scholarly journals Seroprevalence of Leptospirosis in Suspected High Risk Sudanese Patients; A Pilot Exploratory Study

2022 ◽  
Author(s):  
Wisal Mustafa Ibrahim Mohammed ◽  
Nada Abdelghani Abdelrahim
Keyword(s):  
High Risk ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Exploratory Study ◽  
Renal Dialysis ◽  
Unknown Origin ◽  
Dialysis Unit ◽  
Igm Antibodies ◽  
Stage Renal Disease ◽  
End Stage

Abstract BackgroundThe extent of leptospirosis is unknown in Sudan and it might be mistaken for other more common febrile infectious diseases. Leptospirosis might also be associated with renal diseases that are common in Sudan. We intended to explore the existence of human leptospirosis in suspected high risk patients in Khartoum, Sudan, via sero-screening random febrile patients and those undergoing renal dialysis.MethodsThis is a pilot exploratory study that was conducted in 6 months period from April to September of 2013. Hospitals were selected conveniently following a non-random sampling approach. A total of 119 febrile patients (with or without definitive diagnosis) and patients under renal dialysis were included and their serum specimens, clinical and demographic data were collected. Sera were screened qualitatively for the existence of anti-leptospiral IgM antibodies using rapid lateral flow immunosorbent assay. Ethical clearance and official permissions were obtained.ResultsOut of the total 119 patients, 57 (47.9%) had end stage renal disease and were under dialysis at Renal Dialysis Unit in Asbab Charity Hospital in Bahri, 47 (39.5%), were febrile with unknown origin attending the Tropical Medicine Hospital in Omdurman, and 15 (12.6%) were febrile and were diagnosed as having malaria or typhoid and attended Yastabshiron Medical Centre and Bashauer Teaching Hospital. The overall prevalence of anti-leptospiral IgM antibodies among all 119 screened patients was 7%. The prevalence among the 57 with end stage renal disease was 9%, and among the 47 with fever of unknown origin was 6%. The prevalence among the 15 with fever of known origin (diagnosed as malaria or typhoid) was 0%. Almost all positive patients had recurring episodes of fever, are in close contact with livestock, were farmers and have natural untreated source for drinking water.ConclusionLeptospirosis is probably a common febrile condition and can be easily considered as one of the major causes of chronic kidney disease affecting people in this country. A national sero-screening for leptospirosis among those living in high risk geographical areas and those at occupational risk is highly recommended.

Immunodiagnosis and molecular validation of Toxoplasma gondii infection among patients with end-stage renal disease undergoing haemodialysis

Parasitology ◽  
2019 ◽  
Vol 146 (13) ◽  
pp. 1683-1689 ◽  
Author(s):  
Zahra Arab-Mazar ◽  
Shirzad Fallahi ◽  
Davood Yadegarynia ◽  
Amirreza Javadi Mamaghani ◽  
Seyyed Javad Seyyed Tabaei ◽  
...  
Keyword(s):  
Toxoplasma Gondii ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Immunoglobulin M ◽  
Enzyme Linked Immunosorbent Assay ◽  
Healthy Controls ◽  
Blood Samples ◽  
Igm Antibodies ◽  
Stage Renal Disease ◽  
End Stage

AbstractInfection is a significant cause of morbidity and mortality in patients with chronic kidney disease, especially who were under dialysis due to their depressed immunity. Toxoplasma gondii is a ubiquitous parasite that causes severe manifestations in immunocompromised patients. This case-control study was conducted to the immunodiagnosis and molecular validation of T. gondii infection among patients with end-stage renal disease undergoing haemodialysis. The study population consisted of 260 haemodialysis patients and 259 healthy controls referred to the main dialysis centres of Tehran, Iran during 2016. Anti-T. gondii immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies were assessed using enzyme-linked immunosorbent assay. As well, the T. gondii genomic DNA in whole blood samples of IgM-positive patients and healthy controls was evaluated using GRA6-polymerase chain reaction (PCR) and SAG1-loop-mediated isothermal amplification (LAMP) assays. The anti-T. gondii IgG and IgM antibodies were detected in 175 (67.3%) and 18 (7%) of haemodialysis patients and 122 (47%) and 4 (1.5%) of controls, respectively. Two of the 18 blood samples from IgM-positive patients and none of the IgM-positive control subjects were positive by GRA6-PCR. Whereas, nine and two blood samples of IgM-positive patients and controls were positive for Toxoplasma DNA by a SAG1-LAMP technique respectively. The seropositivity of the Toxoplasma IgM antibody was significantly different between haemodialysis patients and healthy controls which was confirmed by PCR and LAMP. The higher prevalence of T. gondii infection in haemodialysis patients compared with the controls proposes that these patients can be a group at risk for toxoplasmosis and screening for toxoplasmosis before dialysis is necessary for the patients.

scholarly journals Treatment effects of Chinese medicine (Yi-Qi-Qing-Jie herbal compound) combined with immunosuppression therapies in IgA nephropathy patients with high-risk of end-stage renal disease (TCM-WINE): study protocol for a randomized controlled trial

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Shen Li ◽  
Jin-pu Li
Keyword(s):  
High Risk ◽  
Renal Disease ◽  
Iga Nephropathy ◽  
End Stage Renal Disease ◽  
Controlled Trial ◽  
Eligible Patient ◽  
Study Phase ◽  
Double Blind ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background IgA nephropathy (IgAN) is the most common glomerular disease worldwide. It has a high incidence in Asians and is more likely to progress to end-stage renal disease (ESRD). For high-risk IgAN, which is clinically characterized by massive proteinuria and renal dysfunction, however, there has been no international consensus on treatment options. Compared with other developed countries, IgAN patients in China are often found to have severe kidney function loss at initial diagnosis. Yi-Qi-Qing-Jie formula (YQF; a compound recipe of Chinese medicinal herbs) has shown potential renal protection in our previous clinical studies. To further confirm the efficacy and safety of YQF in the treatment of high-risk IgAN, we have designed a prospective double-blind randomized placebo-controlled trial. Methods/design The TCM-WINE study is a single-center, prospective, double-blind randomized placebo-controlled trial. We plan to randomize 60 participants with biopsy-proven IgAN to a YQF combined group (YQF compound combined with prednisolone, and cyclophosphamide if necessary) or an immunosuppression group (placebo-YQF combined with prednisolone, and cyclophosphamide if necessary). The two groups will enter a 48-week in-trial treatment phase and receive post-trial follow-up until study completion (3 years). All patients will receive optimal supportive care. The primary composite outcome is defined as the first occurrence of a 40% decrease in estimated glomerular filtration rate (eGFR) from the baseline lasting for 3 months, initiating continuous renal replacement treatment, or death due to chronic kidney disease (CKD) during the 3-year study phase. The secondary endpoint events are defined as the mean annual eGFR decline rate (eGFR slope, ml/min per 1.73 m2 per year), which is calculated by the eGFR regression curve for each eligible patient, and proteinuria remission (prescribed as proteinuria < 0.5 g/day) at weeks 24, 36, and 48 during the in-trial phase. The remission rate of symptoms and inflammation status will be evaluated at week 48. Safety monitoring and assessment will be undertaken during the study. Discussion The TCM-WINE study will evaluate the effects and safety of YQF combined therapy compared with immunosuppression monotherapy on the basis of the optimal supportive treatment in high-risk IgAN. The evidence from this study will provide a novel, effective, and safe Chinese characteristic therapy for high-risk IgAN patients. Trial registration ClinicalTrials.gov, NCT03418779. Registered on 18 June 2018.

scholarly journals High-risk dialysis: pregnancy in a patient with extended Stanford-B-aneurysm of the aorta and end-stage renal disease

2004 ◽  
Vol 19 (6) ◽  
pp. 1634-1636 ◽  
Author(s):  
A. W. Demant ◽  
A. Schmiedel ◽  
S. M. Simula ◽  
B. Klein ◽  
H. U. Klehr ◽  
...  
Keyword(s):  
High Risk ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage ◽  
Stanford B

scholarly journals MO862COVID-19 INFECTION IN HEMODIALYSIS PATIENTS:FINDINGS-EXPERIENCE-OUTCOME

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Ioannis Griveas ◽  
Antonis Schinas ◽  
Anthoula Balitsari ◽  
Gerasimos Asimakopoulos ◽  
Evangelos Pratilas
Keyword(s):  
Respiratory Failure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Average Weight ◽  
Dialysis Unit ◽  
Spring Period ◽  
Dialysis Vintage ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background and Aims Our Nephrology Department during spring period on the first wave of COVID-19 was the referral Dialysis Unit for Covid-19 positive HD patients in the district area of Athens, Greece. The aims of this study are to report characteristics, rates and outcomes of all patients affected by infection with SARS-CoV-2 undergoing HD and treated under our care Method This is an observational study. Our Dialysis Unit has been assigned as a referral unit for Covid-19 positive HD patients. We registered all the data regarding the clinical course of our patients population. Age, primary cause of end stage renal disease, weight, clinical presentation, HD history, outcome, days of hospitalization. Results 22 Covid-19 positive HD patients were treated under the care of our facility during the period 8 April 2020-17 June 2020. 16 patients were symptomatic at admission and 13 patients admitted with or developed during their stay pleural effusions. 12 patients (8 male) of our group died during their hospitalization. 3 out of 12 were admitted to Intensive Care Unit (ICU). 6 patients were septic, 4 had respiratory failure and 2 developed cardiovascular events. 14.5 days were the mean hospitalization days (range: 1-38 days) for the diceased ones. 2 out of 3 patients that admitted to ICU had quick deterioration, incubated and stayed in ICU for 48 hours. The third one with severe cormobidities (multiple myeloma, cancer of bladder) developed respiratory failure after 8 days of hospitalization, incubated, became septic and died after 20 days in ICU. Mean age of our patients was 74.5 years. It has to be pointed out that 13 patients were over 75 years old. Mean age was higher in those who died compared with those who were discharged with double negative Covid-19 tests (79 vs 74,5 years old respectively). Median dialysis vintage for our patients was 63 months and for the diceased ones was 89 months. Average weight of our patients was 69 kgrs. Weight of diceased patients was 63 kgrs. 11 out of 22 patients and 5 out of 12 diceased patients were diabetic. 14 patients were hypertensive and 16 had official cardiovascular backround. 10 out of total 22 patients under our care discharged after 43 days of hospitalization (range:35-56 days). Conclusion As a conclusion our data provide clues regarding out experience of caring HD patients with COVID-19. Mortality was high. It seems that despite the fact that immune response of this population has not been clearly clarified, age, cormobidities and above all end-stage renal disease by its self is a significant and unpredictable risk factor for clinical outcome of HD patients with COVID-19 infection.

scholarly journals Obstetric outcomes in women with end-stage renal disease on chronic dialysis: a review

2010 ◽  
Vol 3 (2) ◽  
pp. 48-53 ◽  
Author(s):  
L Y Yang ◽  
E W H Thia ◽  
L K Tan
Keyword(s):  
High Risk ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Chronic Dialysis ◽  
Obstetric Outcomes ◽  
Evidence Based ◽  
Preconception Counselling ◽  
Stage Renal Disease ◽  
End Stage ◽  
Existing Data

Pregnancies in women on chronic dialysis for end-stage renal disease are high risk, but outcomes appear to have improved with increasing experience and advances in dialysis care. This paper reviews the existing data on outcomes in such pregnancies to enable evidence-based preconception counselling and anticipation of antenatal complications.

scholarly journals Racial disparities in end-stage renal disease in a high-risk population: the Southern Community Cohort Study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Fabian Bock ◽  
Thomas G. Stewart ◽  
Cassianne Robinson-Cohen ◽  
Jennifer Morse ◽  
Edmond K. Kabagambe ◽  
...  
Keyword(s):  
Cohort Study ◽  
High Risk ◽  
Renal Disease ◽  
Racial Disparities ◽  
End Stage Renal Disease ◽  
High Risk Population ◽  
Risk Population ◽  
Stage Renal Disease ◽  
End Stage
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