International Journal of Nephrology最新文献

{"title":"Relation of Wnt Signaling Pathway Inhibitors (Sclerostin and Dickkopf-1) to Left Ventricular Mass Index in Maintenance Hemodialysis Patients.","authors":"Ahmed Bahie,&nbsp;Mohamed M Abdalbary,&nbsp;Dalia Younis El-Sayed,&nbsp;Rasha Elzehery,&nbsp;Ghada El-Said,&nbsp;Ghada El-Kannishy,&nbsp;Ahmed M Abd El Wahab","doi":"10.1155/2021/2439868","DOIUrl":"10.1155/2021/2439868","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular hypertrophy (LVH) is common in hemodialysis (HD) patients. It predicts poor prognosis. Several inhibitors regulate Wnt canonical pathways like Dickkopf-related protein-1 (Dkk-1) and sclerostin.</p><p><strong>Objectives: </strong>To investigate the relationship between serum sclerostin, Dkk-1, left ventricular mass (LVM), and LVM index (LVMI) in HD patients.</p><p><strong>Methods: </strong>This is a cross-sectional study including 65 HD patients in our HD unit. Patients were divided into two groups according to LVMI (group 1 with LVMI < 125 gm/m² (<i>N</i> = 29) and group 2 with LVMI > 125 gm/m² (<i>N</i> = 36)). Echocardiographic evaluation of the LVM, aortic, and mitral valves calcification (AVC and MVC) was done. Serum levels of sclerostin and Dkk-1 and patients' clinical and biochemical data were recorded.</p><p><strong>Results: </strong>Group 2 showed significantly higher age, blood pressure, AVC, and MVC and significantly lower hemoglobin, sclerostin, and Dkk-1 levels. LVM and LVMI had a significant linear negative correlation to both serum sclerostin and Dkk-1 (<i>r</i> = -0.329 and -0.257, <i>P</i>=0.01 and 0.046 for LVM; <i>r</i> = -0.427 and -0.324, <i>P</i>=0.001 and 0.012 for LVMI, resp.). Serum Dkk-1 was an independent negative indicator for LVM and LVMI in multiple regression analyses (<i>P</i>=0.003 and 0.041 with 95% CI = -0.963 to -0.204 and -0.478 to -0.010, resp.).</p><p><strong>Conclusion: </strong>Serum sclerostin and Dkk-1 were significantly lower in HD patients with increased LVMI > 125 gm/m², and both had a significant linear negative correlation with LVM and LVMI. Dkk-1 was a significant negative independent indicator for LVM and LVMI in HD patients.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2021 ","pages":"2439868"},"PeriodicalIF":2.1,"publicationDate":"2021-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8483936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39483682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total Body Sodium Balance in Chronic Kidney Disease.","authors":"Kylie Martin,&nbsp;Sven-Jean Tan,&nbsp;Nigel D Toussaint","doi":"10.1155/2021/7562357","DOIUrl":"https://doi.org/10.1155/2021/7562357","url":null,"abstract":"<p><p>Excess sodium intake is a leading but modifiable risk factor for mortality, with implications on hypertension, inflammation, cardiovascular disease, and chronic kidney disease (CKD). This review will focus mainly on the limitations of current measurement methods of sodium balance particularly in patients with CKD who have complex sodium physiology. The suboptimal accuracy of sodium intake and excretion measurement is seemingly more marked with the evolving understanding of tissue (skin and muscle) sodium. Tissue sodium represents an extrarenal influence on sodium homeostasis with demonstrated clinical associations of hypertension and inflammation. Measurement of tissue sodium has been largely unexplored in patients with CKD. Development and adoption of more comprehensive and dynamic assessment of body sodium balance is needed to better understand sodium physiology in the human body and explore therapeutic strategies to improve the clinical outcomes in the CKD population.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2021 ","pages":"7562357"},"PeriodicalIF":2.1,"publicationDate":"2021-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8481067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39483683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of Creatinine-Based Estimates of the Glomerular Filtration Rate Equation from ^99mTc-DTPA Imaging in the Malaysian Setting.","authors":"Azrina Md Ralib,&nbsp;Farah Nadia Mohd Hanafiah,&nbsp;Iqbalmunawwir Abd Rashid,&nbsp;Mohamad Shahrir Abd Rahim,&nbsp;Fatimah Dzaharudin,&nbsp;Mohd Basri Mat Nor","doi":"10.1155/2021/3465472","DOIUrl":"https://doi.org/10.1155/2021/3465472","url":null,"abstract":"<p><strong>Introduction: </strong>Accurate assessment of glomerular filtration rate (GFR) is very important for diagnostic and therapeutic intervention. Clinically, GFR is estimated from plasma creatinine using equations such as Cockcroft-Gault, Modification of Diet in Renal Disease, and Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equations. However, these were developed in the Western population. To the best of our knowledge, there was no equation that has been developed specifically in our population.</p><p><strong>Objectives: </strong>We developed a new equation based on the gold standard of ^99mTc-DTPA imaging measured GFR. We then performed an internal validation by comparing the bias, precision, and accuracy of the new equation and the other equations with the gold standard of ^99mTc-DTPA imaging measured GFR.</p><p><strong>Methods: </strong>This was a cross-sectional study using the existing record of patients who were referred for ^99mTc-DTPA imaging at the Nuclear Medicine Centre, International Islamic University Malaysia. As this is a retrospective study utilising routinely collected data from the existing pool of data, the ethical committee has waived the need for informed consent.</p><p><strong>Results: </strong>Data of 187 patients were analysed from January 2016 to March 2021. Of these, 94 were randomised to the development cohort and 93 to the validation cohort. A new equation of eGFR was determined as 16.637 ∗ 0.9935^Age ∗ (SCr/23.473)^-0.45159. In the validation cohort, both CKD-EPI and the new equation had the highest correlation to ^99mTc-DTPA with a correlation coefficient of 0.81 (<i>p</i> < 0.0001). However, the new equation had the least bias and was the most precise (mean bias of -3.58 ± 12.01) and accurate (P30 of 64.5% and P50 of 84.9%) compared to the other equations.</p><p><strong>Conclusion: </strong>The new equation which was developed specifically using our local data population was the most accurate and precise, with less bias compared to the other equations. Further study validating this equation in the perioperative and intensive care patients is needed.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2021 ","pages":"3465472"},"PeriodicalIF":2.1,"publicationDate":"2021-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8443382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39430531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lived Experiences of Patients with Chronic Kidney Disease Receiving Hemodialysis in Felege Hiwot Comprehensive Specialized Hospital, Northwest Ethiopia.","authors":"Hailemariam Tadesse,&nbsp;Hordofa Gutema,&nbsp;Yosef Wasihun,&nbsp;Samuel Dagne,&nbsp;Yonatan Menber,&nbsp;Pammela Petrucka,&nbsp;Netsanet Fentahun","doi":"10.1155/2021/6637272","DOIUrl":"https://doi.org/10.1155/2021/6637272","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic kidney disease is a challenging disease and global public health problem. The burden of chronic kidney disease and hemodialysis is increasing in Ethiopia, but few studies explored the lived experiences of chronic kidney disease patients receiving hemodialysis. This study explored the lived experiences of chronic kidney disease patients receiving hemodialysis, in the Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar City, Northwest Ethiopia, 2019.</p><p><strong>Methods: </strong>A phenomenological study design was conducted with 12 chronic kidney disease patients receiving hemodialysis between September 1 and October 30, 2019. A purposive sampling technique was used to select participants, and a semistructured in-depth interview guide was used to collect the data. The investigators audio-taped the interviews and then transcribed them verbatim. Finally, the transcribed data were imported to Atlas.ti™-7 software for coding, and then, thematic analysis was done. Transferability, dependability, credibility, and conformability were embedded to ensure data quality.</p><p><strong>Results: </strong>In this study, six major themes were emerged: (1) the seriousness of the disease, (2) challenges to get hemodialysis, (3) financial constraint, (4) restricted life, (5) feeling of dependency, and (6) psychological impacts.</p><p><strong>Conclusion: </strong>The restrictive nature of the disease affects a participant's financial status which makes it challenging to obtain the service and increases feelings of dependency. These circumstances impact the psychology of the participants. We would recommend that every patient with hemodialysis needs social and psychological support. We would also recommend the need to extend the study to other areas of the country to confirm or disconfirm the findings.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2021 ","pages":"6637272"},"PeriodicalIF":2.1,"publicationDate":"2021-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8410445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39386443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Living Kidney Donor Candidates and Living Kidney Recipient Candidates with JC Polyomavirus and BK Polyomavirus Viruria.","authors":"Sara Querido,&nbsp;Carolina Ormonde,&nbsp;Teresa Adragão,&nbsp;Inês Costa,&nbsp;Maria Ana Pessanha,&nbsp;Perpétua Gomes,&nbsp;André Weigert","doi":"10.1155/2021/8010144","DOIUrl":"https://doi.org/10.1155/2021/8010144","url":null,"abstract":"<p><strong>Introduction: </strong>Recent data have emerged about a protective association between JCV viruria and chronic kidney disease (CKD). <i>Material and Methods</i>. Single-center retrospective cohort study; 230 living kidney donors (LKD) candidates and 59 potential living kidney receptors (LKR) were enrolled. Plasma and urinary JCV and BKV viral loads were measured in all LKD candidates and in nonanuric LKR candidates. Twenty-six living kidney transplant surgeries were performed. LKR were followed in order to evaluate BKV and JCV viremia and urinary viral shedding after KT.</p><p><strong>Results: </strong>In LKD candidates, JCV viruria was negatively associated with proteinuria of >200 mg/24 hours (JC viruric LKD: 12.5% vs JCV nonviruric LKD: 26.7%, <i>p</i>=0.021, OR:0.393; 95% CI: 0.181-0.854). In a multivariate analysis, LKD candidates with JCV viruria had a lower risk of proteinuria of >200 mg/24 hours (<i>p</i>=0.009, OR: 0.342, 95% CI: 0.153-0.764), in a model adjusted for age, gender, presence of hypertension, and eGFR <80 mL/min. Prevalence of JCV viruria was higher in LKD candidates when compared with LKR candidates (40.0% vs 1.7%, <i>p</i> < 0.001). Among the 26 LKR, 14 (53.8%) KT patients evolved with JCV viruria; 71.4% received a graft from a JCV viruric donor.</p><p><strong>Conclusion: </strong>Our data corroborate the recent findings of an eventual protective association between JCV viruria and kidney disease, and we extrapolated this concept to a South European population.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2021 ","pages":"8010144"},"PeriodicalIF":2.1,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39380582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Predictors of Nondiabetic Kidney Disease in Patients with Diabetes: A Single-Center Study.","authors":"Francesco Fontana,&nbsp;Rossella Perrone,&nbsp;Francesco Giaroni,&nbsp;Gaetano Alfano,&nbsp;Silvia Giovanella,&nbsp;Giulia Ligabue,&nbsp;Riccardo Magistroni,&nbsp;Gianni Cappelli","doi":"10.1155/2021/9999621","DOIUrl":"https://doi.org/10.1155/2021/9999621","url":null,"abstract":"<p><strong>Background: </strong>Although diabetic kidney disease (DKD) could affect up to one-third of patients with diabetes mellitus (DM), these patients can develop kidney diseases different from DKD, or these conditions can superimpose on DKD. Several potential predictors of nondiabetic kidney disease (NDKD) have been proposed, but there are no definitive indications available for kidney biopsy in diabetic patients.</p><p><strong>Methods: </strong>We designed a single-center, cross-sectional, and retrospective cohort study to identify clinical and laboratory factors associated with a diagnosis of NDKD after native kidney biopsy in diabetic patients and to investigate differences in time to end-stage kidney disease (ESKD) in patients with a diagnosis of DKD and NDKD.</p><p><strong>Results: </strong>Of 142 patients included in our analysis, 89 (62.68%) had a histopathological diagnosis of NDKD or mixed NDKD + DKD. Patients in the NDKD group had significantly lower HbA1C, lower prevalence of diabetic retinopathy (DR), and less severe proteinuria, and there was a lower proportion of patients with nephrotic syndrome; the DKD group had significantly lower proportion of patients with hematological conditions. In the multivariate binary logistic regression, only absence of DR and presence of a hematological condition significantly predicted NDKD after adjustment for age and sex. Time to ESKD was significantly higher in patients with NDKD or mixed forms than in those with DKD.</p><p><strong>Conclusions: </strong>After a careful selection, more than half of kidney biopsies performed in diabetic patients can identify NDKD (alone or with concomitant DKD). Absence of DR and coexistence of a hematological condition (especially MGUS) were strong predictors of NDKD in our cohort.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2021 ","pages":"9999621"},"PeriodicalIF":2.1,"publicationDate":"2021-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8292077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39266057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunohistochemical Expression of FOXP3+ Regulatory T Cells in Proteinuric Primary Glomerulopathies.","authors":"Georgios Vlachopanos,&nbsp;Argyrios Georgalis,&nbsp;Pinelopi Korkolopoulou,&nbsp;Efstratios Patsouris,&nbsp;Harikleia Gakiopoulou","doi":"10.1155/2021/9961713","DOIUrl":"https://doi.org/10.1155/2021/9961713","url":null,"abstract":"<p><p>FOXP3+ regulatory T-cell (Tregs) detection in renal allograft biopsies has been associated with a less intense immune response. Data about FOXP3+ Tregs' presence and role in primary glomerulopathies of native kidneys are minimal. We comparatively studied the immunohistochemical expression of FOXP3+ Tregs, CD4+ and CD3+ T cells in IgA nephropathy (IgAN), focal segmental glomerulosclerosis (FSGS), and membranous glomerulopathy (MGN). We retrospectively reviewed 71 renal biopsies (28 from patients with IgAN, 22 from patients with FSGS and 21 from patients with MGN) performed with proteinuria as the main indication. FOXP3+ Tregs and CD4+ and CD3+ T cells in inflammatory cell infiltrates of the interstitial tissue and periglomerular space were automatically counted using image analysis software. Univariable and multivariable logistic regressions were applied for statistical analysis. Nuclear FOXP3+ immunohistochemical expression was observed in T cells in 64% of IgAN cases, 77% of FSGS cases, and 76% of MGN cases (<i>p</i> > 0.05). Absolute FOXP3+ Tregs count in the interstitial tissue was higher in patients without arteriolar hyalinosis than in those with arteriolar hyalinosis (1.814 ± 2.160 vs. 831 ± 696; <i>p</i> = 0.029). In patients with a high FOXP3+/CD4+ ratio in the interstitial tissue, the odds ratio for CKD-EPI eGFR ≥60 ml/min/1.73 m² at biopsy was 4.80 (95% CI: 1.29-17.91; <i>p</i> = 0.019). FOXP3+ Tregs intrarenal infiltration in primary glomerulopathies is common. FOXP3+ Tregs' increased expression may be associated with milder histological lesions. High FOXP3+/CD4+ ratio in the interstitial tissue may have prognostic significance for renal function preservation.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2021 ","pages":"9961713"},"PeriodicalIF":2.1,"publicationDate":"2021-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8289604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39266056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prevalence and Risk Factors of Hypokalemia in Pregnancy-Related Hospitalizations: A Nationwide Population Study.","authors":"Chien-Wen Yang,&nbsp;Si Li,&nbsp;Yishan Dong","doi":"10.1155/2021/9922245","DOIUrl":"https://doi.org/10.1155/2021/9922245","url":null,"abstract":"<p><strong>Background: </strong>There are no nationwide population studies conducted to analyze the prevalence and risk factors associated with hypokalemia during pregnancy in the U.S.</p><p><strong>Method: </strong>We retrieved data from the Nationwide Inpatient Sample (NIS) and the National Inpatient Sample of Healthcare Cost and Utilization Project (HCUP) for pregnant patients with hypokalemia from 2012 to 2014. We used a chi-squared test to analyze categorical variables and an adjusted Wald test to compare quantitative variables. We applied logistic regression models to calculate adjusted odds ratios (ORs) with 95% confidence intervals (95% CIs) to identify the risk factors for hypokalemia. We used a <i>p</i> value <0.05 as the cutoff for statistical significance.</p><p><strong>Result: </strong>Among 12,431,909 pregnancy-related discharges, females of younger age (mean age 27.0 ± 6.2 vs. 28.1 ± 6.0, <i>p</i> < 0.001), of African American race, using government-paid insurance, with an income level in the first quartile, and of a higher Charlson Comorbidity Index score (≥1) were found to have a higher likelihood of hypokalemia during pregnancy (<i>p</i> < 0.001). Gestational hypertension (GH) (including pre-eclampsia and eclampsia, aOR 2.03, 95% CI 1.94-2.12, <i>p</i> < 0.001), hyperemesis gravidarum (aOR 33.18, 95% CI 31.61-34.83, <i>p</i> < 0.001), and post-partum hemorrhage (aOR 1.42, 95% CI 1.31-1.53, <i>p</i> < 0.001) were found to be independently associated with a higher rate of hypokalemia during pregnancy.</p><p><strong>Conclusion: </strong>The prevalence of hypokalemia during pregnancy was less than 1% in this large, nationwide population-based study. There were significant differences between those patients who developed hypokalemia during pregnancy. Notably, those who had hypokalemia were younger, of African American race, and of a low-income level. Congestive heart failure, coronary artery disease, Cushing's syndrome, GH, and hyperemesis gravidarum were found to be associated with hypokalemia during pregnancy.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2021 ","pages":"9922245"},"PeriodicalIF":2.1,"publicationDate":"2021-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8261188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39181845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catheter-Related Bloodstream Infections and Catheter Colonization among Haemodialysis Patients: Prevalence, Risk Factors, and Outcomes.","authors":"Shamira Shahar,&nbsp;Ruslinda Mustafar,&nbsp;Lydia Kamaruzaman,&nbsp;Petrick Periyasamy,&nbsp;Kiew Bing Pau,&nbsp;Ramliza Ramli","doi":"10.1155/2021/5562690","DOIUrl":"https://doi.org/10.1155/2021/5562690","url":null,"abstract":"<p><strong>Introduction: </strong>Catheter-related bloodstream infection (CRBSI) and catheter colonization (CC) are two complications among haemodialysis (HD) patients that lead to increased morbidity and mortality. This study aims to evaluate the prevalence of CRBSI and CC among HD patients registered at Universiti Kebangsaan Malaysia Medical Centre and to identify the factors involved by focusing on the demographic profile of the patients as well as their clinical characteristics and outcomes.</p><p><strong>Method: </strong>This is a retrospective study of end-stage renal disease patients with suspected CRBSI during the period from 1 January 2016 to 31 December 2018. Data on patients who fulfilled the blood culture criteria for CRBSI and CC diagnosis were further analysed for clinical manifestations, comorbidities, history of dialysis, catheter characteristics, and microbiological culture results. The outcomes of CRBSI and CC were also assessed. <i>Findings</i>. In the 3-year period under study, there were 496 suspected CRBSI cases with a total of 175 events in 119 patients who fulfilled the inclusion criteria. During that time, the percentage of patients who experienced CRBSI and CC was 4.2% and 4.8%, respectively. The majority of the cohort consisted of male (59.4%), Malay ethnicity (75%), and patients on a tunnelled dialysis catheter (83%). Patients who were fistula naïve and had an internal jugular catheter were more common in the CRBSI group than in the CC group. The predominant microorganisms that were isolated were Gram-positive organisms. In terms of clinical presentation and outcome, no differences were found between the CRBSI and CC groups. Patients with Gram-negative bacteraemia, high initial c-reactive protein, and catheter salvation were likely to have poor outcomes. Recurrence of CRBSI occurred in 31% of the cohort. Neither catheter salvation nor antibiotic-lock therapy were associated with the recurrence of CRBSI. On the other hand, the femoral vein catheter site was associated with risk of recurrence. The overall mortality rate was 1.1%. <i>Discussion</i>. From the analysis, it was concluded that clinical assessment and positive culture are crucial in diagnosing CRBSI with or without peripheral culture. This study provides essential information for the local setting which will enable healthcare providers to implement measures for the better management of CRBSI.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2021 ","pages":"5562690"},"PeriodicalIF":2.1,"publicationDate":"2021-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8238579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39175783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Effects of Hyperbaric Oxygen Therapy in Patients with Diabetes Mellitus: A Retrospective Study.","authors":"Martin Sedlacek, Nicole P Harlan, Jay C Buckey","doi":"10.1155/2021/9992352","DOIUrl":"10.1155/2021/9992352","url":null,"abstract":"<p><p>Hyperbaric oxygen therapy (HBOT) is an adjunctive treatment for patients with diabetic foot ulcers. The prolonged high oxygen level used in HBOT can produce oxidative stress, which may be harmful to the kidney. Animal experiments suggest HBOT does not harm renal function and may have an antiproteinuric effect, but little is known on the effect of HBOT in humans. We performed a retrospective chart review of 94 patients with diabetes mellitus who underwent HBOT at our institution over an eight-year period. Thirty-two patients had serum creatinine levels within 60 days of the start and the end of treatment. Creatinine levels were 1.41 ± 0.89 mg/dl before and 1.52 ± 1.17 mg/dl after hyperbaric treatments with no statistically significant difference (mean (postcreatinine + precreatinine/2) = 0.10 mg/dl, SE = 0.11, <i>t</i> = 0.89). Twenty-three patients had proteinuria measurements before and after HBOT mainly by urine dipstick analysis. A Wilcoxon signed-rank test showed less proteinuria after HBOT than before (<i>N</i> = 23, <i>p</i>=0.002). Proteinuria was absent in 7 of 23 patients (30%) before HBOT and 13 of 23 patients (57%) after HBOT, a reduction by almost 50%. This observation is remarkable because oxidative stress might be expected to increase rather than decrease proteinuria.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2021 ","pages":"9992352"},"PeriodicalIF":2.1,"publicationDate":"2021-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8216821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39162940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}