Patients on maintenance hemodialysis (HD) have a high prevalence of heart failure and coronary artery disease, which are the main causes of morbidity and mortality. Early detection of abnormalities in cardiac structure and function may be critical for timely and appropriate cardiac interventions. The newly-developed three dimensional speckle tracking echocardiography (3DSTE) has the potential to assess the movements of ventricular segments in three spatial directions simultaneously.
Crescentic glomerulonephritis (GN) is a group of the disease spectrum characterized by the presence of glomerular crescent formation as the principal histologic finding. We aimed to investigate the etiologic distribution and clinicopathologic features of the patients with biopsy-proven crescentic GN in the last 13 years in our center according to different percentages of crescents.
Thrombophilia has been implicated in the development of avascular necrosis (AVN) in various diseases. We aimed to search for the relation of both prothrombin gene G20210A mutation and factor V G1691A (factor V Leiden) mutation with AVN among kidney transplant recipients.Nineteen patients with AVN and 38 control patients without AVN were included. Clinical information was collected, and gender, age, type of renal allograft, duration and type of dialysis, presence of acute rejection, and cumulative doses of ciclosporin and corticosteroid administration were taken into consideration. Genotypes of factor V G1691A and prothrombin G20210A were determined by direct sequencing of genomic DNA.Factor V Leiden mutation was detected in six patients (31.6%) among patients with AVN and in only three patients (7.9%) in the control group (P = 0.048). Two patients (10.5%) in the AVN group were determined to have prothrombin G20210A mutation, while no prothrombin G20210A mutation was detected in the control group. When both of the mutations causing thrombophilia were considered, a total of eight patients (42.1%) in the AVN group and three patients (7.9%) in the control group were identified (P = 0.004).Thrombophilia seems to be an important risk factor for development of AVN. More studies are needed to clarify the role of factor V G1691A and prothrombin G20210A mutation for AVN.