Abstract: Because of chronic and progressive nature of disease congestive heart failure become standart therapies. Peritoneal dialysis (PD) has been reported as a long-term maintenance treatment of refracter congestive heart failure (RCHF).In this study, we aimed to evaluate the outcome of patients with RCHF, treated with PD in our center. Patients and methods: Twenty-four incident PD patients with RCHF and chronic kidney disease stage IV. The CAPD programme consisted of 2–3 exchanges daily and one exchange nightly. In follow-up period clinical and echocardiographic biochemical findings and requirement of hospitalization were recorded. Results: Fifteen patients (66.7%) were male and mean age was 62,75 years. The etiology of congestive heart failure were hypertensive cardiomyopathy (5), ischemic coronary artery disease (12), diabetes mellitus (6), dilated cardiomyopathy (1). Under the PD treatment the average daily urine volume and ultrafiltration of the patients were 800-1000 ml and 1000-15000 ml respectively. Ten patients were followed for 24 months, eight patients were followed for 12 months. During the follow up period, there were regression in class of heart failure of NYHA (class IV to class II in 18 patients) , decrease in the body weights and an increase of serum sodium levels in all patients. Only 2 patients were hospitalised for cardiovascular disase in 2 years. During the follow-up period, 1 patient was transferred to hemodialysis due to peritonitis. In conclusion; in patients with resistant congestive heart failure and non-dialysis chronic renal failure PD in addition to standard treatment, may be safe treatment choice.

OBJECTİVE: Kidney transplant recipients (KTRs) may have increased serum uric acid (SUA) level due to presence of existing greft dysfunction and used immunosuppressives. In this retrospective study, we evaluated effect of high SUA levels and allopurinol therapy in KTRs on renal functions. PATIENTS and METHODS: 113 KTRs of 233 KTRs included, had elevated SUA level (G1). Fiftyseven of G1 received allopurinol treatment (G1A+) and 56 patients (G1A-) did not. 56 of 118 patients who were followed for five years (G5) were hyperuricemic (G5-1) and 26 of G5-1 treated with allopurinol (G5-1A+) and 30 of them did not (G5-1A-). 62 patients were normourisemic (G5-2). RESULTS: Of the 233 patients included the mean age was 42.8±11.6 (17-76), 164 were male (70.0%). In 2. year graft loss developed in 9 (7.5 %) and 18 (15.9%) of G2 and G1 respectively (p = 0.045). According to allopurinol therapy 10 of the graft loss occurred in the G1A+ and 8 in the G1A- (p=0,330). Graft loss occurred in 12 (21%) and 9 (14%) in G5-1 and G5-2 respectively (p = 0.62). Graft loss occurred in 7 (23 %) and 5 (19%) in G5-1A+ and G5-1A- respectively P = 0.71). Considering the first 2 in G5; in G5-1 graft loss was higher than in the G5-2 (p = 0.023), and higher SUA levels increased the graft loss by 3.6 times compared to normal SUA levels (95% confidence interval: 1,2-12.70). CONCLUSION: There was a significant relationship between high SUA levels and graf loss in kidney transplant recipients in 2 years and 5 years. Treatment of high SUA with alIopurinol therapy had protective effect on renal functions. So that hyperuricemia should be treated and low dose allopurinol can be option for treatment of hyperuricemia therefore prevention of loss of kidney function in kidney transplant recipients.

BACKGROUND Primary glomerulonephritis (PGN) has a significant part in non-diabetic kidney disease (NDKD) in diabetes mellitus (DM) patients. In our study, we compared the clinical, demographic, and laboratory features of patients with biopsy-proven diabetic nephropathy (DN) and PGN with type 2 DM METHODS In our retrospective study, type 2 DM patients who underwent kidney biopsy between 2011-2019 were included. Demographic, clinical, and laboratory characteristics of DN and PGN patients were compared. RESULTS Seventy patients with a mean age of 55.7 ± 9.4 and 43 (61.4%) males were included. 38 (54.3%) of the patients had DN, and 32 (45.7%) had PGN. In the PGN, membranous GN (20, 62.5%) was most common. In DN patients, diabetes duration was longer; complications such as retinopathy, neuropathy, hypertension, coronary artery disease, heart failure were more frequent. At the time of renal biopsy, blood sugar, HbA1C, blood pressure, serum albumin, and proteinuria values were similar in 2 groups. The pathological damage findings of kidney biopsy in DN patients were more severe. In the first year after kidney biopsy decrease in eGFR was higher in DN patients, whereas eGFR did not change in PGN patients. CONCLUSION In a diabetic patient, fasting blood sugar, hbA1C, serum albumin, and proteinuria did not differ in the differential diagnosis of DN and PGN, whereas complications of DM (retinopathy, neuropathy, hypertension, coronary artery disease) were more characteristic in differentiation. Detection of PGN in a diabetic patient is crucial for the success of the treatment, according to DN.