Journals Case Reports in Nephrology and...

Case Reports in Nephrology and Dialysis
Zi Yun Chang, Thomas Paulraj Thamboo, Clarice Shi Hui Choong, Weng Kin Wong, Clara Lee Ying Ngoh
Many challenges remain in diagnosing monoclonal immunoglobulin-associated renal disease, despite widespread application of immunofluorescence (IF) and immunohistochemistry. Here, we report a newly diagnosed case of multiple myeloma with clinical suspicion of renal amyloidosis, which had negative IF staining for kappa and lambda light chains in the glomeruli. Although laser microdissection and mass spectrometry-based proteomic analysis have emerged as important tools for amyloid typing in the literature, such facilities are still not widely available in Asia...
September 2020: Case Reports in Nephrology and Dialysis
Charmaine Si Min Sia, Samantha Hui Ling Cheong, Clara Lee Ying Ngoh, Yi Hern Tan, Weng Kin Wong
The coronavirus disease 2019 (COVID-19) pandemic has caused a catastrophic global health crisis. There is a lack of mitigation and clinical management strategies for COVID-19 in specific patient cohorts such as hemodialysis (HD) patients. We report our experience in treating the first case of COVID-19 in a HD patient in Singapore who had a severe clinical course including acute respiratory distress syndrome and propose a clinical management strategy. We propose a clinical workflow in managing such patients based on available evidence from literature review...
May 2020: Case Reports in Nephrology and Dialysis
Tayeba Roper, Robert Elias, Satish Jayawardene
Acute kidney injury (AKI) is a common presentation which can result from a number of different underlying pathological processes. Haematological malignancies, particularly multiple myeloma (MM), are known to frequently present with AKI. Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a rare condition which can cause crescentic glomerulonephritis (GN), resulting in AKI. We present the case of a 60-year-old man who presented with clinical features suggestive of AAV in the context of blood tests which demonstrated AKI and positive perinuclear ANCA (p-ANCA) and anti-myeloperoxidase (anti-MPO) titres...
May 2020: Case Reports in Nephrology and Dialysis
Moena Ishikawa, Yumi Tada, Hiromu Tanaka, Wataru Morii, Masako Inaba, Hidetoshi Takada, Takayasu Mori, Emiko Noguchi
Gitelman syndrome (GS) is an autosomal recessive disorder characterized by alkalosis, hypokalemia, and hypomagnesemia. Although hundreds of genetic variants associated with GS have been reported, many of them are categorized as of uncertain significance in ClinVar. Here, we describe a pediatric GS patient from a three-generation family whose mother and maternal grandmother were asymptomatic. The proband was a 16-year-old Japanese girl with muscle weakness and continuous hypokalemic metabolic alkalosis. The patient, her mother, and her maternal grandmother were compound heterozygous for, and each expressing a different combination of, previously reported SLC12A3 variants in GS patients...
May 2020: Case Reports in Nephrology and Dialysis
Layth Dahbour, Jeffrey Gibbs, Christian Coletta, Jeannine Hummell, Mohammad Al-Sarie, Navkirat Pannu Kahlon, Basil Akpunonu
We present the first reported case of peritoneal dialysis-associated peritonitis caused by Staphylococcus pseudintermedius , an organism that had been misclassified as S . aureus in the past. S . pseudintermedius is well recognized in the veterinary literature and noted as flora in the mouth, nares, and anus of domesticated animals. It has been associated with soft tissue infections in pets and is now being reported in increased frequency as the causative agent in various human infections. It also has a different antibiotic sensitivity profile...
May 2020: Case Reports in Nephrology and Dialysis
Alessia Salerno, Marco Leopardi, Annamaria Maggipinto, Marco Ventura
The aim of this paper is to describe the case of a patient successfully treated for left brachial arterial aneurysm occurring 15 years after renal transplantation and consequent 8 years after arteriovenous fistula (AVF) ligation. We describe our experience and our surgical approach. A 45-year-old man presented to our attention for a large pulsatile formation on the volatile face of the left forearm, which he reported to have enlarged in the last year. He had a history of chronic renal impairment in 2000, then AVF for dialysis was realized, and he was finally addressed to kidney transplantation in 2004...
May 2020: Case Reports in Nephrology and Dialysis
Jinichi Mori, Kumi Oshima, Tetsuya Tanimoto
Capnocytophaga canimorsus is a commensal organism colonized in oral flora of dogs and cats and causes severe sepsis through bite wound in immunocompromised patients. To date, hemodialysis has not been reported as a risk of C. canimorsus infection. A 75-year-old woman with end-stage renal disease secondary to hypertension suddenly developed septic shock. She reared 6 cats in her home, but no bite or scratch wound was found on her body. She was empirically treated with piperacillin-tazobactam and temporally received continuous hemodiafiltration...
May 2020: Case Reports in Nephrology and Dialysis
Yuko Oyama, Yoichi Iwafuchi, Tetsuo Morioka, Ichiei Narita
Oliguric acute kidney injury (AKI) with minimal change nephrotic syndrome (MCNS) has long been recognized. Several mechanisms such as hypovolemia due to hypoalbuminemia and the nephrosarca hypothesis have been proposed. However, the precise mechanism by which MCNS causes AKI has not been fully elucidated. Herein, we describe an elderly patient with AKI caused by MCNS who fully recovered after aggressive volume withdrawal by hemodialysis and administration of a glucocorticoid. A 75-year-old woman presented with diarrhea and oliguria, and laboratory examination revealed nephrotic syndrome (NS) and severe azotemia...
January 2020: Case Reports in Nephrology and Dialysis
Mohamed Amine Rahil, Achour Bouzgueg
Insertion of a peritoneal dialysis (PD) catheter is frequently done by interventional nephrologists, but these procedures are typically only performed for adults. Almost all invasive procedures in children are performed by pediatric surgeons. If a pediatric surgeon is unavailable, the initiation of PD in acute situations may be delayed, thus increasing the risk of complications and chronic kidney disease. For these patients, the main obstacle to initiating renal replacement therapy is access, even when involving central vein catheter (CVC) or peritoneal access...
January 2020: Case Reports in Nephrology and Dialysis
Daiki Aomura, Kosuke Sonoda, Makoto Harada, Koji Hashimoto, Yuji Kamijo
Exercise-induced acute kidney injury (EIAKI) frequently develops in patients with renal hypouricemia (RHUC). However, several cases of RHUC with acute kidney injury (AKI) but without intense exercise have been reported. We encountered a 15-year-old male with RHUC who experienced AKI. He reported no episodes of intense exercise and displayed no other representative risk factors of EIAKI, although a vasopressor had been administered for orthostatic dysregulation before AKI onset. His kidney dysfunction improved with discontinuation of the vasopressor and conservative treatment...
January 2020: Case Reports in Nephrology and Dialysis
Cahyani Gita Ambarsari, Evita Karianni Bermanshah, Muhammad Arza Putra, Farhan Haidar Fazlur Rahman, Sudung Oloan Pardede
Peritoneal dialysis (PD) confers many advantages, including a better quality of life for children with end-stage renal disease; however, the procedure is associated with several complications, including pleuroperitoneal leaks. Here, we report an unusual case of hydrothorax caused by long-term PD in a child, which was further complicated by pneumonia. A 9-year-old boy who had received CAPD for 22 months presented with dyspnea, swelling, and increased body weight. Chest tube drainage yielded 500 mL of transudative fluid...
January 2020: Case Reports in Nephrology and Dialysis
Shinya Nakatani, Eiji Ishimura, Yuri Machiba, Kenta Fujimoto, Hideki Uedono, Akihiro Tsuda, Katsuhito Mori, Masanori Emoto, Masaaki Inaba
Tolvaptan, a vasopressin V<sub>2</sub> receptor antagonist, was initially approved in Japan for treatment of autosomal dominant polycystic kidney disease (ADPKD). Recently, a retrospective study showed that the effect of tolvaptan on kidney function could be sustained for a long period. However, the long-term efficacy and safety of high-dose tolvaptan (120 mg/day) in individual cases remain unknown. We report here 2 Japanese ADPKD patients (males, 36 and 29 years old) treated with tolvaptan (120 mg/day) for 9 years, during which time determinations of estimated glomerular filtration rate (eGFR) and total kidney volume (TKV) were performed...
January 2020: Case Reports in Nephrology and Dialysis
Isao Kondo, Yohei Arai, Akiyoshi Hamada, Kota Yamada, Shingo Shioji, Emi Sakamoto, Daisuke Katagiri, Manami Tada, Fumihiko Hinoshita
Adults with minimal-change nephrotic syndrome (MCNS) generally receive oral prednisolone (PSL) at an initial dosage of 1.0 mg/kg/day for a minimum of 4 weeks, with 80% of patients achieving clinical remission. However, relapses are frequent, necessitating repeated treatment with high-dose PSL. Long-term treatment with high-dose steroids increases the risk of steroid toxicities, such as diabetes mellitus, gastric complications, infections, osteoporosis, and steroid-induced psychiatric syndrome (SIPS), which may compromise the patient's quality of life...
January 2020: Case Reports in Nephrology and Dialysis
Davide Spica, Till Junker, Michael Dickenmann, Stefan Schaub, Jürg Steiger, Tanja Rüfli, Jörg Halter, Helmut Hopfer, Andreas Holbro, Patricia Hirt-Minkowski
We report the effectiveness of daratumumab, a human IgGκ monoclonal antibody targeting CD38 on plasma cells, for therapy-refractory antibody-mediated rejection (AMR) due to blood group antibodies in a 59-year-old man who received a living ABO-incompatible kidney transplantation. Standard treatment options for AMR due to blood group antibodies including immunoadsorption, lymphocyte depletion with anti-human T-lymphocyte globulins, intravenous methylprednisolone pulses and eculizumab limited tissue injury, however failed to sufficiently suppress blood group antibody production...
September 2019: Case Reports in Nephrology and Dialysis
Cahyani Gita Ambarsari, Risti Maulani Sindih, Meilania Saraswati, Partini Pudjiastuti Trihono
Multiple wasp stings may cause fatal complications, such as anaphylactic reactions, intravascular hemolysis, rhabdomyolysis, acute kidney injury (AKI), increased levels of liver enzymes, clotting abnormalities, or even death. AKI-related mortality due to multiple wasp stings may reach 25%, occurring within the early onset of disease; therefore, renal function should be continuously monitored within the first few days following the stings. Herein, we report 2 cases of AKI due to multiple stings of wasp ( Vespa affinis )...
September 2019: Case Reports in Nephrology and Dialysis
Konstantina G Yiannopoulou, Aikaterini I Anastasiou, Andreas Kyrozis, Ioannis P Anastasiou
Donepezil is one of the cholinesterase inhibitors that are indicated for the treatment of mild to moderate Alzheimer's disease (AD). Pharmacokinetic analysis has shown that donepezil is primarily eliminated by renal excretion rather than biliary excretion in humans. Therefore, patients with impaired renal function are at high risk of toxicity caused by accumulation of this drug. It is also well known that dialysis patients have very often cholinergic disorders. On the other hand, with the increasing number of long-term chronic dialysis patients, the prevalence of cognitive disorders is increasing in elderly dialysis patients...
September 2019: Case Reports in Nephrology and Dialysis
Shaun Jia Wei Kang, Krishan Madhan
Calciphylaxis is a rare condition usually seen in patients with significant renal disease, affecting 1-4' of patients undergoing haemodialysis. Although the disease usually manifests as lesions in the subcutaneous tissue, there have been rare occurrences of calciphylaxis presenting as lesions in the gastrointestinal tract, leading to complications of bowel necrosis and haemorrhage. In view of this, we report the case of suspected gastrointestinal tract calciphylaxis in a 63-year-old patient with end-stage kidney disease (ESKD) who presented with painful swelling in the medial and lateral aspect of both thighs...
May 2019: Case Reports in Nephrology and Dialysis
Yoshio Shimizu, Keiichi Wakabayashi, Ayako Totsuka, Yoko Hayashi, Shusaku Nitta, Kazuaki Hara, Maiko Akira, Yasuhiko Tomino, Yusuke Suzuki
Hereditary renal hypouricemia is characterized by hypouricemia with hyper-uric acid clearance due to a defect in renal tubular transport. Patients with hereditary renal hypouricemia have a higher risk of exercise-induced acute kidney injury (EAKI) and reduced kidney function. Although the best preventive measure is avoiding exercise, there are many kinds of jobs that require occupational exercise. A 27-year-old male police officer suffered from stage 3 AKI after performing a 20-m multistage shuttle run test...
May 2019: Case Reports in Nephrology and Dialysis
Ramy M Hanna, Huma Hasnain, Michelle D Sangalang, Jennifer Han, Aarthi Arasu, Farid Arman, Marina Barsoum, Hyunah Poa, Anjay Rastogi, Avital Harari
Lithium (Li) carbonate has been established as a mood stabilizer and an efficacious treatment for bipolar disorder since its discovery by Dr. John Cade in 1948. Li interacts significantly with organ systems and endocrine pathways. One of the most challenging side effects of Li to manage is its effect on the parathyroid glands. Dysregulation of parathyroid signaling due to Li results in hypercalcemia due to increased vitamin D<sub>3</sub> generation, increased calcium absorption from the gut, and bone resorption, occasionally resulting in concomitant hypercalciuria...
May 2019: Case Reports in Nephrology and Dialysis
Anne Karmisholt Grosen, Johan Vestergaard Povlsen, Lars Erik Lemming, Simon Mark Dahl Jørgensen, Jens Frederik Dahlerup, Christian Lodberg Hvas
Renal transplant recipients (RTRs) are highly susceptible to infections, and antimicrobial resistance is an increasing problem with limited treatment options. Faecal microbiota transplantation (FMT) is effective for recurrent Clostridium difficile infection and may be used for patients with intestinal carriage of multidrug-resistant (MDR) microorganisms. We present a RTR who suffered from recurrent urinary tract infections (UTIs) caused by extended-spectrum beta-lactamase-producing (ESBL+) Klebsiella pneumoniae ...
May 2019: Case Reports in Nephrology and Dialysis
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