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Öğe The 2-year follow-up results of lyso-GB3 levels in patients with Fabry disease(Academic Press Inc Elsevier Science, 2018) Turkmen, Kultigin; Selcuk, Nedim Yilmaz; Tonbul, Halil Zeki; Baloglu, Ismail[Abstract Not Availabe]Öğe Accelerated atherosclerosis in patients with common variable immunodeficiency: Is it overlooked or absent?(Churchill Livingstone, 2015) Ucar, Ramazan; Arslan, Sevket; Turkmen, Kultigin; Caliskaner, Ahmet ZaferCommon variable immunodeficiency (CVID) is a heterogeneous primary deficiency characterized by hypogammaglobulinemia, recurrent infections, and an increased risk of autoimmune disease and malignancy, and so chronic inflammation. Cardiovascular disease is the leading cause of mortality in the general population. Recent studies have suggested that chronic inflammation is an important player in the pathogenesis of CVID. Accelerated atherosclerosis due to ongoing inflammation from recurrent infections and autoimmunity is an expected clinical entity in patients with CVID. However, cardiovascular mortality as a cause of death in CVID series is either absent or minor. We hypothesized that accelerated atherosclerosis and cardiovascular disease are overlooked by clinicians, or atherosclerosis is really lower than that in the general population that may be prevented by some factors such as life-long immunoglobulin replacement treatment. (C) 2015 Elsevier Ltd. All rights reserved.Öğe Altered pupillary light responses are associated with the severity of autonomic symptoms in patients with Fabry disease(Nature Research, 2021) Bitirgen, Gulfidan; Turkmen, Kultigin; Zengin, Nazmi; Malik, Rayaz A.Symptoms of autonomic dysfunction are common in Fabry disease. In this study we aimed to evaluate alterations in the pupillary response to white light stimulation in patients with Fabry disease and their association with the severity of autonomic symptoms. Fourteen consecutive patients with Fabry disease and 14 healthy control participants were enrolled in this cross-sectional study. The Mainz Severity Score Index (MSSI) was used to measure the severity of Fabry disease and the Composite Autonomic Symptom Scale 31 (COMPASS 31) questionnaire was used to evaluate the severity of autonomic symptoms. The pupil light responses were assessed with an infrared dynamic pupillometry unit. There were significant reductions in the amplitude (P=0.048) and duration (P=0.048) of pupil contraction, and the latency of pupil dilation (P=0.048) in patients with Fabry disease compared to control subjects. The total weighted COMPASS 31 score correlated with MSSI (r=0.592; P=0.026) and the duration of pupil dilation (rho =0.561; P=0.037). The pupillomotor weighted sub-score of the COMPASS 31 correlated inversely with the duration of pupil contraction (r=-0.600; P=0.023) and latency of pupil dilation (rho=-0.541; P=0.046), and directly with the duration of pupil dilation (rho =0.877; P<0.001) and MSSI (r=0.533; P=0.049). In conclusion, abnormal pupillary function is demonstrated in patients with Fabry disease, which is associated with the severity of autonomic symptoms.Öğe Apoptosis, autophagy & endoplasmic reticulum stress in diabetes mellitus(Wolters Kluwer Medknow Publications, 2016) Demirtas, Levent; Guclu, Aydin; Erdur, Fatih Mehmet; Akbas, Emin Murat; Ozcicek, Adalet; Onk, Didem; Turkmen, KultiginThe prevalence of diabetes mellitus (DM) is increasing secondary to increased consumption of food and decreased physical activity worldwide. Hyperglycaemia, insulin resistance and hypertrophy of pancreatic beta cells occur in the early phase of diabetes. However, with the progression of diabetes, dysfunction and loss of beta cells occur in both types 1 and 2 DM. Programmed cell death also named apoptosis is found to be associated with diabetes, and apoptosis of beta cells might be the main mechanism of relative insulin deficiency in DM. Autophagic cell death and apoptosis are not entirely distinct programmed cell death mechanisms and share many of the regulator proteins. These processes can occur in both physiologic and pathologic conditions including DM. Besides these two important pathways, endoplasmic reticulum (ER) also acts as a cell sensor to monitor and maintain cellular homeostasis. ER stress has been found to be associated with autophagy and apoptosis. This review was aimed to describe the interactions between apoptosis, autophagy and ER stress pathways in DM.Öğe Are Kidney Donor Risk Index/Kidney Donor Profile Index Scores Predictor of Future Graft Function?(Wolters Kluwer Medknow Publications, 2021) Baloglu, Ismail; Tonbul, Halil; Turkmen, Kultigin; Selcuk, Nedim; Iyisoy, Mehmet SinanKidney donor profile index (KDPI) is a method developed to assess donor kidney quality for cadaveric transplants. We investigated the relationship between kidney donor risk index (KDRI) and KDPI scores of cadaveric transplants in the last five years in our clinic and current graft conditions. Forty people (12 females, 28 males; mean age, 46.35 + 8.94 years), who underwent cadaveric transplantation between January 2013 and March 2018, were participated in this study. At the same time, the KPDI and KDRI scores of the donor's kidneys were calculated and then compared with that of the recipients' data. The mean KDRI value of donors was 1.11 & PLUSMN; 0.33 and the median KDPI value was 60.50%. KDRI/KDPI scores were found to be high in women (P = 0.021) and, when the posttransplant findings of the recipients were evaluated by bivariate correlation analysis KDRI/KDPI scores were positively correlated with the day when creatinine (Cr) values started to fall off spontaneously (r = 0.457, P = 0.003). It was observed that recipients who were transplanted from the donors with high KDRI/KDPI scores had higher Cr levels (P < 0.01) and this relationship did not change over time (P = 0.115). When the donors were grouped as the standard-criteria donor and expanded-criteria donor (ECD); we found that the relationship between KDRI/KDPI, creatinine, and time was more significant in the ECD group (P = 0.04). KDRI/KDPI scores are closely related to graft outcomes especially in recipients that have kidneys from marginal donors. Therefore, evaluation of KDRI/KDPI scores might be required in marginal donors.Öğe Arterial Stiffness, Carotid Intima-Media Thickness, Endocan, and A Disintegrin and Metalloproteinase With Thrombospondin Type I Motif 9 Levels and Their Relationship With Disease Activity in Patients With Acromegaly With and Without Cardiovascular Risk Factors(Elsevier Inc, 2022) Can, Mustafa; Kocabas, Muhammet; Karakose, Melia; Yerlikaya, Fatma Humeyra; Alsancak, Yakup; Turkmen, Kultigin; Kulaksizoglu, MustafaObjective: Cardiovascular complications such as cardiomyopathy and endothelial dysfunction, which are frequently seen in patients with acromegaly, are among the most important causes of morbidity and mortality. In this study, we aimed to investigate arterial stiffness, carotid intima-media thickness, endocan level, and A disintegrin and metalloproteinase with thrombospondin type I motif 9 level and their relationship with disease activity in patients with acromegaly with and without cardiovascular risk factors. Methods: A total of 60 patients with acromegaly-25 with active disease, 26 with well-controlled disease, and 9 with newly diagnosed disease-and 60 age-, sex-, and body mass index (BMI)-matched healthy control subjects were enrolled in this study. All the subjects' height, weight, BMI, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG) level, insulin, hemoglobin A1C (HbA1C), C-reactive protein, lipid, endocan, A disintegrin and metalloproteinase with thrombospondin type I motif 9 levels, pulse wave velocity (PWV), and carotid intima-media thickness were measured. Results: The SBP, DBP, FPG level, HbA1C level, and PWV of the acromegaly group were higher than those of the control group. In patients with acromegaly with cardiovascular disease (CVD) risk factors, the PWV was higher than that in the control group, and in patients with acromegaly without CVD risk factors, the PWV was similar to that in the control group. In a correlation analysis, a positive correlation was found between PWV and age, BMI, SBP, DBP, FPG level, and HbA1C level in the acromegaly group. Conclusion: In our study, we found that arterial stiffness increased in patients with acromegaly with CVD risk factors and that increased arterial stiffness was associated with hemodynamic (SBP and DBP) and metabolic (BMI, FPG level, and HbA1C level) parameters. (c) 2021 AACE. Published by Elsevier Inc. All rights reserved.Öğe THE ASSOCIATION BETWEEN HRQOL, OTHER FACTORS AND MORTALITY IN PD PATIENTS WHO WERE FOLLOWED FOR 7 YEARS(Oxford Univ Press, 2013) Guney, Ibrahim; Turkmen, Kultigin; Yazici, Raziye; Aslan, Sevket; Altintepe, Lutfullah; Yeksan, Mehdi[Abstract Not Availabe]Öğe ASSOCIATION OF MULTIPLE PLASMA BIOMARKER LEVELS WITH KIDNEY DISEASE ACTIVITY IN FABRY DISEASE(Oxford Univ Press, 2023) Ozcan, Seyda Gul; Atli, Zeynep; Eren, Necmi; Dincer, Mevlut Tamer; Turkmen, Kultigin; Ozer, Hakan; Trabulus, Sinan[Abstract Not Availabe]Öğe Asymmetric Dimethylarginine and Homocysteine Levels in Dialysis Patients(Modestum Ltd, 2013) Erdem, S. Sami; Yerlikaya, F. Humeyra; Tonbul, Zeki; Turkmen, Kultigin; Erdur, F. Mehmet; Taner, Alpaslan; Cicekler, HumeyraCardiovascular diseases and endothelial disfunction are major causes of mortality in patients with end stage renal disease (ESRD). Treatment strategies like continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) have different effects on different parameters. Asymmetric dimethylarginine (ADMA) is an endogenous nitric oxide (NO) synthase inhibitor and it has been reported to be a novel marker for the progression of chronic kidney disease (CKD). Homocysteine is believed to cause atherogenesis and thrombogenesis via endothelial damage, vascular smooth muscle proliferation and coagulation abnormalities. In previous studies, conflicting findings have been reported about the effect of HD and CAPD on oxidant and antioxidant systems. In this study, we aimed to investigate ADMA, homocysteine and C-reactive protein (CRP) levels in patients with ESRD having HD and CAPD treatment and healthy individuals. This study was performed on 44 (23M, 21F) CAPD patients, 26 (13M, 13F) HD patients and 29 (15M, 14F) age and sex matched healthy control subjects. The lipid profile, ADMA, homocysteine, arginine and CRP levels were measured. Serum ADMA, homocysteine and CRP levels of the ESRD patients were significantly higher, whereas serum arginine levels were significantly lower in both HD and CAPD patients compared to control subjects. No differences were found between serum ADMA, homocysteine and CRP levels of the CAPD and HD patients. Our results suggest that ADMA, homocysteine and CRP levels were increased in HD and CAPD patients compared to the control subjects. These findings suggest that ESRD patients are prone to inflammation, oxidative stress and endothelial dysfunction. We conclude that endothelial dysfunction, inflammation and oxidative stress are increased in dialysis patients and ADMA concentrations are not affected by the modality of dialysis treatment.Öğe Atrial electromechanical delay and left atrial mechanical functions in hemodialysis and peritoneal dialysis patients(Springer, 2016) Demirtas, Levent; Turkmen, Kultigin; Buyuklu, Mutlu; Kocyigit, Ismail; Orscelik, OzcanLeft atrium (LA) mechanical functions and atrial electromechanical delay (AEMD) times were considered independent predictors of cardiovascular morbidity in general population. Data are scant about these parameters in end-stage renal disease (ESRD) patients receiving hemodialysis (HD) and peritoneal dialysis (PD). We aimed to evaluate AEMD times and LA mechanical functions and associated risk factors in HD and PD patients. Forty-four healthy individuals, 62 HD and 50 PD patients were enrolled in the study. Echocardiography was performed before midweek dialysis session for HD patients and on admission for PD patients. Data were expressed as mean +/- A SD. Spearman's test was used to assess linear associations. Predictors of left intra-atrial EMD time and LA active emptying volume (LAaeV) were assessed by regression analysis. Left intra-atrial-AEMD times were significantly longer in HD patients compared to PD patients. LAaeV was positively correlated with inter-atrial time, left intra-atrial time, systolic and diastolic BP, calcium and neutrophil-to-lymphocyte ratio (NLR) (r 0.22, p 0.016; r 0.28, p 0.002; r 0.34, p < 0.001; r 0.35, p < 0.001; r 0.37, p < 0.001; r 0.46, p < 0.001, respectively) and negatively correlated with serum uric acid (r -0.31, p 0.013) in ESRD patients. We found positive correlations between left intra-atrial time and LAaeV, LAV(max), LAV(p) and NLR (r 0.28, p 0.002; r 0.27, p 0.003; r 0.27, p 0.003; r 0.22, p 0.03, respectively) and negative correlations with albumin, uric acid and potassium (r -0.24, p 0.008; r -0.19, p 0.04; r -0.26, p 0.037, respectively). Advanced age, decreased serum albumin and increased NLR were found to be independent predictors of LAaeV; however, only NLR was found to be an independent predictor of AEMD time in this population. Increased inflammation might be a risk factor of AEMD and LA mechanical dysfunction in ESRD patients.Öğe BK Virus Nephropathy in Renal Transplantation: Case Series and Review of the Literature(Aves, 2020) Baloglu, Ismail; Turkmen, Kultigin; Esen, Haci Hasan; Selcuk, Nedim Yilmaz; Tonbul, Halil ZekiObjective: BK virus nephropathy (BKVN) is an important cause of kidney transplant failure. In this study, we aimed to evaluate our center's experience with BKVN in patients who had undergone renal transplantation and also discussed important aspects of the disease in this patient population. Materials and Methods: In this study, 8 patients with BKVN were evaluated retrospectively, having been selected from a group of 330 patients (178 females, 152 males; mean age: 48.37 +/- 13.25 years) who had undergone renal transplantation between 2007 and 2017 and were followed up at our center. Results: BKVN was detected in 8 of 330 renal transplantation patients (4 females, 4 males; mean age: 51.25 +/- 11.14 years). Their immunosuppressive regimen consisted of tacrolimus (FK), mycophenolate mofetil (MMF), and methylprednisolone. To reduce immunosuppressive dose, FK was discontinued in 3 patients, and they were switched to everolimus. In 2 of 7 patients, MMF was discontinued, and they were switched to azathioprine. FK or MMF doses were reduced in the8 patients with BKVN. Out of the 8 patients, cidofovir was administered to 1 patient, whereas intravenous immunoglobulins were administered to 3 patients. Additionally, pulse steroid treatment was administered to 1 patient who was diagnosed with acute rejection based on allograft biopsy findings. Among the 8 patients with BKVN, 1 (12.5%) experienced graft loss and was returned to hemodialysis treatment. Conclusion: Although new alternative treatments are available, immunosuppressive dose reduction is still considered the most effective treatment. Therefore, we believe that effective screening and preemptive strategies should be defined more clearly instead of focusing on treatment strategies.Öğe C3 glomerulopathy and atypical hemolytic uremic syndrome: an updated review of the literature on alternative complement pathway disorders(Springer, 2021) Turkmen, Kultigin; Baloglu, Ismail; Ozer, HakanThe complement system plays a significant role within the pathological process of C3 glomerulopathy (C3GP) and atypical hemolytic uremic syndrome (aHUS). In daily practice, clinicians should differentiate the subgroups of C3GP because of they should apply different treatment modalities. In the past, C3GP was considered as a part of membranoproliferative glomerulonephritis (MPGN). MPGN is defined as glomerular capillary thickening secondary to the synthesis of the new glomerular basement membrane and mesangial cellular hyperplasia with mesangial matrix expansion. Atypical hemolytic uremic syndrome is an ultra-rare disease that can be outlined by the triad of Coombs negative microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. Recent advances demonstrated that these diseases share common abnormalities of the control of the alternative complement system. Therefore, nowadays, most researchers advocate that there may be overlap in the pathogenesis of C3GP and aHUS. This review will provide recent novel mechanisms and treatment options in these diseases. For the purposes that we mentioned above and to help clinicians, we aimed to describe the etiology, pathophysiology, and treatment of C3GP and aHUS in this comprehensive review.Öğe The Characteristics of Patients Returning to Hemodialysis due to Nonfunctioning Graft in Turkey(Wolters Kluwer Medknow Publications, 2019) Altun, Ilkem; Selcuk, N. Yilmaz; Baloglu, Ismail; Turkmen, Kultigin; Tonbul, H. ZekiRenal transplantation is the most effective treatment modality for end-stage renal failure. According to the Ministry of Health Organ Transplant Registration System, despite the presence of 14,936 renal transplant recipients in Turkey, there are not enough data about the prognosis of these patients. Therefore, we aimed to ascertain the rate of patients returning to hemodialysis (HD) due to nonfunctioning graft in our country. One thousand four hundred and ninety-eight (males: 826, females: 672) HD patients who undergo HD at 22 HD centers in total, from different geographical regions to represent our country were examined retrospectively. The informations were obtained from patient registry files and anamnesis which were in HD centers. The number of patients returning to HD due to the loss of graft function was 77 (males: 56, females: 21). Eleven of the patients had transplantation from cadavers (14%) and 66 from living donors (86%). Prevelance of patients, who return to HD after the failure of renal transplantation, between HD patients was 5.1. The mean duration of return to HD after renal transplantation was 6.7 +/- 5.9 years for all patients. There was no significant difference in the duration without HD after transplantation between two groups when cadaveric and living donor transplants were compared (P = 0.759). There was no statistically significant difference in duration without HD after transplantation between patients receiving HD treatment before transplantation and preemptive transplant (P = 0.212). The prevelance of patients, who return to HD due to nonfunctioning graft among HD patients was 5.1. The duration without HD were similar after transplantation from both cadavers and living donors. The duration without HD was found longer among those who were operated before 2000.Öğe CHARACTERISTICS OF PRIMARY GLOMERULAR DISEASE PATIENTS WITH HEMATURIA IN TURKEY: THE DATA FROM TSN-GOLD WORKING GROUP(Oxford Univ Press, 2020) Sumnu, Abdullah; Turkmen, Kultigin; Cebeci, Egemen; Turkmen, Aydin; Eren, Necmi; Seyahi, Nurhan; Oruc, Aysegul[Abstract Not Availabe]Öğe Characteristics of primary glomerular diseases patients with hematuria in Turkey: the data from TSN-GOLD Working Group(Springer, 2021) Sumnu, Abdullah; Turkmen, Kultigin; Cebeci, Egemen; Turkmen, Aydin; Eren, Necmi; Seyahi, Nurhan; Oruc, AysegulPurpose Hematuria is one of the most common laboratory findings in nephrology practice. To date, there is no enough data regarding the clinical and histopathologic characteristics of primary glomerular disease (PGD) patients with hematuria in our country. Methods Data were obtained from national multicenter (47 centers) data entered into the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) database between May 2009 and June 2019. The data of all PGD patients over the age of 16 years who were diagnosed with renal biopsy and had hematuria data were included in the study. Demographic characteristics, laboratory and biopsy findings were also recorded. Results Data of 3394 PGD patients were included in the study. While 1699 (50.1%) patients had hematuria, 1695 (49.9%) patients did not have hematuria. Patients with hematuria had statistically higher systolic blood pressure, serum blood urea nitrogen, creatinine, albumin, levels and urine pyuria. However, these patients had statistically lower age, body mass index, presence of hypertension and diabetes, eGFR, 24-h proteinuria, serum total, HDL and LDL cholesterol, and C3 levels when compared with patients without hematuria. Hematuria was present 609 of 1733 patients (35.8%) among the patients presenting with nephrotic syndrome, while it was presented in 1090 of 1661 (64.2%) patients in non-nephrotics (p < 0.001). Conclusion This is the first multicenter national report regarding the demographic and histopathologic data of PGD patients with or without hematuria. Hematuria, a feature of nephritic syndrome, was found at a higher than expected in the PGDs presenting with nephrotic syndrome in our national database.Öğe Comment on Renal Protective Effect of Sirtuin 1(Hindawi Ltd, 2015) Turkmen, Kultigin[Abstract Not Availabe]Öğe Comparison of TIVA and Desflurane Added to a Subanaesthetic Dose of Propofol in Patients Undergoing Coronary Artery Bypass Surgery: Evaluation of Haemodynamic and Stress Hormone Changes(Hindawi Ltd, 2016) Onk, Didem; Ayazoglu, Tulin Akarsu; Onk, Oruc Alper; Aksut, Mehmet; Gunay, Murat; Turkmen, Kultigin; Ozensoy, AynurIntroduction. Increased levels of stress hormones are associated with mortality in patients undergoing coronary artery bypass grafting (CABG). Aim. To compare total intravenous anaesthesia (TIVA) and desflurane added to a subanaesthetic dose of propofol. Material and Methods. Fifty patients were enrolled in this study. Fentanyl (3-5mcg/kg/h) was started in both groups. Patients were divided into two groups. The PD group (n = 25) received 1 minimum alveolar concentration (MAC) desflurane anaesthesia in addition to propofol infusion (2-3 mg/kg/h), while P group (n = 25) received propofol infusion (5-6 mg/kg/h) only. Biochemical data, cortisol, and insulin levels were measured preoperatively (T0), after initiation of CPB but before cross-clamping the aorta (T1), after removal of the cross-clamp (T2), and at the 24th postoperative hour (T3). Results. Systolic, diastolic, and mean arterial pressure levels were significantly higher in PD group than those in P group in T1 and T2 measurements (p <= 0.05). CK-MB showed a significant decrease in group P (p <= 0.05). When we compared both groups, cortisol levels were significantly higher in PD group than P group (p <= 0.05). Conclusion. Stress and haemodynamic responses were better controlled using TIVA than desflurane inhalation added to a subanaesthetic dose of propofol in patients undergoing CABG.Öğe Corneal confocal microscopy detects corneal nerve damage and increased dendritic cells in Fabry disease(Nature Publishing Group, 2018) Bitirgen, Gulfidan; Turkmen, Kultigin; Malik, Rayaz A.; Ozkagnici, Ahmet; Zengin, NazmiFabry disease is characterised by neuropathic pain and accelerated vascular disease. This study evaluates the utility of corneal confocal microscopy (CCM) to non-invasively quantify corneal nerve and endothelial cell morphology and dendritic cell (DC) density in relation to disease severity in subjects with Fabry disease. Seventeen consecutive participants with Fabry disease and 17 healthy control subjects were included in this cross-sectional study. Fabry disease severity was measured using the Mainz Severity Score Index (MSSI). Central corneal sensitivity was assessed with a contact corneal esthesiometer. There was a significant reduction in the corneal sensitivity (5.75 [5.25-6.00] vs. 6.00 [6.00-6.00] cm, P = 0.014), nerve fiber density (NFD) (26.4 +/- 10.1 vs. 33.7 +/- 7.9 fibers/mm(2), P = 0.025) and nerve fiber length (NFL) (15.9 +/- 3.4 vs. 19.5 +/- 4.4 mm/mm(2), P = 0.012) and an increase in DC density (38.3 [17.5-97.3] vs. 13.5 [0-29.4] cells/mm(2), P = 0.004) in subjects with Fabry disease compared to the healthy control subjects. The total MSSI score correlated with NFD (rho = -0.686; P = 0.006), NFL (rho = -0.692; P = 0.006), endothelial cell density (rho = -0.511; P = 0.036), endothelial cell area (rho = 0.514; P = 0.036) and alpha-galactosidase A enzyme activity (rho = -0.723; P = 0.008). This study demonstrates reduced corneal sensitivity, corneal nerve fiber damage and increased DCs in subjects with Fabry disease.Öğe DEMOGRAPHIC AND CLINICAL CHARACTERISTICS OF RAPIDLY PROGRESSIVE GLOMERULONEPHRITIS IN TURKEY(Oxford Univ Press, 2020) Aydin, Zeki; Turkmen, Kultigin; Dede, Fatih; Yasar, Emre; Ozturk, Savas; Aydin, Mehmet; Tatar, Erhan[Abstract Not Availabe]Öğe Demographic, clinical and laboratory characteristics of rapidly progressive glomerulonephritis in Turkey: Turkish Society of Nephrology-Glomerular Diseases (TSN-GOLD) Working Group(Springer, 2021) Aydin, Zeki; Turkmen, Kultigin; Dede, Fatih; Yasar, Emre; Ozturk, Savas; Aydin, Mehmet; Tatar, ErhanBackground In our study, diagnostic and demographic characteristics of patients diagnosed with RPGN by biopsy, clinical and laboratory findings in our country were investigated. Methods Data were obtained from the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) Working Group database. Demographic characteristics, indications for biopsy, diagnosis of the glomerular diseases, comorbidities, laboratory and biopsy findings of all patients were recorded. According to their types, RPGN patients were classified as type 1 (anti-GBM related), type 2 (immuncomplex related) and type 3 (pauci-immune). Results Of 3875 patients, 200 patients with RPGN (mean age 47.9 +/- 16.7 years) were included in the study which constitutes 5.2% of the total glomerulonephritis database. Renal biopsy was performed in 147 (73.5%) patients due to nephritic syndrome. ANCA positivity was found in 121 (60.5%) patients. Type 1 RPGN was detected in 11 (5.5%), type 2 RPGN in 42 (21%) and type 3 RPGN in 147 (73.5%) patients. Median serum creatinine was 3.4 (1.9-5.7) mg/dl, glomerular filtration rate was 18 (10-37) ml/min/1.73m(2)and proteinuria 2100 (1229-3526) mg/day. The number of crescentic glomeruli ratio was ratio 52.7%. It was observed that urea and creatinine increased and calcium and hemoglobin decreased with increasing crescentic glomerular ratio. Conclusions Our data are generally compatible with the literature. Advanced chronic histopathological findings were prominent in the biopsy of 21 patients. Early biopsy should be performed to confirm the diagnosis of RPGN and to avoid unnecessary intensive immunosuppressive therapy. In addition to the treatments applied, detailed data, including patient and renal survival, are needed.
