Arab journal of nephrology and transplantation最新文献

{"title":"Hypertension, new data and implications.","authors":"Elwaleed A Elhassan","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"6 1","pages":"7-10"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31232524","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":"Treatment of hepatitis B virus reactivation in a cadaveric renal transplant recipient with entecavir.","authors":"Omer A Raheem,&nbsp;David P Hickey","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Risk of reactivation of Hepatitis B virus (HBV) infection and other liver related complications continues to be a major cause of concern in HBV carriers undergoing cadaveric renal transplantation. Antiviral medications have been recommended post renal transplantation in patients who are chronic HBV carriers.</p><p><strong>Case report: </strong>Here we present the case of a 15-year-old girl known to have kidney failure and chronic active HBV infection indicated by positivity of both HBsAg and HBeAg. She was treated with interferon alpha for six months resulting in clearance of HBeAg and reduction of HBV-DNA titer to 32.15 copies/ml. She underwent successful cadaveric renal transplantation and was maintained on cyclosporine, azathioprine and prednisolone. Two years post transplant, the patient developed elevated liver enzymes, positive HBeAg and high HBV-DNA titers. She was treated with lamivudin resulting in normalization of liver function tests. Lamivudine was discontinued after nine months due to poor compliance resulting from psychological problems. Three years post transplant, the patient was started on Entecavir 0.5 mg oral, daily. At follow up clinic visits till present time, the patient is tolerating Entecavir treatment with no reported side effects. Liver enzymes remained stable, but the effect on viral load and viral markers was unremarkable.</p><p><strong>Conclusion: </strong>The role of various antiviral agents in treating HBV infection among kidney transplant recipients requires further evaluation.</p>","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":" ","pages":"41-4"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40205674","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":"Pericardial effusion caused by Mycobacterium chelonae after renal transplant.","authors":"Prabha Desikan,&nbsp;Skand Kuma Trivedi,&nbsp;Mahendra Kumar Atlani","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"6 1","pages":"55"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31232525","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":"Negative correlation between fetuin-A and indices of vascular disease in systemic lupus erythematosus patients with and without lupus nephritis.","authors":"Ali F I Abdel-Wahab,&nbsp;Osama Fathy,&nbsp;Randa Al-Harizy","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Fetuin-A, a systemic calcification inhibitor, has been negatively related to vascular calcification (VC) and cardiovascular mortality. In this study we investigated the association between fetuin-A levels and atherosclerotic vascular complications in systemic lupus erythematosus (SLE) patients with and without lupus nephritis (LN).</p><p><strong>Methods: </strong>We recruited 20 SLE patients without LN, 20 SLE patients with LN and 20 healthy controls. We determined serum creatinine, lipid profile, high sensitivity C-reactive protein (hsCRP), calcium, phosphate and fetuin-A levels, and calculated the calcification risk index (CRI) and SLE disease activity index (SLEDAI) for all subjects. Vascular disease burden was assessed by quantification of carotid artery intima-media-thickness (IMT) and the ankle-brachial index (ABI).</p><p><strong>Results: </strong>Fetuin-A levels were significantly lower in LN patients (0.47 ± 0.1 g/L) compared to SLE patients without LN (0.54 ± 0.1 g/L) and both were significantly lower than controls (0.78 ± 0.2 g/L). CRI was significantly higher in LN patients (89.1 ± 12.1 mg/L) compared to SLE patients without LN (67.2 ± 9.3 mg/L) and both were significantly higher than controls (34.2 ± 6.2 mg/L). Peripheral arterial disease (ABI > 0.9) was significantly more common in LN patients (55%) compared to SLE patients without LN (30%) as well as controls (0%). Fetuin-A levels showed significant negative correlations with serum creatinine, hsCRP, CRI, IMT and ABI in SLE patients with and without LN.</p><p><strong>Conclusion: </strong>Fetuin-A levels were decreased in SLE patients with and without LN and negatively correlated with vascular complications. This suggests a potentially important role for fetuin-A deficiency as marker of vascular disease in SLE patients with and without LN.</p>","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":" ","pages":"11-20"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40205669","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":"Gitelman syndrome as a cause of psychomotor retardation in a toddler.","authors":"S. Skálová, D. Neuman, P. Lněnička, J. Štekrová","doi":"10.4314/AJNT.V6I1","DOIUrl":"https://doi.org/10.4314/AJNT.V6I1","url":null,"abstract":"INTRODUCTION Gitelman syndrome (GS) is a very rare autosomal recessive tubulopathy due to loss-of-function or mutation in solute carrier family12, member 3 gene (SLC12A3 gene) encoding thiazide-sensitive NaCl co-transporter in the distal convoluted tubule, leading to hypokalemia, metabolic alkalosis, hypomagnesemia, hypocalciuria and low-to-normal blood pressure. Clinical signs are mostly secondary to chronic hypokalemia and include dizziness, fatigue, constipation and weakness. Patients can also present with muscle cramps, tetany, fatigue and convulsions due to severe metabolic alkalosis or hypomagnesemia. Manifestations of GS are rarely apparent before the age of five, and the syndrome is usually diagnosed during adolescence or adulthood. Here we describe a case of GS presenting in infancy with hypokalemia and psychomotor retardation. CASE REPORT We present an 18-month-old boy who presented with psychomotor retardation and failure to thrive. Investigations revealed hypokalemia at 2.7 mmol/L, metabolic alkalosis, hypocalciuria and normal serum magnesium level. The diagnoses of Barter syndrome (BS) and Gitelman syndrome (GS) were considered. Genetic studies confirmed the diagnosis of GS and three different mutations of in SLC12A3 gene were detected. Two mutations (c.2576T>C and c.2929C>Ty) were considered as causal ones, with the patient´s parents being the heterozygous carriers. Oral potassium supplementation resulted in normalisation of the hypokalemia and psychomotor improvement. CONCLUSION We report a rare case of psychomotor retardation occurring at an early age in genetically confirmed GS. In spite of being a rare disorder, GS has to be considered in children with developmental delay and muscle weakness. With adequate treatment, GS patients have an excellent prognosis.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"6 1 1","pages":"37-9"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4314/AJNT.V6I1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70471756","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":"Applying sodium profile with or without ultrafiltration profile failed to show beneficial effects on the incidence of intradialytic hypotension in susceptible hemodilaysis patients.","authors":"Amine Mohamed Hamzi,&nbsp;Mohamed Asseraji,&nbsp;Kawtar Hassani,&nbsp;Ahmed Alayoud,&nbsp;Bahadi Abdellali,&nbsp;Yassir Zajjari,&nbsp;Dina Brahim Montacer,&nbsp;Ismail Akhmouch,&nbsp;Mohamed Benyahia,&nbsp;Zouhir Oualim","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Intra-dialytic hypotension (IDH) is a common complication during hemodialysis (HD) treatment. Previous studies have reported that modulating dialysate sodium concentration combined or not with modulation of ultrafiltration (UF) rate may reduce the incidence of IDH. The aim of the present study was to evaluate the effect of sodium and UF profiles on the occurrence of intra-dialytic complications and dialysis quality.</p><p><strong>Methods: </strong>From a total of 64 patients, we selected 18 patients who suffered from recurrent IDH. Every patient received ten HD sessions utilizing each of the following treatments: (1) CONTROL: constant sodium concentration and UF rates. (2) Sodium and UF profiles: a linearly decreasing sodium concentration combined with a linearly decreasing UF rate. (3) Sodium profile: decreasing sodium concentration with constant UF rate.</p><p><strong>Results: </strong>Fourteen patients completed the study protocol. The incidence of IDH, mean inter-dialytic weight gain and the delivered dialysis dose were not different between the three treatments. However, symptomatic episodes of IDH were more commonand pre-dialysis systolic blood pressure was higher during the second and third treatment modalities compared to controls. Isolated sodium profile was associated with more malaise and less achievement of target session duration compared to the other two treatments. Isolated sodium profile was associated with less achievement of target UF while combined sodium and UF profiles were associated with more achievement of target UF compared to controls.</p><p><strong>Conclusion: </strong>Our results indicate that sodium profile with or without UF profile does not have a beneficial effect on the incidence of IDH, achievement of target session duration or the delivered dialysis dose. Keywords : Sodium Profile; Ultrafiltration; Intradialytic Complications.</p>","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"5 3","pages":"129-34"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30894984","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":"Rheumatic heart disease associated with secondary renal amyloidosis.","authors":"Emad Ali Abdallah","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Amyloidosis is a disorder of protein folding in which normally soluble proteins undergo conformational changes and are deposited in the extracellular space in an abnormal fibrillar form. Accumulation of these fibrils causes progressive disruption of the structure and function of tissues and organs, and the systemic forms of amyloidosis are frequently fatal. The conditions that underlie amyloid deposition may be either acquired or hereditary. Amyloid-A (AA) amyloidosis is the most common form of systemic amyloidosis worldwide, AA amyloidosis occurs in the course of chronic inflammatory diseases, hereditary periodic fevers, and with certain neoplasms such as Hodgkin disease and renal cell carcinoma. Amyloidosis due to rheumatic heart disease (RHD) is not common but can be seen. We report here a patient with RHD and AA renal amyloidosis.</p><p><strong>Case report: </strong>we present a 30 year-old Egyptian male with a history of RHD, accidently discovered to have nephrotic range proteinuria and rising serum creatinine. Serology studies were negative or normal, including antinuclear antibody (ANA) and antineutrophil cytoplasmic antibody (ANCA). C3 and C4 complement levels were normal. Kidney biopsy revealed AA renal amyloidosis. CT chest and abdomen revealed bilateral hilar and mediastinal lymphadenopathy and para-aortic lymph nodes. Endobronchial biopsy and bronchoalveolar lavage revealed non-specific chronic inflammatory changes. The patient's secondary amyloidosis was presumed to be related to the long standing RHD after exclusion of other causes of secondary amyloidosis. The patient finally died due to heart failure and acute pulmonary edema.</p><p><strong>Conclusion: </strong>Long standing RHD can lead to secondary AA amyloidosis.</p>","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"5 3","pages":"149-52"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30896935","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 renal failure following the Saharan horned viper (Cerastes cerastes) bite.","authors":"Driss Elkabbaj,&nbsp;Kawtar Hassani,&nbsp;Rachid El Jaoudi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The Saharan horned viper (Cerastes cerastes) is a common snake in the sandy and rocky regions in the south of Morocco. Although nearly all snakes with medical relevance can induce acute renal failure (ARF), it's unusual except with bites by some viper species. ARF has very rarely been reported following Cerastes cerastes bite.</p><p><strong>Case report: </strong>A 55-year-old Moroccan man was bitten on his right hand by a Saharan horned viper, Cerastes cerastes. He presented 24 hours later in a state of confusion, agitation and hypotension with marked swelling of his right hand. Investigations revealed evidence of disseminated intravascular coagulation (DIC) and rhabdomyolysis. The appropriate antivenom was not available. Despite adequate hydration, he developed acute renal failure necessitating prolonged hemodialysis. He subsequently improved and was discharged from the hospital after four weeks with normal renal function.</p><p><strong>Conclusion: </strong>Although uncommon, the bite of Cerastes cerastes can result in ARF due to DIC and rhabdomyolysis. The appropriate antivenom should be made available in areas where this snake is prevalent.</p>","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"5 3","pages":"159-61"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30896937","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 HCV infections among hemodialysis patients in Al Gharbiyah Governorate, Egypt.","authors":"Samy A Khodir,&nbsp;Mervt Alghateb,&nbsp;Kamal M Okasha,&nbsp;Safenaz El-Saed Shalaby","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Hepatitis C virus (HCV) is a significant problem for patients undergoing hemodialysis (HD) treatment. This medical problem has never been studied in Al Gharbiyah Governorate; this study was conducted aiming to estimate the prevalence of anti-HCV positive patients and the incidence of seroconversion in its different HD units.</p><p><strong>Methods: </strong>All 2351 patients maintained on HD in the eight towns of Al Gharbiyah Governorate were interviewed and their anti-HCV status was tested by a third-generation enzyme immunoassay. Patients who tested negative for anti-HCV at the start of the study were re-assessed monthly for HCV seroconversion and at the end of the study all patients were screened for HCV antibodies.</p><p><strong>Results: </strong>At the start of our study in March 2011, we found that 824 out of 2351 patients (35%) were anti-HCV reactive. At the end of study in November 2011, we found that HCV seroconversion occurred in 168 out of 1527 patients (11%) who were HCV free at the start of the study. By the end of the study, a total of 42.2% were found to be anti-HCV reactive.</p><p><strong>Conclusion: </strong>The study demonstrated high prevalence of anti-HCV in HD units in Al Gharbiyah Governorate. Similar studies must be conducted in all Egyptian governorates' HD units to evaluate this major health problem all over Egypt. We also encourage strict application of preventive strategies for HCV infection in all health institutes, especially HD units.</p><p><strong>Keywords: </strong>Egypt; HCV; Hemodialysis; Seroconversion.</p>","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"5 3","pages":"145-7"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30896934","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":"Scleroderma renal crisis precipitated by steroid treatment in systemic lupus erythematosus and scleroderma overlap syndrome.","authors":"Ahmed Alayoud,&nbsp;Ouadie Qamouss,&nbsp;Amine Hamzi,&nbsp;Mohammed Benyahia,&nbsp;Zouhir Oualim","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Connective tissue disorders can overlap in various ways. Patients may present with features of more than one specific disease without satisfying the diagnostic criteria and thereafter evolve into a specific disease entity. Occasionally, patients may fulfil simultaneously the diagnostic criteria of two or more diseases. Several cases of systemic sclerosis (SSc) and systemic lupus erythematosus (SLE) overlap syndrome have been reported. SLE patients often develop lupus nephritis, the treatment of which is based on immunosuppression with corticosteroids (CS) and cytotoxic drugs. However, the use of high dose of CS has been associated with scleroderma renal crisis (SRC) in patient with SSc.</p><p><strong>Case report: </strong>a 43-year-old woman presented to the nephrology department of the Military hospital in Rabat, Morocco, in August 2011 with progressive dyspnea and oliguria. She was diagnosed as SLE and scleroderma overlap syndrome based on clinical and serological markers. Renal biopsy showed lupus nephritis. Immunosuppression consisting of high-dose steroid and cyclophosphamide pulses was given. There was response to treatment but 15 days later the course of the disease was complicated by scleroderma renal crisis evidenced by elevated blood pressure, deteriorating kidney function, hemolysis and thrombocytopenia. The patient was treated with perindopril and rapid reduction of steroid doses. This was followed by correction of hemolysis and thrombocytopenia. Two months later, the patient was off dialysis, but had chronic renal insufficiency with an estimated GFR of 25 ml/minute.</p><p><strong>Conclusion: </strong>This report describes the occurrence of SRC in a patient with lupus nephritis and SSc/ SLE overlap syndrome who was treated by CS and cyclophosphamide.</p>","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"5 3","pages":"153-7"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30896936","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}