Journal of The Egyptian Society of Nephrology and Transplantation最新文献

{"title":"Rapidly progressive glomerulonephritis in a tertiary health facility in northeastern Nigeria: Challenges in diagnosis and management","authors":"Sulaiman Mohammad, Shettima Jummai, L. Mustapha, Loskurima Umar, U. Ibrahim","doi":"10.4103/jesnt.jesnt_27_22","DOIUrl":"https://doi.org/10.4103/jesnt.jesnt_27_22","url":null,"abstract":"Background Rapidly progressive glomerulonephritis (RPGN) is a syndrome that is characterized by the rapid decline of kidney function associated with proteinuria and hematuria and often leads to irreversible kidney failure if diagnosis and subsequent institution of appropriate treatment are not made early. It is thought to be rare in Africa due to late presentation and/or diagnosis of the condition, resulting in many of them labeled as chronic glomerulonephritis. This study aims to determine the prevalence of RPGN among patients admitted with kidney disease in a tertiary health facility in northeastern Nigeria. Patients and methods This cross-sectional hospital-based study was conducted at the University of Maiduguri Teaching Hospital, Maiduguri, Northeast Nigeria, between the periods January 2020 and December 2021. Included in the study were patients admitted into the renal unit who had features of rapidly deteriorating kidney function, normal-sized kidneys more than 8.5 cm, proteinuria, and/or hematuria. Kidney biopsy was done for consenting patients who had normal kidney sizes. The biopsy specimen was fixed in formalin, cut, and stained using hematoxylin and eosin stain. Results A total of 1440 patients were admitted into the renal unit of University of Maiduguri Teaching Hospital, out of whom 28 (1.9%) were diagnosed with RPGN. The ages of the study participants ranged from 17 to 40 years and had a mean of 31.14 ± 7.81 years. Their mean serum creatinine was 1203 ± 495.78 µmol/l and urea 32.67 ± 12.58 moml/l. Proteinuria was present in all patients with RPGN, whereas hematuria was seen in 78.6%. Kidney biopsy was done in 42.9% of patients, 83.3% of them had crescents in more than 50% of glomeruli. Antineutrophil cytoplasmic antibody, complements C3 and C4 were not assayed in any of the study participants. Conclusion RPGN contributes to the burden of kidney disease in northeastern Nigeria. Due to lack of proper investigative tools in our institution, many patients are not diagnosed and those who were identified are not adequately characterized.","PeriodicalId":285751,"journal":{"name":"Journal of The Egyptian Society of Nephrology and Transplantation","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133095826","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":"Prevalence of thyroid disorder in patients with systemic lupus erythematosus and patients with lupus nephritis","authors":"H. Elshair, M. Zeid, A. Deghady, Bassant Essa, M. Bondok","doi":"10.4103/jesnt.jesnt_6_22","DOIUrl":"https://doi.org/10.4103/jesnt.jesnt_6_22","url":null,"abstract":"Background Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that can affect many organs. Lupus nephritis (LN) is a major cause of morbidity and mortality in patients with SLE. The interaction between kidney and the thyroid-gland functions has been known for a long time. Thyroid hormones (TH) are necessary for growth and development of the kidney, and for the maintenance of water and electrolyte homeostasis. On the other hand, kidney is involved in the metabolism and elimination of TH. Thyroid disease appears to be more frequent in SLE patients than in the general population. Therefore, screening of thyroid dysfunction in patients with SLE, especially in those with evidence of LN, is recommended. The aim of this work is to study morphological (thyromegaly and thyroid nodules) and functional (hypothyroidism or hyperthyroidism) thyroid disorders in patients with SLE with or without renal affection, and whether LN acts as an independent risk factor of thyroid abnormalities. Patients and methods In total, 60 participants were divided into three groups: group I: 20 patients diagnosed with SLE without evidence of renal affection, group II: 20 patients diagnosed with SLE with evidence of LN, and group III: 20 healthy participants. All were subjected to full history taking, thorough physical examination, laboratory investigations (urea and creatinine), thyroid function, and serological marker serum [antithyroid peroxidase antibody (anti-TPO Ab)]. Ultrasound examination of the thyroid gland was done. Results There was a direct significant relationship between renal function tests, namely urea and creatinine and anti-TPO among cases with SLE, both without and with LN, and an inverse significant relationship between estimated glomerular filtration rate and anti-TPO among both the SLE group and the LN group. Conclusion Screening of thyroid dysfunction in patients with SLE, especially in those with evidence of LN by estimation of thyroid function tests, thyroid autoantibodies, and by ultrasonography, is recommended.","PeriodicalId":285751,"journal":{"name":"Journal of The Egyptian Society of Nephrology and Transplantation","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128125710","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":"Effect of taurolidine–citrate–heparin lock solution on inflammatory response and hemodialysis adequacy in hemodialysis patients with tunneled catheters","authors":"Magdy Elsharkawy, M. Abdelgawad, Omar Gad, A. Emara","doi":"10.4103/jesnt.jesnt_15_22","DOIUrl":"https://doi.org/10.4103/jesnt.jesnt_15_22","url":null,"abstract":"Background Catheter-related bloodstream infections (CRBSIs) are a significant cause of morbidity and mortality in hemodialysis (HD) patients using dialysis catheters. Short-term and long-term catheters are still being used as a vascular access in HD patients in our country. The aim of this study was to assess the effect of TauroLock-HEP500 as a lock solution on the incidence of CRBSIs, performance of HD permanent catheters, and HD adequacy. Patients and methods This was a randomized controlled trial carried out on 60 patients at Al-Zaitoun Specialized Hospital and Al-Demerdash Hospital – Ain Shams University. The patients were divided into two groups: taurolock group (group 1), which included 30 patients who received TauroLock-HEP500 (taurolidine, 4% citrate and 500 IU/ml heparin are combined in this solution), and heparin group (group 2), which included 30 patients who received unfractionated heparin (heparin sodium 5000 IU/ml) as a permanent catheter lock solution. Patients were followed up for 1 month for monitoring HD adequacy and incidence of CRBSI. Result At the end of the study, C-reactive protein was significantly higher in heparin group than the taurolock group (P=0.01). Moreover, urea reduction ratio significantly increased within group 1 (taurolock) (P≤0.001) and significantly decreased in group 2 (heparin) (P=0.034). Moreover, urea reduction ratio was significantly higher in group 1(taurolock) compared with group 2 (heparin) at the end of the study (P≤0.001). Regarding blood flow rate (BFR), there was a significant increase of BFR within group 1 (taurolock) after 1 month compared with the baseline (P≤0.001), whereas there was no significant change in group 2 (heparin) (P=0.387). Moreover, at the end of the study, there was a significant increase of BFR in group 1 (taurolock) than in group 2 (heparin) (P=0.056). One case with CRBSIs was demonstrated in the taurolock group compared with five cases in the heparin group (P=0.19). Conclusion The use of taurolidine–citrate–heparin lock solution in HD patients with dialysis catheters may be associated with better HD adequacy, lower incidence of CRBSI) and lower inflammatory markers in comparison with the use of heparin.","PeriodicalId":285751,"journal":{"name":"Journal of The Egyptian Society of Nephrology and Transplantation","volume":"181 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115796794","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":"Acute effects of online hemodiafiltration versus high-flux hemodialysis on serum levels of asymmetric dimethylarginine and tumor necrosis factor-alpha","authors":"H. Elsayed, H. E. El Said, W. Beshary, A. Jaleel, F. Ahmed","doi":"10.4103/jesnt.jesnt_14_22","DOIUrl":"https://doi.org/10.4103/jesnt.jesnt_14_22","url":null,"abstract":"Background Chronic inflammation as a major determinant of ‘dialysis syndrome’ is considered as the main factor of morbidity and mortality in dialysis patients. Tumor necrosis factor-alpha (TNF-α) may play important roles in the development of T helper (Th) imbalance, cardiovascular disease, and wasting in the uremic milieu. Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide that may be an independent risk factor for endothelial dysfunction and cardiovascular disease. In hemodialysis (HD) patients, plasma ADMA is a strong and independent predictor of overall mortality and cardiovascular outcome. The aim of this study to evaluate the acute effects of hemodiafiltration (HDF) compared with conventional HD on blood levels of ADMA and TNF-α. Patients and methods A cross-sectional study was conducted on 20 patients with end-stage renal disease receiving dialysis in the dialysis unit of Ain Shams Specialized Hospital receiving twice weekly HD session with high-flux (HF) dialyzer and once weekly HDF session. Blood samples were collected from all participants before and after HD session and from the same participants before and after HDF session. ADMA and TNF-α levels were assessed by enzyme-linked immunosorbent assay techniques. Results The decrease in TNF-α was higher after HDF session versus HF HD session (79.47 ± 14.16 vs. 50.43 ± 31.05), with P value of 0.001. Moreover, the decrease in ADMA was higher after HDF session versus HF HD session (75.01 ± 12.55 vs. 41.79 ± 24.73), with P value of 0.001. Conclusion The use of online HDF technique showed a significant reduction of ADMA and TNF-α in adults with end-stage renal disease.","PeriodicalId":285751,"journal":{"name":"Journal of The Egyptian Society of Nephrology and Transplantation","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132273985","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":"Idiopathic polymyositis in renal transplant recipient: a case report and review of literature","authors":"A. Yehia, Osama Ashry Ahmed Gheith, Mohamed Abdelmonem, Medhat Alawady, P. Nair, Eslam Sobhy, A. Nagib, K. Abdeltawab, Z. Elsayed, Ahmad Abbas, T. Alotaibi","doi":"10.4103/jesnt.jesnt_16_22","DOIUrl":"https://doi.org/10.4103/jesnt.jesnt_16_22","url":null,"abstract":"Introduction and aim Myositis is a rare complication following renal transplant and is most commonly the result of a drug-mediated myotoxicity, but the idiopathic cause is still the most common. After kidney transplant, the differential diagnosis of polymyositis includes autoimmune disease, drug-induced viral infections, and rhabdomyolysis associated with electrolyte imbalance. We aimed to report a case of idiopathic polymyositis in a renal transplant recipient and review the literature for similar cases. Case report A 31-year-old male patient developed polymyositis three years following live-related kidney transplantation. Electromyography confirmed myopathic changes. The clinical features and course, MRI findings, electromyography features, positive anti-MI-2 antibody, and the response to high-dose steroid therapy are matched with immune-mediated acute polymyositis, especially after excluding viral infections and drug-induced myopathy. Conclusion Acute polymyositis may occur after a kidney transplant. Possible mechanisms include viral antigen transmission or a localized graft versus host disease. Muscle biopsy is not mandatory before prompt initiation of high-dose steroid therapy, which leads to clinical and biochemical recovery.","PeriodicalId":285751,"journal":{"name":"Journal of The Egyptian Society of Nephrology and Transplantation","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121320334","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":"Outcomes of hospitalized renal allograft transplant recipients with coronavirus disease 2019: an Egyptian single-center retrospective study","authors":"E. William, H. Ahmed, E. Reyad, Mohammed Mogahed, Amira Boghdady","doi":"10.4103/jesnt.jesnt_17_22","DOIUrl":"https://doi.org/10.4103/jesnt.jesnt_17_22","url":null,"abstract":"Background The outcomes of coronavirus disease 2019 in renal-transplant recipients may differ from the general population because of chronic immunosuppression and comorbidities. The aim of this study is to provide information on the clinical characteristics and outcomes of hospitalized renal allograft transplant recipients with coronavirus disease 2019 is restricted in the Arab region. This study aims to narrow this gap. Patients and methods The study was done on 21 renal allograft transplant recipients admitted in the isolation ward of a single Egyptian center for kidney diseases and transplantation during the period from July 2020 to July 2021, all cases were analyzed regarding their clinical presentation, follow-up, workup done, management, and outcomes. Results The main clinical presentations were fever 90.5% and respiratory symptoms 66.7%, not different from the general population. Their clinical course showed remarkable incidence of acute kidney injury (57.1%) than the general population, but mortality was not (14.3%). Remdesivir was tolerable, no noticeable side effects, and did not affect graft function. Conclusion This category of patients need special care, lowering of immunosuppresion during infection, close monitoring of kidney function, and respiratory status. They can receive ventilator support and same treatment as general population, including Remdesivir and Tocilizumab. Both patient and graft survival can be achieved.","PeriodicalId":285751,"journal":{"name":"Journal of The Egyptian Society of Nephrology and Transplantation","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129575470","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":"Influence of donor complement component allotype on renal transplantation outcome","authors":"H. Elshair, S. Naga, Mohammad Ahmed, A. Hanno","doi":"10.4103/jesnt.jesnt_2_22","DOIUrl":"https://doi.org/10.4103/jesnt.jesnt_2_22","url":null,"abstract":"Background Improvements in clinical care and immunosuppressive medications have provided positive outcomes following kidney transplantation such as reducing acute rejection rates. Activation of the complement cascade is inevitable in kidney transplantation because of both the specific and nonspecific immunologic responses of the recipient. This study provides insights on the influence of the donor C3 allotype on renal transplant outcome (graft function). Patients and methods The present study was conducted on 50 pairs of donors and recipients of renal transplantation who fulfilled the inclusion and exclusion criteria. C3 allotypes of donor–recipient pairs were determined and divided into four genotypic groups according to the C3F allotype of the donor and the recipient. The four genotypic groups were analyzed for association with graft function and assessed by serum creatinine, blood urea, and glomerular filtration rate. Results There was a positive statistically significant difference for the group FF/FS donor into SS recipient in comparison with other genotype groups of C3 among recipients, as shown by improvement in glomerular filtration rate, serum creatinine, and blood urea. Conclusion The presence of C3 (F) allele either homozygous or heterozygous in the donor and the absence of this allele in the recipient give a better renal allograft function.","PeriodicalId":285751,"journal":{"name":"Journal of The Egyptian Society of Nephrology and Transplantation","volume":"39 18","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120887559","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":"Serum immunoglobulin G as a predictive marker of early renal affection in type-2 diabetic patients: a single-center study","authors":"Mohammad S. Abdellah, Nabawia M. Tawfik, Effat Tony, A. Mahmoud, Seham Ali, M. Khairallah","doi":"10.4103/jesnt.jesnt_9_22","DOIUrl":"https://doi.org/10.4103/jesnt.jesnt_9_22","url":null,"abstract":"Background Chronic hyperglycemia is a characteristic feature of diabetes mellitus and responsible for its long-term microvascular and macrovascular complications. One of the most problematic issues concerning diabetes complications is diabetic nephropathy ending with renal impairment and costly treatment. Defining new biomarkers to detect renal affection in diabetic patients is necessary. So, we aimed to evaluate serum immunoglobulin G (IgG) as a marker of early renal affection. Patients and methods In this study, 50 patients with type-2 diabetes were selected and classified according to their albuminuria and glomerular filtration rate, 25 apparently healthy participants were enrolled as a control group. We measured serum IgG levels in patients and control groups. Results Significant higher mean levels of serum IgG were observed with diabetic patients more than the control group and higher in patients with normoalbuminuria and microalbuminuria with P value less than 0.001 for each, however, significant lowest mean levels of serum IgG in the patients with macroalbuminuria when compared with other degrees of albuminuria, significantly higher mean levels of serum IgG were observed in stage-IV nephropathy when compared with other stages of chronic kidney disease (P≤0.001). There was a significant positive correlation between serum IgG and blood urea, serum creatinine, glycosylated hemoglobin, and albuminuria and proteinuria, and a significant negative correlation with estimated glomerular filtration rate with a significant difference in microvascular and macrovascular complications between the stages of chronic kidney disease and serum IgG levels. Conclusion Serum IgG is a simple test that can be used as a predictive biomarker for early renal affection in type-2 diabetic patients.","PeriodicalId":285751,"journal":{"name":"Journal of The Egyptian Society of Nephrology and Transplantation","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127761506","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":"In memory of Prof. Rashad Barsoum","authors":"M. Hasaballa","doi":"10.4103/jesnt.jesnt_37_22","DOIUrl":"https://doi.org/10.4103/jesnt.jesnt_37_22","url":null,"abstract":"","PeriodicalId":285751,"journal":{"name":"Journal of The Egyptian Society of Nephrology and Transplantation","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116920713","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":"Survival outcome in patients undergoing chronic hemodialysis: an Egyptian study at Dakahlia Governorate","authors":"H. Yousif, Adel El-Bastawisy, A. Eldeeb","doi":"10.4103/jesnt.jesnt_41_21","DOIUrl":"https://doi.org/10.4103/jesnt.jesnt_41_21","url":null,"abstract":"Background Several research studies aimed to explain the high mortality among hemodialysis (HD) patients. Our study aimed to describe the mortality in our Governorate (Dakahlia) and to explore its potential risk factors. Patients and methods This prospective (follow-up) study was conducted in four HD units on 120 patients who were followed up over the 12-month period (September 2018–August 2019). At enrollment and every 3 months, all patients were subjected to history taking, physical examination, and laboratory tests for the 12-month period or until the patient died. Results The 120 HD cases were 72 (60%) male patients, and 48 (40%) female patients with a median age of 46.5 years. Over 1-year follow-up, 26 (21.7%) patients died. Survival analysis with the Log-rank test shows no statistically significant difference in survival times based on examined variables (sex, diabetes, hypertension, current smoking, and Subjective Global Assessment). The results of the Cox proportional hazards model [to assess sex, age, diabetes, hypertension, current smoking, HD duration (years), and Subjective Global Assessment as predictors of 1-year mortality in HD patients] show that out of these seven predictor variables, only diabetes was a statistically significant independent predictor. Conclusion HD-related mortality is high in Dakahlia Governorate (21.7%). Diabetes mellitus is an independent risk factor for mortality with a hazard ratio of 2.97.","PeriodicalId":285751,"journal":{"name":"Journal of The Egyptian Society of Nephrology and Transplantation","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130019397","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}