Saudi Journal of Kidney Diseases and Transplantation最新文献

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Renal Allograft Malakoplakia Presenting as a Pseudotumoral Lesion. 表现为假瘤状病变的肾脏移植马立克氏病
IF 0.5
Saudi Journal of Kidney Diseases and Transplantation Pub Date : 2023-07-01 Epub Date: 2024-02-12 DOI: 10.4103/1319-2442.395454
Vikarn Vishwajeet, Aasma Nalwa, Mahendra Kumar Jangid, Gautam Ram Choudhary, Pushpinder Khera, Nitin Bajpai, Poonam Abhay Elhence
{"title":"Renal Allograft Malakoplakia Presenting as a Pseudotumoral Lesion.","authors":"Vikarn Vishwajeet, Aasma Nalwa, Mahendra Kumar Jangid, Gautam Ram Choudhary, Pushpinder Khera, Nitin Bajpai, Poonam Abhay Elhence","doi":"10.4103/1319-2442.395454","DOIUrl":"10.4103/1319-2442.395454","url":null,"abstract":"<p><p>Malakoplakia is an uncommon inflammatory disease that can involve many organ systems but is often encountered in the urogenital tract. Kidney allograft malakoplakia is even rarer and can have a diffuse parenchymal or a pseudotumoral presentation. We describe a case of grafi malakoplakia in an adult female, who presented with dull aching pain in the right loin, fever, and vomiting. Ultrasonography of the kidney graft showed a heterogeneous lesion (2.6 cm × 2.9 cm), raising suspicion of primary or metastatic renal tumors. The diagnosis was established after a histopathological examination of the kidney biopsy. This pseudotumoral presentation of malakoplakia can mimic renal cell carcinoma, lymphoma, fungal infections, or tuberculosis. It is essential to perform a biopsy for establishing the diagnosis.</p>","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723846","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}
引用次数: 0
Spectrum and Distribution of Biopsy-proven Kidney Diseases: A 12-year Survey of a Single Center in Iran. 活检证实的肾脏疾病的种类和分布:伊朗单个中心的 12 年调查。
IF 0.5
Saudi Journal of Kidney Diseases and Transplantation Pub Date : 2023-07-01 Epub Date: 2024-02-12 DOI: 10.4103/1319-2442.395451
Fatemeh Nili, Elham Farahani, Mehran Moghimian, Issa Jahanzad, Farzaneh-Sadat Minoo, Samaneh Salarvand, Alireza Abdollahi, Seyed Ali Mirshahvalad
{"title":"Spectrum and Distribution of Biopsy-proven Kidney Diseases: A 12-year Survey of a Single Center in Iran.","authors":"Fatemeh Nili, Elham Farahani, Mehran Moghimian, Issa Jahanzad, Farzaneh-Sadat Minoo, Samaneh Salarvand, Alireza Abdollahi, Seyed Ali Mirshahvalad","doi":"10.4103/1319-2442.395451","DOIUrl":"10.4103/1319-2442.395451","url":null,"abstract":"<p><p>Data about the prevalence of biopsy-proven kidney diseases in Iran are rare, and none of the previous studies used electron microscopy for diagnosis. This study aimed to analyze the prevalence of biopsy-proven kidney diseases in Iran's primary referral center. To the best of our knowledge, this is the most extensive study carried out in Iran. Reports of kidney biopsy samples from patients referred to our center in 2007-2018 were reviewed for demographic data, clinical presentation, and final diagnosis. Statistical analyses were performed. Among the 3455 samples received, 2975 were analyzed. Nephrotic syndrome (39%) was the most common cause of biopsy, followed by subnephrotic proteinuria (18%), hematuria in association with proteinuria (15%), renal failure (9%), isolated hematuria (6%), and lupus nephritis (LN) (4%). The most common diagnoses were membranous glomerulonephritis (17.9%), focal segmental glomerulosclerosis (FSGS) (15.9%), LN (13.7%), minimal histopathological findings (unsampled FSGS vs. minimal change disease, 12.1%), Immunoglobin A nephropathy (IgAN) (6.5%) and Alport syndrome (6.1%). NS and proteinuria were the most common indications for a kidney biopsy. IgAN and LN were the most common causes of primary and secondary glomerulonephritis, presenting with hematuria and proteinuria, respectively. Although membranous glomerulonephritis was the most common disease, it has been replaced by FSGS in recent years.</p>","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723848","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}
引用次数: 0
Study of Serum Fibroblast Growth Factor 23 as a Predictor of Endothelial Dysfunction among Egyptian Patients with Diabetic Kidney Disease. 血清成纤维细胞生长因子 23 预测埃及糖尿病肾病患者内皮功能障碍的研究
IF 0.5
Saudi Journal of Kidney Diseases and Transplantation Pub Date : 2023-07-01 Epub Date: 2024-02-12 DOI: 10.4103/1319-2442.395446
Ahmed Fayed, AbdelAal Mohamed, Rabab Mahmoud Ahmed, Sameh Abouzeid, Ahmed Soliman
{"title":"Study of Serum Fibroblast Growth Factor 23 as a Predictor of Endothelial Dysfunction among Egyptian Patients with Diabetic Kidney Disease.","authors":"Ahmed Fayed, AbdelAal Mohamed, Rabab Mahmoud Ahmed, Sameh Abouzeid, Ahmed Soliman","doi":"10.4103/1319-2442.395446","DOIUrl":"10.4103/1319-2442.395446","url":null,"abstract":"<p><p>Endothelial dysfunction in patients with diabetic nephropathy is caused by nontraditional factors in addition to common risk factors (e.g., hypertension) in people with normal kidney function. These nontraditional factors include factors involved in mineral bone disease in these patients. One of these factors is fibroblast growth factor 23 (FGF-23). We aimed to evaluate the relationship between flow-mediated dilatation (FMD) as a measure of endothelial dysfunction and FGF-23. This was a cross-sectional observational study that was conducted on 100 diabetic patients (Group I: 50 patients with nephropathy; Group II: 50 patients without nephropathy) and 50 healthy volunteers (Group III). Serum levels of intact FGF-23, interleukin-6, intact parathyroid hormone, and 25-hydroxyvitamin D (25-(OH)Vit D); estimated insulin resistance; and FMD were evaluated. FGF-23 was significantly higher in Group I (median: 101 pg/mL) and Group II (median: 101 pg/mL) than in Group III (median: 4 pg/mL) (P <0.001), but FGF-23 was not significantly different between Groups I and II. A significant positive correlation was found between serum levels of FGF-23 and phosphorus in Group I. A significant negative correlation was found between serum levels of FGF-23 and 25-(OH)Vit D in Group II. However, FGF-23 failed to show a significant correlation with FMD in patients with diabetic nephropathy. Our data suggest another factor that rises earlier than FGF-23 in diabetic nephropathy and causes endothelial dysfunction.</p>","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723849","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}
引用次数: 0
Clinicopathological Profile of Immunoglobulin A Nephropathy: A Study from Northeast India. 免疫球蛋白 A 肾病的临床病理特征:印度东北部的一项研究
IF 0.5
Saudi Journal of Kidney Diseases and Transplantation Pub Date : 2023-07-01 Epub Date: 2024-02-12 DOI: 10.4103/1319-2442.395450
Pranjal Kalita, Jaya Mishra, Biswajit Dey, Vandana Raphael, Monaliza Lyngdoh, Himesh Barman, Animesh Mishra
{"title":"Clinicopathological Profile of Immunoglobulin A Nephropathy: A Study from Northeast India.","authors":"Pranjal Kalita, Jaya Mishra, Biswajit Dey, Vandana Raphael, Monaliza Lyngdoh, Himesh Barman, Animesh Mishra","doi":"10.4103/1319-2442.395450","DOIUrl":"10.4103/1319-2442.395450","url":null,"abstract":"<p><p>Immunoglobulin A (IgA) nephropathy is the most common primary glomerulopathy, with wide variation in its prevalence as well as clinical symptoms. Among the laboratory parameters, increased serum creatinine (SCr) levels, mean arterial pressure (MAP), and a decreased estimated glomerular filtration rate (eGFR) point toward poorer renal function. The Oxford 2016 scoring system for IgA nephropathy identified various histopathological variables, which serve as indicators of renal outcomes. There is a paucity of studies on the prevalence as well as the various clinical laboratory parameters correlating with the 2016 Oxford scoring system in northeastern India. The present study showed that IgA nephropathy was more common in the second and third decades, more prevalent in females, and mostly presented with edema. Nephrotic proteinuria, higher SCr, MAP, and decreased eGFR levels at presentation suggested poorer renal function in most subjects. The endocapillary hypercellularity, segmental sclerosis, tubular atrophy, and crescent variables of the 2016 Oxford scoring system showed a statistically significant relationship with various laboratory parameters at presentation.</p>","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723829","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}
引用次数: 0
Renal Survival of Chronic Kidney Disease Patients in a Tertiary Referral Hospital in Malaysia. 马来西亚一家三级转诊医院慢性肾病患者的肾脏存活率。
IF 0.5
Saudi Journal of Kidney Diseases and Transplantation Pub Date : 2023-07-01 Epub Date: 2024-02-12 DOI: 10.4103/1319-2442.395452
Farhanah Omar Fatin, Ab-Hamid Siti Azrin, Bachok Norsa'adah, Azreen Syazril Adnan, Wan-Adnan Wan Nor Asyikeen
{"title":"Renal Survival of Chronic Kidney Disease Patients in a Tertiary Referral Hospital in Malaysia.","authors":"Farhanah Omar Fatin, Ab-Hamid Siti Azrin, Bachok Norsa'adah, Azreen Syazril Adnan, Wan-Adnan Wan Nor Asyikeen","doi":"10.4103/1319-2442.395452","DOIUrl":"10.4103/1319-2442.395452","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) represents a major public health issue, which then progresses to end-stage renal disease (ESRD) sooner or later. This retrospective cohort study aimed to determine the renal survival time of CKD patients. In total, 247 CKD patients in one of the tertiary referral hospitals in Malaysia between January 2005 and December 2015 were enrolled. All CKD patients were included if they were dependent on dialysis. Patients who were transferred out and those with incomplete records were excluded from the study. The renal survival time was calculated from the time of the first diagnosis of CKD to a confirmed ESRD diagnosis or the use of dialysis. In total, 193 (78.1%) CKD patients progressed to ESRD. The mean age of the ESRD patients was 53 years old. The majority of ESRD patients were male (57.0%) and of Malay ethnicity (89.6%). The most common comorbidities among ESRD patients were hypertension (92.2%) and diabetes mellitus (85.5%). The majority of patients were in Stage IV and V (97.9%). The overall renal survival time of CKD patients who develop ESRD was 26 months (95% confidence interval: 20.41, 31.59). Patients who smoked (P = 0.001), had hyperlipidemia (P <0.001) and consumed lipid-lowering agents (P = 0.004) had a significant P-value in the log-rank test. The progression of CKD from diagnosis to ESRD was within 2 years. Therefore, early recognition of CKD is important to improve patients' outcomes and prolong their renal survival time.</p>","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723847","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}
引用次数: 0
Relationship between High-density Lipoprotein Cholesterol and Insulin Resistance in Non-diabetic Chronic Kidney Disease Patients. 非糖尿病慢性肾病患者的高密度脂蛋白胆固醇与胰岛素抵抗之间的关系
IF 0.5
Saudi Journal of Kidney Diseases and Transplantation Pub Date : 2023-07-01 Epub Date: 2024-02-12 DOI: 10.4103/1319-2442.395448
Yasser Abdel-Monem El-Hendy, Mabrouk Ibrahim Ismail, Maher Mohamed Borai, Walid Ahmed Ragab Abdelhamid
{"title":"Relationship between High-density Lipoprotein Cholesterol and Insulin Resistance in Non-diabetic Chronic Kidney Disease Patients.","authors":"Yasser Abdel-Monem El-Hendy, Mabrouk Ibrahim Ismail, Maher Mohamed Borai, Walid Ahmed Ragab Abdelhamid","doi":"10.4103/1319-2442.395448","DOIUrl":"10.4103/1319-2442.395448","url":null,"abstract":"<p><p>Insulin resistance is linked to cardiovascular disease (CVD), even in non-diabetic patients. Therefore, insulin resistance contributes to the development of CVDs, which are the most important cause of morbidity and mortality in chronic kidney disease (CKD) and patients receiving dialysis replacement therapy. Furthermore, CKD greatly affects the enzyme activities responsible for the metabolism of high-density lipoprotein (HDL), causing an abnormal composition and function of HDL, which results in the loss of the anti-inflammatory effect of HDL and its protective effect against CVD. The study aimed to find the relationship between HDL-C, inflammation, and insulin resistance in nondiabetic CKD patients undergoing different modalities of treatment. This prospective cross-sectional comparative study included 80 subjects divided into the control group (20 healthy participants), Group 1 (15 predialysis CKD patients on conservative treatment), Group 2 (10 peritoneal dialysis patients), and Group 3 (35 hemodialysis patients). A full history, medical examination, and a laboratory investigation were carried out on all subjects from June 2018 to June 2019. The patient groups had significantly lower HDL and higher serum insulin than the control group. HDL was negatively correlated with the Homeostatic Model Assessment of Insulin Resistance. There was a strong negative association between HDL and insulin resistance in CKD patients. Therefore, lifestyle modifications and dyslipidemia treatment in CKD might help to prevent cardiovascular events even in nondiabetic nonobese CKD patients.</p>","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723845","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}
引用次数: 0
Effect of Febuxostat versus Allopurinol on the Glomerular Filtration Rate and Hyperuricemia in Patients with Chronic Kidney Disease. 非布司他与别嘌醇对慢性肾病患者肾小球滤过率和高尿酸血症的影响
IF 0.5
Saudi Journal of Kidney Diseases and Transplantation Pub Date : 2023-07-01 Epub Date: 2024-02-12 DOI: 10.4103/1319-2442.395443
Shankar Prasad Nagaraju, Srinivas Vinayak Shenoy, Indu Rao, Ravindra Attur Prabhu, Dharshan Rangaswamy, Mohan V Bhojaraja, Vasudeva Guddattu
{"title":"Effect of Febuxostat versus Allopurinol on the Glomerular Filtration Rate and Hyperuricemia in Patients with Chronic Kidney Disease.","authors":"Shankar Prasad Nagaraju, Srinivas Vinayak Shenoy, Indu Rao, Ravindra Attur Prabhu, Dharshan Rangaswamy, Mohan V Bhojaraja, Vasudeva Guddattu","doi":"10.4103/1319-2442.395443","DOIUrl":"10.4103/1319-2442.395443","url":null,"abstract":"<p><p>Hyperuricemia is a risk factor for the progression of chronic kidney disease (CKD). We compared febuxostat versus allopurinol in the progression of CKD and hyperuricemia in 101 patients with Stage 3-4 CKD treated with febuxostat or allopurinol for at least 6 months for hyperuricemia (>7 mg/dL) between January 2012 and December 2016. Baseline characteristics, serum uric acid (SUA), serum creatinine, and estimated glomerular filtration rate (eGFR) at entry and 6 months were compared. The primary outcome was the decline in eGFR and the secondary outcomes were reductions in SUA and adverse events. Fifty-four were in the febuxostat group and 47 were in the allopurinol group. The baseline characteristics were comparable except for age. The mean dose of febuxostat and allopurinol was 43.70 ± 14.5 mg and 108.51 ± 40 mg, respectively. After 6 months, the median rate of decline in eGFR was 1.2 mL/min/1.73 m2 (IQR: 1.2, 5.5) in the febuxostat group and 3.1 mL/min/1.73 m2 (0.6, 6.2) in the allopurinol group, but this was not statistically significant (P = 0.136). The mean reduction in SUA was significantly better (P = 0.004) in the febuxostat group (3.9 ± 1.7 mg/dL) compared with the allopurinol group (2.1 ± 1.0 mg/dL). Both drugs had no serious adverse events. Febuxostat was better at reducing hyperuricemia than allopurinol, but there was no significant difference in the progression of CKD. Large randomized trials and long-term follow-up are necessary to see whether febuxostat has a favorable effect on the progression of CKD.</p>","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723831","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}
引用次数: 0
Study on the Effect of Low Calcium Dialysate on Biochemical Profile of Adynamic Bone Disease in Patients on Maintenance Hemodialysis. 关于低钙透析液对维持性血液透析患者动力性骨病生化指标影响的研究
IF 0.5
Saudi Journal of Kidney Diseases and Transplantation Pub Date : 2023-05-01 Epub Date: 2024-01-17 DOI: 10.4103/1319-2442.393995
Suman Sethi, Harmeet Singh Dhooria, Sourav Goyal, Vikas Makkar
{"title":"Study on the Effect of Low Calcium Dialysate on Biochemical Profile of Adynamic Bone Disease in Patients on Maintenance Hemodialysis.","authors":"Suman Sethi, Harmeet Singh Dhooria, Sourav Goyal, Vikas Makkar","doi":"10.4103/1319-2442.393995","DOIUrl":"10.4103/1319-2442.393995","url":null,"abstract":"<p><p>In recent years, adynamic bone disease (ABD) has become a common skeletal lesion in adult patients with chronic kidney disease. We aimed to compare the effects of low calcium dialysate (LCD) and standard calcium dialysate of our facility [high calcium dialysate (HCD)] on the evolution of bone and mineral parameter related to ABD in dialysis patients. Forty patients with predialysis intact parathyroid hormone (iPTH) <100 pg/mL and/or bone-specific alkaline phosphatase (BAP) <27 U/L were included in this study and were equally distributed over LCD (1.25 mmol/L) or HCD (1.75 mmol/L) treatment. The duration of the study was 6 months. There was no significant difference in baseline characters and biochemical parameters related to chronic kidney disease-mineral and bone disorder in both the groups. The groups did not differ in the mean tCa before dialysis, but this parameter was significantly lower in the LCD group versus HCD at the end of the study. The mean serum levels of iPTH, total alkaline phosphatase, and BAP in the LCD group were increased at 3 months and at the end of the study compared with the baseline levels. The bone markers in the HCD group did not change significantly. At the end of the study, all bone parameters in the LCD group were significantly higher than in the HCD group. Development of measures indicating increased bone turnover in patients receiving 1.25 mmol/L of dialysate calcium, most likely as a result of inhibiting a positive calcium balance and allowing for long-term PTH secretion stimulation. Hence, LCD might be considered a valuable therapeutic option for ABD patients.</p>","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139484528","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}
引用次数: 0
Clinico-biochemical Profile of Biopsy-proven Minimal Change Disease in Adults from a Tertiary Care Center in South India. 印度南部一家三级医疗中心活检证实的成人微小病变的临床生化概况。
IF 0.5
Saudi Journal of Kidney Diseases and Transplantation Pub Date : 2023-05-01 Epub Date: 2024-01-17 DOI: 10.4103/1319-2442.393997
Karteek R N Udupa, Mahesh Eshwarappa, K C Gurudev, M S Gireesh, Rajshekar Reddy, Mohammed Yousuff
{"title":"Clinico-biochemical Profile of Biopsy-proven Minimal Change Disease in Adults from a Tertiary Care Center in South India.","authors":"Karteek R N Udupa, Mahesh Eshwarappa, K C Gurudev, M S Gireesh, Rajshekar Reddy, Mohammed Yousuff","doi":"10.4103/1319-2442.393997","DOIUrl":"10.4103/1319-2442.393997","url":null,"abstract":"<p><p>Minimal change disease (MCD) is the most common cause of nephrotic syndrome (NS) in children, and in adults, it contributes to 10%-25% of NS. MCD in adults follows a slightly different course associated with increased incidence of steroid resistance, hematuria, and HTN. This is a prospective-record analysis study aimed to analyze the profile of MCD in adults, response to treatment, and relapse rates. A retrospective observational study was carried out and data were collected retrospectively from all biopsy-proven MCD patients between 2012 and 2018. A total of 86 adults were diagnosed to have biopsy-proven MCD. Of these, 32 were excluded due to insufficient data/lost for follow-up. The IBM SPSS Statistics version 22.0 was used for the statistical analysis. Descriptive analysis includes expression of all the explanatory and outcome variables in terms of frequency and proportions for categorical variables whereas in terms of mean ± standard deviation for continuous variables. Chi-square test was used to compare the age, gender, remission, renal failure and response of different drugs, treatment durations, comorbidity conditions, relapse episodes, and different types of infections based on the degree of proteinuria among study patients. A total of 54 biopsy-proven adult MCD patients were analyzed. The mean age of the patients studied was 36.67 years, with the oldest patient being 76 years. In the study group, 37 (68.5%) patients were male and 14 (31.5%) were female. In the study population, 20 (37%) were hypertensive, 3 (5.6%) were diabetic, and 10 (18.5%) had renal failure at presentation. On treatment, 52 out of 54 patients received steroids, of which 41 (75.9%) were steroid responsive, 6 (11.1%) steroid dependent, and 7 (13%) steroid resistant. The mean time for remission in steroidsensitive patients was 8.8 weeks. Among the steroid-dependent and steroid-resistant patients, 11 patients received calcineurin inhibitors (CNIs), of which 3 were CNI resistant. In the study Group 1 patient received cyclophosphamide and two received rituximab. In the study population, two patients failed to achieve remission and one patient was initiated on hemodialysis and later lost for follow-up. Minimal change NS is a type of NS which is highly responsive to steroids with good prognosis in children. Adult MCD patients require a higher and prolonged course of steroid when compared to children. CNIs and rituximab form a promising second-line drug in patients who are steroid resistant/dependent. However, CNI dependency or relapse after stopping steroids is a concern.</p>","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139486388","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}
引用次数: 0
Patency Rates and Outcomes of Renal Access Arteriovenous Fistulas for Hemodialysis in Patients with Chronic Kidney Disease. 用于慢性肾病患者血液透析的肾通路动静脉瘘的通畅率和疗效。
IF 0.5
Saudi Journal of Kidney Diseases and Transplantation Pub Date : 2023-05-01 Epub Date: 2024-01-17 DOI: 10.4103/1319-2442.393992
Anil Sharma, Gaurav Sindwani, Dharamveer Singh, Rajendra Mathur, Ankit Bhardwaj
{"title":"Patency Rates and Outcomes of Renal Access Arteriovenous Fistulas for Hemodialysis in Patients with Chronic Kidney Disease.","authors":"Anil Sharma, Gaurav Sindwani, Dharamveer Singh, Rajendra Mathur, Ankit Bhardwaj","doi":"10.4103/1319-2442.393992","DOIUrl":"10.4103/1319-2442.393992","url":null,"abstract":"<p><p>Hemodialysis remains the most popular modality of renal replacement therapy for end-stage renal disease patients with chronic kidney disease. Various factors such as a radial artery, cephalic vein diameter, age, hypertension, and diabetes mellitus can affect the fistula maturation. This study was carried out to know the patency rates and factors affecting fistula maturation in the Indian population. This is a prospective observational study which aimed to study the patency rate of arteriovenous (AV) fistulas. On the day of surgery, patients were shifted inside the operation theater. Under all aseptic precautions, an AV fistula was formed using the radial artery and cephalic vein. All patients were followed up for 6 months. The data were analyzed using IBM SPSS version 22. To see the change over a period of time, McNemar test for categorical data and repeated measure for continuous data followed by post hoc comparison by Bonferroni method were used. The mean age of the patients was 46.98 ± 13.33 years. The mean diameter of the cephalic vein, ulnar artery, and radial artery at the wrist was 1.733 ± 0.528, 1.700 ± 0.364, and 1.908 ± 0.420, respectively, whereas the mean diameter of the cephalic vein, ulnar artery, and radial artery at the forearm was 1.952 ± 0.488, 1.910 ± 0.421, and 2.058 ± 0.458, respectively. Immediate thrill after the surgery was present in 36/52 (69.2%) of the patients. The radial artery diameter at the wrist was significantly less in the patients with primary failure in whom immediate thrill was not present (P = 0.016). At 1-month follow-up, 30/49 (61.2%) and, at 6 months, 29/48 (60.4%) fistulas were functional. Radiocephalic AV fistulas have a reasonable success rate and minimal morbidity, and radial artery diameter is a good predictor of the outcome.</p>","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139486401","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}
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