Volume 3 Issue 3

2019-12-17 Clinical Image

Cytomegalovirus infection in native kidney biopsy

Text

A 61-year-old Brazilian black woman consulted with a nephrologist due to proteinuria identified on a routine urine test. She has a personal history of thymoma resection five years ago, followed by multiple episodes of pulmonary infections including mycobacteriosis, recurrent mucocutaneous candidiasis, and paraneoplastic pemphigus. Physical examination showed no edema or hypertension and laboratory tests identified proteinuria of 2.43 g/day without hematuria, serum creatinine of 0.69 mg/dl, urea 34 mg/dl, serum albumin of 2.4 g/dl, hemoglobin 10.9 g/dl, platelets 292,000/mm3, leukocytes 4950/mm3, lymphocytes 594/mm3 and neutrophils 3910/mm3. The hemolysis tests were negative and serum iron was low. Analysis of glicemia and serum lipids levels were normal as well as serum complement and imunoglobulins, except for an IgM level of 283 mg/dl (normal values 40 to 230 mg/dl) and undetectable IgE. Serologies for Syphilis, HIV, hepatitis B, C and antibodies for autoimmune diseases were negative.

Abstract Read Full Article HTML DOI: 10.29328/journal.jcn.1001047 Cite this Article

2019-12-09 Research Article

A pilot study on treatment of infantile cystinosis with mesenchymal stem cells

Abstract

Infantile cystinosis is a lysosomal storage disease leading to end stage kidney disease at early ages. There is no effective treatment and patients require long term dialysis or kidney transplant for survival. We present our experience on three affected children who received HLA matched allogeneic stem cell transplant. The protocol used was novel and designed to promote engraftment. The primary endpoint was safety for treatment related mortality or morbidity; All three children survived without serious adverse effects during extended follow up for over 4 years. Although we could not prove engraftment, all three children met secondary end point of sustained target functions over a 6 month follow-up. Further studies are warranted to further evaluate safety and efficacy of MSC treatment for infantile cystinosis.

Abstract Read Full Article HTML DOI: 10.29328/journal.jcn.1001046 Cite this Article

2019-11-27 Research Article

Perceived causes and prevention of catheter-associated urinary tract infections among spinal cord injured patients

Summary

Catheter-associated urinary tract infection (CAUTI) is among the most common nosocomial infections especially in acute care settings. Its economic and unanticipated health implications make it burdensome for the healthcare providers and patients. The paper examined the perceived causes and mode of preventing urinary tract infections in patients with spinal cord injury. Qualitative research approach was utilized; the study site was a Tertiary Hospital in Nigeria. Eight (8) in-depth interviews (IDI) were conducted with healthcare providers managing patients with spinal cord injured in the hospital. The major risk factors causing urinary tract infection identified include financial problems, organization of care, human error, hospital environment and patient-related factors. To prevent urinary tract infections among patients in the hospital, a number of suggestions were made by the participants such as training of caregivers and educating patients and relations. The authors concluded that the incidence of CAUTI could be reduced in the hospital if the opinions of stakeholders are fairly considered.

Abstract Read Full Article HTML DOI: 10.29328/journal.jcn.1001045 Cite this Article

2019-11-22 Research Article

Effect of intradialytic physical activity on the quality of life, biological parameters and sleep in hemodialysis patients

Abstract

Many side effects, in addition to those of the pathology itself, have occurred with hemodialysis treatment but existing literature have shown that physical activity is beneficial to hemodialysis patients. Nevertheless, our parameters have not been studied enough with a resistance training program. In our study we have observed the effect of a 12-week intradialytic resistance training program (T0 vs T12) on the quality of life using the KDQOL-SF questionnaire, blood samples biological parameters and sleep using the Epworth scale and the International restless legs syndrome study group scale. The resistance training program consists of 3 sessions per week and involved lower extremities thanks to elastic band and soft ball. After the training program, the quality of life score trend to the increase at T12 compared to T0. Among the biological parameters, the only trend decrease observed was in the C-reactive protein and a trend increase was observed in urea at T12. Dialysis efficiency presented no changes and no significant results were observed for sleep. Some trends were observed as a result of our program. The type of exercise seems to have different effects on measured parameters. Nevertheless, exercise was beneficial to chronic hemodialysis patients and seemed to improve their health.

Abstract Read Full Article HTML DOI: 10.29328/journal.jcn.1001044 Cite this Article

2019-11-20 Case Report

Diabetes and chronic kidney disease: a rare cause for a very common association

Abstract

The authors present the case of a 45-year-old female patient with diabetes and chronic kidney disease (CKD). She had unsatisfactory glycemic control, and showed some intellectual limitations. Her urine exam was unremarkable, and her renal ultrasound revealed single right kidney with aspects suggesting ureteropelvic junction syndrome. Her mother had also suffered from diabetes and CKD G5D presenting in the sixth to seventh decade.

An hereditary cause for CKD was considered, which led the authors to investigate an autosomal dominant cause for CKD with a tubulointerstitial phenotype, taking into account the personal and family history for diabetes and also the renal imaging; a large deletion in the HNF-1β gene was identified through Multiplex Ligand Probe Assay (MLPA) analysis, explaining the phenotype.

Genetic causes of CKD should be considered in the presence of positive family history for CKD, and the coexistence of diabetes with bland urine sediment should raise the possibility of a syndromic cause of the phenotype, namely involving HNF-1β gene mutations or deletions.

Abstract Read Full Article HTML DOI: 10.29328/journal.jcn.1001043 Cite this Article

2019-09-02 Case Report

Weight loss counseling for dialysis patients to prepare for transplant

Case Report

Obesity has become a worldwide Epidemic affecting more than 300 million people. Overweight is defined as BMI (Body Mass Index) of 25-29.9 kg/m2. Obesity is defined as BMI greater than 30 kg/m2, and Morbid Obesity is a BMI of > than 35 kg/m2 [1].

Many Dialysis patients are overweight. Dialysis patients that are labeled morbidly obese based on BMI, may not be able to be listed on the Transplant list. Some Dialysis Clinics require a BMI less than 35 kg/m2 and some require a BMI < than 40 kg/m2. Hence, many obese dialysis patients are asked to lose weight, and we all know that Renal Transplant provides a better quality of life [2].

Because each transplant center may use different criteria for eligibility, patients and members of the dialysis team should be aware of the BMI criteria for the referral transplant center. Patients who are not eligible for the transplant due to obesity should receive counseling emphasizing a healthy lifestyle and weight loss [3].

Successful weight management requires a multidisciplinary approach encompassing health care team members. They consist of the following: Renal Dietitian, Social Workers, Nurse, Exercise Physiologist and a Physician [6].
 

Abstract Read Full Article HTML DOI: 10.29328/journal.jcn.1001042 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