Журнал нефрологии и терапии

Patients with advanced Chronic Heart Failure (CHF) are inclined to decrease renal capacity due to poor renal perfusion and abundance vasoconstriction. The intense administration of patients with decompensated CHF is frequently muddled by worry for precipitating deteriorating renal capacity. Despite the fact that diuretics and Angiotensin-Converting Enzyme Inhibitors (ACEIs) work on cardiovascular yield and for the most part work on renal perfusion in patients with decompensated CHF, a few patients have deteriorating of renal capacity. When aggravated renal dysfunction does occur, doses of ACEIs and diuretics are often reduced or with held in an attempt to preserve renal function. This training might be improper in patients with diligently raised filling tensions and low cardiovascular yield. Exasperated renal dysfunction may in this way drag out the intense therapy period of CHF, defer the help of indications, and result in imperfect dosing of ACEIs— specialists with portion subordinate long term good results in CHF.

Close urologic follow-up of renal transplant candidates and beneficiaries frequently uncovers prostate carcinoma at a beginning phase. Two patients who went through renal transplantation for end-stage illness additionally went through revolutionary perineal prostatectomy for limited prostate carcinoma, 3 years subsequent to uniting in 1 patient and 4 years prior to joining in the other. The perineal way to deal with prostatectomy might work with later renal transplantation and stay away from allograft harm.

Background: Indoxyl Sulfate (IS) and p-Cresol Sulfate (pCS) are two important gut-derived uremic toxins accumulated in patients with Chronic Kidney Disease (CKD). They have been reported contributing greatly to Cardiovascular Disease (CVD) both in epidemiological studies and animal models. The present study was conducted to explore whether IS and pCS contribute to CVD by accelerating cardiovascular risk factors in Peritoneal Dialysis (PD) patients.

Methods: A cross-sectional study was conducted on 119 PD patients. Serum IS and pCS were measured by Ultra-High-Performance LC–tandem MS (UPLCMS/ MS), and metabolic parameters involved in cardiovascular risk were measured by auto-biochemistry analyzer machine. Univariate and multivariate linear regression models were performed to determine the association between the independent variables (IS and pCS) and clinical indexes. Multivariable-adjusted logistic regression models were used to estimate the odds ratios (ORs, 95% confidence intervals (CIs)).

Results: The median BMI of PD patients was 20.10 (18.95, 22.90) kg/m². The median serum IS and pCS concentrations were 22.46 (13.45, 29.92) mg/L and 12.41 (5.29, 24.45) mg/L, respectively. Positive significant associations were observed between serum IS concentration and PD duration, creatinine, prealbumin, phosphorus, magnesium and β2-microglobulin (β2-m) with the corresponding correlation coefficient r and p value of 0.22 (P=0.020), 0.48 (P<0.001), 0.32 (P<0.001), 0.34 (P<0.001), 0.28 (P=0.002), 0.50 (P<0.001). Also, statistically negative significant associations were observed between IS and estimated Glomerular Filtration Rate (eGFR)-0.46 (P<0.001). Besides, a significant positive association between pCS and albumin 0.32 (P<0.001) was indicated.

Conclusions: Serum clinical indexes were dependent cardiovascular risk factors for increasing IS and pCS levels, which contribute to CVD in peritoneal dialysis patients. Mechanism research should be conducted in the future to explore causality.

Background and objectives: Renal biopsy is an essential diagnostic tool used by nephrologists to establish the diagnosis of many glomerular diseases. The absence of an adequate biopsy sample may affect the course of management of patients who may suffer from a serious underlying disease requiring an early initiation of therapy. We conducted a quality improvement project aiming to assess the rate of adequate percutaneous native kidney biopsy samples in the absence of on-site microscopic examination of samples. Furthermore, the project also aimed to study the effect of some variables on the adequacy rate.

Methods: We included all percutaneous native kidney biopsies performed between January 1, 2017, and December 31, 2020. We excluded allograft renal biopsies from this study. Data were retrospectively collected; and included: patient-related data, procedure-related data, and biopsy results-related data. The sample was labeled as adequate if at least ten glomeruli were seen on light microscopy, and at least one glomerulus on immunofluorescence and one glomerulus on electron microscopy. Biopsies not fulfilling the aforementioned criteria were labeled as inadequate.

Results: Out of 82 percutaneous native kidney biopsies, 35 biopsies (43%) were adequate and the remaining 47 biopsies (57%) were inadequate. When comparing the adequate versus the inadequate group we found that the age, gender, weight, BMI, operator, needle size, number of passes, and the number of cores were the same in both groups.

Conclusion: Our study demonstrates the high rate of inadequate renal biopsy samples associated with the lack of on-site microscopic examination of samples. Age, gender, weight, BMI, operator, needle size, number of passes, and number of cores did not affect the rate of the adequacy. The small sample size represents a limitation of this study.

Renal transplantation acts novel difficulties in youngsters like the authoritative treatment of end stage renal infection. The supply of kidneys, surgical technical challenges, immunosuppression treatment, development and improvement, and social contemplations entangle the administration of end stage renal infection in kids. Also, youngsters have a higher affinity of basic lower urinary parcel anomalies contrasted with the grown-up with procured renal infection. The writing is dubious in the conversation of the standardization of the urinary plot brokenness previously during or after transplantation. Be that as it may, the need and timing of the expansion stay unanswered.