In this issue of the Journal, Jia and colleagues 1 conducted a genetic association study in which they evaluated the relationship between vitamin D receptor (VDR) polymorphism and hypertension in a Chinese Han population. In a case-control model, the study included 2409 patients with known hypertension and initial office blood pressure (BP) elevation as well as 3063 control patients with normal BP and no history of hypertension. Patients and controls were recruited through a community-based epidemiological survey, and both groups included participants of Han Chinese ethnicity only. Basic demographic and clinical features of the study population were gathered through interview with standard questionnaire. Fasting blood samples for studying serum glucose level and lipid profile were obtained. A rigorous methodology was used to select candidate single nucleotide polymorphisms (SNPs) in the VDR gene region. The authors selected three SNPs by setting minor allele frequency at ≥0.05 from Hapmap of Han Chinese and applied the linkage disequilibrium method to determine tagging SNPs with r 2 ≥0.80 as candidate SNPs. Finally, three SNPs (rs11574129, rs2228570, and rs739837) were selected. Genomic DNA was extracted from circulating leucocytes in all patients and controls by means of a commercial system. There was no sex difference seen, although patients were significantly older compared with controls. Serum fasting triglyceride and glucose concentrations as well as systolic and diastolic BPs were significantly higher in patients compared with controls. There was no difference in terms of rate of smoking status and high-density lipoprotein concentration between the groups. The patient and control groups were no different in terms of genotype and allele frequencies of all three SNPs studied, even after adjusting for covariates. The authors also performed a stratified analysis based on sex, age, and smoking. Only SNP of rs2228570 showed a statistically significant association with decreased risk of hypertension in the male group and smokers separately. However, other SNPs did not show such a significant association in stratified analyses. Finally, the authors divided patient group into naive hypertensives and patients who were already taking antihypertensive treatment to control for the effect of antihypertensive medications, and compared genotypes in terms of impact on systolic and diastolic BP levels. Quantitative trait analysis using a general linear model revealed that the TC/CC group of rs2228570 had lower systolic BP compared with the TT genotype in the treated hypertensive subgroup even after adjustment for confounding factors. Moreover, naive hypertensive patients with TT genotype of the latter SNP showed higher SBP compared with the TC/CC genotype. Other SNPs did not show such a relationship in the patient cohort. In brief, the authors concluded that rs2228570 SNP in the VDR gene region was associated with decreased risk of hypertension and systolic BP in a Chinese Han population. SNP rs2228570, also known as FokI, ...
Proton pump inhibitors (PPIs) are extensively prescribed drugs usually used for a long period. Recent reports linked PPI use with development of hypomagnesemia. However, there is still uncertainty regarding risk of hypomagnesemia in outpatients who were on long-term PPI use. Thus, we aimed to evaluate frequency of hypomagnesemia among a well-defined outpatient patient cohort with no other possible risk factors affecting serum magnesium levels. This was a case-control study carried out at the outpatient gastroenterology clinic of a University hospital. Patients who were on PPI therapy for at least 6 months without diuretic use and chronic kidney disease were included. Patients who were subjected to the same inclusion and exclusion criteria and not using PPI were included as control subjects. One hundred fifty-four patients and 84 control subjects were included. The mean duration of PPI use was 27.5 ± 2.5 months. Mean serum magnesium levels of PPI users and nonusers were 2.17 ± 0.20 mg/dL and 2.19 ± 0.15 mg/dL, respectively. None of the patient had a serum magnesium level below laboratory lower range of 1.7 mg/dL. Our results showed that for typical gastroenterology outpatient clinic patients with no other risk factors affecting serum magnesium levels, long-term PPI use did not affect serum magnesium levels.
OBJeCTIve: Despite the unethical characteristic and unfavorable consequences, paid livingunrelated renal transplantation is still considered as an option for end-stage renal disease patients. This study aimed to compare the medical and surgical complications along with allograft functions of PLURT patients with age and gender matched transplant recipients who received a living or deceased donor kidney at our center.
MATerIAl and meTHoDs:End-stage renal disease patients received PLURT (group 1) in a foreign country and age, and gender matched renal transplant recipients that received renal transplantation from living-related donors (LRT patients; group 2) and deceased donors (DDRT patients; group 3) followed between 2003-2010 at our transplantation center were included in the study.reSulTS: There were no significant differences between groups (Group 1&2 and group 1&3) regarding age, sex, urea, creatinine, creatinine clearance, and proteinuria. Data about patients that received renal transplantation from living-related and deceased-donors at our center were sufficient when compared with PLURT patients. PLURT has a negative impact on patients' survival because of surgical and medical problems.
CONCluSION:In the present study, PLURT, LRT and DDRT patients had early and late complications of renal transplantation which were similarly seen in recent studies. The main problem for unfavorable results of PLURT is the commercial aspect of renal transplantation without considering the risks for ESRD patients. key woRDs: Transplant tourism, Renal transplantation, ESRD Öz AMAÇ: Son dönem böbrek yetmezliği bulunan hastalar etik olmamasına ve olumsuz sonuçlara karşın yabancı ülkelerde akraba dışı canlı vericilerden nakil olmaktadırlar. Çalışmamızın amacı, dış ülkelerde canlıdan böbrek nakli yapılan ve sonrasında merkezimizde izlenen hastalarla merkezimizde canlıdan ve kadavradan yapılan nakil yapılan hastaların böbrek işlevlerini, mortalite ve morbiditeleri karşılaştırmaktır.
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