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Saudi Journal of Kidney Diseases and Transplantation
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   2001| October-December  | Volume 12 | Issue 4  
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Long-term Complications in Hemodialysis
Christopher R Blagg
October-December 2001, 12(4):487-493
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Presentation of Posterior Urethral Valves in Saudi Arabia in the 90's
Khalid Fouda Neel, Salah R El-Faqih, Roberto De Castro, Jehad M Abu Daia, Ahmad M Al-Shammari, Abdullah Al-Jasser, Hassan Al-Farraj
October-December 2001, 12(4):516-519
To evaluate the age and mode of presentation of patients with posterior urethral valves (PVU) in the antenatal and postnatal periods, we analyzed the files of 108 patients with the diagnosis of PUV in four referral hospitals in Riyadh, Saudi Arabia from 1989 to 1999. Of the study patients, 29 (27%) were antenatally discovered, 41 (38%) in the first year of life and 38 (35%) after the first year of life. The mode of presentation was by antenatal ultrasound in 29 (27%) patients, urinary tract infection in 33 (30.4%) patients, poor urinary stream in 35 (32.4%) patients, retention of urine in neonatal life in eight (7.4%) patients and symptoms of renal impairment in three (2.8%) patients. We conclude that the antenatal detection rate of PUV in our study patients is less than the international one (70%), despite the fact that most of the antenatal follow-ups were done in centers where ultrasound was available for routine antenatal work up. This calls for more vigilance by the radiologists and obstetricians to enhance the rate of detection of PUV.
  5,030 353 -
Recommended Standards for Acute Renal Failure, Pre-dialysis Chronic Renal Failure and General Nephrology
Ibrahim Hassan Fahal
October-December 2001, 12(4):538-549
  4,788 433 -
Xanthogranulomatous Pyelonephritis: A Retrospective Study of 10 Cases and Review of the Literature
A Fallatah, M Tarakji, J Amuesi
October-December 2001, 12(4):520-524
We herewith report 10 patients with xanthogranulomatous pyelonephritis (XGP) who were treated in our department between the years 1988 and 2000. The patients' age ranged from 20 to 60 years (mean 45 years); there were seven males and three females giving a male-female ratio of 2.3:1. Sixty percent of the patients were over 50 years old. The lesion was unilateral in all cases and pyonephrosis was found in seven patients. Nine cases had associated renal stones (90%), which led to non-functioning kidney in all these cases. Two cases had associated fistulae (one uretero-colonic fistula and one reno-cutaneous fistula). One case of focal XGP was found to be associated with renal cell carcinoma while a second patient with diffuse obstructive type of XGP and renal stone had associated transitional cell carcinoma of the renal pelvis. In all patients, the urine culture was negative. Pus culture revealed Escherechia coli in four cases (40%), Salmonella Para B in one, and no organism could be grown in four other cases. One case did not have any pus. All patients were treated with nephrectomy.
  4,430 651 -
CAPD in Dammam Central Hospital, Saudi Arabia: A Five-Year Experience
Joseph T Youmbissi, Taher Q Malik, Issam A Al Khursany, Reda Ghacha, Sinha Ajitkumar, Farida Al Ahmed, Ali Rafi, Mohamed Abdul Rahman, Ayman Karkar
October-December 2001, 12(4):511-515
Thirty-one patients with end-stage renal disease (ESRD) were offered continuous ambulatory peritoneal dialysis (CAPD) at the Dammam Central Hospital, Dammam, Saudi Arabia over a period of five years. The group included 21 women and 10 men with a mean age of 41.3 ± 17.2 years. The main indication for CAPD was poor or failed vascular access (51.4%). Peritonitis remained the major complication with an overall incidence of 0.62 episode per patient year. Staphylococcus epidermidis was the main causative organism. Therapy with CAPD lasted a mean of 26 ± 7.4 months. Our results, showing good technique survival and low peritonitis rate, suggest that CAPD should be promoted to become a full arm of the integrated care of ESRD in Saudi Arabia.
  4,637 314 -
Kidney Lesions Associated with Systemic Vasculitis: Report of 25 Cases in Morocco
Niang Abdou, Fatihi El Mustapha, Medkoury Ghislaine, Zahiri Khalid, Ramdani Benyounes, Benghanem Gharbi Mohamed, Hachem Khadija, S Squalli, Zaid Driss
October-December 2001, 12(4):554-561
In this retrospective study, we report 25 patients with renal injury caused by systemic vasculitis. These patients were hospitalized at the department of nephrology­hemodialysis in Ibn Rochd hospital from 1985 to 1998. The mean age of the patients was 36 years (range 3 to 57 years) with male predominance (68%). The clinical presentations included cutaneous purpura in 80% of the patients, arthritis in 60% and pulmonary hemorrhage in 20%. The renal injury manifested as abnormal urinary sediment in 20 of the study patients (80%), nephritic syndrome in 14 (56%), renal failure in nine (36%). Three patients (12%) had renal failure as the initial presentation followed by the other manifestations of vasculitis. The anti-neutrophil cytoplasmic antibodies (ANCA) have been checked in only six patients of whom four were positive. Henoch-Schonlein purpura was the most common clinical sign in 11 patients (44%) followed by Behcet's disease in five (20%). The treatment was variable in type and duration but generally included corticoids alone or in combination with immunosuppressants. The prognosis of the renal injury was variable. The renal function remained stable in those with Henoch-Schonlein purpura, but was less favorable with the other etiologies with more predominance of renal failure and end-stage renal disease. This retrospective analysis of our experience is given to throw light on the pattern of vasculitis in our region.
  4,251 442 -
Prevalence of Hepatitis C Antibodies Among Hemodialysis Patients in Al-Hasa Region of Saudi Arabia
Anil K Saxena, BR Panhotra, Mohamed Naguib, Mohammed Nabil Aboras, DS Sundaram, CK Venkateshappa, Wahid Uzzaman Khan
October-December 2001, 12(4):562-565
The prevalence of anti-HCV antibodies among hemodialysis (HD) patients was studied at King Fahad Hospital, Hofuf, Saudi Arabia. The records of 189 patients undergoing HD were reviewed. The overall prevalence of anti-HCV antibodies was 43.9%. Anti-HCV antibody prevalence was more common among female patients. There was no correlation between repeated blood transfusions and anti-HCV positivity as 4.8% of the patients who did not receive any blood transfusion during HD were positive for anti-HCV antibodies. A positive correlation was observed between the duration on dialysis and anti­HCV antibodies. An annual serocoversion rate of 6.8% was observed in this study.
  3,527 343 -
Early Detection of Tubulo-Interstitial Kidney Disease in Children Using Highly Discriminating SDS-Gel Electrophoresis
A Al-Bashir, D Rohrmann, R Mertens, H Melzer, H Mann
October-December 2001, 12(4):503-510
Tubulo-interstitial kidney disease is characterized by moderate proteinuria < 1 g/day of low molecular weight proteins in range of MW 10.000-50.000. Even in the physiological proteinuria of < 150 mg/day, tubulo-interstitial kidney disease may exist. Using optimized sodium dodecyl sulfate polyacrylamid gel electrophoresis (SDS-PAGE) according to the method of Melzer, even in proteinuria of less than 150 mg/day all relevant proteins for diagnosis of glomerular or tubulo-interstitial kidney disease can be detected. This study evaluates the tubulo-interstitial kidney disease due to polychemotherapy for different types of cancer in 115 children and in 16 children with pyelo-ureteral junction obstruction. Fifty-two and 63 children were followed up during and after chemotherapy, respectively. During therapy, renal damage was recorded in 43% of patients with leukemia, 56% with nephroblastoma, and 79% with other tumors. Tubular protein patterns were seen up to three years after termination of chemotherapy (25% in acute lymphoplastic leukemia, 35% in nephroblastoma and 62% in other tumors). Patients with persistent complete tubular proteinuria or mixed glomerular/tubular proteinuria were found to have a high risk for irreversible renal failure. Children with congenital pyelo-ureteral junction obstruction could also be classified according to SDS-PAGE protein patterns. Patients without parenchymal lesions did not need surgery. Most of those with pathologic findings in SDS-PAGE exhibited partial or complete remission after surgery. The highly discriminating SDS-PAGE permits a rapid, sensitive, reproducible, and reliable analysis of urine proteins for diagnosis and follow-up of all kinds of congenital or acquired renal parenchymal kidney diseases.
  3,335 416 -
Adequacy in Peritoneal Dialysis
Izhar H Khan
October-December 2001, 12(4):481-486
  3,319 427 -
Sustained Remission in a Case of Lupus Nephritis with Cyclosporin Therapy
Malik Anas Rabbani, Syed Mansoor Ahmad Shah, Aasim Ahmad
October-December 2001, 12(4):525-529
Systemic lupus erythematosus (SLE) in severe form still presents a major therapeutic challenge. Aggressive treatment of severe renal lesions has improved the prognosis of renal disease over the last decade. However, this benefit is quite frequently offset by the side effects and toxicity of the treatment. Moreover, the disease may appear to be poorly responsive to treatment with steroids and cytotoxic drugs. We report a case of lupus nephritis that relapsed despite having adequate steroid and cytotoxic therapy, but later was successfully treated with cyclosporin. Fifteen months after discontinuing the treatment with cyclosporin, the patient continued to remain in remission.
  3,299 393 -
Recurrent Acute Renal Failure in a Patient with Minimal Change Disease
Mohammad Abdelrahman, Ali Rafi, Reda Ghacha, Sinha Ajit Kumar, Ayman Karkar
October-December 2001, 12(4):530-533
We report on a 16-year old female patient with biopsy proved minimal change disease and steroid state. She was subsequentlygiven cyclosporin for varying periods of time with inadequate response. She developed four episodes of acute renal failure in the background of severe nephrotic state, 10 years after the onset of her illness. Three of these episodes could be reversed with albumin infusion and judicious use of diuretics while the fourth necessitated six sessions of ultrafiltration. In none of the episodes of ARF could we find any cause other than the nephrotic state itself.
  2,960 390 -
The Need for Guidelines for the Practice of Hemodialysis in the Kingdom of Saudi Arabia: A Questionnaire Survey
Abdullah A Al-Khader, KS Ramprasad, Faissal A.M Shaheen
October-December 2001, 12(4):494-502
Hemodialysis remains the most widely used form of renal replacement therapy world-wide. In view of the large number of patients who are on maintenance hemodialysis in Saudi Arabia, it was felt to have some sort of guidelines to standardize dialysis delivery in the Kingdom. We performed a survey on various aspects of dialysis delivery. A detailed questionnaire was sent to 120 hemodialysis centers in the Kingdom and response was obtained from 55 (45.8%). The questionnaire consisted of questions for which answer on the present situation and ideal recommendation were sought. With these data, it is hoped to have proper guidelines that can be laid down to assist the practicing nephrologists in the Kingdom in optimizing dialysis delivery.
  2,961 353 -
A Case of Progressive Tubulo-Interstitial Nephritis due to Culture-negative Renal Tuberculosis
Kamel A El-Reshaid, John Patrick Madda, Mouza A Al-Saleh
October-December 2001, 12(4):534-537
This report describes a woman with progressive renal failure without proteinuria, urinary obstruction or overt systemic disease. The progressive renal disease without pelvicalyceal deformities in the left kidney was not consistent with the vesicoureteric reflux nephropathy. A needle biopsy of the left kidney showed interstitial caseating granulomata. The patient did not have clinical, radiological or urine culture evidence of renal tuberculosis. She improved after treatment with antituberculous therapy. This case report demonstrates the value of kidney biopsy in establishing the diagnosis of such common and treatable disease even if clinically silent and urine culture negative.
  2,704 372 -
Culture Negative Endocarditis After CAPD Peritonitis: True or Fortuitous Association?
JT Youmbissi, S Al Saif, TQ Malik
October-December 2001, 12(4):550-552
  2,220 239 -
Medicine on the Internet
Anil K Saxena, BR Panhotra
October-December 2001, 12(4):552-552
  1,332 214 -
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