A. Abbasi, K. Makhdoomi, S. Babaei, Behzad Banaie, L. Mahmoudzadeh, Sepideh Rahimi, P. Porteghali
It has been more than two years since the COVID-19 pandemic affects the world. COVID-19 affects other organs in addition to the respiratory system. Renal cortical necrosis is a severe kidney injury due to decreased renal arterial perfusion induced by vascular spasm, microvascular injury and endovascular thrombosis. Acute kidney injury is a common finding in COVID-19; however, renal cortical necrosis is rare. To the best of our knowledge, only one case of renal cortical necrosis has been reported in the literature.
{"title":"Extensive renal cortical necrosis in a postpartum patient after COVID-19 infection","authors":"A. Abbasi, K. Makhdoomi, S. Babaei, Behzad Banaie, L. Mahmoudzadeh, Sepideh Rahimi, P. Porteghali","doi":"10.34172/jnp.2023.18380","DOIUrl":"https://doi.org/10.34172/jnp.2023.18380","url":null,"abstract":"It has been more than two years since the COVID-19 pandemic affects the world. COVID-19 affects other organs in addition to the respiratory system. Renal cortical necrosis is a severe kidney injury due to decreased renal arterial perfusion induced by vascular spasm, microvascular injury and endovascular thrombosis. Acute kidney injury is a common finding in COVID-19; however, renal cortical necrosis is rare. To the best of our knowledge, only one case of renal cortical necrosis has been reported in the literature.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47631897","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}
M. Alaei, Mohamad Ghazanfar Hashemi, Gelayol Chatrnour, Amirhossein Fakhre Yaseri
Hypertension (HTN) is the most prevalent chronic non-infected disease and the greatest cause of adult premature mortality. Although in the past clinicians assumed that HTN in childhood and adolescents is uncommon, it is currently a significant public health issue and this narrative review aimed to assess the new finding regarding screening for HTN in Children and adolescents. Relevant English publications were extracted from Web of Science, PubMed, Scopus, and Google Scholar. As there are gaps regarding recommendations, guidelines, and screening for HTN in children and adolescents, this review tried to notice some important points.
高血压（HTN）是最常见的慢性非感染性疾病，也是成人过早死亡的最大原因。尽管过去临床医生认为儿童和青少年的HTN并不常见，但目前这是一个重要的公共卫生问题，本综述旨在评估儿童和青少年HTN筛查的新发现。相关英文出版物摘自Web of Science、PubMed、Scopus和Google Scholar。由于在儿童和青少年HTN的建议、指南和筛查方面存在差距，本综述试图注意到一些重要点。
{"title":"The importance of screening for hypertension in children and adolescents","authors":"M. Alaei, Mohamad Ghazanfar Hashemi, Gelayol Chatrnour, Amirhossein Fakhre Yaseri","doi":"10.34172/jnp.2023.21457","DOIUrl":"https://doi.org/10.34172/jnp.2023.21457","url":null,"abstract":"Hypertension (HTN) is the most prevalent chronic non-infected disease and the greatest cause of adult premature mortality. Although in the past clinicians assumed that HTN in childhood and adolescents is uncommon, it is currently a significant public health issue and this narrative review aimed to assess the new finding regarding screening for HTN in Children and adolescents. Relevant English publications were extracted from Web of Science, PubMed, Scopus, and Google Scholar. As there are gaps regarding recommendations, guidelines, and screening for HTN in children and adolescents, this review tried to notice some important points.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48043902","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}
Paniz Pourpashang, Seyed Mohammad Taghi Hosseini Tabatabaei, M. Fallahi, L. Mohajerzadeh, Arefeh Zahmatkesh
Multicystic dysplastic kidney (MCDK) is a congenital kidney abnormality with an overall incidence rate of 1/4300 live births that is more prevalent in males than females. Here, we describe a rare case of bilateral MCDK complicated by hypertension, severe vesicoureteral reflux (VUR), and urinary tract infection (UTI), who stabilized during hospitalization with prospective kidney transplantation due to poor prognosis. Since bilateral MCDK is a rare disease with numerous complications and a poor prognosis, patient symptom management and treatment may be more challenging.
{"title":"An infant girl with bilateral multicystic dysplastic kidney: a case report","authors":"Paniz Pourpashang, Seyed Mohammad Taghi Hosseini Tabatabaei, M. Fallahi, L. Mohajerzadeh, Arefeh Zahmatkesh","doi":"10.34172/jnp.2023.21432","DOIUrl":"https://doi.org/10.34172/jnp.2023.21432","url":null,"abstract":"Multicystic dysplastic kidney (MCDK) is a congenital kidney abnormality with an overall incidence rate of 1/4300 live births that is more prevalent in males than females. Here, we describe a rare case of bilateral MCDK complicated by hypertension, severe vesicoureteral reflux (VUR), and urinary tract infection (UTI), who stabilized during hospitalization with prospective kidney transplantation due to poor prognosis. Since bilateral MCDK is a rare disease with numerous complications and a poor prognosis, patient symptom management and treatment may be more challenging.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43218468","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}
A 48-year-old male patient presented with dialysis dependent renal failure with biopsy showing crescentic glomerulonephritis and Positron emission tomography–computed tomography (PET-CT scan) revealing features of pericardial, pulmonary tuberculosis with positive urinary GeneXpert test for tuberculosis bacilli. Clinicians should keep in mind the atypical presentations of tuberculosis while managing rapidly progressive renal failure especially in tropical countries with high prevalence of tuberculosis.
{"title":"Disseminated tuberculosis presenting as a crescentic glomerulonephritis","authors":"Gerry George Mathew, Dinesh Babu","doi":"10.34172/jnp.2023.21434","DOIUrl":"https://doi.org/10.34172/jnp.2023.21434","url":null,"abstract":"A 48-year-old male patient presented with dialysis dependent renal failure with biopsy showing crescentic glomerulonephritis and Positron emission tomography–computed tomography (PET-CT scan) revealing features of pericardial, pulmonary tuberculosis with positive urinary GeneXpert test for tuberculosis bacilli. Clinicians should keep in mind the atypical presentations of tuberculosis while managing rapidly progressive renal failure especially in tropical countries with high prevalence of tuberculosis.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49326856","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}
Sara Cardoso Fernandes, Joana Marques, M. Pinto, M. Góis, H. Sousa, F. Nolasco
Sjögren’s syndrome is a chronic inflammatory disorder mostly involving the exocrine glands. Extraglandular disease may occur in up to one quarter of patients. Kidney involvement is rare, more often manifested by tubular dysfunction secondary to tubulointerstitial nephritis. Primary glomerular disease is uncommon. The authors present the case of a 73-year-old woman with xerostomia and positivity for anti-Ro and anti-La antibodies admitted for acute kidney injury and exudative pleural effusion. Biopsy of salivary glands was compatible with Sjögren’s syndrome. Extraglandular involvement was also confirmed by renal and pleural deposition of AA-amyloid. The patient was started on prednisolone followed by azathioprine with rapid improvement of lung disease. However, due to progressing renal disease and clinical deterioration, prognosis was guarded and the patient died. We describe a case of secondary amyloidosis with systemic involvement and infrequent clinical manifestations, briefly reviewing the key aspects of Sjögren’s syndrome and AA-amyloidosis.
{"title":"Renal failure and pleural effusion; a diagnostic challenge","authors":"Sara Cardoso Fernandes, Joana Marques, M. Pinto, M. Góis, H. Sousa, F. Nolasco","doi":"10.34172/jnp.2023.17309","DOIUrl":"https://doi.org/10.34172/jnp.2023.17309","url":null,"abstract":"Sjögren’s syndrome is a chronic inflammatory disorder mostly involving the exocrine glands. Extraglandular disease may occur in up to one quarter of patients. Kidney involvement is rare, more often manifested by tubular dysfunction secondary to tubulointerstitial nephritis. Primary glomerular disease is uncommon. The authors present the case of a 73-year-old woman with xerostomia and positivity for anti-Ro and anti-La antibodies admitted for acute kidney injury and exudative pleural effusion. Biopsy of salivary glands was compatible with Sjögren’s syndrome. Extraglandular involvement was also confirmed by renal and pleural deposition of AA-amyloid. The patient was started on prednisolone followed by azathioprine with rapid improvement of lung disease. However, due to progressing renal disease and clinical deterioration, prognosis was guarded and the patient died. We describe a case of secondary amyloidosis with systemic involvement and infrequent clinical manifestations, briefly reviewing the key aspects of Sjögren’s syndrome and AA-amyloidosis.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48386247","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}
Gerry George Mathew, Jayaprakash Varadharajan, Sreedhar Sailapathy
Introduction: Rituximab is the recent treatment of choice for primary membranous nephropathy However, dose of rituximab mentioned in literature is high and not economical in middle income countries. Low dose rituximab based on CD 19 cell count can be tried as an alternative for high dose rituximab for inducing clinical remission in appropriate clinical settings. Case Series: Four patients were administered low dose rituximab and initial CD 19 count was monitored for optimal rituximab response. Three males and one female are part of this case series. Renal biopsies showed membranous nephropathy with tissue phospholipase A2 receptor (PLA2R) positivity in two cases. Serum PLA2R was positive for the same two cases. Two patients completely remitted after one year, one male patient required additional rituximab dose based on CD19 count, one patient required single dose of rituximab for partial remission in the background of tacrolimus with steroids. One patient failed to remit on low dose rituximab protocol. Conclusion: Low dose Rituximab can be tried as a favorable alternative for high dose Rituximab in appropriate clinical settings.
{"title":"Case series of low dose rituximab for membranous nephropathy; a single centre experience","authors":"Gerry George Mathew, Jayaprakash Varadharajan, Sreedhar Sailapathy","doi":"10.34172/jnp.2023.21440","DOIUrl":"https://doi.org/10.34172/jnp.2023.21440","url":null,"abstract":"Introduction: Rituximab is the recent treatment of choice for primary membranous nephropathy However, dose of rituximab mentioned in literature is high and not economical in middle income countries. Low dose rituximab based on CD 19 cell count can be tried as an alternative for high dose rituximab for inducing clinical remission in appropriate clinical settings. Case Series: Four patients were administered low dose rituximab and initial CD 19 count was monitored for optimal rituximab response. Three males and one female are part of this case series. Renal biopsies showed membranous nephropathy with tissue phospholipase A2 receptor (PLA2R) positivity in two cases. Serum PLA2R was positive for the same two cases. Two patients completely remitted after one year, one male patient required additional rituximab dose based on CD19 count, one patient required single dose of rituximab for partial remission in the background of tacrolimus with steroids. One patient failed to remit on low dose rituximab protocol. Conclusion: Low dose Rituximab can be tried as a favorable alternative for high dose Rituximab in appropriate clinical settings.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42124925","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}
Introduction: Chronic renal failure (CRF) is a life-threatening condition which can be defined as a progressive and irreversible loss of renal function associated with inflammation and oxidative stress having limited treatment options. The anti-platelet drug, clopidogrel showed nephroprotective action in 5/6 nephrectomy model, lithium induced nephrogenic diabetes insipidus and diabetes-induced renal fibrosis. Objectives: In this study we evaluated the effect of clopidogrel on various serum, urine parameters linked with CRF, vascular calcification, electrolyte abnormalities, inflammatory markers and renal histology. Materials and Methods: Seven groups of male Wistar rats were treated with saline normal control), adenine (50 mg/kg, disease control), clopidogrel (15, 30, 60 mg/kg) concomitantly with adenine (preventive regimen), clopidogrel 60 mg/kg from day 15th curative regimen) and acetylcysteine (50 mg/kg) in combination with taurine as standard drug (50 mg/kg) from day 15th in a 4-week model. Following the completion of the treatments, urine, blood, and kidneys were collected from all rats, and then various biochemical, oxidative, and histological parameters were estimated. Results: Adenine administration decreased body weight and kidney function due to injury as indicated by increased markers like serum urea, uric acid, creatinine and potassium in all animals except normal control group. There was a significant difference between disease and test drug groups especially for 60 mg/kg of preventive and curative regimen for all the estimated parameters. Adenine administration caused histopathological alterations, significant reduction in antioxidant indices and initiated a fibrotic response in kidney by increasing the profibrotic protein like transforming growth factor-beta (TGF-β1). Conclusion: The results suggest that clopidogrel treatment improves majority of the parameters in a dose-dependent manner and the renoprotective effect might be associated with its antioxidant and anti- fibrosis activity.
{"title":"Evaluating the drug repurposing benefits of clopidogrel against adenine induced chronic renal failure in experimental animals","authors":"Rahul Hemani, Priyal Patel, Sandip Patel, Alkesh Patel","doi":"10.34172/jnp.2023.17363","DOIUrl":"https://doi.org/10.34172/jnp.2023.17363","url":null,"abstract":"Introduction: Chronic renal failure (CRF) is a life-threatening condition which can be defined as a progressive and irreversible loss of renal function associated with inflammation and oxidative stress having limited treatment options. The anti-platelet drug, clopidogrel showed nephroprotective action in 5/6 nephrectomy model, lithium induced nephrogenic diabetes insipidus and diabetes-induced renal fibrosis. Objectives: In this study we evaluated the effect of clopidogrel on various serum, urine parameters linked with CRF, vascular calcification, electrolyte abnormalities, inflammatory markers and renal histology. Materials and Methods: Seven groups of male Wistar rats were treated with saline normal control), adenine (50 mg/kg, disease control), clopidogrel (15, 30, 60 mg/kg) concomitantly with adenine (preventive regimen), clopidogrel 60 mg/kg from day 15th curative regimen) and acetylcysteine (50 mg/kg) in combination with taurine as standard drug (50 mg/kg) from day 15th in a 4-week model. Following the completion of the treatments, urine, blood, and kidneys were collected from all rats, and then various biochemical, oxidative, and histological parameters were estimated. Results: Adenine administration decreased body weight and kidney function due to injury as indicated by increased markers like serum urea, uric acid, creatinine and potassium in all animals except normal control group. There was a significant difference between disease and test drug groups especially for 60 mg/kg of preventive and curative regimen for all the estimated parameters. Adenine administration caused histopathological alterations, significant reduction in antioxidant indices and initiated a fibrotic response in kidney by increasing the profibrotic protein like transforming growth factor-beta (TGF-β1). Conclusion: The results suggest that clopidogrel treatment improves majority of the parameters in a dose-dependent manner and the renoprotective effect might be associated with its antioxidant and anti- fibrosis activity.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47705285","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}
K. Saberi, Ali Rahnama Sisakht, G. Sobhani, F. Zandiyeh, M.S. Golvardi Yazdi, Saeed Soltanizadeh, S. Rasta, Farshad Gharebakhshi, Mohamad Khaledi
Introduction: Contrast-induced acute kidney injury (CI-AKI) is a major acute renal failure that can be prevented by atorvastatin administration. This study aims to evaluate the association between atorvastatin use and CI-AKI incidence using a systematic review and meta-analysis approach. Materials and Methods: Several international databases, including Cochrane, Web of Science, Scopus, ProQuest, PubMed, and the Google Scholar search engine, were queried in this study. STATA 14 software was conducted to analyze the data. In this study, standardized mean difference (SMD) index was conducted to investigate the relationship between atorvastatin and serum creatinine level. Results: Twelve clinical trials with a total sample size of 3299 were retrieved. The effect of atorvastatin on serum creatinine levels indicated a SMD of -2.26 (95% CI: -2.53, -1.98) at a dose of 20 mg/kg, -0.76 (95% CI: -1.47, -0.05) at a dose of 40 mg/kg, -2.69 (95% CI: -2.96, -2.42) at a dose of 60 mg/ kg, and -0.03 (95% CI: -0.14, 0.09) at a dose of 80 mg/kg. The effect of atorvastatin use on serum creatinine levels achieved a SMD of -2.72 (95% CI: -3.02, -2.43) in the 40-49 years age group and a SMD of -0.96 (95% CI: -1.73, -0.19) in the 50-59 years age group. The effect of high-dose atorvastatin therapy in reducing the serum creatinine levels, compared to low-dose therapy, was a SMD of -0.54 (95% CI: -1.03, -0.04). However, estimates for the effect of atorvastatin compared to rosuvastatin and placebo showed a SMD of -0.26 (95% CI: -0.76, 0.24) and -1.23 (95% CI: -2.22, -0.25), respectively. The effect of atorvastatin on blood urea nitrogen (BUN) and high-sensitivity C-reactive protein (hs-CRP) levels relative to the comparison group was a SMD of -1.10 (95% CI: -1.61, -0.58) and -1.36 (95% CI: -2.30, -0.42) respectively. Conclusion: Pre-treatment with atorvastatin is effective in CI-AKI prevention. High-dose atorvastatin administration at younger ages provides the best outcome for preventing CI-AKI. Meta-analysis Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO website (ID: CRD42023397276, available at https:// www.crd.york.ac.uk/prospero/#recordDetails).
引言：造影剂诱导的急性肾损伤（CI-AKI）是一种主要的急性肾功能衰竭，阿托伐他汀可以预防。本研究旨在通过系统综述和荟萃分析方法评估阿托伐他汀的使用与CI-AKI发病率之间的关系。材料和方法：本研究查询了几个国际数据库，包括Cochrane、Web of Science、Scopus、ProQuest、PubMed和Google Scholar搜索引擎。使用STATA14软件对数据进行分析。本研究采用标准化平均差（SMD）指数研究阿托伐他汀与血清肌酐水平的关系。结果：检索到12项临床试验，总样本量为3299份。阿托伐他汀对血清肌酸酐水平的影响表明，20 mg/kg剂量时SMD为-2.26（95%CI:-2.53，-1.98），40 mg/kg剂量时的SMD为-0.76（95%CI:-1.47，-0.05），60 mg/kg剂量时为-2.69（95%CI:-2.96，-2.42），80 mg/kg剂量时，SMD为-0.03（95%CI:-0.14，0.09）。阿托伐他汀对40-49岁年龄组血清肌酸酐水平的影响达到-2.72（95%CI:3.02，-2.43），50-59岁年龄组的SMD达到-0.96（95%CI:1.73，-0.19）。与低剂量治疗相比，高剂量阿托伐他汀治疗在降低血清肌酸酐水平方面的SMD为-0.54（95%CI:1.03，-0.04）。然而，与瑞舒伐他汀和安慰剂相比，阿托伐伐他汀的疗效估计值分别为-0.26（95%CI:-0.760.24）和-1.23（95%CI:-2.22，-0.25）。与对照组相比，阿托伐他汀对血尿素氮（BUN）和高敏C反应蛋白（hs-CRP）水平的影响SMD分别为-1.10（95%CI:1.61，-0.58）和-1.36（95%CI:2.30，-0.42）。结论：阿托伐他汀治疗前预防CI-AKI是有效的。年轻时给予高剂量阿托伐他汀是预防CI-AKI的最佳结果。荟萃分析注册：本研究基于PRISMA检查表编制，其方案已在PROSPERO网站上注册（ID:CRD42023397276，可在https://www.crd.york.ac.uk/prostro/#recordDetails上获得）。
{"title":"The effects of atorvastatin on contrast-induced acute kidney injury; a systematic review and meta-analysis on clinical trials","authors":"K. Saberi, Ali Rahnama Sisakht, G. Sobhani, F. Zandiyeh, M.S. Golvardi Yazdi, Saeed Soltanizadeh, S. Rasta, Farshad Gharebakhshi, Mohamad Khaledi","doi":"10.34172/jnp.2023.21452","DOIUrl":"https://doi.org/10.34172/jnp.2023.21452","url":null,"abstract":"Introduction: Contrast-induced acute kidney injury (CI-AKI) is a major acute renal failure that can be prevented by atorvastatin administration. This study aims to evaluate the association between atorvastatin use and CI-AKI incidence using a systematic review and meta-analysis approach. Materials and Methods: Several international databases, including Cochrane, Web of Science, Scopus, ProQuest, PubMed, and the Google Scholar search engine, were queried in this study. STATA 14 software was conducted to analyze the data. In this study, standardized mean difference (SMD) index was conducted to investigate the relationship between atorvastatin and serum creatinine level. Results: Twelve clinical trials with a total sample size of 3299 were retrieved. The effect of atorvastatin on serum creatinine levels indicated a SMD of -2.26 (95% CI: -2.53, -1.98) at a dose of 20 mg/kg, -0.76 (95% CI: -1.47, -0.05) at a dose of 40 mg/kg, -2.69 (95% CI: -2.96, -2.42) at a dose of 60 mg/ kg, and -0.03 (95% CI: -0.14, 0.09) at a dose of 80 mg/kg. The effect of atorvastatin use on serum creatinine levels achieved a SMD of -2.72 (95% CI: -3.02, -2.43) in the 40-49 years age group and a SMD of -0.96 (95% CI: -1.73, -0.19) in the 50-59 years age group. The effect of high-dose atorvastatin therapy in reducing the serum creatinine levels, compared to low-dose therapy, was a SMD of -0.54 (95% CI: -1.03, -0.04). However, estimates for the effect of atorvastatin compared to rosuvastatin and placebo showed a SMD of -0.26 (95% CI: -0.76, 0.24) and -1.23 (95% CI: -2.22, -0.25), respectively. The effect of atorvastatin on blood urea nitrogen (BUN) and high-sensitivity C-reactive protein (hs-CRP) levels relative to the comparison group was a SMD of -1.10 (95% CI: -1.61, -0.58) and -1.36 (95% CI: -2.30, -0.42) respectively. Conclusion: Pre-treatment with atorvastatin is effective in CI-AKI prevention. High-dose atorvastatin administration at younger ages provides the best outcome for preventing CI-AKI. Meta-analysis Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO website (ID: CRD42023397276, available at https:// www.crd.york.ac.uk/prospero/#recordDetails).","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48490600","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}
Defined as the destruction of the skeletal muscle wall and the release of cellular contents into the bloodstream, rhabdomyolysis has been reported as a complication for some forms of vaccines. On the other hand, the COVID-19 pandemic has led to the extensive production and use of several vaccines against SARS-CoV-2, meanwhile, the side effects of these vaccines are gradually being reported. Up to now, few cases of rhabdomyolysis due to COVID-19 vaccination have been reported in the studies. The present study intended to report two cases of rhabdomyolysis due to vaccination with Oxford/AstraZeneca COVID-19 vaccines. The patients were two men aged 70 and 75 years old who presented to a healthcare facility with weakness, myalgia, nausea, and vomiting for about ten days after receiving their first dose of the Oxford/AstraZeneca COVID-19 vaccine. Patients had elevated levels of creatine phosphokinase (CPK), which were 5540 IU/L and 18760 IU/L in patients, respectively.
{"title":"Rhabdomyolysis following Oxford/AstraZeneca COVID-19 vaccination; two case reports from Iran","authors":"M. Hashemi, Ghazaleh Sajadi, Samaneh Pourajam","doi":"10.34172/jnp.2023.18408","DOIUrl":"https://doi.org/10.34172/jnp.2023.18408","url":null,"abstract":"Defined as the destruction of the skeletal muscle wall and the release of cellular contents into the bloodstream, rhabdomyolysis has been reported as a complication for some forms of vaccines. On the other hand, the COVID-19 pandemic has led to the extensive production and use of several vaccines against SARS-CoV-2, meanwhile, the side effects of these vaccines are gradually being reported. Up to now, few cases of rhabdomyolysis due to COVID-19 vaccination have been reported in the studies. The present study intended to report two cases of rhabdomyolysis due to vaccination with Oxford/AstraZeneca COVID-19 vaccines. The patients were two men aged 70 and 75 years old who presented to a healthcare facility with weakness, myalgia, nausea, and vomiting for about ten days after receiving their first dose of the Oxford/AstraZeneca COVID-19 vaccine. Patients had elevated levels of creatine phosphokinase (CPK), which were 5540 IU/L and 18760 IU/L in patients, respectively.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46353344","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}
Sreedhara C. Gurusiddaiah, Bhushan C Shetty, Kishan Aralapuram, S. Shetty, M. Shankar, M. Vankalakunti
Introduction: Tenofovir remains the cornerstone drug in various antiretroviral regimens and is commonly associated with renal failure in susceptible individuals with a renal biopsy suggestive of proximal tubular injury. Objectives: To investigate clinical, histopathological and outcome findings in tenofovir-induced nephrotoxicity patients. Patients and Methods: Between August 1, 2014, and March 31, 2017, an observational study was conducted in a government-run tertiary care facility in South India. All patients receiving a regimen based on tenofovir disoproxil fumarate (TDF) and testing positive for human immunodeficiency virus (HIV) were included. A renal biopsy was performed when needed. Results: A total of 27 cases were identified, with a mean age of 45.03± 12.95 years, while 19 (70%) of them were men. Mean creatinine and mean proteinuria among the participants were 5.78 ±2.71 mg/dL and 1643.96 ±1056.44 mg/dL, respectively, at the time of the renal biopsy. Interval between TDF treatments to kidney biopsies ranged between 7 to 52 weeks with mean (±SD) of 30.8±22 weeks. Phosphaturia and glycosuria were found in 10 (37.03%) and 8 (29.5%) patients respectively, all of whom had normoglycemia. In contrast to the remaining 13 instances, which all had moderate to severe diffuse inflammation, 14 patients exhibited toxic proximal tubular damage along with mild and localized interstitial inflammation. Hemodialysis was required by 10 individuals. A total of 22 patients were monitored after TDF was stopped, while 17 (77.27%) of them had fully recovered renal function at the end of monitoring period. Conclusion: This study demonstrates that TDF nephrotoxicity is a reversible form of toxic acute tubular necrosis with concurrent interstitial inflammation that affects the proximal tubules. As a result, it is crucial to carefully monitor renal parameters in these patients.
{"title":"Tenofovir induced acute kidney injury and its outcome; an Indian perspective","authors":"Sreedhara C. Gurusiddaiah, Bhushan C Shetty, Kishan Aralapuram, S. Shetty, M. Shankar, M. Vankalakunti","doi":"10.34172/jnp.2023.17306","DOIUrl":"https://doi.org/10.34172/jnp.2023.17306","url":null,"abstract":"Introduction: Tenofovir remains the cornerstone drug in various antiretroviral regimens and is commonly associated with renal failure in susceptible individuals with a renal biopsy suggestive of proximal tubular injury. Objectives: To investigate clinical, histopathological and outcome findings in tenofovir-induced nephrotoxicity patients. Patients and Methods: Between August 1, 2014, and March 31, 2017, an observational study was conducted in a government-run tertiary care facility in South India. All patients receiving a regimen based on tenofovir disoproxil fumarate (TDF) and testing positive for human immunodeficiency virus (HIV) were included. A renal biopsy was performed when needed. Results: A total of 27 cases were identified, with a mean age of 45.03± 12.95 years, while 19 (70%) of them were men. Mean creatinine and mean proteinuria among the participants were 5.78 ±2.71 mg/dL and 1643.96 ±1056.44 mg/dL, respectively, at the time of the renal biopsy. Interval between TDF treatments to kidney biopsies ranged between 7 to 52 weeks with mean (±SD) of 30.8±22 weeks. Phosphaturia and glycosuria were found in 10 (37.03%) and 8 (29.5%) patients respectively, all of whom had normoglycemia. In contrast to the remaining 13 instances, which all had moderate to severe diffuse inflammation, 14 patients exhibited toxic proximal tubular damage along with mild and localized interstitial inflammation. Hemodialysis was required by 10 individuals. A total of 22 patients were monitored after TDF was stopped, while 17 (77.27%) of them had fully recovered renal function at the end of monitoring period. Conclusion: This study demonstrates that TDF nephrotoxicity is a reversible form of toxic acute tubular necrosis with concurrent interstitial inflammation that affects the proximal tubules. As a result, it is crucial to carefully monitor renal parameters in these patients.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44384740","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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