Arab journal of nephrology and transplantation最新文献_第3页

Management of Anemia and other Hematologic Derangements in Patients with Chronic Kidney Disease. 慢性肾病患者贫血和其他血液学紊乱的处理。

Arab journal of nephrology and transplantation Pub Date : 2014-01-01

Iqra Ansari, Asfandyar Sheikh, Syed Salman Ahmed, Qamar Jabbar, Sajid Ali

{"title":"Management of Anemia and other Hematologic Derangements in Patients with Chronic Kidney Disease.","authors":"Iqra Ansari, Asfandyar Sheikh, Syed Salman Ahmed, Qamar Jabbar, Sajid Ali","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Chronic Kidney Disease (CKD) has adverse consequences on almost all body systems. The kidney does not function merely as an excretory organ, but participates in normal erythropoiesis, normal bone mineral deposition and blood pressure regulation.Review: Anemia is prevalent in CKD with known deleterious effects on the car diovascular system. It is mostly due to erythropoietin deficiency, inhibition of erythropoiesis by uremic solutes, and reduction in red blood cell life span. Other possible causes include iron, B12 or folic acid deficiency or blood loss. Dysfunction of the endogenous erythropoietin is usually clinically evident once the glomerular filtration rate (GFR) falls below 20-25 ml/min. Treating anemia of CKD is based on correction of iron deficiency and replacement of decreased erythropoietin production by erythropoietin stimulating agents (ESA). Guidelines recommend targeting hemoglobin levels of no more than 10-12 g/dl since there is evidence of increased mortality and morbidity in patients with higher levels. Increased level of pro-coagulant biomarkers cause enhanced thrombotic activity in CKD patients which promotes ischemic cardiac events while platelet dysfunction leads to bleeding diathesis. If anticoagulation is indicated, low molecular weight heparins (LMWHs) offer certain advantage sbut the dosage needs to be adjusted with increasing grade of renal insufficiency. Antiplatelet agents are effective in averting shunt and catheter thrombosis, but not for avoiding the thrombosis of arteriovenous grafts.Conclusion: Health related quality of life in CKD patients can be improved by treating anemia. Newly available ESAs and the entry into the market of epoetinbiosimilars are expected to lead to improvements in the management of CKD and its complications.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"7 1","pages":"13-9"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32238709","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

Acute pancreatitis: a rare complication in a patient with senior loken syndrome. 急性胰腺炎:一种罕见的并发症，在病人的老年外表综合征。

Arab journal of nephrology and transplantation Pub Date : 2014-01-01

Kamel Abidi, Manel Jallouli, Ouns Naija, Chokri Zarrouk, Tahar Gargah

{"title":"Acute pancreatitis: a rare complication in a patient with senior loken syndrome.","authors":"Kamel Abidi, Manel Jallouli, Ouns Naija, Chokri Zarrouk, Tahar Gargah","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Senior-Loken syndrome is a rare entity that combines familial nephronophthisisand retinal dystrophy. It has an autosomal recessive inheritance pattern and is characterized by a chronic tubulointerstitial nephritis that progress to terminal renal failure during the first or second decades of life. Systemic associations of this syndrome include sensorineural hearing loss, liver fibrosis or cerebral vermis hypoplasia. Acute pancreatitis has not been previously reported in this syndrome.Case report: This is a 28- years-old patient who was diagnosed to have Senior Loken syndrome at the age of 10 years because of renal impairment and tapetoretinal degeneration and was later started on regular hemodialysis. He had no family history of renal disease, hypertriglyceridemia or cholelithiasis. He presented to our center complaining of acute abdominal pain and vomiting. He had abdominal tenderness without guarding. Investigations revealed a lipase level of 3856 I U/l and an abdominal CT scan showed features of acute pancreatitis. The abdominal ultrasound showed no biliary tree malformations or gallstone obstruction. He had no history of recent drug intake or alcohol consumption and his serum triglyceride level was normal. A diagnosis of moderate acute pancreatitis was made and the patient was managed conservatively with good outcome.Conclusion: Taking into consideration the uncertainty about the presence of liver fibrosis and the fact that imaging may have missed a passing gallstone, this case may indicate another rare systemic complication of Senior-Loken syndrome.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"7 1","pages":"41-3"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32238136","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

Experience in using thermal disinfection to remove viable bacteria and endotoxins in centraly distributed reverse osmosis water. 热消毒去除集中分布的反渗透水中活菌和内毒素的经验。

Arab journal of nephrology and transplantation Pub Date : 2014-01-01 DOI: 10.4314/AJNT.V7I1

A. Alayoud, M. Hamzi, Abdelaziz Razkaoui, M. Benyahia

{"title":"Experience in using thermal disinfection to remove viable bacteria and endotoxins in centraly distributed reverse osmosis water.","authors":"A. Alayoud, M. Hamzi, Abdelaziz Razkaoui, M. Benyahia","doi":"10.4314/AJNT.V7I1","DOIUrl":"https://doi.org/10.4314/AJNT.V7I1","url":null,"abstract":"INTRODUCTION The water used for dilution of hemodialysis concentrates has to meet official quality recommendations regarding microbiology and chemical parameters. To avoid chemical use and to simplify treatments, hot water has been used to control microbial contamination of water distribution systems. In this study we evaluated the efficacy of heat disinfection in maintaining the quality of dialysis water generated by reverse osmosis (RO). METHODS During the first part of the study, we consecutively used (1) continuous water circulation, (2) daily heat disinfection and (3) a combination of daily heat disinfection and weekly chemical disinfection while checking bacterial count and endotoxin level every 4-5 weeks. During the second part of the study, we continued using daily heat disinfection while checking bacterial count and endotoxin level on weekly basis. RESULTS The endotoxin levels at all sampling points of the water treatment system were lower than 0.005/ ml throughout the study. The application of heat disinfection alone reduced bacterial levels but an escape phenomenon occurred. After an interval of 21 days, an exponential increase of bacterial count was noted and cultures from the RO unit revealed growth of Pseudomonas fluorescence. The addition of chemical disinfection was successful in eliminating micro-organisms. Throughout this study, micro-organisms and endotoxins were not detectable in dialysate fluid and substitution fluid in dialysis monitors. CONCLUSION The isolation of a thermo-sensitive organism from the RO unit after a period of relying on thermal disinfection suggests the existence of dead space in the RO unit that is not adequately exposed to heat but is accessible to chemical disinfection. .","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"7 1 1","pages":"27-31"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70472505","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: 9

The spectrum of glomerular diseases as studied by immunofluorescence microscopy a single center study in Iraq. 免疫荧光显微镜研究肾小球疾病的光谱:伊拉克单中心研究。

Arab journal of nephrology and transplantation Pub Date : 2013-09-01

Riyadh Muhi Al-Saegh, Lina Wagih Assad

{"title":"The spectrum of glomerular diseases as studied by immunofluorescence microscopy a single center study in Iraq.","authors":"Riyadh Muhi Al-Saegh, Lina Wagih Assad","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Immunofluorescence (IF) microscopy is an important tool for the diagnosis of glomerular diseases. In this study, we focused on using IF technique together with light microscopy (LM) and clinical features in the diagnosis of different types of glomerulonephritis (GN). We aimed to evaluate the spectrum of glomerular diseases in our center and compare it with other centers in Iraq as well as in other countries.Methods: We studied a total of 58 kidney biopsies taken between June 2010 and June 2012. All biopsies were examined by LM and 56 of them were examined by IF technique. Clinical information was recorded in a predesigned form before taking the biopsy.Results: Nephrotic syndrome was the predominant clinical presentation in this study (75.9%). Focal segmental glomerulosclerosis (FSGS) was the commonest GN in this study (29.3%) followed by minimal change disease (20.7%) and membranous glomerulonephritis (13.8%). Immune deposition was observed in 37.5% of cases and the predominant deposit was immunoglobulin G (IgG). In all cases but one, deposition was granular and was found in the glomerular basement membrane (GBM) and/ or in the mesangium. In one case, IF showed dominant positive staining (3+) for complement factor 1q (C1q) in the glomerular mesangium and slightly positive staining for complement factor 3 (C3) in the same mesangeal areas. Two cases (3.4%) fulfilled the clinical, serological and histopathological criteria of lupus nephritis (LN).Conclusion: Nephrotic syndrome was the predominant clinical presentation and FSGS was the most commonly diagnosed GN in this study. Using IF technique and correlating it with LM, clinical, biochemical and serological markers was very useful for the correct diagnosis of glomerular diseases.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"6 3","pages":"161-7"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31748369","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

Idiopathic membranous nephropathy preceding the onset of rheumatoid arthritis: a case report. 类风湿性关节炎发病前的特发性膜性肾病:1例报告。

Arab journal of nephrology and transplantation Pub Date : 2013-09-01

Intissar Haddiya, Hakima Rhou, Loubna Benamar, Fatima Ezzaitouni, Rabia Bayahia, Naima Ouzeddoun

{"title":"Idiopathic membranous nephropathy preceding the onset of rheumatoid arthritis: a case report.","authors":"Intissar Haddiya, Hakima Rhou, Loubna Benamar, Fatima Ezzaitouni, Rabia Bayahia, Naima Ouzeddoun","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Membranous nephropathy (MN) in the context of rheumatoid arthritis (RA), is often an iatrogenic complication due to the nephrotoxic effects of antirheumatic drugs. Rare cases of non-iatrogenic association between these two diseases were reported in the literature.Case report: A 30-year-old female patient presented in September 2005 with nephrotic syndrome. Renal biopsy showed features consistent with MN. Search for etiology was negative, particularly lupus serology which remained negative throughout the course of her illness. Accordingly, she was diagnosed as a case of idiopathic MN. Initially, she was treated with angiotensin converting enzyme inhibitors and angiotensin receptor blockers which maintained her protein excretion below nephrotic range for two years. Her nephrotic syndrome then relapsed and was treated with steroids and chlorambucil, according to the Ponticelli protocol. A few months later, she presented with early morning joint stiffness, polyarthritis involving the small joints of the hands, and strongly positive rheumatoid factor, fulfilling the diagnostic criteria of rheumatoid arthritis (RA). Her serum creatinine remained normal and a second renal biopsy revealed the same features of MN. Her RA was treated with pulsed methylprednisolone followed by oral steroids and methotrexate resulting in remission of the joints disease and the nephrotic syndrome. Remission was maintained for the last two years up to the time of this report.Conclusion: We hereby report a case of secondary membranous nephropathy that preceded the onset of rheumatoid arthritis by three years.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"6 3","pages":"181-4"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31748373","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

Nephrogenic diabetes insipidus with intracranial calcification in a child with thalassemia minor. 轻度地中海贫血儿童肾源性尿崩症伴颅内钙化1例。

Arab journal of nephrology and transplantation Pub Date : 2013-09-01

Jain Dimple, Jadhav Alka, Gajre Mona, Deshmukh Atul

引用次数: 0

A preliminary survey of un-diagnosed hypertension among Nubians and Coptics in Atbara and Eldamer Cities, Sudan: does ethnicity affect prevalence? 苏丹阿特巴拉和埃尔达默尔城市努比亚人和科普特人未确诊高血压的初步调查:种族是否影响患病率?

Arab journal of nephrology and transplantation Pub Date : 2013-09-01

Sufian K M Noor, Sarra O E Bushara, Amel A Sulaiman, Wadie M Y Elmadhoun

{"title":"A preliminary survey of un-diagnosed hypertension among Nubians and Coptics in Atbara and Eldamer Cities, Sudan: does ethnicity affect prevalence?","authors":"Sufian K M Noor, Sarra O E Bushara, Amel A Sulaiman, Wadie M Y Elmadhoun","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Hypertension is a non-communicable disease of increasing importance in developing countries. Due to its silent nature and serious complications, active screening is essential in case detection. The aim of this study was to determine the prevalence of undiagnosed hypertension and to find out whether there are ethnic variations in prevalence between two Sudanese ethnicities.Methods: This is a cross-sectional community-based study in which 100 subjects from Nuba tribe and 70 Coptics not previously known to have hypertension volunteered to participate. Blood pressure was measured and a questionnaire delineating demographic, clinical and social data was obtained from each participant.Results: Female to male ratio was 2:1. The mean age was 39.5 ± 8 years for Nubians and 40.5 ± 5.5 years for Coptics. High blood pressure was detected in 48% of Nubians and 24.3% of Coptics (p>0.001). The prevalence of stage II hypertension was higher in Nubians compared to Coptics (25% vs. 3.8%; p<0.001). Besides the ethnic variation, other significant differences between the two groups were illiteracy and alcohol consumption, both of which were significantly commoner among Nubians.Conclusion: Undiagnosed high blood pressure is common in our local community, with some variations in prevalence and severity among different ethnic groups. Key words: Coptics; Nubians; River Nile State; Sudan; Undiagnosed hypertension.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"6 3","pages":"193-5"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31748794","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

Prevalence of non-communicable diseases and its awareness among inhabitants of Sokoto metropolis: outcome of a screening program for hypertension, obesity, diabetes mellitus and overt proteinuria. 索科托大都市居民中非传染性疾病的流行及其认识:高血压、肥胖、糖尿病和显性蛋白尿筛查方案的结果

Arab journal of nephrology and transplantation Pub Date : 2013-09-01

Muhammad Ali Makusidi, Hamid Muhammad Liman, Abdulmunin Yakubu, Muhammad Dan Asabi Isah, Ridwan Muhammad Jega, Habibullah Adamu, Adindu Chijioke

{"title":"Prevalence of non-communicable diseases and its awareness among inhabitants of Sokoto metropolis: outcome of a screening program for hypertension, obesity, diabetes mellitus and overt proteinuria.","authors":"Muhammad Ali Makusidi, Hamid Muhammad Liman, Abdulmunin Yakubu, Muhammad Dan Asabi Isah, Ridwan Muhammad Jega, Habibullah Adamu, Adindu Chijioke","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Developing countries confront double jeopardy of prevalent infectious disease and increasing Non-Communicable Diseases (NCD) with imminent projected epidemic proportions. Nigeria has witnessed tremendous socio-economic changes and rural to urban migration culminating in emergence of NCD. The impact of these diseases on the lives of people is enormous when measured in terms of outcomes. We initiated a screening program among inhabitants of Sokoto metropolis in an attempt to unravel the prevalence and pattern of NCD.Methods: This is a descriptive cross sectional study involving 535 participants who were randomlyselected during World Kidney Day Screening in Sokoto. Health promotion talk was organized for the participants before commencing the screening. We took anthropometric measurements and calculated body mass index (BMI) and waist/hip ratio for all individuals. We also checked blood pressure and blood glucose levels and performed urinalysis for all participants.Results: There were 535 participants including 332 males and 203 females with a mean age of 37 ± 17 years. Overweight, obesity and morbid obesity were found in 12.3%, 6.7% and 0.9% of participants respectively. About 11% had waist/hip ratio greater than 1. The prevalence of pre-hypertension and hypertension was 8.5% and 30.2% respectively. Elevated random blood glucose levels were found in 6% of participants while 17.9% had at least 1+ of proteinuria in urinalysis.Conclusion: Non-communicable diseases are common in our environment and the level of awareness is low. Regular health education and screening programs are necessary in order to reduce the menace.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"6 3","pages":"189-91"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31748793","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

Nephrogenic Diabetes Insipidus with Intracranial Calcifications in a Child with Thalassemia Minor 轻度地中海贫血儿童肾源性尿崩症伴颅内钙化1例

Arab journal of nephrology and transplantation Pub Date : 2013-09-01 DOI: 10.4314/AJNT.V6I3

Jain Dimple, J. Alka, Gajre Mona, Deshmukh Atul

引用次数: 24

The definitions and staging systems of acute kidney injury and their limitations in practice. 急性肾损伤的定义和分期系统及其在实践中的局限性。

Arab journal of nephrology and transplantation Pub Date : 2013-09-01

Norbert Lameire

{"title":"The definitions and staging systems of acute kidney injury and their limitations in practice.","authors":"Norbert Lameire","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: It is now evident that even minimal reductions in glomerular filtration rate (GFR) are associated with a dramatic increase in mortality. The term acute kidney injury (AKI) describes an acute fall of estimated GFR (eGFR) and allows patient stratification based on AKI severity.Review: The Risk, Injury, Failure, Loss and End-stage kidney disease (RIFLE) system defines AKI by a change in serum creatinine (SCr) level or eGFR from a baseline value, and urine output per kilogram of body weight over a specified time period. The Acute Kidney Injury Network (AKIN) definition was based on the RIFLE system but added an absolute change in SCr of ≥ 0.3 mg/dL, omitted eGFR criteria and included a time constraint of 48 hours. The AKIN system also omitted the stages \"Loss\" and \"End-stage\" and allocated patients who needed acute dialysis to stage-3. The most recent Kidney Disease Improving Global Outcomes (KDIGO) guidelines retained the AKIN staging criteria but allowed a time frame of seven days for a 50% increase in SCr. The KDIGO criteria do not rely on changes in GFR for staging except in children under the age of 18 years. AKI misclassification may result from the lack of a uniform approach to estimate baseline SCr and the changes in SCr concentrations resulting from acute severe illness and altered fluid balance. In addition, exact data on urine output are not always available resulting in underutilization of the urine output criteria.Conclusion: The existing definitions of AKI rely on imperfect markers of renal function rather than direct measures of kidney damage, but remain an important diagnostic and prognostic tool.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"6 3","pages":"145-52"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31748367","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