It is the accumulation of a protein called amyloid in organs such as kidneys, heart and liver. There are different types of amyloid. It usually causes diseases such as Familial Mediterranean Fever and chronic bronchitis. However, chronic inflammatory diseases, rheumatic diseases, certain cancers may also cause amyloidosis. It may lead to loss of protein in the urine and kidney failure, if the kidneys are affected. Biopsy is necessary for the diagnosis of amyloidosis.

The course of the disease depends on the type of the accumulated amyloid, involved organ and the degree of organ damage. The treatment depends on the underlying disease.

Blood in urine (hematuria) is the observance of blood cells in the urine. Hematuria are divided into two:

1. Visible haematuria: Blood mixed can easily be understood from the color of the urine.

2. Microscopic hematuria: Blood in the urine is not visible to the naked eye but blood cells are observed in urinanalysis. The urine color may be dark in these patients.

Hematuria may have repeatitive features, sometimes periods in which urine is completely normal can be observed.

Hematuria is the symptom of a serious disease. Diseases that cause hematuria are urinary tract infection, inflammations of the kidneys called nephritis, urinary tract and kidney cancers, stone disease, renal tuberculosis, urinary bladder diseases and kidney cysts. Also, blood can be mized to the urine, although there is no problem in the urinary tract in prostate and uterine diseases.

Common point in the majority of the diseases causing hematuria is that the treatment of these diseases is possible with early diagnosis. Therefore, the patients, in whom blood is detected in their urine, must be evaluated by nephrology and urology specialists together.

Cysts are fluid-filled sachets. They can be observed in different regions of the body; kidney is one of them. Cysts may cause no symptoms, as well as can lead to problems such as high blood pressure, inflammation, stone, bleeding and renal failure.

Kidney cyst is diagnosed with radiological procedures such as ultrasound, CT. Kidney cysts may be mixed with kidney cancer.

Kidney cysts are classified according to the onset age, localization and other symptoms. The prevalence increases with age. Numerous cysts in different sizes can be found in one third of people over the age of 70.

It is often enough to follow up the simple cysts in the treatment, but to understand the nature of the cyst is important; they should be distinguished from familial cystic diseases and kidney cancer.

One of the most affected organs in diabetes are the kidneys. Diabetes-induced kidney problems are more common today because patients with diabetes live longer as a result of developments providen in the treatment. The most common cause of kidney failure patients undergoing dialysis treatment in our country is diabetes. Kidney problems observed in people with diabetes is called diabetic nephropathy.

Diabetic nephropathy is composed of five stages.

1. Growth and excessive function

2. Silent stage

3. Hidden diabetic nephropathy

4. Significant diabetic nephropathy

5. End-stage renal failure

Treatment varies according to the stage of the disease. High blood pressure should be treated; blood glucose must be taken under control. The progression of diabetic nephropathy may be prevented with correct treatment. If the filtering function of the kidney is thoroughly reduced, then treatments such as dialysis, kidney transplantation are planned.

It is the fluid accumulation in the body and is a widespread problem. Swelling can be noticed in the legs, hands and around the eyelids. Flud may also accumulate in the lungs. It is often a symptom of a serious disease.

The disease causing edama are:

1. Kidney diseases

2. Liver diseases

3. Heart diseases

4. Hormonal diseases

5. Vascular occlusion

6. Other diseases.

These diseases should be investigated in patients with edema. For this purpose, various laboratory examinations are needed. Diseases that cause edema are investigated before starting edema treatment and the treatment is planned according to the underlying disease.

Familial Mediterranean Fever (FMF) is a disease commonly seen in Turkish, Arabic, Jewish and Armenian people. FMF is a disease, which creates recurrent fever, abdominal pain, chest pain and joint pain attacks. Attacks usually lasts for 24-48 hours. The patients are indistinguishable from a normal human in the time outside attacks.

It has three basic features, as the title suggests;

1. Familial transition: Both of mothers and fathers must be carriers or patient for the emergence of the disease.

2. Often seen in the Mediterranean region and around (including the Black Sea region).

3. Creating fever attacks: Fever is accompanied by abdominal pain, joint pain or chest pain. Abdominal pain can be confused with acute appendicitis and can be very severe. Some of these patients were operated with the diagnosis of acute appendicitis, but abdominal pain but did not relieved.

Amyloidosis is the feared and unwanted problem in FMF. A substance containing fibrils in its protein structure accumulates in extracellular tissues. However, FMF may occur in many different ways in some patients.

The gene causing the disease was found in 1997. Today, the only known treatment of FMF is the medication called Colchicine. Colchicine reduce the frequency of and severity of fever, abdominal pain … attacks. It is possible to prevent amyloidosis with Colchicine treatment.

Patients with recurrent attacks of fever and abdominal pain should be evaluated in terms of FMF and FMF diagnosed patients should not interrupt Colchicine treatment.

Inflammatory diseases of the kidney are called nephritis. The causes of nephritis are divided into two:

1. Non-microbial nephritis: Non-infectious inflammatory diseases of the kidney are divided into two.

A. Glomerulonephritis

B. Tubular nephritis (interstitial nephritis)

2. Microbial nephritis (pyelonephritis): Another name for pyelonephritis is the infection of the upper urinary tract.

A common cause of chronic renal failure in Turkey is glomerulonephritis. Signs and symptoms vary according to the type of glomerulonephritis. The diagnosis of glomerulonephritis is usually very easy with examination of the patient, examination of urea and creatinine levels in the blood and simple urine examination. The glomerulonephritis findings in the examination are swelling in hand, foot and eyelid, darkening of urine color (urine may take tea-color) and high blood pressure. Blood and protein loss in the urine analysis results are in favor of glomerulonephritis. The main challenge in the glomerulonephritis diagnosis is to identify the disease that causes glomerulonephritis. The cause of glomerulonephritis is usually undetectable. Kidney biopsy should be performed to understand the type of glomerulonephritis, in other words a part should be taken from the kidney for microscopic examination.

In practice, glomerulonephritis is encountered in five ways. The patient may have no complaints, as well as advanced renal failure.

1. Abnormalities in the urinanalysis: There are no symptoms and findings in the patient. Blood or protein loss is detected in the urine examination in the patient, who admitted to the physician due to another reason.

2. Nephrotic syndrome: There is a loss of more than 3-3.5 grams of protein in the urine per day. Swellings marked with the pressure are present in the hands, feet, face and other areas of the patient. In addition, albumin level in the blood decreases, cholesterol level increases.

3. Sudden onset of glomerulonephritis: Problems in the forefront in these patients are blood in urine, high blood pressure and an accumulation of fluid in the body. Most of the nephritis in children developed after streptococcal infections are included in this group.

4. Chronic glomerulonephritis: Blood in urine, protein loss, high blood pressure and swelling is present in these patients; it is a long-term disease.

5. Rapidly progressive nephritis: Kidney failure develops in a short time and the patient requires dialysis treatment.

Treatment is different in each patient. The treatment is planned based on the result of the kidney biopsy and problems existing in the patient.

What is the organ transplantation?

It is the procedure of transplanting the obtained organ from living or cadaveric donors to the patients, to perform the duties of a failured organ.

What is organ donation?

A person, while alive, to give permission for the use of tissues and organs for the treatment of another patients after the medical end of the life with free will, or giving permission for the transplantation of the organs of brain dead or medically dead people by their relatives to the patients with organ failure.

What is cadaver donor?

The person, who gave permission for the use of organs after the end of the medical life while alive, or the person authorized by the family after brain death occurs.

For which organs and tissues is it in question?

• Heart / Lung
• Liver
• Kidney
• Pancreas
• Cornea
• Cardiac valve
• Bone, Skin, Tendons
• Other organs

What is brain death?

It is the irreversible status of loss of all brain functions, including respiration. These people can only continue their current status with the support of the respirator. A patient with the diagnosis of brain death is considered medically as ‘dead’ and it is not possible to change this situation. All organs including the heart become incapable of functioning usually within 48-72 hours, despite medical support.

What is the difference between brain death and vegetative state?

There is a slight function in the brain of the patients in vegetative state. Patients may not require to the respirator.

How is the diagnosis of brain death?

The patient is evaluated in detail by a specialist committee consisted of four people; clinical and laboratory analysis are performed. At the end of these analyses the brain death is diagnosed unanimously, however diagnosis is avoided if there is a slight hesitation.

Who is in the team that diagnoses brain death?

It is consisted of four people as cardiologist, neurologist, neurosurgeon and anesthesiology  and resuscitation specialist (Source: Law on obtaining, storage and transplantation of organs and tissues, Official Gazette, Date: 03.06.1979, Number: 16655). This committee is fully independent from the team that will perform the organ transplantion.

Does organ donation affect the patient’s medical care?

No. The use of organs of the organ donor only comes to the agenda with the realization of brain death after all the medical treatments are performed and these treatments are proved to be failed.

Why is organ transplantation important?

The most successful treatment for the patients with a disease developing end-stage organ failure, whose recovery is not possible, (kidney failure, liver cirrhosis, advanced heart failure, etc.) is organ transplantation methods. Organ transplantation increases the patients’ quality of life (social / economic) and prolongs life. The patients with kidney failure has time to wait until a new organ with dialysis treatment, but the time of patients with diseases such as liver cirrhosis, advanced heart failure is limited. So far, many patients have lost their lives due to the failure to find an organ donor. The most important source for organ transplantation patients is those who are brain-dead.

I have donated my organs; can I desist?

Yes. It is enough to tear up the donation card that you carry with you and to tell your family that you don’t want to donate your organs.

Can the organs I have donated be sold to someone else with the money?

No. There has not been such an event in Turkey up till now and possibility of being may be considered as zero. Organ trade news reflected in the media decribes the people, who sells their one kidney for money.

Is there an age limit in organ donation?

Anyone who’s over 18 years old and compos mentis can donate all or a portion of his/her organs before two witnesses and with physician approval. Parents should allow for the use of the organs of brain death person under the age of 18.

What should I do to donate my organs?

It is enough to receive an organ donor card and carry with you. Organ donation cards can be obtained from the hospitals. It is useful for a person donating the organs to inform his/her family about this condition in advance. It is usually sufficient to fill out a donor card available from this page and inform your family about your decision. Your family should accept your organ donation decision as your will.

I just want to donate my kidney, what should I do?

Simply specify that the donation card.

Is organ donation against religion?

Absolutely not. There is no violation of organ donation in all major religions, including Islam.

Polycystic kidney disease is a hereditary disease that causes cysts in many organs, mainly in the kidneys. Mother or father should have the disease for the emergence of disease. Rarely, the disease may be seen without being in the mother or father. Its genetic transition feature is autosomal dominant, so the incidence of the disease in a child with mother or father with disease is 50% (half and half). There is no gender discrimination, so the incidence in the girls and boys are with equal chances.

Although polycystic kidney disease is hereditary, it shows symptoms in advancing ages. The disease mentioned here is adult type polycystic kidney disease; there is also polycystic kidney disease seen in children. The course polycystic kidney disease seen in children is very different, renal failure occurs at an early age (often in the first month) and courses quickly. Cysts may be observed in organs such as liver, kidney, pancreas, spleen, lung, thyroid, brain and ovaries other than kidney in polycystic kidney disease. In polycystic kidney disease, heart valves may be affected; expansion of the vessels in the brain (aneurysm) may occur, sacculations (diverticula) may develop in colon and abdominal hernia may be observed.

Cysts in the kidney can lead to problems such as pain, high blood pressure, inflammation, stones, bleeding and kidney failure. Sometimes pain may occur for reasons such as stretching of cysts, inflammation and bleeding. Bleeding may be into the cyst, as well as to the urine. Sometimes, cysts grow too much and fill the abdomen.

High blood pressure treatment is very important. If kidney failure occurs, so the kidney’s filtering function decreases, then substances in the blood such as urea, creatinine starts to increase. If end-stage renal failure develops, dialysis and kidney transplantation comes to the agenda. To have a family screening may be needed.

Urinary tract infection may occur starting from kidney to the urinary bladder or lower urinary tract. Inflammatory disease of the kidney due to microbes is called pyelonephritis. Another name for it is the infection of the upper urinary tract. The most common factor is coli resulting from the bowels. Symptoms and findings include fever, sweats, chills, flank pain, painful urination, frequent urination and urgent need to urinate. Headache, nausea and vomiting may occur. It can be mixed with passing stones. Untreated or late cases can lead to the loss of the patient due to the mixing of germs to the patient’s blood.

Lower urinary tract infection may be at different levels. The most commonly known is cystitis, which is an inflammation of the urinary bladder. It is common in women. Symptoms include painful urination, frequent urination and urgent need to urinate. Symptoms are less compared to the upper urinary tract infections.

Observation of microbes and inflammatory cells (leukocytes) in the microscopic examination of the urine is helpful in diagnosis. The definitive diagnosis is the microscopic examination of the urine collected via appropriate technique (urine culture).

Urine culture should be obtained for the treatment to be healthy. The use of antibiotics before obtaining urine culture will effect on the results of urine culture negatively. Therefore, unconscious use of antibiotics should be avoided. It is possible to treat the disease permanently and without any damage with a correct treatment.

It is often detected incidentally with a simple urine examination, but is usually a symptom of serious kidney disease. If the amount of protein loss in the urine is much, foamy urine can be observed. Blood in urine may be found together.

If there is a protein loss of more than 3-3.5 grams in the urine per day, it is called nephrotic syndrome. Swellings marked with the pressure are present in the hands, feet, face and other areas of the patient. In addition, albumin level in the blood decreases, cholesterol level increases.

Detailed examination is needed in patients in whom protein is detected in the urine. To determine the amount of protein loss by collecting 24-hour urine and kidney biopsy may be required for diagnosis. The treatment depends on the disease that leads to protein loss in the urine.