Journal of Renal Injury Prevention最新文献

{"title":"Relationship between contrast-induced nephropathy and blood methemoglobin levels in acute coronary syndrome patients","authors":"Oya İmadoğlu, Ulaş Türker","doi":"10.34172/jrip.2024.37312","DOIUrl":"https://doi.org/10.34172/jrip.2024.37312","url":null,"abstract":"Introduction: Contrast-induced nephropathy (CIN) is an iatrogenic complication occurring in patients exposed to contrast agents. Objectives: We aimed to investigate the relationship between blood methemoglobin (MHb) levels and the development of CIN in patients undergoing coronary angiography (CAG), with or without primary coronary intervention for acute coronary syndrome (ACS). Patients and Methods: In this retrospective study, 119 patients diagnosed with ACS who underwent coronary angiography were included. MHb levels were measured in patients before and at during the first 1 to 3 hours after the procedure. CIN was defined as an increase in serum creatinine levels by ≥0.3 mg/dL (26.5 µmol/L) from baseline within 48 hours after contrast exposure or an increase of 1.5-1.9 times the baseline value within 7 days. Results: The relationship between CIN-positive and CIN-negative patients and patients with MHb ≤%1 and MHb >% 1 was similar (P=0.4). Multivariate logistic regression analysis showed that an MHb value greater than 1 did not independently predict the development of CIN. Significant differences were observed between these two groups in terms of pre-CAG creatinine levels (P=0.02), Mehran risk score (<0.001), hemoglobin levels (P=0.03), the presence of hypotension (P=0.03), blood pH value (P=0.03), left ventricular ejection fraction (LVEF) (<0.001), the presence of diabetes mellitus (P=0.014), age (P=0.001), and smoking history (P=0.02). Conclusion: Our study demonstrates that traditional risk factors contribute to nephropathy. However, the increased blood MHb levels do not appear to contribute to the development of CIN in ACS patients.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141831152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of glomerular IgA immunostaining patterns and disease progression in IgA nephropathy patients; a 13-year study of clinical and morphological features of renal biopsies","authors":"Ali Rastegar-Kashkouli, Pourya Yousefi, Mohsen Jafari, Zahra Pirasteh, Azadeh Tafakori, Amir Mohammad Taravati, Farzaneh Moammer, Seyedeh Ghazal Shahrokh, Dordaneh Rastegar, H. Mardanparvar, Yassamin Rabiei, Muhammed Mubarak, R. Valizadeh, Hamid Nasri","doi":"10.34172/jrip.2024.38327","DOIUrl":"https://doi.org/10.34172/jrip.2024.38327","url":null,"abstract":"Introduction: IgA nephropathy (IgAN) is a common primary glomerulonephritis with highly heterogeneous clinical and histopathological features. The MEST-C scoring system has been developed to improve prognostic assessment but lacks elements related to immunostaining study. Objectives: This study aimed to investigate the association between the immunofluorescence (IF) deposits’ patterns of IgA (mesangiocapillary versus pure mesangial) with demographic, clinical, biochemical, and morphological parameters of MEST-C classification in IgAN patients. Patients and Methods: This retrospective, cross-sectional study was conducted on 268 biopsy-proven cases of IgAN from July 2009 to July 2022 at a single laboratory in Isfahan in Iran. The demographic, clinical, and laboratory data including age, gender, serum creatinine, and proteinuria were collected from the biopsy request forms. The morphological parameters of MEST-C classification and IF study patterns were collected from the biopsy reports. Results: The average age of all patients was 37.7 ± 13.47 years, with 67% being males. The mean serum creatinine and proteinuria levels were 1.43 mg/dL and 1730.94 mg/day, respectively. MEST-C score analysis revealed that 171 patients (63.8%) had mesangial expansion (M1), while 105 patients (39.2%) exhibited endocapillary hypercellularity (E1). Additionally, segmental glomerulosclerosis (S1) and tubular atrophy/interstitial fibrosis (T1 and T2) was observed in 160 biopsy samples (59.7%). Moreover, crescent (C) formation was noted in 76 (28.4%) of biopsies. Data analysis using univariate logistic regression demonstrated that E, T, and C on morphology, complement C3, IgG, IgM deposits on IF, and the total MEST score were all associated with an increased risk for mesangiocapillary deposits of IgA. However, using the multivariate method, the results indicated that only the total MEST score (OR: 2.4), presence of crescent (OR: 3.22), presence of endocapillary hypercellularity (OR: 4.86), tubular atrophy/interstitial fibrosis grade II (OR: 34.4), and IgG deposition (OR: 3.37) were independent risk factors for mesangiocapillary deposits of IgA. Conclusion: The total MEST score is significantly higher in mesangiocapillary patterns. Furthermore, the presence of E1, T2, and C1-2 morphological parameters of the updated Oxford classification in renal biopsies are independent risk factors for IgA mesangiocapillary deposits. Hyperactivation of immunoglobulins and the complement system appears to contribute to mesangial-capillary proliferation.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141700173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative study of true and pseudo-peroxidase and their relative biomarkers between male and female patients with chronic kidney disease","authors":"Yamama Zuhair Hani, I. Zainal","doi":"10.34172/jrip.2024.34306","DOIUrl":"https://doi.org/10.34172/jrip.2024.34306","url":null,"abstract":"<strong data-sider-select-id=\"11a9137d-9415-4aad-b5a7-19d6da3961c1\">Introduction: Pseudo-peroxidase enzymes, despite mimicking the catalytic prowess of true peroxidases, lack authentic enzymatic functionality. The critical discernment between pseudo and true peroxidases is imperative when assessing oxidative biomarkers in both sexes, as variations in enzymatic activity may underpin gender-specific disparities in oxidative stress profiles, potentially impacting disease vulnerability and therapeutic modalities. <strong data-sider-select-id=\"aaaa4c03-16f7-4d90-beb3-504f5f00591d\">Objectives: This study aims to ascertain true and pseudo peroxidase activity alongside other oxidative stress biomarkers, comparing these parameters between male and female patients afflicted with chronic kidney disease (CKD). <strong data-sider-select-id=\"c97b0b7c-d944-4557-8a85-2fcc93cd3979\">Patients and Methods: A total of 140 blood samples were analyzed, comprising 80 from CKD patients and 60 from healthy controls. Various parameters, including total protein, albumin, glomerular filtration rate (GFR), urea, creatinine, hemoglobin (Hb), free amino acids, globulins, ischemia-modified albumin (IMA), carbonyls, total thiols, native thiols, disulfides, peroxidase, and pseudo peroxidase activity, as well as specific activity, were assessed in both groups. <strong data-sider-select-id=\"dc21f466-82fd-429b-bd66-659b46eec949\">Results: Females with CKD exhibited a significant elevation in numerous serum parameters, including total protein, albumin, globulins, IMA, GFR, urea, creatinine, free amino acids, carbonyls, and disulfides compared to their male counterparts with CKD. Conversely, males with CKD demonstrated a notable increase in peroxidase activity, peroxidase specific activity, pseudo peroxidase activity, and pseudo peroxidase specific activity in comparison to females with CKD. <strong data-sider-select-id=\"ed43600a-8a62-477d-bec6-993c25f035de\">Conclusion: The comparative analysis between male and female CKD patients regarding the assessed parameters revealed notable differences in albumin, total protein, GFR, urea, creatinine, Hb, free amino acids, globulins, IMA, carbonyls, total thiols, native thiols, disulfides, peroxidase, and pseudo peroxidase activity and specific activity.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140679329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between cadmium exposure and risk of chronic kidney disease; a systematic review and meta-analysis","authors":"Mehrdad Abbaszadeh, Hassan Pakdel, Somayeh Barakeh, Ahmad Pakdel","doi":"10.34172/jrip.2024.32254","DOIUrl":"https://doi.org/10.34172/jrip.2024.32254","url":null,"abstract":"Introduction: Chronic kidney disease (CKD) is the twelfth most common cause of death worldwide. The kidneys are the primary site of cadmium accumulation and the most sensitive organ to cadmium toxicity. Therefore, the current study aimed to investigate the relationship between cadmium exposure and the risk of CKD using a systematic review and meta-analysis method. Materials and Methods: In this systematic review and meta-analysis, databases including PubMed, Scopus, Web of Science, Cochrane, and Google Scholar were searched without time restrictions until September 9, 2023. Data were analyzed using STATA 14 software, and P <0.05 was considered statistically significant. Results: The results of combining 18 observational studies with a total of 230,790 participants showed that an increase in blood cadmium levels was associated with an increased risk of CKD (OR: 1.42; 95% CI: 1.18, 1.70). This association was significant in cross-sectional studies (OR: 1.21; 95% CI: 1.04, 1.41), case-control studies (OR: 3.08; 95% CI: 1.47, 6.41), and cohort studies (OR: 1.36; 95% CI: 0.85, 2.17). Generally, the relationship between urinary cadmium levels and CKD was not statistically significant (OR: 1.14; 95% CI: 0.84, 1.54). In cross-sectional studies, high urinary cadmium levels reduced the risk of CKD (OR: 0.77; 95% CI: 0.60, 0.99). However, in case-control studies, the relationship between high urinary cadmium levels and risk of CKD was not statistically significant (OR: 0.20; 95% CI: 0.02, 2.40). Since in cohort studies, high urinary cadmium levels were a risk factor for CKD (OR: 1.40; 95% CI: 1.07, 1.83)]. The relationship between cadmium consumption and the risk of CKD was statistically significant (OR: 1.55; 95% CI: 1.00, 2.42), with significance in case-control studies (OR: 18.16; 95% CI: 1.75, 188.64) but not in cohort studies (OR: 1.45; 95% CI: 0.93, 2.25). Conclusion: Overall, an increase in blood cadmium levels was associated with a 42% increased risk of CKD. Furthermore, cadmium consumption through the diet increased the risk of CKD by 55%. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD42023463145).","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140731152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nirmatrelvir-ritonavir efficacy and safety in high-risk COVID-19 patients: a review of recent retrospective cohort studies – nephrology point of view","authors":"Alireza Amin, Shiva Maleki, M. Moonesan","doi":"10.34172/jrip.2024.32257","DOIUrl":"https://doi.org/10.34172/jrip.2024.32257","url":null,"abstract":"The COVID-19 pandemic has prompted researchers to look for efficient treatments to lower high-risk patients’ probabilities of hospitalization, rapid disease progression, and death. Nirmatrelvir-ritonavir (Paxlovid) is a promising treatment option that has been evaluated in several recent retrospective cohort studies. In this article, we review four such studies conducted in China and the USA between 2022 and 2023. The studies, which included large groups of COVID-19 patients, found that Paxlovid treatment was linked to a significant drop in the risk of hospitalization, severe disease progression, and death in high-risk patients. This was true even for patients who had been immune to the disease before from an infection or vaccination. However, more research is needed to validate these results and evaluate the long-term efficacy and safety of this medication. In addition to highlighting the need for larger studies to evaluate both the effectiveness and safety of this treatment in patients with a variety of populations, our review sheds light on the present understanding of Paxlovid and its application for high-risk COVID-19 patients.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140745232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment outcomes of multiple myeloma in patients requiring renal replacement therapy","authors":"Aruni Ratnayake, Mukunthan Srikantharajah, Simon Stern, David Makanjuola","doi":"10.34172/jrip.2024.32105","DOIUrl":"https://doi.org/10.34172/jrip.2024.32105","url":null,"abstract":"Introduction: Renal impairment is a recognised complication of multiple myeloma (MM). Bortezomib and dexamethasone are used as first line therapy but are associated with important side effects. Objectives: We investigated outcomes of patients with MM requiring renal replacement therapy (RRT), assessed renal and haematological responses, and compared effects of different chemotherapy regimens. Patients and Methods: Retrospective study of 67 patients with MM with associated renal impairment managed at our centre from 2007–2017. Approximately 29 patients required RRT and were included in the final analysis. Results: Bortezomib was administered to treat 65.5% patients; overall response rate was 84.2% (complete 21.1%, partial 63.1%). The remaining patients were treated with other agents; of these 50% responded to therapy, all with partial response. Bortezomib was associated with improved survival (P=0.02), however a higher proportion of patients experienced side effects (P=0.02). Of the patients who received bortezomib, 47% came off RRT, compared to 10% of patients who did not (P=0.04). Independence from RRT had the best association with survival (P=0.07). Patients who came off RRT had significant reduction in serum free light chains after two cycles of chemotherapy; those remaining dialysis-dependent showed variable changes in free light chain levels (P=0.02). Conclusion: Bortezomib treatment resulted in a significant improvement in survival, albeit with more side effects. Gaining independence from RRT was associated with better patient survival. A greater degree of reduction of free light chains corresponded to an increased likelihood of being independent of dialysis; this could be used as a marker for renal recovery and overall prognosis.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140741211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Astaxanthin supplementation as a potential anti-fibrotic agent in peritoneal dialysis rats","authors":"R. Dewi, Bambang Purwanto, B. Wasita, Vitri Widyaningsih, R. Cilmiaty, S. Soetrisno, R. Febrinasari, Mahatma Chakra Wardana, M. T. Giani, Indah Sagitaisna Putri","doi":"10.34172/jrip.2023.32156","DOIUrl":"https://doi.org/10.34172/jrip.2023.32156","url":null,"abstract":"Introduction: Peritoneal dialysis (PD) is a recommended treatment for chronic kidney disease (CKD). Continuous exposure to dialysate solution in PD leads to peritoneal fibrosis, which is characterized by changes in morphology and function of the peritoneal membrane. Astaxanthin is considered to have potent antioxidant and anti-inflammatory properties, which has a promising anti-fibrosis effect and suppresses peritoneal thickness in peritoneal fibrosis. Objectives: This study aimed to investigate the impact of astaxanthin supplementation on histological features among PD model rats, which determined astaxanthin as a potential anti-fibrotic agent for PD. Materials and Methods: This study used a laboratory experimental study with a posttest-only control group design. Thirty-two male rats were divided randomly into four groups. There are two control groups and two treatment groups. Negative (NC), given intraperitoneal (IP) injection of sterilized aquadest, positive control (PC), given dialysate 4.25% injection IP. Treatment group 1 (T1) was given dialysate 4.25% injection IP and astaxanthin 0.216 mg supplementation for 14 days, and treatment group 2 (T2) was given dialysate 4.25% IP and astaxanthin 0.216 mg supplementation for 21 days. The peritoneum tissues were then collected and prepared for histological examination. Results: Astaxanthin supplementation prevents peritoneal fibrosis development in CKD model rats (P<0.05). However, there was no significant difference in the mean fibrosis thickness based on astaxanthin duration (P>0.05). Conclusion: Astaxanthin could reduce fibrotic thickness in PD model rats. This study was relevant to conclude that astaxanthin has a potential antifibrotic agent for PD.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140486303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Macrophage activation syndrome: a review of recent renal findings","authors":"Sarah Hosseinpoor, Mansour Salesi","doi":"10.34172/jrip.2024.32269","DOIUrl":"https://doi.org/10.34172/jrip.2024.32269","url":null,"abstract":"The pathogenesis of Macrophage activation syndrome consists of excessive macrophage and T-cell activation, leading to the uncontrolled release of cytokines and chemokines, which can cause multi-organ dysfunction. The diagnostic criteria for MAS include fever, splenomegaly, cytopenia, hypertriglyceridemia and/or hypofibrinogenemia, hemophagocytosis, low or absent natural killer cell activity, elevated ferritin levels, and elevated soluble interleukin-2 receptor levels. Kidney involvement in this disease included glomerular changes, including mesangial expansion, endocapillary proliferation, and thrombotic microangiopathy. Renal biopsy in MAS may also show evidence of macrophage infiltration and activation, such as the presence of hemophagocytic macrophages within the glomeruli and interstitium. These macrophages may contain phagocytosed erythrocytes, platelets, and other cells, indicating ongoing hemophagocytosis. The presence of hemophagocytic macrophages on renal biopsy is highly suggestive of MAS and can help differentiate it from other causes of acute kidney injury (AKI). Management of macrophage activation syndrome-associated kidney involvement involves treating the underlying autoimmune disorder and controlling the systemic inflammation. This may include the use of immunosuppressive medications, such as corticosteroids, disease-modifying anti-rheumatic drugs, and biological agents. Supportive measures, such as renal replacement therapy, may be necessary in severe cases of renal dysfunction.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140486979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacteriological quality of water in hemodialysis unit using ozone disinfection; a 12-year experience","authors":"Nabadwip Pathak, Sujitha Elan, Sheela Devi","doi":"10.34172/jrip.2023.32154","DOIUrl":"https://doi.org/10.34172/jrip.2023.32154","url":null,"abstract":"Introduction: A substantial quantity of pure/ultrapure water is required to initiate hemodialysis (HD)/hemofiltration (HF) therapy for patients with renal failure. Routine disinfection of the water treatment plant is highly needed to produce ultrapure/pure water for HD. To the best of our knowledge and belief, this study is the first of its type and origin to evaluate ozone disinfection levels in a HD unit. Objectives: This study was conducted in the Pondicherry Institute of Medical Sciences (PIMS) HD unit and examined the treated product’s bacteriological quality. Methods and Materials: The hospital record was utilized to obtain the product water culture reports based on the ozone disinfection and product water culture strategy. The product water culture fraction was investigated in concordance with the recommended limits. Results: Of 109 product water culture report samples, 108 (99.1%) aligned with the recommended limits. The product water was cultured via the sterile molten nutrient agar approach; satisfactory numbers of colony counts (<100 CFU/mL) were obtained within 24–48 hours of analysis. The product water purification/disinfection was undertaken per week via the 0.1 Parts-Per-Million ozone dose, administered consistently for 15 minutes. Conclusion: The purification/disinfection of the product water in a HD unit may be undertaken by expert supervision via the ozone disinfection strategy.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140486358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal manifestations of metformin-associated lactic acidosis; new findings","authors":"Parisa Tajdini, M. Foroutan","doi":"10.34172/jrip.2024.32258","DOIUrl":"https://doi.org/10.34172/jrip.2024.32258","url":null,"abstract":"Risk factors for metformin-associated lactic acidosis (MALA) include impaired renal function, liver disease, heart failure, sepsis, and alcohol abuse. Patients with these risk factors should be closely monitored while on metformin therapy, and the dose should be adjusted accordingly. It is also important to screen patients for these risk factors before starting metformin therapy. In addition, patients should be educated on the symptoms of lactic acidosis, such as abdominal pain, nausea, vomiting, and muscle weakness, and advised to seek medical attention immediately if they experience any of these symptoms. Overall, early recognition and appropriate management of MALA can improve patient outcomes and prevent mortality.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140489396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}