Arab journal of nephrology and transplantation最新文献_第7页

Active tuberculous infection among adult Sudanese patients on long term peritoneal dialysis. 苏丹成人长期腹膜透析患者的活动性结核感染。

Arab journal of nephrology and transplantation Pub Date : 2012-09-01

Mazin Shigidi, Nazik Farouk, Ramy Ibrahim Abulikailik, Rabab Tag Alsir, Hasan Abu-Aisha

{"title":"Active tuberculous infection among adult Sudanese patients on long term peritoneal dialysis.","authors":"Mazin Shigidi, Nazik Farouk, Ramy Ibrahim Abulikailik, Rabab Tag Alsir, Hasan Abu-Aisha","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: The prevalence of tuberculosis in Sudan is 209 cases per 100,000 populations. There are no reports available regarding the prevalence of tuberculosis among the end-stage kidney disease and dialysis populations.Methods: We reviewed the medical records of all adults who were on peritoneal dialysis (PD) in the Sudan Peritoneal Dialysis Program, during the period from June 2005 to December 2011. Those diagnosed as having active tuberculous infections were retrospectively studied regarding their demography, clinical presentation and outcomes.Results: Out of 350 patients in our program, 19 were diagnosed as having active tuberculosis (5.4%). All patients were diagnosed during their first year on peritoneal dialysis, 74% were males; the mean age was 37 ± 11 years, extrapulmonary tuberculosis was seen in 16/19 (84%) patients and it was abdominal in nine of the 16 (47%) patients. In addition to high clinical suspicion, the diagnosis of active tuberculosis was supported by tissue biopsy findings in 16%, positive polymerase chain reaction in 26%, exudative ascites with suggestive radiological features in 21%, strongly positive tuberculin test in 21% and a favourable response to empirical antituberculous therapy in 26% of patients. HIV test was negative in all 19 patients and only one patient tested positive for hepatitis B viral infection. Antituberculous drugs side effects were seen in 68% of patients. Forty seven percent of patients showed complete recovery and continued on peritoneal dialysis. Our case fatality was 32%.Conclusion: Abdominal tuberculosis is common among PD patients and its diagnosis should always be considered in suspected patients.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"5 3","pages":"135-40"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30896932","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 the metabolic syndrome in renal transplant recipients. 肾移植受者代谢综合征的患病率。

Arab journal of nephrology and transplantation Pub Date : 2012-09-01

Ibrahim M Elkehili, Ahmed B Kekli, Ali M Grera

{"title":"Prevalence of the metabolic syndrome in renal transplant recipients.","authors":"Ibrahim M Elkehili, Ahmed B Kekli, Ali M Grera","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: The cause of the metabolic syndrome (MS) is incompletely understood but represents a complex interaction between genetic, environmental, and metabolic factors, clearly including diet, and level of physical activity. The prevalence of MS is continuously increasing in the general population. Recently it has been found that MS is also common in renal transplant recipients (RTRs). The aim of this study was to determine the prevalence and characteristics of MS in a group of Libyan renal transplant recipients, using two different diagnostic criteria.Methods: This study was conducted at the Nephrology Department of the National Heart Center, Tripoli, Libya. We determined the prevalence of MS in a group of renal transplant recipients using both the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria and the International Diabetes Federation (IDF) criteria. All patients were more than six months post transplantation. Patients with Pre-transplant diabetes mellitus were excluded from the analysis.Results: By using the NCEP-ATP III criteria 26 out of 91 patients (28.6%) had the metabolic syndrome. MS was commoner in females than males, affecting 12 out of 35 females (34.3%) and 14 out of 56 males (25%). Using the IDF criteria the metabolic syndrome was diagnosed in 23 patients (25.3%). In this group of patients the most common component of the metabolic syndrome was high blood pressure and the least common was impaired glucose tolerance and diabetes.Conclusions: The prevalence of MS in our renal transplant patients is high, affecting females more than males. Key words: International Diabetes Federation; Metabolic Syndrome; NCEP-ATP III; Renal Transplant Recipients.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"5 3","pages":"141-4"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30896933","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

Posterior reversible encephalopathy syndrome in a child with steroid sensitive nephrotic syndrome. 类固醇敏感性肾病综合征患儿的后路可逆性脑病综合征

Arab journal of nephrology and transplantation Pub Date : 2012-09-01

Doaa Youssef, Faten Fawzy

{"title":"Posterior reversible encephalopathy syndrome in a child with steroid sensitive nephrotic syndrome.","authors":"Doaa Youssef, Faten Fawzy","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Posterior reversible encephalopathy syndrome (PRES) was described in adults more than children. It was reported in cases of nephrotic syndrome which were mainly on immunosuppressant medications or had severe hypertension.Case report: We report the case of a 9-years old girl who presented with nephrotic syndrome and moderate hypertension. Nine days after the initiation of steroid therapy she developed disturbed level of consciousness and generalized tonic clonic seizures. Her blood pressure was 145/90 mm Hg and she had normal serum creatinine and electrolytes levels. She was treated with furosemide and convulsions were controlled. After regaining consciousness, the patient complained of loss of vision. Fundal examination was normal. Magnetic resonant imaging, axial FLAIR images and diffusion weighted imaging showed hyper-intensity signal in the parietooccipital areas. Magnetic resonant arteriography and spectroscopy excluded ischemic insults and neoplastic process. She regained full consciousness and normal vision and was discharged from the ICU four days later. PRES was diagnosed based on the typical pattern of brain imaging and the reversibility of symptoms.Conclusion: Nephrotic syndrome in children should be considered a risk factor for developing PRES even without the use of immunosuppressant agents or high doses of steroid.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"5 3","pages":"163-6"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30896938","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

Crossed renal ectopia coexisting with nephrolithiasis in a young Nigerian man. 交叉肾异位合并肾结石一例尼日利亚青年。

Arab journal of nephrology and transplantation Pub Date : 2012-05-01

Bello Babawale Taslim, Busari Adeniyi Abdulwasiu, Sheyin Olusegun, Amira Catherine Oluwatoyin, Mabayoje Monica Omolara

{"title":"Crossed renal ectopia coexisting with nephrolithiasis in a young Nigerian man.","authors":"Bello Babawale Taslim, Busari Adeniyi Abdulwasiu, Sheyin Olusegun, Amira Catherine Oluwatoyin, Mabayoje Monica Omolara","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Renal ectopia or ectopic kidney is a congenital anomaly in which one or both kidneys are located in an unusual position. It results from the kidney failing to ascend properly from its origin in the true pelvis. In some cases, one kidney may cross over (crossed renal ectopia) so that both kidneys are on the same side of the body. When a crossover occurs, the two kidneys may grow together and become fused (crossed fused renal ectopia). Renal ectopia is generally uncommon; its coexistence with nephrolithiasis is even rarer. Due to its variable presentations, it is usually discovered incidentally, especially when investigating patients for abdominal pain. Treatment may be conservative when renal function is preserved and no complication is associated.Case report: we highlight the unusual occurrence of renal ectopia with nephrolithiasis in a 34 year-old Nigerian businessman who presented to the renal clinic of our hospital with a three-month history of intermittent dull right flank pain radiating to the right groin. Physical examination revealed right lumbar tenderness without guarding. The rest of the examination was unremarkable. An abdominal ultrasound scan done revealed a linear calculus in the right renal collecting system but the left kidney was not visualised. An intravenous urogram (IVU) showed a crossed ectopic kidney with nephrolithiasis. The patient was treated conservatively and his kidney function has remained stable.Conclusion: This case report describes the relatively uncommon finding of crossed renal ectopia associated with nephrolithiasis.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"5 2","pages":"107-10"},"PeriodicalIF":0.0,"publicationDate":"2012-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30633194","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

Thrombotic thrombocytopenic purpura and systemic lupus erythematosus: a rare and life-threatening association. 血栓性血小板减少性紫癜和系统性红斑狼疮:一种罕见且危及生命的关联。

Arab journal of nephrology and transplantation Pub Date : 2012-05-01

Selma Siham El Khayat, Ghislaine Medkouri, Armel Mbourou Etomba, Mohamed Zamd, Mohamed Benghanem Gharbi, Benyounes Ramadani

{"title":"Thrombotic thrombocytopenic purpura and systemic lupus erythematosus: a rare and life-threatening association.","authors":"Selma Siham El Khayat, Ghislaine Medkouri, Armel Mbourou Etomba, Mohamed Zamd, Mohamed Benghanem Gharbi, Benyounes Ramadani","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: The association between thrombotic thrombocytopenic purpura (TTP) and systemic lupus erythematosus (SLE) is uncommon. Diagnosis is often difficult because of their clinical and biological similarities. The presence of TTP in SLE worsens the prognosis and causes high mortality in the absence of early therapeutic interventions.Case report: We report the case of a 20 year-old man, admitted with nephrotic range proteinuria, hematuria and rapidly progressive renal failure. He also had anemia, thrombocytopenia and pericardial effusion. The diagnosis of SLE was made based on these clinical findings along with positive antinuclear and anti dsDNA antibodies. Renal biopsy revealed class IV/ V lupus nephritis (LN) with active lesions of thrombotic microangiopathy. The evolution of neurological deficit, persistent thrombocytopenia and active microangiopathic changes suggested the diagnosis of associated TTP. The patient was treated initially with corticosteroids and cyclophosphamide. Plasmapheresis could only be started 16 days later. Mycophenolate mofetil and rituximab were successively tried in the absence of improvement in renal function and persistent thrombocytopenia. The patient's neurological condition deteriorated necessitating transfer to the intensive care unit and mechanical ventilation. There he developed pneumonia and died of septic shock two months after presentation.Conclusion: The coexistence of TTP and SLE needs to be considered early in SLE patients with complicated course. It may not respond to the conventional immunosuppressive treatment of SLE.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"5 2","pages":"103-5"},"PeriodicalIF":0.0,"publicationDate":"2012-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30633193","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 ethical aspects of medical research. 医学研究的伦理问题。

Arab journal of nephrology and transplantation Pub Date : 2012-05-01

Sarra Elamin

引用次数: 0

Clinical course of acute pancreatitis in chronic kidney disease patients in a single kidney center (PGTi) in Karachi. 卡拉奇单一肾脏中心(PGTi)慢性肾脏疾病患者急性胰腺炎的临床病程

Arab journal of nephrology and transplantation Pub Date : 2012-05-01

Kiran Nasir, Aasim Ahamd

{"title":"Clinical course of acute pancreatitis in chronic kidney disease patients in a single kidney center (PGTi) in Karachi.","authors":"Kiran Nasir, Aasim Ahamd","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: The aim of this study was to assess the clinical course, etiology and complications of acute pancreatitis among chronic kidney disease (CKD) patients in a tertiary care renal center in Karachi.Methods: We retrospectively evaluated the clinical course of CKD patients who presented to our emergency room with signs and symptoms of acute pancreatitis over a period of two years.Results: During the study period, 247 CKD patients presented to our emergency room with symptoms suggestive of acute pancreatitis. Only 43 patients (17.4%) had more than a threefold increase in serum amylase and/or lipase levels fulfilling the diagnostic criteria of acute pancreatitis. They included 25 pre-dialysis CKD patients (58.13%) and 18 end stage renal failure patients (41.86%) on regular hemodialysis (HD). Among the 25 pre-dialysis CKD patients, 17 patients developed acute kidney injury (AKI), ten of whom required temporary HD. Twelve of those patients (70%) returned back to their baseline renal functions after 3-4 weeks. Gallstones were the cause of pancreatitis in seven patients (16.3%) while no cause was identified in 29 patients (67.4%). Nine patients (20.9%) developed multi-organ failure and 12 patients (27.9%) required admission to the intensive care unit (ICU). All patients survived except for one patient (2.3%) who died in the ICU. patients with less than threefold increase in serum amylase and lipase levels responded well to conservative management and had a favorable clinical course.Conclusion: In severe acute pancreatitis the mortality rate can be as high as 40-58% especially in association with comorbid conditions. In this series of CKD patients however, the overall mortality rate was 2.3%, probably due to the predominance of milder forms of pancreatitis.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"5 2","pages":"87-90"},"PeriodicalIF":0.0,"publicationDate":"2012-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30631763","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

Reaching target hemoglobin level and having a functioning arteriovenous fistula significantly improve one year survival in twice weekly hemodialysis. 达到目标血红蛋白水平和有一个功能正常的动静脉瘘显著提高一年的生存在每周两次血液透析。

Arab journal of nephrology and transplantation Pub Date : 2012-05-01

Sarra Elamin, Hasan Abu-Aisha

{"title":"Reaching target hemoglobin level and having a functioning arteriovenous fistula significantly improve one year survival in twice weekly hemodialysis.","authors":"Sarra Elamin, Hasan Abu-Aisha","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: This is a prospective study of a cohort of 1011 patients maintained on regular hemodialysis (HD) in Khartoum, Sudan, studied in the year 2009 and reevaluated one year later. Their survival rates in November 2010 were related to their baseline characteristics.Methods: Demographic and clinical data of studied patients was collected by direct patient interviews and dialysis records revision. Survival rates were calculated using the Kaplan Meier method.Results: Patients had a median age of 45 years and a median duration on dialysis of 25 months. Two thirds of patients were males and 4.2% were children. Studied patients had a one-year survival rate of 86%. Most patients (74.8%) received twice weekly HD, and their survival rate was lower than patients receiving thrice weekly HD (85% versus 89%, P = 0.06). The strongest independent predictors of mortality were lack of a documented measure of dialysis adequacy (HR = 2.7, P = 0.00), poor functional capacity (HR = 2.4, P = 0.00), lack of a functioning AV fistula (HR = 2.0, P = 0.00), age ≥ 65 years (HR = 1.6, P = 0.02) and cardiovascular disease (HR = 1.5, P = 0.04). Patients with hemoglobin level < 10 g/dl had significantly lower survival rates (81% versus 92%, P = 0.00) compared to other patients. HD patients' perception of their own general health was also significantly correlated to their survival rates (P = 0.00).Conclusion: Patients on thrice weekly HD did marginally better than those on twice weekly HD. In the latter group, however, having an AV fistula and a hemoglobin level of > 10 g/dl appeared to have a positive effect on their survival. Twice weekly HD could be acceptable for many patients provided other aspects of renal care are cared for adequately.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"5 2","pages":"81-6"},"PeriodicalIF":0.0,"publicationDate":"2012-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30631762","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 pattern of histologically-proven acute post-infectious glomerulonephritis in Tunisian adults seen in 1976-2004. 1976-2004年突尼斯成人经组织学证实的急性感染后肾小球肾炎的模式

Arab journal of nephrology and transplantation Pub Date : 2012-05-01

Imed Helal, Hayet Kaaroud, Rym Goucha, Fatma Ben Moussa, Hedi Ben Maiz, Adel Kheder

{"title":"The pattern of histologically-proven acute post-infectious glomerulonephritis in Tunisian adults seen in 1976-2004.","authors":"Imed Helal, Hayet Kaaroud, Rym Goucha, Fatma Ben Moussa, Hedi Ben Maiz, Adel Kheder","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Acute post-infectious glomerulonephritis (APIGN) is uncommon in adults. It is widely recognized that the prognosis of APIGN is good in children. There is however little information about its long-term prognosis in adults.Methods: Between December 1976 and October 2004, 148 adult cases of APIGN were managed in our center. We retrospectively reviewed these patients' records and evaluated their clinical course and outcome.Results: The mean age of studied patients was 36 ± 15 years, and the male to female ratio was 2.3. The most common site of preceding infection was the respiratory tract (68.8%). At presentation, 89.2% had nephritic syndrome and 9.4% had rapidly progressive glomerulonephritis. Proteinuria was observed in 99.3%, hematuria in 95.3%, peripheral edema in 89.2% and hypertension in 81.8%. Most patients (60.7%) had acute kidney injury and four patients (2.7%) required dialysis. Renal biopsy showed diffuse endocapillary proliferative glomerulonephritis in 88.8% of patients, associated with extracapillary proliferation in 12%. After a median follow-up of 2.5 year, only two patients died and 16.12% of patients had persistent clinical and/or biological abnormality. Chronic kidney disease was noted in 10 patients (6.75%) including four patients (2.7%) who progressed to end-stage renal disease. Poor prognostic factors included nephrotic range proteinuria, extracapillary proliferation in renal biopsy, acute kidney injury and the need for dialysis.Conclusion: In this cohort of patients, APIGN progressed to chronic kidney disease in less than 10% of patients.","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"5 2","pages":"93-6"},"PeriodicalIF":0.0,"publicationDate":"2012-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30633191","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

Informed consent for inclusion into clinical trials: a serious subject to note in the developing world. 纳入临床试验的知情同意:发展中国家需要注意的一个严肃问题。

Arab journal of nephrology and transplantation Pub Date : 2012-05-01

Morteza Izadi, Mozhgan Fazel, Taha Nasiri-Vanashi, Seyed Hasan Saadat, Saeed Taheri

{"title":"Informed consent for inclusion into clinical trials: a serious subject to note in the developing world.","authors":"Morteza Izadi, Mozhgan Fazel, Taha Nasiri-Vanashi, Seyed Hasan Saadat, Saeed Taheri","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Informed consent is a critical issue especially in conducting clinical trials that expose human life to medical or surgical interventions. It necessitates a long and complex process through which the participant is presented with all potential favorable and non-favorable consequences upon getting enrolled in the study.Review: The process of taking informed consent is well-understood in developed countries, with every effort taken to enhance and maintain the autonomy of patients and their right to make an informed choice of whether to participate or not. This may not be the case in the developing world.The information given to patients before the trial might not be properly developed and presented, an issue that can result in serious threat to the decision-making process. On the other hand, investigators should remember that enrolling people into a trial with no potential benefit for themselves cannot be considered ethical. In the current debate, we aim to address the issue of how respectfully and ethically clinical research trials can be done on human subjects and what we can do to enhance the practice in an ethical context.Conclusion: Development of a system through which we could warrant all rights of study participants in all cases around the world seems far from view. However, if we are in doubt about the ethics of a clinical trial, we can ask ourselves: \"what would we do, if we were in the same position our patients are in now?\"","PeriodicalId":89079,"journal":{"name":"Arab journal of nephrology and transplantation","volume":"5 2","pages":"97-100"},"PeriodicalIF":0.0,"publicationDate":"2012-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30633192","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