Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia
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Saudi J Kidney Dis Transpl · Nov 2009
Comparative StudyValue of serum cystatin C as a marker of renal function in the early post kidney transplant period.
Management of renal transplant patients requires periodic measurement of renal function especially in early post transplant period. This is usually assessed by measuring the creatinine clearance, but because of its limitations, it is not an ideal marker for assessing the renal function. Serum cystatin C (sCyC) appears to be an endogenous marker of glomerular filtration rate (GFR). ⋯ During the first 5 days following transplantation, there was a progressive decline in sCr levels. In the first 5 days, post transplantation we could not find good correlation between CrC and sCyC, and the sCyC increased during these 5 days, but after that in day 7, there was a good correlation between CrC and sCyC which is coinciding with decreasing the dose of steroid (r= .625). Therefore, we recommend using sCyC may be used as a marker of renal function after one-week post kidney transplantation.
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Saudi J Kidney Dis Transpl · Sep 2009
Randomized Controlled Trial Comparative StudyEfficacy of folate and vitamin B12 in lowering homocysteine concentrations in hemodialysis patients.
To evaluate the efficacy of supplementation with high dose folic acid with and without vitamin B 12 in lowering plasma total homocysteine (tHcy) concentrations in hemodialysis (HD) patients, we studied 36 HD patients randomized into four groups according to the received therapeutic regimen: group I (only folic acid (FA), 5 mg/day), group II (FA, 5 mg/day + vitamin B 12 , 1 mg/day) group III (only FA, 15 mg/day), group IV (FA, 15 mg/day, vitamin B 12 , 1 mg/day) for a period of 8 weeks. Plasma tHcy and serum FA and vitamin B 12 levels were measured at baseline and after the supplementation period. Dietary intakes were assessed during the study period. ⋯ No correlations were found between changes of plasma tHcy levels and dietary intakes. We conclude that oral supplementation with 15 mg/day folic acid together with 1 mg/day of vitamin B 12 is effective in reducing tHcy levels in HD patients. These supplements also have a desirable effect on serum folic acid and vitamin B12.
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Saudi J Kidney Dis Transpl · Sep 2009
ReviewPrevention of iodinated contrast induced acute kidney injury (ICI--AKI) - what have we learnt so far?
The use of imaging modalities and endovascular procedures has escalated phenomenaly in the last two decades. In view of increasing number of elderly patients, rising incidence of chronic kidney disease and diabetes along with the complication of nephrogenic systemic fibrosis with gadolinium, a large patient population will be at risk of developing iodinated contrast induced acute kidney injury (ICI-AKI) which is associated with significant morbidity and mortality and increased health care costs. Hence a search for more effective ways to prevent ICI-AKI continues to be a focus within the medical community.
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Saudi J Kidney Dis Transpl · Sep 2009
Application of intravenous electrocardiography for insertion of central veins dialysis catheters.
One fifth of the inserted dialysis catheters in the internal jugular or subclavian veins may be misplaced. Appropriate positioning of the catheter tip is sometimes difficult. We attempted to use intravenous electrocardiography (ECG) to guide catheter tip positioning in 30 hemodialysis patients (17 (57%) were men, and the mean age was 43 +/- 12 years). who required vascular accesses for dialysis by insertion of double lumen temporary catheters via the jugular veins. ⋯ The difference between the mean P-wave voltages measured in standard and intravenous ECG (blue and red catheter tips) was statistically significant (P< 0.05). We conclude that the dialysis catheter tip can be positioned appropriately via the measurement of the P-wave height by intravenous ECG and using the sinoatrial node as an accurate landmark. This method can complement the chest radiography in the appropriate placement of the central vein catheters.
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Saudi J Kidney Dis Transpl · Sep 2009
Case ReportsSevere acute renal failure in a patient with diabetic ketoacidosis.
Acute renal failure (ARF) is a rare but potentially fatal complication of diabetic ketoacidosis (DKA). Early recognition and aggressive treatment of ARF during DKA may im-prove the prognosis of these patients. We present a case report of a 12 year old female admitted to the hospital with severe DKA as the 1s t manifestation of her diabetes mellitus. ⋯ In addition, rhabdomyolysis was noted during the course of DKA which probably contributed to the ARF. Management of DKA and renal replacement therapy resulted in quick recovery of renal function. We suggest that early initiation of renal replacement therapy for patients with DKA developing ARF may improve the potentially poor outcome of patients with ARF associated with DKA.