Nephro-urology Monthly最新文献

{"title":"Ambulatory Percutaneous Nephrolithotomy: Initial Series in Iran","authors":"B. Shakiba, Zahra Shekofteh, Ali Faegh, R. Maghsoudi, K. Mehravaran, M. Etemadian, Niloofar Soleimani","doi":"10.5812/numonthly-144075","DOIUrl":"https://doi.org/10.5812/numonthly-144075","url":null,"abstract":"Background: Percutaneous nephrolithotomy (PCNL) procedures in the United States typically cost between 9000 to 16000 USD. In developing countries like Iran, healthcare performance is hindered by issues such as high bed occupancy rates. Therefore, performing PCNL in an outpatient setting could significantly reduce surgical costs and improve healthcare outcomes by reducing bed occupancy and associated complications. Objectives: This study aimed to explore the feasibility of same-day discharge for selected PCNL patients. Methods: Out of 142 patients, 32 were discharged within 12 hours post-operation (Study Group), while 32 randomly selected patients from the remaining 110 served as the control group. Same-day discharge criteria included stable vital signs, tolerance to oral intake, appropriate mobility, and normal laboratory results. Exclusion criteria encompassed the need for red blood cell transfusion, hemoglobin drops exceeding 2 mg/dL, and abnormal post-operative laboratory findings. Results: Patient characteristics and medical histories did not significantly differ between the study and control groups. Additionally, stone laterality (P-value = 0.606), location (P-value = 0.731), size (P-value = 0.334), and density (P-value = 0.065) showed no significant differences between the two groups. The post-surgical observation period in the study group (mean: 7.88 hours) was significantly shorter than that in the control group (mean: 62 hours) (P-value < 0.001). The mean hemoglobin level change was 1.48 mg/dL (SD: ± 1.02) in the study group and 1.31 mg/dL (SD: ± 0.91) in the control group. Similarly, the change in creatinine levels was 0.13 ± 0.04 in the study group and 0.23 ± 0.03 in the control group. Conclusions: This study demonstrates that outpatient PCNL procedures are feasible without increasing perioperative complications. However, careful patient selection based on strict criteria is crucial for successful implementation.","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":"77 S40","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140429337","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":"Correlation of Calcium Metabolic Axis with Urinary Stone Characteristics","authors":"Anahita Ansari Djafari, Muhammadhosein Moradi, Mohaddese Malek Mohammadi, B. Javanmard, Hamidreza Rismanchi","doi":"10.5812/numonthly-142398","DOIUrl":"https://doi.org/10.5812/numonthly-142398","url":null,"abstract":"Background: Urinary stone disease (USD) refers to the presence of stones or salt crystals within the urinary tract, with calcium stones accounting for approximately 80% of cases. Increased urinary calcium and phosphorus excretion predispose individuals to urinary stones, with hypercalciuria being the most significant risk factor. Vitamin D plays a pivotal role in modifying urine calcium and phosphorus excretion, and it enhances calcium and phosphorus reabsorption in the kidneys. Urinary stone disease is a recognized risk factor for chronic kidney disease (CKD) and may also lead to life-threatening complications such as perinephric abscesses, urosepsis, and urinary tract malignancies. The role of serum vitamin D and its effects on serum calcium and phosphorus in urinary stone formation have been subjects of controversy. Objectives: This study aims to evaluate the associations between serum calcium, phosphorus, and vitamin D levels and urinary stones. Methods: This retrospective study involved two groups of 90 patients, one with urinary stones and the other without. Demographic and biochemical data, including serum calcium, phosphorus, and 25-(OH) vitamin D levels, were recorded for all patients. Patients were categorized into four groups based on their serum vitamin D levels: Excess, sufficient, insufficient, and deficient. The presence and characteristics of urinary stones were assessed using non-contrast CT scans. Results: The mean age of the patients was 54.62 ± 15.46 years. Laboratory investigations revealed mean serum calcium, phosphorus, and vitamin D levels of 9.56 ± 0.65 mg/dL, 3.53 ± 0.79 mg/dL, and 25.05 ± 12.96 ng/mL, respectively. This study demonstrated a significant correlation between serum calcium levels and the maximum diameter of urinary stones (correlation = 0.313, P-value = 0.005). No other significant associations were found between serum calcium, serum phosphorus, and serum vitamin D levels and the number of kidney stones, stone laterality, and type of kidney stone. There was also no significant difference between the two groups. Conclusions: In conclusion, the role of serum calcium, phosphorus, and 25-(OH) vitamin D levels in urinary stone formation remains controversial. This study suggests that there is no significant association between serum calcium, phosphorus, or 25-(OH) vitamin D and urinary stones, except for a positive association between serum calcium and the diameter of the stone.","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":"53 3-4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140510570","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":"Vitamin Supplementation and Urinary Tract Infection in Children: A Narrative Review","authors":"Amirhossein Baharvand, Aref Zarei, P. Yousefichaijan","doi":"10.5812/numonthly-135068","DOIUrl":"https://doi.org/10.5812/numonthly-135068","url":null,"abstract":": Urinary tract infections (UTIs) are one of the most prevalent infections among pediatric patients, making them a very common type of infection. Recently, there has been growing interest in the use of vitamin supplements as supplementary therapies. However, the existing research in this field appears to be fragmented and lacking coherence. Thus, this study aimed to provide a comprehensive overview of the current status of vitamin supplements' role in UTI treatment. We reviewed articles in PubMed and Google Scholar from 1950 to 2022. Vitamins C, E, and A have shown promising results as adjuvant therapies in UTI.","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139214253","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":"The Causative Agents and Antibiotic Susceptibility Patterns of Healthcare-Associated Urinary Tract Infections (HAUTIs) in Isfahan, Iran: The Impact on Empiric Therapy","authors":"Sayed Nassereddin Mostafavi Esfahani, Soodabeh Rostami, Amir Hossein Shafiei","doi":"10.5812/numonthly-140033","DOIUrl":"https://doi.org/10.5812/numonthly-140033","url":null,"abstract":"Background: Healthcare-associated urinary tract infections (HAUTIs) are the most prevalent healthcare-associated infection worldwide. They can lead to major problems in hospitalized patients, including the increase in the length of the hospital stay, the cost of the hospitalization, and the inappropriate administration of antibiotics. Objectives: We aim to investigate the prevalence and antibacterial sensitivity of various bacteria that cause HAUTIs. Methods: This cross-sectional study was conducted in three referral hospitals in Isfahan, Iran. Urine specimens were taken from urinary catheters of the patients with a suspected diagnosis of HA-UTI. Bacteria were identified by conventional methods, and antimicrobial sensitivity testing was performed by disk diffusion and E-test methods according to standard guidelines. Data was extracted from WHONET software, and further statistical analysis was performed by SPSS v.21. Results: Among 283 HAUTIs, Escherichia coli was the most prevalent pathogen (33.2%), followed by Enterococcus spp. (25.9%), Klebsiella pneumonia (16.6%), Pseudomonas aeruginosa (8.8%), and Acinetobacter baumannii (8.8%). Escherichia coli was more common in females. The most active antibiotics against Gram-negative isolates were nitrofurantoin (69.8%), carbapenems (69.7%), and aminoglycosides (68.3%), and the most effective antibiotics against Gram-positive isolates were linezolid (100%) and nitrofurantoin (74.5%). Conclusions: This study showed that nitrofurantoin, carbapenems, and aminoglycosides are the most effective antibiotics against Gram-negative causes of HAUTIs. Also, linezolid and nitrofurantoin demonstrated significant activity against Gram-positive isolates. As a result, for the empiric treatment of nosocomial UTI in the area under study, judicious use of the mentioned antibiotics is recommended.","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":"28 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135043004","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":"Structural Equation Modeling of Treatment Adherence Based on General Health and Demographic Characteristics in Patients Undergoing Hemodialysis","authors":"Mahmoud Movahedi, Batool Nehrir, Malihe Sadat Moayed, Masoud Sirati Nir","doi":"10.5812/numonthly-140108","DOIUrl":"https://doi.org/10.5812/numonthly-140108","url":null,"abstract":"Background: A complete adherence to treatment is essential for patients undergoing hemodialysis treatment. This health behavior is the product of various overlapping variables that may change over time. Objectives: This study aimed to investigate treatment adherence based on general health and demographic characteristics among hemodialysis patients. Methods: This was a descriptive-correlation research conducted based on structural equation modeling. The population included all patients with chronic kidney disease in Tehran, Iran, of whom 200 patients undergoing hemodialysis admitted to 2 medical centers from September to March 2022 were selected by convenience sampling. The data were collected using the General Health Questionnaire (GHQ) and End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ). The data were analyzed using correlation analysis and path analysis in SPSS v. 19 and SmartPLS v. 3. Results: The results showed the direct and significant effect of general health (P = 0.001) and age (P = 0.017) on treatment adherence. However, sex, marital status, level of education, and duration of dialysis treatment had no significant effect on treatment adherence. Conclusions: Considering the power of general health and age in predicting treatment adherence, these two variables can be included in training, clinical, and psychological interventions.","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":" 1289","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135186701","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":"Successful Application of PTRA in a Patient with AKI Due to Severe Unilateral Renal Artery Stenosis: A Case Report with 4-Year Follow-up and Review of Literature","authors":"Hossein Saghafi, Mohammad Reza Ahmadi, Mohammad Sina Mirjani, Alireza Saghafi","doi":"10.5812/numonthly-139952","DOIUrl":"https://doi.org/10.5812/numonthly-139952","url":null,"abstract":"Introduction: Renal artery stenosis (RAS) is defined by a decrease in the internal diameter of one or both of the renal arteries. This can lead to renal insufficiency. RAS mostly occurs due to atherosclerosis; however, other conditions can cause this complication. Case Presentation: We present a 66-year-old man who was initially presented with abrupt bilateral lower limbs and scrotal edema in Shahid Beheshti Hospital of Qom. The patient had been regularly visiting the nephrology clinic for mild CKD. Due to the increased levels of creatinine (Cr) and urea in serum, he underwent angiography with suspicion of RAS, and 99% stenosis was confirmed in the left renal artery. Immediately after the diagnosis, we subjected the patient to angioplasty. After removing the arterial stenosis, the patient passed 8 liters of urine during one day, and his symptoms, including generalized edema, weight gain, and dyspnea, were improved gradually. The patient was discharged after 8 days of hospitalization with dramatically improved kidney function and relatively good general conditions. Conclusions: This patient had an uncommon presentation for a unilateral RAS and significant narrowing in the healthy renal artery. Angioplasty and stenting yielded a satisfactory result as a definite and effective treatment, and the patient enjoyed a relatively normal life with preserved kidney function during 4 years of follow-up.","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":"88 S373","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135341620","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":"Oral Melatonin for Colistin-induced Nephrotoxicity Reduction in Intensive Care Unit: A Randomized Placebo Controlled Clinical Trial","authors":"Seyedpouzhia Shojaei, Mohammad Torabi, Mohammad Sistanizad, Mehran Kouchek, Mir Mohammad Miri, Sara Salarian, Padideh Ansar","doi":"10.5812/numonthly-135436","DOIUrl":"https://doi.org/10.5812/numonthly-135436","url":null,"abstract":"Background: Colistin is a drug of choice against multidrug-resistance (MDR) bacteria. The most important side effect of colistin is nephrotoxicity, observed in 20 - 54% of patients. According to the studies that examined its antioxidant effect, it can reduce the kidney toxicity of various drugs, including colistin. Objectives: This study aimed to investigate melatonin's effect on reducing colistin-induced kidney toxicity to use this drug with fewer complications. Methods: This double-blind, randomized clinical trials with two groups involved 56 critically ill adults infected by MDR bacteria. The intervention group received 3 mg of oral melatonin simultaneously with intravenous colistin, which continued until the end of the treatment. The control group received placebo orally with IV colistin. We measured urine volume, blood creatinine, and BUN daily and determined the patients with renal failure using the KDIGO guideline. STATA software analyzed data with a P-value of less than 0.05 as the significance level. Results: Data obtained from recipients were analyzed for age (P-value = 0.357), gender (P-value = 0.945), weight (P-value = 0.438), APACHE score (P-value = 0.162). We did not observe significant difference in AKI criteria between the two groups. Compared to the control group, melatonin did not decrease blood creatinine (P-value = 0.110) and BUN (P-value = 0.567) and, made no change of urinary volume (P-value = 0.913). There was no decrease in kidney failure in the intervention group compared to the control group. As a result, we did not find a significant difference in outcome of the two groups. Conclusions: We did not reveal any significant difference in the AKI criteria including blood creatinine, BUN, and daily urine volume with the addition of melatonin in participants receiving colistin; However, no complication was observed in the intervention group who received melatonin.","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":"52 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135113194","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":"Cysteamine Mitigates the Deleterious Impact of Cryopreservation on Sperm Parameters","authors":"Mohammad Amin Behmanesh, Sima Janati, Behnam Ghorbanzadeh, Ahmad Baniasadian, Seyedeh Mahsa Poormoosavi","doi":"10.5812/numonthly-138581","DOIUrl":"https://doi.org/10.5812/numonthly-138581","url":null,"abstract":"Background: Sperm cryopreservation can reduce the quality of sperm. Antioxidants can improve sperm parameters by decreasing oxidative stress. Objectives: This study was performed to determine the effect of supplementing sperm freezing media with cysteamine on the quality of sperm after freezing. Methods: This descriptive-analytical research was conducted at Omolbanin Center for Infertility Treatment in Dezful, Iran, in 2022. The samples included 60 men with normosperm based on the World Health Organization standards. Each sample was divided into three parts: 1. fresh semen group, 2. semen frozen with 10 mmol cysteamine supplementation, and 3. semen frozen without cysteamine supplementation. Viability, motility, morphology, total antioxidant capacity (TAC), and malondialdehyde (MDA) levels were evaluated. The results were described using SPSS version 22, and the significance level was considered P ≤ 0.05. Results: The mean of progressive motility was significantly higher in the fresh semen group (48.3 ± 4.74) compared to the two other groups. The mean progressive motility was significantly lower in the group without cysteamine supplementation (24.4 ± 3.38) than in the group with cysteamine supplementation (35.3 ± 4.9). Moreover, TAC was significantly higher in the group with cysteamine supplementation (816.6 ± 4.36) than in the other groups. We found that the MDA level was significantly higher in the group without cysteamine supplementation than in the other groups (36.5 ± 2.51). Conclusions: According to the results of the present study, appropriate conditions for preserving the sperm parameters after cryopreservation could be created by adding cysteamine to the sperm cryopreservation media as an antioxidant effective on sperm parameters.","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135512183","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 Rare Case of Urachal Remnant with Calculus Just Above the Bladder","authors":"Amin Mirsani, Mohammad Amin Dana, Seyed Hadi Sajjadi, Raheleh Baradaran","doi":"10.5812/numonthly-137320","DOIUrl":"https://doi.org/10.5812/numonthly-137320","url":null,"abstract":": The urachus closes naturally after birth. Its opening leads to anomalies in which secondary complications, including urachus calculi, may be formed. This disease is often discovered incidentally in radiographic examinations and is rare in adults. The purpose of this study is to present a rare case of urachus calculus in an adult located precisely in the anterior wall of the bladder, at the junction of the bladder and urachus. Our case was a 38-year-old man with complaints of abdominal pain. The computerized tomography (CT) scan images showed a calculus attached to the anterior and inner wall of the bladder in inserting the urachus into the bladder. Cystoscopy showed the calculus is connected to the urachus duct without any mass/tumor. The collection of evidence suggests a calcified urachus. The patient was discharged with conservative treatment and a mild analgesic.","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136113707","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":"Home Hemodialysis as a Suitable Alternative as COVID-19 Pandemic Resurges","authors":"Nader Aghakhani, Mohammad Delirrad, Ebrahim Aliafsari Mamaghani","doi":"10.5812/numonthly-140193","DOIUrl":"https://doi.org/10.5812/numonthly-140193","url":null,"abstract":"<jats:p />","PeriodicalId":19466,"journal":{"name":"Nephro-urology Monthly","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136184874","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}