A 67-year-old female with type 2 diabetes mellitus developed nephrotic syndrome with in one week of receiving the first dose of SARS-CoV-2 CoronaVac vaccine. A kidney biopsy was consistent with minimal change nephrotic syndrome and treatment was symptomatic with antiproteinurik therapy and improvement in proteinuria. Edema returned within one week of the second dose of CoronaVac. In this occasion acute kidney injury and massive proteinuria were noted. In kidney biopsy, glomeruli were normal, but tubulointerstitial inflammation consistent with acute tubulointerstitial nephritis were noted. Pulse followed by oral steroids were followed by recovery of kidney function. Proteinuria decreased after initiation of cyclosporine A.
Our study showed that interdialytic volume overload increased both LVMI and FGF-23 values. We can consider that interdialytic volume control exerts positive effects on increased FGF-23 levels which predict the negative cardiovascular outcomes.
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