Pub Date : 2016-10-01DOI: 10.4103/2394-2916.193497
F. Han, Jianghua Chen
The incidence of end-stage renal disease (ESRD) increases in the elderly population. Patients received kidney transplantation have better long-term survival and quality of life than those received maintaining dialysis. However, only a smaller proportion of the elderly patients receive kidney transplantation because of the concerns about high posttransplant complications such as infections and diabetes. In this review, we make a discussion on treatment strategies including prophylaxis of risk factors, donor selection, and postoperative monitoring to raise awareness and improve long-term prognosis in the elderly patients with ESRD.
{"title":"Kidney Transplantation in the Elderly with End-stage Renal Disease","authors":"F. Han, Jianghua Chen","doi":"10.4103/2394-2916.193497","DOIUrl":"https://doi.org/10.4103/2394-2916.193497","url":null,"abstract":"The incidence of end-stage renal disease (ESRD) increases in the elderly population. Patients received kidney transplantation have better long-term survival and quality of life than those received maintaining dialysis. However, only a smaller proportion of the elderly patients receive kidney transplantation because of the concerns about high posttransplant complications such as infections and diabetes. In this review, we make a discussion on treatment strategies including prophylaxis of risk factors, donor selection, and postoperative monitoring to raise awareness and improve long-term prognosis in the elderly patients with ESRD.","PeriodicalId":158840,"journal":{"name":"Journal of Integrative Nephrology and Andrology","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124538943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-10-01DOI: 10.4103/2394-2916.193514
R. Biswas, M. Kashem
Background and Objectives: Chronic kidney disease (CKD) is a common health problem in Bangladesh. Etiological factors of CKD are very vital for management but largely unknown in our setting. Hence, the main objective of the study is to identify etiology of CKD of patients who are on maintenance hemodialysis (MHD) at different dialysis units of Chittagong. Methods: This descriptive study was conducted on 107 patients of CKD who were on MHD in different dialysis centers of Chittagong town, Bangladesh. A pretested questionnaire was adopted from previous study addressing different etiology of the CKD. This study was based solely on history and previous health records. After collection of data, it was compiled and analyzed manually. Results: In the present study, there were 61.62% males and 38.31% females and male-female ratio was 1.61:1. Majority (42 [39.25%]) of the patients were in the age group of 50-60 years, next to which was 40-50 years (23 [21.49%]). Diabetes mellitus (DM) with or without hypertension (HTN) was found as the most common etiology (70 [65.45%]) of CKD in our study, next to which was HTN (53 [49.53%]), nonsteroidal anti-inflammatory drug (NSAID) (15 [14.1%]), chronic glomerulonephritis (7 [6.54%]), polycystic kidney disease (6 [5.60]), systemic lupus erythematosus (1 [0.93%]), contrast-induced (1 [0.93%]), and following acute kidney injury (1 [0.93%]). Only 4 (3.73%) cases were found to have biopsy-confirmed nephritis. Conclusion: DM was found the most common etiology of CKD among patients who are on MHD in Bangladesh, next to which was HTN. Maximum patients had no biopsy proof of CKD and NSAID constituting a significant segment of etiology which is a potentially preventable etiology, in our setting.
{"title":"Etiological Survey of Chronic Kidney Disease Patients on Maintenance Hemodialysis in Different Centers of Chittagong, Bangladesh","authors":"R. Biswas, M. Kashem","doi":"10.4103/2394-2916.193514","DOIUrl":"https://doi.org/10.4103/2394-2916.193514","url":null,"abstract":"Background and Objectives: Chronic kidney disease (CKD) is a common health problem in Bangladesh. Etiological factors of CKD are very vital for management but largely unknown in our setting. Hence, the main objective of the study is to identify etiology of CKD of patients who are on maintenance hemodialysis (MHD) at different dialysis units of Chittagong. Methods: This descriptive study was conducted on 107 patients of CKD who were on MHD in different dialysis centers of Chittagong town, Bangladesh. A pretested questionnaire was adopted from previous study addressing different etiology of the CKD. This study was based solely on history and previous health records. After collection of data, it was compiled and analyzed manually. Results: In the present study, there were 61.62% males and 38.31% females and male-female ratio was 1.61:1. Majority (42 [39.25%]) of the patients were in the age group of 50-60 years, next to which was 40-50 years (23 [21.49%]). Diabetes mellitus (DM) with or without hypertension (HTN) was found as the most common etiology (70 [65.45%]) of CKD in our study, next to which was HTN (53 [49.53%]), nonsteroidal anti-inflammatory drug (NSAID) (15 [14.1%]), chronic glomerulonephritis (7 [6.54%]), polycystic kidney disease (6 [5.60]), systemic lupus erythematosus (1 [0.93%]), contrast-induced (1 [0.93%]), and following acute kidney injury (1 [0.93%]). Only 4 (3.73%) cases were found to have biopsy-confirmed nephritis. Conclusion: DM was found the most common etiology of CKD among patients who are on MHD in Bangladesh, next to which was HTN. Maximum patients had no biopsy proof of CKD and NSAID constituting a significant segment of etiology which is a potentially preventable etiology, in our setting.","PeriodicalId":158840,"journal":{"name":"Journal of Integrative Nephrology and Andrology","volume":"141 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117051825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-07-01DOI: 10.4103/2394-2916.187792
Cheng-jun Wang, Yinghua Shen, Kai Chen, Xiaorong Bao
Background and Objectives: Tubulointerstitial fibrosis (TIF), the common pathway of chronic kidney disease (CKD) to end-stage kidney disease, is sorely lacking of effective drugs in prevention, even synthetic chemical drugs have made significant progress. Therefore, this study was to investigate the effects of Danhong (active agents of Salvia miltiorrhiza and safflower Carthamus) on TIF in early CKD with unilateral nephrectomy animal model. Materials and Methods: Forty Sprague-Dawley rats were randomly divided into four groups (each n = 10): A, control; B, CKD; C, CKD + Danhong; and D, CKD + Losartan. In Group A and B, rats were treated with normal saline for 12 weeks. In Group C and D, rats were treated with Danhong (8 mL/kg/day) and losartan (20 mg/kg/day), respectively. The concentrations of angiotensin II (Ang II) and transforming growth factor (TGF-β) in kidney were measured by immunohistochemistry technique and enzyme-linked immunosorbent assay. The relationship among the indicators relating to TIF was analyzed. Data were collected and analyzed using SPSS software. Results: The concentrations of Ang II and TGF-β in renal cortex homogenate, TGF-β1 positive area in renal cortex tissue, and semi-quantitative nephropathological scores of TIF were dramatically lower in CKD rats treated with Danhong, compare with those without Danhong management. Conclusions: Danhong has a protective effect on TIF in CKD rats, similar to losartan, may through a series of approach including suppression of Ang II and TGF-β in kidney.
{"title":"The Protective Effect of Danhong on Tubulointerstitial Fibrosis is Associated with Suppression of Angiotensin II and Transforming Growth Factor β in the Kidney","authors":"Cheng-jun Wang, Yinghua Shen, Kai Chen, Xiaorong Bao","doi":"10.4103/2394-2916.187792","DOIUrl":"https://doi.org/10.4103/2394-2916.187792","url":null,"abstract":"Background and Objectives: Tubulointerstitial fibrosis (TIF), the common pathway of chronic kidney disease (CKD) to end-stage kidney disease, is sorely lacking of effective drugs in prevention, even synthetic chemical drugs have made significant progress. Therefore, this study was to investigate the effects of Danhong (active agents of Salvia miltiorrhiza and safflower Carthamus) on TIF in early CKD with unilateral nephrectomy animal model. Materials and Methods: Forty Sprague-Dawley rats were randomly divided into four groups (each n = 10): A, control; B, CKD; C, CKD + Danhong; and D, CKD + Losartan. In Group A and B, rats were treated with normal saline for 12 weeks. In Group C and D, rats were treated with Danhong (8 mL/kg/day) and losartan (20 mg/kg/day), respectively. The concentrations of angiotensin II (Ang II) and transforming growth factor (TGF-β) in kidney were measured by immunohistochemistry technique and enzyme-linked immunosorbent assay. The relationship among the indicators relating to TIF was analyzed. Data were collected and analyzed using SPSS software. Results: The concentrations of Ang II and TGF-β in renal cortex homogenate, TGF-β1 positive area in renal cortex tissue, and semi-quantitative nephropathological scores of TIF were dramatically lower in CKD rats treated with Danhong, compare with those without Danhong management. Conclusions: Danhong has a protective effect on TIF in CKD rats, similar to losartan, may through a series of approach including suppression of Ang II and TGF-β in kidney.","PeriodicalId":158840,"journal":{"name":"Journal of Integrative Nephrology and Andrology","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126121834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-07-01DOI: 10.4103/2394-2916.187788
A. Tanaka, Yoichi Kobayashi, Yuichi Ito, N. Tanaka
Background and Objectives: Studies have investigated the effect of antihypertensive treatment in patients with hypertensive nephrosclerosis. To our knowledge, there is no cohort study on the effect of antihypertensive treatment in elderly patients with nephrosclerosis. Therefore, our aim was to evaluate the efficacy and risks associated with the use of antihypertensive agents, especially renin-angiotensin system (RAS) inhibitors, in this population. Patients and Methods: This was a retrospective cohort study. Patients aged ≥65 years and diagnosed with nephrosclerosis who were treated in our department between August 2013 and October 2014 were included in this study and were observed for 12 consecutive months. Results: Forty-three patients were included in this study. Thirty-three patients were men, and 10 were women. The mean age of the subjects was 79.3 ± 7.1 years. At the start of this study, mean values of serum creatinine (Cr) and estimated glomerular filtration rate (eGFR) were 2.48 ± 1.32 mg/dL and 25.0 ± 12.8 mL/min/1.73 m 2 , respectively. At the end of the observation period, hemodialysis was initiated for 5 patients. The mean value of eGFR decreased by 12.2 ± 21.5%, and 3 patients had a decrease of more than 30% in eGFR. Cr values at the start correlated positively with the percentage of decrease in eGFR. Cr values at the start and RAS inhibitor usage rate were significantly associated with adverse effects, such as hyperkalemia and transient Cr elevation. Conclusion: Our study suggests that antihypertensive treatment with RAS inhibitors may cause adverse effects in elderly patients with nephrosclerosis. Caution should be exercised when administering RAS inhibitors to these patients.
{"title":"Risks Associated with Renin-angiotensin System Inhibitor Therapy in Elderly Patients with Nephrosclerosis","authors":"A. Tanaka, Yoichi Kobayashi, Yuichi Ito, N. Tanaka","doi":"10.4103/2394-2916.187788","DOIUrl":"https://doi.org/10.4103/2394-2916.187788","url":null,"abstract":"Background and Objectives: Studies have investigated the effect of antihypertensive treatment in patients with hypertensive nephrosclerosis. To our knowledge, there is no cohort study on the effect of antihypertensive treatment in elderly patients with nephrosclerosis. Therefore, our aim was to evaluate the efficacy and risks associated with the use of antihypertensive agents, especially renin-angiotensin system (RAS) inhibitors, in this population. Patients and Methods: This was a retrospective cohort study. Patients aged ≥65 years and diagnosed with nephrosclerosis who were treated in our department between August 2013 and October 2014 were included in this study and were observed for 12 consecutive months. Results: Forty-three patients were included in this study. Thirty-three patients were men, and 10 were women. The mean age of the subjects was 79.3 ± 7.1 years. At the start of this study, mean values of serum creatinine (Cr) and estimated glomerular filtration rate (eGFR) were 2.48 ± 1.32 mg/dL and 25.0 ± 12.8 mL/min/1.73 m 2 , respectively. At the end of the observation period, hemodialysis was initiated for 5 patients. The mean value of eGFR decreased by 12.2 ± 21.5%, and 3 patients had a decrease of more than 30% in eGFR. Cr values at the start correlated positively with the percentage of decrease in eGFR. Cr values at the start and RAS inhibitor usage rate were significantly associated with adverse effects, such as hyperkalemia and transient Cr elevation. Conclusion: Our study suggests that antihypertensive treatment with RAS inhibitors may cause adverse effects in elderly patients with nephrosclerosis. Caution should be exercised when administering RAS inhibitors to these patients.","PeriodicalId":158840,"journal":{"name":"Journal of Integrative Nephrology and Andrology","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115487850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-07-01DOI: 10.4103/2394-2916.187785
G. Cai, Xiang-Mei Chen
The elderly are at high risk of chronic kidney disease, who has become a major population in the newly admission to dialysis treatment. So the elderly will be the focus of CKD prevention task in future. At present, challenges still remain in the diagnosis and treatment of CKD in the elderly: there is no unified criteria for CKD diagnosis in the elderly, un-settled treatment target of CKD complications in the elderly; complicated theraputic strategies in the elderly ESRD patients. We particularly stress the importance of patient-centered, instead of disease-oriented, individualized treatment in the prevention and treatment of CKD in the elderly.
{"title":"Prevention, Diagnosis, and Treatment of Chronic Kidney Diseases in Older Adults: Current Status and Prospective","authors":"G. Cai, Xiang-Mei Chen","doi":"10.4103/2394-2916.187785","DOIUrl":"https://doi.org/10.4103/2394-2916.187785","url":null,"abstract":"The elderly are at high risk of chronic kidney disease, who has become a major population in the newly admission to dialysis treatment. So the elderly will be the focus of CKD prevention task in future. At present, challenges still remain in the diagnosis and treatment of CKD in the elderly: there is no unified criteria for CKD diagnosis in the elderly, un-settled treatment target of CKD complications in the elderly; complicated theraputic strategies in the elderly ESRD patients. We particularly stress the importance of patient-centered, instead of disease-oriented, individualized treatment in the prevention and treatment of CKD in the elderly.","PeriodicalId":158840,"journal":{"name":"Journal of Integrative Nephrology and Andrology","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115421721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-07-01DOI: 10.4103/2394-2916.187793
S. Bhat, Manjunatha Sathyanarayanaprasad, A. Giridhar, Y. Srinivasa, F. Paul
Objectives: To assess the accuracy of Prader′s orchidometer and ultrasonography in estimating the volume of testis against the actual volume of testis as measured by Archimedes principle of water displacement. Subjects and Methods: Fifty-six patients with advanced prostate cancer had an estimation of testicular volume by Prader′s orchidometer by the same urologist and ultrasonography by the same radiologist. Lambert′s formula was used for calculating the volume of testis. All patients underwent bilateral orchiectomy, and the actual volume of the testes was estimated by the water displacement method. Results: Mean age of patients was 71.53 years. The reliability of both the methods was calculated by Bland-Altman plot. The discrepancy of individual measurement and the bias (average discrepancy) was calculated for each method separately, and the plot was derived. In both the plots, the values were more concentrated around the value 0, showing that both were reliable in measuring the volume accurately. Conclusions: The volume of testis measured by Prader′s orchidometer correlated with that measured by ultrasonography as well as the actual volume measured by water displacement method. This method is hence useful in office practice, community screening, adolescent clinics, and teen clinics.
{"title":"Testicular Volume Measurement: Comparison of Prader′s Orchidometry, Ultrasonography, and Actual Volume by Water Displacement","authors":"S. Bhat, Manjunatha Sathyanarayanaprasad, A. Giridhar, Y. Srinivasa, F. Paul","doi":"10.4103/2394-2916.187793","DOIUrl":"https://doi.org/10.4103/2394-2916.187793","url":null,"abstract":"Objectives: To assess the accuracy of Prader′s orchidometer and ultrasonography in estimating the volume of testis against the actual volume of testis as measured by Archimedes principle of water displacement. Subjects and Methods: Fifty-six patients with advanced prostate cancer had an estimation of testicular volume by Prader′s orchidometer by the same urologist and ultrasonography by the same radiologist. Lambert′s formula was used for calculating the volume of testis. All patients underwent bilateral orchiectomy, and the actual volume of the testes was estimated by the water displacement method. Results: Mean age of patients was 71.53 years. The reliability of both the methods was calculated by Bland-Altman plot. The discrepancy of individual measurement and the bias (average discrepancy) was calculated for each method separately, and the plot was derived. In both the plots, the values were more concentrated around the value 0, showing that both were reliable in measuring the volume accurately. Conclusions: The volume of testis measured by Prader′s orchidometer correlated with that measured by ultrasonography as well as the actual volume measured by water displacement method. This method is hence useful in office practice, community screening, adolescent clinics, and teen clinics.","PeriodicalId":158840,"journal":{"name":"Journal of Integrative Nephrology and Andrology","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124501692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-07-01DOI: 10.4103/2394-2916.187797
M. Arya, M. Baid, R. Mittal, Rajeev Kumar
Bilateral subconjunctival hemorrhage is usually caused by conjunctivitis and trauma. Other causes are straining, sneezing, coughing, or vomiting. We report here two cases of severe stricture urethra who presented to us with bilateral subconjunctival hemorrhage. Both patients had to strain for more than half an hour to empty bladder once, since many months. On evaluation both patients were found to have very narrow segment stricture urethra, underwent subsequent augmented urethroplasty and in about 3 weeks subconjunctival hemorrhage resolved on its own. We conclude that bilateral subconjunctival hemorrhage could be potential presenting sign of stricture urethra in patients who strain severely to empty their bladder.
{"title":"Bilateral Subconjunctival Hemorrhage: A New Presentation of Stricture Urethra","authors":"M. Arya, M. Baid, R. Mittal, Rajeev Kumar","doi":"10.4103/2394-2916.187797","DOIUrl":"https://doi.org/10.4103/2394-2916.187797","url":null,"abstract":"Bilateral subconjunctival hemorrhage is usually caused by conjunctivitis and trauma. Other causes are straining, sneezing, coughing, or vomiting. We report here two cases of severe stricture urethra who presented to us with bilateral subconjunctival hemorrhage. Both patients had to strain for more than half an hour to empty bladder once, since many months. On evaluation both patients were found to have very narrow segment stricture urethra, underwent subsequent augmented urethroplasty and in about 3 weeks subconjunctival hemorrhage resolved on its own. We conclude that bilateral subconjunctival hemorrhage could be potential presenting sign of stricture urethra in patients who strain severely to empty their bladder.","PeriodicalId":158840,"journal":{"name":"Journal of Integrative Nephrology and Andrology","volume":"89 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134007479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-07-01DOI: 10.4103/2394-2916.187786
R. Onwuchekwa
Human immunodeficiency virus (HIV)/AIDS is unique for its devastating impact on social, economic, and demographic developments. Recent studies have thrown more light on the reasons for the mortality and morbidity associated with HIV/AIDS in general and on its renal complications in particular. The classic involvement of the kidney by HIV infection in HIV-associated nephropathy (HIVAN) was reported in New York in 1984. HIVAN clinically presents with proteinuria and renal dysfunction and pathologically with focal segmental glomerulosclerosis. The imaging modality most commonly used in the assessment of renal dysfunction is ultrasonography, followed by computerized tomography. These renal lesions manifest in a protean number of ways in sonography. Renal survival has improved with the introduction of highly active antiretroviral therapy.
{"title":"Impact of Human Immunodeficiency Virus/AIDS on the Kidneys: Radiologist Perspective","authors":"R. Onwuchekwa","doi":"10.4103/2394-2916.187786","DOIUrl":"https://doi.org/10.4103/2394-2916.187786","url":null,"abstract":"Human immunodeficiency virus (HIV)/AIDS is unique for its devastating impact on social, economic, and demographic developments. Recent studies have thrown more light on the reasons for the mortality and morbidity associated with HIV/AIDS in general and on its renal complications in particular. The classic involvement of the kidney by HIV infection in HIV-associated nephropathy (HIVAN) was reported in New York in 1984. HIVAN clinically presents with proteinuria and renal dysfunction and pathologically with focal segmental glomerulosclerosis. The imaging modality most commonly used in the assessment of renal dysfunction is ultrasonography, followed by computerized tomography. These renal lesions manifest in a protean number of ways in sonography. Renal survival has improved with the introduction of highly active antiretroviral therapy.","PeriodicalId":158840,"journal":{"name":"Journal of Integrative Nephrology and Andrology","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132158871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-07-01DOI: 10.4103/2394-2916.187799
M. Arya, Rajeev Kumar, M. Baid, L. Kumar
Radical cystectomy with ileal conduit is one of the treatment options for patients with muscle invasive carcinoma bladder. Giant ileal conduit calculus is a very rare complication. A 60-year-old male had undergone radical cystectomy with ileal conduit about 12 years back and now presented left gross hydrourereteronephrosis with perinephric collection and features of renal failure. We performed drainage of perinephric collection followed by left sided percutaneous nephrostomy and patient′s condition improved gradually. Later on, we performed contrast-enhanced computed tomography (CT) intravenous urogram and nephrostogram which revealed a huge calculus of size 9 cm × 5 cm in the ileal conduit. Calculus was removed by open surgery by incising the conduit over antimesenteric border. Above presentation is a sequel of a huge ileal conduit calculus obstructing left ureter. Calculus formation can result from stomal stenosis, metabolic acidosis, small bowel syndrome, recurrent infection, any foreign body like a staple or nonabsorbing suture material. These patients require close surveillance with X-ray kidney, ureter, and bladder for a longer period after the urinary diversion. In doubtful cases, helical CT may be useful. Giant ileal conduit calculus is a very uncommon presentation after radical cystectomy.
{"title":"A Giant Ileal Conduit Calculus after Radical Cystectomy","authors":"M. Arya, Rajeev Kumar, M. Baid, L. Kumar","doi":"10.4103/2394-2916.187799","DOIUrl":"https://doi.org/10.4103/2394-2916.187799","url":null,"abstract":"Radical cystectomy with ileal conduit is one of the treatment options for patients with muscle invasive carcinoma bladder. Giant ileal conduit calculus is a very rare complication. A 60-year-old male had undergone radical cystectomy with ileal conduit about 12 years back and now presented left gross hydrourereteronephrosis with perinephric collection and features of renal failure. We performed drainage of perinephric collection followed by left sided percutaneous nephrostomy and patient′s condition improved gradually. Later on, we performed contrast-enhanced computed tomography (CT) intravenous urogram and nephrostogram which revealed a huge calculus of size 9 cm × 5 cm in the ileal conduit. Calculus was removed by open surgery by incising the conduit over antimesenteric border. Above presentation is a sequel of a huge ileal conduit calculus obstructing left ureter. Calculus formation can result from stomal stenosis, metabolic acidosis, small bowel syndrome, recurrent infection, any foreign body like a staple or nonabsorbing suture material. These patients require close surveillance with X-ray kidney, ureter, and bladder for a longer period after the urinary diversion. In doubtful cases, helical CT may be useful. Giant ileal conduit calculus is a very uncommon presentation after radical cystectomy.","PeriodicalId":158840,"journal":{"name":"Journal of Integrative Nephrology and Andrology","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122063215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-04-01DOI: 10.4103/2394-2916.181218
Aarti Malavade, P. Malavade, M. Biyani, S. Hiremath, A. Akbari
Pregnancy with chronic kidney disease carries substantial risk to the mother and the baby. Incidence of women becoming pregnant while having chronic kidney disease is increasing. The major risk to the mother is development of preeclampsia which may be hard to diagnose in patients with chronic kidney disease. Depending on the kidney function, women may also be at risk of decline in their kidney function. The major risk to baby is prematurity. The renal physiological changes that occur with pregnancy are quite profound and normal values of blood pressure, electrolytes and parameters to monitor kidney function are different then in non-pregnant state. Counselling these women about pregnancy and managing them through pregnancy remains a challenge. This review discusses the physiological changes that occur during pregnancy, risks of pregnancy with CKD and management of CKD during pregnancy.
{"title":"Chronic Kidney Disease in Pregnancy","authors":"Aarti Malavade, P. Malavade, M. Biyani, S. Hiremath, A. Akbari","doi":"10.4103/2394-2916.181218","DOIUrl":"https://doi.org/10.4103/2394-2916.181218","url":null,"abstract":"Pregnancy with chronic kidney disease carries substantial risk to the mother and the baby. Incidence of women becoming pregnant while having chronic kidney disease is increasing. The major risk to the mother is development of preeclampsia which may be hard to diagnose in patients with chronic kidney disease. Depending on the kidney function, women may also be at risk of decline in their kidney function. The major risk to baby is prematurity. The renal physiological changes that occur with pregnancy are quite profound and normal values of blood pressure, electrolytes and parameters to monitor kidney function are different then in non-pregnant state. Counselling these women about pregnancy and managing them through pregnancy remains a challenge. This review discusses the physiological changes that occur during pregnancy, risks of pregnancy with CKD and management of CKD during pregnancy.","PeriodicalId":158840,"journal":{"name":"Journal of Integrative Nephrology and Andrology","volume":"312-315 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130862630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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