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    Biopsy-proven BK virus nephropathy in renal transplant recipients: A multi-central study from Turkey (BK-TURK STUDY)
    (Dustri-Verlag Dr Karl Feistle, 2024) Gungor, Ozkan; Dheir, Hamad; Islam, Mahmud; Toz, Huseyin; Yildiz, Abdulmecit; Sinangil, Ayse; Tatar, Erhan
    Aim: BK polyomavirus infection is a challenging complication of renal transplantation. The management is not standardized and is based on reports from transplantation centers' experiences, usually with small sample sizes. Therefore, we aimed to present our countrywide experience with BK virus nephropathy (BKVN) in renal transplant recipients. Materials and methods: Our study was carried out with the participation of 30 transplantation centers from all regions of Turkey. Only cases with allograft biopsy-proven BKVN were included in the study. Results: 13,857 patients from 30 transplantation centers were screened, and 207 BK nephropathy cases were included. The mean age was 46.4 +/- 13.1 years, and 146 (70.5%) patients were male. The mean time to diagnosis of BK nephropathy was 15.8 +/- 22.2 months after transplantation. At diagnosis, the mean creatinine level was 1.8 +/- 0.7 mg/dL, and the mean estimated glomerular filtration rate was 45.8 +/- 19.6 mL/min/1.73m2. 2 . In addition to dose reduction or discontinuation of immunosuppressive drugs, 18 patients were treated with cidofovir, 11 patients with leflunomide, 17 patients with quinolones, 15 patients with intravenous immunoglobulin (IVIG), 5 patients with cidofovir plus IVIG, and 12 patients with leflunomide plus IVIG. None of the patients receiving leflunomide or leflunomide plus IVIG had allograft loss. During follow-up, allograft loss occurred in 32 (15%) out of 207 patients with BK nephropathy. Conclusion: BKVN is still a frequent cause of allograft loss in kidney transplantation and is not fully elucidated. The results of our study suggest that leflunomide treatment is associated with more favorable allograft outcomes.
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    Pregnancy and its outcomes in hemodialysis patients in Turkey
    (2022) Dheır, Hamad; Güngör, Özkan; Ulu, Memnune Sena; Oguz, Ebru Gok; Eren, Necmi; Altunören, Orçun; Tatar, Erhan
    Background/aim: This study aimed to investigate pregnancy frequency and evaluate the factors affecting live births in hemodialysis\r(HD) patients. \rMaterials and methods: Female HD patients whose pregnancy was retrospectively reported between January 1, 2014, and December 31, 2019. The duration of HD, primary disease, and the information on whether the pregnancy resulted in abortion, stillbirth, or live birth, whether the HD duration was prolonged after diagnosing the pregnancy and whether it accompanied preeclampsia were recorded.\rResults: In this study, we reached 9038 HD female patients’ data in the study. A total of 235 pregnancies were detected in 145 patients.\rThe mean age was 35.42 (35 ± 7.4) years. The mean age at first gestation was 30.8 ± 6.5 years. The average birth week was 32 (28 –36) weeks. A total of 53.8% (no = 78) of the patients had live birth, 51.7% (no = 70) had at least one abortion in the first 20 weeks, and 13.1% (no = 19) had at least one stillbirth after 20 weeks. The rate of patients’ increased numbers of dialysis sessions during pregnancy was 71.7%. The abortion rate was 22.4% in those with increased HD sessions, whereas 79.3% in those not increased HD sessions (p < 0.001).\rLive birth frequency was 67.2% in the increased HD sessions group and 3.4% in those who did not differ in HD sessions (p < 0.001).\rConclusion: For the first time, we reported pregnancy outcomes in HD female patients, covering all regions of Turkey. It has been observed that; increasing the number of HD sessions in dialysis patients will decrease fetal and maternal complications and increase live birth rates.