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Saudi Journal of Kidney Diseases and Transplantation
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   1996| January-March  | Volume 7 | Issue 1  
    Online since March 13, 2008

 
 
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EDITORIALS
Malignancy in Renal Transplant Recipients
Israel Penn
January-March 1996, 7(1):1-5
PMID:18417907
Immunosuppressed organ allograft recipients have a 3-4 fold increased risk of developing cancer, but the chance of developing certain malignancies is increased several hundredfold. With the exception of skin cancers, most of the common neoplasms seen in the general population are not increased in incidence in organ allograft recipients. Instead, there is a higher frequency of relatively rare tumors including lymphomas, Kaposi's sarcoma, other sarcomas, vulvar and perineal carcinomas, renal and hepatobiliary carcinomas. Tumors appear after a relatively short time post-transplantation. The earliest is Kaposi's sarcoma, which appears after an average of 22 months post-transplantation, and the latest are vulvar and perineal carcinomas, which present after an average of 113 months post-transplantation. Unusual features of lymphomas are: (a) high incidence of non-Hodgkin's lymphomas; (b) high frequency of Epstein-Barr virus-related lesions; (c) frequent involvement of extra-nodal sites; (d) marked predilection for the brain; and (e) frequent allograft involvement. Skin cancers also present unusual features: (a) remarkably high frequency of Kaposi's sarcoma; (b) reversal of the ratio of basal to squamous cell carcinomas seen in the general population; (c) young age of the patients; and (d) high incidence of multiple tumors, which occur in 43% of patients. Vulvar and perineal cancers occur at a much younger age than in the general population. Probably, multiple factors play a role in the etiology of the cancers. Immunodeficiency per se and infection with oncogenic viruses may be major influences. Other factors possibly playing a role include direct damage to DNA by various immunosuppressive agents; possibly synergistic effects of these treatments with carcinogens; and genetic factors influencing susceptibility or resistance to development of malignancy.
  2,916 295 -
ORIGINAL ARTICLES
The Effect of Short Term Use of Indomethacin, a Non-Steroidal Anti­-inflammatory Drug, on Peritoneal Dialysis Patients
Elhadi E Abbas, Ibrahim M Albawab, Saad K Safarini, Riaz A Alhassan, Mohamed S Khatim
January-March 1996, 7(1):10-14
PMID:18417909
In this study, the effect of indomethacin a nonsteroidal anti-inflammatory drug (NSAID) was studied to evaluate the effect of its short-term use on peritoneal clearance of urea and creatinine as well as protein excretion in nine chronic renal failure patients on intermittent peritoneal dialysis therapy. Four of them were males and five were females with mean age of 54.4 years. Clearance values and protein excretion in the dialysate effluents were measured before and after administering the indomethacin. There was no significant effect on the urea and creatinine clearance after the use of this drug. However, the mean ± SE protein concentration in the dialysate effluents decreased significantly after the use of indomethacin from 43.1 + 4.5 to 37.0 + 3.5 mg/dl (p<0.01). This reduction of protein excretion in the dialysate after the use of indomethacin might enhance the nutritional status of patients on peritoneal dialysis.
  2,744 233 -
BRIEF COMMUNICATIONS
Aluminum Monitoring for Chronic Renal Failure Patients in Kuwait
Mangalathillam R.N Nampoory, Nabieh Al-Hilali, Mandalam S Seshadri, Aisha Abdulla, Ariyoor S Kanagasabhapathy, Nabeen C Nayak, Kaivilayil V Johny
January-March 1996, 7(1):27-30
PMID:18417913
The importance of monitoring serum aluminum (Al) level in patients undergoing long-term hemodialysis (HD) is well known. This study on 94 HD patients from Mubarak Hospital, Kuwait revealed that serum Al level was significantly higher in HD patients on aluminum hydroxide therapy (n = 57) than those not on this treatment (n = 37) (p = < 0.001). None of the patients showed levels > 100 ug/L. Analysis of water and dialysis fluid showed Al levels just above the permissible limit, on certain occasions, suggesting the need for regular monitoring of these substances for Al contamination. Patients on HD for longer than five years and those above the age of 50 years had higher serum Al levels. The most important single factor causing elevated serum Al levels in the study patients was aluminum hydroxide therapy, administered orally as a phosphate binder.
  2,367 221 -
EDITORIALS
Tuberculosis in Hemodialysis Patients
Magdi Hussein, Jacob Mooij, Haysam Roujouleh
January-March 1996, 7(1):6-9
PMID:18417908
  2,172 263 -
BRIEF COMMUNICATIONS
Vesico Ureteric Reflux and Renal Scarring in Children with Urinary Tract Infection
Issa Hazza, Adel Wahadeneh, Emad Qudah, Mjalli Ahmad
January-March 1996, 7(1):24-26
PMID:18417912
To evaluate the presence of vesico ureteric reflux (VUR) and renal scarring in children with documented symptomatic urinary tract infection (UTI), and the importance of age at time of presentation, we studied 29 patients with UTI. Nineteen patients were females and 10 were males. Three patients were below one year of age, 13 were between one and five years, and 13 were above five years. None of the patients had systemic hypertension or renal insufficiency. All patients had renal ultrasound and renal scintigraphy with dimercapto succinic acid (DMSA). Micturating cystourethrogram was done in all children below age of five, and in patients above age of five if renal scintigraphy showed evidence of scarring. Of the 29 UTI patients 10 (34%) had VUR. Of the patients with VUR, seven were below age of five while three were above five. Renal scarring was found in 3/7 patients with VUR below age of five years, but was in all patients with VUR above age of five years. All patients with grade 3 and 4 reflux nephropathy had renal scarring, while it was found in half of the patients with grade 1 and 2 reflux. We conclude that in UTI patients VUR is not uncommon finding, which needs further investigations and follow-up.
  2,174 256 -
ORIGINAL ARTICLES
Tuberculosis in Patients on Maintenance Hemodialysis: A Single Center Experience
Nabil Akash, Ibrahim Smadi, Ma'an Hadidi, Hari Afara, Mohammed El-Lozi
January-March 1996, 7(1):20-23
PMID:18417911
This retrospective study was performed to review the prevalence, clinical presentation and outcome of tuberculosis (TB) in patients on maintenance hemodialysis (HD) as compared to that of the general population in Jordan. The records of 927 patients who were maintained on maintenance HD at King Hussein Medical Center between 1986 and 1993 were reviewed for the development of TB. There were 550 males and 377 females in the study group. Eleven of these patients (1.2%) were diagnosed to have TB during this period. This figure is higher than the prevalence rate of 0.015% reported among the general population in some regions of Jordan. Of the 11 patients with TB, there were four males and seven females. Their ages varied from 28 to 70 years and the duration on maintenance HD before the onset of TB ranged between 1 and 24 months. Extra-pulmonary manifestations predominated (81.8%) and TB lymphadenitis was the commonest lesion observed. Five patients died during the study period but none due to a direct consequence of TB or its treatment. We conclude that the prevalence of TB is high among patients on HD In Jordan when compared with the general population.
  2,076 224 -
CASE REPORT
Pefloxacin in the Treatment of Childhood Nephrotic Syndrome: A Case Report
Boucar Diouf, Maziar Djoneidi, Saidou Diallo, Therese Moreira Diop, Oumar Bao
January-March 1996, 7(1):31-33
PMID:18417914
The idiopathic nephrotic syndrome (INS) of childhood is characterized chiefly by a remitting and relapsing course and its striking susceptibility to corticosteroid therapy. We report a case of relapsing nephrotic syndrome associated with urinary tract infection (UTI) treated with pefloxacin, which is a fluoro-quinolone derivative, in a dose of 800 mg per day. Steroids were avoided because of associated UTI. The UTI responded well and proteinuria disappeared after ten days of treatment with pefloxacin. However, the patient developed arthralgia involving the ankles, the knees and the neck. At this juncture, the drug was discontinued resulting in complete cessation of the joint pain. Pefloxacin increases the production of interleukin-2, a cytokine whose metabolism is modified during nephrotic syndrome. It has been used earlier in children with INS with equivocal results. The toxicity of quinolones for the joints seems more frequent in children, whose cartilage is immature and several cases have been reported. Studies on a larger number of patients are required before drawing any firm conclusions on the usefulness of pefloxacin in the treatment of INS.
  2,012 214 -
LETTERS TO THE EDITOR
Pneumocystis carinii Pneumonia after Renal Transplantation
Mansour F Karadsheh, Mohammad A Ghneimat, Nael M Soudi, Ibrahim M Smadi, Nabeel A Akash, Mohammad Tarawneh, Mohammad El-Lozi
January-March 1996, 7(1):36-37
PMID:18417916
  1,906 222 -
ORIGINAL ARTICLES
Is Peritonitis a Limiting Factor in the Widespread Use of CAPD in the Developing Countries?
Yassin I El-Shahat, Shakuntala Varma, Avinash Pingle, AK Hadi, Shah Nawaz, M Zahir Bari
January-March 1996, 7(1):15-19
PMID:18417910
Although continuous ambulatory peritoneal dialysis (CAPD) is now an established form of treatment for patients with end-stage renal failure (ESRF), it is not being used on a large scale in developing countries (DC). One of the limiting factors in this regard is peritonitis which is the most common complication of CAPD. Data on 70 patients on CAPD in our center were analyzed to study the impact of peritonitis on long-term outcome of this treatment. The mean age of the study patients was 37.2 years and the mean follow-up was 32.8 months per patient. A total of 41 patients (58.6%) received CAPD as first choice, 27 (38.6%) were started on CAPD after being on hemodialysis earlier and two (2.8%) were started on CAPD after a failed renal transplantation. Thirty three patients (47.1%) used safe-leur lock system, 23 (32.9%) used the spike system and 14 (20%) used safe-leur system initially and subsequently were changed to spike system. The overall incidence of peritonitis encountered was one episode per 32.3 patients months and was higher among patients who started CAPD as second choice. The incidence of peritonitis was not influenced by sex, age, profession or presence of diabetes mellitus or cardiovascular disease. This study shows that peritonitis rate in CAPD patients in our hospital is low and compares favorably with results from established centers in the developed countries. Thus, worries about recerrent peritonitis should not hinder CAPD programs in DC.
  1,792 229 -
LETTERS TO THE EDITOR
Renal Involvement in Henoch-Schonlein Purpura
Matrouk Al Aun, Abd El-Hamid Njada, Issa Hazza, Muffeed Al Hamoori, Emad Kudah, Hussein Al Maghribi
January-March 1996, 7(1):34-35
PMID:18417915
  1,445 208 -
Kidney Transplantation from Living Unrelated Donors
Riad Al Asfari, Sayed Hadidy, Shaza Yagan
January-March 1996, 7(1):38-39
PMID:18417917
  1,468 175 -
I want a Saudi Doctor!
Hatem Mansy, Ali Al Harbi, Saad HF Ghasib, S Al Shalash, Z Al Shareef
January-March 1996, 7(1):44-44
PMID:18417920
  1,252 159 -
Incidence of ESRD: Magnitude of the Problems and Implications
PT Subramanian
January-March 1996, 7(1):42-43
PMID:18417919
  905 213 -
Use of Erythropoeitin in Pre-dialysis Patients
PT Subramanian
January-March 1996, 7(1):40-40
PMID:18417918
  774 149 -
Authors' reply
T Timothy Paul, KS Ramprasad, Faissal A.M Shaheen
January-March 1996, 7(1):40-41
  752 142 -
Author's Reply
KMS Aziz
January-March 1996, 7(1):43-43
  698 134 -
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