Chun-Hao Liu, Chien-Chou Chen, Chih-Chien Sung
Icodextrin has been widely prescribed for peritoneal dialysis (PD) patients with inadequate ultrafiltration, but icodextrin induced acute generalized exanthematous pustulosis (AGEP) has been not well recognized in clinical practice. We described a young-aged female with IgA nephropathy and end stage kidney disease under continuous automated peritoneal dialysis. She developed skin erythema with exfoliation over the groin 7th day after initiation of icodextrin based PD dialysate. Initially, her scaling skin lesion with pinhead-sized pustules affected the bilateral inguinal folds, and then it extended to general trunk accompanied by pruritus...
April 10, 2024: Nephrology
William Hughes, Susan Blair, Hannah Rose
This report details the case of a 51-year-old man with a Tiger snake bite who developed systemic envenomation, coagulopathy and thrombotic microangiopathy (TMA) requiring renal replacement therapy. He received plasma exchange as additional therapy while awaiting confirmation of the cause of the TMA. We discuss clinical decision making in detection of systemic envenomation and management of the rare complication of TMA, as well as current Australian guidelines around antivenom administration. This is the fourth known documented case of TMA from a Tiger snake bite in Australia...
April 10, 2024: Nephrology
Yun Zhang, Min Liu, Yan Wu, Yaling Xu, Yuanhao Hong, Haiyan Xiang
PURPOSE: Podocyte injury plays a crucial role in the development of diabetic nephropathy (DN). A high serum level of insulin-like growth factor 1 (IGF-1) has been observed in patients with DN. This paper is to study the role and mechanism of IGF-1 in high glucose (HG)-induced podocyte injury. METHODS: Mouse podocytes MPC-5 were treated with HG to establish a DN model in vitro. db/db diabetic mice and db/m nondiabetic mice were used to evaluate the IGF-1 role in vivo...
April 8, 2024: Nephrology
Xuyan Liu, Hong Wang, Yiyin Zhang, Ran Zhang, Ruixiao Zhang, Xiaomeng Shi, Fengjiao Pan, Dan Qiao, Qing Xin, Zhiying Liu, Yan Zhang, Changying Li, Yanhua Lang, Leping Shao
Townes-Brocks syndrome (TBS) is an autosomal dominant disorder characterised by the triad of anorectal, thumb, and ear malformations. It may also be accompanied by defects in kidney, heart, eyes, hearing, and feet. TBS has been demonstrated to result from heterozygous variants in the SALL1 gene, which encodes zinc finger protein believed to function as a transcriptional repressor. The clinical characteristics of an atypical TBS phenotype patient from a Chinese family are described, with predominant manifestations including external ear dysplasia, unilateral renal hypoplasia with mild renal dysfunction, and hearing impairment...
April 7, 2024: Nephrology
Aruni Ratnayake, Alexander Sarnowski, Fiona Sinclair, Nicholas M P Annear, Debasish Banerjee, Irina Chis Ster
PURPOSE: Acute kidney injury (AKI) associated with COVID-19 is associated with poor prognosis. This study assessed the hitherto uninvestigated impact of COVID-19 on the progression and clinical outcomes of patients with AKI. METHODS: Data from 576 patients with AKI admitted between 13/3/20 and 13/5/20 were studied. Increasingly complex analyses, from logistic regressions to competing-risk and multi-state models, have revealed insights into AKI progression dynamics associated with PCR-confirmed COVID-19 acquisition and death...
March 28, 2024: Nephrology
Seyoung Ryou, Hyeran Park, Seung Yun Chae, Yaeni Kim, Yeong-Jin Choi, Cheol Whee Park
Post-infectious glomerulonephritis (PIGN), an uncommon variety of glomerulonephritis (GN), is characterized by emergence of nephritic syndrome within a few weeks following an infectious event. PIGN typically presents as a mild condition and tends to resolve by the time of diagnosis for GN. Aggregatibacter actinomycetemcomitans belongs to the HACEK group of bacteria, which constitutes less than 3% of bacteria responsible for community-acquired infective endocarditis. We present a case of 29-year-old man suspected of lymphoma with B-symptoms along with severe splenomegaly and nephromegaly...
March 28, 2024: Nephrology
Matthew D Jose, Laura Cuthbertson, James Burgess, Kim Jose, Timothy Saunder, Alex Kitsos, Jan Radford, Rajesh Raj
AIM: To determine the change in incidence and prevalence of chronic kidney disease (CKD) in rural and remote communities over the last decade. METHODS: We examined the change in age-standardized incidence and prevalence in Tasmania between 2010 and 2020, using a linked dataset that included any adult with a creatinine test taken in a community laboratory during the study period (n = 581 513; 87.8% of the state's adult population). We defined CKD as two measures of eGFR <60 mL/min per 1...
March 27, 2024: Nephrology
Sonoo Mizuiri, Yoshiko Nishizawa, Kazuomi Yamashita, Toshiki Doi, Aiko Okubo, Kenichi Morii, Koji Usui, Michiko Arita, Takayuki Naito, Kenichiro Shigemoto, Takao Masaki
AIM: We studied the effects of overhydration (OH), Kt/Vurea and β2-microglobulin (β2-MG) on coronary artery calcification and mortality in patients undergoing haemodialysis (HD). METHODS: The Agatston coronary artery calcium score (CACS), postdialysis body composition using bioimpedance analysis, single-pool Kt/Vurea and predialysis β2-MG at baseline were assessed and followed up for 3 years in patients undergoing HD. We performed logistic regression analyses for a CACS ≥400 and Cox proportional hazard analyses for all-cause and cardiovascular mortality...
March 21, 2024: Nephrology
Deeksha Pal, Neeraj Inamdar, Prabhjot Kaur, Manphool Singhal, Anupam Lal, Ujjwal Gorsi, Ritambhra Nada, Harbir S Kohli, Vinod Kumar, Raja Ramachandran
There is evidence to suggest that M-type phospholipase A2 (PLA2R) antibodies activate the mannose-binding lectin (MBL) cascade, resulting in glomerular damage and proteinuria in patients with primary membranous nephropathy (PMN). Furthermore, there are few reports indicating that aberrant MBL activation is associated with endothelial dysfunction and accelerated atherosclerosis. While PMN is a common cause of adult nephrotic syndrome, and patients are at increased risk of cardiovascular disease (CVD), there is a lack of research that explores the factors that contribute to this condition...
March 21, 2024: Nephrology
Sonoo Mizuiri, Yoshiko Nishizawa, Kazuomi Yamashita, Toshiki Doi, Aiko Okubo, Kenichi Morii, Koji Usui, Michiko Arita, Takayuki Naito, Kenichiro Shigemoto, Takao Masaki
AIM: The effects of iron on vascular calcification in rats and vascular smooth muscle cells were recently reported, but clinical studies on iron and vascular calcification are scant. We studied the associations of absolute iron deficiency, coronary artery calcification and mortality in patients with maintenance haemodialysis (MHD). METHODS: Transferrin saturation (TSAT), ferritin, mean corpuscular haemoglobin (MCH) and Agatston coronary artery calcium score (CACS) were studied at baseline in MHD patients and followed up for 3 years...
March 19, 2024: Nephrology
Naoto Usui, Junichiro Nakata, Akimi Uehata, Sho Kojima, Masakazu Saitoh, Yasuo Chiba, Shuji Ando, Akihito Inatsu, Hideki Hisadome, Shigeyuki Ota, Yusuke Suzuki
AIM: Circulating blood volume (BV) during exercise changes depending on the intensity and duration, and post-exercise hypotension is observed after continuous exercise. We investigated the safety and efficacy of both interval and continuous IDE at anaerobic threshold (AT) levels with respect to hemodynamic stability and dialysis efficiency. METHODS: In this crossover randomized controlled trial, 16 patients on haemodialysis were subjected to three trial arms, including non-IDE, interval-IDE, and continuous-IDE arms...
April 2024: Nephrology
Emre Yasar, Yesim Yildiz, Erensu Ozturk, Ebru Gok Oguz, Ezgi Coskun Yenigun, Ramazan Ozturk, Ozant Helvaci, Hasan Selcuk Ozger, Meryem Keles, Cengiz Karacin, Asiye Ugras Dikmen, Kayhan Caglar, Murat Duranay, Mehmet Deniz Ayli, Murat Dizbay, Yasemin Erten, Galip Guz, Ulver Derici
AIM: To evaluate the vaccine response and the effect of the booster dose on COVID-19 positivity in haemodialysis (HD) and peritoneal dialysis (PD) patients who received and did not receive BNT162b2 as a booster dose after two doses of CoronaVac. METHODS: The study included 80 PD and 163 HD patients, who had been administered two doses of the CoronaVac. Antibody levels were measured on Days 42 and 90 after the first dose. Measurements were repeated on Day 181 after the first dose in the patients that received two vaccine doses and on Day 28 after the third dose in those that also received the booster dose...
March 14, 2024: Nephrology
Pao-Wen Yen, Yung-An Chen, Wei Wang, Fang-Sheng Mao, Chia-Ter Chao, Chih-Kang Chiang, Shih-Hua Lin, Der-Cherng Tarng, Yi-Wen Chiu, Ming-Ju Wu, Yung-Chang Chen, Juliana Tze-Wah Kao, Mai-Szu Wu, Chun-Liang Lin, Jenq-Wen Huang, Kuan-Yu Hung
Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited cause of end-stage kidney disease (ESKD) worldwide. Guidelines for the diagnosis and management of ADPKD in Taiwan remains unavailable. In this consensus statement, we summarize updated information on clinical features of international and domestic patients with ADPKD, followed by suggestions for optimal diagnosis and care in Taiwan. Specifically, counselling for at-risk minors and reproductive issues can be important, including ethical dilemmas surrounding prenatal diagnosis and pre-implantation genetic diagnosis...
March 10, 2024: Nephrology
Wesley Du Plessis, Mogamat-Yazied Chothia
Congenital nephrogenic diabetes insipidus (CNDI) is a rare disorder. The condition is characterised by an inability of distal nephron segments to respond to normal or raised concentrations of serum antidiuretic hormone. In this report, we describe the case of a 13-year-old male known with CNDI who experienced a pedestrian vehicle accident leading to coma following a head injury. Intra-operatively, severe hypernatraemia and polyuria were observed. Following an inadequate response to conventional therapy, acetazolamide was prescribed resulting in an immediate response to therapy...
March 7, 2024: Nephrology
Ayman Kamal Almadani, Wasim Ahmed, Ali Abdul Kareem Al Obaidli, Stephen G Holt
AIM: We aimed to better understand the prevalence of chronic kidney disease in Abu Dhabi, UAE, where a very diverse ethnic population lives, each with their own risk profile. METHODS: Data were analysed on all patients who were tested for serum creatinine in December 2019 for 4 years within our healthcare network. We analysed data for kidney disease by age, gender and nationality to study differences in prevalence and risk. RESULTS: The entire cohort (EC) consisted 1 925 672 samples from 703 122 patients...
March 7, 2024: Nephrology
Junxing Chay, Jason C J Choo, Eric A Finkelstein
INTRODUCTION: Hyperkalaemia (HK) is prevalent among patients with chronic kidney disease (CKD) and chronic heart failure, especially if they are treated with renin-angiotensin-aldosterone system inhibitors (RAASi). This study evaluated the cost-effectiveness of a newly developed anti-HK therapy, sodium zirconium cyclosilicate (SZC), to the current standard of care for treating HK in advanced CKD patients from the Singapore health system perspective. METHODS: We adapted a global microsimulation model to simulate individual patients' potassium level trajectories with baseline potassium ≥5...
March 5, 2024: Nephrology
Xieguanxuan Xu, Yu Zhang, Yuhao Chen, Chen Yang, Xinru Guo, Qiuyue Zhang, Yisha Li, Jie Wu, Xueying Cao, XiangMei Chen, Guangyan Cai
AIM: Patients with chronic kidney disease (CKD) are more susceptible to endothelial dysfunction and cardiovascular disease (CV). Remote ischemic preconditioning (rIPC) has been proven efficient in improving endothelial function and lowering the risk of CV. However, the safety and effect of rIPC on endothelial function in patients with CKD have not been effectively assessed. METHODS: 45 patients with CKD (average estimated glomerular filtration rate: 48.4 mL/min/1...
March 4, 2024: Nephrology
Azusa Kawaguchi, Ryoma Kimura, Yoshinori Araki
Albeit rare, renal vein abnormalities on autopsy and in cases of abdominal surgery complications have been reported and should be kept in mind when performing invasive procedures, such as renal biopsy. We detected a rare renal vein abnormality on colour Doppler ultrasound before renal biopsy, thereby, avoiding a haemorrhagic complication. A 10-year-old boy presented to our department for the first time because of incidental findings of haematuria and proteinuria. We suspected chronic glomerulonephritis and scheduled an ultrasound-guided percutaneous renal biopsy...
February 25, 2024: Nephrology
Desmond Y H Yap, Ronald C W Ma, Emmanuel C K Wong, Matthew S H Tsui, Esther Y T Yu, Vivien Yu, Cheuk Chun Szeto, Wing Fai Pang, Hung Fat Tse, David C W Siu, Kathryn C B Tan, Walter W C Chen, Chiu Leong Li, Wei Chen, Tak Mao Chan
Hyperkalaemia is an electrolyte imbalance that impairs muscle function and myocardial excitability, and can potentially lead to fatal arrhythmias and sudden cardiac death. The prevalence of hyperkalaemia is estimated to be 6%-7% worldwide and 7%-10% in Asia. Hyperkalaemia frequently affects patients with chronic kidney disease, heart failure, and diabetes mellitus, particularly those receiving treatment with renin-angiotensin-aldosterone system (RAAS) inhibitors. Both hyperkalaemia and interruption of RAAS inhibitor therapy are associated with increased risks for cardiovascular events, hospitalisations, and death, highlighting a clinical dilemma in high-risk patients...
February 25, 2024: Nephrology
Qinghua Yang, Xiaowan Fang, Xiaoying Ren, Yujing Pan, Mei Wang, Jiaxiang Ding
AIM: Patients undergoing dialysis are at high risk for coronavirus disease 2019 (COVID-19). Haemoglobin (Hb) levels may be changed in patients infected with the Omicron variant of COVID-19 who are undergoing peritoneal dialysis (PD). Therefore, we aimed to explore the effect of anti-anaemia treatment on such patients. METHODS: This study enrolled patients undergoing PD who were infected with the Omicron variant of COVID-19 at our centre between November 2022 and February 2023...
February 21, 2024: Nephrology
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