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Urinary tract infection in nephrotic children: A cross-sectional study 肾病儿童尿路感染:一项横断面研究
Pub Date : 2020-01-01 DOI: 10.4103/jina.jina_5_20
S. Bakshi, Subhendu S. Samanta
Background and Objectives: Nephrotic syndrome, characterized by the presence of heavy proteinuria, hypoalbuminemia, edema, and hyperlipidemia, is a common renal disorder in pediatric population. The aim of this study was to find out the prevalence of urinary tract infection (UTI) in nephrotic syndrome, bacterial etiologies, and antibiotic sensitivity pattern. Subjects and Methods: After matching the criteria, 82 cases were taken for this prospective, single-center, observational study. The diagnosis was confirmed by bacterial culture. This is an institution-based, cross-sectional, descriptive observational study. All newly diagnosed and relapse cases of nephrotic syndrome based on the inclusion exclusion criteria were included in the study. Respondent was either of the parents or caregiver of the study subjects. Analysis of all data was done by appropriate statistical software (SPSS-23). Results: Among 82 participants evaluated with nephrotic syndrome, 29.3% of participants had UTI, majority (66.7%) were asymptomatic, and 33.3% were symptomatic. Significant microscopic hematuria was found in 20.7% of study subjects and significant pyuria was found in 58.54%. Majority (33.3%) of UTIs were caused by Escherichia coli, followed by Klebsiella 25%, Proteus 16.7%, and Staphylococcus aureus 12.5%, and Citrobacter, Acinetobacter, and mixed growth were found in 4.2% each. The mean serum cholesterol of group with UTI was 422.13 ± 34.65 and group without UTI was 307.43 ± 26.13. The variation among the two groups was found to be statistically significant (P = 0.0001). Conclusions: The children with nephrotic syndrome are frequently predisposed to UTI, and in most cases, it is asymptomatic and often undiagnosed. Higher serum cholesterol level may predispose the nephrotic child for UTI.
背景和目的:肾病综合征是一种儿科常见的肾脏疾病,以大量蛋白尿、低白蛋白血症、水肿和高脂血症为特征。本研究的目的是了解尿路感染(UTI)在肾病综合征中的患病率、细菌病因和抗生素敏感性模式。对象和方法:符合标准后,纳入82例前瞻性、单中心、观察性研究。细菌培养证实了诊断。这是一项基于机构的、横断面的、描述性观察性研究。所有符合入选排除标准的肾病综合征新诊断及复发病例均纳入研究。被调查者是研究对象的父母或照顾者。采用SPSS-23统计软件对所有数据进行分析。结果:在82名肾病综合征评估的参与者中,29.3%的参与者有尿路感染,大多数(66.7%)无症状,33.3%有症状。20.7%的研究对象显微镜下发现明显血尿,58.54%的研究对象显微镜下发现明显脓尿。以大肠杆菌为主(33.3%),其次为克雷伯菌(25%)、变形杆菌(16.7%)和金黄色葡萄球菌(12.5%),柠檬酸杆菌(4.2%)、不动杆菌(4.2%)和混合生长杆菌(4.2%)。尿路感染组平均血清胆固醇为422.13±34.65,无尿路感染组平均血清胆固醇为307.43±26.13。两组间差异有统计学意义(P = 0.0001)。结论:肾病综合征患儿易患尿路感染,且多数患儿无症状且常未确诊。较高的血清胆固醇水平可能使肾病儿童易患尿路感染。
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引用次数: 1
Hypomagnesemia: Hidden key of life and primary event for hypovitaminosis D and hypoalbuminemia in hemodialysis 低镁血症:血液透析中维生素D缺乏症和低白蛋白血症的生命隐藏关键和主要事件
Pub Date : 2019-07-01 DOI: 10.4103/jina.jina_18_18
M. Malaki
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引用次数: 0
X-linked alport syndrome presenting as bilateral lenticonus and end-stage renal disease x连锁alport综合征表现为双侧晶状体和终末期肾脏疾病
Pub Date : 2019-07-01 DOI: 10.4103/jina.jina_19_18
Mritunjay Kumar, S. Sushanth Kumar, A. Sharma, R. Kumari
Alport syndrome (AS) is a type of inherited nephropathy characterized by hematuria, proteinuria, and progressive renal failure; often associated with extrarenal manifestations such as sensorineural deafness and anterior lenticonus. X-linked AS causes end-stage kidney disease in young male patients, sometimes without prominent clinical manifestation beforehand due to its heterogeneous phenotype. Here, we report a case of AS where ignorance of visual and auditory symptoms led to progression to end-stage renal disease.
Alport综合征(AS)是一种以血尿、蛋白尿和进行性肾衰竭为特征的遗传性肾病;常伴有肾外表现,如感音神经性耳聋和前晶状体。x连锁AS在年轻男性患者中引起终末期肾脏疾病,有时由于其异质性表型而事先没有明显的临床表现。在这里,我们报告一个AS的情况下,忽视视觉和听觉症状导致进展到终末期肾脏疾病。
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引用次数: 0
Kidney disease screening in a group of female health personnel: Who are often missing? 一组女性卫生人员的肾脏疾病筛查:谁经常被遗漏?
Pub Date : 2019-07-01 DOI: 10.4103/jina.jina_20_18
M. Kashem, R. Biswas, K. Jewel
Background and Objective: Data on early-stage of chronic kidney disease (CKD) and the prevalence of CKD are very limited, especially more scanty in our female population. Hence, data from a kidney screening program organized at the Chattagram Maa-O-Shishu Hospital premises in connection with the observance of World Kidney Day 2018 were looked at for renal function among a group of female health personnel. Methods: This was a cross-sectional study among a group of female health personnel working at the hospital. Age, body weight, height, Body mass index (BMI), and blood pressure were documented, and serum creatinine was measured at a single sitting. The kidney function was estimated by calculating the glomerular filtration rate (GFR) using the Modified Diet in Renal Disease formula. Kidney function was classified according to estimated GFR (eGFR) and Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines. Results: A total of 101 female health personnel were studied – physicians - 23; nurses - 45, and health assistants - 33. Majority participants (51%) were in the age group of 20–29 years; 5% were <20-year-old; and 9.9% were more than 40-year-old. The distribution of eGFR was symmetrical, with the majority (82%) of individuals in the 60–89 mL/min category; 11.88% had 30–59 mL/min category and only 5.9% of the study population had eGFR >90 mL/min category. An inverse relation between the age and eGFR and a direct relation between the BMI and eGFR were observed in the study. Conclusion: The results indicate that low GFR levels and consequently a high burden of likely CKD are prevailing in our female population. It is not clear whether such observations are the result of the transportability problems associated with the GFR prediction equations or with the suitability of K/DOQI guidelines for the classification of CKD in our population or both. Well-planned, larger, and community- and hospital-based studies are warranted to clarify these issues, especially for our female population.
背景与目的:关于早期慢性肾脏疾病(CKD)和CKD患病率的数据非常有限,特别是在我国女性人群中更为缺乏。因此,在Chattagram Maa-O-Shishu医院举办的与2018年世界肾脏日有关的肾脏筛查项目的数据被用于研究一组女性卫生人员的肾功能。方法:这是一项横断面研究,在一组在医院工作的女性卫生人员。记录年龄、体重、身高、身体质量指数(BMI)和血压,并一次测定血清肌酐。采用肾脏疾病改良饮食公式计算肾小球滤过率(GFR)来评估肾功能。根据估计的GFR (eGFR)和肾脏疾病结局质量倡议(K/DOQI)指南对肾功能进行分类。结果:共调查了101名女性卫生人员——医生23名;护士45人,卫生助理33人。大多数参与者(51%)年龄在20-29岁;5%为90 mL/min。研究发现,年龄与eGFR呈反比关系,BMI与eGFR呈正相关。结论:结果表明,低GFR水平和由此导致的高CKD负担在我国女性人群中普遍存在。目前尚不清楚这些观察结果是与GFR预测方程相关的可转运性问题的结果,还是与K/DOQI指南在我们人群中对CKD分类的适用性有关,还是两者兼而有之。有必要进行计划周密、规模更大、以社区和医院为基础的研究,以澄清这些问题,特别是针对我们的女性人群。
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引用次数: 1
25(OH) vitamin D: Serum levels and related factors in hemodialysis patients 25(OH)维生素D:血液透析患者血清水平及相关因素
Pub Date : 2019-01-01 DOI: 10.4103/jina.jina_9_18
D. Nascimento, M. Luz, K. Remor, T. Sakae, M. Machado
Background and Objective: Advanced chronic renal failure leads to changes in calcium metabolism that cause disturbances in the parathyroid, vascular system, and bones. The 25(OH) Vitamin D plays a key role in regulating calcium metabolism and preventing these complications. The objective of this study was to determine 25(OH) Vitamin D levels in dialysis patients and to relate to clinical and sociodemographic characteristics. Methods: This was a cross-sectional study. The data collection was given by interview and consultation in electronic records, and the dosage of 25(OH) Vitamin D was performed on heparinized plasma samples collected at the beginning of the dialysis session. Results: Of the 77 patients studied, noted that seven (9.1%) showed poor values of 25(OH) Vitamin D and 19 (24.7%) showed insufficient values. As for the presence of comorbidities, 31 (40.3%) reported having diabetes mellitus, and 54 (70.1%) reported having arterial hypertension. It was also observed that the serum levels of 25(OH) Vitamin D are inferior in the carriers of diabetes mellitus and decrease with the increase of age and with the elevation of serum creatinine. The use of Vitamin D supplements presented positive correlation with serum calcium levels. Conclusion: The insufficiency of 25(OH) Vitamin D is frequent in dialysis patients especially in the carriers of diabetes mellitus.
背景与目的:晚期慢性肾功能衰竭导致钙代谢的改变,引起甲状旁腺、血管系统和骨骼的紊乱。25(OH)维生素D在调节钙代谢和预防这些并发症中起着关键作用。本研究的目的是确定透析患者的25(OH)维生素D水平,并与临床和社会人口学特征相关。方法:采用横断面研究。数据收集采用面谈和电子记录咨询的方式,并对透析开始时收集的肝素化血浆样本进行25(OH)维生素D的剂量测定。结果:在研究的77例患者中,有7例(9.1%)显示25(OH)维生素D值偏低,19例(24.7%)显示维生素D值不足。在合并症方面,31例(40.3%)报告有糖尿病,54例(70.1%)报告有动脉高血压。糖尿病患者血清25(OH)维生素D水平较低,且随着年龄的增加和血清肌酐的升高而降低。维生素D补充剂的使用与血清钙水平呈正相关。结论:25(OH)维生素D缺乏在透析患者中较为常见,尤其是糖尿病患者。
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引用次数: 0
Aggressive angiomyxoma of the scrotum in a man: A case report and literature review of 73 cases of aggressive angiomyxoma in men 男性阴囊侵袭性血管黏液瘤:73例男性侵袭性血管黏液瘤病例报告及文献复习
Pub Date : 2019-01-01 DOI: 10.4103/jina.jina_14_18
M. Al-Mendalawi
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引用次数: 0
Sertraline - Associated acute urinary retention in a patient with benign prostatic hyperplasia 良性前列腺增生患者舍曲林相关性急性尿潴留1例
Pub Date : 2019-01-01 DOI: 10.4103/jina.jina_16_18
N. Uvais, T. Mohammed
Urinary Retention Secondary To The Use Of Selective Serotonin Reuptake Inhibitors Is A Rare Event. We Report The Case Of A Man With Benign Prostatic Hyperplasia (Bph), Who Began To Experience Urinary Retention After Starting Treatment With Relatively Higher Starting Dose Of Sertraline For Panic Disorder. He Required Foley Catheterization And Was Maintained On Indwelling Catheter For 7 Days. Our Report Recommends Monitoring Of Urinary Symptoms In Bph Patients On Sertraline.
选择性5 -羟色胺再摄取抑制剂继发的尿潴留是一种罕见的事件。我们报告一例男性良性前列腺增生(Bph),谁开始与相对较高的起始剂量舍曲林治疗惊恐障碍后,开始经历尿潴留。患者需要Foley导尿,留置导尿7天。我们的报告建议对服用舍曲林的前列腺增生患者的泌尿系统症状进行监测。
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引用次数: 0
Clinical profile of acute kidney injury in a tertiary care center in the Tropical Region 急性肾损伤在热带地区三级保健中心的临床概况
Pub Date : 2018-10-01 DOI: 10.4103/jina.jina_15_18
Utkarsh Rajesh Patel, A. Pasari, M. Balwani, A. Bhawane, P. Tolani, Shaurya Acharya
Objective: The objectives of the study were to study etiology, manifestations, and outcome of acute kidney disease in the tropical region in a tertiary care center. Materials and Methods: In the present prospective study, patients with acute kidney disease admitted to JNMC, Wardha, India, between January 2017 and December 2017 were studied with a detailed history, general physical examination, and systemic examination. Data were collected and analyzed. Statistical analysis was performed using descriptive and inferential statistics using the Chi-square test and Student's unpaired t-test and software used in the analysis was SPSS 22.0 version and Graph Pad Prism 6.0 version. Results: This study showed male-to-female ratio of 1.8:1. Maximum incidence was seen in patients aged >60 years. As per the Kuppuswamy's scale, most of the patients belonged to lower-middle and upper lower class. The study showed various etiological factors associated with acute kidney injuries (AKIs) such as renal causes (most common), heart failure, respiratory failure, cirrhosis, malaria, snake bite, acute gastroenteritis, poisoning, drug nephrotoxicity, and sepsis. Common symptoms were oliguria followed by pedal edema and dyspnea. The most common comorbid illness was hypertension followed by diabetes mellitus which may have made them prone to AKI. About 81.42% of patients survived and 18.58% expired. Of 70, 56 patients were managed conservatively, whereas 14 underwent hemodialysis. Mean duration of hospitalization was 11.01 ± 8.60 days. Conclusion: Intrinsic renal causes followed by heart failure were the common causes of AKI as against infective causes a few years earlier. This shows the changing trend of AKI causes in a developing nation. Average duration of hospitalization was 11 days in the study.
目的:本研究的目的是研究热带地区三级保健中心急性肾脏疾病的病因、表现和预后。材料与方法:在本前瞻性研究中,研究对象是2017年1月至2017年12月在印度Wardha的JNMC住院的急性肾病患者,他们有详细的病史、一般体格检查和全身检查。收集数据并进行分析。统计分析采用描述性统计和推断性统计,采用卡方检验和学生非配对t检验,分析软件为SPSS 22.0版本和Graph Pad Prism 6.0版本。结果:本研究男女比例为1.8:1。发病率最高的患者年龄>60岁。根据Kuppuswamy量表,大多数患者属于中下阶层和中下阶层。该研究显示了与急性肾损伤(AKIs)相关的各种病因,如肾脏原因(最常见)、心力衰竭、呼吸衰竭、肝硬化、疟疾、蛇咬伤、急性胃肠炎、中毒、药物肾毒性和败血症。常见的症状是少尿,其次是足部水肿和呼吸困难。最常见的合并症是高血压,其次是糖尿病,这可能使他们容易发生AKI。81.42%的患者存活,18.58%的患者死亡。在70例患者中,56例采用保守治疗,14例采用血液透析。平均住院时间11.01±8.60天。结论:与感染原因相比,肾脏内源性原因继发心力衰竭是AKI的常见原因。这显示了发展中国家AKI病因的变化趋势。在研究中,平均住院时间为11天。
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引用次数: 2
Study of some electrocardiographic and echocardiographic data in toddelers and children with primary glomerulonephropathy 幼儿及儿童原发性肾小球肾病心电图及超声心动图资料的研究
Pub Date : 2018-10-01 DOI: 10.4103/jina.jina_36_17
M. El-Gamasy, Walid El-Shehabi
Background and Objective: Primary glomerulonephropathy mainly acute poststreptococcal glomerulonephritis (APSGN) is the most common cause of hypertensive heart failure in the pediatric age as APSGN may involve various systems including cardiovascular system. There are few research publications on electrocardiographic (ECG) and echocardiographic (two-dimensional [2D]-echo) data in childrenwith primary glomerulonephropathy. The aim is to study some ECG and 2D-echo data in Egyptian pediatric patients with ANS). Subjects and Methods: Sixty children with ANS were included and subjected to clinical, laboratory, ECG for corrected QT (QTc) interval and 2D echocardiographic study on admission and repeated at 6 and 12 weeks using GE Vivid 7 (GE Medical System, Horten, Norway with a 3.5-MHz multifrequency transducer) to measure left ventricular ejection fraction (LVEF), left atrium to aorta ratio and E/A ratio. Results: Prolonged QTc interval was reported in 22 patients (37%), of whom 18 had hypertension. Fourteen of the 60 children had LVEF <60%. The same children also had left atrium/aorta ratio >2 and E/A ratio more than two. LVEF became within normal values by 1½ month (6 weeks) in 12 patients, two become normal by three months of follow-up. Four (28.6%) from 14 children with low LVEF had normal arterial blood pressure. All the 14 children had completely recovered on follow-up period of 3 months. Conclusion: Changes in ECG and echo data which were reported in the acute phase of ANS appear to be temporary (transient) as they became within normal values in almost all children by 12 weeks period of follow-up. Although elevated blood pressure was the most common etiology of congestive heart failure in children with ANS, the impact of primary myocardial functional disturbance could also be put into consideration.
背景与目的:原发性肾小球肾病主要是急性链球菌后肾小球肾炎(APSGN),是儿童年龄段高血压性心力衰竭最常见的原因,因为APSGN可累及包括心血管系统在内的多个系统。关于儿童原发性肾小球肾病的心电图(ECG)和超声心动图(二维[2D]-回声)数据的研究文献很少。目的是研究埃及儿童ANS患者的一些心电图和2d回波数据。对象和方法:纳入60例ANS患儿,入院时进行临床、实验室、心电图校正QT间期及二维超声心动图研究,并于6周和12周重复使用GE Vivid 7 (GE Medical System, Horten, Norway, 3.5 mhz多频传感器)测量左室射血分数(LVEF)、左心房与主动脉比值及E/ a比值。结果:22例(37%)患者QTc间期延长,其中18例合并高血压。60例患儿中有14例lvef2和E/A比值大于2。12例患者LVEF在1个半月(6周)后恢复正常,2例在随访3个月后恢复正常。14例低LVEF患儿中4例(28.6%)动脉血压正常。随访3个月,14例患儿均完全康复。结论:在ANS急性期报告的心电图和回声数据的变化似乎是暂时的,因为在12周的随访期间,几乎所有儿童的心电图和回声数据都在正常值范围内。虽然血压升高是ANS患儿充血性心力衰竭最常见的病因,但原发性心肌功能障碍的影响也可以考虑在内。
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引用次数: 1
To study the prevalence of thyroid disorders in chronic renal disease patients 探讨慢性肾病患者甲状腺功能障碍的患病率
Pub Date : 2018-10-01 DOI: 10.4103/jina.jina_13_18
Upendra Gupta, Apoorva Jain, Prashant Prakash, P. Agrawal, Ravi Kumar, M. Farooqui
Background and Objectives: The high prevalence of thyroid dysfunction in chronic kidney disease (CKD) patients reveals significant association between CKD progression and thyroid dysfunction. The aim was to study the thyroid dysfunction in patients of CKD for the prevalence of subclinical hypothyroidism (SCH) and clinical hypothyroidism and study the correlation between thyroid dysfunction and severity of renal diseases. In view of the variability of thyroid profile in CKD patients in previous studies, a prospective study of various thyroid function has been undertaken to establish a correlation if any between thyroid dysfunction and severity of renal diseases. Materials and Methods: A total of 100 patients with CKD on conservative management fulfilling the criteria for CKD who were admitted at the Department of Medicine, SNMC, Agra, Uttar Pradesh, India, during the period of July 2016–June 2017, were selected in this study. Descriptive analysis of the collected data was done and association of various parameters with the presence or absence of SCH or overt hypothyroidism was studied using Chi-square test and correlated. Results: Results showed that out of the 100 patients with CKD, 53 patients had thyroid dysfunction which accounted for 53%. The prevalence of SCH and clinical hypothyroidism was 33% and 20%, respectively. The number of patients with hypothyroidism progressively increased with increased severity of renal failure. Conclusions: We observed a high prevalence of thyroid dysfunction in our CKD patients and revealed significant association between CKD progression and thyroid dysfunction.
背景与目的:慢性肾脏疾病(CKD)患者中甲状腺功能障碍的高发率揭示了CKD进展与甲状腺功能障碍之间的显著关联。目的研究慢性肾病患者的甲状腺功能障碍,了解亚临床甲状腺功能减退(SCH)和临床甲状腺功能减退的患病率,并研究甲状腺功能障碍与肾脏疾病严重程度的相关性。鉴于以往研究中CKD患者甲状腺特征的变异性,我们对各种甲状腺功能进行了前瞻性研究,以确定甲状腺功能障碍与肾脏疾病严重程度之间是否存在相关性。材料与方法:本研究选择2016年7月至2017年6月在印度北方邦阿格拉SNMC医学部收治的100例符合CKD标准的保守治疗CKD患者。对收集到的数据进行描述性分析,并使用卡方检验研究各种参数与是否存在SCH或明显甲状腺功能减退的关联。结果:结果显示,100例CKD患者中有53例存在甲状腺功能障碍,占53%。SCH和甲状腺功能减退的患病率分别为33%和20%。随着肾功能衰竭的加重,甲状腺功能减退的患者数量逐渐增加。结论:我们观察到CKD患者中甲状腺功能障碍的患病率很高,并揭示了CKD进展与甲状腺功能障碍之间的显著关联。
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引用次数: 6
期刊
Journal of Integrative Nephrology and Andrology
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