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  • Küçük Resim
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    Clinical and histopathological characteristics of primary focal segmental glomerulosclerosis in Turkish adults
    (Nature Research, 2024) Kurultak, İlhan; Güngör, Özkan; Öztürk, Savaş; Dirim, Ahmet Burak; Eren, Necmi; Yenigün, Ezgi; Dal, Elbis Ahbab; Dinçer, Mevlüt Tamer; Bora, Feyza; Akgür, Suat; Sumnu, Abdullah; Dursun, Belda; Sipahi, Savaş; Çetinkaya, Hakkı; Şahin, İdris; Şahin, Garip; Yılmaz, Mürvet; Vatansever, Bülent; Aydın, Emre; Ulu, Memnune Sena; Gündoğdu, Ali; Üstündağ, Sedat; Sayarlıoğlu, Hayriye; Kumru, Gizem; Elçioğlu, Ömer C.; Aydın, Zeki; Selçuk, Nedim Yılmaz; Önal Güçlü, Ceren; Oruç, Meriç; Küçük, Mehmet; Aktaş, Nimet; Derici, Ülver; Süleymanlar, Gültekin
    The data regarding primary FSGS (pFSGS) from different parts of the world differ. While the prevalence of pFSGS has been increasing in Western countries like the USA, it follows an inconsistent trend in Europe and Asia and a decreasing trend in Far Eastern countries such as China in the last two decades. There are undetermined factors to explain those national and geographic discrepancies. Herein, we aimed to reveal the current prevalence with clinical and histopathological characteristics of pFSGS in Turkish adults. This study includes the biopsy-proven pFSGS patients data recorded between 2009 and 2019, obtained from the national multicenter primary glomerulonephritis registry system of the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) database. 850 of the 3875 primer glomerulonephritis patients(21.9%) have pFSGS. The mean age is 40.5 ± 14.2 and 435 (51.2%) of patients are male. Nephrotic syndrome is the most common biopsy indication (59.2%). 32.6% of patients have hematuria, 15.2% have leukocyturia and 7.8% have both. Serum creatinine, albumin, and proteinuria are 1.0 mg/dL (IQR = 0.7–1.4) mg/dl, 3.4 ± 0.9 g/dl, 3400 mg/day(IQR, 1774–5740), respectively. Females have lower mean arterial pressure (? 2.2 mmHg), higher eGFR (+ 10.0 mL/min/1.73 m2), and BMI (+ 1.6 kg/m2) than males. Thickened basal membrane(76.6%) and mesangial proliferation (53.5%) on light microscopy are the major findings after segmental sclerosis. IgM (32.7%) and C3 (32.9%) depositions are the most common findings on immunofluorescence microscopy. IgM positivity is related to lower eGFR, serum albumin, and higher proteinuria. The prevalence of pFSGS is stable although slightly increasing in Turkish adults. The characteristics of the patients are similar to those seen in Western countries.
  • Küçük Resim
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    Immunosuppressive treatment results in patients with primary IgA nephropathy in Turkiye; the data from TSN-GOLD working group
    (2024) Oruç, Ayşegül; Türkmen, Aydın; Baştürk, Taner; Cebeci, Egemen; Turgutalp, Kenan; Çetinkaya, Hakkı; Üzerk Kibar, Müge; Seyahi, Nurhan; Tatar, Erhan; Ergül, Metin; Derici, Ülver; Aylı, Mehmet Deniz; Pınar, Musa; Bakar, Betül; Kazancıoğlu, Rümeyza; Yıldız, Abdülmecit; Dirim, Ahmet Burak; Yılmaz, Zülfükar; Türkmen, Kültigin; Tunca, Onur; Koç, Mehmet; Kutlay, Sim; Micozkadıoğlu, Hasan; Azak, Alper; Boztepe, Burcu; Üstündağ, Sedat; Şafak Öztürk, Seda; Ünsal, Abdulkadir; Karadağ, Serhat; Şahin, Gülizar; Coşgun Yenigün, Ezgi; Eren, Necmi; Güllülü, Mustafa; Gürsu, Meltem; Öztürk, Savaş; Şumnu, Abdullah
    Background: Immunoglobulin A (IgA) nephropathy (IgAN) treatment consists of maximal supportive care and, for high-risk individuals, immunosuppressive treatment (IST). There are conflicting results regarding IST. Therefore, we aimed to investigate IST results among IgAN patients in Turkiye. Method: The data of 1656 IgAN patients in the Primary Glomerular Diseases Study of the Turkish Society of Nephrology Glomerular Diseases Study Group were analyzed. A total of 408 primary IgAN patients treated with IST (65.4% male, mean age 38.4 ± 12.5 years, follow-up 30 (3–218) months) were included and divided into two groups according to treatment protocols (isolated corticosteroid [CS] 70.6% and combined IST 29.4%). Treatment responses, associated factors were analyzed. Results: Remission (66.7% partial, 33.7% complete) was achieved in 74.7% of patients. Baseline systolic blood pressure, mean arterial pressure, and proteinuria levels were lower in responsives. Remission was achieved at significantly higher rates in the CS group (78% vs. 66.7%, p = 0.016). Partial remission was the prominent remission type. The remission rate was significantly higher among patients with segmental sclerosis compared to those without (60.4% vs. 49%, p = 0.047). In the multivariate analysis, MEST-C S1 (HR 1.43, 95% CI 1.08–1.89, p = 0.013), MEST-C T1 (HR 0.68, 95% CI 0.51–0.91, p = 0.008) and combined IST (HR 0.66, 95% CI 0.49–0.91, p = 0.009) were found to be significant regarding remission. Conclusion: CS can significantly improve remission in high-risk Turkish IgAN patients, despite the reliance on non-quantitative endpoints for favorable renal outcomes. Key predictors of remission include baseline proteinuria and specific histological markers. It is crucial to carefully weigh the risks and benefits of immunosuppressive therapy for these patients.
  • Küçük Resim Yok
    Öğe
    The prevalence, clinical and pathological characteristics of primary focal segmental glomerulosclerosis in Turkish adults: The data from TSN-Gold (Turkish society of nephrology glomerular diseases) working group
    (Oxford University Press, 2020) Kurultak, İlhan; Güngör, Özkan; Öztürk, Savaş; Dirim, Ahmet Burak; Eren, Necmi; Yenigün, Ezgi; Ahbap Dal, Elbis; Dinçer, Mevlüt Tamer; Bora, Feyza; Akgür, Suat; Şumnu, Abdullah; Dursun, Belda; Sipahi, Savaş; Çetinkaya, Hakkı; Şahin, İdris; Şahin, Garip; Yılmaz, Mürvet; Vatansever, Bülent; Aydın, Emre; Ulu, Memnune Sena; Gündoğan, Ali; Üstündağ, Sedat; Sayarlıoğlu, Hayriye; Şahin, Gizem Kumru; Elçioğlu, Ömer Celal; Aydın, Zeki; Selçuk, Nedim Yılmaz; Önal, Ceren; Oruç, Meriç; Küçük, Mehmet; Aktaş, Nimet; Derici, Ülver; Süleymanlar, Gültekin
    [Abstract Not Available]