Arab journal of nephrology and transplantation最新文献_第10页

Management of pediatric tumor lysis syndrome. 小儿肿瘤溶解综合征的处理。

Arab journal of nephrology and transplantation Pub Date : 2011-09-01 DOI: 10.4314/ajnt.v4i3.71027

Illias Tazi, Hatim Nafl, Jamila Elhoudzi, Lahoucine Mahmal, Mhamed Harif

{"title":"Management of pediatric tumor lysis syndrome.","authors":"Illias Tazi, Hatim Nafl, Jamila Elhoudzi, Lahoucine Mahmal, Mhamed Harif","doi":"10.4314/ajnt.v4i3.71027","DOIUrl":"https://doi.org/10.4314/ajnt.v4i3.71027","url":null,"abstract":"Introduction: Tumor lysis syndrome (TLS) is a serious complication of malignancies and can result in renal failure or death.Review: In tumors with a high proliferative rate with a relatively large mass and a high sensitivity to cytotoxic agents, the initiation of therapy often results in the rapid release of intracellular anions, cations and the metabolic products of proteins and nucleic acids into the bloodstream. The increased concentrations of uric acid, phosphates, potassium and urea can overwhelm the body's homeostatic mechanisms to process and excrete these materials and result in the clinical spectrum associated with TLS. Typical clinical sequelae include gastrointestinal disturbances, neuromuscular effects, cardiovascular complications, acute renal failure and death. Tumor lysis syndrome can also compromise the efficacy or administration of curative therapies. Available evidence suggests that the incidence of clinical TLS is approximately 3-7% for acute leukemias and 4-11% for lymphomas. Pediatric cancers are the leading cause of death by disease in children. The most common pediatric cancers include the leukemias, lymphomas, central nervous system tumors and neuroblastoma. Thus, TLS is a major concern to practitioners caring for pediatric oncology patients. Given the complexity of TLS prevention and treatment, a multidisciplinary approach involving the collaboration of medical oncologists/ hematologists and nephrologists has the greatest potential of ensuring optimal patient outcomes. Rehydration is fundamental in the management of TLS in addition to the current standard therapy for hyperuricemia which include rasburicase and allopurinol.Conclusion: The early recognition and treatment of metabolic abnormalities often prevents the severe and life-threatening complications associated with tumor lysis syndrome.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"4 3","pages":"147-54"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4314/ajnt.v4i3.71027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30230803","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: 5

A nephrology fellowship training program in Sudan: the goals and challenges. 苏丹肾病学奖学金培训项目:目标与挑战。

Arab journal of nephrology and transplantation Pub Date : 2011-09-01

Mazin Mohammed Taha Shigidi

引用次数: 0

Towards a unified renal registry in Africa and the Middle East. 在非洲和中东建立统一的肾脏登记系统。

Arab journal of nephrology and transplantation Pub Date : 2011-05-01

Hasan Abuaisha

引用次数: 0

Polyomavirus associated nephropathy presenting five years after kidney transplantation. 肾移植后5年出现的多瘤病毒相关性肾病。

Arab journal of nephrology and transplantation Pub Date : 2011-05-01

Malleshappa Pavan, Ravi Ranganath, Anup P Chaudhari, Hemant J Mehta

{"title":"Polyomavirus associated nephropathy presenting five years after kidney transplantation.","authors":"Malleshappa Pavan, Ravi Ranganath, Anup P Chaudhari, Hemant J Mehta","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Polyomavirus associated nephropathy (PVAN) is being recognised as an important cause of renal transplant dysfunction. It is a difficult diagnosis to make and requires a high index of suspicion. Here we describe an unusually late presentation of PVAN that responded favourably to reduction of immunosuppression.Case report: A 52 year-old male presented with an elevated serum creatinine of 3.8 mg/dl five years after kidney transplantation. He was maintained on tacrolimus, mycophenolate mofetil (MMF), and prednisolone. He had loose motions that subsided when MMF was withdrawn. His tacrolimus trough level was very high and its dose was reduced, with no improvement in creatinine level. Doppler of the transplanted kidney revealed normal perfusion. The patient's urine was negative for decoy cells and his plasma PCR for polyoma BK virus DNA was also negative. Kidney biopsy revealed histological features suggestive of PVAN and this diagnosis was confirmed by immunohistochemistry which was positive for simian virus 40 (SV40) antigen. Tacrolimus was discontinued and the patient maintained on azathioprine and prednisolone. His serum creatinine stabilized at 1.2 mg/dl.Conclusion: This case highlights the propensity of PVAN to present very late after transplantation. Renal biopsy is very valuable in establishing the diagnosis and timely management can prevent graft loss.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"4 2","pages":"87-90"},"PeriodicalIF":0.0,"publicationDate":"2011-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30064792","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

Can we improve diagnosis of renal failure? A revised coding system for Middle East and North Africa. 我们能提高肾功能衰竭的诊断吗?修订后的中东和北非编码系统。

Arab journal of nephrology and transplantation Pub Date : 2011-05-01

Guy H Neild, Deren Deren Oygar, Mohamed Ben Hmida

{"title":"Can we improve diagnosis of renal failure? A revised coding system for Middle East and North Africa.","authors":"Guy H Neild, Deren Deren Oygar, Mohamed Ben Hmida","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Reporting data on primary renal disease (PRD) causing end-stage renal failure (ESRF) is generally inconsistent and diagnostic groups poorly defined.Methods: We have identified all papers published from the Eastern Mediterranean, Middle East, Arabia and North Africa during the decade 2000-2009 that report data on PRD in patients reaching ESRF in this region.Results: We propose a system in which all diagnoses fall into one of 8 broad groups: ESRF of uncertain etiology, Congenital abnormalities of the kidney and urinary tract (CAKUT) and acquired Uropathy, Glomerular diseases, Tubulo-interstitial disease (TID), Other Congenital and Familial diseases, Diabetes, Renovascular disease, Other Specified Diagnoses. Each group has sub-headings, for instance, primary glomerulonephritis, secondary glomerulonephritis, and hereditary glomerular disease. And then for each sub-heading there is list of specific diagnoses similar to that used by EDTA and USRDS coding systems. We also recommend that 'etiology unknown' group should be reported in more detail as either 'glomerular phenotype' or 'tubular phenotype' and careful attention paid to evidence for a family history of renal disease. To improve reporting, all patients who are diabetic, and all who have evidence of familial inheritance, should be recorded and then a diagnostic category should also be chosen. So a diabetic patient is designated as 'diabetic nephropathy' only if they fulfil the case definition for that diagnosis.Conclusion: We know that collecting PRD data can be done much better as we have the example of the pediatric community which collects data that is very consistent, and has a low rate of 'unknown disease'.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"4 2","pages":"61-9"},"PeriodicalIF":0.0,"publicationDate":"2011-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30063803","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 of acute kidney injury in a tertiary care hospital in Cairo. 开罗一家三级保健医院急性肾损伤谱。

Arab journal of nephrology and transplantation Pub Date : 2011-05-01

Amin R Soliman

{"title":"Spectrum of acute kidney injury in a tertiary care hospital in Cairo.","authors":"Amin R Soliman","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Data concerning the spectrum of acute kidney injury (AKI) in Egypt are scarce. The study aims to describe the spectrum of AKI in a tertiary hospital in Cairo.Methods: We retrospectively collected the data of all cases of AKI who were treated at Dar El Shefa Hospital, Cairo, Egypt, from January 2006 to January 2007.Results: There were 51 cases of AKI during the study period (29 males and 22 females). Their age ranged from 19 to 81 years with a mean of 48 years. Pre-renal azotemia and acute tubular necrosis (ATN) accounted for 53% of all cases. These were due to cardiovascular disease in ten patients, sepsis in six patients, obstetrical complications in five patients, post surgical in four patients, trauma in one patient and gastroenteritis in one patient. Contrast induced nephrotoxicity was responsible for AKI in eight cases (15.7%), glomerulonephritis/vasculitis in eight (15.7%), obstructive uropathy in five (9.8%) acute interstitial nephritis in two (3.9%), and acute urate nephropathy in one (2%). Thirty cases were treated conservatively, nineteen received hemodialysis, and two received peritoneal dialysis. Average duration of hospital stay was 11.7 days. Out of the fifty one cases, thirty-three recovered normal renal function (64.7%), eleven expired, five progressed to chronic kidney disease and two were lost follow up. Overall mortality was 21.5%.Conclusion: The common causes of acute kidney injury in our setting were pre-renal azotemia and ATN due to acute cardiovascular disease (19.6%), contrast induced nephrotoxicity (15.6%), glomerulonephritis (15.6%) and sepsis induced ATN (11.7%). Most cases were managed conservatively and two thirds recovered their normal kidney function.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"4 2","pages":"83-6"},"PeriodicalIF":0.0,"publicationDate":"2011-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30064791","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

The prevalence of proteinuria among pregnant women as detected by a semi-quantitative method: a single center experience. 用半定量方法检测孕妇蛋白尿的患病率:单中心经验。

Arab journal of nephrology and transplantation Pub Date : 2011-05-01

Osama Osman, Ayodeji O Bakare, Sarra Elamin

{"title":"The prevalence of proteinuria among pregnant women as detected by a semi-quantitative method: a single center experience.","authors":"Osama Osman, Ayodeji O Bakare, Sarra Elamin","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: We aimed at estimating the prevalence and the natural history of proteinuria among pregnant women attending Bakare and associates OB/GYN center, Harrisburg Pa, USA.Methods: We chose a simple random sample from patients who attended the center for antenatal care and reviewed their medical and obstetrical records focusing on urine dipstick testing results, blood pressure measurements and pregnancy outcome.Results: The study included 202 pregnant women with no history of proteinuria. Their mean age was 27 ± 7 years (range 15-44 years). Significant proteinuria (≥ 1+ protein) was detected in 3.8%, 10.7% and 10.6% of dipstick tests performed in the first, second and third trimesters respectively. Hypertensive disorders were diagnosed in thirteen patients (6.4%); three patients had chronic hypertension, two patients had preeclampsia, two patients had preeclampsia superimposed on chronic hypertension, and six patients had gestational hypertension. Obese patients were significantly more likely to develop one of the hypertensive disorders of pregnancy (OR 6.1; P = 0.04) than other patients. These disorders tended to be more common among patients who tested positive for proteinuria (≥ 1+) during the first trimester compared to patients with negative urine dipstick testing (OR 3.1; P = 0.3) but the difference was not statistically significant. Proteinuria disappeared in all patients postpartum, and none of the patients had deterioration in her kidney function.Conclusion: Despite the fact that proteinuria was common in this study population, both renal and pregnancy outcomes were favorable.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"4 2","pages":"77-82"},"PeriodicalIF":0.0,"publicationDate":"2011-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30064790","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

Factors affecting Saudi hemodialysis patients' perception of healthcare providers' empathy. 影响沙特血液透析患者对医护人员共情感知的因素

Arab journal of nephrology and transplantation Pub Date : 2011-05-01

Mariam Al Onazi, Mohamed Al Jondeby, Mubashar Azeem, Abdulla Al Sayyari

{"title":"Factors affecting Saudi hemodialysis patients' perception of healthcare providers' empathy.","authors":"Mariam Al Onazi, Mohamed Al Jondeby, Mubashar Azeem, Abdulla Al Sayyari","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: We aimed to assess the empathy level of healthcare providers as perceived by hemodialysis (HD) patients and its determinants.Method: This survey included 100 hemodialysis patients from two major dialysis units in Riyadh, Saudi Arabia (Units A and B). Patients were asked to score their perception of empathy by health care providers in 13 areas using 1 to 5 Likert Scale.Results: Unit \"A\" contained more patients with diabetic nephropathy than unit \"A\". Unit \"B\" contained a higher number of native Arabic speaking nurses and its patients had longer mean duration on dialysis compared to unit \"A\". The overall score given for doctors empathy was 81.6% (84.5% for Unit \"A\" doctors and 78.8% for Unit \"B\" doctors (P=0.01). The overall score given for nurses empathy was 73.6% (76.2% for Unit \"A\" nurses and 70.9% for Unit \"B\" nurses (P=0.002). Female patients' perception of empathy was significantly greater than male patients in 8 out of 13 questions. Older patients gave higher score than younger patients. Patients with lower educational level perceived higher empathy levels than patients with higher education. Significantly lower scores were given by patients who received their dialysis treatment at night. We observed no differences in scores in relation to patients' duration on dialysis, diabetic status or Charlson Co-morbidity Index (CCI).Conclusion: Empathy goes beyond the language barrier. Patients dialyzed in evening shifts perceive less empathy from healthcare workers. The higher scores given by older, female and less educated patients might simply reflect their lower expectation of empathy.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"4 2","pages":"71-6"},"PeriodicalIF":0.0,"publicationDate":"2011-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30063804","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

Salmonella typhi infection complicated by rhabdomyolysis, pancreatitis and polyneuropathy. 伤寒沙门氏菌感染并发横纹肌溶解、胰腺炎和多发性神经病变。

Arab journal of nephrology and transplantation Pub Date : 2011-05-01

Medhat Ali, Hosam Abdalla

{"title":"Salmonella typhi infection complicated by rhabdomyolysis, pancreatitis and polyneuropathy.","authors":"Medhat Ali, Hosam Abdalla","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Typhoid is a common infection that can have serious complications. Here we present a severe case of Salmonella typhi infection complicated by rhabdomyolysis and acute kidney injury.Case report: A 42-year-old male presented with shortness of breath, generalized body aches and upper abdominal pain two weeks after returning from India. Investigations revealed severe metabolic acidosis (arterial blood pH 6.9), high serum creatinine (12.7 mg/dl), hyperuricemia (16.4 mg/dl), hypocalcemia (4.1 mg/dl), hyperphosphatemia (16.1 mg/dl), high serum amylase (1458 u/L), thrombocytopenia (59,000/mm3) and disturbed coagulation profile. The diagnosis of rhabdomyolysis was confirmed by an elevated creatine phosphokinase level of 17,000 U/L. The patient was started on hemodialysis, and two days later he developed broncho-pneumonia and required mechanical ventilation. Blood cultures grew Salmonella typhi; parenteral imipenem-cilastin and ciprofloxacin were initiated. After one week, the patient continued to have fever despite improvement of biochemical parameters and negative blood and stool cultures. Antibiotic drug-fever was suspected and antibiotics were stopped. Subsequently, fever and rash disappeared and the patient was switched to ceftazidime two days later. The patient eventually regained normal kidney function but continued to have weakness in both lower limbs. Electromyography (EMG) and nerve conduction studies revealed diffuse axonal sensorimotor polyneuropathy that progressively improved over time.Conclusion: Common infective agents, including salmonella typhi, can present in unusual ways. The possibility of a severe systemic infection being the underlying cause of rhabdomyolysis should not be overlooked.Keywords: Acute Kidney Injury; Neuropathy; Rhabdomyolysis; Salmonellosis; Typhoid.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"4 2","pages":"91-3"},"PeriodicalIF":0.0,"publicationDate":"2011-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30064793","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

Bone Activity Biomarkers and Bone Mineral Density in Children with Chronic Kidney Disease 慢性肾脏疾病儿童的骨活性生物标志物和骨密度

Arab journal of nephrology and transplantation Pub Date : 2011-01-11 DOI: 10.4314/ajnt.v3i3.63147

Yf Ali, A. Abdel-latif, Ma El-Koumi, A. Ghorab, H. Labib

{"title":"Bone Activity Biomarkers and Bone Mineral Density in Children with Chronic Kidney Disease","authors":"Yf Ali, A. Abdel-latif, Ma El-Koumi, A. Ghorab, H. Labib","doi":"10.4314/ajnt.v3i3.63147","DOIUrl":"https://doi.org/10.4314/ajnt.v3i3.63147","url":null,"abstract":"Introduction: Chronic kidney disease - mineral and bone disorder (CKD-MBD) is a spectrum of bone minerals changes that range from high turnover lesions of secondary hyperparathyroidism to the low turnover lesions of adynamic bone disease. Bone biopsy is the gold standard for the diagnosis, but it is not routinely performed because it is invasive technique. Methods: Fifteen CKD children on regular hemodialysis (group I) and 15 CKD children on conservative management (group II) were selected from the nephrology clinics of Zagazig University Hospitals along with 15 age and sex-matched healthy controls. Participants were subjected to biochemical assessment that included osteocalcin (OC), total and bone-specific alkaline phosphatase (tALP and bALP), isomerized beta form of type I collagen cross-linked telopeptide (β-Crosslaps) and intact parathyroid hormone (iPTH) levels. Patients with CKD also had their bone mineral density (BMD) measured using dual energy X-ray absorptiometry (DEXA) at lumbar spine and femoral neck. Results: Serum β-Crosslaps, OC and bALP were significantly higher in patient groups than controls and in group I compared to group II .There was a negative significant correlation between mean Z-score at lumbar spines and bALP, OC and iPTH in group I and with β-Crosslaps in both patient groups. The mean Z-score at femoral neck correlated negatively with bALP in group I, with OC in group II and with iPTH and β-Crosslaps in both groups. Conclusion: Biochemical bone markers and assessment of BMD in patients with CKD may have a role in the early detection of CDK-MBD. Keywords: chronic kidney disease; bone mineral density; bone biomarkers","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2011-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4314/ajnt.v3i3.63147","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70471407","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: 1