O. Kara, N. Dinçel, I. Bulut, K. Özdemir, E. Yilmaz, Z. Gun, C. Hoşçoşkun, B. Sözeri, S. Mir
Background: Infections in children with renal transplantation often lead to fatal complications. This study aimed to evaluate the incidence and risk factors of infection after renal transplantation, as well as its impact on graft function. Methods : The study included 105 children, in two groups based on the presence of infection within the first 2 years after renal transplantation. Results: In total, 137 infection episodes were found in 62 (59%) patients. The number of episodes was 20, 5 and 54 that developed in months 6, 12 and 24 after transplantation, respectively. There were 72 urinary tract infection episodes. Among patients with pulmonary infections (16.7%), two had H1N1, one of whom experienced graft loss and died of sepsis. The aspergillus infection episodes were lethal. Infection with BK virus was detected in four patients, all of whom were asymptomatic, except with decline in glomerular filtration rate. Seventeen patients developed 25 episodes of cytomegalovirus infection. Conclusions: This study established the incidence of infections and risk factors in the first 2 years after transplantation at a single center. Long-term follow-up periods and prospective studies confirming specific risk factors, preventive measures and impact on graft survival are necessary. World J Nephrol Urol. 2014;3(2):92-99 doi: http://dx.doi.org/10.14740/wjnu159w
{"title":"Infectious Complications in Pediatric Renal Transplant Patients","authors":"O. Kara, N. Dinçel, I. Bulut, K. Özdemir, E. Yilmaz, Z. Gun, C. Hoşçoşkun, B. Sözeri, S. Mir","doi":"10.14740/WJNU159W","DOIUrl":"https://doi.org/10.14740/WJNU159W","url":null,"abstract":"Background: Infections in children with renal transplantation often lead to fatal complications. This study aimed to evaluate the incidence and risk factors of infection after renal transplantation, as well as its impact on graft function. Methods : The study included 105 children, in two groups based on the presence of infection within the first 2 years after renal transplantation. Results: In total, 137 infection episodes were found in 62 (59%) patients. The number of episodes was 20, 5 and 54 that developed in months 6, 12 and 24 after transplantation, respectively. There were 72 urinary tract infection episodes. Among patients with pulmonary infections (16.7%), two had H1N1, one of whom experienced graft loss and died of sepsis. The aspergillus infection episodes were lethal. Infection with BK virus was detected in four patients, all of whom were asymptomatic, except with decline in glomerular filtration rate. Seventeen patients developed 25 episodes of cytomegalovirus infection. Conclusions: This study established the incidence of infections and risk factors in the first 2 years after transplantation at a single center. Long-term follow-up periods and prospective studies confirming specific risk factors, preventive measures and impact on graft survival are necessary. World J Nephrol Urol. 2014;3(2):92-99 doi: http://dx.doi.org/10.14740/wjnu159w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"3 1","pages":"92-99"},"PeriodicalIF":0.0,"publicationDate":"2014-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67236865","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}
L. McMahon, S. Safari, E. Smith, W. Tesoriero, R. Macginley, S. Holt
A hemodialysis patient with atrial fibrillation and ischemic heart disease, already taking amiodarone and diltiazem, presented with complete blindness after commencing digoxin. A highly elevated serum digoxin concentration was discovered and treated with Digibind ® , with gradual but complete return of his vision. This case highlights a rare complication of digoxin potentiated by renal failure, medication interactions and poor communication. World J Nephrol Urol. 2014;3(2):100-102 doi: http://dx.doi.org/10.14740/wjnu155w
{"title":"Sudden Blindness in a Hemodialysis Patient on Digoxin","authors":"L. McMahon, S. Safari, E. Smith, W. Tesoriero, R. Macginley, S. Holt","doi":"10.14740/WJNU155W","DOIUrl":"https://doi.org/10.14740/WJNU155W","url":null,"abstract":"A hemodialysis patient with atrial fibrillation and ischemic heart disease, already taking amiodarone and diltiazem, presented with complete blindness after commencing digoxin. A highly elevated serum digoxin concentration was discovered and treated with Digibind ® , with gradual but complete return of his vision. This case highlights a rare complication of digoxin potentiated by renal failure, medication interactions and poor communication. World J Nephrol Urol. 2014;3(2):100-102 doi: http://dx.doi.org/10.14740/wjnu155w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"3 1","pages":"100-102"},"PeriodicalIF":0.0,"publicationDate":"2014-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67237033","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}
Bilateral single system ectopic ureter (BSSEU) is a rare congenital malformation. We report a case of BSSEU with a rare association of ectopic ureter with contralateral ectopic sphinctero-stenotic ureterocele with agenesis of one seminal vesicle with normal urinary continence and fertility presenting in adulthood as a case of chronic kidney disease. Diagnosis of ureterocele was missed even after detailed radiological investigations, so concurrent endoscopic evaluation is important for final diagnosis and operative intervention. As renal functions were markedly deranged, so transurethral incision of the right ureterocele with double J stenting was done as a preliminary procedure. Renal functions improved subsequently. Patient is planned for left nephroureterectomy and if necessary right ureteric reimplantation as a secondary major surgery in the follow-up period. World J Nephrol Urol. 2014;3(2):103-105 doi: http://dx.doi.org/10.14740 /wjnu162w
{"title":"Bilateral Single System Ectopic Ureters With Ureterocele: A Rare Association in an Adult Male","authors":"Harjinder Singh, A. Singla, Anahat Kaur","doi":"10.14740/WJNU162W","DOIUrl":"https://doi.org/10.14740/WJNU162W","url":null,"abstract":"Bilateral single system ectopic ureter (BSSEU) is a rare congenital malformation. We report a case of BSSEU with a rare association of ectopic ureter with contralateral ectopic sphinctero-stenotic ureterocele with agenesis of one seminal vesicle with normal urinary continence and fertility presenting in adulthood as a case of chronic kidney disease. Diagnosis of ureterocele was missed even after detailed radiological investigations, so concurrent endoscopic evaluation is important for final diagnosis and operative intervention. As renal functions were markedly deranged, so transurethral incision of the right ureterocele with double J stenting was done as a preliminary procedure. Renal functions improved subsequently. Patient is planned for left nephroureterectomy and if necessary right ureteric reimplantation as a secondary major surgery in the follow-up period. World J Nephrol Urol. 2014;3(2):103-105 doi: http://dx.doi.org/10.14740 /wjnu162w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"3 1","pages":"103-105"},"PeriodicalIF":0.0,"publicationDate":"2014-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67236983","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. Okumura, S. Tsuritani, T. Nozaki, Hitomi Kimura, T. Kazama
Background: The efficacy and tolerability of naftopidil 75 mg administered once daily (OD) in the evening (g roup O) were compared to those of naftopidil 25 mg thrice daily (TID), given in the morning, afternoon and evening (g roup T), for lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH). The factors predicting the efficacy of each dosage regimen were also examined. Methods: The participants were 101 patients with LUTS/BPH who were randomly administered naftopidil for 8 weeks in either group O or group T. Inclusion criteria were international prostate symptom score (IPSS) greater than or equal to 8 and IPSS quality of life (IPSS-QoL) greater than or equal to 3. Results: IPSS total score, IPSS-QoL and the BPH impact index were all significantly improved compared to baseline for both groups at 8 weeks after treatment. Voided volume, maximum flow rate and average flow rate were significantly improved compared to baseline only for group O at 8 weeks after treatment. The effectiveness rate based on the criteria for treatment efficacy of the Japanese clinical practice guideline for voiding dysfunction was not significantly different between the two groups. There was no independent predictive factor for the efficacy of naftopidil in group O, but prostate volume and symptom severity were identified as predictive factors in group T. The rate of adverse events was not significantly different between the two groups. Conclusions: The overall efficacy of naftopidil 75 mg/day given OD was approximately equal to that of 75 mg/day TID, but OD therapy was objectively more effective. LUTS/BPH patients with large prostate volume should be given OD therapy because the therapy is not affected by the severity of subjective symptoms or prostate volume. World J Nephrol Urol. 2014;3(2):72-82 doi: http://dx.doi.org/10.14740/wjnu169e
{"title":"A Randomized Study Comparing Once-Daily and Thrice-Daily Naftopidil 75 mg/Day for Lower Urinary Tract Symptoms of Benign Prostatic Hyperplasia","authors":"A. Okumura, S. Tsuritani, T. Nozaki, Hitomi Kimura, T. Kazama","doi":"10.14740/WJNU169E","DOIUrl":"https://doi.org/10.14740/WJNU169E","url":null,"abstract":"Background: The efficacy and tolerability of naftopidil 75 mg administered once daily (OD) in the evening (g roup O) were compared to those of naftopidil 25 mg thrice daily (TID), given in the morning, afternoon and evening (g roup T), for lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH). The factors predicting the efficacy of each dosage regimen were also examined. Methods: The participants were 101 patients with LUTS/BPH who were randomly administered naftopidil for 8 weeks in either group O or group T. Inclusion criteria were international prostate symptom score (IPSS) greater than or equal to 8 and IPSS quality of life (IPSS-QoL) greater than or equal to 3. Results: IPSS total score, IPSS-QoL and the BPH impact index were all significantly improved compared to baseline for both groups at 8 weeks after treatment. Voided volume, maximum flow rate and average flow rate were significantly improved compared to baseline only for group O at 8 weeks after treatment. The effectiveness rate based on the criteria for treatment efficacy of the Japanese clinical practice guideline for voiding dysfunction was not significantly different between the two groups. There was no independent predictive factor for the efficacy of naftopidil in group O, but prostate volume and symptom severity were identified as predictive factors in group T. The rate of adverse events was not significantly different between the two groups. Conclusions: The overall efficacy of naftopidil 75 mg/day given OD was approximately equal to that of 75 mg/day TID, but OD therapy was objectively more effective. LUTS/BPH patients with large prostate volume should be given OD therapy because the therapy is not affected by the severity of subjective symptoms or prostate volume. World J Nephrol Urol. 2014;3(2):72-82 doi: http://dx.doi.org/10.14740/wjnu169e","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"3 1","pages":"72-82"},"PeriodicalIF":0.0,"publicationDate":"2014-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67237464","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. Cai, Sanjeev Beweja, Rachel Reilly, Amy Clements, A. Kent, N. Taylor, R. Macginley, S. Holt, L. McMahon
Background: Patients with end stage kidney disease (ESKD) have a reduced health related quality of life (HRQoL). This pilot study examined the effect of a 6-month combined cognitive behavioral therapy (CBT) and muscle strength training program on hemodialysis patients. Methods: The outcomes of interest included HRQoL as measured by Short-Form 36 version 2 (SF-36v2), cardiac depression scale, self-efficacy score, 6-minute walk distance (6MWD), physical activity and muscle strengths. Twenty-seven patients were recruited for intervention, but only eight completed the study. Results: At baseline, participants who completed intervention (CI) had a higher role emotional score (P = 0.028), role physical score (P = 0.008) and self-efficacy score (P = 0.019), compared to the participants who dropped out (ID). At the end of intervention, CI had improvements in physical functioning scores (P = 0.040) and 6MWD (P = 0.018), whereas ID had a decline in their role emotional scores (P = 0.045). Conclusions: The result of this study suggests that a combined CBT and physical training intervention can benefit hemodialysis patients, but non-adherence to therapy is common. Self- efficacy could play an important role in therapy adherence in the ESKD population. World J Nephrol Urol. 2014;3(2):83-91 doi: http://dx.doi.org/10. 14740/ wjnu156w
{"title":"Psychological and Exercise Intervention Training for Hemodialysis Patients: A Pilot Study","authors":"M. Cai, Sanjeev Beweja, Rachel Reilly, Amy Clements, A. Kent, N. Taylor, R. Macginley, S. Holt, L. McMahon","doi":"10.14740/wjnu156w","DOIUrl":"https://doi.org/10.14740/wjnu156w","url":null,"abstract":"Background: Patients with end stage kidney disease (ESKD) have a reduced health related quality of life (HRQoL). This pilot study examined the effect of a 6-month combined cognitive behavioral therapy (CBT) and muscle strength training program on hemodialysis patients. Methods: The outcomes of interest included HRQoL as measured by Short-Form 36 version 2 (SF-36v2), cardiac depression scale, self-efficacy score, 6-minute walk distance (6MWD), physical activity and muscle strengths. Twenty-seven patients were recruited for intervention, but only eight completed the study. Results: At baseline, participants who completed intervention (CI) had a higher role emotional score (P = 0.028), role physical score (P = 0.008) and self-efficacy score (P = 0.019), compared to the participants who dropped out (ID). At the end of intervention, CI had improvements in physical functioning scores (P = 0.040) and 6MWD (P = 0.018), whereas ID had a decline in their role emotional scores (P = 0.045). Conclusions: The result of this study suggests that a combined CBT and physical training intervention can benefit hemodialysis patients, but non-adherence to therapy is common. Self- efficacy could play an important role in therapy adherence in the ESKD population. World J Nephrol Urol. 2014;3(2):83-91 doi: http://dx.doi.org/10. 14740/ wjnu156w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"3 1","pages":"83-91"},"PeriodicalIF":0.0,"publicationDate":"2014-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67236692","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}
Background: Despite the survival benefit offered by kidney transplantation, only a small percent of hemodialysis patients are on a kidney transplant list. Methods: We performed a prospective study to assess the impact of patient awareness on access to kidney transplantation. We administered a standardized questionnaire (13 questions) to 129 prevalent end stage renal disease (ESRD) patients undergoing in-center hemodialysis at one large and one small dialysis organization. Results: Discussion of the transplant option with the physician was the only significant factor (P = 0.003) associated with patient’s presence on a kidney transplant list or being in the work-up process. Conclusions: Patient’s awareness of renal transplantation after initiation of dialysis plays a major role in their access to transplantation. World J Nephrol Urol. 2014;3(2):67-71 doi: http://dx.doi.org/10.14740/wjnu158w
{"title":"Impact of Patient Awareness on Access to Transplantation in End Stage Renal Disease","authors":"L. Mackelaite, A. Gaweda, E. Muhs, R. Ouseph","doi":"10.14740/WJNU158W","DOIUrl":"https://doi.org/10.14740/WJNU158W","url":null,"abstract":"Background: Despite the survival benefit offered by kidney transplantation, only a small percent of hemodialysis patients are on a kidney transplant list. Methods: We performed a prospective study to assess the impact of patient awareness on access to kidney transplantation. We administered a standardized questionnaire (13 questions) to 129 prevalent end stage renal disease (ESRD) patients undergoing in-center hemodialysis at one large and one small dialysis organization. Results: Discussion of the transplant option with the physician was the only significant factor (P = 0.003) associated with patient’s presence on a kidney transplant list or being in the work-up process. Conclusions: Patient’s awareness of renal transplantation after initiation of dialysis plays a major role in their access to transplantation. World J Nephrol Urol. 2014;3(2):67-71 doi: http://dx.doi.org/10.14740/wjnu158w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"3 1","pages":"67-71"},"PeriodicalIF":0.0,"publicationDate":"2014-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67236807","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. Adachi, Akahito Sako, Ayako Ikuta, Kazuha Nakamura, Akihiro Machitori, S. Mishima, H. Yanai
Diffusion-weighted magnetic resonance imaging (DWMRI) is widely used for the diagnosis of cerebrovascular diseases. However, it is recently gaining attention for the diagnosis of infection and tumor in the abdominal region. We experienced a case of an 80-year-old woman whose diagnosis was difficult to differentiate between pyelonephritis and cholangitis. DWMRI showed high signal intensity in renal parenchyma and renal cyst, which led to the diagnosis of pyelonephritis and renal cyst infection. Radiation exposure and contrast media could be avoided for DWMRI. DWMRI is a safe and reliable modality in diagnosing pyelonephritis and renal cyst infection. World J Nephrol Urol. 2014;3(2):106-109 doi: http://dx.doi.org/10.14740/wjnu170e
{"title":"The Case of Pyelonephritis and Renal Cyst Infection Diagnosed by Diffusion-Weighted Magnetic Resonance Imaging","authors":"H. Adachi, Akahito Sako, Ayako Ikuta, Kazuha Nakamura, Akihiro Machitori, S. Mishima, H. Yanai","doi":"10.14740/WJNU170E","DOIUrl":"https://doi.org/10.14740/WJNU170E","url":null,"abstract":"Diffusion-weighted magnetic resonance imaging (DWMRI) is widely used for the diagnosis of cerebrovascular diseases. However, it is recently gaining attention for the diagnosis of infection and tumor in the abdominal region. We experienced a case of an 80-year-old woman whose diagnosis was difficult to differentiate between pyelonephritis and cholangitis. DWMRI showed high signal intensity in renal parenchyma and renal cyst, which led to the diagnosis of pyelonephritis and renal cyst infection. Radiation exposure and contrast media could be avoided for DWMRI. DWMRI is a safe and reliable modality in diagnosing pyelonephritis and renal cyst infection. World J Nephrol Urol. 2014;3(2):106-109 doi: http://dx.doi.org/10.14740/wjnu170e","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"3 1","pages":"106-109"},"PeriodicalIF":0.0,"publicationDate":"2014-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67237514","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}
Leiomyosarcomas account for 0.8 to 2.7% of all malignant renal tumors. Like the leiomyomas, the leiomyosarcomas originate from the cells of the renal capsule, pelvis renalis, the calyces and smooth muscle of the blood vessels. They are two-folds more common in women and most frequently seen in the fourth and sixth decades. They are solitary lesions. Their major symptoms are pain, palpable mass and hematuria. Clinical, radiological and pathological findings of a 51 years old patient presenting with diagnosed flank pain and nausea and diagnosed as having high-grade primary renal leiomyosarcomas were evaluated under the light of current literature. World J Nephrol Urol. 2014;3(1):63-65 doi: http://dx.doi.o rg/ 10.14740 /wjnu 158e
{"title":"High-Grade Primary Leiomyosarcoma of the Kidney","authors":"H. Öztürk, Serap Karaaslan","doi":"10.14740/WJNU158E","DOIUrl":"https://doi.org/10.14740/WJNU158E","url":null,"abstract":"Leiomyosarcomas account for 0.8 to 2.7% of all malignant renal tumors. Like the leiomyomas, the leiomyosarcomas originate from the cells of the renal capsule, pelvis renalis, the calyces and smooth muscle of the blood vessels. They are two-folds more common in women and most frequently seen in the fourth and sixth decades. They are solitary lesions. Their major symptoms are pain, palpable mass and hematuria. Clinical, radiological and pathological findings of a 51 years old patient presenting with diagnosed flank pain and nausea and diagnosed as having high-grade primary renal leiomyosarcomas were evaluated under the light of current literature. World J Nephrol Urol. 2014;3(1):63-65 doi: http://dx.doi.o rg/ 10.14740 /wjnu 158e","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"3 1","pages":"63-65"},"PeriodicalIF":0.0,"publicationDate":"2014-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67236748","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}
Hung-Chieh Wu, Yu-wei Chen, Wei-Jei Wang, J. Ting, Han-hsiang Chen
Backgrounds: It has been known that severity of acute kidney injury can predict in-hospital and long term mortality. Recently, an additional parameter, duration of acute kidney injury (AKI), might allow better prediction of in-hospital mortality. We aimed to determine if duration of AKI adds additional prognostic information in postoperative patients with AKI. Methods: The study enrolled surgical patients who were admitted to the intensive care unit. AKI cases were defined by RIFLE (risk, injury, failure, loss and end-stage renal failure) criteria and categorized according to tertiles of AKI duration: first tertile, less than 1 day; second tertile, 2 - 5 days; third tertile, greater than or equal to 6 days. The hazard ratios (HRs) for in-hospital mortality after adjust multiple covariates compared to those without AKI were recorded . The predictability of mortality was accessed by calculating the area under the curve (AUC) of receiver operating characteristic curve. Results: In total, 504 postoperative patients with 377 developed AKI (first tertile: 124 cases, second tertile: 140 cases, third tertile: 113 cases) and 127 without AKI were enrolled. The overall in-hospital mortality was 39%. The in-hospital mortality rates were 15.7% (non-AKI), 28.2% (first tertile), 55% (second tertile), and 38.3% (third tertile) as well as the HRs for in-hospital mortality were 1.632, 2.956 and 2.212 compared to non-AKI group (P = 0.201, 0.010 and 0.040). Cumulative in-hospital survival rates differed significantly for non-AKI group vs. AKI groups (first, second and third tertile) (P < 0.001 by log-rank test). The AUC of AKI duration and stage together (0.696) was higher than AKI stage alone using RIFLE criteria (0.665) (both P < 0.001). Conclusions: AKI duration was an additional predictor of in-hospital mortality in patients with postoperative acute kidney injury. World J Nephrol Urol. 2014;3(1):18-24 doi: http://dx.doi.o rg/10.14740/wjnu143 w
{"title":"The Duration of Postoperative Acute Kidney Injury Predicts In-Hospital Mortality in Surgical Patients","authors":"Hung-Chieh Wu, Yu-wei Chen, Wei-Jei Wang, J. Ting, Han-hsiang Chen","doi":"10.14740/WJNU143W","DOIUrl":"https://doi.org/10.14740/WJNU143W","url":null,"abstract":"Backgrounds: It has been known that severity of acute kidney injury can predict in-hospital and long term mortality. Recently, an additional parameter, duration of acute kidney injury (AKI), might allow better prediction of in-hospital mortality. We aimed to determine if duration of AKI adds additional prognostic information in postoperative patients with AKI. Methods: The study enrolled surgical patients who were admitted to the intensive care unit. AKI cases were defined by RIFLE (risk, injury, failure, loss and end-stage renal failure) criteria and categorized according to tertiles of AKI duration: first tertile, less than 1 day; second tertile, 2 - 5 days; third tertile, greater than or equal to 6 days. The hazard ratios (HRs) for in-hospital mortality after adjust multiple covariates compared to those without AKI were recorded . The predictability of mortality was accessed by calculating the area under the curve (AUC) of receiver operating characteristic curve. Results: In total, 504 postoperative patients with 377 developed AKI (first tertile: 124 cases, second tertile: 140 cases, third tertile: 113 cases) and 127 without AKI were enrolled. The overall in-hospital mortality was 39%. The in-hospital mortality rates were 15.7% (non-AKI), 28.2% (first tertile), 55% (second tertile), and 38.3% (third tertile) as well as the HRs for in-hospital mortality were 1.632, 2.956 and 2.212 compared to non-AKI group (P = 0.201, 0.010 and 0.040). Cumulative in-hospital survival rates differed significantly for non-AKI group vs. AKI groups (first, second and third tertile) (P < 0.001 by log-rank test). The AUC of AKI duration and stage together (0.696) was higher than AKI stage alone using RIFLE criteria (0.665) (both P < 0.001). Conclusions: AKI duration was an additional predictor of in-hospital mortality in patients with postoperative acute kidney injury. World J Nephrol Urol. 2014;3(1):18-24 doi: http://dx.doi.o rg/10.14740/wjnu143 w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"3 1","pages":"18-24"},"PeriodicalIF":0.0,"publicationDate":"2014-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67236938","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}
Perihan Öztürk, Kemal Özyurt, E. Kurutaş, Murat Kalender, A. Ataseven, Ekrem Doğan
Background: Nail disorders are common in patients with end-stage renal diseases. Even though there are some studies regarding the nail disorders in hemodialysis and renal transplant patients, to the best of our knowledge, no studies are present in the area of the nail disorders in the peritoneal dialysis patients. The purpose of this study was to investigate the frequencies of nail disorders in chronic renal failure (CRF) patients treated by peritoneal dialysis (PD). Material and Methods: The study group consisted of 61 CRF patients treated by PD and 61 healthy individuals were used as controls. The findings of nail examinations of patient and control groups were assessed. Results: Both the study and the control groups consisted of 37 (61%) males and 24 (39%) females each. T he most frequently observed nail disorders in patients were absent lunula (61%), vertical stripes (48.8%) and onychomycosis (26.8%). Significantly increased frequencies of absent lunula, vertical stripes, onychomycosis, color changes and pitting were determined in patients (P < 0.05). Conclusion: The frequency of nail disorders in CRF patients treated by PD is increased. This finding emphasizes the significance of nail assessment as part of physical examination in PD patients. World J Nephrol Urol. 2014;3(1):30-34 doi: http://dx.doi.org/10.14740/wjnu156e
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