Introduction: Hepatitis C virus (HCV) is one of the most common infections among hemodialysis (HD) patients. It continues to be exasperating problem in many HD centers, in spite of strictly following infection and quality control measures.
Methods: This is a multi-center retrospective comparative study, carried out in different HD units of Menoufia Governorate, Egypt. Read More
Introduction: Our aim was to study the demographic and social characteristics of 189 living related kidney donors in Tunisia, and explore some of the social consequences of kidney donation.
Methods: This is a descriptive retrospective study of 189 living related kidney donors who had their nephrectomy in Charles Nicolle Hospital between 1986 and 2009. The demographic and social characteristics at the time of donation were studied and changes in the social and occupational status after donation were assessed. Read More
Introduction: Systemic lupus erythematosus (SLE) is an unpredictable autoimmune systemic disorder that often involves the kidney. In this study, we aimed to assess the clinical characteristics, pathological findings, and therapeutic response of children presenting with lupus nephritis (LN).
Methods: We retrospectively studied 50 children with SLE admitted to the pediatric nephrology departments of four teaching hospitals in Baghdad between December 2009 and December 2011. Read More
Introduction: Hyperoxaluria is a metabolic disorder that can lead to end stage renal disease (ESRD). It can be either inherited or acquired. Primary hyperoxaluria (PHO) is more common and characterized by an excessive production of oxalate leading to recurrent urolithiasis and progressive nephrocalcinosis. Read More
Introduction: C4d immunostaining of renal allograft biopsies is recommended for the diagnosis of antibody-mediated rejection (ABMR), but it was not available to us prior to June 2012. In June 2012, we were able to obtain anti-human C4d polyclonal antibody and decided to retrospectively evaluate archived kidney allograft biopsies at our center for C4d deposition.
Methods: Twenty-four paraffin blocks were available for this study. Read More
Introduction: Emphysematous pyelonephritis (EP) is an uncommon acute infection characterized by the presence of gas in the renal parenchyma. It is extremely rare in hemodialysis (HD) patients and diabetics account for most cases. It is a rapidly progressive and life threatening infection with a high mortality rate. Read More
Introduction: Acute post streptococcal glomerulo-nephritis (APSGN) is a form of acute nephritic syndrome characterized by edema, hematuria, proteinuria, and hypertension. The immediate prognosis of acute post-streptococcal glomerulonephritis in children is usually excellent, however, the long-term prognosis has been a subject of debate.
Methods: This is a retrospective and prospective cohort study of Sudanese children with APSGN followed in a tertiary care hospital between 2006 and 2010. Read More
Introduction: The recognition of antibody mediated rejection has led to re-appreciation of the role of B cells in acute and chronic allograft rejection. The presence of CD20 positive lymphocytic infiltrates in acute cellular rejection has been associated with poor clinical outcomes and reduced graft survival. Recently molecular gene analysis has shown that grafts with antibody-mediated rejection (ABMR) have lower expression of CD20. Read More
Introduction: Uremia is the most important systemic cause of pruritus. Uremic pruritus (UP) was found to affect 50-90% of patients undergoing dialysis and about 25% of patients with chronic kidney disease (CKD). Despite its high prevalence, morbidity and the marked influence on quality of life, UP remains poorly characterized. Read More
Introduction: Cardiovascular complications are the leading cause of death among renal transplant recipients; renal graft dysfunction has special effects on cardiovascular morbidity and mortality.
Review: Several studies have demonstrated a significant correlation between creatinine level and major coronary events, congestive heart failure and cerebrovascular events. Cardiovascular mortality has been related in different reports to serum creatinine levels and duration on renal replacement therapy. Read More
Introduction: Childhood renal diseases are increasing in Nigeria. It is necessary to monitor the nature of these diseases in each locality for effective health care planning. Our aim was to document the nature of renal diseases in the Niger Delta Region of Nigeria and compare it with other regions in the country. Read More
Introduction: Central vein stenosis (CVS) is a common complication of central venous catheter (CVC) insertion. In this study we evaluated the prevalence and risk factors of CVS among hemodialysis (HD) patients in a single center in Sudan, using Doppler ultrasound as a screening tool.
Methods: The study included 106 prevalent HD patients. Read More
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. Read More
Introduction: Rare cases of association between lupus nephritis (LN) and minimal changes nephrotic syndrome (MCNS) were described. Some authors suggest that this association, taking into account the low prevalence of both diseases, may not be a simple coincidence. Several pathophysiological hypotheses have been proposed to explain this association, including a potential central role of T lymphocytes. Read More
Introduction: Congenital abnormalities of the kidney and urinary tract (CAKUT) are significant causes of end stage renal disease (ESRD) in children. Some of these abnormalities, when identified early, are amenable to treatment. In developing countries, very few published reports exist concerning the pattern and scope of CAKUT in childhood. Read More
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). Read More
Introduction: The term hypertensive nephrosclerosis has traditionally been used to describe a clinical syndrome characterized by long-term essential hypertension, hypertensive retinopathy, left ventricular hypertrophy, minimal proteinuria, and progressive renal insufficiency. In the absence of renal biopsy, the diagnosis of hypertensive nephrosclerosis is one of exclusion.
Methods: We retrospectively studied 735 patients who had renal biopsies at Ain Shams University Hospitals between January 2008 and Dec 2010. Read More
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. Read More
Youth, which is forgiven everything, forgives itself nothing: age, which forgives itself everything, is forgiven nothing. George Bernard Shaw The proportion of older people in the general population is steadily increasing worldwide, with the most rapid growth in low-and middle-income countries . This demographic change is to be celebrated, because it is the consequence of socioeconomic development and better life expectancy. Read More
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. Read More
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. Read More
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. Read More
Introduction: Anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis involving the kidney usually comprises pauci-immune, necrotizing glomerulonephritis with crescents. Mononuclear tubulo-interstitial infiltrates are common in ANCA associated vasculitis, but these have usually been described in conjunction with glomerulitis. Acute tubulo-interstitial nephritis (ATIN) is a common cause of acute kidney injury that is most frequently induced by drugs or infections. Read More
Introduction: This study aimed to assess the therapeutic efficacy of traditional Chinese acupuncture in the treatment of persistent primary nocturnal enuresis (PNE).
Methods: Fifty children and adolescents suffering from persistent PNE were recruited from the Pediatrics and Urology Outpatient Clinic of Zagazig University Hospital during the year 2010. They included 31 boys and 19 girls, with a mean age of 116 ± years (range 9-17 years). Read More
Introduction: Affective disorders, particularly depression, are the commonest and probably the most important psychopathological complication of end stage renal disease (ESRD). Depression has the potential to alter adversely the medical outcome of ESRD patients and the psychological stress can affect patient's adherence to medication regimen. In Iraq as well as many other Arab countries, the true prevalence of depression among ESRD patients is unknown. Read More
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. Read More
Introduction: Dense Deposit Disease (DDD) is a devastating renal disease that leads to renal failure within 10 years of diagnosis in about half of affected patients. In this study, we evaluated the relative prevalence and pathological features of DDD diagnosed at our center over a 29 years period.
Methods: We reviewed the clinical and pathological features of all cases of DDD diagnosed at the Electron Microscopy Unit of Ain Shams University (ASUSH) between January 1983 and December 2011. Read More
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. Read More
Acute kidney injury (AKI) is increasingly prevalent in developing and developed countries and is associated with severe morbidity and mortality. Most etiologies of AKI can be prevented by interventions at the individual, community, regional and in-hospital levels. Effective measures must include community-wide efforts to increase an awareness of the devastating effects of AKI and provide guidance on preventive strategies, as well as early recognition and management. Read More
Introduction: In hemodialysis (HD) wards, nurses play a pivotal role in HD access care. Unfortunately, guideline recommendations for routine preventive care are not always followed. This study was designed to evaluate nurses' awareness and practice of HD access care in Khartoum state, Sudan. Read More
Introduction: Hemodialysis (HD) patients are predisposed to infective endocarditis (IE) mainly due to repeated manipulation of the vascular access. However, catheter seeding and IE may also result from a distant infection site.
Case Series: A diabetic patient who was maintained on regular HD through a permanent catheter in the right internal jugular vein presented with septicemia of urinary origin due to Pseudomonas aeruginosa. Read More
Introduction: Due to dearth of data, chronic kidney disease (CKD) outcome in African children has been dismal owing to poor understanding of its etiology, manifestations and management.
Methods: We retrospectively analyzed the records of 154 CKD children and adolescents who were managed at Obafemi Awolowo University Teaching Hospitals Complex between 2000 and 2009 to evaluate the epidemiology and clinicopathologic outcome of pediatric CKD in Nigeria.
Results: Overall mean incidence was 11 (6-20) per million children population (pmcp)/year while prevalence averaged 48 (8-101) pmcp. Read More
Introduction: Hemodialysis (HD) is a complex procedure with many specifications and requires adherence to a set of particular clinical practice guidelines. These guidelines had already been established by globally acclaimed renal authorities and their implementation was shown to correlate with patients' morbidity and mortality. This study was conducted to evaluate the adherence of healthcare professionals to the evidence-based clinical practice patterns in Khartoum State HD units. Read More
Introduction: Malnutrition is common in maintenance hemodialysis (HD) and is associated with increased mortality and morbidity in affected patients. The aim of this study was to determine the prevalence of malnutrition and correlate the methods of nutritional assessment.
Methods: We evaluated the nutritional status of 40 prevalent HD patients by subjective global assessment (SGA) score, anthropometrics [body mass index (BMI), arm circumference (AC), triceps skin-fold thicknesses (TSF), arm muscle circumference (AMC)], biochemical tests [normalized protein equivalent to total nitrogen appearance (nPNA), and pre-dialysis serum albumin and serum prealbumin levels] and bio-electrical impedance (BEI) analysis to estimate body composition [lean tissue index (LTI) and fat tissue index (FTI)]. Read More
Introduction: In view of the conflicting evidence of helper T cell type 1 (Th1) or type 2 (Th2) pattern of cytokine synthesis in steroid sensitive nephrotic syndrome (SSNS), this study aimed to assess type-1/type-2 cytokines level in different stages of SSNS and to evaluate the role of IL-18.
Methods: We prospectively studied thirty children with SSNS, aged 2-12 years. The children were evaluated in the active stage before treatment initiation and re-evaluated again during remission while still on steroid treatment. Read More
Introduction: Hypertension (HTN), diabetes mellitus (DM) and chronic kidney disease (CKD) are important health problems worldwide, and it is possible to reduce their burden through effective HTN screening and treatment programs. It may be feasible to incorporate such programs in the community outreach activities of nursing and medical schools in Sudan.
Methods: Village inhabitants in the Northern state of Sudan were invited to attend a free clinic for screening of hypertension as well as for follow up and treatment of persons with previously diagnosed hypertension. Read More
Introduction: Kidney transplantation is the treatment of choice for patients with end-stage renal disease. Despite great progress in surgical aspects and immunosupression therapy, long-term graft survival has not been consistent. Chronic allograft dysfunction (CAD) remains a major cause of late grafts failure. Read More
Introduction: 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.
Case Report: 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. Read More
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. Read More
Introduction: Thrombotic microangiopathy (TMA) is characterized by aggregation of platelets in the renal and/or systemic circulation, thrombocytopenia and intravascular hemolysis. The syndrome classically spares the lung. The term pulmonary-renal syndrome describes a number of diseases in which pulmonary hemorrhages and glomerulopathy coexist. Read More
Introduction: Vesicoureteral reflux (VUR) is a risk factor for kidney scarring, hypertension and declining renal function. Standard diagnostic methods are invasive and can cause exposure to radiation and urinary tract infections (UTIs). We aimed to investigate urine albumin and interleukin-8 levels as markers of ongoing VUR and renal damage in children without UTIs. Read More
Introduction: Early detection of Acute Kidney Injury (AKI) is important. We conducted a prospective observational study to test the ability of cystatin C (CysC) to predict AKI and mortality among in intensive care unit (ICU) patients after acute myocardial infarction (MI).
Methods: One hundred patients were enrolled in this study, CysC and serum creatinine (SCr) were measured at admission in the ICU and then daily for three days. Read More
Introduction: 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).
Methods: We recruited 20 SLE patients without LN, 20 SLE patients with LN and 20 healthy controls. Read More
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. Read More
Introduction: 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. Read More