatives, have higher survival rates.Öğe The relationship between glomerular IgG staining and poor prognostic findings in patients with IgA nephropathy: the data from TSN-GOLD working group(BioMed Central Ltd, 2021) Turgutalp, Kenan; Cebeci, Egemen; Türkmen, Aydın; Derici, Ülver Boztepe; Seyahi, Nurhan; Eren, Necmi; Dede, Fatih; Güllülü, Mustafa; Baştürk, Taner; Şahin, Gülizar Manga; Yılmaz, Mürvet; Sipahi, Savaş; Şahin, Garip; Ulu, Sena Memnune; Tatar, Erhan; Gündogdu, Ali; Kazancıoğlu, Rümeyza Turan; Sevinç, Can; Güngör, Özkan; Şahin, İdris; Kutlay, Sim; Kurultak, İlhan; Aydın, Zeki; Altun, Bülent; Dursun, Belda; Yılmaz, Zülfükar; Uzun, Özcan; Süleymanlar, Gültekin; Candan, Ferhan; Sezer, Siren; Tanburoğlu, Derya Basak; Bicik, Zerrin; Taymez, Dilek Güven; Akcali, Esra; Oygar, Düriye Deren; İstemihan, Zülal; Bardak, Simge; Bardak, Simge; Akçay, Ömer Faruk; Dincer, Mevlüt Tamer; Dervişoğlu, Erkan; Yenigün, Ezgi Çoşkun; Türkmen, Kültigin; Özturk, SavaşBackground: Galactose-deficient IgA1 (Gd-IgA1) has an increased tendency to form immunocomplexes with IgG in the serum, contributing to IgAN pathogenesis by accumulating in the glomerular mesangium. Several studies showed that glomerular IgG deposition in IgAN is an important cause of mesangial proliferation and glomerular damage. This study aims to determine the association of the positivity of IgG and the intensity of IgG staining with a poor renal prognosis. Methods: A total of 943 IgAN patients were included in the study. Glomerular IgG staining negative and positive patients were compared using Oxford classification scores, histopathological evaluations, proteinuria, eGFR, albumin, blood pressures. IgG positive patients were classified as (+), (++), (+++) based on their staining intensity, and the association with the prognostic criteria was also evaluated. Results: 81% (n = 764) of the patients were detected as IgG negative, while 19% (n = 179) were positive. Age, gender, body mass index, blood pressure, proteinuria, eGFR, uric acid values were similar in IgG positive and negative patients who underwent biopsy (p > 0.05). Intensity of glomerular IgG positivity was not found to be associated with diastolic and systolic blood pressure, urea, uric acid, age, eGFR, albumin, proteinuria (p > 0.05 for all, r = − 0.084, r = − 0.102, r = − 0.006, r = 0.062, r = 0.014, r = − 0.044, r = − 0.061, r = − 0.066, r = 0.150, respectively). There was no difference for histopathological findings between IgG (+), IgG (++), IgG (+++) groups (for all, p > 0.05). Conclusion: Glomerular IgG negativity and positivity detected by routine IFM in IgAN patients is not associated with poor renal prognostic risk factors.