Kidney disease is a common complication of monoclonal gammopathies including multiple myeloma. Patients with multiple myeloma and other monoclonal gammopathies can present with a variety of kidney manifestations that depend upon the pathological monoclonal proteins involved and the compartments of the kidney that are targeted. The most common clinical findings include acute or subacute kidney injury, chronic kidney disease (CKD), albuminuria or nephrotic syndrome, and electrolyte abnormalities. The spectrum of kidney impairment ranges from mild to severe acute kidney injury (AKI) requiring hemodialysis. Most patients presenting with AKI have light chain cast nephropathy. A 58-year-old female patient was referred to our clinic due to proteinuria. We aimed to represent a light chain cast nephropathy patient presenting with asymptomatic, non-nephrotic range proteinuria and who were eventually treated with autologous stem cell transplantation. Light chain cast nephropathy should be kept in mind at the differential diagnosis of patients presenting with asymptomatic non-nephrotic range proteinuria, especially who were treated with anti-proteinuric medications. Kidney biopsy should not be deferred during the diagnostic process.

Type 2 diabetes mellitus is a growing public health problem worldwide. It has a close relation with metabolic problems like obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular diseases. There are different antidiabetic agents being used in the treatment of diabetes mellitus with different mechanisms of action and a patient-centered approach is required when choosing the appropriate treatment option. Sodium-glucose cotransporter (SGLT) 2 inhibitors also called glucoretics or gliflozins are members of a relatively new group of antidiabetic agents with promising cardioprotective and renoprotective effects beyond their glucose-lowering efficacies.

Fabry disease, also known as Anderson-Fabry disease, is a X-linked lysosomal storage disease. Alpha-galactosidase A (alpha-Gal A) enzyme deficiency leads globotriaosylceramide (Gb3) accumulation in several cells which causes clinical manifestations of the disease. The clinical heterogeneity and non-specific symptoms cause under-diagnosis and diagnosis delay. There are several clinical variants of FD which are associated with genetic and residual enzyme activity and listed as the classical, atypical (later-onset), renal and cardiac variants. Renal, cardiovascular and neurovascular involvement are the main causes of morbidity and mortality. Patients with acroparesthesias, episodic pain crises, proteinuria, chronic kidney disease, ventricular hypertrophy and cerebrovascular evets of unknown etiology should be screened for Fabry disease. Early initiation of enzyme replacement treatment improves the quality of life and prognosis. Therefore it is essential to have awareness and knowledge about Fabry disease. Herein we aimed to summarize Fabry disease and point out that a Fabry patient might have visited you at your outpatient clinic.

Introduction. Granulocyte colony-stimulating factor (G-CSF) therapy is commonly used in kidney and liver transplant recipients with severe neutropenia. However, rapid and high increases in neutrophil counts of some patients may occur during treatment. This retrospective study aimed to determine the efficacy and safety of G-CSF treatment in neutropenic kidney transplant recipients. Methods. Eight kidney transplant recipients treated with G-CSF for drug-induced neutropenia (neutrophil count <1000 cells/µL) were included in the study. Daily renal function tests, leukocyte (WBC) and absolute neutrophil counts were measured. Results. The median duration of G-CSF treatment was 4 days (2-5). The median WBC and neutrophil count elevated from 1130 and 565 cells/µL to 4400 and 1950 cells/µL after treatment, respectively (p=0.012). The median peak WBC and neutrophil counts during treatment were 18,045 and 16,445 cells/µL, respectively. The WBC counts returned to normal limits after a median of 22 days from the maximum value. No acute rejection was observed within three months of discontinuation of treatment. Conclusions. G-CSF may be a useful therapeutic alternative for kidney recipients with severe neutropenia. It seems reasonable to withdraw G-CSF treatment when WBC and neutrophil counts reach certain cut-off values during treatment.

Aim: Uric acid levels increase in chronic renal failure especially due to protein metabolism. In this study, we aimed to compare uric acid clearance who are also nephrotoxic in patients with end-stage renal disease. Methods: Sixty-one chronic peritoneal dialysis (PD) patients and fifty-one chronic hemodialysis (HD) patients included in the study. Duration of PD and HD, uric acid levels, age and gender of the patients evaluated. Uric acid levels in PD patients and HD patients compared. Results: The mean ages of PD and HD patients were 56.77 ±13.58 and 57.25 ± 16.45 years, respectively (p=0.864). The number of male patients was more in the PD group and female in the HD group (p=0.959). The duration of dialysis was 3.25 in PD, 3.75 in HD (p=0.925). The mean uric acid levels were 5.54 ± 1.13 mg/dL in PD patients, and 5.76 ±1.52 mg/dL in HD patients (p=0.389). Conclusion: Dialysis is used to remove toxins in end-stage renal disease. Uric acid levels may be elevated in patients with end-stage renal disease. There is no difference in uric acid clearance in PD and HD patients.

Background Fluorine 18-fluorodeoxyglucose (FDG) positron emission tomography (PET) is a well-accepted examination for diagnosis, staging, and monitoring in clinical oncology.1 According to the higher glucose metabolism rate, malignant tumor cells have higher FDG uptake, besides higher FDG uptake is strictly correlated with poor prognosis in various types of cancer.2 However, FDG-PET has limitations associated with some of the cancer types that have low FDG uptake, even high metabolism.3 Low cellularity, low glucose metabolism, inadequate patient preparation, small-sized tumor, and cellular mucin might be cause to low FDG uptake.4 Low FDG uptake frequently presented in lepidic growth adenocarcinoma (formerly defined as bronchoalveolar adenocarcinoma), renal cell cancer, and mucinous neoplasms. Case Report We report on a case of 57-year-old female biopsy proven Signet Ring Cell Carcinoma (SRCC) patient without FDG-PET uptake in the evaluation for staging. The patient admitted to hospital with massive ascites and dyspeptic complaints. Further evaluation revealed the existence of SRCC with no FDG-PET uptake. Conclusion FDG-PET reveals valuably findings in clinical oncology for diagnosis, staging, and monitoring. Although FDG-PET uptake is correlated with most of the malignant tumors’ activity, some aggressive malignancies may have no/low FDG uptake and FDG uptake is not predictive of survival.