OBJECTIVE: Vascular calcifications and chronic inflammation are the main reasons of the decreased life span and prevalent morbidity for patients on renal replacement therapy due to chronic renal failure. Scoring systems used to determine the chance of cardiovascular (CV) risk and traditional CV risk factors frequently fail to identify the risk in these patients. New markers to predict the risk of CV disease continues to be investigated. One of the most studied marker in recent years is a serum glycoprotein fetuin-A, which is major calcification inhibitor. We aimed to study the relation between fetuin-A subclinical inflammation and cardiovascular risk factors in Peritoneal Dialysis (PD) patients and healthy volunteers.MATERIAL and METHODS: Forty-eight PD patients and 27 healthy volunteers were included in the study. Fetuin-A levels, body weight, body mass index, blood pressure, markers of inflammation (sedimentation, C-reactive protein, ferritin) and lipid profile tests were performed. The relationship between these parameters was compared with fetuin-A.RESULTS : CRP and sedimentation levels were significantly higher in the group of PD patients. Fetuin-A levels were significantly lower in PD patients than the control group. There was a negative correlation between serum fetuin-A levels, average arterial blood pressure and CRP.CONCLUSION: Fetuin-A can be used to predict subclinic inflammation, and cardiovascular mortality risk in PD patients.

Hypokalemic periodic paralysis (HPP) is a rare disease characterized by reversible attacks of muscle weakness due to hypokalemia. The attacks may occur everyday, weak, month or once a year and may last for a few hours to several days. The serum potassium level is low during the attack. However, the serum potassium levels are normal between two attacks. The most common causes of HPP are familial periodic paralysis (FPP), thyrotoxic periodic paralysis (TPP) and sporadic periodic paralysis (SPP). We report, hypokalemic periodic paralysis due to use of corticosteroid.

A 64-year-old woman with end-stage renal disease secondary to hypertension undergoing haemodialysis for 2 years was admitted with a history of fever, pain and swollen left foot lasting for 1 year. Clinical examination demonstrated localized erythema, warmness and swelling (Figure ​(Figure1).1). The erythrocyte sedimentation rate was 122 mm/h and C-reactive protein was 12.6 mg/dL (normal <0.5 mg/dL). The tuberculin skin test revealed 26 mm enduration with bullous oedema. Thoracic computed tomography indicated only calcified lymph nodes in the left hilar region. Magnetic resonance imaging showed destruction in the navicular bone and widespread oedema in the adjacent bones and fluid collection (Figure ​(Figure2).2). After surgical intervention, a diagnosis of tuberculosis (TB) was established with the histopathological examination of the tissue. Growth of mycobacterium tuberculosis complex was found in the culture obtained at the time of bone debridement. However, she was lost to follow-up without anti-TB treatment. After 10 months, she presented with fever, swelling and drainage in the left inguinal region. Ultrasonographic examination revealed enlarged inguinal lymph nodes. The diagnosis of TB lymphadenitis was made by demonstrating positive acid-fast bacilli in the drainage fluid. She was cured with standard anti-TB drugs for 9 months. Fig. 1 Swollen left foot in the lateral position. Fig. 2 The MRI of the patient showed a diffuse low-intensity signal on T1-weighted sagittal image in the left navicular bone. TB osteomyelitis is one of the unusual manifestations of osteoarticular TB and comprises 2–3% of all cases [1]. Due to nonspecific presentation, symptoms together with frequent extrapulmonary localization, this rare condition is often misdiagnosed or the true nature of the lesion is identified late in the diagnostic process as in our case.

Angiotensin donusturucu enzim inhibitorleri ve kalsiyum kanal blokerleri hipertansiyon tedavisinde en yaygin kullanilan ilaclardir. Son yillarda her iki ilac grubu kombine edilerek kullanilmaktadir. Bu calismada primer hipertansiyonlu hastalarda trandolapril ve trandolapril + verapamil kombinasyonunun antihipertansif ve antiproteinurik etkinlikleri karsilastirildi. Calismaya 29 hipertansif hasta alindi. Hafif veya orta derecede hipertansif olup onceden herhangi bir antihipertansif tedavi kullanmayan olgular secildi. Olgular rastgele iki gruba ayrildilar. Birinci grupta 15 hasta 2 mg/gun trandolapril, 2. grupta 14 hasta 2 mg/gun trandolapril + 180 mg/gun verapamil kombinasyonunu 3 ay sureyle aldilar. Hastalarin tedavi oncesi ve sonrasi kan basinclari, renal fonksiyonlari, gunluk protein atilimlari ve kreatinin klirensleri degerlendirildi. Her iki grupta da kan basinclari anlamli olarak dustu. Ancak degerlendirilen diger parametrelerde tedavi sonrasi anlamli bir degisiklik gozlenmedi. Ayrica her iki grubun tedavi oncesi ve sonrasi degerleri arasinda anlamli bir fark yoktu. Sonuc olarak her iki tedavi protokolunun kisa donemde idrar protein atilimini etkilemedigi kanaatine varildi.