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Objective: The aim of this study was to examine the effect of volume status on the progressions of renal disease in normovolemic and hypervolemic patients with advanced non-dialysis-dependent chronic kidney disease (CKD) who were apparently normovolemic in conventional physical exam­ination. Materials and Methods: This was a prospective interventional study performed in a group of stage 3–5 CKD patients followed up for 1 year. Three measurements were made for volume and renal status for every patient. The fluid status was assessed by a bioimpedance spectroscopy method. A blood pressure (BP) value > 130/80 mm Hg prompted the initiation or dose increment of diuretic treatment in normovolemic patients. Result: Forty-eight patients (48%) were hypervolemic. At the end of the 1-year follow-up, hypervolemic patients were found to have a significantly lower estimated glomerular filtration rate and higher systolic BP compared to baseline. Hypervolemia was associated with an increased incidence of death. Conclusion: We have shown that maintenance of normovolemia with diuretic therapy in normovolemic patients was able to slow down and even improve the progression of renal disease. Volume overload leads to an increased risk for dialysis initiation and a decrease in renal function in advanced CKD. Volume overload exhibits a stronger association with mortality in CKD patients.

Background and Aim: PD-1 (programmed death-1) is an immune checkpoint receptor that modulates T-cell activity in peripheral tissues via interaction with its ligands, PD-L1 (programmed death-ligand 1) and PD-L2 (programmed death-ligand 2). Tumor cells upregulate PD-L1 or PD-L2 to dampen this T lymphocyte attack. Our goal was to demostrate the PD-1 and PD-L2 expresion rate of various hematologic malignancies, and to evaluate whether PD-1 and PD-L2 expresion have impact on prognosis. Materials and Methods: For this purpose, pre-treatment bone marrow biopsy specimens of 83 patients [42 multiple myeloma (MM), 21 acute leukemias, and 20 chronic lymphocytic leukemia (CLL)] have been stained with monoclonal antibody immunstains of PD-1 and PD-L2. Results: As a result, the overall expression rate of PD-1 was 26.2%, 4.8%, and 60% in patients with MM, acute leukemias, and CLL, respectively. Whereas, PD-L2 expression rate was 61.9%, 14.3%, and 10% in patients with MM, acute leukemias, and CLL, respectively. Conclusion: Finally, we conclude that the role of PD-1 pathway can be demonstrated by immunohistochemistry (IHC). Since we have evaluated whether there is a correlation between (IHC) results and survival of patients with MM, acute leukemias, and CLL, we couldn’t demonstrate a meaningful evidence that these markers have an impact on prognosis. Key Words: PD-1, PD-L2, multiple myeloma, acute leukemias, chronic lymphocytic leukemia.

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