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 · Jan 2018
Case ReportsPage kidney: A rare but surgically treatable cause of hypertension.
The Page kidney is a rare phenomenon. External renal parenchymal compression is the culprit. We report two cases of young males with flank pain, renal mass, and hypertension with history of blunt abdominal trauma. ⋯ Laparoscopic nephrectomy was performed in both patients. We emphasize the Page kidney as a cause of hypertension in young patients, presenting with flank pain and renal mass with or without complications of hypertension. Management is aimed to control blood pressure by ACE inhibitors, aspiration of the hematoma, open hematoma evacuation, or nephrectomy.
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Saudi J Kidney Dis Transpl · Nov 2017
Lactate levels and risk of lactic acidosis with metformin in diabetic kidney disease patients.
Metformin as an oral antidiabetic drug (OAD) is not recommended in renal failure due to the presumed risk of lactic acidosis though it has advantages in cardiovascular protection with a low risk of hypoglycemia. Few studies have measured lactic acid blood levels in patients with diabetic kidney disease on metformin and demonstrated lactic acidosis. The aim of our study is to see if patients with diabetic kidney disease are at risk of elevated lactate blood levels and lactic acidosis. ⋯ Mean serum pH (P = 0.572), bicarbonate (P = 0.978), and plasma lactate (P = 0.449) levels in those taking and not taking metformin were comparable. There was no difference in the plasma lactate levels in different stages of CKD in the metformin group (P = 0.498) although there was significant correlation with metformin dose (P <0.05). Blood lactate levels were not elevated in patients with diabetic kidney disease at a daily dose of metformin <1 g.
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Saudi J Kidney Dis Transpl · Sep 2017
Comparative StudyHepatitis C virus status in hemodialysis patients in Menoufia Government, Egypt, five years apart: Do we have any improvement?
There is a high prevalence of hepatitis C virus (HCV) infection in hemodialysis (HD) patients in Menoufia Governorate, Egypt. The aim of this cross-sectional study was to assess current HCV status and its seroconversion in HD patients after implementing preventative measures to limit transmission of HCV. All data were compared with our previous data collected in 2011 before implementation of isolation policy. ⋯ Binary logistic regression analysis for all data demonstrated that isolation reduced the likelihood of seroconversion while longer duration of dialysis increased the risk for seroconversion. HCV infection and its seroconversion in HD patients were significantly reduced in year 2016 compared to year 2011. Isolation policy is recommended for HD patients with HCV in dialysis units with high HCV prevalence in developing countries.
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Saudi J Kidney Dis Transpl · Jul 2017
ReviewAssessment of frailty in elderly pre-dialysis population using simple tools.
Prevalence of chronic kidney disease (CKD) is increasing worldwide principally among the elderly population many of whom will eventually need renal replacement therapy. The relationship between frailty and CKD in the elderly population has been recognized. However, studies concentrating on frailty in pre-dialysis patients are limited. ⋯ Modalities that may improve frailty in elderly pre-dialysis patients such as treatment of anemia and bone mineral disease may improve outcome. However, this has not been established and further research is needed. The aim of this review is to address the importance of recognizing frailty in elderly pre-dialysis patients using simple tools and describing its implications on clinical outcome.
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Saudi J Kidney Dis Transpl · Jul 2017
Observational StudyClinical profile of geriatric acute kidney injury in a tertiary care center from south India.
The incidence of acute kidney injury (AKI) is high in the elderly, who comprise an ever-growing segment of the population. Elderly patients pose a different set of diagnostic and therapeutic challenge owing to their associated comorbidities. AKI in the elderly is associated with an increased risk of mortality, morbidity, prolonged length of stay, and progression to chronic kidney disease. ⋯ The mortality rate was higher among postsurgical AKI compared to the medical causes (P <0.001) and in patients who required dialysis. Sepsis is the most common cause of AKI in elderly with high morbidity and mortality. Oliguria, postsurgical AKI, and need for dialysis were independent predictors of mortality.