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UROLOGY, NEPHROLOGY AND ANDROLOGY (151 journals)                     

Showing 1 - 144 of 144 Journals sorted alphabetically
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 1)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 1)
Advances in Chronic Kidney Disease     Hybrid Journal   (Followers: 15)
Advances in Urology     Open Access   (Followers: 13)
African Journal of Nephrology     Open Access   (Followers: 1)
African Journal of Urology     Open Access   (Followers: 7)
AJP Renal Physiology     Hybrid Journal   (Followers: 8)
Aktuelle Urologie     Hybrid Journal   (Followers: 4)
American Journal of Kidney Diseases     Hybrid Journal   (Followers: 54)
American Journal of Men's Health     Open Access   (Followers: 9)
American Journal of Nephrology     Full-text available via subscription   (Followers: 31)
Andrologia     Hybrid Journal   (Followers: 3)
Andrology     Hybrid Journal   (Followers: 5)
Andrology & Gynecology : Current Research     Hybrid Journal   (Followers: 4)
Andrology and Genital Surgery     Open Access   (Followers: 8)
Arab Journal of Nephrology and Transplantation     Open Access   (Followers: 2)
Arab Journal of Urology     Open Access   (Followers: 7)
Archives of Clinical Nephrology     Open Access   (Followers: 2)
Archivio Italiano di Urologia e Andrologia     Open Access   (Followers: 1)
Archivos Españoles de Urología     Open Access   (Followers: 1)
Asian Journal of Andrology     Open Access   (Followers: 1)
Asian Journal of Urology     Open Access   (Followers: 3)
Asian Pediatric Nephrology Association     Open Access   (Followers: 3)
Bangladesh Journal of Urology     Open Access   (Followers: 5)
Basic and Clinical Andrology     Open Access  
BJU International     Hybrid Journal   (Followers: 19)
BJUI Compass     Open Access   (Followers: 1)
BMC Nephrology     Open Access   (Followers: 9)
BMC Urology     Open Access   (Followers: 14)
Canadian Journal of Kidney Health and Disease     Open Access   (Followers: 7)
Canadian Urological Association Journal     Open Access   (Followers: 1)
Cancer Urology     Open Access   (Followers: 1)
Cardiorenal Medicine     Full-text available via subscription   (Followers: 1)
Case Reports in Nephrology     Open Access   (Followers: 6)
Case Reports in Nephrology and Dialysis     Open Access   (Followers: 8)
Case Reports in Urology     Open Access   (Followers: 11)
Clinical and Experimental Nephrology     Hybrid Journal   (Followers: 5)
Clinical Journal of the American Society of Nephrology     Full-text available via subscription   (Followers: 25)
Clinical Kidney Journal     Open Access   (Followers: 5)
Clinical Medicine Insights : Urology     Open Access   (Followers: 3)
Clinical Nephrology     Full-text available via subscription   (Followers: 8)
Cuadernos de Cirugía     Open Access  
Current Opinion in Nephrology & Hypertension     Hybrid Journal   (Followers: 12)
Current Opinion in Urology     Hybrid Journal   (Followers: 11)
Current Urology     Open Access   (Followers: 10)
Current Urology Reports     Hybrid Journal   (Followers: 5)
Der Nephrologe     Hybrid Journal  
Der Urologe     Hybrid Journal   (Followers: 1)
Diabetic Nephropathy     Open Access  
EMC - Urología     Full-text available via subscription  
Enfermería Nefrológica     Open Access   (Followers: 1)
European Urology     Hybrid Journal   (Followers: 24)
European Urology Focus     Hybrid Journal   (Followers: 4)
European Urology Oncology     Hybrid Journal   (Followers: 1)
European Urology Open Science     Open Access   (Followers: 8)
Forum Nefrologiczne     Full-text available via subscription  
Geriatric Nephrology and Urology     Hybrid Journal   (Followers: 7)
Giornale di Clinica Nefrologica e Dialisi     Open Access  
Hellenic Urology     Open Access   (Followers: 3)
IJU Case Reports     Open Access  
Indian Journal of Nephrology     Open Access   (Followers: 2)
Indian Journal of Urology     Open Access   (Followers: 5)
International Brazilian Journal of Urology     Open Access   (Followers: 5)
International Journal of Nephrology     Open Access   (Followers: 2)
International Journal of Nephrology and Renovascular Disease     Open Access   (Followers: 2)
International Journal of Urology     Hybrid Journal   (Followers: 10)
International Urology and Nephrology     Hybrid Journal   (Followers: 6)
Journal für Urologie und Urogynäkologie/Österreich     Hybrid Journal  
Journal of Clinical Nephrology     Open Access   (Followers: 1)
Journal of Clinical Urology     Hybrid Journal   (Followers: 12)
Journal of Endoluminal Endourology     Open Access  
Journal of Endourology     Hybrid Journal   (Followers: 2)
Journal of Endourology Case Reports     Hybrid Journal  
Journal of Genital System & Disorders     Hybrid Journal   (Followers: 1)
Journal of Integrative Nephrology and Andrology     Open Access   (Followers: 2)
Journal of Kidney Cancer and VHL     Open Access  
Journal of Lower Genital Tract Disease     Hybrid Journal  
Journal of Nephrology     Hybrid Journal   (Followers: 5)
Journal of Nephrology Research     Open Access   (Followers: 2)
Journal of Pediatric Nephrology     Open Access   (Followers: 3)
Journal of Renal Care     Hybrid Journal   (Followers: 8)
Journal of Renal Nursing     Full-text available via subscription   (Followers: 8)
Journal of Renal Nutrition     Hybrid Journal   (Followers: 28)
Journal of Renal Nutrition and Metabolism     Open Access   (Followers: 2)
Journal of the American Society of Nephrology     Full-text available via subscription   (Followers: 39)
Journal of The Egyptian Society of Nephrology and Transplantation     Open Access  
Journal of Urology & Nephrology     Open Access  
Kidney Diseases     Open Access   (Followers: 3)
Kidney International     Hybrid Journal   (Followers: 53)
Kidney International Reports     Open Access   (Followers: 6)
Kidney Medicine     Open Access   (Followers: 1)
Kidney Research Journal     Open Access   (Followers: 6)
Kidneys (Počki)     Open Access  
Nature Reviews Nephrology     Full-text available via subscription   (Followers: 30)
Nature Reviews Urology     Full-text available via subscription   (Followers: 10)
Nefrología     Open Access  
Nefrología (English Edition)     Open Access  
Nephro-Urology Monthly     Open Access   (Followers: 1)
Nephrology     Hybrid Journal   (Followers: 13)
Nephrology Dialysis Transplantation     Hybrid Journal   (Followers: 27)
Nephron     Hybrid Journal   (Followers: 3)
Nephron Clinical Practice     Full-text available via subscription   (Followers: 3)
Nephron Experimental Nephrology     Full-text available via subscription   (Followers: 4)
Nephron Extra     Open Access   (Followers: 1)
Nephron Physiology     Full-text available via subscription   (Followers: 4)
Neurourology and Urodynamics     Hybrid Journal   (Followers: 1)
OA Nephrology     Open Access   (Followers: 2)
Open Access Journal of Urology     Open Access   (Followers: 6)
Open Journal of Nephrology     Open Access   (Followers: 4)
Open Journal of Urology     Open Access   (Followers: 6)
Open Urology & Nephrology Journal     Open Access  
Paediatric Nephrology Journal of Bangladesh     Open Access   (Followers: 4)
Portuguese Journal of Nephrology & Hypertension     Open Access   (Followers: 1)
Progrès en Urologie     Full-text available via subscription  
Progrès en Urologie - FMC     Full-text available via subscription  
Prostate Cancer and Prostatic Diseases     Hybrid Journal   (Followers: 4)
Renal Failure     Open Access   (Followers: 11)
Renal Replacement Therapy     Open Access   (Followers: 3)
Research and Reports in Urology     Open Access   (Followers: 4)
Revista de Nefrología, Diálisis y Trasplante     Open Access   (Followers: 1)
Revista Mexicana de Urología     Open Access  
Revista Urologia Colombiana     Open Access  
Scandinavian Journal of Urology     Hybrid Journal   (Followers: 6)
Seminars in Nephrology     Hybrid Journal   (Followers: 11)
The Prostate     Hybrid Journal   (Followers: 6)
Therapeutic Advances in Urology     Open Access   (Followers: 3)
Translational Research in Urology     Open Access   (Followers: 1)
Trends in Urology & Men's Health     Partially Free   (Followers: 1)
Urine     Open Access  
Uro-News     Hybrid Journal  
Urolithiasis     Hybrid Journal   (Followers: 1)
Urologia Internationalis     Full-text available via subscription   (Followers: 1)
Urologia Journal     Hybrid Journal  
Urologic Clinics of North America     Full-text available via subscription   (Followers: 3)
Urologic Nursing     Full-text available via subscription   (Followers: 3)
Urological Science     Open Access  
Urologicheskie Vedomosti     Open Access  
Urologie in der Praxis     Hybrid Journal  
Urology     Hybrid Journal   (Followers: 26)
Urology Case Reports     Open Access   (Followers: 3)
Urology Times     Free   (Followers: 3)
Urology Video Journal     Open Access  
World Journal of Nephrology and Urology     Open Access   (Followers: 5)
World Journal of Urology     Hybrid Journal   (Followers: 10)


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Journal Cover
International Journal of Nephrology
Journal Prestige (SJR): 0.697
Citation Impact (citeScore): 1
Number of Followers: 2  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2090-214X - ISSN (Online) 2090-2158
Published by Hindawi Homepage  [339 journals]
  • COVID-19 Rapid Antigen Test Screening in Patients on Hemodialysis

    • Abstract: Introduction. Patients receiving in-center hemodialysis are extremely vulnerable to COVID-19. It is unclear if routine screening of asymptomatic hemodialysis patients is an effective strategy to prevent COVID-19 outbreaks within the dialysis unit. Methods. We conducted a retrospective analysis of in-center hemodialysis patients who underwent bimonthly COVID-19 rapid antigen test screening from February 15th to December 26th, 2021. Nasal rapid antigen testing was performed in all asymptomatic patients. All rapid antigen-positive tests were confirmed by RT-PCR nasopharyngeal swab. Besides universal rapid antigen screening, RT-PCR testing was conducted in all symptomatic patients and contacts of COVID-19 subjects. Results. Overall, 4079 rapid antigen tests were performed in 277 hemodialysis patients on chronic hemodialysis with a mean age of 68.4 ± 14.6 years. Thirty-eight (0.9%) rapid antigen tests resulted positive. Only five (13.8%) positive-rapid antigen tests were also positive by RT-PCR testing. During the same period, 219 patients regularly screened by rapid antigen tests bimonthly underwent 442 RT-PCR nasopharyngeal swabs for clinical reasons. RT-PCR testing yielded a positive result in 13 (5.9%) patients. The time elapsed between PCR and the negative-rapid antigen test was 7.7 ± 4.6 days (range 1.8–13.9 days). At the end of the follow-up, 6.4% of the population on in-center hemodialysis contracted COVID-19, and routine rapid antigen tests detected only 5 out of 18 (27.7%) COVID-19 cases. No outbreaks of COVID-19 were identified within the dialysis unit. Conclusion. Bimonthly rapid antigen screening led to the early diagnosis of COVID-19 in less than one-third of cases. The short incubation period of the new SARS-CoV-2 variants makes bimonthly test screening inadequate for an early diagnosis of COVID-19. More frequent tests are probably necessary to improve the utility of COVID-19 nasal rapid antigen test in patients on hemodialysis.
      PubDate: Wed, 14 Sep 2022 05:50:01 +000
  • Predictors of Mortality in Adults with Acute Kidney Injury Requiring
           Dialysis: A Cohort Analysis

    • Abstract: Introduction. Acute kidney injury (AKI) requiring renal replacement therapy is accompanied by considerable mortality. This present study evaluated predictors of mortality at initiation of hemodialysis (HD) in AKI patients in Goma (in the Democratic Republic of the Congo (DRC)). Methods. A single-centre cohort survey evaluated the clinical profile and survival rates of AKI patients admitted to HD in the only HD centre in Goma, North Kivu province (DRC). Data were collected from patients who underwent HD for AKI. Patient demographics, comorbidities, clinical presentation, laboratory tests, and mortality were reviewed and analyzed. The survival study used the Kaplan–Meier curve. Predictors of mortality were evaluated using Cox regression. Results. Of the 131 eligible patients, the mean age was 43.69 ± 16.56 years (range: 18–90 years). Men represented 54.96% of the cohort. The overall HD mortality rate was 25.19% (n = 33). In multivariate analysis, independent predictors of mortality in AKI stage 3 patients admitted to HD were as follows: age ≥ 60 years (adjusted hazard ratio (AHR) = 15.89; 95% CI: 3.98–63.40; ), traditional herbal medicine intake (AHR = 5.10; 95% CI: 2.10–12.38; ), HIV infection (AHR = 5.55; 95% CI: 1.48–20.73; ), anemia (AHR = 9.57; 95% CI: 2.08–43.87; ), hyperkalemia (AHR = 6.23; 95% CI: 1.26–30.72; ), respiratory distress (AHR = 4.66; 95% CI: 2.07–10.50; ), and coma (AHR = 11.39; 95% CI: 3.51–36.89; ).Conclusion. Initiation of hemodialysis with AKI has improved survival in patients with different complications.
      PubDate: Mon, 12 Sep 2022 10:35:04 +000
  • Phosphate Frustration: Treatment Options to Complement Current Therapies

    • Abstract: Hyperphosphatemia eventually develops in almost all patients with advanced chronic kidney disease and is associated with negative clinical outcomes. Thus, guidelines recommend targeting treatment to normal phosphate levels in patients with chronic kidney disease. Despite low phosphorus diets, clearance by dialysis, and phosphate binder use, many patients with chronic kidney disease on dialysis are unable to consistently achieve and maintain serum phosphate concentrations
      PubDate: Mon, 22 Aug 2022 13:35:02 +000
  • Time on Therapy of Automated Peritoneal Dialysis with and without Remote
           Patient Monitoring: A Cohort Study

    • Abstract: Background. Remote patient monitoring (RPM) of patients undergoing automated peritoneal dialysis (APD-RPM) may potentially enhance time on therapy due to possible improvements in technique and patient survival. Objective. To evaluate the effect of APD-RPM as compared to APD without RPM on time on therapy. Methods. Adult incident APD patients undergo APD for 90 days or more in the Baxter Renal Care Services (BRCS) Colombia network between January 1, 2017, and June 30, 2019, with the study follow-up ending June 30, 2021. The exposure variable was APD-RPM vs. APD-without RPM. The outcomes of time on therapy and mortality rate over two years of follow-up were estimated in the full sample and in a matched population according to the exposure variable. A propensity score matching (PSM) 1:1 without replacement utilizing the nearest neighbor within caliper (0.035) was used and created a pseudopopulation in which the baseline covariates were well balanced. Fine & Gray multivariate analysis was performed to assess the effect of demographic, clinical, and laboratory variables on the risk of death, adjusting for the competing risks of technique failure and kidney transplantation. Results. In the matched sample, the time on APD therapy was significantly longer in the RPM group than in the non-RPM group, 18.95 vs. 15.75 months, . The mortality rate did not differ between the two groups: 0.10 events per patient-year in the RPM group and 0.12 in the non-RPM group, .Conclusion. Over two years of follow-up, the use of RPM vs. no RPM in APD patients was associated with a significant increase in time on therapy, by 3.2 months. This result indicates that RPM-supported APD therapy may improve the clinical effectiveness and the overall quality of APD.
      PubDate: Mon, 22 Aug 2022 11:05:02 +000
  • Management of COVID-19 in Kidney Transplant Recipients: A Single-Center
           Case Series

    • Abstract: Background. Kidney transplant recipients (KTRs) were reported to be at higher risk of developing severe coronavirus disease-2019 (COVID-19). Despite being one of the most impacted countries, little is known about KTRs with COVID-19 in Indonesia. This report aims to explore the management strategies and short-term clinical outcomes of KTRs with COVID-19 in an Indonesian transplant center. Methods. We observed KTRs who were admitted following COVID-19 diagnosis. Anamnesis, physical, laboratory, and radiologic examinations were performed. Demographic and transplant histories were recorded, along with symptoms, vaccination status, and management related to COVID-19. Results. Nineteen KTRs were observed and 14 (73.6%) were male. The most common presenting symptoms were fever, cough, and shortness of breath. Nine (47.3%) KTRs had severe-critical COVID-19. The mortality rate was 42.1%. Acute kidney injury (AKI) was present in six (31.6%) of KTRs, five (83.3%) of whom were nonsurvivors. The median D-dimer level was higher in nonsurvivors (5,800 versus 670 μL), while other laboratory parameters were comparable. Seven (36.8%) KTRs were vaccinated. The mortality rates of vaccinated and unvaccinated KTRs were 14.2% and 70%, respectively. Antiviral therapy, anticoagulant, intravenous immunoglobulin, and tocilizumab were prescribed to 89.5%, 89.5%, 15.8%, and 10.5%, respectively. Immunosuppressive therapy (IST) was halted in 68% of KTRs, among which 61.5% passed away. Conclusion. The clinical presentation of COVID-19 in KTRs was similar to that in the general population, whereas the mortality rate was higher. Management strategies for KTRs with COVID-19 should include prevention of AKI and hypercoagulation. Vaccination seems to be beneficial for KTRs, while temporary withdrawal of IST does not.
      PubDate: Thu, 18 Aug 2022 14:50:01 +000
  • Challenging, Safe, and Effective Use of External Iliac Vein for Insertion
           of Tunneled Cuffed Hemodialysis Catheters: A Single-Center Prospective

    • Abstract: Background. Providing well-functioning vascular access is crucial for patients undergoing chronic hemodialysis. Peripheral arteriovenous fistulas and grafts are the preferred accesses in hemodialysis patients. Patients with bilateral obstruction of internal jugular veins and subclavian veins require a suitable vascular access. Thus, the insertion of iliac vein tunneled cuffed catheters (TCCs) by interventional nephrologists may be a good option for these patients. We aimed to evaluate the outcomes of iliac vein TCCs in patients lacking other vascular options. Methods. 80 tunneled cuffed hemodialysis catheters were inserted through the iliac veins of 80 patients with an end-stage kidney disease. Catheter insertion was guided by Doppler ultrasonography followed by plain radiography to detect the catheter tip and exclude complications. Results. The insertion success rate was 100%. 25 patients developed catheter-related infections. The mean survival time per catheter was 328 days. At the end of the study, 40 catheters were still functioning, 15 patients were shifted to continuous ambulatory peritoneal dialysis and 5 patients were referred to the interventional radiology department for insertion of transhepatic inferior vena cava tunneled catheters. Resistant catheter-related infection was the main cause of catheter removal in 11 patients (17.5%) in this study. Catheter malfunction was the second most common cause of catheter removal in 9 patients (11.25%). Conclusion. This study concluded that iliac vein TCCs can provide suitable vascular access in hemodialysis patients with bilateral obstruction of internal jugular veins and subclavian veins.
      PubDate: Tue, 09 Aug 2022 14:50:01 +000
  • Early, Noninvasive Clinical Indicators of Kidney Prognosis in Primary
           Nephrotic Syndrome: A Retrospective Exploratory Study

    • Abstract: This retrospective exploratory study aimed to identify early clinical indicators of kidney prognosis in primary nephrotic syndrome (NS). Univariate Cox proportional hazards regression analysis identified clinical parameters in the 2-month period after initiating immunosuppressive therapy (IST); it predicted 40% reduction in the estimated glomerular filtration rate (eGFR) in 36 patients with primary NS. Time-dependent receiver operating characteristic curve analysis was used to evaluate the performance of the predictors for the cumulative incidence of 40% reduction in the eGFR up to 8 years after initiating IST. The mean follow-up period was 71.9 months. The eGFR was reduced by 40% in four patients. Significant predictors for time to 40% reduction in the eGFR were as follows: an increase in the serum soluble urokinase plasminogen activator receptor (s-suPAR) 2 months after initiating IST (Δs-suPAR (2M); hazard ratio (HR) for every 500 pg/mL increase: 1.36, ), s-suPAR at 2 months after initiating IST (s-suPAR (2M); HR for every 500 pg/mL increase: 1.13, ), urinary protein-to-creatinine ratio (u-PCR) (u-PCR (2M); HR for every 1.0 g/gCr increase: 2.94, ), and urinary liver-type fatty acid-binding protein (u-L-FABP) (u-L-FABP (2M); HR for every 1.0 μg/gCr increase: 1.14, ). All four factors exhibited high predictive accuracy for cumulative incidence of 40% reduction in the eGFR up to 8 years after initiating IST, with areas under the receiver operating characteristic curve of 0.92 for Δs-suPAR (2M), 0.87 for s-suPAR (2M), 0.93 for u-PCR (2M), and 0.93 for u-L-FABP (2M). These findings suggest that Δs-suPAR (2M), s-suPAR (2M), u-PCR (2M), and u-L-FABP (2M) could be useful indicators of initial therapeutic response for predicting kidney prognosis in primary NS.
      PubDate: Tue, 09 Aug 2022 02:35:08 +000
  • Anti-Phospholipase A2 Receptor Antibody Expression at Different Stages of
           Idiopathic Membranous Nephropathy

    • Abstract: The significance of blood anti-phospholipase A2 receptor (PLA2R) antibodies in the diagnosis of different stages of idiopathic membranous nephropathy (IMN) was investigated. The expression and distribution of anti-PLA2R antibodies in renal biopsy tissue of patients with different stages of IMN were examined by immunohistochemistry. In addition, blood anti-PLA2R antibodies were determined by indirect immunofluorescence for the same patients, and the results were compared with the anti-PLA2R antibody expression in renal biopsy tissue. The positive fluorescence intensities of IMN stages I, IV, and V were mostly ± or + (40/80). There was no significant difference in fluorescence titer between these stages (). These results were consistent with the immunohistochemistry results, and the kappa statistic was 0.95. The positive fluorescence intensities of IMN stages II and III were mostly ++ to ++++ (33/60). There was no significant difference in fluorescence intensities between these two stages (), but there was a significant difference in fluorescence intensities between stages II and III and stages I, IV, and V (). These results were consistent with the immunohistochemistry results, and the kappa statistic was 0.97 (). Therefore, blood anti-PLA2R levels were positively correlated with anti-PLA2R expression in renal biopsy tissue in patients with different stages of IMN. In addition, the fluorescence intensities of IMN stages II and III were significantly different from those of stages I, IV, and V. Therefore, blood anti-PLA2R levels can be used for in vitro differential diagnosis and the monitoring of treatment, as it can distinguish stage II; and III; from stage I, IV, and V IMN.
      PubDate: Sat, 30 Jul 2022 12:05:03 +000
  • Laparoscopic Surgery for Pheochromocytoma in Hemodialysis Patients

    • Abstract: Objectives. We analyzed the clinical outcomes of laparoscopic adrenalectomy for pheochromocytomas in hemodialysis compared with nonhemodialysis patients. Methods. Fifty-seven patients (7 hemodialysis and 50 nonhemodialysis) were included in the study. We analyzed the differences in clinical parameters and outcomes between the hemodialysis patient groups and nonhemodialysis patient groups as well as identified predictors for an intraoperative hypertensive spike. Results. The increasing intravascular volume before surgery in hemodialysis patients made perioperative hemodynamic management safer. No significant difference in clinical parameters between the two groups was observed except for the length of hospitalization that was significantly longer in the hemodialysis patients (9 vs. 6 days, ). An increase in systolic blood pressure at CO2 insufflation was an independent predictor of a hypertensive spike with a cutoff value of 22.5 mmHg (odds ratio 1.038, 95% confidence interval 1.012–1.078). Conclusion. Laparoscopic adrenalectomy for pheochromocytomas in hemodialysis was safe and feasible. An increase in systolic blood pressure at CO2 insufflation was a predictor of the intraoperative hypertensive spike. The research in this manuscript is not registered. This is a retrospective study.
      PubDate: Thu, 21 Jul 2022 09:05:04 +000
  • Renal Amyloidosis: Epidemiological, Clinical, and Laboratory Profile in
           Adults from One Nephrology Center

    • Abstract: Background. Renal amyloidosis is one of the main differential diagnoses of nephrotic proteinuria in adults and the elderly. The aim of this study with the most important series in our country is to contribute to the epidemiological, clinical, and etiological study of the renal amyloidosis. Methods. In a retrospective study carried out between 1975 and 2019, 310 cases of histologically proven and typed renal amyloidosis were selected for this study. Results. There were 209 men and 101 women with a mean age of 53.8 ± 15.4 years (range, 17–84 years). Of the 310 cases, 255 (82.3%) were diagnosed with AA renal amyloidosis and 55 (17.7%) with non-AA amyloidosis. Infections were the main cause of AA amyloidosis, and tuberculosis was the most frequent etiology. The period from the onset of the underlying disease to diagnosis of the renal amyloidosis was an average of 177 months. The most frequent manifestations at the time of diagnosis were nephrotic syndrome (84%), chronic renal failure (30.3%), and end-stage renal disease (37.8%). After a medium follow-up of 16 months (range, 0–68 months), mortality occurred in 60 cases. Conclusions. Given the high frequency of AA amyloidosis in our country, awareness of the proper management of infectious and chronic inflammatory diseases remains a priority in reducing the occurrence of this serious disease.
      PubDate: Mon, 18 Jul 2022 10:50:03 +000
  • Common Glomerular Diseases in Adult Jordanians: A Single-Center Experience

    • Abstract: The pattern of glomerular diseases has been reported previously with contradictory results. Our primary objective is to assess the relative frequencies of glomerular disease in adult Jordanians and compare it with other institutes. A secondary objective is to assess the contribution of environmental factors, in an industrial city Zarqa, to kidney disease patterns. Methods. A retrospective study was conducted at a referral hospital center in the central region of Jordan. Assessment of native kidney biopsies, pathological reports, and the patients’ characteristics were obtained from electronic medical records. Results. Our study assessed a total of 178 biopsies, of which 106 patients were included achieving the age criterion for adults. The mean age of our patient was 34 ± 12.7. The number of females (53.7%) was slightly more than males (46.3%). The average creatinine at presentation was 198 umol/L. Almost half of the patients had mild renal impairment (50.9%), while the remaining were divided between moderate (26.1%) and severe (27.3%). The indications of kidney biopsy were proteinuria (11.3%), proteinuria (54.7%), and unexplained renal impairment (34%). The leading common glomerular diseases were represented as a group with a relative frequency ranging between 11% and 13%. Both IgA nephropathy (13.2%) and lupus nephritis (12.2%) were the top conditions causing the nephritic syndrome, while focal segmental glomerulosclerosis (12.2%) and minimal change disease (11.3%) were the conditions leading to nephrotic syndrome. Our secondary analysis showed nonstatistically significantly higher glomerular filtration rates in the city of Zarqa, when compared to Amman (median 94 and 54, respectively, U = 469.5, r = 0.08, ). Additionally, Zarqa had higher frequency rates of interstitial/tubular nephritis (χ2(1) = 1.17, , Cramér’s  = 0.13. Conclusion. Common glomerular diseases, as reported internationally, were common among Jordanian adults.
      PubDate: Mon, 04 Jul 2022 13:05:00 +000
  • The Significance of Exposure to Pregestational Type 2 Diabetes in Utero on
           Fetal Renal Size and Subcutaneous Fat Thickness

    • Abstract: Objectives. To determine the relationship between exposure to pregestational type 2 diabetes (T2D) and renal size and subcutaneous fat thickness in fetuses during routine obstetrical ultrasound. Methods. This was a case-control study (January 1, 2019 to December 31, 2019). Routine obstetrical ultrasounds performed between 18 and 22 weeks’ gestation at a tertiary-care fetal assessment unit were reviewed. “Cases” comprised ultrasounds of fetuses exposed to pregestational T2D in utero. The control group was assembled from ultrasounds of healthy controls. Postprocessing measurements of fetal renal size and abdominal wall thickness from stored images were performed by two independent observers, and findings were compared between groups. Results. There were 54 cases and 428 ultrasounds of healthy controls. The mean maternal age of cases was 32.1 years (SD 6.2) compared to 33.2 years (SD 5.3) for healthy controls, and the majority of ultrasounds were performed in multiparous patients (83%). At the 18 to 22 week ultrasound, there was a significant reduction in renal size amongst fetuses exposed to maternal T2D in utero compared to controls; among cases, the mean renal width was 8.0 mm (95% CI 7.8–8.1) compared to 11.4 mm (95% CI 10.6–12.7) in controls (); the mean renal thickness among cases was 8.1 mm (95% CI 7.9–8.2) compared to 11.5 mm (95% CI 10.7–12.9) in controls (). There was no obvious difference in estimated fetal weight between groups, yet fetuses exposed to maternal T2D had increased subcutaneous abdominal wall fat thickness at this early gestational age ().Conclusions. Fetal renal size in cases exposed to pregestational T2D is significantly smaller compared to controls, and subcutaneous abdominal wall fat is significantly thicker. Given emerging evidence about the developmental origins of disease, further study is needed to correlate the association between fetal renal size and fat distribution in the fetus and the long-term risk of chronic renal disease and diabetes in these offspring.
      PubDate: Thu, 30 Jun 2022 08:05:02 +000
  • Urinary Podocyte Excretion Predicts Urinary Protein Selectivity and Renal

    • Abstract: Background. Urinary podocyte excretion is related to a reduction in glomerular podocyte numbers, glomerulosclerosis, and urinary protein selectivity. To elucidate the role of urinary podocytes in proteinuria and renal prognosis and to identify the factors that cause podocyte detachment, we examined urinary podocytes in 120 renal biopsy patients. Methods. Podocytes were identified in urinary sediments stained with fluorescent-labeled anti-podocalyxin antibodies in ten high power fields. The amounts of protein bands, separated by SDS-polyacrylamide gel electrophoresis, were calculated using an image software program and the correlation with urinary podocytes was analyzed. Podocyte surface pores were observed using a low-vacuum scanning electron microscope. The renal prognosis, including induction of hemodialysis or 30% reduction in eGFR, was investigated. Results. Urinary podocyte excretion showed a higher positive correlation with albumin excretion compared to IgG, prealbumin, and transferrin. There were no significant correlations between urinary podocyte count and low molecular weight proteins, including β2-microglobulin and α1-microglobulin. The number of podocyte surface pores was positively correlated with proteinuria, suggesting enhanced albumin transcytosis. The hemodynamic pressure on the glomerular capillary wall, including products of pulse pressure and pulse rate (water hammer pressure), was positively correlated with urinary podocyte excretion. Urinary podocyte excretion and Tamm–Horsfall protein (THP) were independent risk factors for renal prognosis but were not related to response to treatment. Conclusion. Urinary podocyte excretion was correlated with urinary albumin excretion, indicating specific albumin transport by podocytes. Podocytes were detached from the glomerular capillaries by water hammer pressure and THP was involved in the renal prognosis.
      PubDate: Wed, 29 Jun 2022 12:20:01 +000
  • Dialysis Service in the Embattled Tigray Region of Ethiopia: A Call to

    • Abstract: Haemodialysis is extremely limited in low-income countries. Access to haemodialysis is further curtailed in areas of active conflict and political instability. Haemodialysis in the Tigray region of Ethiopia has been dramatically affected by the ongoing civil war. Rapid assessment from the data available at Ayder Hospital’s haemodialysis unit registry, 2015–2021, shows that enrollment of patients in the haemodialysis service has plummeted since the war broke out. Patient flow has decreased by 37.3% from the previous yearly average. This is in contrary to the assumption that enrollment would increase because patients could not travel to haemodialysis services in the rest of the country due to the complete blockade. Compared to the prewar period, the mortality rate has doubled in the first year after the war broke out, i.e., 28 deaths out of 110 haemodialysis recipients in 2020 vs. 43 deaths out of 81 haemodialysis recipients in the year 2021. These untoward outcomes reflect the persistent interruption of haemodialysis supplies, lack of transportation to the hospital, lack of financial resources, and the unavailability of basic medications due to the war and the ongoing economic and humanitarian blockade of Tigray in Northern Ethiopia. In the setting of this medical catastrophe, the international community should mobilize to advocate for resumption of life-saving haemodialysis treatment in Ethiopia’s Tigray region and put pressure on the Ethiopian government to allow the passage of life-saving medicines, essential medical equipment, and consumables for haemodialysis into Tigray.
      PubDate: Fri, 24 Jun 2022 06:20:01 +000
  • Health Care Quality in CKD Subjects: A Cross-Sectional In-Hospital

    • Abstract: Background and Aim. Chronic kidney disease (CKD) is an emerging problem in both clinical and ambulatory medicine. Much effort in terms of managing CKD must be put into the control of so-called progression factors. In the current investigation, we evaluated the CKD-associated health care quality in all in-hospital subjects that were treated in a newly founded university hospital for a period of 1 year. Methods. The study was performed in a retrospective and observational manner. All adult (age 18 years or older) in-hospital subjects treated from January until December 2019 were included. CKD was diagnosed according to the KDIGO 2012 CKD Guideline. The following variables were assessed: CKD stage, quantification/analysis (yes/no) of blood pressure, proteinuria, serum phosphate, serum 25-OH-D3, ferritin and transferrin saturation, and blood gas analysis. In addition, recommendations of the following medicines were analyzed (given/not given): ACE inhibitor or sartan, phosphate binder, vitamin D3 (activated or native), iron, erythropoietin, and bicarbonate. It was also evaluated whether discharge letters contained CKD-related diagnoses or not. Results. In total, 581 individuals were included in the study. The majority of aspects related to the monitoring and therapeutic management of CKD were either considered in only a small proportion of affected individuals (e.g., quantification of PTH − 5.5%/25-OH-D3 − 6%/transferrin saturation − 13.6%) or avoided nearly at all (e.g., recommendation of erythropoietin—1%, documentation of CKD-MBD diagnosis—0.3%). A reasonable quality of care was identified concerning the blood pressure monitoring (performed in 100%) and blood gas analysis (55% of the patients received analysis). Serum phosphate was measured in 12.9%, particularly in subjects at higher CKD stages. Conclusions. The current investigation revealed poor quality of care in CKD patients treated at the Brandenburg University Hospital over the period of one year. Quality improvement must be achieved, most likely via a standardized educational program for physicians and a directer access to CKD management guidelines.
      PubDate: Thu, 23 Jun 2022 07:20:01 +000
  • Test-Retest Reliability, Validity, and Minimal Detectable Change of the
           Measurement of Lower Limb Muscular Strength with Handheld Dynamometry in
           Patients Undergoing Hemodialysis

    • Abstract: Background. Chronic kidney disease is an exponentially growing medical and economic worldwide problem. There are specific elements used to assess patient’s functional capacity loss and overall deterioration in order to determine the patient’s clinical status, and muscle impairment is one of the most common. It is therefore necessary to develop reliable and applicable methods to determine muscle impairment in patients with chronic kidney disease Methods. This is a prospective, nonexperimental, descriptive methodological investigation performed in patients undergoing hemodialysis. This study analyzes the reliability and validity of muscle strength assessments performed with handheld dynamometry in patients with chronic kidney disease undergoing hemodialysis. Results. Results show overall high reliability and validity in the assessment of muscle strength of the lower limbs Conclusion. To our knowledge, this is the first study to assess handheld dynamometry in patients undergoing hemodialysis, presenting promising results with a relatively affordable and easily applicable method.
      PubDate: Wed, 15 Jun 2022 12:50:01 +000
  • Effects of Low-Flux and High-Flux Dialysis Membranes on Erythropoietin
           Responsiveness in Hemodialysis Patients

    • Abstract: Background. Chronic kidney disease (CKD) is often accompanied by anemia. High-flux membranes contribute to a reasonable removal of uremic toxins which cause anemia in CKD. Inadequate data have described the efficiency of high-flux dialysis in promoting erythropoietin responsiveness in CKD patients in the Middle East. This study was conducted to compare the efficiency of maintaining high-flux hemodialysis versus low-flux dialysis for ≥1 year in promoting erythropoietin responsiveness and to show the factors associated with erythropoietin hyporesponsiveness in Arab chronic hemodialysis patients. Methods. It was a retrospective cohort study that involved 110 subjects who were categorized into group 1 (50 patients receiving low-flux dialysis) and group 2 (60 patients receiving high-flux dialysis). History taking, examination, and laboratory investigations were conducted for all patients every 3 months from January 2021 to January 2022. Results. Group 2 had significantly higher weight and body mass index than group 1 but lower cholesterol and intact parathyroid hormone levels than group 1. Erythropoietin resistance index levels did not differ between the two groups upon repeated measures over a 1-year follow-up. Significant risk factors for erythropoietin hyporesponsiveness on multivariate analysis were lower weight (Odds ratio (OR): 0.966; 95% Confidence interval (CI): 0.94–0.992; ), longer hemodialysis vintage (OR: 1.172; 95% CI: 1.036–1.325; ), lower hemoglobin levels (OR: 0.531; 95% CI: 0.362–0.779; ), and higher neutrophil-to-lymphocyte ratio (OR: 2.436; 95% CI: 1.321–4.493; ).Conclusion. High-flux dialysis was not superior to low-flux dialysis in improving erythropoietin responsiveness.
      PubDate: Tue, 14 Jun 2022 09:20:02 +000
  • Health Facts Medication Adherence in Transplantation (H-MAT) Study: A
           Secondary Analysis of Determinants and Outcomes of Medication Nonadherence
           in Adult Kidney Transplant Recipients

    • Abstract: Aims. To explore the relationship between determinants and posttransplant medication nonadherence (MNA) in adult kidney transplant recipients, and to examine the relationship between posttransplant MNA and clinical outcomes. Methods. Using the World Health Organization’s model, this retrospective, multicenter, correlational study examined the relationship between determinants, posttransplant MNA, and clinical outcomes in 16,671 adult kidney transplant recipients from the Cerner Health Facts national data warehouse. Results. With 12% MNA, those who were nonadherent were more likely to have the social/economic factors of being younger, single, Caucasian versus Hispanic race, have the condition-related factor of mental health/substance use disorder, and have the healthcare system-related factor of government/health maintenance organization/managed care insurance (). Bivariate correlations indicated both age (OR = 1.006, ) and mental health or substance use disorder diagnosis (OR = 1.26, ) were significant predictors of MNA. Patients were 0.6% more likely to be medication adherent for each year they increased in age and 26% more likely to be MNA if they were diagnosed with a mental health/substance use disorder. Nonadherent patients were less likely to be readmitted, but more likely to have complications after transplant and medication side effects ().Conclusions. Using one of the largest samples of adult kidney transplant patients, our findings support the WHO model and move the body of medication adherence intervention research forward by clarifying the importance of focusing interventions not only on the patient but on multilevel determinants. Consistent with previous studies, MNA negatively impacts transplant outcomes.
      PubDate: Fri, 10 Jun 2022 11:35:01 +000
  • A Comprehensive Comparison of Clinical Presentation and Outcomes of Kidney
           Transplant Recipients with COVID-19 during Wave 1 versus Wave 2 at a
           Tertiary Care Center, India

    • Abstract: Data comparing the clinical spectrum of COVID-19 in kidney transplant recipients (KTRs) during the first and second waves of the pandemic in India is limited. Our single-center retrospective study compared the clinical profile, mortality, and associated risk factors in KTRs with COVID-19 during the 1st wave (1st February 2020 to 31st January 2021) and the second wave (1st March-31st August 2021). 156 KTRs with PCR confirmed SARS-CoV-2 infection treated at a tertiary care hospital in New Delhi during the 1st and the second waves were analyzed. The demographics and baseline transplant characteristics of the patients diagnosed during both waves were comparable. Patients in the second wave reported less frequent hospitalization, though the intensive care unit (ICU) and ventilator requirements were similar. Strategies to modify immunosuppressants such as discontinuation of antinucleoside drugs with or without change in calcineurin inhibitors and the use of steroids were similar during both waves. Overall patient mortality was 27.5%. The demographics and baseline characteristics of survivors and nonsurvivors were comparable. A higher percentage of nonsurvivors presented with breathing difficulty, low SpO2, and altered sensorium. Both wave risk factors for mortality included older age, severe disease, ICU/ventilator requirements, acute kidney injury (AKI) needing dialysis, Chest Computerized Tomographic (CT) scan abnormalities, and higher levels of inflammatory markers particularly D-dimer and interleukin-6 levels. Conclusions. KTRs in both COVID-19 waves had similar demographics and baseline characteristics, while fewer patients during the second wave required hospitalization. The D-dimer and IL-6 levels are directly correlated with mortality.
      PubDate: Thu, 02 Jun 2022 07:05:02 +000
  • Impact of Early versus Late Referral to Nephrologists on Outcomes of
           Chronic Kidney Disease Patients in Northern India

    • Abstract: Background. CKD patients are often asymptomatic in the early stages and referred late to nephrologists. Late referred patients carry a poor prognosis. There is a lack of data on outcomes associated with referral patterns in CKD patients from northern India. Methods. In this observational cohort study, all CKD patients who visited the nephrology OPD of the institute between Nov 1, 2018, and Dec 31, 2020, were classified as early referral (ER) if their first encounter with a nephrologist occurred more than one year before initiation of dialysis and education about dialysis (from a nurse or nephrologist). The remaining others were considered late referrals (LRs). The outcomes impact of early and late referrals was analyzed. Results. A total of 992 (male 656) CKD patients (ER, n = 475 and LR, n = 517) were enrolled. Patients referred early were older and diabetic and had higher BMI, better education, occupation, and socioeconomic status as compared to those referred late. The mean eGFR at first contact with the nephrologist was (25.4 ± 11.5 ml/min) in ER and 9.6 ± 5.7 ml/min in the LR group and had a higher comorbidity score. The CKD-MBD parameters, hemoglobin, and nutritional parameters were worse in LR. Only a few patients had AVF, and the majority required emergency dialysis in the LR group. A total of 91 (9.2%) patients died, 17 (1.7% ER and 74 (7.5%) patients in the LR group patients. There was significantly lower survival at 6 months (ER 97.1% vs. LR 89.7%), 12 months (ER 96.4% vs. LR 85.7%), 18 months (ER 96.4% vs. LR 85.7%), and 24 months (ER 96.4% vs. LR 85.7%) in late referral group as compared to early referral group .Conclusions. LR to nephrologists has the risk of the emergency start of dialysis with temporary vascular access and had a higher risk of mortality. The timely referral to the nephrologist in the predialysis stage is associated with better survival and reduced mortality.
      PubDate: Wed, 01 Jun 2022 12:20:03 +000
  • Comparison of Two Waves of COVID-19 in Critically Ill Patients: A
           Retrospective Observational Study

    • Abstract: Background. The SARS-CoV-2 virus caused the global COVID-19 pandemic, with waxing and waning course. This study was conducted to compare outcomes in the first two waves, in mechanically ventilated patients. Methods. This retrospective observational study included all mechanically ventilated COVID-19 patients above 18 years of age, between March 2020 and January 2021. Patients were grouped into first wave from March 2020 to July 2020, and second wave from August 2020 to January 2021. Outcome measures were mortality, the development of acute kidney injury (AKI), and need for renal replacement therapy (RRT). Univariate and multivariate cox regression analysis were used to delineate risk factors for the outcome measures. Results. A total of 426 patients, 285 in the first wave and 185 in the second wave, were included. The incidence of AKI was significantly lower in the second wave (72% vs. 63%; ). There was no significant difference in mortality (70% vs. 63%; ) and need for RRT (36% vs. 30%; ). Risk factors for mortality were increasing age and AKI in both waves, and chronic kidney disease (CKD) (adj. HR 1.7; 95% CI 1.02–2.68; ) in the second wave. Risk factors for AKI were CKD in both the waves, while it was diabetes (adj. HR 1.4; 95% CI 1.02–1.95; ) and increasing age in the first wave. Remdesivir (adj. HR 0.5; 95% CI 0.3–0.7; ) decreased the risk of AKI, and convalescent plasma (adj. HR 0.5; 95% CI 0.3–0.9; ) decreased the risk of mortality in the first wave, however, such benefit was not observed in the second wave. Conclusions. Our study shows a decrease in the incidence of AKI in critically ill patients, however, the reason for this decrease is still unknown. Studies comparing the waves of the pandemic would not only help in understanding disease evolution but also to develop tailored management strategies.
      PubDate: Tue, 31 May 2022 08:20:03 +000
  • Abnormal Obesity Phenotype Is Associated with Reduced eGFR among Diabetes
           Mellitus and Hypertensive Patients in a Peri-Urban Community in Ghana

    • Abstract: Background. Diabetes mellitus (DM) is a chronic disease characterized by hyperglycemia due to obesity and defects in insulin action. Significant complications of DM include kidney disease due to its association with hypertension and obesity. Thus, the contribution of the various obesity phenotypes to the kidney impairment observed among hypertensive and diabetes mellitus patients is of major concern. Aim. The study assessed the association between obesity phenotypes and reduced glomerular filtration rate among diabetes mellitus and hypertensive patients. Methods. Three hundred and ten (310) adult patients diagnosed with type 2 diabetes mellitus, hypertension, or both who attended the Presbyterian Hospital, Dormaa Ahenkro, from October 2016 to March 2017 were recruited for the study. Blood samples were collected to analyze biochemical parameters (fasting blood glucose (FBG), lipid profile, and creatinine). Questionnaires were used to collect sociodemographic information, and anthropometrics were appropriately measured. The estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI equation, and reduced eGFR was defined as eGFR
      PubDate: Sun, 29 May 2022 11:35:02 +000
  • Comparison of Laboratory Diagnosis of Urinary Tract Infections Based on
           Leukocyte and Bacterial Parameters Using Standardized Microscopic and Flow
           Cytometry Methods

    • Abstract: Background. Rapid and reliable tests are essential for the diagnostic laboratory confirmation of urinary tract infections (UTIs). Until now, UTI has been confirmed by the microbiology culture of urine, requiring at least 48-hour turnaround time (TAT), with a standardized microscopic method being widely favored. Automated urine flow cytometry, however, has recently been used to improve the rapid TAT by analyzing the urine sediment. This study therefore aimed to compare the diagnostic value of the Shih-Yung conventional microscopic and urine flow cytometry methods in the detection of leukocyte and bacterial parameters of patients with UTIs in an outpatient clinic. Methods. A cross-sectional study was conducted on a total of 100 patients. Seventy urine samples were positive for leukocytes and nitrite chemistry, and 30 were negative for both. The measurements of urine leukocytes and bacteria were compared between Sysmex UF-5000 urine flow cytometry and the Shih-Yung method. The diagnostic value was obtained from ROC analysis of urine flow cytometry and the culture. Results. A leukocyte cutoff value of 87.2/μL had a sensitivity and specificity of 98.33% and 95%, respectively, and 98.33% sensitivity and 75% specificity at a bacterial cutoff of 582.22/μL. Interestingly, our study identified strong and consistent agreement of leukocyte and bacterial parameters between urine flow cytometry and Shih-Yung (k = 0.959, and k = 0.939, , respectively). Furthermore, through analyzing the dominance angle of the scattergram, a strong agreement was obtained with the culture result (k = 0.880, ).Conclusions. The Shih-Yung method showed consistent agreement with urine flow cytometry for the detection of leukocytes and bacteria. The use of certain cutoffs for bacterial and leukocyte parameters in urine flow cytometry demonstrated very good performance in detecting acquired symptomatic UTIs.
      PubDate: Fri, 27 May 2022 11:05:02 +000
  • Continuous Infusion of Iohexol to Monitor Perioperative Glomerular
           Filtration Rate

    • Abstract: Continuous monitoring of the glomerular filtration rate (GFR) in the perioperative setting could provide valuable information about acute kidney injury risk for both clinical and research purposes. This pilot study aimed to demonstrate that GFR measurement by a continuous 72 hrs iohexol infusion in patients undergoing colorectal cancer surgery is feasible. Four patients undergoing robot-assisted colorectal cancer surgery were recruited from elective surgery listings. GFR was determined preoperatively by the single-sample iohexol clearance method, and postoperatively at timed intervals by a continuous iohexol infusion for 72 hrs. Plasma concentrations of creatinine and cystatin C were measured concurrently. GFR was calculated as (iohexol infusion rate (mg/min))/(plasma iohexol concentration (mg/mL)). The association of the three different filtration markers and GFR with time were analysed in generalized additive mixed models. The continuous infusion of iohexol was established in all four patients and maintained throughout the study period without interfering with ordinary postoperative care. Postoperative GFR at 2 hours were elevated compared to the preoperative measurements for patients 1, 2, and 3, but not for patient 4. Whereas patients 1, 2, and 3 had u-shaped postoperative mGFR curves, patient 4 demonstrated a linear increase in mGFR with time. We conclude that obtaining continuous measurements of GFR in the postoperative setting is feasible and can detect variations in GFR. The method can be used as a tool to track perioperative changes in renal function.
      PubDate: Tue, 24 May 2022 09:05:02 +000
  • Knowledge and Risk Perceptions of Chronic Kidney Disease Risk Factors
           among Women of Childbearing Age in Lagos State, Nigeria: From a Health
           Demography Approach

    • Abstract: Background. Kidney disease (KD), also known as chronic kidney disease (CKD), is a long-term underrecognized public health concern and one of the eight leading causes of death in women. Despite that, little is known about women’s knowledge, perceived risk, and perceptions of CKD risk factors. In this study, we assessed knowledge, perceived risk, and perceptions of CKD risk factors among women of childbearing age in Lagos State, Nigeria. Methods. Administering a pretested and structured questionnaire among 825 women aged 15–49 years, we conducted a cross-sectional descriptive study to evaluate knowledge, self-reported CKD risk factors, and risk perception among women of childbearing age in urban and semiurban communities in Lagos State, Nigeria. We used descriptive (mean, frequencies, and percentages) and bivariate statistics (chi-square) to assess sociodemographic factors influencing knowledge and perceptions of CKD risk factors. Binary and multinomial logistic regressions were further employed to assess risk perceptions of CKD factors associated with knowledge. Results. Five hundred and forty (65.5%) out of 825 women reported being knowledgeable of CKD risk factors with majority of the younger adult women (15–29 years) having good knowledge than other age cohorts, with a mean age of 33.5 ± 11.5 years. The women’s knowledge of CKD was found to be significantly associated with independent and dependent risk factors ( 
      PubDate: Thu, 19 May 2022 10:05:02 +000
  • Analysis of Various Types of Glomerulonephritis with Crescents at a Single

    • Abstract: Background. The importance of crescent formation in glomerulonephritis has increased. However, detailed analysis of crescentic glomerulonephritis in Asia is scarce. In addition, advances in serological diagnostic techniques (antineutrophil cytoplasmic and antiglomerular basement membrane autoantibodies) and early diagnosis have reduced the number of cases meeting the strict definition of crescentic glomerulonephritis (>50% of glomeruli are crescentic). Therefore, we analyzed the clinicopathological features and renal prognosis of glomerulonephritis cases that exhibited at least one crescentic lesion. Methods. We retrospectively evaluated 265 adult patients diagnosed with glomerulonephritis with at least one crescent formation based on the results of renal biopsy. We divided the patients into two groups based on the four types of glomerulonephritis, namely, the immune-complex (type II: IgA nephropathy, IgA vasculitis with nephritis, and lupus nephritis) and pauci-immune (type III: microscopic polyangiitis) groups. Factors affecting renal prognosis (end-stage renal failure requiring renal replacement therapy) were examined in a multivariate analysis using the Cox proportional hazards model. Kaplan–Meier curves and log-rank test were used to analyze and compare time from entry to renal death. Results. Renal prognosis differed significantly between the immune-complex and pauci-immune groups. Among the four types of glomerulonephritis, IgA nephropathy was the most prevalent. Multivariate analysis showed that renal function at renal biopsy and the ratio of global sclerosis independently predicted renal prognosis, but the type of glomerulonephritis was not a factor. Conclusions. Renal dysfunction at renal biopsy and the ratio of global sclerosis predicted renal prognosis, because it reflects the degree of irreversible renal damage. We also suspect that the formation of at least one crescentic lesion led to the development of these predictive factors, regardless of the type of glomerular disease and degree of crescent formation.
      PubDate: Mon, 09 May 2022 17:35:05 +000
  • Diabetic Retinopathy Is a Predictor of Progression of Diabetic Kidney
           Disease: A Systematic Review and Meta-Analysis

    • Abstract: Aims and Objectives. This systematic review and meta-analysis aimed to assess the predictive value of diabetic retinopathy (DR) for progression of diabetic kidney disease (DKD). Methods. A systematic search was conducted on PubMed, Embase, and the Google scholar for eligible studies through September 2021. The quality of selected articles was assessed using JBI checklist. Higgins and Thompson’s I2 statistic was used to see the degree of heterogeneity. Based on degree of heterogeneity, fixed or random effects model was used to estimate pooled effect using inverse variance method. Results were expressed as hazard ratios and odds ratios with 95% CIs. Results. After scrutinizing 18017 articles, data from ten relevant studies (seven prospective and three retrospective) was extracted. DR was significantly associated with DKD progression with a pooled HR of 2.42 (95% CI: 1.70–3.45) and a pooled OR of 2.62 (95% CI: 1.76–3.89). There was also a significant association between the severity of DR and risk of progression of DKD with a pooled OR of 2.13 (95% CI: 1.82–2.50) for nonproliferative DR and 2.56 (95% CI: 2.93–.33) for proliferative DR. Conclusion. Our study suggests that presence of DR is a strong predictor of risk of kidney disease progression in DKD patients. Furthermore, the risk of DKD progression increases with DR severity. Screening for retinal vascular changes could potentially help in prognostication and risk-stratification of patients with DKD.
      PubDate: Fri, 29 Apr 2022 10:20:01 +000
  • Course of Hyperkalemia in Patients on Hemodialysis

    • Abstract: Background. Evidence of longitudinal serum potassium (sK+) concentrations in hyperkalemic hemodialysis patients is sparse. Objective. These post hoc analyses of the placebo arm of the phase 3b DIALIZE study (NCT03303521) explored the course of hyperkalemia in hemodialysis patients receiving placebo. Methods. In DIALIZE, 196 patients receiving hemodialysis three times weekly were randomized to placebo or sodium zirconium cyclosilicate 5 g starting dose once daily on nondialysis days for 8 weeks. In these post hoc analyses of placebo patients overall (n = 86) and by predialysis sK+ subgroups at randomization
      PubDate: Thu, 28 Apr 2022 14:05:01 +000
  • Longitudinal Changes of Serum Creatine Kinase and Acute Kidney Injury
           among Patients with Severe COVID-19

    • Abstract: Background. Acute kidney injury (AKI) is a common complication of COVID-19. Several etiologies have been identified, including pigment deposition likely associated with myopathic damage. Nevertheless, the relationship between longitudinal creatine-kinase trends and renal outcomes is uncertain. Aim. To correlate longitudinal changes in serum creatine-kinase levels with hospital-acquired AKI (beyond 48 h of hospital admission) in severe COVID-19 patients. Methods. This is a retrospective cohort study, and creatine-kinase levels were assessed over time in 1551 hospitalized patients with normal renal function at the time of hospital admission. Results. In subjects who developed hospital-acquired AKI (n = 126, 8.1%), the serum creatine-kinase concentration before AKI onset was not different when compared to patients without AKI (slope of log creatine-kinase/day = −0.09 [95% CI −0.17 to +0.19] vs. +0.03 [95% CI −0.1 to +0.1]). After AKI diagnosis, serum creatine-kinase levels showed a significantly ascendent slope (slope of log creatine-kinase/day after AKI diagnosis = +0.14; 95% CI + 0.05 to +0.3). The AKI evolution was the main factor associated with the creatine-kinase trend. Subjects with persistent AKI (n = 40, 32%) had rising creatine-kinase levels during hospitalization (slope of log creatine-kinase/day = +0.30 95% CI + 0.19 to +0.51). A rising creatine-kinase trend (n = 114, 8%) was associated with a 1.89-fold higher risk of in-hospital death (95% CI 1.14 to 3.16). Nevertheless, this association disappeared after adjusting AKI evolution and LDH baseline levels. Conclusion. In severe COVID-19 patients, a slight increase in creatine-kinase levels was observed after AKI occurrence but not before. Our results show that, at least for the appearance of hospital-acquired AKI, the CK rise does not meet the temporality criterion of causality regarding the occurrence of AKI. Rising creatine-kinase trends were associated with a higher risk of mortality, but this association was modified by AKI evolution and inflammation. There is a limited efficiency for AKI prognosis in the serial follow-up of CK levels in severe COVID-19 patients with normal renal function.
      PubDate: Tue, 26 Apr 2022 10:35:01 +000
  • Potential Protective Effects of Antioxidants against
           Cyclophosphamide-Induced Nephrotoxicity

    • Abstract: Cyclophosphamide is an alkylating antineoplastic agent, and it is one of the most successful drugs with wide arrays of clinical activity. It has been in use for several types of cancer treatments and as an immunosuppressive agent for the management of autoimmune and immune-mediated diseases. Nowadays, its clinical use is limited due to various toxicities, including nephrotoxicity. Even though the mechanisms are not well understood, cyclophosphamide-induced nephrotoxicity is reported to be mediated through oxidative stress. This review focuses on the potential role of natural and plant-derived antioxidants in preventing cyclophosphamide-induced nephrotoxicity.
      PubDate: Sat, 16 Apr 2022 16:36:20 +000
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