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Article Citation - WoS: 9Citation - Scopus: 10Impact of Hospital-Acquired Acute Kidney Injury on Covid-19 Outcomes in Patients With and Without Chronic Kidney Disease: a Multicenter Retrospective Cohort Study(Tubitak Scientific & Technological Research Council Turkey, 2021) Ozturk, Savas; Turgutalp, Kenan; Arıcı, Mustafa; Çetinkaya, Hakkı; Altıparmak, Mehmet Rıza; Aydın, Zeki; Ateş, Kenan; Dolarslan, Mursıde Esra; Seyahi, Nurhan; Yıldız, Alaattın; Bora, FeyzaBackground/aim: Hospital-acquired acute kidney injury (HA-AKI) may commonly develop in Covid-19 patients and is expected to have higher mortality. There is little comparative data investigating the effect of HA-AKI on mortality of chronic kidney disease (CKD) patients and a control group of general population suffering from Covid-19. Materials and methods: HA-AKI development was assessed in a group of stage 3–5 CKD patients and control group without CKD among adult patients hospitalized for Covid-19. The role of AKI development on the outcome (in-hospital mortality and admission to the intensive care unit [ICU]) of patients with and without CKD was compared. Results: Among 621 hospitalized patients (age 60 [IQR: 47–73]), women: 44.1%), AKI developed in 32.5% of the patients, as stage 1 in 84.2%, stage 2 in 8.4%, and stage 3 in 7.4%. AKI developed in 48.0 % of CKD patients, whereas it developed in 17.6% of patients without CKD. CKD patients with HA-AKI had the highest mortality rate of 41.1% compared to 14.3% of patients with HA-AKI but no CKD (p < 0.001). However, patients with AKI+non-CKD had similar rates of ICU admission, mechanical ventilation, and death rate to patients with CKD without AKI. Adjusted mortality risks of the AKI+non-CKD group (HR: 9.0, 95% CI: 1.9–44.2) and AKI+CKD group (HR: 7.9, 95% CI: 1.9–33.3) were significantly higher than that of the non-AKI+non-CKD group. Conclusion: AKI frequently develops in hospitalized patients due to Covid-19 and is associated with high mortality. HA-AKI has worse outcomes whether it develops in patients with or without CKD, but the worst outcome was seen in AKI+CKD patients.Key words: Acute kidney injury, chronic kidney disease, Covid-19, hospitalization, mortalityArticle Citation - WoS: 16Citation - Scopus: 19The Triglyceride-Glucose Index Predicts Peripheral Artery Disease Complexity(Tubitak Scientific & Technological Research Council Turkey, 2020) Karaduman, Bilge Duran; Ayhan, Hüseyin; Keles, Telat; Bozkurt, Engin; Duran Karaduman, BilgeBackground/aim: High levels of triglyceride (TG) and fasting blood glucose (FBG) values increase atherosclerosis risk. This study\revaluates the relationship between peripheral artery disease (PAD) severity and complexity, as assessed by TransAtlantic InterSociety\rConsensus-II (TASC-II) classification and the triglyceride-glucose (TyG) index.\rMaterials and methods: A total of 71 consecutive patients with PAD (males 93%, mean age 63.3 ± 9.7), who underwent percutaneous\rperipheral intervention were included retrospectively. The patients were divided into two groups according to the angiographically\rdetected lesions. Those with TASC A-B lesions were included in Group 1, and those with TASC C-D lesions were included in Group 2.\rTyG index was calculated as formula: ln[fasting TG (mg/dL) × fasting plasma glucose (mg/dL)/2].\rResults: There were 40 patients in Group 1 (90.3% men, with a mean age of 63.6 ± 9.3 years) and 31 patients in Group 2 (96.8% men,\rwith a mean age of 62.0 ± 8.6 years). In the majority of patients in both groups, the target vessels are iliac arteries and femoral arteries.\rIn Group 2, platelet count and TyG index were significantly high, according to Group 1. The TyG index was significantly correlated with\rTASC-II, Rutherford category, HbA1c, and HDL-C.\rConclusion: In this present study, we showed that the TyG index was an independent predictor of peripheral artery disease complexity,\raccording to TASC-II classification, for the first time in the literature.Article Evaluation of Covid-19 Cases Who Received Immunosuppressive Therapy at a Tertiary Care Hospital(Doc design informatics Co Ltd, 2022) Sayar, Merve Sefa; Acar, Ali; Bulut, Dilek; Celik, Sebahattin; Oguz, EminObjective: Immunosuppressive drugs are included in the treatment protocols of severe COVID-19 cases that may present with cytokine storm. In this study, we aimed to examine the characteristics of COVID-19 patients who received immunosuppressive therapy Methods: Patients diagnosed with COVID-19 and followed in the quarantine wards of our hospital between 01.03.2020-24.05.2020 were included in the study. Patient information was obtained retrospectively from patient files and discharge reports, and 263 COVID-19 patients-aged 18 and over-were included in the study. Results: The median age of the patients who received immunosuppressive therapy was 60.74 +/- 1.96, and 39.6% of them were women. The average symptom duration of the patients examined in the study at the time of admission to the hospital was 4.59 +/- 0.29 days. There was a significant difference in age, lymphocyte count, neutrophil/lymphocyte ratio, C-reactive protein, ferritin, D-Dimer, blood oxygen saturation, fever after antiviral therapy, qSOFA score, and total hospital stay between the two groups that received and did not receive immunosuppressive therapy (p<0.05). The need for immunosuppressive therapy increased 15.9 times over the age of 40, 15.6 times in the presence of diffuse involvement on thoracic CT, 6.6 times in the presence of chronic disease, 2.7 times in the presence of thrombocytopenia, and 1.7 times in the presence of lymphopenia (p <0.05).Conclusions: We observed that patients whose immunosuppressive therapy was added to their treatment protocols were admitted to the hospital later than others, had more prevalent involvement in thorax CT, high acute phase reactants, low SPO2, and more than one underlying disease.
