OBJECTIVE: The aim of this study was to evaluate the impact of sodium-glucose cotransporter-2 inhibitors on haematological parameters and other clinical markers in this patient population. METHODS: We retrospectively analyzed the medical records of 150 diabetic patients with chronic kidney disease who initiated sodium-glucose cotransporter-2 inhibitor therapy, comparing their baseline and 3-month post-treatment laboratory and clinical data. RESULTS: Following 3 months of treatment with sodium-glucose cotransporter-2 inhibitors, mean haemoglobin and haematocrit levels significantly increased, even in patients with an estimated glomerular filtration rate below 60 mL/min/1.73 m2. This therapy also led to significant reductions in the spot urine albumin-to-creatinine ratio, as well as in both systolic and diastolic blood pressure. CONCLUSION: Sodium-glucose cotransporter-2 inhibitor therapy was associated with significant increases in haemoglobin and haematocrit levels in diabetic patients with chronic kidney disease. These findings suggest that sodium-glucose cotransporter-2 inhibitors may represent a potential area requiring further investigation for the treatment of anaemia associated with diabetic chronic kidney disease.

BACKGROUND:This study aimed to evaluate the impact of sarcopenia and frailty on the quality of life of older hemodialysis patients. METHODS:Seventy hemodialysis patients aged ⩾60 years were assessed. Daily living activities (Katz Index), depression (Yesavage Scale), frailty (Fried's Criteria), and sarcopenia (EWGSOP2) were evaluated. Quality of life was measured using the KDQOL-36 questionnaire. RESULTS:The median age was 67 years, and 50% were female. Nineteen patients (27.1%) were partially dependent, 71.4% were pre-frail, and 15.7% were frail. Probable sarcopenia was detected in 77.1%, and sarcopenia in 8.6% of patients. Sarcopenia was associated with older age, higher dependency, depression, lower income, and frailty (p < 0.05). It was also related to the KDQOL-36 physical component (p = 0.031), while frailty correlated with the symptom component (p = 0.047). CONCLUSION:Frailty and sarcopenia are common in older hemodialysis patients and adversely affect their quality of life.

Background: The present study sought to explore the association between nasal mucociliary clearance time (MCT) and the frequency of peritonitis among patients with chronic kidney disease (CKD) treated by peritoneal dialysis (PD). Methods: This cross-sectional study enrolled 24 patients with CKD treated by PD and 24 healthy volunteers. Nasal muco ciliary function was assessed using the saccharin transit time test. In this procedure, a saccharin particle with a 1 mm diameter was meticulously placed on the anteromedial surface of the inferior nasal concha. The 2 groups were compared based on their mean MCT. Within the patient group, the number of peritonitis cases in the last year was evaluated, and the correlation between MCT and the occurrence of peritonitis was analyzed. Results: The patient group consisted of 15 females and 9 males, with a mean age of 52.6 years. The control group included 14 females and 10 males, with a mean age of 47.5 years. The mean duration of PD among the followed cohort was 20 months, ranging from 3 to 190 months. The comparison of mean MCT between patients with a history of peritonitis and those with out peritonitis did not reveal a statistically significant difference (P = .333). However, the neutrophil-to-lymphocyte ratio was significantly elevated in the group exhibiting prolonged MCT (P = .046). Conclusion: Although this study found no statistically significant direct relationship between peritonitis incidence and MCT, the research aimed to evaluate MCT as a potential indicator of susceptibility to respiratory tract infections, which play a role in the development of peritonitis. Cite this article as: Doğan B, Ergül F, Basut R, et al. The relationship between mucociliary clearance time and peritonitis frequency in patients receiving peritoneal dialysis. Turk J Nephrol. 2026;35(1):67-71.

Aim: This study aimed to determine the frequency of irritable bowel syndrome (IBS) and associated factors, as well as the levels of depression and anxiety, in patients with chronic kidney disease (CKD) not receiving dialysis. It also aimed to explore potential measures to improve quality of life.Materials and Methods: Patients with stage III–V predialysis CKD were assessed for IBS based on the Rome IV criteria. Anxiety and depression levels were evaluated using the Hamilton Anxiety and Depression Rating Scales. Patients were divided into two groups based on the presence of IBS.Results: Among 154 patients, 33 (21.4%) had IBS and 121 (78.6%) did not. In the IBS group, 5 patients had no anxiety, 14 had mild, and 14 had major anxiety. In the non-IBS group, 44 had no anxiety, 52 had mild, and 25 had major anxiety. A significant difference in anxiety levels was observed between the two groups, but no significant difference was found in depression levels. Subgroup analysis also revealed a significant difference in anxiety. While no significant differences were found regarding the use of phosphate binders, calcium channel blockers, or beta-blockers, ACE inhibitor/ARB use was significantly higher in the IBS group.Conclusion: IBS was more frequent in predialysis CKD patients compared to the general population. Anxiety was more common in IBS patients, and ACEI/ARB use was associated with increased IBS frequency. IBS can begin before dialysis, so it should be considered when managing treatment in predialysis CKD patients.

Background: Klotho is an anti-ageing gene that extends lifespan when overexpressed and accelerates ageing when disrupted. In our study, we will investigate the correlations between plasma a-Klotho (a-KL) protein levels with body mass index (BMI), carotid intima media thickness (CIMT), total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), high-sensitivity C-reactive protein (hsCRP) and cholesterol values in obese patients. Methods: This study was conducted as a single-centre, cross-sectional study. Results: The study included 90 participants: 35 women (38.9%) and 55 men (61.1%). Of the participants included in the study, 30 were normal weight (33.3%) (Group 1), 30 were overweight (33.3%) (Group 2), and 30 were obese (33.3%) (Group 3). There were statistically significant dif-ferences in the a-KL protein (p=0.010), hsCRP (p<0.001), and homeostasis model assessment of insulin resistance (HOMA-IR) (p=0.022) between the study groups. There is no significant difference between the study groups for CIMT (p=0.380), TOS (p=0.613), TAS (p=0.056), or OSI (p=0.943). Conclusions: In this study, the overweight group had a-KL protein levels that were significantly higher than those in the obese group, whereas hsCRP levels were significantly higher in the obese group than in the overweight and normal weight groups. There were no significant differences in CIMT, TAS, TOS, and OSI values between the studygroups. There were no significant correlations between a-KL protein values and BMI, hsCRP, CIMT, TAS, TOS, or OSI in participants in the study.

Background The most common cause of end-stage kidney disease is diabetes mellitus (DM). The most commonly used renal replacement therapy in our country and in many countries around the world is hemodialysis (HD). Glycemia control is important in these populations. In this study, we aimed to screen for glycemic control and complications in a large population of diabetic HD patients in our country. Methods 16043 patients were screened in 253 dialysis centers in Turkey. 5038 diabetic HD patients were included in the study. At participating centers, patients' diabetes history, complications, medications, HbA1c and other laboratory data were reviewed and recorded by nephrologists. Results The average age of the patients was 64.0 ± 11.2 years and 56% were male. Mean HbA1c values were 7.4 ± 1.5. Patients were divided into 3 groups according to HbA1c value (<6.5, 6.5-8 and >8). As the HbA1c levels of the groups increase; the mean systolic blood pressure and diastolic blood pressure of the groups increased significantly. In addition, as the HbA1c levels of the groups increased, the frequency of patients with coronary artery disease, patients undergoing coronary artery bypass graft surgery and the rate of patients with diabetic retinopathy and vision loss increased. Diabetic foot disease and amputation rates were also higher in the group with poor glycemic control. The frequency of patients using intensive or mixed insulin was also higher in the group with high HbA1c levels. In ordinal logistic regression analysis; age significantly decreases, and higher body mass index slightly increases the risk of a higher HbA1c. Besides, the need to take a diabetic diet was higher in those with high HbA1c levels. Conclusion Our study highlights that the target values ​​for diabetic hemodialysis patients in our country are partially compatible with the KDIGO DM 2022 guidelines. Nevertheless, more efforts and teamwork are needed to improve patient outcomes.

PURPOSE:Chronic kidney disease (CKD) poses a significant public health challenge, severely affecting patients' quality of life. The Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines recommend discussing renal replacement therapy options when patients reach CKD stage 4. Arteriovenous fistula (AVF) creation is considered the gold standard for vascular access in hemodialysis. This retrospective study aims to evaluate whether any changes in kidney function occur during the follow-up period after AVF creation in patients with end-stage kidney disease (ESKD). METHODS:We analyzed data from 60 CKD patients who underwent AVF creation and were monitored in our nephrology outpatient clinics. Seventeen patients who consistently attended follow-up visits were included for detailed analysis. We performed a retrospective review of laboratory and medical records from 6 months before and 6 months following AVF creation. RESULTS:The cohort comprised 41.2% males, with a mean age of 62.4 years. The predominant underlying conditions were diabetes mellitus (58.8%), hypertension (29.4%), and polycystic kidney disease (11.8%). Statistical analysis of laboratory values before and after AVF creation (at 1, 3, and 6 months) revealed a significant decline in estimated glomerular filtration rate (eGFR) before AVF placement, followed by stabilization in the subsequent 6 months. CONCLUSION:The rate of eGFR decline was significantly reduced in CKD patients with AVF. This may be attributed to increased awareness of impending hemodialysis, leading to better dietary adherence and treatment compliance.

Background:The most common cause of end-stage kidney disease is diabetes mellitus (DM). The most commonly used renal replacement therapy in Turkey and in many countries around the world is haemodialysis (HD). Glycaemia control is important in these populations. In this study we aimed to screen for glycaemic control and complications in a large population of diabetic HD patients in Turkey. Methods:A total of 16 043 patients were screened in 253 dialysis centres in Turkey and 5038 diabetic HD patients were included in the study. At participating centres, patients' diabetes history, complications, medications, haemoglobin A1c (HbA1c) and other laboratory data were reviewed and recorded by nephrologists. Results:The average age of the patients was 64.0 ± 11.2 years and 56% were male. The mean HbA1c was 7.4 ± 1.5%. Patients were divided into three groups according to the HbA1c level (<6.5%, 6.5-8% and >8%). As the HbA1c levels increased, the mean systolic blood pressure and diastolic blood pressure increased significantly. In addition, as the HbA1c levels increased, the number of patients with coronary artery disease, patients undergoing coronary artery bypass graft surgery and the rate of patients with diabetic retinopathy and vision loss increased. Diabetic foot disease and amputation rates were also higher in the group with poor glycaemic control. The number of patients using intensive or mixed insulin was also higher in the group with high HbA1c levels. In ordinal logistic regression analysis, age significantly decreased and higher body mass index slightly increased the risk of a higher HbA1c. Also, the need for a diabetic diet was greater in those with high HbA1c levels. Conclusion:Our study highlights that the target values for diabetic HD patients in Turkey are partially compatible with the 2022 Kidney Disease: Improving Global Outcomes guidelines for diabetes management. Nevertheless, more effort and teamwork are needed to improve patient outcomes.

Background: We aimed to reveal the frequency, prognosis and factors affecting the prognosis of coronavirus disease 2019 (COVID-19) in hemodialysis patients. Methods: The frequency, symptoms (fever, throat ache, cough, weakness and diarrhea), laboratory findings (lymphocyte count and ratio, ferritin, c-reactive protein, d-dimer and fibrinogen), duration of hemodialysis, hemodialysis adequacy (determined by KtV Ure) and factors affecting patients who recovered or died of COVID-19 infection in chronic hemodialysis patients (n=730) in 5 different centers were investigated. Results: COVID-19 infection occurred in 141 of 730 patients in the 13-month period (19.3%), and twenty-nine died (20.5%). While the mean age of those who died was higher than those who recovered, the duration of hemodialysis treatment, gender distribution, and mean Kt/V were not different. The number of comorbidities was higher in patients who died than in those who recovered. Additional diseases such as type 2 diabetes mellitus, coronary artery disease, and heart failure were found at a higher rate in patients who died. Conclusion: Mortality rates in hemodialysis patients were found to be higher than in the general population, and similar to the general population, death was more common in patients with higher comorbidity and cardiovascular disease compared to patients who recovered. Since cardiovascular diseases are common in chronic hemodialysis patients, death from COVID-19 may be higher.

BACKGROUND:This study sought to investigate the effects of polycystic kidney disease and tolvaptan administration on mucociliary clearance. METHODS:The cross-sectional study enrolled 30 patients with autosomal dominant polycystic kidney disease undergoing tolvaptan therapy, 30 patients with autosomal dominant polycystic kidney disease not on tolvaptan, and 30 healthy volunteers. Nasal mucociliary clearance time was determined using the saccharin transit time test, with a 1 mm diameter saccharin particle carefully placed on the anteromedial surface of the inferior nasal concha. Comparisons of mucociliary clearance time were then performed between the groups. RESULTS:In our study, the average mucociliary clearance time for patients with polycystic kidney disease was determined to be 9, in contrast to an average of 11 in the control group. A comparative analysis of patients receiving tolvaptan and those not receiving tolvaptan revealed an identical average mucociliary clearance time of 9 for both cohorts (p = 0.706). Furthermore, patients treated with tolvaptan demonstrated an average urine specific gravity of 1004, significantly lower than the 1011 observed in the non-tolvaptan group (p = 0.001). CONCLUSION:This study indicates that the administration of tolvaptan yielded a beneficial impact on hydration status; however, this improved hydration did not translate into a significant effect on mucociliary clearance. Furthermore, the mucociliary clearance times recorded in the patient group were found to be in alignment with those typically associated with chronic kidney disease cohorts.

Background: Bleeding and thrombotic occlusion are complications of Central venous catheters. When selecting a catheter lock solution, factors such as bleeding, thrombotic occlusion, infection, and cost-effectiveness must be considered. Methods: The study included 35 patients who used heparin as a locking solution and 35 patients who used 0.9% saline, retrospectively. In our center, after injecting the solution equal to the catheter lumen volume from the syringe, approximately 1 cc of locking solution is left in the syringe, the catheter is locked and the syringe is removed from the catheter after locking. Intergroup complications were observed. Results: No significant difference was observed between the groups concerning the catheter insertion site ( p = 0.143 and 0.143). Additionally, no significant differences were found between the groups in terms of thrombosis and bleeding complications ( p = 0.314 and 0.239, respectively). Conclusion: Our study concluded that heparin locking is not superior to normal saline locking in terms of catheter dysfunction. We aimed to emphasize that the technique of catheter locking is more important than the type of lock solution used.

Objective: This study aimed to investigate the longitudinal relationship between pulse wave velocity (PWV), a measure of arterial stiffness, and estimated glomerular filtration rate (eGFR), an indicator of renal function, in patients with chronic kidney disease (CKD).Methods: A total of 55 CKD patients (Stage 3–5), not on renal replacement therapy, were prospectively followed for approximately four years. PWV and eGFR were measured at baseline and at the end of follow-up. Patients were divided into two groups based on eGFR progression: stable and progressive decline. Demographic, clinical, and laboratory data were collected. The association between changes in PWV (ΔPWV) and eGFR (ΔeGFR) was analyzed.Results: No significant correlation was found between changes in PWV and changes in eGFR (P>.05). While there was a significant decline in eGFR in the progressive group compared to the stable group (P=.001), ΔPWV did not significantly differ between the groups. Variables such as age, blood pressure, and baseline PWV were not significantly different between groups. Parathormone and phosphorus levels were higher, and hemoglobin and albumin levels were lower in patients with eGFR progression.Conclusion: Over a four-year follow-up, changes in arterial stiffness (PWV) were not significantly associated with changes in renal function (eGFR) among CKD patients. The lack of correlation suggests that separate pathophysiological mechanisms may govern vascular stiffness and kidney function deterioration. Further studies, including molecular-level analyses, are required to clarify these complex interactions.

AIM:This study investigated inflammatory markers involved in the pathogenesis of atherosclerosis in patients with Chronic Kidney Disease (CKD) undergoing maintenance hemodialysis (HD). METHODS:This cross-sectional study included 144 patients with CKD (65 females, 79 males) undergoing maintenance HD and 23 healthy controls (12 females, 11 males). Serum concentrations of Transforming Growth Factor-β (TGF-β), C-reactive protein (CRP), Neutrophil-to-Lymphocyte Ratio (NLR), and Platelet-to-Lymphocyte Ratio (PLR) were determined. Group comparisons were performed, and associations were examined using crude and multivariable-adjusted logistic regression models. RESULTS:TGF-β, NLR, and PLR levels were significantly higher in HD patients than in controls (p < 0.001, p < 0.001, and p = 0.041, respectively), along with elevated CRP (p < 0.001). ROC analysis showed good diagnostic performance for TGF-β (AUC 0.812) and NLR (AUC 0.863), but weaker for PLR (AUC 0.633). In the crude logistic regression analysis, all three markers demonstrated significant associations with end-stage renal disease (ESRD). After adjustment for age, sex, hypertension, cardiovascular disease (CVD), malignancy, and inflammatory diseases, TGF-β remained significantly associated with ESRD (OR: 1.026; 95% CI: 1.003-1.050; p = 0.027). Similarly, after adjustment for age, sex, hypertension, CVD, diabetes mellitus (DM), malignancy, and inflammatory diseases, NLR was independently associated with ESRD (OR: 8.196; 95% CI: 1.554-43.227; p = 0.013). Finally, following adjustment for age, sex, hypertension, CVD, DM, and malignancy, PLR also showed a significant association with ESRD (OR: 1.019; 95% CI: 1.002-1.037; p = 0.033). CONCLUSION:Inflammatory markers, including TGF-β, NLR, and PLR, are significantly elevated in patients with CKD receiving maintenance HD compared with healthy individuals. These markers are associated with HD even after adjusting for significant covariates.

The most common cause of rhabdomyolysis is trauma. In the presence of rhabdomyolysis attacks triggered by heavy exercise and fever, hereditary causes should be investigated. In our study, a case was presented that developed rhabdomyolysis and acute kidney injury due to carnitine palmitoyltransferase 2 (CPT2) deficiency and then required hemodialysis treatment. We wanted to draw attention to hereditary rhabdomyolysis in this case. A 25-year-old male patient was hospitalized with pneumonia and acute kidney injury. On examination, muscle enzymes, creatinine, and potassium levels were high. The patient, who was evaluated as having rhabdomyolysis and acute kidney injury, underwent three sessions of hemodialysis treatment due to the indication for renal replacement therapy. He had a history of rhabdomyolysis and acute kidney injury 5 years ago. The only trigger for both attacks was febrile infection. There was a history of acute kidney injury in two of his siblings in family history. In the gene analysis requested due to suspicion of hereditary causes, homozygous mutation was detected in CPT2 whole gene sequence analysis. Medium-chain triglycerides, low-fat diet, and L-carnitine capsules were given for treatment. Carnitine palmitoyltransferase 2 deficiency is the most common form of muscle fatty acid metabolism disorder. The phenotype of the patients can vary from severe infantile form to milder muscle form characterized by rhabdomyolysis. Cases requiring hemodialysis are very rare, so we wanted to present this case. Detection of hereditary rhabdomyolysis is important for preventing new attacks and preventive treatments.

Introduction: Different data systems have been used to reach a common decision in the interpretation of chest computed tomography (CT) scans for the detection of COVID-19 infection. The aim of our study was to determine the usefulness of the COVID-19 Reporting and Data System (CO-RADS) for COVID-19 in patients undergoing hemodialysis. Methods: We included 90 hemodialysis patients who underwent chest CT and had samples available for real-time reverse transcription-polymerase chain reaction (RT-PCR). The files of the patients were retrospectively reviewed and the data were recorded. Image interpretation and CO-RADS staging were performed retrospectively by two radiologists experienced in COVID-19 patients, blinded to the RT-PCR results. The RT-PCR results were then compared with the CO-RADS stages obtained. The success of CO-RADS in diagnosing COVID-19 was evaluated according to its prediction of a positive RT-PCR result. At the same time, the relationship between CO-RADS stages and prognosis was also evaluated. Results: Patients were divided into two groups according to the RT-PCR results, of which 38 (42.2%) had positive results. Validity tests of CO-RADS were performed according to the RT-PCR test. While 71.1% of patients with CO-RADS >= 4 were RT-PCR (+), 13.2% of patients with CO-RADS <= 2 were RT-PCR (+) (p < 0.001). CO-RADS >= 4 detected COVID-19 with 71.1% sensitivity and 51.9% specificity. ROC analysis confirmed the diagnostic performance of CO-RADS for predicting RT-PCR positivity with AUC = 0.73 (95% CI: 0.63-0.84). The relationship between CO-RADS stages and mortality was not significant (p = 0.21). Conclusion: CO-RADS is moderately sensitive and poorly specific for the diagnosis of COVID-19 in hemodialysis patients. In these patients, CO-RADS would be more useful to exclude other infections than to diagnose COVID-19.

Context:Inflammation-related markers may predict cardiovascular diseases. Objective:In this study, it was aimed to assess pentraxin-3 (PTX-3) levels and its relationship with carotid intima-media thickness (CIMT) and high-sensitive C-reactive protein (hsCRP) in patients with subclinical hypothyroidism. Design:Prospective cross-sectional study. Methods:This study included 60 patients (aged 30-60 years) with subclinical hypothyroidism and 30 healthy volunteers as controls. The demographic characteristics and anthropometric measurements were performed in all patients and controls. In addition, sonographic carotid artery examination, thyroid functional tests, lipid profile, hsCRP, and PTX-3 levels of the participants were investigated. Results:The PTX-3, hsCRP levels and CIMT were higher in patients with subclinical hypothyroidism when compared to controls (p=0.008, p=0.001, p<0.001, respectively). The PTX-3 level was strongly correlated with hsCRP (r=0.865; p<0.001), but no such correlation was detected with CIMT (r=-0.255; p=0.50). In binominal logistic regression analysis, it was found that CIMT and serum uric acid levels were independent parameters associated with subclinical hypothyroidism. In ROC analysis, a cut-off value of >3.75 ng/mL for serum PTX-3 level predicted subclinical hypothyroidism with a sensitivity of 60% and specificity of 60.7% (AUC: 0.672, p=0.004). Conclusion:Showing inflammation and endothelial dysfunction, the PTX-3 may be a helpful marker in patients with subclinical hypothyroidism associated with increased risk for cardiovascular disease.

Aims: In chronic kidney disease (CKD), chronic systemic inflammation contributes to premature ageing and morbidity; it is a predictor of overall mortality. In this study, we aimed to investigate prognostic value of inflamatory markers including systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) for mortality outcomes in hemodialysis patients. Methods: In this retrospective study, CKD patients on maintenance hemodialysis between January 1, 2020 and January 31, 2020 were included. SII, PIV, NLR, PLR values of the patients were calculated. SII was calculated by (neutrophil count x platelet count)/lymphocyte count; PIV was calculated by (neutrophil count x platelet count x monocyte count)/lymphocyte count. Mortality rate of the study population during approximately 38-month follow-up period was calculated. The relationships of inflamatory markers and other variables with mortality were analysed. Results: Of 162 patients, 53.1% were male and 46.9% were female (mean age: 61.6±13.5). During 38-month follow-up period, a total of 60 patients (37%) died. Compared with surviving group, NLR values, mean age and the rate of diabetes mellitus (DM) and coronary artery disease (CAD) comorbidities were higher (p=0.012, p

Recent years have witnessed a growing trend in the use of complementary and alternative herbal products. However, the ingestion of some herbal products may cause a wide spectrum of adverse effects. We report a case of multiorgan toxicity following the ingestion of mixed herbal tea. A 41-year-old woman presented to the nephrology clinic with complaints of nausea, vomiting, vaginal bleeding, and anuria. She had consumed a glass of mixed herbal tea three times a day after meals for three days, to lose weight. Initial clinical and laboratory findings showed serious multiorgan toxicity including hepatotoxicity, bone marrow toxicity, and nephrotoxicity. Although herbal preparations are marketed as natural products, they may cause various toxic effects. There should more efforts to raise public awareness about the possible toxic effects of herbal preparations. Clinicians should consider the ingestion of herbal remedies as an etiology when encountering patients with unexplained organ dysfunctions.

Abstract Objective It was aimed to compare visceral adiposity index (VAI) levels in patients with normal bone mineral density (BMD), osteopenia, and osteoporosis. Methods One hundred twenty postmenopausal women (40 with normal BMD, 40 with osteopenia, and 40 with osteoporosis) between the ages of 50 to 70 years were included in the study. For females, the VAI was calculated using the formula (waist circumference [WC]/[36.58 + (1.89 x body mass index (BMI))]) x (1.52/High-density lipoprotein [HDL]-cholesterol [mmol/L]) x (triglyceride [TG]/0.81 [mmol/L]). Results The time of menopause from the beginning was similar in all groups. Waist circumference was found to be higher in those with normal BMD than in the osteopenic and osteoporotic groups (p = 0.018 and p < 0.001, respectively), and it was also higher in the osteopenic group than in the osteoporotic group (p = 0.003). Height and body weight, BMI, blood pressure, insulin, glucose, HDL-cholesterol, and homeostasis model assessment-insulin resistance (HOMA-IR) levels were similar in all groups. Triglyceride levels were found to be higher in the normal BMD group, compared with the osteoporotic group (p = 0.005). The level of VAI was detected as higher in those with normal BMD, compared with the women with osteoporosis (p = 0.002). Additionally, the correlation analysis showed a positive correlation between dual-energy X-ray absorptiometry (DXA) spine T-scores, WC, VAI, and a negative correlation between DXA spine T-scores and age. Conclusion In our study, we found higher VAI levels in those with normal BMD, compared with women with osteoporosis. We consider that further studies with a larger sample size will be beneficial in elucidating the entity.

Introduction The anti-aging protein Klotho levels are decreased, and Klotho deficiency is associated with cardiovascular diseases in patients with chronic kidney disease. There are recent studies about the relation between soluble Klotho levels and anemia. We aimed to investigate the correlation of anemia and hemoglobin variability with soluble Klotho levels in hemodialysis patients. Methods Ninety-one hemodialysis patients were included in this study. The mean hemoglobin value, hemoglobin variability, and coefficient of variation of hemoglobin for each patient were calculated. According to mean hemoglobin levels, two groups were defined as under 11 and >= 11 g/dl. Soluble Klotho levels of each patient were studied. Results Mean hemoglobin levels, hemoglobin variability, and coefficient of variation of hemoglobin were not significantly correlated with soluble Klotho levels. According to mean hemoglobin levels under 11 and >= 11 g/dl, there was no statistically significant correlation between anemia and soluble Klotho levels. Conclusion Soluble Klotho levels were not associated with anemia and hemoglobin variability in hemodialysis patients. Further studies are needed to reveal the complicated relation between anemia and soluble Klotho levels.