Volume 2 Issue 3

2018-12-31 Case Report

Lessons from the success and failures of peritoneal Dialysis-Related Brucella Peritonitis in the last 16 years: Case report and Literature review

Abstract

Brucellosis is a zoonotic infection that is endemic in some Mediterranean countries, North Africa and the Middle East. Brucella is a rare cause of peritonitis in Peritoneal Dialysis (PD) population and in non-dialysis patients alike. We report here a challenging case of PD-related Brucella peritonitis in a 45-year-old Saudi male with late peritonitis that delivered some key learning throughout its course from presentation, diagnosis and treatment to catheter salvage attempts so as to circumvent PD failure. We provide an in-depth review of limited published literature on PD-related Brucella peritonitis (seven cases, and present case) and summarized the data on key clinical characteristics, management and PD technique outcome to benefit nephrologists when encountered with this rare presentation.

Abstract Read Full Article HTML DOI: 10.29328/journal.jcn.1001020 Cite this Article

2018-12-14 Case Report

Liver cyst infection in kidney transplant patient with autosomal dominant polycystic kidney disease: Interest of PET/CT in diagnosis and treatment

Liver cyst infection in patients with autosomal dominant polycystic kidney disease (ADPKD) is a rare but life-threatening complication. Diagnosis and treatment remain challenging. We report the case of a 64-year-old kidney transplant patient presenting with fever and abdominal pain. The diagnosis of liver cyst infection was made by positron emission tomography scan (PET/CT). Moreover, the course of our patient illustrates the interest of subsequent PET/CT during follow-up as our patient failed on antibiotherapy and required liver cyst drainage.

Abstract Read Full Article HTML DOI: 10.29328/journal.jcn.1001019 Cite this Article

2018-10-02 Review Article

Urine Leak Following Kidney Transplantation: An Evidence-based Management Plan

Abstract

Care of kidney transplant recipient remains complex and long-term graft survival is not seen in every transplant recipient. Due to reduced supply and increased demand of human organs, more transplants are carried out using marginal grafts on emergency lists. Transplant recipients have altered physiology due to known end-stage renal disease, recent surgery and the use of potent analgesic and immunosuppressive medications. Amongst the known surgical complications, urine leak remains the most common. It can result from poor graft preparation due to excessive peri ureteric or lower pole dissection or damage to lower polar artery resulting in ischemic necrosis. In addition, poor surgical technique, bladder outflow obstruction, iatrogenic injury to bladder or renal pelvis may contribute to urine leak. Ongoing urine leak may manifest itself as swelling, pain, high drain output, sepsis, ileus and eventual graft loss. Early identification, localisation and quantification of leak remain essential in management of these patients. In addition, sepsis should be identified and treated promptly as these patients are highly susceptible to infections. Early recognition of this complication can significantly reduce hospital stay, improve quality of life and reduce graft loss and mortality. In this article, we aim to develop an evidence-based management approach to a patient with urine leak using a clinical scenario.

Abstract Read Full Article HTML DOI: 10.29328/journal.jcn.1001018 Cite this Article

2018-09-12 Case Report

A case report of Hypocomplementemic urticarial vasculitic syndrome presenting with Renal failure

Abstract

We present a case of hypocomplementemic urticarial vasculitic syndrome (HUVS) who developed severe renal failure requiring ICU-level care. Our patient is a 66-year-old man who presented with abdominal pain, rash, confusion, oliguria, and shortness of breath. He was found to be in acute renal failure with leukocytosis and elevated lactate. Work-up for infectious, autoimmune, and hematologic malignant diseases was negative. The presence of chronic urticaria, abdominal pain, hypocomplementemia, and leukocytoclastic vasculitis on skin biopsy confirmed the diagnosis of HUVS. He required hemodialysis for renal failure as well as gastrostomy tube placement for nutritional support secondary to the development of mucosal ulcers, a rare finding in HUVS. He recovered with several months of high-dose steroids and hemodialysis. This case highlights the effectiveness of steroids for initial treatment of HUVS, and the relapsing and remitting nature of the disease. Providers should also be aware of the broad range of presenting symptoms such as mucosal lesions that may require nutritional support. Interestingly, unlike many previously reported cases of HUVS, our patient had not yet developed signs and symptoms of systemic lupus erythematosus, which often overlaps with HUVS.

Abstract Read Full Article HTML DOI: 10.29328/journal.jcn.1001017 Cite this Article

Recent Articles

2021-05-05 Research Article

Impact of a multidisciplinary pre-dialysis program on renal treatment modalities choice

Luis Miguel Castro Fonseca dos Santos Oliveira*, Rui Arlindo dos Santos Alves de Castro and Teresa Margarida Ribeiro Pinto Morgado

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2021-04-27 Research Article

Prognostic factors for chronic kidney disease and end-stage renal disease in patients with lupus nephritis: A retrospective cohort study

Fernanda Nogueira Holanda Ferreira Braga*, Marta Maria das Chagas Medeiros, Antônio Brazil Viana Jr., Levi Coelho Maia Barros, Marcelo Ximenes Pontes, Matheus Eugênio de Sousa Lima, Allyson Wosley de Sousa Lima and Paula Frassinetti Castelo Branco Camurça Fernandes

Abstract Read Full Article HTML DOI: 10.29328/journal.jcn.1001071 Citation

2021-04-22 Case Report

Diffuse alveolar hemorrhage: Unusual presentation of systemic lupus erythematosus

Zajjari Yassir*, Sobhi Aya, Aatif Taoufiq, Azizi Mounia and El Kabbaj Driss

Abstract Read Full Article HTML DOI: 10.29328/journal.jcn.1001070 Citation

2021-01-20 Clinical Image

Hyperacute fatal course in a hypercalcemic crisis

Sara Turco*, Alice Chiara Manetti, Aniello Maiese, Matteo Scopetti and Marco Di Paolo

Abstract Read Full Article HTML DOI: 10.29328/journal.jcn.1001066 Citation