Journal of Renal and Hepatic Disorders
type: channel
description: Journal of Renal and Hepatic Disorders (eISSN: 2207-3744) is a peer-reviewed, online-only, open-access journal that publishes basic science and clinical research articles on disorders of the kidneys and the liver. In addition to considering disorders of each organ separately, the journal aims to be a scholarly forum for discussing how disorders of one organ influence the other. Chronic liver disease is associated with primary and secondary kidney diseases. Similarly, renal disorders are associated with hepatic disorders. Original articles, reviews, and case reports on any aspects of nephrology and hepatology are suitable for submission.
publisher: Troika Publisher
language: en
publication name: Journal of Renal and Hepatic Disorders
issn: 2207-3744
copyright: Authors who publish with this journal agree to the following terms: Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access
items: Emergence of antibiotic resistance in bloodstream infections associated with catheters in hemodialysis patients: a prospective observational study
items: Chaos in the diagnosis of hepatitis C virus inhemodialysis patients
items: Clinical profile, response and outcome of variousimmunosuppressive regimens used for treatment ofidiopathic membranous nephropathy—a retrospective cohort study
items: Liver biopsies in pediatric patients—a histopathologicalreview of common entities
items: Prevalence of dysmagnesemia among CKD patients in North India
items: Mitochondrial Impairment and Oxidative Stress Are Essential Mechanisms Involved in the Pathogenesis of Acute Kidney Injury
items: Acute Hepatitis by Bartonella henselae Infection in an Adult Patient with Decompensated Liver Cirrhosis
items: The Interplay of Iron and Lipid Homeostasis in Non-Alcoholic Fatty Liver Disease
items: Incidence, Histopathological Pattern, and Predictors of Non-Diabetic Renal Disease in Type 2 Diabetes Mellitus: A Single-Center Prospective Observational Study
items: Pulmonary Hypertension in Patients of Chronic Kidney Disease on Maintenance Hemodialysis: Study from a Tertiary Care Center in Central India
items: IgA Nephropathy Associated with IgA Vasculitis Coexisting with Focal Segmental Glomerulosclerosis Tip Variant: A Case Report
items: Clinicopathologic Spectrum of Nephrotic Syndrome in the Elderly
items: A Prospective Non-Randomised Interventional Study of Goal-Directed Ultrafiltration Compared With Clinical Dry-Weight Assessment in Achieving Euvolemic Status of Patients on Maintenance Hemodialysis
items: A Comprehensive Overview of In-patients Treated for Hepatocellular Carcinoma at a Tertiary Care Facility in Tanzania
items: L-Ornithine-L-Aspartate and Intermittent Renal Replacement Therapy in Fulminant Hepatitis A: A Case Report
items: Impact of Induction Therapy on Clinical Outcomes of Kidney Transplant Recipients: A Single-Centre Cohort Study
items: Indications for Percutaneous Ultrasound-Guided Renal Biopsy and Complications Associated with it: An Observational Study
items: Quality of Life of Patients on Peritoneal Dialysis and Contributing Factors: A Cross-Sectional Study
items: Paraquat-associated Severe Acute Kidney Injury—Study from India
items: Fibrolamellar Carcinoma with DNAJB1-PRKACA Fusion in a 16-Year-Old: Case Report and Review of Literature
items: Differences in Urinary Calculi Characteristics among the Three Main Racial Groups in KwaZulu-Natal, South Africa
items: Time-Dependent Alterations in Liver Oxidative Stress due to Ethanol and Acetaldehyde
items: Histopathological Spectrum of Nephrectomies; a Single Centre Experience of over 14 Years
items: Epidemiological, Clinical, and Diagnostic Aspects of Urinary Tract Infection in Newborns at the Departmental Teaching Hospital of Borgou-Alibori (DTH-B/A) in Benin
items: Epidemiological, Clinical, Therapeutic, and Evolutionary Aspects of Acute Kidney Damage during Severe Malaria in Children at the Borgou Departmental Teaching Hospital (Benin)
items: Outcome of Hospitalized Pneumonia Patients with and without COVID-19: A Retrospective Cohort Study
items: Clinicopathologic Spectrum of Xanthogranulomatous Pyelonephritis: A Single Center Experience over 8 Years
items: Clinical Profile and Outcomes of COVID-19 in Renal Transplant Recipients
items: Clinicopathological Features of Lupus Nephritis Patients in North-East India; A Single Center Retrospective Observational Study
items: Clinicopathological Spectrum and Outcome of Crescentic Glomerulonephritis: A Retrospective Study from North-East India

Emergence of antibiotic resistance in bloodstream infections associated with catheters in hemodialysis patients: a prospective observational study
type: item
description: Background: Catheter-related bloodstream infections (CRBSIs) are a significant cause of hospitalization and mortality among hemodialysis patients. Incidence rates and resistance patterns vary widely. Recent studies show a rise in CRBSIs caused by multidrug-resistant organisms (MDROs). This study aims to determine the incidence, microbiological profile, antibiogram and outcomes of CRBSIs in hemodialysis patients at our institution. Methods: This prospective single center observational study included all patients initiating hemodialysis with central venous double-lumen catheters. Results: During the study, 240 catheters were inserted in 240 patients. A total of 48/240 (20%) developed CRBSI with 41/48 (85.4%) having culture-positive probable CRBSI and 07/48 (14.6%) having culture-negative possible CRBSI. Concomitant exit site infection was present in 09/48 (18.8%). The CRBSI incidence rate was 1.46 episodes per 1000 catheter days, based on 48 episodes over 32,782 catheter days. The mean time to CRBSI was 204.6 ± 87.1 days. Gram-positive bacteria were cultured in 15 cases (31.3%), Gram-negative bacteria in 26 cases (54.2%), and 7 cases (14.6%) had negative culture. Coagulase negative Staphylococcus Aureus (CoNS) was the most common Gram-positive pathogens isolated, making up 46.7% of the cases. Klebsiella pneumonia, Pseudomonas, and Acinetobacter species were identified as the most prevalent Gram-negative pathogens (n = 06/26 each; 23.1%. Among 8 cultured Gram-negative bacterial species, resistance patterns observed was Ampicillin: 4/4 tested (100.0%), Quinolones: 4/6 tested (66.7%), Clotrimazole: 3/5 tested (60.0%), Carbapenems: 3/6 tested (50.0%), Gentamicin: 2/5 tested (40.0%), Amikacin: 1/3 tested (33.3%), and Piperacillin-Tazobactam: 1/5 tested (20.0%). A total of 39/48 catheters were salvaged. Conclusions: CRBSI remains a significant issue in patients using central venous catheters. The rise of multidrug-resistant Gram-negative infections necessitates stricter mea…
subject: Original Articles Nephrology
  topic: section
subject: Catheter related blood stream infection; Cuffed dialysis catheter; Un-cuffed dialysis catheter; Hemodialysis
  topic: keywords
creator: Mohammad Bhat
creator: Danish Muqbool
creator: Rayees Yousuf
creator: Manzoor Parry
creator: Amir Farooq
creator: Muzamil Wani
creator: Imran Khan
creator: Imtiyaz Wani
creator: Muzafar Wani
rights: Copyright (c) 2025 Rayees Yousuf, Mohammad Ashraf Bhat, Danish Muqbool, Manzoor Ahmad Parry, Amir Farooq, Muzamil Ahmad Wani, Imran Khan, Imtiyaz Wani, Muzafar Wani https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2025-06-20
publication date: 2025-06-20
starting page: 12
ending page: 17
doi: 10.63268/jrenhp.v9i1.211

Chaos in the diagnosis of hepatitis C virus inhemodialysis patients
type: item
description: Background: In India, a broad range of prevalence of Hepatitis C virus (HCV) infection in hemodialysis (HD) patients was reported. Variations in screening methods and regional differences in the HCV genome render challenges in the accurate detection of HCV. In this background, the present study was undertaken to assess the prevalence of HCV by HCV RNA PCR (Ribose nucleic acid Polymerase Chain Reaction) and HCV antibody detection by immunochromatography (ICT) and ELISA (Enzyme Linked Immuno-Sorbent Assay). Methods: A total of 50 patients with chronic kidney disease (CKD) on maintenance HD for more than six months were included in the study. Blood sample was collected and subjected to HCV RNA PCR, and HCV antibody by ICT and ELISA. Results: Of the 50 samples tested, ICT for HCV antibody was detected in 22 (44%) patients. They were positive for ELISA also. HCV RNA was positive in 15 (30%) patients. PCR positive was also positive for HCV antibody. Conclusions: This study concludes, that HCV antibody screening should be performed monthly and RNA PCR once every three months among HD patients.
subject: Original Articles Nephrology
  topic: section
subject: epatitis C virus; Hemodialysis; Antibody detection; Molecular method
  topic: keywords
creator: Ananthapadmanabasamy Indira
creator: Gomathinayagam Velvizhi
creator: Koshy M Koshy
creator: Santhana Kumarasamy Poongodi
rights: Copyright (c) 2024 Ananthapadmanabasamy Indira, Gomathinayagam Velvizhi1, Koshy M Koshy, Santhana Kumarasamy Poongodi http://creativecommons.org/licenses/by/4.0
date: 2024-12-20
publication date: 2024-12-20
starting page: 7
ending page: 10
doi: 10.63268/jrenhp.v8i2.207

Clinical profile, response and outcome of variousimmunosuppressive regimens used for treatment ofidiopathic membranous nephropathy—a retrospective cohort study
type: item
description: Background: Membranous nephropathy (MN) is a glomerular disease commonly presenting as a nephrotic syndrome in adults. Various immunosuppressive medications have been used in the treatment of the same with different levels of success. Hence we have undertaken a retrospective analysis of “Clinical profile, response and outcome of various immunosuppressive regimens used for treatment of membranous nephropathy” to determine the efficacy of each treatment regimen. Methods: A retrospective observational cohort study was conducted in a single tertiary care centre in southern India. Patients with proven primary membranous nephropathy from 2010 to June 2020 with a minimum duration of follow-up of one year and treated with different immunosuppressive regimens were included in the study. Results: The total number of patients in the study was 129. Mean age of onset was 39 years with a follow-up of a minimum of 1 year and a maximum of 10 years, the mean follow-up being 3 years. 46.5% achieved complete remission, 23.3% had partial remission and 10.9% had relapse, doubling of serum creatinine was seen in 5 (3.9%) and chronic kidney failure requiring kidney replacement therapy in 3 (2.3%) respectively. Presence of interstitial fibrosis and tubular atrophy (IFTA) had a significant correlation p-value 0.02, patients with IFTA less than 30% performed the best with 54/71 patients (60%) achieving remission. Conclusions: Hypertension and IFTA at presentation were predictors for worse outcomes. modified Ponticelli, followed by rituximab, were the most effective in inducing and maintaining remission.
subject: Original Articles Nephrology
  topic: section
subject: Glomerular diseases; Membranous nephropathy; Immunosuppression; Outcome
  topic: keywords
creator: Megha Saigal
creator: Swarnalatha Guditi
creator: Gangadhar Taduri
rights: Copyright (c) 2024 Megha Saigal, Swarnalatha Guditi, Gangadhar Taduri http://creativecommons.org/licenses/by/4.0
date: 2024-12-20
publication date: 2024-12-20
starting page: 1
ending page: 6
doi: 10.63268/jrenhp.v8i2.200

Liver biopsies in pediatric patients—a histopathologicalreview of common entities
type: item
description: With the advent of sophisticated non-invasive assays and advanced radiologic techniques, there has been a significant evolution in the role of liver biopsy in the evaluation and management of hepatic diseases. Liver biopsy has a vital role in establishing the diagnosis, staging and prognostic evaluation of various pediatric liver diseases. It is an essential tool in deciding therapeutic management and treatment response. Liver biopsy when used in combination with clinical findings and other diagnostic modalities is useful in guiding treatment and predicting prognosis in the pediatric population. Here we discuss the indications of liver biopsy in various common pediatric liver diseases.
subject: Review Hepatology
  topic: section
subject: Biopsy; Indications; Liver; Management; Pediatric
  topic: keywords
creator: Maria Kamal
creator: Zhongxin Yu
creator: Neha Varshney
rights: Copyright (c) 2025 Maria Kamal, Zhongxin Yu, Neha Varshney https://creativecommons.org/licenses/by-nc-sa/4.0
date: 2025-06-20
publication date: 2025-06-20
starting page: 1
ending page: 11
doi: 10.63268/jrenhp.v9i1.198

Prevalence of dysmagnesemia among CKD patients in North India
type: item
description: Magnesium is the second-most common intracellular cation after calcium with 99% of total body magnesium distributed intracellularly in bones, muscles, and soft tissues. Only 1% of total body magnesium is present extracellularly that contributes to the normal serum magnesium concentration of 1.8–2.6 mg/dL. Recently, many studies have focused on the role of magnesium homeostasis and human health. Diabetes and hypertension are the leading causes of chronic kidney disease (CKD), and the significance of magnesium in CKD has been astonishing in medical practice. In this study, we investigated the serum levels of magnesium and its prevalence at different stages of CKD. This cross-sectional descriptive study was conducted over a period of 2 months. Serum magnesium levels were analysed in 224 patients with CKD and were grouped into five stages of CKD according to the guidelines of the Kidney Disease: Improving Global Outcomes (KDIGO) based on glomerular filtration rate. Laboratory data of patients was analysed using the IBM SPSS V23 software (Chicago, USA) for statistical relationship between serum magnesium levels and stages of CKD in patients with CKD. Mean serum magnesium level of the study population was 2.21 ± 0.75 mg/dL; 50.9% of the patients were normomagnesemic (normal level of magnesium ions in the blood), followed by 30.4% hypomagnesemic and 20.5%, hypermagnesemic. CKD was more common in males (63.4%), compared to females (36.6%). Mean age of patients in G5 stage was significantly higher than in G3a, G3b, and G4 stages (P = 0.001). A progressive decline in renal function and retention of uraemic solutes was observed with progression of CKD. Multiple factors, both inherited or acquired, such as diuretics and alcohol, are implicated in controlling serum magnesium levels. Magnesium deficiency leads to 2.12-fold higher risk of progression to end-stage renal disease (ESRD).
subject: Original Articles Nephrology
  topic: section
subject: CKD
  topic: keywords
subject: dysmagnesemia
  topic: keywords
subject: magnesium level
  topic: keywords
subject: prevalence
  topic: keywords
creator: Shailata Prisi
creator: Kajal Nandi
creator: Elvia Jamatia
creator: Biplob Kumar Biswas
creator: Vatsala Khurana
creator: Binita Goswami
rights: Copyright (c) 2024 Shailata Prisi, Kajal Nandi, Elvia Jamatia, Biplob Kumar Biswas, Vatsala Khurana, Binita Goswami http://creativecommons.org/licenses/by/4.0
date: 2025-03-11
publication date: 2025-03-11
starting page: 17
ending page: 22
doi: 10.15586/jrenhep.v8i1.173

Mitochondrial Impairment and Oxidative Stress Are Essential Mechanisms Involved in the Pathogenesis of Acute Kidney Injury
type: item
description: Acute kidney injury (AKI) is an emergency condition that requires restrictive and appropriate clinical interventions. Identifying mechanisms of organ injury is a critical step in developing clinical interventions. Unilateral ureter obstruction (UUO) is widely used as an animal model for investigating AKI. The current study was designed to evaluate the role of mitochondrial impairment and oxidative stress in the pathogenesis of renal injury in UUO model. Mice underwent UUO surgery. Then, kidney tissue histopathological changes, plasma biomarkers of renal injury, oxidative stress, and different renal mitochondrial indices were evaluated at scheduled time intervals (3, 7, 14, and 21 days after UUO surgical procedure). Significant increase in plasma creatinine and blood urea nitrogen levels was evident in UUO mice. The UUO surgery induced severe kidney tissue histopathological alterations, including necrosis, severe tubular atrophy, and interstitial inflammation. Moreover, kidney biomarkers of oxidative stress included reactive oxygen species formation, lipid peroxidation, protein carbonylation, decreased glutathione reservoirs (GSH), and increased oxidized glutathione (GSSG) observed in UUO mice. On the other hand, significant mitochondrial depolarization, decreased mitochondrial dehydrogenases activity, mitochondrial permeabilization, and decreased adenosine triphosphate and GSH/GSSG levels were discovered in mitochondria isolated from the kidneys of UUO mice. The data obtained from the current study demonstrated a pivotal and interconnected role for oxidative stress and mitochondrial dysfunction in the pathogenesis of renal injury in UUO model. Therefore, these directions could serve as therapeutic targets in animal models or patients of acute renal failure.
subject: Original Articles Nephrology
  topic: section
subject: antioxidants
  topic: keywords
subject: bioenergetics
  topic: keywords
subject: mitochondria
  topic: keywords
subject: nephrotoxicity
  topic: keywords
subject: renal failure
  topic: keywords
creator: Heresh Rezaei
creator: Zahra Honarpishefard
creator: Fatemeh Ghaderi
creator: Ayeh Rouhani
creator: Akram Jamshidzadeh
creator: Seyyed Mohammad Amin Kashani
creator: Narges Abdoli
creator: Forouzan Khodaei
creator: Omid Farshad
creator: Abdollah Arjmand
creator: Issa Sadeghian
creator: Negar Azarpira
creator: Mohammad Mehdi Ommati
creator: Reza Heidari
rights: Copyright (c) 2023 Heresh Rezaei, Zahra Honarpishefard , Fatemeh Ghaderi, Ayeh Rouhani, Akram Jamshidzadeh, Seyyed Mohammad Amin Kashani, Narges Abdoli , Forouzan Khodaei , Omid Farshad , Abdollah Arjmand, Issa Sadeghian , Negar Azarpira , Mohammad Mehdi Ommati, Reza Heidari http://creativecommons.org/licenses/by/4.0
date: 2023-12-26
publication date: 2023-12-26
starting page: 30
ending page: 45
doi: 10.15586/jrenhep.v7i2.94

Acute Hepatitis by Bartonella henselae Infection in an Adult Patient with Decompensated Liver Cirrhosis
type: item
description: Hepatitis caused by Bartonella henselae in adults is a condition that is seldom reported in the literature, as well as its current incidence and prevalence. While there is a broad spectrum of well-defined and established clinical entities, hepatic involvement represents the third most frequent clinical manifestation of infection by this genus of bacteria. It may or may not be characterized by the presence of hepatosplenic granulomas. Diagnosis requires a high level of clinical suspicion, exclusion of additional etiologies, and a causal relationship with risk factors. Polymerase chain reaction is the diagnostic test with the highest diagnostic yield, and treatment varies depending on the clinical expression. We describe the case of an adult patient with hepatitis secondary to Bartonella henselae infection.
subject: Case Reports Hepatology
  topic: section
subject: adult
  topic: keywords
subject: Bartonella
  topic: keywords
subject: gastroenterology
  topic: keywords
subject: hepatitis
  topic: keywords
subject: hepatology
  topic: keywords
creator: Jorge Alonso Garay-Ortega
creator: Louis Fernando Robles Fernandes
creator: Vianey Guadalupe Téllez Bolaños
creator: Karla Paulina Sandoval Mosqueda
creator: Karla Daniela Salgado Guizar
rights: Copyright (c) 2023 Jorge Alonso Garay Ortega, Louis Fernando Robles Fernandes, Vianey Guadalupe Tellez Bolaños, Karla Paulina Sandoval Mosqueda, Karla Daniela Salgado Guizar http://creativecommons.org/licenses/by/4.0
date: 2023-08-30
publication date: 2023-08-30
starting page: 15
ending page: 17
doi: 10.15586/jrenhep.v7i2.172

The Interplay of Iron and Lipid Homeostasis in Non-Alcoholic Fatty Liver Disease
type: item
description: The liver is essential for numerous metabolic functions and is the primary site of iron storage and regulation in addition to maintaining critical functions in lipid metabolism. Both iron deficiency and overload have been demonstrated as being involved with metabolic dysfunction; hence, tight regulation of iron absorption is essential to maintain health. Approximately one-third of individuals suffering from non-alcoholic fatty liver disease have elevated hepatic iron concentrations, with increased iron associated with increased disease severity, suggesting a convergence in dysregulation between lipid and iron metabolism. Increasingly, the literature is demonstrating, using a myriad of model organisms and iron-loading methods, that iron loading induces dysregulation in multiple aspects of hepatic lipid metabolism. However, the molecular mechanisms involved, and their subsequent effects on human diseases, are unclear. As iron is a fundamental component of many enzymes and proteins involved in lipid metabolism and is involved in the production of free radicals and oxidative stress, the mechanisms are numerous. In this review, we examine and summarise the dysregulation that iron loading elicits on hepatic lipid availability, de novo synthesis, catabolism, and export. We propose that understanding the interplay between iron and lipid metabolism holds the key to unlocking the complexities of disease development and progression, ultimately leading to improved therapeutic avenues.
subject: Review Hepatology
  topic: section
subject: cholesterol
  topic: keywords
subject: iron metabolism
  topic: keywords
subject: lipid metabolism
  topic: keywords
subject: non-alcoholic fatty liver disease
  topic: keywords
subject: triglycerides
  topic: keywords
creator: Clinton J. Kidman
creator: Cyril D.S. Mamotte
creator: Keea R. Inder-Smith
creator: Mark J. Tobin
creator: Mark J. Hackett
creator: Ross M. Graham
rights: Copyright (c) 2024 Clinton J Kidman, Cyril DS Mamotte, Keea R Inder-Smith, Mark J Tobin, Mark J Hackett, Ross M Graham http://creativecommons.org/licenses/by/4.0
date: 2025-03-11
publication date: 2025-03-11
starting page: 1
ending page: 16
doi: 10.15586/jrenhep.v8i1.170

Incidence, Histopathological Pattern, and Predictors of Non-Diabetic Renal Disease in Type 2 Diabetes Mellitus: A Single-Center Prospective Observational Study
type: item
description: Patients with type 2 diabetes mellitus (T2DM) may have renal involvement because of isolated diabetic nephropathy (DN), isolated non-diabetic renal disease (NDRD), or mixed lesions (DN combined with NDRD). This study was conducted to find out incidence, histopathological pattern, and clinical predictors of NDRD in the Kashmiri population. This is a single-center prospective observational study conducted from August 2015 to July 2017. Patients with T2DM presenting with atypical clinical features of renal involvement underwent kidney biopsy. A total of 33 patients were included. Isolated NDRD was found in 16/33 (48.5%) patients, isolated DN was discovered in 10/33 (30.3%), and mixed lesions in 7/33 (21.2%) patients. NDRD with or without DN was present in 23/33 (69.7%) patients. Overall, the most common renal histopathological lesion in NDRD was immunoglobulin A (IgA) nephropathy present in 7/23 (30.4%) patients. In mixed lesions, FSGS and TMA were the most common renal lesions present in 2/7 (28.57%) patients. The mean duration of diabetes in NDRD and isolated DN groups was 4.4±3.6 and 7.0±2.9 years, respectively (P = 0.04). NDRD was present in 21/23 (91.3%) patients without diabetic retinopathy (P = 0.016). Our data demonstrated that more than half of the patients with T2DM with atypical features had NDRD upon renal biopsy. The absence of diabetic retinopathy and a shorter duration of diabetes were indicators of NDRD. IgA nephropathy was the most prevalent renal pathology. Clinicians must consider kidney biopsy liberally, especially in patients with unclear etiology of a kidney disease. Patients with type 2 diabetes mellitus (T2DM) may have renal involvement because of isolated diabetic nephropathy (DN), isolated non-diabetic renal disease (NDRD), or mixed lesions (DN combined with NDRD). This study was conducted to find out incidence, histopathological pattern, and clinical predictors of NDRD in the Kashmiri population. This is a single-center prospective observatio…
subject: Original Articles Nephrology
  topic: section
subject: diabetic nephropathy
  topic: keywords
subject: diabetic retinopathy
  topic: keywords
subject: focal segmental glomerulosclersosis
  topic: keywords
subject: IgA nephropathy
  topic: keywords
subject: non-diabetic renal disease
  topic: keywords
creator: Aabid Hussain
creator: Rayees Yousuf Sheikh
creator: Murtaza Rashid Pala
creator: Manzoor Ahmad Parry
rights: Copyright (c) 2023 Aabid Hussain, Rayees Sheikh, Murtaza Pala, Manzoor Parry http://creativecommons.org/licenses/by/4.0
date: 2023-09-06
publication date: 2023-09-06
starting page: 24
ending page: 29
doi: 10.15586/jrenhep.v7i2.167

Pulmonary Hypertension in Patients of Chronic Kidney Disease on Maintenance Hemodialysis: Study from a Tertiary Care Center in Central India
type: item
description: To study the incidence of pulmonary hypertension (PH) in chronic kidney disease (CKD) stage V patients on maintenance hemodialysis (HD) at our center. To compare clinical and metabolic variables among CKD patients with and without PH to search for possible etiologic factors. Comparison of PH in CKD patients at baseline and after 3 months of sildenafil therapy. The study was conducted in the Department of Nephrology, Sri Aurob-indo Institute of Medical Sciences, Indore, for a period of 1 year from December 2021 to November 2022. All CKD patients on maintenance HD at our center were included in the study. A pre-structured proforma was used to record patient data. Detailed clinical examination, 2DECHO, and Biochemical tests were done. All patients with mean pulmonary artery pressure (mPAP) > 25 mmHg on 2D echocardiography were considered to have PH and were started on sildenafil therapy 20 mg three times a day for 3 months. PH was classified as mild PH (mPAP > 25 up to 40 mmHg), moderate PH (mPAP > 40 mmHg to 60 mmHg), and severe PH (mPAP > 60 mmHg). Patients were then followed for 3 months to look for episodes of dyspnea and emergency admissions and reassessed after 3 months by repeat 2D echocardiography to find improvement in PH. A total of 102 patients were analyzed during the study period; among them, 40 patients (39.2%) had PH. Out of them, 18 patients (45%) had mild PH, 14 patients (35%) had moderate PH, and 8 patients (20%) patients had severe PH. Average age of our patients was 48.8 ± 9.4 years, the majority being men. On comparing the clinical features between patients with and without PH, none of the clinical parameters had any statistically significant impact on PH. Also, none of the laboratory parameters had statistical significance among PH and non-PH groups. Among the patients with PH, 25 patients (62.5%) had Arteriovenous (AV) fistula, 10 patients (25%) had temporary dialysis catheters. Eight patients (20%) had jugular catheters, two patients (5%) had fe…
subject: Original Articles Nephrology
  topic: section
subject: chronic kidney disease
  topic: keywords
subject: hemodialysis
  topic: keywords
subject: mean pulmonary artery pressure
  topic: keywords
subject: pulmonary hypertension
  topic: keywords
subject: two-dimensional echocardiography
  topic: keywords
creator: Trishala Chhabra
creator: Naresh Pahwa
creator: Shraddha Goswami
creator: Riyaz Asad
creator: Mohit Mahajan
creator: Sharada Chandrashekhar Aher
rights: Copyright (c) 2023 Trishala Chhabra, Naresh Pahwa, Shraddha Goswami, Riyaz Asad, Mohit Mahajan, Sharada Chandrashekhar Aher http://creativecommons.org/licenses/by/4.0
date: 2023-08-31
publication date: 2023-08-31
starting page: 18
ending page: 23
doi: 10.15586/jrenhep.v7i2.168

IgA Nephropathy Associated with IgA Vasculitis Coexisting with Focal Segmental Glomerulosclerosis Tip Variant: A Case Report
type: item
description: IgA vasculitis (IgAV), previously known as Henoch–Schönlein purpura, is a form of small vessel vasculitis that affects the skin, joints, intestines, and kidneys. The clinical presentation in adults is usually infrequent, more severe, with a worse prognosis and a higher recurrence rate. Due to limited scientific evidence, IgAV is viewed similarly to IgA nephropathy (IgAN), and the renal histopathological lesions are indistinguishable between the two. IgAN is the most prevalent glomerular diseases worldwide. The diagnosis of IgAN is confirmed through a renal biopsy. The most frequently found histopathological lesions are mesangial proliferation and concurrent IgA deposition confirmed by direct immunofluorescence. Focal segmental glomerulosclerosis (FSGS) appears as a glomerular pattern of injury in up to 40% of renal biopsies with IgAN, although there are few reported cases in the international literature where both diseases coexist as primary etiologies. We report a case of a female patient presenting with vasculitic lesions, abdominal pain, and nephrotic syndrome, whose cause is confirmed by a renal biopsy with a diagnosis of IgAN secondary to IgAV and coexistence of FSGS, an unusual presentation with few case reports.
subject: Case Reports Nephrology
  topic: section
subject: glomerulosclerosis
  topic: keywords
subject: IgA nephropathy
  topic: keywords
subject: IgA vasculitis
  topic: keywords
subject: nephrotic syndrome
  topic: keywords
creator: Zitlali Guadalupe Paulín Zepeda
creator: Karla Daniela Salgado Guizar
creator: Vianey Guadalupe Téllez Bolaños
creator: Louis Fernando Robles Fernandes
creator: María Inés Gil Arredondo
rights: Copyright (c) 2023 Zitlali Guadalupe Paulín Zepeda, Karla Daniela Salgado Guizar, Vianey Guadalupe Tellez Bolaños, Louis Fernando Robles Fernandes, María Inés Gil Arredondo http://creativecommons.org/licenses/by/4.0
date: 2023-07-14
publication date: 2023-07-14
starting page: 10
ending page: 14
doi: 10.15586/jrenhep.v7i2.166

Clinicopathologic Spectrum of Nephrotic Syndrome in the Elderly
type: item
description: The elderly population is affected by a wide range of kidney diseases like young adult patients. However, their clinical course and morphological manifestations are affected by aging. Recognition, diagnosis, and management of glomerular disease in elderly persons have several unique challenges. We aimed to study the clinicopathologic spectrum of elderly patients with nephrotic syndrome (NS). In this retrospective study, we looked at 234 patients of adult NS who were biopsied during the last 5 years. Among them, 31 patients were above the age of 60 years (Elderly). Mean age in elderly patients was 67.48 ± 6.11 years, with age range from 60 to 86 years. Elderly NS patients constituted 13.2% of total adult NS patients. Nineteen patients (61.2%) were males and 12 (38.7%) were females. Hematuria was observed in 19% and hypertension in 48% patients. Mean serum albumin was 2.79 ± 0.39 g/dl and mean 24 h urinary protein was 3.77 ± 0.8 grams. Membranous nephropathy (MN) followed by minimal change disease (MCD) was the most common diagnosis. No major complication with biopsy was reported in our study as has been the case with most studies.
subject: Original Articles Nephrology
  topic: section
subject: elderly
  topic: keywords
subject: nephrotic syndrome
  topic: keywords
subject: kidney biopsy
  topic: keywords
subject: Membranous nephropathy
  topic: keywords
subject: MCD
  topic: keywords
subject: FSGS
  topic: keywords
creator: Sheikh Zubair
creator: Junaid Ahmed
creator: Syed Mubashir Nissar
creator: Muzamil Rashid Pala
creator: Aabid Hussain
creator: Murtaza Rashid Pala
creator: Muzamil Latief
rights: Copyright (c) 2023 Sheikh Zubair, Junaid Ahmed, Syed Mubashir Nissar, Muzamil Rashid Pala, Aabid Hussain , Murtaza Rashid Pala, Muzamil Latief http://creativecommons.org/licenses/by/4.0
date: 2023-04-24
publication date: 2023-04-24
starting page: 34
ending page: 37
doi: 10.15586/jrenhep.v7i1.162

A Prospective Non-Randomised Interventional Study of Goal-Directed Ultrafiltration Compared With Clinical Dry-Weight Assessment in Achieving Euvolemic Status of Patients on Maintenance Hemodialysis
type: item
description: An accurate assessment of intravascular volume status in hemodialysis (HD) patients presents a significant challenge. Current clinical practices to determine dry weight is flawed due to interobserver variability and nonreproducibility. This miscalculation results in either chronic hypervolemia or hypovolemia with intra or interdialytic hypotension. The quest for noninvasive volume assessment tools to aid in the estimation of dry weight still continues. This study aims at goal-directed ultrafiltration removal compared with clinical dry-weight assessment in achieving euvolemic status of patients on chronic HD. It is a prospective, single-centered, nonrandomized, noninvasive interventional study on HD patients, for 12 months. Fifty two patients participated out of which 46 completed the study. Ultrasound-guided inferior vena cava collapsing index (IVCCI) and B lines were measured at intervals along with cardiac parameters. Dry weight was first estimated clinically by trial and error method. New dry weight target was set when B-lines were less than four in the eight site lung ultrasound and IVCCI between 50 and 75%, after 30 min post dialysis. Approximately 23.9% of the patients did not require dry-weight modification throughout the study. About 19% patients did not achieve dry weight in spite of all interventions. Overall, 56.5% of the patients achieved dry weight during the study period. A total of 46.3% of patients with NYHA Grade 3 dyspnoea observed at the start of study was reduced to 2.2%, showing statistical significance. Clinical assessment when bundled with noninvasive technology of assessment of dry weight showed encouraging results. B-lines and IVCCI estimation could be additional tools to achieve target weight goals, reducing complications and increasing compliance.
subject: Original Articles Nephrology
  topic: section
subject: B-lines
  topic: keywords
subject: dry weight assessment
  topic: keywords
subject: hemodialysis
  topic: keywords
subject: inferior vena cava collapsing index (IVCCI)
  topic: keywords
subject: left ventricular hypertrophy
  topic: keywords
creator: Pankaj Ganvir
creator: C.H. Sudhiranjan Dash
creator: Amjad Khan Pathan
creator: Rushi Deshpande
creator: Ashay Shingare
creator: Madan Mohan Bahadur
creator: Ashwin Patil
rights: Copyright (c) 2023 Dr Pankaj Ganvir, Dr Sudhiranjan Dash, Dr Amjad Khan Pathan, Dr Rushi Deshpande, Dr Ashay Shingare, Dr M M Bahadur, Dr Ashwin Patil http://creativecommons.org/licenses/by/4.0
date: 2023-07-03
publication date: 2023-07-03
starting page: 1
ending page: 9
doi: 10.15586/jrenhep.v7i2.148

A Comprehensive Overview of In-patients Treated for Hepatocellular Carcinoma at a Tertiary Care Facility in Tanzania
type: item
description: Hepatocellular carcinoma (HCC) is one of the commonest causes of cancer-related morbidity and mortality worldwide. However, only a limited number of studies on HCC have been conducted in Tanzania. We therefore conducted a cross-sectional study among in-patients treated for HCC in a tertiary referral hospital located in Dar es Salaam, Tanzania, in order to provide a concise description of the clinical characteristics and treatment options offered in the study setting. We identified 36 in-patients treated for HCC over a 6-month data collection period. Seventy-seven percent (n = 28) of the participants were males and about two-thirds (61.2%) were aged between 40 and 60 years. Majority (44.4% [n = 16]) of the patients had Child-Pugh class B and an Eastern Cooperative Oncology Group (ECOG) performance status of 2 (33.3% [n = 12]). Patients with tumors >6.5 cm and multinodular tumors (>3 nodules) accounted for 69.4% (n = 25) and 55.6% (n = 20), respectively. Portal vascular invasion and extrahepatic metastasis were respectively present in 27.8% (n = 10) and 25% (n = 9) of the patients. Of the study participants, only two had early-stage disease as per the Barcelona Clinic Liver Cancer (BCLC) staging system, corresponding to the observed tumor resection rate of 5.6%. The most frequently reported inoperable factor among the study participants was an ECOG performance status > 0 (n = 30 [83.3%]). Findings thus reveal a high proportion of late-stage diseases among participants that could have resulted in the observed low tumor resection rate. Initiatives to facilitate identification of the disease at an early stage are therefore paramount in optimizing care.
subject: Original Articles Hepatology
  topic: section
subject: epidemiology
  topic: keywords
subject: hepatocellular carcinoma
  topic: keywords
subject: liver cancer
  topic: keywords
subject: liver resection
  topic: keywords
subject: liver transplantation
  topic: keywords
subject: Tanzania
  topic: keywords
creator: Ally H. Mwanga
creator: James D. Mwakipesile
creator: Daniel W. Kitua
creator: Yona E. Ringo
rights: Copyright (c) 2023 Ally H. Mwanga, James D. Mwakipesile, Daniel W. Kitua, Yona E. Ringo http://creativecommons.org/licenses/by/4.0
date: 2023-03-11
publication date: 2023-03-11
starting page: 22
ending page: 27
doi: 10.15586/jrenhep.v7i1.153

L-Ornithine-L-Aspartate and Intermittent Renal Replacement Therapy in Fulminant Hepatitis A: A Case Report
type: item
description: Hepatitis A is a common viral infection worldwide that is transmitted via the fecal-oral route. Since the introduction of an efficient vaccine, the incidence of infection has decreased but the number of cases has risen due to widespread community outbreaks among unimmunized individuals. Classic symptoms include fever, malaise, dark urine, and jaundice, and are more common in older children and adults. People are often most infectious 14 days prior to and 7 days following the onset of jaundice. We will discuss the case of a young male patient, diagnosed with acute hepatitis A, leading to fulminant hepatitis refractory to conventional therapy and the development of subsequent kidney injury. The medical treatment through the course of hospitalization was challenging and included the use of L-ornithine-L-aspartate and prolonged intermittent hemodialysis, leading to a remarkable outcome. Hepatitis A is usually self-limited and vaccine-preventable; supportive care is often sufficient for treatment, and chronic infection or chronic liver disease rarely develops. However, fulminant hepatitis, although rare, can be very challenging to manage as in the case of our patient.
subject: Case Reports Hepatology
  topic: section
subject: fulminant hepatitis
  topic: keywords
subject: hepatitis A
  topic: keywords
subject: L-ornithine-L-aspartate
  topic: keywords
subject: intermittent renal replacement therapy
  topic: keywords
subject: continuous renal replacement therapy
  topic: keywords
subject: a case report
  topic: keywords
creator: Nourhane J. Obeid
creator: Khaled H. Soukarieh
creator: Jessy G. Fadel
creator: Rayyan M. Wazzi-Mkahal
creator: Marianne A. Alwan
creator: Jessica J. Fakhir
creator: Paul W. Rassam
creator: Najat I. Joubran
creator: Mona H. Hallak
rights: Copyright (c) 2023 Nourhane Obeid, Khaled H. Soukarieh, Jessy G. Fadel, Rayyan M. Wazzi-Mkahal, Marianne A. Alwan, Jessica J. Fakhir, Paul W. Rassam, Najat I. Joubran, Mona H. Hallak http://creativecommons.org/licenses/by/4.0
date: 2023-03-24
publication date: 2023-03-24
starting page: 28
ending page: 33
doi: 10.15586/jrenhep.v7i1.154

Impact of Induction Therapy on Clinical Outcomes of Kidney Transplant Recipients: A Single-Centre Cohort Study
type: item
description: The purpose of this study was to evaluate long-term efficacy of immunosuppressive drugs based on the type of induction therapy given to kidney transplant recipients, and determine the occurrence of graft dysfunctions or rejections. We compared the safety and efficacy of anti-thymocyte globulin (ATG) and basiliximab (BAS) in high-risk patients and analyzed the cumulative incidence of immediate, slow, and delayed graft function in kidney transplant recipients to determine their initial short-term graft function. Evaluation of the long-term efficacy after 3 years post-transplantation by assessment of patients and graft survival, incidence of infections, and risks of rejection were the primary endpoints. Patients with stable graft survival were observed more with ATG (85%) than BAS (70%); in contrast, graft dysfunctions, graft nephrectomy, rejection episodes, and patient deaths were more prevalent with BAS than ATG, with statistically significant differences in long-term graft functioning. Patient survival at 3 years in ATG group was 90.4%, compared to 88% in BAS group, and graft survival was 90.4% in the ATG group and 81.3% in the BAS group (P < 0.001). The use of both induction therapies resulted in good patient and graft survival outcomes than placebo, and the results showed that there was a significant difference in both patient and graft survival after 3 years between induction of ATG and BAS, suggesting that ATG can be safer, effective, and preferable drug over BAS for high-risk recipients.
subject: Original Articles Nephrology
  topic: section
subject: immunosuppressive therapy
  topic: keywords
subject: induction therapy
  topic: keywords
subject: initial graft function
  topic: keywords
subject: long-term graft function
  topic: keywords
subject: transplantation
  topic: keywords
creator: Vijaya Madhuri Devraj
creator: Gangadhar Taduri
creator: Swarnalatha Guditi
creator: Uttara Das
creator: MP Shamsudheen
creator: Megha Saigal
creator: Raja Kartik Kalidindi
rights: Copyright (c) 2023 Vijaya Madhuri Devraj, Gangadhar Taduri, Swarnalatha Guditi, Uttara Das, MP Shamsudheen, Megha Saigal, Karthik Kalidindi http://creativecommons.org/licenses/by/4.0
date: 2023-01-24
publication date: 2023-01-24
starting page: 1
ending page: 10
doi: 10.15586/jrenhep.v7i1.150

Indications for Percutaneous Ultrasound-Guided Renal Biopsy and Complications Associated with it: An Observational Study
type: item
description: Renal biopsy is performed for various reasons depending on the clinical manifestations presented. Although percutaneous kidney biopsy is a safe procedure, major or minor complications could occur. Our study aimed to assess the indications for percutaneous renal biopsy and complications associated with the procedure. This was a prospective observational study conducted in the Department of Nephrology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India. Patients who underwent percutaneous ultrasound-guided renal biopsy at the institute between October 2017 and June 2019 were enrolled in the study. Data regarding indications for performing a percutaneous renal biopsy and incidence of minor and major post-biopsy complications were collected. A total of 229 patients who underwent ultrasound-guided percutaneous renal biopsy were enrolled in the study. The most common indications for ultrasound-guided percutaneous renal biopsy were nephrotic syndrome (33.3%), subnephrotic proteinuria with azotemia (14%), and unexplained azotemia with proteinuria and hematuria (13.5%). Post-biopsy complications were observed in 89 (37.55%) patients. Minor complications developed in 83 (36.22%) patients and major complications in six (2.62%) patients. Among patients with major complications, two (0.87%) patients underwent invasive procedures (embolization and cystoscopic removal of bladder clot) and four patients developed hemodynamic instability. No procedure-related mortality was reported in the study. The most common indications for renal biopsy were nephrotic syndrome, subnephrotic proteinuria with azotemia, unexplained azotemia with proteinuria, and hematuria. The incidence of major complications was low.
subject: Original Articles Nephrology
  topic: section
subject: azotemia
  topic: keywords
subject: complications
  topic: keywords
subject: nephrotic syndrome
  topic: keywords
subject: percutaneous ultrasound-guided renal biopsy
  topic: keywords
subject: renal biopsy
  topic: keywords
creator: Mohammad Ashraf Bhat
creator: Shahid Sulayman
creator: Manzoor Ahmad Parry
creator: Muzaffar Maqsood Wani
creator: Imtiyaz Ahmad Wani
rights: Copyright (c) 2022 Mohammad Ashraf Bhat, Shahid Sulayman, Manzoor Parry, Muzaffar Wani, Imtiyaz Wani http://creativecommons.org/licenses/by/4.0
date: 2022-12-31
publication date: 2022-12-31
starting page: 8
ending page: 13
doi: 10.15586/jrenhep.v6i2.149

Quality of Life of Patients on Peritoneal Dialysis and Contributing Factors: A Cross-Sectional Study
type: item
description: In recent years, interest in Health-Related Quality of Life (HRQoL) as a major indicator of clinical efficacy and treatment outcome in patients of End-Stage Renal Disease (ESRD) has grown significantly. This study aimed to determine the contributing factors affecting the quality of life (QoL) of ESRD patients undergoing peritoneal dialysis (PD). A cross-sectional study was conducted on PD patients presented at PD centres of Al-Zahra and Noor hospitals in Isfahan, Iran, from May to August 2019. A total of 173 patients having peritoneal dialysis for more than 3 months filled the validated 36-item short-form health survey questionnaire (SF-36). Baseline demographic details and dialysis-related factors were collected from patients’ medical records. The overall QoL score of patients was 50.28 ± 20.87. Male patients had a higher QoL score than female patients (58.18 in males, compared to 48.18 in females; P = 0.04). A significant association between frequency of dialysis and quality of life was observed, where three sessions of dialysis per day yielded the highest quality of life (QoL score = 59.62; P = 0.047). A significant positive correlation was discovered between QoL score and residual renal function (P = 0.013). In addition, a higher QoL score was observed in self-employed patients (60.95), compared to housewives (46.49) (P = 0.001). QoL assessment should be included as an integral part of patient follow-up to evaluate treatment outcomes and implement possible interventions to improve patient’s quality of life.
subject: Original Articles Nephrology
  topic: section
subject: chronic kidney disease
  topic: keywords
subject: end-stage renal disease
  topic: keywords
subject: peritoneal dialysis
  topic: keywords
subject: quality of life
  topic: keywords
subject: SF-36 questionnaire
  topic: keywords
creator: Niloofar Nili
creator: Shiva Seirafian
creator: Sayed Mohsen Hosseini
creator: Abdolamir Atapour
creator: Maryam Kazemi Naeini
creator: Mojgan Mortazavi
rights: Copyright (c) 2023 Niloofar Nili, Shiva Seirafian, Sayed Mohsen Hosseini, Abdolamir Atapour, Maryam Kazemi Naeini, Mojgan Mortazavi http://creativecommons.org/licenses/by/4.0
date: 2023-03-01
publication date: 2023-03-01
starting page: 11
ending page: 21
doi: 10.15586/jrenhep.v7i1.151

Paraquat-associated Severe Acute Kidney Injury—Study from India
type: item
description: To analyze the outcomes of severe acute kidney injury in patients with paraquat ingestion. This retrospective analysis of case records was done in our institute, a tertiary care government teaching hospital, over a period of 4 years. Of the total 1310 acute paraquat poisonings during this period, severe acute kidney injury (AKI), referred for nephrology management was observed in 60 patients. Common symptoms at presentation include vomiting, oral ulcers, and abdominal pain. Oliguric AKI was present in 26%. Need for renal replacement therapy was observed in 95% of the cases. Mortality was observed in 38 of the 60 patients (68%). Factors associated with mortality on Cox regression analysis include amount of consumption. Estimated duration of survival on analysis curves was 8 days in 50% after admission and 15 days after consumption in 50%. Paraquat poisoning is associated with grave outcomes of morbidity and mortality. Severity of AKI is significant in this poisoning. Amount of consumption, latency of referral play a major role in outcomes.
subject: Original Articles Nephrology
  topic: section
subject: severe acute kidney injury
  topic: keywords
subject: paraquat ingestion
  topic: keywords
subject: poisoning
  topic: keywords
subject: renal replacement therapy
  topic: keywords
creator: Manjusha Yadla
creator: K. Manu
creator: K.V. Anupama
creator: B. Rajasekhar
rights: Copyright (c) 2022 Manjusha Yadla, Manu K, KV Anupama, B Rajasekhar http://creativecommons.org/licenses/by/4.0
date: 2022-12-13
publication date: 2022-12-13
starting page: 14
ending page: 23
doi: 10.15586/jrenhep.v6i2.140

Fibrolamellar Carcinoma with DNAJB1-PRKACA Fusion in a 16-Year-Old: Case Report and Review of Literature
type: item
description: Fibrolamellar hepatocellular carcinoma (FLC) is a unique primary liver malignancy arising in noncirrhotic livers of young adults with an incidence of 0.02 per 100,000 in the USA (1). In the 5th edition of the WHO classification of the digestive system tumors published in 2019, fibrolamellar carcinoma is categorized as a subset of hepatocellular carcinoma (HCC). In 2014, the unique DNAJB1-PRKACA chimeric fusion protein was identified. Later studies proved this chimeric fusion protein as the main pathological driver in the disease manifestation of fibrolamellar carcinoma. Despite the invention of specific molecular genetic alteration in FLC, its oncogenic role and implication in FLC treatment remain an enigma. Surgical resection remains the primary therapeutic option, and the recurrence rate is extremely high (1). We present a case of fibrolamellar carcinoma in a pediatric patient with the PRKACA rearrangement resulting in DNAJB1-PRKACA fusion.
subject: Case Reports Hepatology
  topic: section
subject: DNAJB1-PRKACA fusion
  topic: keywords
subject: fibrolamellar carcinoma
  topic: keywords
subject: hepatocellular carcinoma
  topic: keywords
subject: mixed fibrolamellar hepatocellular carcinoma
  topic: keywords
subject: PRKACA rearrangement
  topic: keywords
creator: Varsha Prakash
creator: Neha Varshney
rights: Copyright (c) 2022 Varsha Prakash, Neha Varshney http://creativecommons.org/licenses/by/4.0
date: 2022-07-19
publication date: 2022-07-19
starting page: 1
ending page: 7
doi: 10.15586/jrenhep.v6i2.147

Differences in Urinary Calculi Characteristics among the Three Main Racial Groups in KwaZulu-Natal, South Africa
type: item
description: Racial differences in the characteristics of urinary calculi are poorly described in the South African context, limiting our local understanding of urolithiasis pathology and thwarting our efforts in designing appropriate preventative interventions. We sought to investigate differences in urinary calculi characteristics among the main racial groups in KwaZulu-Natal, South Africa. We conducted a retrospective chart review of patients with urinary calculi at a quaternary hospital in KwaZulu-Natal, South Africa, during 2018–2019. We collected data on the patient’s age, sex, race (Caucasian, Asian, Black African), residence, and pre-stenting. Five study outcomes were investigated across racial groups: number of calculi, location of the calculi, size of the calculi, density of the calculi (Hounsfield Unit measurement >600), and the number of operative interventions performed. Data were analyzed with descriptive statistics, the chi-squared test, and unadjusted/adjusted logistic regression. Our study sample consisted of 147 patients (10.9% Caucasian, 55.8% Asian, and 33.3% Black African). Most patients (86.4%) were from urban areas. A higher proportion of Black Africans had urinary calculi with Hounsfield Unit measurements >600 (P = 0.002). In the logistic regression models, Black Africans had a higher probability of having urinary calculi with Hounsfield Unit measurements >600 (Unadjusted Odds Ratio: 7.17, 95% Confidence Interval: 2.00–27.80; Adjusted Odds Ratio: 18.75, 95% Confidence Interval: 3.37–157.57). Our analysis suggests that Black Africans are at higher risk of having harder urinary calculi than other race groups. This has implications for urolithiasis management and highlights the importance of primary prevention in this group. We recommend additional research to confirm our findings.
subject: Original Articles Nephrology
  topic: section
subject: characteristics
  topic: keywords
subject: racial disparity
  topic: keywords
subject: South Africa
  topic: keywords
subject: Urinary calculi
  topic: keywords
subject: Urolithiasis
  topic: keywords
creator: Dhesigan Naidoo
creator: Vishan Ramloutan
rights: Copyright (c) 2023 Dhesigan Naidoo, Vishan Ramloutan http://creativecommons.org/licenses/by/4.0
date: 2023-05-04
publication date: 2023-05-04
starting page: 38
ending page: 43
doi: 10.15586/jrenhep.v7i1.142

Time-Dependent Alterations in Liver Oxidative Stress due to Ethanol and Acetaldehyde
type: item
description: Binge drinking is a major public health issue and ethanol-related liver insult may play a major role in the pathology of alcoholic liver disease. However, the degree of oxidative stress, cell death and contribution of acetaldehyde to liver damage over a 24-h period has yet to be determined. Herein, we aimed to investigate the effect of acute alcohol and elevated acetaldehyde levels on hepatic oxidative damage, apoptosis, and antioxidant enzyme activity over a 24-h period. Male Wistar rats were divided into four groups and animals were pre-injected (intraperitonially [i.p.]) with either saline (0.15 mol/L) or cyanamide (5-mmol/kg body weight), followed by either saline (0.15 mol/L) or ethanol (75-mmol/kg bodyweight). After 2.5, 6 and 24 h, hepatic cytosolic and mitochondrial fractions were analysed for indices of oxidative stress. At 2.5 h, cytosolic glutathione and malondialdehyde levels were significantly reduced and increased, respectively, with alcohol treatment. Caspase-3 activity and cytochrome c levels were increased with alcohol treatment at 24 h. The combination of cyanamide and alcohol treatment at 24 h led to a significant increase in serum alanine aminotransferase levels, and reduced albumin and total protein levels. Furthermore, glutathione peroxidase activity and glutathione reductase activity were significantly decreased and increased, respectively. Finally, superoxide dismutase activity was decreased in cytosol and increased in the mitochondria after cyanamide and ethanol treatment, respectively. This study indicates a complex differential effect of alcohol and acetaldehyde, whereby alcohol toxicity in the mitochondria takes place throughout the 24-h period, but raised acetaldehyde has a further detrimental effect on liver function.
subject: Original Articles Hepatology
  topic: section
subject: acetaldehyde
  topic: keywords
subject: alcohol
  topic: keywords
subject: antioxidant
  topic: keywords
subject: apoptosis
  topic: keywords
subject: mitochondria
  topic: keywords
subject: oxidative stress
  topic: keywords
creator: Lucy Petagine
creator: Hannah Everitt
creator: Roy Sherwood
creator: Daniel Gyamfi
creator: Vinood B. Patel
rights: Copyright (c) 2022 Lucy Petagine, Hannah Everitt, Roy Sherwood, Daniel Gyamfi, Vinood Patel http://creativecommons.org/licenses/by/4.0
date: 2022-05-11
publication date: 2022-05-11
starting page: 56
ending page: 66
doi: 10.15586/jrenhep.v6i1.143

Histopathological Spectrum of Nephrectomies; a Single Centre Experience of over 14 Years
type: item
description: Nephrectomy is conducted either as an open or a laparoscopic procedure for a variety of clinical indications. These include both neoplastic and non-neoplastic conditions, such as the non-functioning kidney. In many patients the final diagnosis is established on the histopathology of the retrieved kidney. In this study, retrospective analysis of data of last 14 years was studied pertaining to the number and indications of nephrectomy at the present study centre. Demographic and clinical details were assessed. Gross and microscopic histopathological details were recorded. Diagnosis was established on the basis of clinical features and histopathology. A total of 638 total nephrectomy specimens were received. Of these, 280 cases were of neoplastic and 358 of non-neoplastic lesions, with a male-to-female ratio of 1.21:1. The age range varied widely according to clinical manifestations. The age range in the present study was 5–84 years. Patients operated for non-neoplastic disorders were younger (mean age: 38.1 years) than those operated for neoplastic disorders (mean age: 54.4 years). Clear renal cell carcinoma (RCC) was the commonest RCC type (150 patients) followed by papillary RCC (51 cases). Nephrectomy is done due to both benign and malignant clinical indications as observed in this study. The most common indication was chronic pyelonephritis with the non-functioning kidney.
subject: Original Articles Nephrology
  topic: section
subject: Nephrectomy
  topic: keywords
subject: Pyelonephritis
  topic: keywords
subject: RCC
  topic: keywords
creator: Farhat Abbas
creator: Gul Aalmeen
creator: Muzamil Latief
creator: Shahid Wani
creator: Mohsin Wani
creator: Summyia Farooq
rights: Copyright (c) 2022 Farhat Abbas, Muzamil Latief, Shahid Wani, Gul Aalmeen, Mohsin Wani, Summyia Farooq http://creativecommons.org/licenses/by/4.0
date: 2022-04-13
publication date: 2022-04-13
starting page: 36
ending page: 40
doi: 10.15586/jrenhep.v6i1.138

Epidemiological, Clinical, and Diagnostic Aspects of Urinary Tract Infection in Newborns at the Departmental Teaching Hospital of Borgou-Alibori (DTH-B/A) in Benin
type: item
description: To study epidemiological and diagnostic aspects of urinary tract infection (UTI) in newborns at the Departmental Teaching Hospital of Borgou-Alibori (DTH-B/A). This was a cross-sectional study conducted from April 1, 2019 to September 30, 2019 and concerned all newborns admitted to the neonatal unit of DTH-B/A. According to the National Agency for Health Accreditation and Evaluation (NAHAE)recommendations of 2002, all symptomatic newborns who did not have a visible malformation outside the genitourinary system and whose parents gave their consent were included in the study. The census was exhaustive despite the calculated minimum size of 109 newborns. Urine sedimentation and cytobacteriological examination of urine samples, taken in adhesive bags after local disinfection, demonstrated presence of pathogenic microbes. Sensitivity of detected microbes was studied to different antibiotics. Interpretive reading of antibiograms was established according to the Standards of the French Society of Microbiology (FEMS), edition 2012. If UTI was confirmed, an abdominopelvic ultrasound was performed in search for a malformative uropathy as a contributing factor in newborns. A standardized survey was developed for data collection. The data entered were analyzed using the Epi info software, version 3.5.4. In all, 124 newborns were included in the study. UTI accounted for 8.06% of all neonatal infections and 2.15% of admissions. The average age of onset was 7.8 days, with a gender ratio of 1:1. The main clinical manifestations were jaundice and respiratory distress. Microbes involved were Staphylococcus aureus (6/10), Escherichia coli (2/10), and Klebsiella oxytoca (2/10). The resistance of microbes to antibiotics was generally high. No abnormalities were revealed in the ultrasound. Although neonatal UTI is not a rare infection, bacterial resistance is of concern.
subject: Original Articles Nephrology
  topic: section
subject: Benin
  topic: keywords
subject: newborn
  topic: keywords
subject: urinary tract infection
  topic: keywords
creator: Séraphin Ahoui
creator: Gerard Kpanidja
creator: Alphonse Noudamadjo
creator: Falilatou Agbeille
creator: Hermione Nelly Djima
creator: Ahmed Adegbola
creator: Aristide Dah
creator: Julien Didier Adedemy
creator: Joseph Agossou
rights: Copyright (c) 2022 Seraphin Ahoui , Gerard Kpanidja, Alphonse Noudamadjo, , Hermione Nelly Djima, Ahmed Adegbola, Aristide Dah , Julien Didier Addemy, Joseph Agossou http://creativecommons.org/licenses/by/4.0
date: 2022-04-26
publication date: 2022-04-26
starting page: 41
ending page: 47
doi: 10.15586/jrenhep.v6i1.127

Epidemiological, Clinical, Therapeutic, and Evolutionary Aspects of Acute Kidney Damage during Severe Malaria in Children at the Borgou Departmental Teaching Hospital (Benin)
type: item
description: Malaria is an endemic pathology with several complications, including kidney damage. The objective of this work was to study kidney damage during severe malaria in children at the pediatrics department of the Borgou Departmental Teaching Hospital (Borgou DTH), Benin in 2021. This was a longitudinal study carried out over 4 months from June 1, 2021 to September 30, 2021 (with 1 month of recruitment from June 1 to July 1, 2021) at the pediatric department of the Borgou DTH. The study included children aged 1 month–15 years, hospitalized for Plasmodium falciparum malaria with at least one clinical manifestation of malaria severity established by the World Health Organization in 2000 and whose parents had given their informed consent. The damage was established by urinary sedimentation using urine dipstick and urinary cap and serum creatinine. Acute kidney injury (AKI) was intended and classified according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. The dependent variable was the presence of at least one clinical, biological, and functional impairment. Follow-up was regular for up to 3 months. Lost to follow-up were excluded. Predictors of occurrence were identified. Statistical difference was considered significant at P < 0.05. Of the 164 children hospitalized for severe malaria during the study period, 72 had at least one renal impairment, with a frequency of 43.90%. The average age of the children was 44.93 months. On urine dipstick, 76.39% of the patients had hemoglobinuria and 55.56% had albuminuria. Urinary cap revealed 44% granular cylindruria and 32% crystalluria. AKI was detected in 4.54% patients. Recovery was complete in all follow-up cases. The predictors of kidney damage were coma ( P = 0.017), jaundice ( P = 0.007), thrombocytopenia ( P = 0.021), and long hospital stay ( P = 0.008). Kidney damage in severe malaria is frequent. Early diagnosis and prompt treatment are fundamentals of rapid and complete recovery of kidney functions.
subject: Original Articles Nephrology
  topic: section
subject: children
  topic: keywords
subject: kidney disease
  topic: keywords
subject: malaria
  topic: keywords
subject: predictors
  topic: keywords
subject: Parakou
  topic: keywords
creator: Séraphin Ahoui
creator: Alphonse Noudamadjo
creator: Gerard Kpanidja
creator: Evariste Eteka
creator: K.O. Auguste Akoto
creator: Falilatou Agbeille
creator: Muriel Toutche
creator: Aristide Dah
creator: Julien Didier Adedemy
creator: Joseph Agossou
rights: Copyright (c) 2022 Seraphin Ahoui , Alphonse Noudamadjo, Gerard Kpanidja, Evariste Eteka, K. O. Auguste Akoto, Falilatou Agbeille, Muriel Toutche, Mr, Julien Didier Adedemy, Joseph Agossou http://creativecommons.org/licenses/by/4.0
date: 2022-04-26
publication date: 2022-04-26
starting page: 48
ending page: 55
doi: 10.15586/jrenhep.v6i1.137

Outcome of Hospitalized Pneumonia Patients with and without COVID-19: A Retrospective Cohort Study
type: item
description: COVID-19 pneumonia and community-acquired pneumonia (CAP) have been associated with morbidity and mortality. The aim of this study was to evaluate the outcome of hospitalized patients with COVID-19 pneumonia versus CAP in terms of mortality. This was a retrospective cohort study conducted between pre-COVID-19 era (May 2019–November 2019) and COVID-19 era (May 2020–November 2020). The study included all adult patients with COVID-19 pneumonia (Group 1) and adult patients with CAP but are COVID-19 negative (Group 2). A total of 106 patients were included in the study, of which 56 were in the COVID-19 pneumonia group and 50 in the CAP group. Patients who developed acute kidney injury (AKI) were 60.7% (n = 34) in Group 1 and 48% (n = 24) in Group 2. Mortality occurred in 37.5% (n = 21) patients in Group 1 and 12.0% (n = 6) in Group 2 (P = 0.003). A total of 52 patients required admission to intensive care unit (ICU), of which 44.6% (n = 25) were in Group 1 and 54.0% (n = 27) in Group 2. Of the 58 patients who developed AKI, 3 (8.8%) patients in Group 1 passed away compared to none in Group 2. Moreover, 58.8% patients (n = 20) in Group 1 and 70.8% patients (n = 17) in Group 2 required ICU admission. Mortality rate in the ICU was 80.0% (n = 16) and 35.3% (n = 6) in Groups 1 and 2, respectively (P = 0.006). The overall mortality rate was higher in case of COVID-19 patients than those with CAP. In case of patients with AKI, mortality rate in the ICU was significantly higher in COVID-19 pneumonia patients compared to CAP patients.
subject: Original Articles Nephrology
  topic: section
subject: acute kidney injury
  topic: keywords
subject: COVID-19
  topic: keywords
subject: mortality
  topic: keywords
subject: pneumonia
  topic: keywords
creator: Rabab Khalil
creator: Loubna Sinno
creator: Housam Rabah
rights: Copyright (c) 2022 Rabab Khalil, Loubna Sinno, Housam Rabah http://creativecommons.org/licenses/by/4.0
date: 2022-01-07
publication date: 2022-01-07
starting page: 17
ending page: 23
doi: 10.15586/jrenhep.v6i1.132

Clinicopathologic Spectrum of Xanthogranulomatous Pyelonephritis: A Single Center Experience over 8 Years
type: item
description: Xanthogranulomatous pyelonephritis (XGP) is a chronic pyelonephritis subtype in which destruction of the renal parenchymal occurs, resulting in progressive loss of kidney functions. Although middle age is the predominant age group affected, but it can be spotted at any age. There is accumulation of macrophages (lipid-laden), leading to renal parenchymal destruction and fibrosis. In this study, we present our data of 15 patients who had undergone nephrectomy and had biopsy-proven XGP. XGP constituted 4.53% of the 331 nephrectomies performed for infective causes over a period of 8 years. All our patients had undergone unilateral total nephrectomy. Demographic and clinical data were analyzed after taking consent from all the patients. The age range of patients in our study was 18–65 years with a mean age of 43.93 ± 13.86 years. Ten (66.6%) of our patients were females. Diabetes was present in 40% of the patients. Three patients had imaging, suggestive of pyonephrosis, 3 had perinephric collection and 9 patients (60%) had concomitant nephrolithiasis. All the kidneys were grossly enlarged and were nonfunctional on renal scintigraphy. XGP is a form of chronic pyelonephritis, which, although less common, is devastating because of destruction of the renal parenchyma and associated morbidity. Clinicoradiologic correlation cannot be overemphasized. Definitive diagnosis is established through histopathologic examination.
subject: Original Articles Nephrology
  topic: section
subject: pyelonephritis
  topic: keywords
subject: pyonephrosis
  topic: keywords
subject: XGP
  topic: keywords
creator: Farhat Abbas
creator: Summyia Farooq
creator: Gul Aalmeen
creator: Muzamil Latief
creator: Mohsin Wani
rights: Copyright (c) 2022 Farhat Abbas, Summyia Farooq, Gul Aalmeen, Muzamil Latief, Mohsin Wani http://creativecommons.org/licenses/by/4.0
date: 2022-04-07
publication date: 2022-04-07
starting page: 32
ending page: 35
doi: 10.15586/jrenhep.v6i1.135

Clinical Profile and Outcomes of COVID-19 in Renal Transplant Recipients
type: item
description: There is minimal information on coronavirus disease 2019 (COVID-19) in developing countries regarding renal transplant recipients (RTRs). This paper aimed to study the clinical profile, immunosuppressive regimen, treatment, and outcomes in an RTR with COVID-19. This retrospective study was conducted in the nephrology department of Sri Aurobindo Medical College & Postgraduate Institute, Indore (MP), India, from April 1, 2020 to December 15, 2020. We studied 15 patients, of which 13 were treated at our hospital and two were treated in OPD. The median age of transplant recipients was 45 (Interquartile range [IQR]: 26–62) years, the majority being males, and recipients presented at a median of 4 (IQR: 0.3–11) years after transplant. The most common comorbidities included hypertension in 14 (94%) and diabetes 3 (20%) patients. The presenting symptoms at presentation were cough (80%), headache (52%), fever (46%), and breathlessness (26%). Clinical severity as per computerized tomography (CT) severity score ranged from mild (20%), moderate (53%), and severe (27%). Strategies to modify immunosuppressants included discontinuation of antimetabolites without changes in calcineurin inhibitors and steroids (100%). Antiviral therapy (Favipiravir and Remdesivir) was associated with better outcomes and reduced hospital stay. Risk factors for mortality included ABO-incompatibility, severity of disease, high Coronavirus Disease 2019 (COVID-19) Reporting and Data System (CO-RADS) score, allograft dysfunction before COVID-19 infection, acute kidney injury, elevated inflammatory markers, and intensive care unit/ventilator requirement. Overall patient mortality was 13.2%. Risk factor for mortality in COVID-19 positive with RTR appears to be ABO-incompatible transplant, having a previous history of rejection, and patient requiring ventilatory support.
subject: Original Articles Nephrology
  topic: section
subject: acute kidney injury
  topic: keywords
subject: corona virus disease
  topic: keywords
subject: intensive care unit
  topic: keywords
subject: renal transplant recipients
  topic: keywords
subject: mycophenolate mofetil
  topic: keywords
creator: Mohit Mahajan
creator: Naresh Pahwa
creator: Shraddha Goswami
creator: Vijay Malviya
creator: Vishnu Shukla
creator: Trishala Chhabra
rights: Copyright (c) 2021 Mohit Mahajan, Naresh Pahwa, Shraddha Goswami, Vijay Malviya , Vishnu Shankar Shukla , Trishala Chhabra http://creativecommons.org/licenses/by/4.0
date: 2021-12-23
publication date: 2021-12-23
starting page: 10
ending page: 16
doi: 10.15586/jrenhep.v6i1.133

Clinicopathological Features of Lupus Nephritis Patients in North-East India; A Single Center Retrospective Observational Study
type: item
description: Clinicopathological presentation of lupus nephritis (LN) patients varies with different race and ethinicity of the population. Only few studies describe clinicopathological spectrum of LN patients in the Indian population. The aim of this study was to determine the clinicopathological spectrum of LN in the North-East Indian population. This was a retrospective observational study that included patients with LN at a tertiary care center in North-East India from March 2007 to August 2018. Clinical and histopathological data at the time of presentation were collected from hospital records. Renal biopsies were examined by light microscopy and direct immunofluorescence techniques. A total of 340 patients of LN were included in this study. The mean age of presentation was 22.42 ± 4.3 years. The minimum age at presentation was 8 years and 18.8% belonged to the <18 year age group. The present study showed a male:female ratio of 1:8. The majority of patients were of class IV (71.9%). Arthralgia (47.1%) and anemia (60.3%) were the most common presenting symptom and sign, respectively. Immunoglobulin (Ig) G was the most abundant immunoglobulin (positive in 98.47%) and the least positive was IgA (positive in 41.18%). Complement (C) 3 and C1q were positive in all. Full house deposition was found in 59.3% of the biopsies. The rates of hypertension, microscopic hematuria, renal dysfunction, and nephrotic syndrome were 43.5, 59.12, 45.9, and 35.3%, respectively. Patients of LN in the North-East Indian population present at an earlier age with a more severe form of the disease (class IV) at the time of presentation.
subject: Original Articles Nephrology
  topic: section
subject: clinicopathological presentation
  topic: keywords
subject: histopathology
  topic: keywords
subject: lupus nephritis
  topic: keywords
subject: systemic lupus erythematosus
  topic: keywords
creator: Shahzad Alam
creator: Manzoor Parry
creator: Manjuri Sharma
creator: Hamad Jeelani
creator: Mastakim Mazumder
rights: Copyright (c) 2022 Shahzad Alam, Manzoor Parry, Manjuri Sharma, Hamad Jeelani, Mastakim Mazumder http://creativecommons.org/licenses/by/4.0
date: 2021-12-10
publication date: 2021-12-10
starting page: 1
ending page: 6
doi: 10.15586/jrenhep.v6i1.130

Clinicopathological Spectrum and Outcome of Crescentic Glomerulonephritis: A Retrospective Study from North-East India
type: item
description: Crescentic glomerulonephritis (CrGN) is characterized by the presence of crescents in more than 50% of glomeruli. This study aims to identify the etiology and clinicopathological features and outcomes of CrGN. In this observational study, 80 biopsy-proven CrGN were included. Patients’ demographic profile, clinical parameters, treatments, and outcomes were collected and analyzed. The mean age in our study population was 40.86 ± 16.5 years. Type II CrGN was the most common type of CrGN. Female predominance was observed in type I and type II CrGN. The highest percentage of glomeruli with crescents was seen in type I (87 ± 15.2%, P = 0.04), followed by type III and type II. At the last follow-up, mean estimated glomerular filtration rate was 25.8 ± 11.41 mL/min/1.73 m2 and was significantly lower in type I CrGN (11.6 ± 4.8 mL/min/1.73 m2 P = 0.001). The overall 5-year renal survival rate was 55% and was highest in type II (69.4%), followed by type III and type I (27.3%) CrGN (P = 0.0299). In our study, oliguria at the time of presentation, percentage of crescents, glomerular sclerosis, and moderate/severe IFTA were associated with poor renal outcomes. In conclusion, CrGN was seen in 5.7% of kidney biopsies in our study. Type II CrGN was the most common type of CrGN followed by type III CrGN. Renal survival was poor in type I CrGN patients compared to type II and type III CrGN. Also, oliguria, crescents, glomerular sclerosis, and moderate/severe IFTA were associated with poor renal outcomes.
subject: Original Articles Nephrology
  topic: section
subject: crescentic glomerulonephritis
  topic: keywords
subject: pauci-immune glomerulonephritis
  topic: keywords
subject: antineutrophil cytoplasmic antibodies–associated vasculitis
  topic: keywords
subject: lupus nephritis
  topic: keywords
subject: Ig A nephropathy
  topic: keywords
creator: Manzoor Ahmad Parry
creator: Mastakim Ahmad Mazumder
creator: Manjuri Sharma
creator: Hamad Jeelani
creator: Shahzad Alam
rights: Copyright (c) 2022 Manzoor Parry, Mastakim Mazumder, Manjuri Sharma, Hamad Jeelani, Shahzad Alam http://creativecommons.org/licenses/by/4.0
date: 2022-01-25
publication date: 2022-01-25
starting page: 24
ending page: 31
doi: 10.15586/jrenhep.v6i1.125