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Hong Kong Journal of Nephrology
Journal Prestige (SJR): 0.137

Number of Followers: 3

This is an Open Access Journal

Open Access journal
ISSN (Print) 1561-5413
Published by Elsevier

[3203 journals]

Pharmacokinetic study of once-daily formulation of tacrolimus (Advagraf)
in stable Chinese kidney transplant recipients
- Authors: Terry King-Wing Ma; Kai Ming Chow; Phyllis Mei-Shan Cheng; Bonnie Ching-Ha Kwan; Chi Bon Leung; Philip Kam-Tao Li; Cheuk Chun Szeto
  Pages: 1 - 6
  Abstract: Publication date: October 2016
  Source:Hong Kong Journal of Nephrology, Volume 19
  Author(s): Terry King-Wing Ma, Kai Ming Chow, Phyllis Mei-Shan Cheng, Bonnie Ching-Ha Kwan, Chi Bon Leung, Philip Kam-Tao Li, Cheuk Chun Szeto
  Background/Purpose The objective of this study is to determine whether tacrolimus trough level is appropriate for therapeutic drug monitoring (TDM) of Advagraf in stable Chinese kidney transplant recipients (KTRs). Methods In this single-center pharmacokinetic study, stable adult Chinese KTRs on Advagraf were recruited and their blood tacrolimus levels measured at 12 time points within 24 hours. Trough level was defined as predose drug level (C 0). The pharmacokinetic parameters were calculated using standardized noncompartmental methods. Drug exposure, defined as 24-hour area under the curve (AUC0–24), was calculated using the linear trapezoidal method. Whole blood tacrolimus level measurement was performed by high-performance liquid chromatography/tandem mass spectrophotometry. Results Fourteen patients (8 males; mean age, 47.1 ± 9.2 years; mean duration of transplant, 8.3 ± 3.6 years) completed the study. The mean C 0 was 4.4 ± 1.9 ng/mL, and the mean AUC0–24 was 143.8 ± 57.0 ng h/mL. The mean maximum concentration (C max) was 10.2 ± 3.9 ng/mL, and the median time to C max was 2.0 hours (interquartile range, 1.0–3.0 hours). There was a strong correlation between C 0 and AUC0–24 (r = 0.90, p < 0.001). Patients receiving diltiazem had higher mean AUC0–24 (153.0 ± 55.3 ng h/mL vs. 110.1 ± 60.1 ng h/mL) despite a lower dose (mean tacrolimus dose, 0.039 ± 0.022 mg/kg/d vs. 0.054 ± 0.021 mg/kg/d), although both differences did not reach statistical significance. Apart from C 0, tacrolimus level obtained from 6 hours to 12 hours (C 6 to C 12) also had good correlation with AUC0–24. Conclusion Tacrolimus trough level is a good surrogate marker for TDM of Advagraf in stable Chinese KTRs. The role of C 6 to C 12 in TDM remains to be determined. 背景 / 目的本研究旨在調查在病情穩定的華裔腎臟移植接受者 (KTRs) 間,Cmin 是否適用於藥物血中濃度監測 (TDM)。方法在這一項單中心藥物動力學研究中,對象為病情穩定的華裔 KTRs,在 24 小時內 12 個時間點接受了動脈血的取樣,谷值的定義為服藥前藥物濃度 (C0)。藥物動力學參數的計算是採用標準化無房室模式,AUC0–24 的計算採用線性梯形方式。全血 tacrolimus 濃度的測量儀器,則是採用高效能液相色層分析串聯質譜儀...
  PubDate: 2016-10-16T19:26:47Z
  DOI: 10.1016/j.hkjn.2016.03.002
  Issue No: Vol. 19 (2016)
Changes in peritoneal membrane with different peritoneal dialysis
solutions: Is there a difference'
- Authors: Abdullah Khalaf Al-Hwiesh; Mohamed A. Shawarby; Ibrahiem Saeed Abdul-Rahman; Nadia Al-Oudah; Bander Al-Dhofairy; Jose Carolino Divino-Filho; Abdalla Abdelrahman; Hazem Zakaria; Mohammad A. Nasr El-Din; Ahmed Eldamati; Tamer El-Salamony; Fahd A. Al-Muhanna
  Pages: 7 - 18
  Abstract: Publication date: October 2016
  Source:Hong Kong Journal of Nephrology, Volume 19
  Author(s): Abdullah Khalaf Al-Hwiesh, Mohamed A. Shawarby, Ibrahiem Saeed Abdul-Rahman, Nadia Al-Oudah, Bander Al-Dhofairy, Jose Carolino Divino-Filho, Abdalla Abdelrahman, Hazem Zakaria, Mohammad A. Nasr El-Din, Ahmed Eldamati, Tamer El-Salamony, Fahd A. Al-Muhanna
  Background/Purpose The peritoneal membrane of long-term peritoneal dialysis (PD) patients is characterized by morphological and microvascular changes. It is said that lactate-based peritoneal dialysate is implicated in the development of these changes. The aim of this study is to compare the effects of long-term exposure to glucose-based, lactate-buffered (Dianeal), and biocompatible bicarbonate/lactate-buffered, low glucose degradation product (Physioneal) peritoneal solutions on the peritoneal membrane. Methods Thirty-nine incident PD patients were randomized into two groups: 19 patients with Dianeal dialysate (Group A) and 20 with biocompatible Physioneal dialysate (Group B). All patients used automated PD for a median of 31 months in Group A and 32 months in Group B. Three biopsies at one occasion only were taken from the peritoneal membrane at the end of the study. All samples were collected and fixed in accordance with a standardized protocol, and a histopathologist blinded to the clinical status and PD solutions allocated to the patients carried out the analysis. Results The commonest change observed was peritoneal fibrosis, seen in 35 out of 39 cases (89.7%); it was moderate to severe in 28 cases (71.8%) and mild in 11 (28.2%) cases. This was followed by loss of mesothelial cells (22 cases, 56.4%), elastosis (20 cases, 51.3%), increased blood vessels (15 cases, 38.5%), thick-walled blood vessels (10 cases, 25.6%), and finally chronic inflammation and mesothelial cell hyperplasia (7 cases, 17.9%, and 6 cases, 15.4%, respectively). Of the patients with blood vessel abnormalities, 22 (88.0%) exhibited significant fibrosis and only three (12.0%) did not. Of those without blood vessel changes, only six (42.9%) patients exhibited similar degree of fibrosis (p < 0.01). The prevalence of vascular changes, moderate to severe fibrosis, as well as mesothelial cell abnormalities increased as the duration of PD increased. The prevalence of fibrosis, mesothelial cell loss, and vascular abnormalities increased significantly with diabetes mellitus (p < 0.001). Conclusion There was no difference in the effects of long-term exposure to glucose-based, lactate-buffered, and biocompatible bicarbonate/lactate-buffered, low glucose degradation product peritoneal solutions on the peritoneal membrane. Risk factors other than PD dialysate composition need to be considered when assessing peritoneal membrane adequacy. The factors that were proved to be significant in our study are duration of end-stage renal disease, diabetes mellitus, and time on PD. 背景 / 目的在接受長期腹膜透析 (PD) 的病人間，腹膜會出現若干的形態學與微血管變化，這些變化被認為與採用乳酸鹽腹膜透析液有關。本研究旨在比較兩種透析液的長期暴露—乳酸鹽緩衝之 Dianeal®、與生物相容之 Physioneal® 對病人腹膜的影響。方法共 39 位剛開始接受 PD 的病人被分為兩組：19 人接受 Dianeal 透析液 (A 組)、20 人接受生物相...
  PubDate: 2016-10-16T19:26:47Z
  DOI: 10.1016/j.hkjn.2016.03.001
  Issue No: Vol. 19 (2016)
Advance care planning for 600 Chinese patients with end-stage renal
disease
- Authors: Sze-Kit Yuen; Hay Ping Suen; Oi-Ling Kwok; Sai-Ping Yong; Man-Wah Tse
  Pages: 19 - 27
  Abstract: Publication date: October 2016
  Source:Hong Kong Journal of Nephrology, Volume 19
  Author(s): Sze-Kit Yuen, Hay Ping Suen, Oi-Ling Kwok, Sai-Ping Yong, Man-Wah Tse
  Background/purpose There is increasing recognition of the need to integrate advance care planning (ACP) into end-stage renal disease (ESRD) care with attention to medical, ethical, psychosocial, and spiritual issues but publications comparing patients who chose renal replacement therapy (RRT) and renal palliative care (RPC) is scarce. We here share our experience on ACP for ESRD patients in a center with renal replacement and palliative programs in place. Methods From June 2006 to December 2011, ESRD patients were empowered to make an informed choice of future medical care in a structured ACP that was emphasized to be an ongoing process. Patients who opted for RRT and RPC would be followed up at the predialysis clinic and the one-stop multidisciplinary RPC clinic, respectively. This was a single-center study in a secondary care hospital. A total of 600 patients (265 RRT, 335 RPC) were enrolled and followed up over a median of 782 days. Results The majority of patients and relatives declined dialysis because of perceived physical burden. Only 1.6% of palliative care patients changed their decision and commenced dialysis. Baseline characteristics differed between patients who chose RRT or RPC. Survival declined according to the modified Charlson comorbidity index scores. Older age, mental incompetence, hyperlipidemia, high modified Charlson comorbidity index, low estimated glomerular filtration rate, and low albumin were important independent predictors of poor survival. Factors affecting the ACP decision were discussed in the Chinese culture context. Conclusion A structured ACP could empower the patient to make an informed decision on the management of ESRD. 背景於未期腎病患者的照顧中加入關注身心社靈和倫理問題的預設照顧計劃(ACP)受到日益重視，但有關比較接受腎替代療法和接受腎臟紓緩治療文獻討論為數不多。作為同時提供腎透析服務以及腎臟紓緩治療的部門，本文旨在分享我們為未期腎病者討論預計照顧計劃的經驗。方法自二零零六年六月至二零一零五月間，透過有組織的預設照顧計劃討論，未期腎病患者會被鼓勵就未來的治療計劃作出知情選擇。選擇腎透析和腎臟紓緩治療的病人會分別於透析預備門診和一站式跨科際腎臟紓緩治療門診去覆診。本研究於一家二級醫院進行。總共有六百病人參與此研究，當中265名接受腎透析，335名接受腎臟紓緩治療，其中位跟進日數為782日。
  PubDate: 2016-10-16T19:26:47Z
  DOI: 10.1016/j.hkjn.2016.04.001
  Issue No: Vol. 19 (2016)
The analysis of patients with primary and secondary glomerular diseases: A
single-center experience
- Authors: Yavuz Ayar; Alparslan Ersoy; Emel Isiktas; Gokhan Ocakoglu; Abdulmecit Yildiz; Aysegül Oruc; Dilay Demirayak; Ismail Bayrakci; Hakan Duger; Tugba Bozbudak
  Pages: 28 - 35
  Abstract: Publication date: October 2016
  Source:Hong Kong Journal of Nephrology, Volume 19
  Author(s): Yavuz Ayar, Alparslan Ersoy, Emel Isiktas, Gokhan Ocakoglu, Abdulmecit Yildiz, Aysegül Oruc, Dilay Demirayak, Ismail Bayrakci, Hakan Duger, Tugba Bozbudak
  Background/Purpose Glomerulonephritis is among the most important group of diseases causing end-stage renal disease (ESRD). The prevalence of glomerulonephritis varies depending on age, gender, geographical features, etc. In the present study, we evaluated the clinical and laboratory parameters of patients who underwent renal biopsy. Methods In this retrospective study, demographic and clinical characteristics, specific diagnoses of glomerular diseases, and biopsy findings of all patients in whom native renal biopsy was performed in our hospital between January 2009 and December 2014 were analyzed. Results A total of 384 patients were divided into two groups as primary glomerular diseases (PGD) and secondary glomerular diseases (SGD). Some 37.1% of patients with PGD and 49.2% of patients with SGD were female. The mean age was 43.8 ± 14.1 years in the PGD group and 47.3 ± 16.1 years in the SGD group (p = 0.044). Nephrotic syndrome in the PGD group and unexplained renal dysfunction in the SGD group were observed more frequently at the time of admission. In the SGD group, biopsy findings (crescents, sclerosis, vascular involvement, etc.) were dominant and more pronounced (p < 0.001). In the PGD group, responsiveness to the therapy was higher than in the SGD group (p < 0.001). Mortality rates were 2.27% in the PGD group and 18.3% in the SGD group. According to the multivariate analysis, the increase of creatinine level after treatment (odds ratio 1.49) and presence of SGD (odds ratio 7.74) were independent risk factors for patient death (p < 0.001). Conclusion The present study showed important data about the etiology, clinical findings, follow ups, and prognosis of PGD and SGD among adults in our center. We observed that mortality was higher in patients with SGD. 背景 / 目的腎小球腎炎是導致末期腎病 (ESRD) 的最重要疾病,其盛行率與年齡、性別、及地域特性有關。在本研究中,我們在接受腎臟組織活檢的腎小球疾病患者間,對相關的臨床及檢驗特徵進行了調查。方法在本回溯性研究中,對象為於 2009 年 1 月至 2014 年 12 月期間,在本院接受自身腎臟組織活檢的病人。我們對其人口學與臨床特徵、腎小球疾病診斷、及活檢結果進行了分析。結果調查對象為 384 位原發性腎小球疾病 (PGD) 或次發性腎小球疾病 (SGD) 患者。在 PGD 及 SGD 組別中,女性比例分別佔 37.1% 及 49.2%,平...
  PubDate: 2016-10-16T19:26:47Z
  DOI: 10.1016/j.hkjn.2016.05.001
  Issue No: Vol. 19 (2016)
Carotid intima-media thickness in kidney transplant recipients
- Authors: Rizna Abdul Cader; Noor Izyani Zakaria; Yazmin Yaacob; Shamsul Azhar Shah
  Pages: 36 - 41
  Abstract: Publication date: October 2016
  Source:Hong Kong Journal of Nephrology, Volume 19
  Author(s): Rizna Abdul Cader, Noor Izyani Zakaria, Yazmin Yaacob, Shamsul Azhar Shah
  Background/Purpose Cardiovascular disease is the leading cause of mortality among kidney transplant recipients. Carotid intima-media thickness (CIMT) of the common carotid artery is a surrogate marker for early atherosclerosis. We wanted to compare the prevalence of increased CIMT among kidney transplant recipients with matched controls and its association with clinical and laboratory parameters. Methods A comparative cross-sectional study involving kidney transplant recipients and controls matched for age, sex, chronic kidney disease staging, and cardiovascular risks was used. CIMT measurements were done using carotid ultrasound and considered increased if >75th percentile matched for age- and sex-matched normal controls. Standard laboratory investigations, high sensitivity C-reactive protein, and asymmetric diamethylarginine were analyzed. Results Thirty-six kidney transplant recipients (25 men, 11 women) with a median age of 41 years [interquartile range (IQR), 38–52 years] and 36 matched controls with a median age of 44 years (IQR, 37–53 years) were enrolled. There were no demographic differences between the two groups. Kidney transplant recipients had a significantly increased CIMT, 0.8 mm (IQR, 0.6–0.9) compared to matched-controls 0.55 mm (IQR, 0.5–0.7, p = 0.001). Two thirds of kidney transplant recipients had increased CIMT, which was associated with a higher low density lipoprotein (LDL) (p =0.022) and higher hemoglobin (p =0.006). Smoking status (p =0.058) and male gender (p =0.073) had a trend towards significance to increased CIMT. Multiple linear stepwise regression demonstrated both age and hemoglobin were independent predictors of CIMT (p < 0.001). We found no relationship between high sensitivity C-reactive protein and asymmetric diamethylarginine with CIMT. Conclusion CIMT among our kidney transplant recipients was significantly higher compared to controls thereby increasing their cardiovascular risk. 背景心血管疾病是腎臟移植接受者的主要死因,總頸動脈的內膜中膜厚度 (CIMT) 則是早期動脈粥樣硬化的替代性指標。在本研究中,我們比較了 CIMT 增厚於腎臟移植接受者與匹配對照組之間的盛行率,並調查了 CIMT 與臨床及實驗室參數之間的關聯。方法這是一項橫斷式比較性研究,涉及的對象包括腎臟移植接受者、及與其匹配 (年齡、性別、慢性腎病分期及心血管風險) 的對照者。CIMT 以頸動脈超音波測量,增厚的定義為對應年齡性別匹配正常對照組之 > 75th 百分位數。其他測量項目除了標準實驗室參...
  PubDate: 2016-10-16T19:26:47Z
  DOI: 10.1016/j.hkjn.2016.08.001
  Issue No: Vol. 19 (2016)
Outcomes in elderly patients with end-stage renal disease: Comparison of
renal replacement therapy and conservative management
- Authors: Wing-Hang Kwok; Sai-Ping Yong; Oi-Ling Kwok
  Pages: 42 - 56
  Abstract: Publication date: October 2016
  Source:Hong Kong Journal of Nephrology, Volume 19
  Author(s): Wing-Hang Kwok, Sai-Ping Yong, Oi-Ling Kwok
  Background/purpose With global socioeconomic development and improvement in the general health care system, life expectancy increases, resulting in an increasing incidence of end-stage renal disease in the elderly population. We compared the survival rate in elderly patients aged≥65 years with Stage 5 chronic kidney disease, managed with either renal replacement therapy (RRT) or conservative treatment. We also tried to identify factors associated with survival in these two groups. Methods This is a single-center retrospective study of patients aged≥65 years with Stage 5 chronic kidney disease, who were referred to the nephrology team for renal advance care planning to assist in decision making for RRT or conservative treatment from 2005 to 2013. They were followed up till death or till December 31, 2014. Baseline characteristics (demographics, clinical data, functional status, socioeconomic factors, and laboratory parameters) and mortality data between the two groups were compared. Results A total of 558 patients were recruited during the study period, in which 126 (22.6%) patients opted for RRT and 432 (77.4%) for conservative treatment. Patients with less significant comorbidities, lower modified Charlson's Comorbidity Index scores, better functional and mental statuses, as well as better socioeconomic status were more likely to choose RRT. The RRT group had a longer median survival of 44.6 months compared with 10.0 months in the conservative treatment group. The survival advantage of the RRT group was lost in patients older than 85 years, or in those with high comorbidity (modified Charlson's Comorbidity Index score of ≥11) or dependent mobility. Age, comorbidity, and mobility were predictors of mortality in the RRT group. For the conservative group, age, mobility, and gender were predictors of mortality. Conclusion Elderly patients with end-stage renal disease can be benefited from RRT. However, the survival advantage of RRT was lost in very-advanced-age patients older than 85 years of age, in those with high comorbidity, or in functionally dependent patients. 目的在全球性的社會經濟發展下;預期壽命得以延長;導致在老年人口中;末期腎病的發生率亦有所增長。我們在 ≥ 65 歲的第 5 期慢性腎病年老患者間;比較了腎置換療法 (RRT) 與保守療法所達到的存活率。同時;我們亦嘗試找出影響這兩組病人存活的因素。方法這是一項單中心的回溯性研究;對象為 ≥ 65 歲的第 5 期慢性腎病患者。他們是在 2005 年至 2013 年期間;被轉介至腎科團隊接受預設照顧計劃;以協助他們選擇 RRT 或保守療法；追蹤期至 2014 年 12 月 31 日或病人去世為止。我們比較了兩組病人的基線特徵及死亡率數據。
  PubDate: 2016-11-03T02:14:01Z
  DOI: 10.1016/j.hkjn.2016.04.002
  Issue No: Vol. 19 (2016)
Bleeding post-transplantation intrarenal pseudoaneurysms
- Authors: Ho Kwan Ken Sin; Samuel Ka Shun Fung; Hon Lok Tang; Au Cheuk; William Lee; Ka Fai Yim; Ka Yan Poon; Lok Yan Wong; Hiu Man Cheng
  Pages: 57 - 60
  Abstract: Publication date: October 2016
  Source:Hong Kong Journal of Nephrology, Volume 19
  Author(s): Ho Kwan Ken Sin, Samuel Ka Shun Fung, Hon Lok Tang, Au Cheuk, William Lee, Ka Fai Yim, Ka Yan Poon, Lok Yan Wong, Hiu Man Cheng
  We herein present a case of an intrarenal pseudoaneurysm developing 2 weeks after renal transplantation. The patient presented with hemorrhagic shock. Computed tomography confirmed an intrarenal pseudoaneurysm with extravasation of contrast and a large surrounding hematoma. Angiography confirmed the pseudoaneurysm, and embolization of the segmental graft renal artery was performed. In view of the uncertain etiology and the possibility of a mycotic pseudoaneurysm, we administered empiric antimicrobial therapy. The clinical course, investigations, and management are described. Finally, a review of the literature regarding post-transplantation pseudoaneurysms is presented. 以下是一宗於移植後 2 週出現的腎內僞動脈瘤個案，患者以出血性休克表現。當時為其安排緊急電腦斷層攝影 (CT)，發現有一個腎內僞動脈瘤，並呈現顯影劑溢出現象，且被一大型血腫圍繞。緊急血管攝影證實為植入腎之僞動脈瘤，同時我們對涉及的節段性動脈予以栓塞處置。基於病因並不明確，而且不能排除黴菌性僞動脈瘤的可能性，因此我們實施了經驗性抗微生物學療法。在本文中，我們描述了本個案的臨床歷程、相關檢查及後續處置，並指出我們在治療上所遭遇到的困難。最後，我們對移植後僞動脈瘤的相關文獻作出了回顧。
  
  PubDate: 2016-11-17T07:08:06Z
  DOI: 10.1016/j.hkjn.2016.06.001
  Issue No: Vol. 19 (2016)
Employment status in peritoneal-dialysis patients
- Authors: Man Ching Law; Kai Ming Chow; Janny Suk Fun Fung; Cheuk Chun Szeto; Philip Kam Tao Li
  Pages: 11 - 14
  Abstract: Publication date: April 2016
  Source:Hong Kong Journal of Nephrology, Volume 18
  Author(s): Man Ching Law, Kai Ming Chow, Janny Suk Fun Fung, Cheuk Chun Szeto, Philip Kam Tao Li
  Background/Purpose The employment status of peritoneal-dialysis patients could have been related to selection bias. This study examined the employment rate and associated factors in a population with peritoneal-dialysis-first policy. Method We performed a single-center cross-sectional survey on the employment status of prevalent peritoneal-dialysis patients between January and September 2013 in Hong Kong. Results The survey included 383 prevalent peritoneal-dialysis patients, with 128 of them in the labor force. Among the patients in the labor force, the employment rates were 65.8% and 18.9% for automated peritoneal-dialysis patients and continuous-ambulatory-peritoneal-dialysis patients, respectively, whereas 39.1% of patients in the labor force had expressed that they were able to work, but were unemployed. In adjusted analysis, the use of automated peritoneal dialysis (adjusted odds ratio of 7.93; 95% confidence interval 2.92–21.74) was independently associated with employment, whereas older age was associated with lower likelihood of employment (adjusted odds ratio of 0.53 for each 10 years old; 95% confidence interval 0.38–0.72). Conclusion The employment rate in peritoneal-dialysis patients is very low when compared to that in the general population. Patients on automated peritoneal dialysis were more likely to be employed. 背景腹膜透析患者就業狀況的研究，有可能會受到選擇性偏倚的影響。這項調查是在一個採納了 é腹膜透析第一û 政策的地區，進行就業率及其相關因素的研究。方法在2013年1月至9月期間，我們在香港一個腹膜透析中心對現存的腹膜透析患者的就業狀況進行了一次橫斷面調查。結果本次調查包括383名現存的腹膜透析患者，其中有128人被納入勞動力人口。在勞動力人口的患者中，自動腹膜透析的使用者就業率為65.8 %，連續性家居腹膜透析的使用者就業率為18.9 % 。另一方面，39.1%的勞動力人口患者，表示他們有能力工作，但並未受僱用。在調整後的分析，使用自動腹膜透析與就業率有獨立關聯，另外，較年長的患者與較低就業率有關聯。
  PubDate: 2016-01-18T16:36:01Z
  DOI: 10.1016/j.hkjn.2015.10.002
  Issue No: Vol. 18 (2016)
Unaffordability of renal replacement therapy in Nigeria
- Authors: Samuel Ajayi; Yemi Raji; Temitope Bello; Lanre Jinadu; Babatunde Salako
  Pages: 15 - 19
  Abstract: Publication date: April 2016
  Source:Hong Kong Journal of Nephrology, Volume 18
  Author(s): Samuel Ajayi, Yemi Raji, Temitope Bello, Lanre Jinadu, Babatunde Salako
  With the increase in epidemic proportions of diabetes worldwide, the number of patients who will require renal replacement therapy (RRT) will be a great challenge to the health infrastructures of developing countries such as Nigeria. Because those mostly affected are in the economically productive age group, a vicious circle is established whereby those who keep the economy going are the same people affected. Secondary and tertiary care of chronic kidney disease involving RRT would exact disproportionate toll on the income of patients in the developing world where patients pay out of pocket for their own care. Whilst there is an increase in the number of facilities offering RRT, there is no commensurate sustainability of care either by the patients themselves or even by the government. The level of unemployment is increasing. Kidney transplantation is out of reach in addition to the cost of post-transplant care, which includes hospitalization and immunosuppressive medications. Most of the end-stage kidney disease patients who enlisted in our dialysis program were unable to get or sustain adequate hemodialysis. The data also showed that more men were dialyzed at our facilities over the period under review and the age distribution has not changed much over the decade. From this dismal picture in the last decade emerges a series of questions as to why this is so and what must be done to increase access to RRT. Prudent fund management and cost containment, local manufacture of dialysis materials and nongovernmental sources of funding are means of driving down the cost of dialysis. In countries where drugs and equipment for health services are locally manufactured, such as India and other countries, the cost of health care is more affordable than in countries such as Nigeria where these are imported. 在全世界，糖尿病的盛行率與日俱增，然而對於發展中國家如尼日利亞，基礎醫療架構並不足以應付患者對腎置換療法 (RRT) 的需求。本地民眾必須自費支付自身的醫療費用，但其收入水平遠不足以負擔慢性腎病二級與三級照護所需的 RRT。即使目前 RRT 設施已有所增加，但無論是患者或政府均難以維持治療的長期實施。此外，腎臟移植所需的資源在本地更是相當之有限。在被我們納入透析計劃的末期腎病 (ESKD) 患者間，大多數並未能接受足夠或持續的透析治療。過去十年間，在我們設施內接受透析的病人中，年齡分佈大致穩定，且男性佔較多數。目前，我們正研究如何能促進 RRT 普及實施的方案。透過謹慎的理財與成本控制、透析物料的本土生產、及非政府資金的運用，透析的相關費用可望得以降低。目前，發展中國家如尼日利亞的藥物與醫療器材大多仰賴進口，因此相關物資的本土生產是降低醫療成本的可行方案。
  
  PubDate: 2016-01-21T17:31:38Z
  DOI: 10.1016/j.hkjn.2015.11.002
  Issue No: Vol. 18 (2016)
ECE1 gene variant shows tendency toward chronic kidney disease advancement
among autosomal polycystic kidney disease patients
- Authors: Shiva Nagendra Reddy Annapareddy; Vinuutna Sravani Kumbakonam; Ramprasad Elumalai; Gnanasambandan Ramanathan; Soundararajan Periyasamy; Bhaskar V.K.S. Lakkakula
  Pages: 20 - 25
  Abstract: Publication date: April 2016
  Source:Hong Kong Journal of Nephrology, Volume 18
  Author(s): Shiva Nagendra Reddy Annapareddy, Vinuutna Sravani Kumbakonam, Ramprasad Elumalai, Gnanasambandan Ramanathan, Soundararajan Periyasamy, Bhaskar V.K.S. Lakkakula
  Background/Purpose Autosomal dominant polycystic kidney disease (ADPKD) is characterized by numerous epithelium-lined cysts in the kidney and is the leading genetic cause of end-stage renal disease worldwide. Endothelin-1 is a potent vasoactive peptide implicated in the regulation of basal vascular tone. Endothelin (ET)-converting enzyme 1 (ECE1) is well known for its critical role in the process of ET. Methods We investigated ECE1 gene variants to unravel ECE1 modifier effects associated with renal disease progression in ADPKD. Three ECE1 functional polymorphisms [rs213046 (−839 A>C), rs213045 (−338 G>T), and rs1076669 (Thr338Ile)] were genotyped using a fluorescence resonance energy transfer-based KASPar method in 106 ADPKD patients and 112 healthy participants. A Chi-square test was used to determine the relationship between ADPKD and ECE1 variants, and multivariate logistic regression analysis was performed to assess the effect of ECE1 variants on chronic kidney disease (CKD) progression. Mantel-Haenszel stratified analysis was performed to assess relationships between different CKD stages, hypertension, and their interaction. Results All loci are polymorphic and followed a Hardy-Weinberg equilibrium. Distribution of ECE1 genotypes in controls and ADPKD groups was not statistically significant, and linkage disequilibrium was not strong between pairs of single-nucleotide polymorphisms. The rs213046 variant genotypes were overrepresented in advanced CKD stages (p = 0.031). Conclusion Significant confounding effects of hypertension on CKD progression in ADPKD were observed. These results suggested that the ECE1 gene variant is a modifier of CKD advancement among ADPKD patients. 背景自體顯性多囊性腎病 (ADPKD) 的特點，是腎臟呈現相當多由上皮構成的囊腫，在全球是導致末期腎病 (ESRD) 的主要遺傳性原因。Endothelin-1 (ET-1) 是一種具有高度血管活性的胜肽，被認為與基礎血管張力的調節有關。眾所周知，endothelin (ET) 轉化酵素 1 (ECE1) 則在 ET 代謝上佔有重要的角色。方法在本研究中，我們調查了在 ADPKD 患者間，ECE1 基因變體與 CKD 病情發展的可能關聯。我們採用以 FRET 為基礎的 KASPar 方法，對 106 位 ADPKD 患者及 112 位健康人士，作出 3 種 ECE1 功能性多態性 [rs213046 (-839 A>C)、rs213045 (-338 G>T) 及 rs1076669 (Thr338Ile)] 的基因型辨識。對於 ADPKD 與 ECE1 基因變體的關聯，我們採取卡方檢驗；ECE1 基因變體與 CKD 病情發展的關聯，以多變項邏輯迴歸進行分析；CKD 分期與...
  PubDate: 2016-03-28T07:38:28Z
  DOI: 10.1016/j.hkjn.2016.02.001
  Issue No: Vol. 18 (2016)
Recurrent acute pancreatitis due to tertiary hyperparathyroidism
manifesting as pancreatic calcification in a patient receiving continuous
ambulatory peritoneal dialysis
- Authors: Chen-Yi Liao; Chao-Wen Hsueh; Ching-Chang Lee; Wu-Hsien Kuo; Ren-Jy Ben; En-Hua Huang; Chih-Chiang Wang; I-Hung Chen; Ming-Kai Tsai
  Pages: 26 - 30
  Abstract: Publication date: April 2016
  Source:Hong Kong Journal of Nephrology, Volume 18
  Author(s): Chen-Yi Liao, Chao-Wen Hsueh, Ching-Chang Lee, Wu-Hsien Kuo, Ren-Jy Ben, En-Hua Huang, Chih-Chiang Wang, I-Hung Chen, Ming-Kai Tsai
  Chronic alcohol use and gallstones are the most frequent causes of acute pancreatitis (AP), a life-threatening medical emergency. Above-normal calcium levels in these patients indicate potential malignancy or hyperparathyroidism (HPT). Whereas primary HPT has been associated with AP, tertiary HPT has seldom been linked with AP. Herein we present a case of peritoneal dialysis presenting with recurrent AP and incidental pancreatic duct calcification due to tertiary HPT. 急性胰炎是致命的緊急疾病,最常見的病因為長期飲酒及膽結石。當這些病人的血鈣過高,意味著癌症或副甲狀腺功能亢進的可能性。急性胰炎可能與原發性副甲狀腺功能亢進有關,但鮮少見於三發性副甲狀腺功能亢進患者。以下是一宗三發性副甲狀腺功能亢進所致復發性急性胰炎的個案,患者為腹膜透析接受者,並以偶發性胰管鈣化呈現。
  
  PubDate: 2016-04-02T08:22:43Z
  DOI: 10.1016/j.hkjn.2015.11.001
  Issue No: Vol. 18 (2016)
Indexes - Contents list, Author index, Keyword Index
- Abstract: Publication date: October 2016
  Source:Hong Kong Journal of Nephrology, Volume 19
  
  PubDate: 2016-11-30T13:42:17Z
Time to say goodbye
- Authors: Sing Leung Lui
  Abstract: Publication date: Available online 16 November 2016
  Source:Hong Kong Journal of Nephrology
  Author(s): Sing Leung Lui
  
  PubDate: 2016-11-17T07:08:06Z
  DOI: 10.1016/j.hkjn.2016.08.006
Mission accomplished
- Authors: Alex
  Abstract: Publication date: Available online 13 November 2016
  Source:Hong Kong Journal of Nephrology
  Author(s): Alex W. Yu
  
  PubDate: 2016-11-17T07:08:06Z
Concluding issue of the Hong Kong Journal of Nephrology
- Authors: Fu-Keung
  Abstract: Publication date: Available online 1 November 2016
  Source:Hong Kong Journal of Nephrology
  Author(s): Fu-Keung Li
  
  PubDate: 2016-11-03T02:14:01Z
The Last Issue of Hong Kong Journal of Nephrology
- Authors: Francis K.M. Wong
  Abstract: Publication date: Available online 31 October 2016
  Source:Hong Kong Journal of Nephrology
  Author(s): Francis K.M. Wong
  
  PubDate: 2016-11-03T02:14:01Z
  DOI: 10.1016/j.hkjn.2016.08.004
Hong Kong Journal of Nephrology: Milestones from 1999 to 2016
- Authors: Sydney C.W. Tang
  Abstract: Publication date: Available online 31 October 2016
  Source:Hong Kong Journal of Nephrology
  Author(s): Sydney C.W. Tang
  
  PubDate: 2016-11-03T02:14:01Z
  DOI: 10.1016/j.hkjn.2016.08.002
Until then, enjoy this issue!
- Authors: Siu-Ka Mak
  Abstract: Publication date: Available online 22 October 2016
  Source:Hong Kong Journal of Nephrology
  Author(s): Siu-Ka Mak
  
  PubDate: 2016-11-03T02:14:01Z
  DOI: 10.1016/j.hkjn.2016.08.005
Reflections on Hong Kong Journal of Nephrology 1999–2016
- Authors: Philip Kam Tao Li
  Abstract: Publication date: Available online 18 October 2016
  Source:Hong Kong Journal of Nephrology
  Author(s): Philip Kam Tao Li
  
  PubDate: 2016-11-03T02:14:01Z
  DOI: 10.1016/j.hkjn.2016.08.008
Editorial
- Authors: John Y.H.; Chan
  Abstract: Publication date: Available online 17 October 2016
  Source:Hong Kong Journal of Nephrology
  Author(s): John Y.H. Chan
  
  PubDate: 2016-11-03T02:14:01Z
So long, farewell, auf wiedersehen, adieu—Au revoir to our beloved
journal
- Authors: Desmond Y.H. Yap
  Abstract: Publication date: Available online 15 October 2016
  Source:Hong Kong Journal of Nephrology
  Author(s): Desmond Y.H. Yap
  
  PubDate: 2016-10-16T19:26:47Z
  DOI: 10.1016/j.hkjn.2016.08.011
Farewell
- Authors: Cheuk-Chun Szeto
  Abstract: Publication date: Available online 12 October 2016
  Source:Hong Kong Journal of Nephrology
  Author(s): Cheuk-Chun Szeto
  
  PubDate: 2016-10-16T19:26:47Z
A peritoneal dialysis patient with osmotic demyelination syndrome
- Authors: Hing Ming Cheng; Siu Hung Li
  Pages: 1 - 3
  Abstract: Publication date: April 2016
  Source:Hong Kong Journal of Nephrology, Volume 18
  Author(s): Hing Ming Cheng, Siu Hung Li
  A peritoneal dialysis patient with cirrhosis presented with drowsiness, vomiting, and mild hyponatremia. Despite no active correction of hyponatremia, she developed convulsion and quadriplegia. Magnetic resonance imaging of the brain showed changes of osmotic demyelination syndrome. This case illustrates that osmotic demyelination syndrome may occur in peritoneal dialysis without rapid correction of hyponatremia.
  
  PubDate: 2015-12-20T06:09:17Z
  DOI: 10.1016/j.hkjn.2015.10.001
  Issue No: Vol. 18 (2015)
Cognitive impairment in hemodialysis patients: What can slow this
decline'
- Authors: Mitesh Patel; Indranil Dasgupta; George Tadros; Jyoti Baharani
  Pages: 4 - 10
  Abstract: Publication date: April 2016
  Source:Hong Kong Journal of Nephrology, Volume 18
  Author(s): Mitesh Patel, Indranil Dasgupta, George Tadros, Jyoti Baharani
  With over 70% of hemodialysis (HD) patients, aged ≥55 years, having moderate to severe chronic cognitive impairment (CI), in an increasingly aging population, the need to stop this cognitive decline is paramount. CI amongst HD patients raises patient safety concerns, while limiting their ability to understand information such as medical advice and their decision-making ability. Unfortunately, the data available on assessment of cognition in HD patients and interventions utilized remain extremely limited. This paper discusses assessment of cognition, the theories of CI in HD patients, and current literature on cognitive interventions in chronic disease, with many not applicable to the HD population. An encouraging psychological intervention called cognitive stimulation therapy helps improve cognition as well as social skills in CI. This is the first review article discussing the possibility of cognition stimulation during HD which has not been investigated previously. With cognitive stimulation therapy showing improvements in cognition at 6-month follow-up, as well as being recommended by the National Institute for Health and Care Excellence for use in dementia, we suggest the need to study whether this therapy has any effect on cognition in HD patients both in short term, with respect to daily activities and decision making, and in long term, with respect to the possibility of reducing the risk of dementia. 在 55 歲或以上的血液透析 (HD) 病人間, 逾 70% 有中至重度的慢性認知障礙 (CI), 在目前老年化的人口中, 這是必須要解決的問題。在接受 HD 後, CI 可引發病人安全的隱憂, 同時亦限制患者接受資訊如醫囑、及決策的能力。然而, 至今關於 HD 病人認知功能與改善方案的數據仍非常有限。本文探討了認知功能的評估方法、及 CI 發生於 HD 的相關理論, 亦回顧了目前有關慢性病中認知功能改善方案的文獻, 雖然很多並不特定於 HD 病人群。我們注意到一種稱為認知刺激療法 (cognitive stimulation therapy, CST) 的心理治療方案, 可望改善 CI 患者的認知功能和社交技能。本文將首度就這種療法對 HD 病人的效應作出探討。事實上, CST 經證實可於 6 個月期間達到認知功能的改善, 亦是英國 NICE (National Institute for Health and Care Excellence) 建議的失智症療法, 我們認為有需要研究 CST 對 HD 病人認知功能的影響, 不論是在短期 (日常活動及決策能力)、或長期層面 (失智症的預防)。
  
  PubDate: 2015-12-24T06:34:49Z
  DOI: 10.1016/j.hkjn.2015.08.003
  Issue No: Vol. 18 (2015)
Triptolide, an Extracted Phytomedicine Attenuates Glomerularsclerosis in
Diabetic Nephropathy Rats via Regulation of Akt/AMPK/mTOR and
TGF-beta1/Smad Signaling Activities, Compared with Rapamycin
- Authors: Y.G. Wan; Z.M. Mao
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2, Supplement
  Author(s): Y.G. Wan, Z.M. Mao
  
  PubDate: 2015-11-21T20:04:55Z
  DOI: 10.1016/j.hkjn.2015.08.005
  Issue No: Vol. 17, No. 2 (2015)
Total Flavone Glycosides of Flos Abelmoschus Manihot Ameliorates Renal
Fibrosis in Diabetic Nephropathy Rats via Inhibiting Oxidative Stress and
p38MAPK Signaling Activity Compared with Alpha-Lipoic Acid
- Authors: Z.M. Mao; Y.G. Wan
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2, Supplement
  Author(s): Z.M. Mao, Y.G. Wan
  
  PubDate: 2015-11-21T20:04:55Z
  DOI: 10.1016/j.hkjn.2015.08.006
  Issue No: Vol. 17, No. 2 (2015)
Deposition of Complement 3 Influences the Prognosis of Nodular Sclerosis
of Diabetic Nephropathy
- Authors: D.W. Liu; Ping Wang; X.M. Liu
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2, Supplement
  Author(s): D.W. Liu, Ping Wang, X.M. Liu
  
  PubDate: 2015-11-21T20:04:55Z
  DOI: 10.1016/j.hkjn.2015.08.007
  Issue No: Vol. 17, No. 2 (2015)
Increased Serum Platelet Microparticle Contributes to Glomerular
Endothelial Injury in Diabetic Nephropathy
- Authors: Yang Zhang; Kun Ling Ma; Gui Hua Wang; Jian Lu; Yu Wu; Ze Bo Hu; Liang Liu; Bi Cheng Liu
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2, Supplement
  Author(s): Yang Zhang, Kun Ling Ma, Gui Hua Wang, Jian Lu, Yu Wu, Ze Bo Hu, Liang Liu, Bi Cheng Liu
  
  PubDate: 2015-11-21T20:04:55Z
  DOI: 10.1016/j.hkjn.2015.08.008
  Issue No: Vol. 17, No. 2 (2015)
Urinary Tubular Biomarkers Predict Renal Injurious Progress in Early
Diabetic Nephropathy Patients
- Authors: J.J. Yang; Y.G. Wan
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2, Supplement
  Author(s): J.J. Yang, Y.G. Wan
  
  PubDate: 2015-11-21T20:04:55Z
  DOI: 10.1016/j.hkjn.2015.08.009
  Issue No: Vol. 17, No. 2 (2015)
A Novel Therapy for Type-2 Diabetic Nephropathy by Targeting
Smad3-dependent lncRNA_5318
- Authors: S.F. Sun; X.R. Huang; M. Feng; P.M.K. Tang; R.C.W. Ma; H.Y. Lan
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2, Supplement
  Author(s): S.F. Sun, X.R. Huang, M. Feng, P.M.K. Tang, R.C.W. Ma, H.Y. Lan
  
  PubDate: 2015-11-21T20:04:55Z
  DOI: 10.1016/j.hkjn.2015.08.010
  Issue No: Vol. 17, No. 2 (2015)
Deletion of Smad3 Prevents Renal Fibrosis and Inflammation in Type 2
Diabetes
- Authors: B.H. Xu; Y.K. You; S.F. Sun; X.R. Huang; H.F. Liu; R.C.W. Ma; H.Y. Lan
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2, Supplement
  Author(s): B.H. Xu, Y.K. You, S.F. Sun, X.R. Huang, H.F. Liu, R.C.W. Ma, H.Y. Lan
  
  PubDate: 2015-11-21T20:04:55Z
  DOI: 10.1016/j.hkjn.2015.08.011
  Issue No: Vol. 17, No. 2 (2015)
Gene Deficiency of GPR124 Exacerbates Podocyte Injury in Diabetic
Nephropathy
- Authors: Xiaojie Wang; Yiqi Duan; Fan Yi
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2, Supplement
  Author(s): Xiaojie Wang, Yiqi Duan, Fan Yi
  
  PubDate: 2015-11-21T20:04:55Z
  DOI: 10.1016/j.hkjn.2015.08.012
  Issue No: Vol. 17, No. 2 (2015)
MiR302a-3p Modulates Renal Epithelial-Mesenchymal Transition in DKD by
Targeting ZEB1
- Authors: W.T. Tang; L.Z. Zheng; R.Y. Yan; J.Y. Yang; J.N. Ning; L.P. Peng; Q.Z. Zhou; L.C. Chen
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2, Supplement
  Author(s): W.T. Tang, L.Z. Zheng, R.Y. Yan, J.Y. Yang, J.N. Ning, L.P. Peng, Q.Z. Zhou, L.C. Chen
  
  PubDate: 2015-11-21T20:04:55Z
  DOI: 10.1016/j.hkjn.2015.08.013
  Issue No: Vol. 17, No. 2 (2015)
Perfluorooctane Sulfonate (PFOS) Promotes Renal Injury Under Diabetic
Condition In Vitro
- Authors: Arthur C.K. Chung
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2, Supplement
  Author(s): Arthur C.K. Chung
  
  PubDate: 2015-11-21T20:04:55Z
  DOI: 10.1016/j.hkjn.2015.08.014
  Issue No: Vol. 17, No. 2 (2015)
Hyperphosphatemia and Tubulointerstitial Injury in the Progression of
Diabetic Nephropathy
- Authors: S.J. Jiang; Y.P. Pan; D.D.Q. Qiu; Y.A. An; H.C. Chen; Y.C.G. Ge; H.L.X. Xie; Z.H.L. Liu
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2, Supplement
  Author(s): S.J. Jiang, Y.P. Pan, D.D.Q. Qiu, Y.A. An, H.C. Chen, Y.C.G. Ge, H.L.X. Xie, Z.H.L. Liu
  
  PubDate: 2015-11-21T20:04:55Z
  DOI: 10.1016/j.hkjn.2015.08.015
  Issue No: Vol. 17, No. 2 (2015)
Prediction of Renal Outcome in Type 2 Diabetic Nephropathy by Estimating
GFR from a Combination of Serum Creatinine and Cystatin C
- Authors: Y.P. Pan; S.J. Jiang; D.D.Q. Qiu; Y.A. An; Y.C.G. Ge; H.L.X. Xie; Z.H.L. Liu
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2, Supplement
  Author(s): Y.P. Pan, S.J. Jiang, D.D.Q. Qiu, Y.A. An, Y.C.G. Ge, H.L.X. Xie, Z.H.L. Liu
  
  PubDate: 2015-11-21T20:04:55Z
  DOI: 10.1016/j.hkjn.2015.08.016
  Issue No: Vol. 17, No. 2 (2015)
Gene Expression Profile Analysis of Tangshen Formula-treated db/db Mice
- Authors: Hailing Zhao; Tingting Zhao; Xin Li; Ping Li
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2, Supplement
  Author(s): Hailing Zhao, Tingting Zhao, Xin Li, Ping Li
  
  PubDate: 2015-11-21T20:04:55Z
  DOI: 10.1016/j.hkjn.2015.08.017
  Issue No: Vol. 17, No. 2 (2015)
Tangshen Formula Attenuates Hepatic Steatosis in db/db Mice by Mechanisms
Involving AMPK/SREBP Pathway
- Authors: Qin Kong; Ping Li
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2, Supplement
  Author(s): Qin Kong, Ping Li
  
  PubDate: 2015-11-21T20:04:55Z
  DOI: 10.1016/j.hkjn.2015.08.018
  Issue No: Vol. 17, No. 2 (2015)
C-Reactive Protein Exacerbates Diabetic Kidney Fibrosis by Enhancing
CD32-Smad3-mTOR Signaling in Human CRP-Tg/db/db Mice
- Authors: Yong K. You; Xiao R. Huang; Hai Y. Chen; Bi H. Xu; Hua F. Liu; Hui Y. Lan
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2, Supplement
  Author(s): Yong K. You, Xiao R. Huang, Hai Y. Chen, Bi H. Xu, Hua F. Liu, Hui Y. Lan
  
  PubDate: 2015-11-21T20:04:55Z
  DOI: 10.1016/j.hkjn.2015.08.019
  Issue No: Vol. 17, No. 2 (2015)
Autophagy Modulates Mitochondrial Morphogenesis in Diabetic Renal Tubules
- Authors: Chiu-Hua Chen; Wen-Chin Lee; Lung-Chih Lee; Jin-Bor Chen; Ming-Hong Tai
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2, Supplement
  Author(s): Chiu-Hua Chen, Wen-Chin Lee, Lung-Chih Lee, Jin-Bor Chen, Ming-Hong Tai
  
  PubDate: 2015-11-21T20:04:55Z
  DOI: 10.1016/j.hkjn.2015.08.020
  Issue No: Vol. 17, No. 2 (2015)
Protective Effect of Tangshen Formula on Renal Inflammation in Type 2
Diabetes
- Authors: Tingting Zhao; Sifan Sun; Ping Li
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2, Supplement
  Author(s): Tingting Zhao, Sifan Sun, Ping Li
  
  PubDate: 2015-11-21T20:04:55Z
  DOI: 10.1016/j.hkjn.2015.08.021
  Issue No: Vol. 17, No. 2 (2015)
The Expression of Electron Transfer Flavoprotein β Mediating Apoptosis of
Renal Tubular Epithelial Cells in Diabetic Nephropathy
- Authors: Hua Wang; Tingting Zhao; Haojun Zhang; Ping Li
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2, Supplement
  Author(s): Hua Wang, Tingting Zhao, Haojun Zhang, Ping Li
  
  PubDate: 2015-11-21T20:04:55Z
  DOI: 10.1016/j.hkjn.2015.08.022
  Issue No: Vol. 17, No. 2 (2015)
Haematuria and Outcomes in Patients with Diabetic Chronic Kidney Disease
- Authors: Chi-Chih Hung; Hugo You-Hsien Lin; I-Ching Kuo; Hung-Chun Chen
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2, Supplement
  Author(s): Chi-Chih Hung, Hugo You-Hsien Lin, I-Ching Kuo, Hung-Chun Chen
  
  PubDate: 2015-11-21T20:04:55Z
  DOI: 10.1016/j.hkjn.2015.08.023
  Issue No: Vol. 17, No. 2 (2015)
The Study of Syndrome Differentiation Based on Renal Biopsy Pathology of
Diabetic Kidney Disease
- Authors: Maosheng Chen
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2, Supplement
  Author(s): Maosheng Chen
  
  PubDate: 2015-11-21T20:04:55Z
  DOI: 10.1016/j.hkjn.2015.08.024
  Issue No: Vol. 17, No. 2 (2015)
An unusual case of acute kidney injury due to poisoning with blue stone
- Authors: Manjusha Yadla; Priyadarshini John; Sai Kanth; Hari Prasad
  Pages: 26 - 27
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2
  Author(s): Manjusha Yadla, Priyadarshini John, Sai Kanth, Hari Prasad
  Blue stone (neela thotha, in local terms) is dehydrated copper sulfate and is commonly used as a pesticide, in the leather industry, and in homemade glue. It results in a rare form of poisoning limited to the Asian continent, with a high incidence in India and Sri Lanka prior to the 1980s. Poisoning due to copper sulfate results in multiorgan involvement. Here, we present a case of poisoning due to copper sulfate with acute kidney injury and intravascular hemolysis. 「藍石」指的是無水硫酸銅 (民間稱為 “neela thotha”), 常用於農藥、皮革工業、及黏合劑。藍石中毒是罕見的, 僅可見於亞洲大陸地區, 但在 80 年代之前頗常見於印度及斯里蘭卡。硫酸銅中毒可導致多重器官障礙, 以下是一宗硫酸銅中毒個案, 患者因此出現急性腎損傷及血管內溶血。
  
  PubDate: 2015-10-03T19:04:07Z
  DOI: 10.1016/j.hkjn.2015.08.002
  Issue No: Vol. 17, No. 2 (2015)
Cardiorenal syndrome
- Authors: Pearl Pai
  Pages: 36 - 45
  Abstract: Publication date: Available online 19 August 2015
  Source:Hong Kong Journal of Nephrology
  Author(s): Pearl Pai
  Patients with cardiorenal syndrome (CRS) suffer from extremely high levels of morbidity and mortality. The pathophysiology of the CRS involves inter-related hemodynamic and neurohormonal mechanisms including the renin–angiotensin–aldosterone system (RAAS), endothelin, and arginine–vasopressin system activation. The management of CRS remains a challenge despite extensive research into the pathophysiology, discovery of new biomarkers, and ongoing drug trials. This article reviews some of the most important trials for patients with acute decompensated heart failure and CRS using diuretics, vasodilator, levosimendan (a calcium sensitizer), vasoactive and neurohormonal therapies, and finally ultrafiltration for refractory cases. In addition, the trials of a new agent that combines angiotensin-receptor blockade with neprilysin inhibition (enhancing endogenous natriuretic peptide action), and of a new recombinant human relaxin-2 called serelaxin are discussed. For chronic CRS, the blockade of the RAAS and levosimendan given in repetitive dosing is discussed. Finally, some data on how the newer generation devices such as left ventricular assist device may improve outcome of CRS are presented; additionally, some new ideas about prevention and treatment of calcification-induced congestive cardiac failure in renal patients are presented. 心腎綜合症(CRS, cardiorenal syndrome)是嚴重的疾病，死亡率極高，其致病過程涉及一系列血行動力-神經內分泌機轉的變化，包括腎素-血管緊縮素-醛固酮系統(RAAS, renin–angiotensin–aldosterone system)、內皮素(endothelin)及抗利尿素(arginine–vasopressin)系統的活化。至今，即使已有大量關於病理生理學、生物標識物、及藥物治療的研究問世，然而CRS仍然是臨床上的一大挑戰。本文將針對合併有CRS的急性失代償性心衰竭 (ADHF)患者，回顧利尿劑、血管擴張劑、levosimendan (鈣增敏劑)、血管活性及神經內分泌療法的相關重要研究，更會回顧超過濾(UF, ultrafiltration)在頑抗性個案間的治療表現。此外，我們亦會探討利鈉肽(NPs, natriuretic peptides)或神經荷爾蒙藥物的潛在效用，包括一種兼具血管緊縮素受體阻斷(ARB)與neprilysin抑制作用(促進內源性NP活動)的新藥物、及一種新的重組人類relaxin-2 (稱為serelaxin)。至於慢性CRS，我們主要著眼於RAAS阻斷劑與levosimendan的重複給藥、及腹膜透析(PD)療法。最後，我們將回顧新世代裝置例如左心室輔助裝置(LVAD)對CRS的潛在效用，更會對腎病患者間，鈣化誘發鬱血性心衰竭(CCF)的預防與治療作出探討。
  
  PubDate: 2015-08-20T07:36:27Z
  DOI: 10.1016/j.hkjn.2015.03.001
  Issue No: Vol. 17, No. 2 (2015)
Use of steroid therapy in immunoglobulin A-dominant poststaphylococcal
glomerulonephritis
- Authors: Mahesh Eswarappa; Vijay Varma; K.C. Gurudev
  Pages: 46 - 49
  Abstract: Publication date: Available online 7 July 2015
  Source:Hong Kong Journal of Nephrology
  Author(s): Mahesh Eswarappa , Vijay Varma , K.C. Gurudev
  
  PubDate: 2015-07-09T03:34:47Z
  DOI: 10.1016/j.hkjn.2015.03.002
  Issue No: Vol. 17, No. 2 (2015)
Peritoneal dialysis-associated peritonitis caused by vancomycin-resistant
Enterococcus: Comprehensive review on treatment options
- Authors: Chi-kwan Lam; Siu-kim Chan; Yiu-wing Ho; Sin-man Li; Chun-hay Tam; Anthony Wing-chung Tang; Sze-ho Wong
  Pages: 50 - 55
  Abstract: Publication date: Available online 26 July 2015
  Source:Hong Kong Journal of Nephrology
  Author(s): Chi-kwan Lam, Siu-kim Chan, Yiu-wing Ho, Sin-man Li, Chun-hay Tam, Anthony Wing-chung Tang, Sze-ho Wong
  Vancomycin-resistant enterococci have emerged as a global health care threat and their occurrence in peritoneal dialysis-related peritonitis is a challenging condition for nephrologists because the treatment options are limited. In this review, we will discuss the established efficacy of linezolid, quinupristin/dalfopristin (Q/P), daptomycin, and the potential use of tigecycline in treating this condition. Because experience in treating this condition is extremely limited and there is a lack of well-constructed clinical trials on different treatment options, case reports/series were adopted for descriptive analysis. The treatment strategy in olden days involved using Q/P (switching to linezolid in case of treatment failures), whereas recent case reports have described successful use of daptomycin with preservation of the dialysis catheter in all cases. However, more studies are required to confirm the superiority of any one of these options in treating this specific condition. 抗萬古黴素腸球菌(vancomycin-resistant Enterococcus)已發展成一個全球性的公共衛生威脅,其所導致的腹膜透析相關腹膜炎基於治療選項有限,對腎科醫生更是一大挑戰。在本文中我們將回顧linezolid、quinupristin/dalfopristin (Q/P)、及daptomycin對此病的功效,並探討tigecycline的潛在角色。基於相關臨床研究與治療經驗的不足,目前這方面的資料主要來自個案報告/系列。我們大致可見,過去的治療策略從Q/P發展至linezolid;而近年來則出現關於成功使用daptomycin的個案報告,所有個案的透析導管均得以保存。至於何種治療方案佔優,仍然有待更多研究的進一步證實
  
  PubDate: 2015-07-29T21:13:19Z
  DOI: 10.1016/j.hkjn.2015.03.003
  Issue No: Vol. 17, No. 2 (2015)
Weight change during the 1st year of peritoneal dialysis: Risk factors and
prognostic implications
- Authors: Agnes Shin-Man; Choy Kai-Ming Chow Bonnie Ching-Ha Kwan Phyllis Mei-Shan
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2
  Author(s): Agnes Shin-Man Choy, Kai-Ming Chow, Bonnie Ching-Ha Kwan, Phyllis Mei-Shan Cheng, Vickie Wai-Ki Kwong, Wing-Fai Pang, Chi-Bon Leung, Man-Ching Law, Philip Kam-Tao Li, Cheuk-Chun Szeto
  Background Weight gain is common amongst patients who start peritoneal dialysis (PD). However, the prevalence, risk factors, and long-term implications of body weight gain in new PD patients have not been explored. Methods We studied 444 consecutive new PD patients. Body weight at the time of initiation of PD and 1 year later, and related clinical factors, were reviewed. Patients were followed for 60.9 ± 32.8 months for survival analysis. Results The mean weight change after 1 year of PD was 1.34 ± 3.27 kg; 109 patients (24.6%) had weight gain > 3 kg. Patients without any peritonitis episodes during the 1st year of PD had significantly more weight gain than those who had peritonitis (1.58 ± 3.17 vs. 0.16 ± 3.56 kg, p = 0.001). There were no significant correlations between body weight change and glucose load, peritoneal transport characteristics, dialysis adequacy index, or baseline residual renal function. For patients with weight loss > 0.5 kg, weight change within 0.5 kg, weight gain > 0.5–3.0 kg, and weight gain > 3 kg, the patient survival rates at 60 months were 45.0%, 54.8%, 54.0%, and 52.9%, respectively (p = 0.213), while technique survival were 28.1%, 40.3%, 40.8%, and 36.7%, respectively (p = 0.03). Conclusion Weight gain is common among Chinese patients during the 1st year of PD but is not associated with any adverse clinical outcome. In contrast, weight loss during the 1st year of PD is common amongst PD patients who have peritonitis, and is associated with worse technique survival subsequently.
  
  PubDate: 2015-10-11T21:23:28Z
Handbook of Dialysis, 5th edition, John T. Daugirdas, Peter G. Blake,
Todd S. Ing. Lippincott, Williams & Wilkins (2015)
- Authors: Cheuk Chun; Szeto
  Abstract: Publication date: October 2015
  Source:Hong Kong Journal of Nephrology, Volume 17, Issue 2
  Author(s): Cheuk Chun Szeto
  
  PubDate: 2015-09-29T18:05:04Z