Kidney Transplant Recipients’ Weight Change and their Behaviors and Attitudes Related to Diet and Exercise

Background: Weight gain after kidney transplant has been demonstrated to have adverse effects on allograft function and longevity. We sought to determine both the prevalence of post-transplant weight gain and factors associated with weight gain.

Urgent-Start Peritoneal Dialysis: A Comparison of Catheter Insertion Using Seldinger Technique and Surgical Operation

Background: Urgent-Start Peritoneal Dialysis (USPD) is increasingly used worldwide and represents a safe, convenient and cost-effective method to initiate dialysis. However, good catheter insertion techniques are imperative to avoid postoperative complications. While percutaneous catheter insertion by Seldinger technique is considered a safe method with few post-operative complications, comparisons with surgical operation technique are needed, especially in China, where there a few reports on the outcome of percutaneous catheter insertion by Seldinger technique in USPD patients.

Loud P2 on Cardiac Auscultation: A Useful Clinical Clue to Fluid Overload

Patients with renal disease are at risk of fluid overload which escalates as the disease progresses. In the present study, we evaluated the increase in the intensity of the second heart sound generated by its pulmonary component (P2) and its correlation with fluid overload in such patients. To confirm its potentials and avoid interference with patients with cardiac disease; we included only those who lacked echocardiographic evidence of (a) ASD or VSD, (b) primary cardiac defects associated with high P2 viz pulmonary aneurysm, mitral stenosis and myocardial disease, (c) primary cardiac defects associated with soft P2 viz pulmonary stenosis, pulmonary atresia and tetralogy of Fallot, (d) primary cardiac defects associated with low A2 viz mitral regurgitation, aortic regurgitation, low diastolic arterial pressure, severe immobile aortic valve disease. To assess the extent of fluid overload; the clinical examination was complemented with radiological imaging as well as the echocardiographic measurement of systolic pulmonary arterial pressure. There was a significant correlation between P2 intensity and fluid changes. In conclusion; load P2 is a useful clinical clue to fluid overload and decline in its intensity correlates with the extent of fluid removal.

Involvement of Serum Uric Acid in Essential Hypertension, Progressive Proteinuria and Impairment in Renal Function among Type-2 Diabetic Patients

Type-2 diabetes is a metabolic disorder with vast complications. Uric acid (UA) was recently discovered as a risk biomarker for the development of type-2 diabetes. Several studies have found a significant association of Hyperuricemia with Hypertension (HTN), renal complications and cardiovascular disease. However, no study has found an association of hyperuricemia with the development of essential hypertension, nephropathy and Diabetic Kidney Disease (DKD) among type-2 diabetics. Moreover, in the past no study has found cut off points for serum uric acids for the development of DKD/CKD among diabetics with sensitivity and specificity, which was achieved in the current study. We collected 10,300 type-2 diabetics data for more than 15 years in a cross sectional retrospective manner. 17% demonstrated hyperuricemia while 16% were found to be DKD. Significant correlations were found between serum UA and other variables (serum creatinine, systolic and diastolic BP, microalbumin and spot urine protein). Levels of UA were observed to be elevated among patients with HTN, nephropathy and DKD (p<0.0001). Similarly, serum creatinine, systolic and diastolic BP, microalbuminuria and spot urine protein were higher for the group with hyperuricemia (p<0.0001). Pearson’s (χ²) and logistic regression with odds ratio demonstrated that hyperuricemia was significantly associated with HTN (odds ratio 2.5; 95% CI 1.8 to 23.4; p<0.0001). Similarly, hyperuricemia was significantly associated with the development of nephropathy and DKD/CKD; odds ratio 2.1 (95% CI 1.46 to 2.8; p<0.0001) and 27.3 (95% CI 14 to 53; p<0.0001), respectively. Moreover, regression model between serum UA and serum creatinine was also significantly associated with each other and proves our hypothesis that UA linearly causes an increase in the blood creatinine with the following relationship : Serum creatinine=0.221 + [0.154 × serum UA]. ROC for DKD and serum UA demonstrated that with AUC of 0.98 (95% CI 0.961 to 0.986), UA level of 6.8 was 91% sensitive and 79% specific for the development and significant association with DKD/CKD (p<0.0001). This is the first study of its kind that has demonstrated significant associations of UA with HTN, nephropathy and DKD. It is the time to revise the normal levels of UA among type-2 diabetics and to initiate regular screening for hyperuricemia to prevent further diabetes complications.

Acute Kidney Failure during Preeclampsia at Parakou University Hospital in Benin in 2019: Diagnostic and Therapeutic Aspects

Background: Acute renal injury during preeclampsia is a relatively common complication in intensive care and grafted with significant morbidity and mortality.

Compensation Capacity of the Living-Related Donor’s Remnant Kidney and Recipient’s Transplanted Kidney

Introduction: We try to explore the compensatory capacity of living-related donor’s remnant kidney and recipient’s transplanted kidney in terms of the glomerular filtration rate (GFR).

Real-Time Monitoring and Reminding of Remote Peritoneal Dialysis System Based on the Principle of Least Squares

Peritoneal dialysis has been widely studied and applied for kidney disease because of its low cost and easy operation. Given the development of chronic kidney disease worldwide, peritoneal dialysis has attracted more and more attention. At the same time, with the development and popularization of mobile network technology, mobile telematics has begun to become a mainstream trend. By integrating the experience of clinicians, the remote diagnosis and treatment system of the peritoneal dialysis developed by Shenzhen Traditional Chinese Medicine Hospital can monitor the entire peritoneal dialysis data of patients. The peritoneal dialysis data were analyzed by statistical methods. In this paper, we designed a data acquisition device with Bluetooth transmission protocol and a user APP to collect peritoneal dialysis data from experimental patients, and built a regression model based on the least square principle according to the clinical data of real patients. Through the model, abnormal or discrete points can be identified in real time. In clinical practice, by analyzing the possible medical risks and adverse events of patients according to the abnormal points, we realize the function of prediction and early reminding. The system indicates the results to patients according to the confidence interval of regression prediction, which greatly strengthens the interaction of the system and improves patient compliance.

Cervical Tumor in Patient on Chronic Hemodialysis about a Case

Patients with Chronic Kidney Disease on Dialysis (CDRD) have a major risk of developing cancer when compared with the general population [1], thyroid carcinoma being the most common in the first group of patients [2]. The definitive treatment is thyroidectomy, but in patients at risk of recurrence ablative therapy with radioactive iodine I-131 is necessary [2]. We present the clinical case of a 61-year-old patient on hemodialysis with a slow growing anterior cervical tumor studied for more than two years until the diagnosis of papillary thyroid carcinoma. Initially the patient received surgical treatment and is currently awaiting treatment with radioactive iodine I-131.

Quality of Life of Haemodialysis Patients and Complications of CVC and AA

Background: The increase in life expectancy, as well as in chronic diseases, has resulted in giving emphasis not only to medical interventions, but to the continuous care of the patient. The measurement of Quality of Life (QOL) of haemodialysis patients provides information relevant to their needs and the consequences of haemodialysis in their life, which could be used to implement interventions that will lead to the improvement of their QOL.

Identification of Social and Occupational Risk Factors Associated with CKDu (Chronic Kidney Disease of Unknown Etiology) Patients Living in an Agricultural Community in Kebithigollewa, Sri Lanka

Aim: To identify the social and occupational risk factors associated with CKDu (Chronic Kidney Disease of unknown etiology) patients living in an agricultural community in Kebithigollewa, Sri Lanka.