M. Kahbazi, P. Yousefichaijan, D. Habibi, Somaie Nejabat, A. Najmi, F. Karimi
Introduction: The prevalence of urinary tract infections (UTIs) due to extended-spectrum beta-lactamase (ESBL)-producing bacteria is rising, which needs more potent antibiotics, such as carbapenems. Objectives: To evaluate the clinical and laboratory differences between ESBL-positive and ESBL-negative bacteria in febrile UTI in children between one month to seven years to indicate prognostic parameters for ESBL+ UTI and to suggest appropriate antibiotic treatment. Patients and Methods: This cross-sectional study investigated 282 patients diagnosed with the first febrile UTI. The participants were assigned to ESBL-positive and ESBL-negative UTI groups. The groups were compared based on their clinical and laboratory characteristics and outcomes; the infant group was assessed separately (with the onset age of <3 months). Results: The ESBL UTI was detected in 10.2% of the cases with a history of more frequent hospitalization (P=0.002), longer hospitalization (P=0.04), higher recurrence rate (P=0.003), and more red blood cell count in urine analysis findings (P=0.02). In the antimicrobial susceptibility assay, the ESBL-positive UTI group indicated resistance to third-generation cephalosporins; nevertheless, 93.1% of the cases responded clinically. The infant group showed 13% of the patients with ESBL-positive UTI that was correlated with a history of longer preonset hospital stay (P=0.001), elevated C-reactive protein (CRP) concentration (P=0.002), and elevated recurrence rate (P=0.03), compared to the older group. Conclusion: The ESBL UTI should be further considered due to the resulted recurrence rate. The antimicrobial sensitivity assay indicated resistance to third-generation cephalosporins; however, these drugs are applied as the first choice due to the high response rate. Aminoglycosides are applicable as second choice drugs prior to initiating the use of carbapenems, if third-generation cephalosporins did not indicate bactericidal impacts on ESBL UTI.
{"title":"Clinical and laboratory differences between extended-spectrum β-lactamase-positive and extended-spectrum β-lactamase-negative bacteria in febrile urinary tract infection in pediatrics","authors":"M. Kahbazi, P. Yousefichaijan, D. Habibi, Somaie Nejabat, A. Najmi, F. Karimi","doi":"10.34172/jrip.2022.02","DOIUrl":"https://doi.org/10.34172/jrip.2022.02","url":null,"abstract":"\u0000 Introduction: The prevalence of urinary tract infections (UTIs) due to extended-spectrum beta-lactamase (ESBL)-producing bacteria is rising, which needs more potent antibiotics, such as carbapenems. Objectives: To evaluate the clinical and laboratory differences between ESBL-positive and ESBL-negative bacteria in febrile UTI in children between one month to seven years to indicate prognostic parameters for ESBL+ UTI and to suggest appropriate antibiotic treatment. Patients and Methods: This cross-sectional study investigated 282 patients diagnosed with the first febrile UTI. The participants were assigned to ESBL-positive and ESBL-negative UTI groups. The groups were compared based on their clinical and laboratory characteristics and outcomes; the infant group was assessed separately (with the onset age of <3 months). Results: The ESBL UTI was detected in 10.2% of the cases with a history of more frequent hospitalization (P=0.002), longer hospitalization (P=0.04), higher recurrence rate (P=0.003), and more red blood cell count in urine analysis findings (P=0.02). In the antimicrobial susceptibility assay, the ESBL-positive UTI group indicated resistance to third-generation cephalosporins; nevertheless, 93.1% of the cases responded clinically. The infant group showed 13% of the patients with ESBL-positive UTI that was correlated with a history of longer preonset hospital stay (P=0.001), elevated C-reactive protein (CRP) concentration (P=0.002), and elevated recurrence rate (P=0.03), compared to the older group. Conclusion: The ESBL UTI should be further considered due to the resulted recurrence rate. The antimicrobial sensitivity assay indicated resistance to third-generation cephalosporins; however, these drugs are applied as the first choice due to the high response rate. Aminoglycosides are applicable as second choice drugs prior to initiating the use of carbapenems, if third-generation cephalosporins did not indicate bactericidal impacts on ESBL UTI.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46617742","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 : 2021-07-13DOI: 10.34172/jrip.2022.27829
B. Hadian, Azita Zafarmohtashami, Mahdi Razani
Introduction: The 2019 recent coronavirus disease (COVID- 19) is a novel pandemic disease in the world. The main organ involved in this viral sepsis is the respiratory system. Objectives: Regarding the expression of angiotensin-converting enzyme (ACE) receptors as entering route for virus’ particles into cells, the kidney organ is another important target in this catastrophic sepsis. There is little data about renal complications and related risk factors in victims. Patients and Methods: All patients with COVID-19 admitted to a referral and tertiary center (Shohada hospital, Khorramabad, Iran) were included in the study. The research was performed from February 20 to April 19, 2020. Diagnosis of patients was confirmed by COVID-19 upper respiratory sampling using real-time PCR. Patients’ demographic data, clinical and laboratory variables were included in pre-designed questionnaires according to the considered factors; then all collected data was entered into SPSS-26 software and statistical analysis was performed. Results: All COVID-19 patients included in the study were 232 cases. Out of them, 99 cases were female (42.7%) and 133 males (57.3%). Among patients, 19 cases had AKI (acute kidney injury); of these cases. Out of AKI patients, 12 (63.2%) were admitted to the ICU, whereas the mortality rate in patients with AKI was 63.2%. AKI was significantly associated with older age, ICU admission, and lower lymphocyte count. AKI occurrence was associated with the history of hypertension, or underlying kidney disease but hadn’t a significant relationship with diabetes. Conclusion: According to this study, age is an important risk factor for renal disease and poor outcomes in COVID-19 patients. Hence, old age patients should be given more attention. Concerning more prevalence of potassium disorders, further monitoring of hypokalemia or hyperkalemia is recommended. Considering, poor outcomes in patients with COVID-19 and AKI, nephrologist’s consultation is necessary.
{"title":"Investigation of acute kidney injury and related risk factors in patients with COVID-19","authors":"B. Hadian, Azita Zafarmohtashami, Mahdi Razani","doi":"10.34172/jrip.2022.27829","DOIUrl":"https://doi.org/10.34172/jrip.2022.27829","url":null,"abstract":"Introduction: The 2019 recent coronavirus disease (COVID- 19) is a novel pandemic disease in the world. The main organ involved in this viral sepsis is the respiratory system. Objectives: Regarding the expression of angiotensin-converting enzyme (ACE) receptors as entering route for virus’ particles into cells, the kidney organ is another important target in this catastrophic sepsis. There is little data about renal complications and related risk factors in victims. Patients and Methods: All patients with COVID-19 admitted to a referral and tertiary center (Shohada hospital, Khorramabad, Iran) were included in the study. The research was performed from February 20 to April 19, 2020. Diagnosis of patients was confirmed by COVID-19 upper respiratory sampling using real-time PCR. Patients’ demographic data, clinical and laboratory variables were included in pre-designed questionnaires according to the considered factors; then all collected data was entered into SPSS-26 software and statistical analysis was performed. Results: All COVID-19 patients included in the study were 232 cases. Out of them, 99 cases were female (42.7%) and 133 males (57.3%). Among patients, 19 cases had AKI (acute kidney injury); of these cases. Out of AKI patients, 12 (63.2%) were admitted to the ICU, whereas the mortality rate in patients with AKI was 63.2%. AKI was significantly associated with older age, ICU admission, and lower lymphocyte count. AKI occurrence was associated with the history of hypertension, or underlying kidney disease but hadn’t a significant relationship with diabetes. Conclusion: According to this study, age is an important risk factor for renal disease and poor outcomes in COVID-19 patients. Hence, old age patients should be given more attention. Concerning more prevalence of potassium disorders, further monitoring of hypokalemia or hyperkalemia is recommended. Considering, poor outcomes in patients with COVID-19 and AKI, nephrologist’s consultation is necessary.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48682947","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}
Raghad Abdulsalam Khaleel, Narjes Alfuraiji, Balsam Waleed Hussain, M. F. Nassar, F. Ebrahimzadeh
Introduction: The newly-launched strain of the Staphylococcus aureus, methicillin-resistant S. aureus, is considered the most emerging bacterium in-hospital infections globally. Objectives: The current research focused on the prevalence and virulence features of methicillin-resistant S. aureus (MRSA) bacteria recovered from urinary tract infections (UTIs) cases. Patients and Methods: A total of 710 urine specimens were taken from hospitalized patients who suffered from UTIs. S. aureus was recovered from urine specimens using the microbial culture. S. aureus antimicrobial susceptibility was assessed toward oxacillin and cefoxitin antimicrobial disk to determine the MRSA strains. The polymerase chain reaction (PCR) assessed the distribution of antimicrobial resistance encoding genes. S. aureus antimicrobial resistance was evaluated by disk diffusion. Results: Fifty-five out of 710 (7.7%) urine specimens were positive for the MRSA bacteria. The uppermost antibiotic resistance was obtained against penicillin (100%), ceftaroline (100%), gentamicin (87.2%), erythromycin (76.3%), and ciprofloxacin (69.0%). BlaZ (100%) and tetK (85.4%) had the higher frequency amid examined antimicrobial resistance-encoding genes. Conclusion: The high prevalence of MRSA isolates harboring antimicrobial resistance-encoding genes in the UTIs suggests that diseases caused by them need more expansion healthcare monitoring with essential demand for novel antimicrobials.
{"title":"Methicillin-resistant Staphylococcus aureus in urinary tract infections; prevalence and antimicrobial resistance","authors":"Raghad Abdulsalam Khaleel, Narjes Alfuraiji, Balsam Waleed Hussain, M. F. Nassar, F. Ebrahimzadeh","doi":"10.34172/jrip.2022.08","DOIUrl":"https://doi.org/10.34172/jrip.2022.08","url":null,"abstract":"\u0000 Introduction: The newly-launched strain of the Staphylococcus aureus, methicillin-resistant S. aureus, is considered the most emerging bacterium in-hospital infections globally. Objectives: The current research focused on the prevalence and virulence features of methicillin-resistant S. aureus (MRSA) bacteria recovered from urinary tract infections (UTIs) cases. Patients and Methods: A total of 710 urine specimens were taken from hospitalized patients who suffered from UTIs. S. aureus was recovered from urine specimens using the microbial culture. S. aureus antimicrobial susceptibility was assessed toward oxacillin and cefoxitin antimicrobial disk to determine the MRSA strains. The polymerase chain reaction (PCR) assessed the distribution of antimicrobial resistance encoding genes. S. aureus antimicrobial resistance was evaluated by disk diffusion. Results: Fifty-five out of 710 (7.7%) urine specimens were positive for the MRSA bacteria. The uppermost antibiotic resistance was obtained against penicillin (100%), ceftaroline (100%), gentamicin (87.2%), erythromycin (76.3%), and ciprofloxacin (69.0%). BlaZ (100%) and tetK (85.4%) had the higher frequency amid examined antimicrobial resistance-encoding genes. Conclusion: The high prevalence of MRSA isolates harboring antimicrobial resistance-encoding genes in the UTIs suggests that diseases caused by them need more expansion healthcare monitoring with essential demand for novel antimicrobials.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47787717","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 : 2021-07-01DOI: 10.34172/jrip.2022.28847
S. Roupakias, X. Sinopidis, I. Spyridakis, A. Karatza, A. Varvarigou, G. Tsikopoulos
Introduction: Endoscopic injection treatment (EIT) for vesicoureteral reflux (VUR) correction is widely accepted as an optimal method for more than thirty years. However, it is still in its infancy in many pediatric surgical centers. It presents variable cure rates, with many factors affecting its successfulness. Objectives: We aimed to identify how accumulated endoscopic experience affected the VUR resolution success rates, in association with a variety of characteristics, since the beginning of practicing the technique. We attempt to improve patient selection. Patients and Methods: The outcomes of 53 children, corresponding to 78 refluxing ureteral units (RUUs), treated with endoscopic injection during the first years of practice (2010-2016), and 26 children with 42 RUUs during the latest years (2017-2020), were compared. Characteristics such as age, gender, VUR grades, preoperative voiding cystogram and dimercaptosuccinic acid scintigraphy, side, laterality were analyzed in relation with outcome of the groups of the study population. Outcomes presenting statistically significant differences were considered related to experience. Results: Refluxing ureters of the second group presented significant improved endoscopic treatment success rates and also significant reduced need for open surgery. The second group of experienced performance presented significant improved success rates in younger children, in girls, in children with bilateral VUR or duplex ureteral system, and when reflux presented at the filling phase of voiding cystourethrogram. Furthermore, the second group of experienced performance presented significant improved success rates in ureteral units of a duplex system or with grade III and high grades IV-V VUR. Conclusion: Our initial experience with EIT has been promising. Boys, and children with bilateral VUR or duplex ureteral system should be treated by more experienced endoscopic surgeons. Furthermore, high grade VUR is a predisposing factor for endoscopic treatment failure, performing by less experienced surgeons. Pediatric surgeons must upgrade their learning curve, initiating their experience, and developing their surgical skills with more simple cases before expanding their practice to more complicated.
{"title":"The impact of our acquired experience on endoscopic injection treatment outcomes of vesicoureteral reflux during the first ten years of practice","authors":"S. Roupakias, X. Sinopidis, I. Spyridakis, A. Karatza, A. Varvarigou, G. Tsikopoulos","doi":"10.34172/jrip.2022.28847","DOIUrl":"https://doi.org/10.34172/jrip.2022.28847","url":null,"abstract":"Introduction: Endoscopic injection treatment (EIT) for vesicoureteral reflux (VUR) correction is widely accepted as an optimal method for more than thirty years. However, it is still in its infancy in many pediatric surgical centers. It presents variable cure rates, with many factors affecting its successfulness. Objectives: We aimed to identify how accumulated endoscopic experience affected the VUR resolution success rates, in association with a variety of characteristics, since the beginning of practicing the technique. We attempt to improve patient selection. Patients and Methods: The outcomes of 53 children, corresponding to 78 refluxing ureteral units (RUUs), treated with endoscopic injection during the first years of practice (2010-2016), and 26 children with 42 RUUs during the latest years (2017-2020), were compared. Characteristics such as age, gender, VUR grades, preoperative voiding cystogram and dimercaptosuccinic acid scintigraphy, side, laterality were analyzed in relation with outcome of the groups of the study population. Outcomes presenting statistically significant differences were considered related to experience. Results: Refluxing ureters of the second group presented significant improved endoscopic treatment success rates and also significant reduced need for open surgery. The second group of experienced performance presented significant improved success rates in younger children, in girls, in children with bilateral VUR or duplex ureteral system, and when reflux presented at the filling phase of voiding cystourethrogram. Furthermore, the second group of experienced performance presented significant improved success rates in ureteral units of a duplex system or with grade III and high grades IV-V VUR. Conclusion: Our initial experience with EIT has been promising. Boys, and children with bilateral VUR or duplex ureteral system should be treated by more experienced endoscopic surgeons. Furthermore, high grade VUR is a predisposing factor for endoscopic treatment failure, performing by less experienced surgeons. Pediatric surgeons must upgrade their learning curve, initiating their experience, and developing their surgical skills with more simple cases before expanding their practice to more complicated.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49438425","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}
Mohammed Makkawi, S. Alasmari, N. Shubayr, Y. Alashban, G. Zaman, N. Eisa, Hussain Khairy, Ahmed Hadi, Najla Mawkili
Introduction: Chronic radiation exposure, particularly among technicians using medical imaging instruments, may contribute to chronic disease, including renal dysfunction. Investigating the potential association of this exposure with biochemical changes may assist disease detection and prevention. Objectives: The study explores the risk of renal dysfunction among radiologic technologists (RTs) with ten years or more of diagnostic imaging experience to evaluate the association of accumulated radiation doses and possible renal injury. Patients and Methods: A retrospective analysis was performed on the effective accumulative radiation dose from 2009 to 2019 among RTs of radiological department at a general hospital in southern Saudi Arabia. Blood samples were collected, and key biomarkers analyzed using a fully automated biochemical analyzer. Serum levels of the following were measured; sodium, gamma-glutamyl transferase (GGT), chloride, creatine kinase (CK), calcium, albumin, urea, creatinine, lactate dehydrogenase, total protein and potassium. In statistical analysis, P<0.05 was considered significant. Results: Even with exposure to only low-level radiation sources, RTs were statistically predisposed to variation in biochemical profiles. RTs exhibited GGT and CK levels higher than that of controls, while serum chloride was significantly low. Conclusion: The current study found a significant change in renal biochemical profiles among RTs who had worked in a radiological department for more than ten years. The association between GGT, CK with Kidney diseases was reported in several reports. Chronic exposure to radiation may contribute to a rise in GGT and CK levels and reduction of chloride and thus could develop the risk of renal diseases.
{"title":"Investigating the consequence of chronic exposure to radiation on renal biomarkers among selected radiologic technologists","authors":"Mohammed Makkawi, S. Alasmari, N. Shubayr, Y. Alashban, G. Zaman, N. Eisa, Hussain Khairy, Ahmed Hadi, Najla Mawkili","doi":"10.34172/jrip.2021.26","DOIUrl":"https://doi.org/10.34172/jrip.2021.26","url":null,"abstract":"\u0000 Introduction: Chronic radiation exposure, particularly among technicians using medical imaging instruments, may contribute to chronic disease, including renal dysfunction. Investigating the potential association of this exposure with biochemical changes may assist disease detection and prevention. Objectives: The study explores the risk of renal dysfunction among radiologic technologists (RTs) with ten years or more of diagnostic imaging experience to evaluate the association of accumulated radiation doses and possible renal injury. Patients and Methods: A retrospective analysis was performed on the effective accumulative radiation dose from 2009 to 2019 among RTs of radiological department at a general hospital in southern Saudi Arabia. Blood samples were collected, and key biomarkers analyzed using a fully automated biochemical analyzer. Serum levels of the following were measured; sodium, gamma-glutamyl transferase (GGT), chloride, creatine kinase (CK), calcium, albumin, urea, creatinine, lactate dehydrogenase, total protein and potassium. In statistical analysis, P<0.05 was considered significant. Results: Even with exposure to only low-level radiation sources, RTs were statistically predisposed to variation in biochemical profiles. RTs exhibited GGT and CK levels higher than that of controls, while serum chloride was significantly low. Conclusion: The current study found a significant change in renal biochemical profiles among RTs who had worked in a radiological department for more than ten years. The association between GGT, CK with Kidney diseases was reported in several reports. Chronic exposure to radiation may contribute to a rise in GGT and CK levels and reduction of chloride and thus could develop the risk of renal diseases.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48525091","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}
Telma Zahirian Moghadam, Hamed Mohseni Rad, A. Hossein Khani, A. Ghazi
Introduction: Access by ultrasonography rather than fluoroscopy in addition to reducing radiation exposure to the patient and staff, is safe and effective. Access by ultrasonography is bi-planar and real-time compared to fluoroscopy, because it provides fewer side effects and more stone free rate. Objectives: To study the complications and outcome of PCNL (percutaneous nephrolithotomy) with or without using ureteral catheter. Patients and Methods: We studied 59 patients with at least 2 cm diameter of renal stone from January to December of 2018. After general anesthesia, 35 patients in the ureteral stent group were prepared in bladder lithotomy position. Then 5-French (Fr) ureteral catheters were introduced endoscopically in stone affected side and fixed to 16 Fr urethral Foley catheters in the patients. Other 24 patients in the non-stent group following anesthesia were directed to prone position instantly. In all of the patients, ultrasonography was performed in posterior auxiliary line below the ribs in prone position. Retrograde instillation of normal saline was performed through ureteral catheter in stent-group. Then we inserted 18G Chiba needle to desired calyx without needle holder guidance in all patients. Our approach according to probe was transverse. Results: Our patients comprised of 24 men and 35 women aged 24 to 66 years. Thirteen of them had no hydronephrosis and their stone sizes ranged from 21 mm to 65 mm. Patients in the ureteral stent group were more obese compared to the non-stent group (P=0.02) in addition to significantly more operation time (P=0.03). However hydronephrosis was not significantly different between groups (P=0.3). Postoperative residual stone rate, hospital stay days and complications (Fever, blood transfusion) were the same between both groups. Only urinary leak was more common in the non-stent group (P=0.04) Conclusion: Ultra-sonographic-PCNL without inserting ureteral catheter before surgery is conceivable especially in patients with lower body mass index (BMI). Advantages and complications are same in ureteral stent and non-stent patients except urinary leak that is more common in non-stent patients.
{"title":"Ultrasonographic percutaneous nephrolithotomy, with or without ureteral catheter","authors":"Telma Zahirian Moghadam, Hamed Mohseni Rad, A. Hossein Khani, A. Ghazi","doi":"10.34172/jrip.2022.07","DOIUrl":"https://doi.org/10.34172/jrip.2022.07","url":null,"abstract":"\u0000 Introduction: Access by ultrasonography rather than fluoroscopy in addition to reducing radiation exposure to the patient and staff, is safe and effective. Access by ultrasonography is bi-planar and real-time compared to fluoroscopy, because it provides fewer side effects and more stone free rate. Objectives: To study the complications and outcome of PCNL (percutaneous nephrolithotomy) with or without using ureteral catheter. Patients and Methods: We studied 59 patients with at least 2 cm diameter of renal stone from January to December of 2018. After general anesthesia, 35 patients in the ureteral stent group were prepared in bladder lithotomy position. Then 5-French (Fr) ureteral catheters were introduced endoscopically in stone affected side and fixed to 16 Fr urethral Foley catheters in the patients. Other 24 patients in the non-stent group following anesthesia were directed to prone position instantly. In all of the patients, ultrasonography was performed in posterior auxiliary line below the ribs in prone position. Retrograde instillation of normal saline was performed through ureteral catheter in stent-group. Then we inserted 18G Chiba needle to desired calyx without needle holder guidance in all patients. Our approach according to probe was transverse. Results: Our patients comprised of 24 men and 35 women aged 24 to 66 years. Thirteen of them had no hydronephrosis and their stone sizes ranged from 21 mm to 65 mm. Patients in the ureteral stent group were more obese compared to the non-stent group (P=0.02) in addition to significantly more operation time (P=0.03). However hydronephrosis was not significantly different between groups (P=0.3). Postoperative residual stone rate, hospital stay days and complications (Fever, blood transfusion) were the same between both groups. Only urinary leak was more common in the non-stent group (P=0.04) Conclusion: Ultra-sonographic-PCNL without inserting ureteral catheter before surgery is conceivable especially in patients with lower body mass index (BMI). Advantages and complications are same in ureteral stent and non-stent patients except urinary leak that is more common in non-stent patients.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48394548","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}
Behzad Abbasi Jamaati, R. Ghorbani, M. Zahmatkesh, M. Tamadon
Introduction: Cardiovascular events are the most important complications of end-stage renal disease (ESRD). The role of fetuin-A and vascular calcification inhibitors in cardiovascular complications, dysregulated biochemical markers, and mortality is uncertain in patients under hemodialysis. Objectives: The aim of this study was to investigate the relationship of fetuin-A with cardiovascular complications and biochemical markers in hemodialysis patients. Patients and Methods: In this cross-sectional study, 65 patients undergoing hemodialysis were enrolled. Blood samples were taken at pre-dialysis to determine serum fetuin-A, calcium, phosphorus, intact parathyroid hormone (iPTH), C-reactive protein (CRP), albumin, triglyceride, total cholesterol, as well as blood hemoglobin, and hematocrit. The data was analyzed considering the statistical significance level of 0.05. Results: Out of 65 patients, seven patients died during the study, and 58 patients were finally evaluated. Mean (±SD) serum fetuin-A level was 1268.71 ± 1229.4 μg/mL. There was no significant difference in the mean fetuin-A level between genders (P=0.904). There were no significant correlations between the serum level of fetuin-A and age, duration of dialysis, heart diseases, serum levels of calcium, phosphorus, PTH, albumin, CRP, cholesterol and finally blood hemoglobin. However, significant relationships were found between fetuin-A level and serum triglyceride (TG) level (P=0.019) and body mass index (BMI) (P=0.024). Conclusion: Fetuin-A level was significantly associated with serum TG level and BMI. Regarding the links of obesity and hypertriglyceridemia with cardiovascular diseases (CVDs), controlling serum TG level and body weight can reduce the risk of vascular atherosclerosis in patients undergoing dialysis.
{"title":"Serum fetuin-A levels and its relationship with biochemical parameters in hemodialysis patients","authors":"Behzad Abbasi Jamaati, R. Ghorbani, M. Zahmatkesh, M. Tamadon","doi":"10.34172/jrip.2022.06","DOIUrl":"https://doi.org/10.34172/jrip.2022.06","url":null,"abstract":"\u0000 Introduction: Cardiovascular events are the most important complications of end-stage renal disease (ESRD). The role of fetuin-A and vascular calcification inhibitors in cardiovascular complications, dysregulated biochemical markers, and mortality is uncertain in patients under hemodialysis. Objectives: The aim of this study was to investigate the relationship of fetuin-A with cardiovascular complications and biochemical markers in hemodialysis patients. Patients and Methods: In this cross-sectional study, 65 patients undergoing hemodialysis were enrolled. Blood samples were taken at pre-dialysis to determine serum fetuin-A, calcium, phosphorus, intact parathyroid hormone (iPTH), C-reactive protein (CRP), albumin, triglyceride, total cholesterol, as well as blood hemoglobin, and hematocrit. The data was analyzed considering the statistical significance level of 0.05. Results: Out of 65 patients, seven patients died during the study, and 58 patients were finally evaluated. Mean (±SD) serum fetuin-A level was 1268.71 ± 1229.4 μg/mL. There was no significant difference in the mean fetuin-A level between genders (P=0.904). There were no significant correlations between the serum level of fetuin-A and age, duration of dialysis, heart diseases, serum levels of calcium, phosphorus, PTH, albumin, CRP, cholesterol and finally blood hemoglobin. However, significant relationships were found between fetuin-A level and serum triglyceride (TG) level (P=0.019) and body mass index (BMI) (P=0.024). Conclusion: Fetuin-A level was significantly associated with serum TG level and BMI. Regarding the links of obesity and hypertriglyceridemia with cardiovascular diseases (CVDs), controlling serum TG level and body weight can reduce the risk of vascular atherosclerosis in patients undergoing dialysis.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46765709","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}
H. Nourmohammadi, Zahra Abdan, Melina Ramezanpour, Razieh Abdollahipour, Diana Sarokhani, M. Fakhri, A. Hasanpour Dehkordi
Introduction: Anemia is a common complication of chronic kidney disease (CKD) due to the insufficient production of erythropoietin by the kidneys. The administration of erythropoietin is one of the most common methods for the treatment of patients with anemia. Objectives: This study aimed to investigate the effect of the administration of synthetic erythropoietin on hemoglobin levels in dialysis patients using a systematic review and meta-analysis. Methods: In order to identify the related studies, the international databases of Web of Science, PubMed, Scopus, and Embase were searched from 2015 to 2020 using standard and valid keywords. The data were analyzed using STATA software (version 14), and a p-value of less than 0.05 was considered statistically significant. Results: In 12 reviewed articles with a sample size of 4,060 individuals, the standard effect size of the effect of synthetic erythropoietin on Hb in dialysis patients was reported as 2.08 (95% CI: 1.53-2.63), which was statistically significant; however, erythropoietin biosimilars did not show similar results. Conclusion: The administration of erythropoietin to hemodialysis patients increases Hb levels by more than 2 units.
简介：贫血是慢性肾脏疾病（CKD）的常见并发症，原因是肾脏产生的红细胞生成素不足。红细胞生成素的给药是治疗贫血患者最常见的方法之一。目的：本研究旨在通过系统综述和荟萃分析研究合成红细胞生成素对透析患者血红蛋白水平的影响。方法：为了确定相关研究，使用标准有效的关键词检索2015年至2020年的国际数据库Web of Science、PubMed、Scopus和Embase。使用STATA软件（版本14）对数据进行分析，p值小于0.05被认为具有统计学意义。结果：在12篇样本量为4060人的综述文章中，合成红细胞生成素对透析患者Hb影响的标准效应大小为2.08（95%CI:1.53-2.63），具有统计学意义；然而，红细胞生成素生物类似物并没有显示出类似的结果。结论：血液透析患者应用促红细胞生成素可使Hb水平升高2个单位以上。
{"title":"A systematic review and meta-analysis of effect of synthetic erythropoietin on hemoglobin in dialysis patients","authors":"H. Nourmohammadi, Zahra Abdan, Melina Ramezanpour, Razieh Abdollahipour, Diana Sarokhani, M. Fakhri, A. Hasanpour Dehkordi","doi":"10.34172/jrip.2021.28","DOIUrl":"https://doi.org/10.34172/jrip.2021.28","url":null,"abstract":"\u0000 Introduction: Anemia is a common complication of chronic kidney disease (CKD) due to the insufficient production of erythropoietin by the kidneys. The administration of erythropoietin is one of the most common methods for the treatment of patients with anemia. Objectives: This study aimed to investigate the effect of the administration of synthetic erythropoietin on hemoglobin levels in dialysis patients using a systematic review and meta-analysis. Methods: In order to identify the related studies, the international databases of Web of Science, PubMed, Scopus, and Embase were searched from 2015 to 2020 using standard and valid keywords. The data were analyzed using STATA software (version 14), and a p-value of less than 0.05 was considered statistically significant. Results: In 12 reviewed articles with a sample size of 4,060 individuals, the standard effect size of the effect of synthetic erythropoietin on Hb in dialysis patients was reported as 2.08 (95% CI: 1.53-2.63), which was statistically significant; however, erythropoietin biosimilars did not show similar results. Conclusion: The administration of erythropoietin to hemodialysis patients increases Hb levels by more than 2 units.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41388898","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 : 2021-04-12DOI: 10.34172/jrip.2022.26827
A. Zeraati, F. Sharifipour, M. Hami, Z. Ataee, mohamad samadi, K. samadi, Tina Zeraati
Introduction: The relationships between serum magnesium(Mg) levels and body composition or clinical outcomes of incident dialysis patients remain unclear. The aim of this study was to evaluate the possible correlations between magnesium and bio-electrical impedance variables, a method of determining body composition in two groups of hemodialysis(HD) and peritoneal dialysis(PD) patients. Methods: This prospective observational study examined the relationships between Serum Mg levels and Bio-impedance variables including total body fat, body cell mass, extra cellular mass, total body water (TBW), intra and extra cellular water (ICW and ECW), ECW/ICW and phase angle (PA) in incident 38 HD and 34 PD patients since December of 2012 in Mashhad Imam Reza Hospital dialysis center. The correlation between Mg and bio-impedance variables was assessed applying the student test and Pearson’s correlation coefficient. Results: the average concentration of serum Mg was 1.22 mmol/L in HD patients and 1.20 mmol/L in PD patients which is well above the reference range in normal population. the average amount of body water and also ICW in patients were significantly higher than HD patients. Our statistical analysis showed no significant relation between serum Mg and Bio-electrical impedance variables in HD patients, however in PD patients, a statistically significant correlation was found between serum Mg and ECW (r = 0.48, p = 0.02), ICW (r =- 0.48, p = 0.02), and ECW/ICW (r = 0.43, p = 0.02). Conclusion: we speculated that there is a link between serum Mg level and intravascular and extravascular water content in PD patients, however we cannot prove any correlation between serum Mg level and Bio-impedance variables in such patients. This could be considered as a sign of Mg role in healthy cell function in PD patients.
摘要:急性透析患者血清镁(Mg)水平与机体成分或临床结局之间的关系尚不清楚。本研究的目的是评估镁和生物电阻抗变量之间可能的相关性，生物电阻抗是测定两组血液透析(HD)和腹膜透析(PD)患者身体成分的一种方法。方法:本前瞻性观察研究了2012年12月以来马什哈德伊玛姆雷扎医院透析中心38例HD和34例PD患者血清Mg水平与生物阻抗变量(体脂、体细胞质量、细胞外质量、总水(TBW)、细胞内和细胞外水(ICW和ECW)、ECW/ICW和相位角(PA)的关系。应用学生测试和Pearson相关系数评估Mg与生物阻抗变量之间的相关性。结果:HD患者血清Mg的平均浓度为1.22 mmol/L, PD患者血清Mg的平均浓度为1.20 mmol/L，远高于正常人群的参考范围。患者的平均体水量和ICW均显著高于HD患者。我们的统计分析显示，HD患者血清Mg与生物电阻抗变量之间无显著相关性，而PD患者血清Mg与ECW (r = 0.48, p = 0.02)、ICW (r =- 0.48, p = 0.02)、ECW/ICW (r = 0.43, p = 0.02)有显著相关性。结论:我们推测PD患者血清Mg水平与血管内和血管外水分含量之间存在联系，但我们无法证明PD患者血清Mg水平与生物阻抗变量之间存在相关性。这可能被认为是Mg在PD患者健康细胞功能中的作用的标志。
{"title":"The relationship between serum magnesium and bio-electrical impedance variables in patients undergoing dialysis","authors":"A. Zeraati, F. Sharifipour, M. Hami, Z. Ataee, mohamad samadi, K. samadi, Tina Zeraati","doi":"10.34172/jrip.2022.26827","DOIUrl":"https://doi.org/10.34172/jrip.2022.26827","url":null,"abstract":"Introduction: The relationships between serum magnesium(Mg) levels and body composition or clinical outcomes of incident dialysis patients remain unclear. The aim of this study was to evaluate the possible correlations between magnesium and bio-electrical impedance variables, a method of determining body composition in two groups of hemodialysis(HD) and peritoneal dialysis(PD) patients. Methods: This prospective observational study examined the relationships between Serum Mg levels and Bio-impedance variables including total body fat, body cell mass, extra cellular mass, total body water (TBW), intra and extra cellular water (ICW and ECW), ECW/ICW and phase angle (PA) in incident 38 HD and 34 PD patients since December of 2012 in Mashhad Imam Reza Hospital dialysis center. The correlation between Mg and bio-impedance variables was assessed applying the student test and Pearson’s correlation coefficient. Results: the average concentration of serum Mg was 1.22 mmol/L in HD patients and 1.20 mmol/L in PD patients which is well above the reference range in normal population. the average amount of body water and also ICW in patients were significantly higher than HD patients. Our statistical analysis showed no significant relation between serum Mg and Bio-electrical impedance variables in HD patients, however in PD patients, a statistically significant correlation was found between serum Mg and ECW (r = 0.48, p = 0.02), ICW (r =- 0.48, p = 0.02), and ECW/ICW (r = 0.43, p = 0.02). Conclusion: we speculated that there is a link between serum Mg level and intravascular and extravascular water content in PD patients, however we cannot prove any correlation between serum Mg level and Bio-impedance variables in such patients. This could be considered as a sign of Mg role in healthy cell function in PD patients.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42969298","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}
B. Daminov, S. Abdullaev, O. Sharapov, R. Igamberdieva
The mini-review presents modern data on the epidemiology, clinical and morphological aspects of kidney damage in COVID-19. Potential mechanisms of kidney involvement in the clinical picture of the disease may include cytokine damage, cross-organ damage, and systemic effects that determine the treatment strategy. These mechanisms are closely interrelated and are especially important for individuals undergoing extracorporeal therapy and kidney transplants. Autopsy data provide evidence of SARS-CoV-2 virus invasion into kidney tissue with damage to tubular epithelial cells and podocytes, and erythrocyte aggregation in persons with severe COVID-19. By including people with chronic kidney disease in planned COVID-19 research protocols, an evidence base for effective and safe treatments can be generated.
{"title":"Epidemiological, clinical and morphological aspects of kidney damage in COVID-19","authors":"B. Daminov, S. Abdullaev, O. Sharapov, R. Igamberdieva","doi":"10.34172/jrip.2021.17","DOIUrl":"https://doi.org/10.34172/jrip.2021.17","url":null,"abstract":"The mini-review presents modern data on the epidemiology, clinical and morphological aspects of kidney damage in COVID-19. Potential mechanisms of kidney involvement in the clinical picture of the disease may include cytokine damage, cross-organ damage, and systemic effects that determine the treatment strategy. These mechanisms are closely interrelated and are especially important for individuals undergoing extracorporeal therapy and kidney transplants. Autopsy data provide evidence of SARS-CoV-2 virus invasion into kidney tissue with damage to tubular epithelial cells and podocytes, and erythrocyte aggregation in persons with severe COVID-19. By including people with chronic kidney disease in planned COVID-19 research protocols, an evidence base for effective and safe treatments can be generated.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49449107","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：