Aidin Tarokhian, A. Dehghan, Sohrab Kulivand, S. Borzouei
Von Hippel-Lindau (VHL) is a rare autosomal dominant genetic disease. Affected individuals manifest clinically with tumors involving multiple organs including hemangioblastoma of the central nervous system and retina, cystic kidney disease, renal cell carcinoma (RCC), pheochromocytoma, and pancreatic neuroendocrine tumors. Its diagnosis is based on genetic testing and clinical criteria in suspected patients. Treatment principles are to save organs and periodic surveillance for in-time tumor detection and appropriate follow-ups. This case report presents a 47-year-old woman with five years history of abdominal pain alongside long-standing headaches and progressive hearing loss. On imaging, multiple suspicious tumors throughout her body were detected and she proceeded to surgical resection. She was finally diagnosed with RCC, central nervous system tumor hemangioblastoma, and pancreatic cyst. The patient underwent a right-sided nephrectomy and Sunitinib therapy. She is continuing therapy and currently does not have any sign of metastasis. Due to her constellation of tumors VHL disease was suspected. Although she did not have any positive family history, the VHL diagnosis was conducted based on clinical criteria. The case emphasized the importance of timely recognition and evaluation of suspected cases and evidence base surveillance. Physician familiarity with the underestimated disease is of paramount importance.
Von Hippel-Lindau (VHL)是一种罕见的常染色体显性遗传病。患者临床表现为累及多器官的肿瘤，包括中枢神经系统和视网膜血管母细胞瘤、囊性肾病、肾细胞癌(RCC)、嗜铬细胞瘤和胰腺神经内分泌肿瘤。其诊断是基于基因检测和疑似患者的临床标准。治疗原则为保存器官，定期监测，及时发现肿瘤并适当随访。本病例报告提出一名47岁女性，腹痛5年，伴有长期头痛和进行性听力丧失。影像学检查发现全身多发可疑肿瘤，遂行手术切除。她最终被诊断为肾细胞癌、中枢神经系统肿瘤、血管母细胞瘤和胰腺囊肿。患者接受了右侧肾切除术和舒尼替尼治疗。她正在继续治疗，目前没有任何转移的迹象。由于她的肿瘤群，怀疑是VHL疾病。虽然她没有任何阳性家族史，但VHL的诊断是根据临床标准进行的。该病例强调了及时识别和评估疑似病例以及证据基础监测的重要性。医生对这种被低估的疾病的熟悉程度至关重要。
{"title":"Von Hippel-Lindau; A 47-year-old woman with renal cell carcinoma and multiorgan involvement","authors":"Aidin Tarokhian, A. Dehghan, Sohrab Kulivand, S. Borzouei","doi":"10.34172/jre.2022.25065","DOIUrl":"https://doi.org/10.34172/jre.2022.25065","url":null,"abstract":"Von Hippel-Lindau (VHL) is a rare autosomal dominant genetic disease. Affected individuals manifest clinically with tumors involving multiple organs including hemangioblastoma of the central nervous system and retina, cystic kidney disease, renal cell carcinoma (RCC), pheochromocytoma, and pancreatic neuroendocrine tumors. Its diagnosis is based on genetic testing and clinical criteria in suspected patients. Treatment principles are to save organs and periodic surveillance for in-time tumor detection and appropriate follow-ups. This case report presents a 47-year-old woman with five years history of abdominal pain alongside long-standing headaches and progressive hearing loss. On imaging, multiple suspicious tumors throughout her body were detected and she proceeded to surgical resection. She was finally diagnosed with RCC, central nervous system tumor hemangioblastoma, and pancreatic cyst. The patient underwent a right-sided nephrectomy and Sunitinib therapy. She is continuing therapy and currently does not have any sign of metastasis. Due to her constellation of tumors VHL disease was suspected. Although she did not have any positive family history, the VHL diagnosis was conducted based on clinical criteria. The case emphasized the importance of timely recognition and evaluation of suspected cases and evidence base surveillance. Physician familiarity with the underestimated disease is of paramount importance.","PeriodicalId":16964,"journal":{"name":"Journal of Renal Endocrinology","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78560127","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}
S. Bahadoram, B. Keikhaei, M. Bahadoram, M. Mahmoudian-sani, S. Hassanzadeh
The nephropathy and renal complications of sickle cell disease are associated with various events such as hypoxic or ischemic conditions and reperfusion injury. Erythrocyte sickling occurs following these events and renal medullary acidosis.
{"title":"Renal complications of sickle cell disease","authors":"S. Bahadoram, B. Keikhaei, M. Bahadoram, M. Mahmoudian-sani, S. Hassanzadeh","doi":"10.34172/jre.2021.20","DOIUrl":"https://doi.org/10.34172/jre.2021.20","url":null,"abstract":"The nephropathy and renal complications of sickle cell disease are associated with various events such as hypoxic or ischemic conditions and reperfusion injury. Erythrocyte sickling occurs following these events and renal medullary acidosis.","PeriodicalId":16964,"journal":{"name":"Journal of Renal Endocrinology","volume":"383 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74269070","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}
COVID-19 infection increases the risk of death in patients with chronic conditions such as diabetes or obesity. The exact role of vitamin D in COVID-19 infection is unknown and controversial. Furthermore, the exact prevalence of vitamin D deficiency is still unknown but it affects individuals worldwide regardless of ethnicity and age. Herein, we give an overview of vitamin D deficiency as a global public health problem, the role of vitamin D in COVID-19 infection, and the proper approach to treating vitamin D deficiency.
{"title":"Vitamin D and COVID-19 infection; recent findings","authors":"Alireza Pouramini, Fatemeh Kafi, S. Hassanzadeh","doi":"10.34172/jre.2021.19","DOIUrl":"https://doi.org/10.34172/jre.2021.19","url":null,"abstract":"COVID-19 infection increases the risk of death in patients with chronic conditions such as diabetes or obesity. The exact role of vitamin D in COVID-19 infection is unknown and controversial. Furthermore, the exact prevalence of vitamin D deficiency is still unknown but it affects individuals worldwide regardless of ethnicity and age. Herein, we give an overview of vitamin D deficiency as a global public health problem, the role of vitamin D in COVID-19 infection, and the proper approach to treating vitamin D deficiency.","PeriodicalId":16964,"journal":{"name":"Journal of Renal Endocrinology","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82944916","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}
Vinit Singh Baghel, Sapnita Shinde, Vibha Sinha, S. Pandey, S. Dwivedi, Nikita Singh, A. Tiwari, S. Saxena, N. Vishvakarma, Dhananjay Shukla, P. Bhatt
The novel coronavirus outbreak has become a global health emergency. The common symptoms of COVID-19 disease which have affected a large population are common cold, fatigue, headache and fever. However, complications such as multiple organ failure, acute respiratory syndrome and septic shock are seen in about 5% of patients with persisting severe symptoms and post-COVID syndrome. The COVID-19 acute kidney injury in patients displays damage in the kidney, proteinuria, hematuria and elevated serum creatinine. The symptoms of acute kidney injury vary from mild to severe, which necessitates proper clinical management and renal replacement therapy (RRT). Therefore, it is necessary to understand the pathophysiology of acute kidney injury involving infiltrated immune cells, thrombosis, and cytokine regulation. There is no definite treatment for acute kidney injury; the strategy for preventing the complications will only come through clinical experience. Therefore, more studies are needed for the proper understanding of the disease etiology in acute kidney injury patients with COVID-19. New strategies, International collaboration and multi-disciplinary research are needed to be implemented for the proper management.
{"title":"Post-COVID–19 complication and its effect on acute kidney injury","authors":"Vinit Singh Baghel, Sapnita Shinde, Vibha Sinha, S. Pandey, S. Dwivedi, Nikita Singh, A. Tiwari, S. Saxena, N. Vishvakarma, Dhananjay Shukla, P. Bhatt","doi":"10.34172/jre.2021.18","DOIUrl":"https://doi.org/10.34172/jre.2021.18","url":null,"abstract":"The novel coronavirus outbreak has become a global health emergency. The common symptoms of COVID-19 disease which have affected a large population are common cold, fatigue, headache and fever. However, complications such as multiple organ failure, acute respiratory syndrome and septic shock are seen in about 5% of patients with persisting severe symptoms and post-COVID syndrome. The COVID-19 acute kidney injury in patients displays damage in the kidney, proteinuria, hematuria and elevated serum creatinine. The symptoms of acute kidney injury vary from mild to severe, which necessitates proper clinical management and renal replacement therapy (RRT). Therefore, it is necessary to understand the pathophysiology of acute kidney injury involving infiltrated immune cells, thrombosis, and cytokine regulation. There is no definite treatment for acute kidney injury; the strategy for preventing the complications will only come through clinical experience. Therefore, more studies are needed for the proper understanding of the disease etiology in acute kidney injury patients with COVID-19. New strategies, International collaboration and multi-disciplinary research are needed to be implemented for the proper management.","PeriodicalId":16964,"journal":{"name":"Journal of Renal Endocrinology","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81027703","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}
Mehrdad Rabiee Rad, Ghazal Ghasempour Dabaghi, S. Hassanzadeh
One of the possible causes of renal failure due to heart failure is congestive kidney failure (CKF). Venous congestion has a key role in the development of renal dysfunction and damage in patients with heart failure. This condition is named congestive nephropathy. In this mini-review the common causes of congestive kidney failure, its pathophysiology, histopathological changes and treatment are discussed.
{"title":"Congestive kidney failure; recent knowledge and new trends","authors":"Mehrdad Rabiee Rad, Ghazal Ghasempour Dabaghi, S. Hassanzadeh","doi":"10.34172/jre.2021.17","DOIUrl":"https://doi.org/10.34172/jre.2021.17","url":null,"abstract":"One of the possible causes of renal failure due to heart failure is congestive kidney failure (CKF). Venous congestion has a key role in the development of renal dysfunction and damage in patients with heart failure. This condition is named congestive nephropathy. In this mini-review the common causes of congestive kidney failure, its pathophysiology, histopathological changes and treatment are discussed.","PeriodicalId":16964,"journal":{"name":"Journal of Renal Endocrinology","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83896532","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: Hepcidin is a key regulatory peptide in iron homeostasis, the pathogenesis of functional iron deficiency (FID) anemia and erythropoiesis-stimulating agent (ESA) resistance is contributed to the inflammatory mediated increase in the serum hepcidin levels among prevalent hemodialysis (HD) patients. Objectives: To test the reducing therapeutic effect of oral vitamin C supplements on hepcidin levels and iron status among HD patients with FID anemia. Patients and Methods: This study is an interventional prospective cohort study; 48 prevalent HD patients were enrolled. Group one: 31 patients who received the conventional treatment of erythropoietin stimulating agents together with oral supplementation of vitamin C 500 mg every other day dose for 3 months. Group two: 17 patients who received only the conventional therapy of erythropoietin stimulating agents. Patients with hemoglobin level <11 g/dL, ferritin level >200 ng/mL and transferrin saturation (TSAT) >20 % were included. Laboratory parameters: serum hepcidin, high-sensitivity C-reactive protein (hs-CRP) titre, CBC, and iron indices were measured at baseline and after 3 months. Results: On comparing the two groups, oral vitamin C in group 1 resulted in a statistically significant reduction in hepcidin levels [mean 2506.456 ± 1320.53 pg/mL to 1748.396 ± 1432.28 pg/mL (P = 0.03)], and a significant reduction in hs-CRP level [mean 8603.236 ± 2547.77 ng/mL to 5611.296 ± 2829.27 ng/mL] (P = 0.001) after three months of treatment in comparison to control group. A decrease of EPO requirement and elevation of hemoglobin level were observed in a study group with oral vitamin C. Conclusion: Oral vitamin C may be a promising therapy in decreasing serum hepcidin and inflammatory markers among prevalent HD patients with FID anemia.
{"title":"Effect of oral vitamin C on serum hepcidin level, iron status and inflammation among hemodialysis patients with functional iron deficiency anaemia","authors":"M. Behairy, A. Gharib, M. Zaki, Reem El Sharabasy","doi":"10.34172/jre.2021.16","DOIUrl":"https://doi.org/10.34172/jre.2021.16","url":null,"abstract":"Introduction: Hepcidin is a key regulatory peptide in iron homeostasis, the pathogenesis of functional iron deficiency (FID) anemia and erythropoiesis-stimulating agent (ESA) resistance is contributed to the inflammatory mediated increase in the serum hepcidin levels among prevalent hemodialysis (HD) patients. Objectives: To test the reducing therapeutic effect of oral vitamin C supplements on hepcidin levels and iron status among HD patients with FID anemia. Patients and Methods: This study is an interventional prospective cohort study; 48 prevalent HD patients were enrolled. Group one: 31 patients who received the conventional treatment of erythropoietin stimulating agents together with oral supplementation of vitamin C 500 mg every other day dose for 3 months. Group two: 17 patients who received only the conventional therapy of erythropoietin stimulating agents. Patients with hemoglobin level <11 g/dL, ferritin level >200 ng/mL and transferrin saturation (TSAT) >20 % were included. Laboratory parameters: serum hepcidin, high-sensitivity C-reactive protein (hs-CRP) titre, CBC, and iron indices were measured at baseline and after 3 months. Results: On comparing the two groups, oral vitamin C in group 1 resulted in a statistically significant reduction in hepcidin levels [mean 2506.456 ± 1320.53 pg/mL to 1748.396 ± 1432.28 pg/mL (P = 0.03)], and a significant reduction in hs-CRP level [mean 8603.236 ± 2547.77 ng/mL to 5611.296 ± 2829.27 ng/mL] (P = 0.001) after three months of treatment in comparison to control group. A decrease of EPO requirement and elevation of hemoglobin level were observed in a study group with oral vitamin C. Conclusion: Oral vitamin C may be a promising therapy in decreasing serum hepcidin and inflammatory markers among prevalent HD patients with FID anemia.","PeriodicalId":16964,"journal":{"name":"Journal of Renal Endocrinology","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85543066","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}
Essam Afifi, A. Tawfik, Essam Eldin Rashed Saeed Abdulkhalek, L. Khedr
Introduction: Anemia is a common complication in end-stage renal disease (ESRD) patients on regular hemodialysis (HD). There has been a lot of interest recently in the non-classical effects of 25(OH) vitamin D (calcidiol), including its association with erythropoiesis and anemia pathogenesis. Objectives: To study the relation between anemia and vitamin D status in patients on regular HD Results: This study is a cross-sectional study that included 90 patients on regular HD. Vitamin D status was classified into deficient (<20 ng/ mL), insufficient (20-30 ng/mL) and sufficient (>30 ng/mL). The level of vitamin D measured in the patients ranged between 3.5 to 66 ng/mL with median of 16.35 ng/mL. There were statistically significant positive correlations between vitamin D levels and the level of hemoglobin (P<0.001), serum calcium levels (P<0.001) and serum PO4 levels (P=0.023). Higher hemoglobin levels were statistically related to both higher vitamin D values (P<0.001) and higher serum calcium concentration P<0.001). Meanwhile, a significant negative correlation was found between hemoglobin levels and serum PTH values (P<0.001). Conclusion: There was a significant association between the status of vitamin D and the level of hemoglobin in dialysis population who were studied, independent from iron status. other associations with hemoglobin levels included PTH level and calcium.
{"title":"The relation between vitamin D status and anemia in patients with end stage renal disease on regular hemodialysis","authors":"Essam Afifi, A. Tawfik, Essam Eldin Rashed Saeed Abdulkhalek, L. Khedr","doi":"10.34172/jre.2021.15","DOIUrl":"https://doi.org/10.34172/jre.2021.15","url":null,"abstract":"Introduction: Anemia is a common complication in end-stage renal disease (ESRD) patients on regular hemodialysis (HD). There has been a lot of interest recently in the non-classical effects of 25(OH) vitamin D (calcidiol), including its association with erythropoiesis and anemia pathogenesis. Objectives: To study the relation between anemia and vitamin D status in patients on regular HD Results: This study is a cross-sectional study that included 90 patients on regular HD. Vitamin D status was classified into deficient (<20 ng/ mL), insufficient (20-30 ng/mL) and sufficient (>30 ng/mL). The level of vitamin D measured in the patients ranged between 3.5 to 66 ng/mL with median of 16.35 ng/mL. There were statistically significant positive correlations between vitamin D levels and the level of hemoglobin (P<0.001), serum calcium levels (P<0.001) and serum PO4 levels (P=0.023). Higher hemoglobin levels were statistically related to both higher vitamin D values (P<0.001) and higher serum calcium concentration P<0.001). Meanwhile, a significant negative correlation was found between hemoglobin levels and serum PTH values (P<0.001). Conclusion: There was a significant association between the status of vitamin D and the level of hemoglobin in dialysis population who were studied, independent from iron status. other associations with hemoglobin levels included PTH level and calcium.","PeriodicalId":16964,"journal":{"name":"Journal of Renal Endocrinology","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74223845","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}
S. Silva, Cristina Milano, G. García, A. Abib, Carlos Díaz, G. Laham
Introduction: Frailty (F) refers to the cumulative organic damage caused by aging, as a consequence of a diminished physiological reserve. Frailty’s prevalence is 73% in dialysis. Objectives: Our aim was to identify the prevalence of F in patients starting hemodialysis (HD) or hemodiafiltration online (HDF) treatment. To asses change in frailty during a six-month period of dialysis Patients and Methods: This prospective cohort study evaluated 67 incident patient starting-HD or HDF at one year, with a follow-up period of at least six months. The frailty was assessed by the Fried frailty method. According to this test, we divided the population in two groups: Pre-frail (0-2) and frail (3-5). Results: Mean age was 64 years, 64% were male and 92% were treated with HD. A total of 35.8% of the patients were admitted to dialysis with a prosthetic or native fistula. The prevalence of F at the beginning of dialysis was 65.7%. The mean value of Charlson index (CHI) was 5.2 ± 2. There was a significant correlation between CHI and frailty test (P<0.0001). Basal F score (n=67) improved after 6 month (n=52): 3 (2-4) versus1 (1-2) (P<0.0001). Hematocrit (28 versus 32% P=0.05) and calcium levels (8.6 and 8.9 mg/dL, P<0.002) also increased after sixth-month. Global mortality was 7.5%. In the multivariate analysis CHI (P<0.001) and albumin (P=0.003) were frailty predictors. Conclusion: The prevalence of F in patients who start dialysis therapy is high. There was an improvement in F score after six-month of dialysis treatment. Patients with higher F score had higher mortality with higher CHI
{"title":"Frailty at the beginning of dialysis; is it a prognostic factor?","authors":"S. Silva, Cristina Milano, G. García, A. Abib, Carlos Díaz, G. Laham","doi":"10.34172/jre.2021.13","DOIUrl":"https://doi.org/10.34172/jre.2021.13","url":null,"abstract":"Introduction: Frailty (F) refers to the cumulative organic damage caused by aging, as a consequence of a diminished physiological reserve. Frailty’s prevalence is 73% in dialysis. Objectives: Our aim was to identify the prevalence of F in patients starting hemodialysis (HD) or hemodiafiltration online (HDF) treatment. To asses change in frailty during a six-month period of dialysis Patients and Methods: This prospective cohort study evaluated 67 incident patient starting-HD or HDF at one year, with a follow-up period of at least six months. The frailty was assessed by the Fried frailty method. According to this test, we divided the population in two groups: Pre-frail (0-2) and frail (3-5). Results: Mean age was 64 years, 64% were male and 92% were treated with HD. A total of 35.8% of the patients were admitted to dialysis with a prosthetic or native fistula. The prevalence of F at the beginning of dialysis was 65.7%. The mean value of Charlson index (CHI) was 5.2 ± 2. There was a significant correlation between CHI and frailty test (P<0.0001). Basal F score (n=67) improved after 6 month (n=52): 3 (2-4) versus1 (1-2) (P<0.0001). Hematocrit (28 versus 32% P=0.05) and calcium levels (8.6 and 8.9 mg/dL, P<0.002) also increased after sixth-month. Global mortality was 7.5%. In the multivariate analysis CHI (P<0.001) and albumin (P=0.003) were frailty predictors. Conclusion: The prevalence of F in patients who start dialysis therapy is high. There was an improvement in F score after six-month of dialysis treatment. Patients with higher F score had higher mortality with higher CHI","PeriodicalId":16964,"journal":{"name":"Journal of Renal Endocrinology","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79634962","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}
E. Abdallah, B. Al Helal, Reem Asad, G. Nessim, Shaikha Al-Bader, Y. Elsharkawi, A. Elmasry, Mohamed Fathy Mohamed Abdelgelil, Essam Allam, Sahar Abdelkareem, M. Kamal, Mohamed Hemida, Y. Shaaban, Zeinab Zeid, A. Saad, A. Ahmed
Introduction: Coronavirus disease 2019 (COVID-19) is an outbreak due to SARS-CoV-2, declared by the World Health Organization (WHO) as a global pandemic in March 2020. Patients with underlying diseases, such as those with end-stage kidney disease (ESKD) on dialysis, are at greater risk. Objectives: The aim of our study to assess the outbreak and impact of COVID-19 on dialysis patients. Patients and Methods: Our study prospectively assessed and followed 442 patients with ESKD undergoing dialysis [390 patients on maintenance hemodialysis (HD) and 52 patients on peritoneal dialysis (PD)] for outbreak and impact of COVID-19 on these patients during the period from April 22, 2020 until March 23, 2021 in Al Khezam dialysis center, Kuwait. Age, gender, nationality, original kidney disease, history of hypertension (HTN), diabetes mellitus (DM), ischemic heart disease (IHD), congestive heart failure (CHF), bronchial asthma (BA), chronic obstructive pulmonary disease (COPD), history of pulmonary embolism (PE) and source of infection were analyzed. Symptoms as fever, fatigue, cough, loss of smell and taste and chest pain were recorded, the need for ICU admission, mechanical ventilation (MV), extracorporeal membrane oxygenation (ECMO), medications were recorded. The need to shift to continuous renal replacement therapy (CRRT) and outcomes (complications and mortality) were analyzed. Results: Our study reported that 102 out of 442 (23%) dialysis patients [97 out of 390 (24.8%) HD patients and 5 out of 52 (9.6%) PD patients] got infected with COVID-19 and reinfection reported in 4 out of 97 (4%) COVID-19 HD patients. Around 27% of COVID-19 HD patients had fever, 19% had fatigue, 8% had cough, 4% had loss of smell, 4% had loss of taste, 4% had chest pain and 40% of COVID-19 PD patients had fever. Fifteen out of 97 (15 %) COVID-19 HD patients needed ICU admission, 12 out of 97 (12 %) COVID-19 HD patients needed MV. A 33 out of 97 (34%) COVID-19 HD patients and 4 out of 5 (80%) COVID-19 PD patients needed to switch to CRRT. Mortality was 17 (15 HD and 2 PD) out of 102 (16.6 %) COVID-19 dialysis patients and common causes of death were sepsis, myocardial infarction (MI), heart failure and PE. Conclusion: Outbreak and mortality of COVID-19 infection is high in ESKD patients undergoing dialysis compared with general populations. Strict protocol for prevention of COVID-19 should be undertaken in dialysis centers and encourage of home dialysis and highly protective COVID-19 vaccination priority for dialysis patients.
{"title":"Outbreak and impact of coronavirus disease 2019 (COVID-19) on dialysis patients; Al Khezam dialysis center experience, Kuwait","authors":"E. Abdallah, B. Al Helal, Reem Asad, G. Nessim, Shaikha Al-Bader, Y. Elsharkawi, A. Elmasry, Mohamed Fathy Mohamed Abdelgelil, Essam Allam, Sahar Abdelkareem, M. Kamal, Mohamed Hemida, Y. Shaaban, Zeinab Zeid, A. Saad, A. Ahmed","doi":"10.34172/jre.2021.14","DOIUrl":"https://doi.org/10.34172/jre.2021.14","url":null,"abstract":"Introduction: Coronavirus disease 2019 (COVID-19) is an outbreak due to SARS-CoV-2, declared by the World Health Organization (WHO) as a global pandemic in March 2020. Patients with underlying diseases, such as those with end-stage kidney disease (ESKD) on dialysis, are at greater risk. Objectives: The aim of our study to assess the outbreak and impact of COVID-19 on dialysis patients. Patients and Methods: Our study prospectively assessed and followed 442 patients with ESKD undergoing dialysis [390 patients on maintenance hemodialysis (HD) and 52 patients on peritoneal dialysis (PD)] for outbreak and impact of COVID-19 on these patients during the period from April 22, 2020 until March 23, 2021 in Al Khezam dialysis center, Kuwait. Age, gender, nationality, original kidney disease, history of hypertension (HTN), diabetes mellitus (DM), ischemic heart disease (IHD), congestive heart failure (CHF), bronchial asthma (BA), chronic obstructive pulmonary disease (COPD), history of pulmonary embolism (PE) and source of infection were analyzed. Symptoms as fever, fatigue, cough, loss of smell and taste and chest pain were recorded, the need for ICU admission, mechanical ventilation (MV), extracorporeal membrane oxygenation (ECMO), medications were recorded. The need to shift to continuous renal replacement therapy (CRRT) and outcomes (complications and mortality) were analyzed. Results: Our study reported that 102 out of 442 (23%) dialysis patients [97 out of 390 (24.8%) HD patients and 5 out of 52 (9.6%) PD patients] got infected with COVID-19 and reinfection reported in 4 out of 97 (4%) COVID-19 HD patients. Around 27% of COVID-19 HD patients had fever, 19% had fatigue, 8% had cough, 4% had loss of smell, 4% had loss of taste, 4% had chest pain and 40% of COVID-19 PD patients had fever. Fifteen out of 97 (15 %) COVID-19 HD patients needed ICU admission, 12 out of 97 (12 %) COVID-19 HD patients needed MV. A 33 out of 97 (34%) COVID-19 HD patients and 4 out of 5 (80%) COVID-19 PD patients needed to switch to CRRT. Mortality was 17 (15 HD and 2 PD) out of 102 (16.6 %) COVID-19 dialysis patients and common causes of death were sepsis, myocardial infarction (MI), heart failure and PE. Conclusion: Outbreak and mortality of COVID-19 infection is high in ESKD patients undergoing dialysis compared with general populations. Strict protocol for prevention of COVID-19 should be undertaken in dialysis centers and encourage of home dialysis and highly protective COVID-19 vaccination priority for dialysis patients.","PeriodicalId":16964,"journal":{"name":"Journal of Renal Endocrinology","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74305419","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}
Non-steroidal anti-inflammatory drugs (NSAIDs) have been used in the management of inflammatory disease for decades. The spectrum of nephrotoxicity attributed to NSAIDs includes mainly acute tubulointerstitial nephritis. However, much less attention has been given to drug-induced glomerular injury. NSAIDs treating patients presenting with nephrotic syndrome may have a variety of glomerular changes indistinguishable from those found in idiopathic minimal change disease (MCD), for example. The clinical presentation is typically abrupt with nephrotic syndrome while in the elderly it can present as acute renal failure from the beginning. We present an MCD-NSAID induced in elderly patient and discuss possible pathogenic mechanism, thinking about on the indiscriminate use of NSAIDs. Here we report the case of a 66-year-old woman with a history of nephrotic syndrome and hypertension without an apparent secondary etiology. However, an exhaustive history showed and indiscriminate use of NSAIDs. Renal biopsy showed a MCD with a mild interstitial nephritis. To our knowledge the morphology of drug-induced diseases often does not differ from the primary forms, making the distinction difficult. There are subtle clues, although the dialogue between clinician and pathologist is essential to reach an etiological diagnosis. Physicians should suspect glomerulonephritis in patients who receive drugs and its management must be determined based on the histological characteristics of the disease. Although corticosteroid therapy seems to be of value, the effectiveness of this approach must still be tested in randomized and multicentric clinical trials.
{"title":"What about NSAID and secondary minimal change disease in adult’s people? A case report and review of the literature","authors":"E. E. Faure, J. Mukdsi","doi":"10.34172/jre.2021.12","DOIUrl":"https://doi.org/10.34172/jre.2021.12","url":null,"abstract":"Non-steroidal anti-inflammatory drugs (NSAIDs) have been used in the management of inflammatory disease for decades. The spectrum of nephrotoxicity attributed to NSAIDs includes mainly acute tubulointerstitial nephritis. However, much less attention has been given to drug-induced glomerular injury. NSAIDs treating patients presenting with nephrotic syndrome may have a variety of glomerular changes indistinguishable from those found in idiopathic minimal change disease (MCD), for example. The clinical presentation is typically abrupt with nephrotic syndrome while in the elderly it can present as acute renal failure from the beginning. We present an MCD-NSAID induced in elderly patient and discuss possible pathogenic mechanism, thinking about on the indiscriminate use of NSAIDs. Here we report the case of a 66-year-old woman with a history of nephrotic syndrome and hypertension without an apparent secondary etiology. However, an exhaustive history showed and indiscriminate use of NSAIDs. Renal biopsy showed a MCD with a mild interstitial nephritis. To our knowledge the morphology of drug-induced diseases often does not differ from the primary forms, making the distinction difficult. There are subtle clues, although the dialogue between clinician and pathologist is essential to reach an etiological diagnosis. Physicians should suspect glomerulonephritis in patients who receive drugs and its management must be determined based on the histological characteristics of the disease. Although corticosteroid therapy seems to be of value, the effectiveness of this approach must still be tested in randomized and multicentric clinical trials.","PeriodicalId":16964,"journal":{"name":"Journal of Renal Endocrinology","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81878104","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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