Amyloidosis is an important cause of mortality and morbidity in patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD). In this study, depending on the idea that the clearance of middle and high molecular weight toxins could be improved, we aimed to investigate the effect of high-flux dialyzer on clearance of beta-2 microglobulin (beta2-MG) and calcium (Ca) phosphorus (P) metabolism in patients under HD treatment. Forty-eight patients with ESRD under chronic HD treatment were included in the study. All patients were randomized into two groups, and HD was performed with low-flux or high-flux dialyzer for 6 months. In the high-flux group, the reduction of beta2-MG and P levels during dialysis was significantly higher when compared with the low-flux group (p<0.001). During the follow-up period, while beta2-MG levels decreased significantly in the high-flux group (p<0.05), there was an increase in the low-flux group (p<0.05). As a result, our findings suggest that use of high-flux dialyzer can be an efficient alternative in terms of controlling the clearance of beta2-MG and impaired Ca and P metabolism. These beneficial effects of high-flux dialyzers are probably mediated by the improved clearance of middle and high molecular weight toxins.

Background/Aims: We aimed to evaluate the impact of low- or high-flux haemodialysis (HD) and online haemodiafiltration (OL-HDF) on inflammation and the lipid profile in HD patients. Methods: 50 HD patients were assigned to two groups for HD with low-flux (n = 25) or high-flux (n = 25) polysulphone dialysers for 6 weeks. Subsequently, all patients were haemodialysed with a low-flux polysulphone dialyser for 6 weeks, then transferred to OL-HDF for another 6 weeks. Blood samples for lipids and inflammatory markers (IL-6, IL-8, TNF-α, hs-CRP) were obtained at baseline and every 6 weeks. Results: Changes in inflammatory markers and lipids from baseline to the 6-week dialysis period did not differ between low- and high-flux groups. When patients were transferred from low-flux HD to OL-HDF, IL-6, IL-8, and TNF-α levels significantly decreased whereas HDL and LDL cholesterol significantly increased. Conclusion: Low- and high-flux polysulphone membranes had similar effects on lipids and inflammatory markers, whereas OL-HDF potently reduced pro-inflammatory cytokines.

Cannulation of IJV under real-time ultrasound guidance is very safe with high technical success rates. Nephrologists can use this technique with ease and with minimal complications in normal- and high-risk patients.

OBJecTIVe: There is no consensus on superiority of peritoneal dialysis catheter placement methods to each other in the literature.Therefore, the aim of this study was to determine whether there were differences in complications between laparoscopic and percutaneous PD catheter placement methods performed in our hospital. mATerIAl and meTHODS: Forty patients with ESRD files were evaluated retrospectively. The patients were divided into two groups according to the placement method of PD catheters; namely, the Percutaneous Group (PG) and the Laparoscopic Group (LG). reSulTS: Dialysate leakage was seen only in one patient in PG (3.33%) while it was not seen in LG (p= 0.75). Malposition was detected only in five patients in PG (16.7%) and it was not seen in LG (p= 0.22). Catheter dysfunction occurred in four patients in PG (13.3%) while it was not seen in LG (p= 0.30). Hemoperitoneum did not develop in PG while it appeared in one patient (10%) in LG (p=0.25). Early peritonitis was detected in four patients in PG (13.3%) and in one (10%) patient in LG (p = 0.78). Exit site infection developed only in 10 patients (33.3%) from PG; however, it did not develop in LG (p=0.04). cONcluSION: Percutaneous PD catheter placement was preferred in our center, and fewer complications were observed with laparoscopic methods. We recommend laparoscopic PD catheter placement in patients with morbid obesity, prior abdominal surgery, herniation or malposition developing due to the percutaneous method and where percutaneous fixation is not possible.

A 56-year-old male admitted to the hospital for generalized weakness and fever. He was treated in hospital for 10 days due to COVID-19. He did not receive any immunosuppressive therapy during admission. One day after his discharge he experienced back pain and received analgesic therapy for 10 days. About one month later he experienced severe back pain and gross hematuria. He was admitted to hospital with acute kidney injury and new-onset lower extremity muscle weakness. His renal biopsy revealed IgA nephropathy and thoracic/cervical/lumbar-spine imaging showed an epidural abscess. This is a unique case report of a patient developing an epidural abscess and acute kidney injury together as a serious complication of COVID-19 infection.