Nephrology Journals Research Articles

Preprint Servers in Kidney Disease Research: A Rapid Review.

Preprint servers, such as arXiv and bioRxiv, have disrupted the scientific communication landscape by providing rapid access to research before peer review. medRxiv was launched as a free online repository for preprints in the medical, clinical, and related health sciences in 2019. In this review, we present the uptake of preprint server use in nephrology and discuss specific considerations regarding preprint server use in medicine. Distribution of kidney-related research on preprint servers is rising at an exponential rate. Survey of nephrology journals identified that 15 of 17 (88%) are publishing original research accepted submissions that have been uploaded to preprint servers. After reviewing 52 clinically impactful trials in nephrology discussed in the online Nephrology Journal Club (NephJC), an average lag of 300 days was found between study completion and publication, indicating an opportunity for faster research dissemination. Rapid review of papers discussing benefits and risks of preprint server use from the researcher, publisher, or end user perspective identified 53 papers that met criteria. Potential benefits of biomedical preprint servers included rapid dissemination, improved transparency of the peer review process, greater visibility and recognition, and collaboration. However, these benefits come at the risk of rapid spread of results not yet subjected to the rigors of peer review. Preprint servers shift the burden of critical appraisal to the reader. Media may be especially at risk due to their focus on "late-breaking" information. Preprint servers have played an even larger role when late-breaking research results are of special interest, such as during the global coronavirus disease 2019 pandemic. Coronavirus disease 2019 has brought both the benefits and risks of preprint servers to the forefront. Given the prominent online presence of the nephrology community, it is poised to lead the medicine community in appropriate use of preprint servers.

Recombinant Human Erythropoietin for Kidney Transplantation: A Systematic Review and Meta-Analysis.

The protective effect of recombinant human erythropoietin (rHuEPO) on kidney transplantation has not been established. Therefore, we conducted a systematic review and meta-analysis to evaluate the potential influence of rHuEPO on transplanted kidneys. To identify relevant studies, we searched electronic databases (PubMed, Medline, EMBASE, Ovid, the Cochrane Library, and major nephrology journals) from inception until June 15, 2018. Two independent reviewers assessed study quality. The systematic review and meta-analysis were performed with fixed- or random-effects models according to heterogeneity, and results are expressed as risk ratios (RR) or weighted mean differences. Six randomized controlled trials with a total of 435 patients met the inclusion criteria. rHuEPO, compared with placebo, had no statistically significant effect on delayed graft function (RR = 0.89, 95% confidence interval [CI] , 0.73 to 1.07; P = 0.22) and slow graft function (RR = 0.93, 95% CI, 0.60 to 1.43; P = 0.73). The rHuEPO and control groups did not differ in thromboembolic events, mortality, acute rejection, and blood transfusion. A significant difference was found in long-term estimated glomerular filtration rate (RR = 3.65, 95% CI, -4.45 to 11.75; P = 0.003). Our findings suggests that rHuEPO has a limited nephroprotective effect in patients undergoing kidney transplantation and does not increase the susceptibility to adverse events.

Impact, Strategies, and Opportunities for Early and Midcareer Cardiovascular Researchers During the COVID-19 Pandemic.

Impact, Strategies, and Opportunities for Early and Midcareer Cardiovascular Researchers During the COVID-19 Pandemic.

COVID19 y sistema renina angiotensina aldosterona (SRAA)

The Colombian Journal of Nephrology (Revista Colombiana de Nefrología)is the official organ of the Colombian Association of Nephrology and Hypertension. It was created in 2007. Its main mission is to disseminate scientific information derived from research in the different areas of Nephrology. It publishes original articles on applied research, review articles, reflection articles, case reports and letters to the director.

Editorial note: welcome to Volume 23 and the year 2020

The Editorial Board of African Journal of Nephrology (AJN) and I wish all readers, contributors and reviewers a very happy and successful year 2020. The year 2019 was a very productive year for AJN and the African Association of Nephrology (AFRAN). The 2019 AFRAN congress, held from 25 to 29 September 2019 in Mombasa (Kenya), was a very successful one, with the participation of hundreds of delegates from all regions of Africa. The congress was held in partnership with the Kenya Renal Association and the African Paediatric Nephrology Association (AFPNA). The main congress was preceded by several successful courses. Prof Antony Were from Kenya was elected President of AFRAN. The next AFRAN congress will be held next year in Côte d’Ivoire. In 2019, we published excellent reviews covering global disparities in kidney disease and its treatment as well as the use of data from renal registries in randomised controlled trials. We therefore encourage our readers to participate in the collection of data for registries as well as to make use of registry data for research. The AJN 2019 volume also published excellent original articles that showcased the strength of clinical nephrology research in various regions of Africa. The year 2020 is expected to witness several national and regional nephrology meetings. I urge all convenors to use AJN to publicize their meetings, as well as publish their proceedings. The World Congress of Nephrology will take place in Abu Dhabi from 26 to 29 March 2020. This year, World Kidney Day is scheduled for Thursday, 12 March 2020. The theme is “Kidney Health for Everyone Everywhere – from Prevention to Detection and Equitable Access to Care”. I am confident that, in 2020, AJN will continue the trends set in the previous year, by publishing outstanding in-depth review articles as well as interesting original research articles. Finally, I am pleased to announce that this year, the South African Renal Society Congress will take place in Durban at the International Convention Centre, from 25-29 November 2020. The theme of the congress is “Big Data and Access to Quality Renal Care”. As President of the Local Organising Committee, I invite everyone to SARS Congress 2020. WOZA – DURBAN! Alain G AssoungaEditor-in-Chief

NOTTO transplant specific guidelines with reference to COVID-19

NOTTO transplant specific guidelines with reference to COVID-19

Scientific Publication Productivity and Research Activities of Iraqi Pediatricians in the Field of Pediatric Nephrology: A Bibliometric Analysis to Identify Pioneers

Background: Bibliometrics is increasingly used to assess the quantity and quality of scientific research output in many research fields throughout the world. This study aims to update Iraqi pediatricians’ research productivity in the field of nephrology using bibliometric methods, and analysis of the contribution of Iraqi pediatricians to the field of pediatric nephrology literature. Methods: Papers published by Iraqi pediatricians’ in the field of pediatric nephrology were retrieved from “Web of Science” and “PubMed”. The number and types of papers, and author’s h-index (Hirsch index) were analyzed. Papers published by researchers other than pediatricians such urologic surgeons, and basic sciences researchers were not included in this study. Results: A total of 53 papers were found published in a total of 11 journals including Pediatric Nephrology, Therapy (Clinical practice), Journal of Tropical Pediatrics, Journal of Nephrology and Renal Transplantation, Urology, Clin Exp Nephrol, American Journal of Medical Genetics A, The Open Urology & Nephrology Journal, Acta Paediatrica, Archives of Disease in Childhood, and Saudi Journal of Kidney Disease and Transplantation. The vast majority of papers, 49 (92.4 %) were published by Aamir Jalal Al-Mosawi. Only four our papers [Etiological and clinical patterns of childhood urolithiasis in Iraq (2005), .Profile of renal diseases in Iraqi children: A single-center report. (2015), Hypertension in hemodialyzed children (2016), The predictive factors for relapses in children with steroid-sensitive nephrotic syndrome (2016)] were published by authors other than Aamir Jalal Al-Mosawi, and was carefully examined and found to include unreliable, non-authentic and largely misleading information. The work of Aamir Jalal Al-Mosawi represented the authentic reliable source about childhood renal disorders in Iraq. The work of Aamir Jalal Al-Mosawi provided a comprehensive knowledge about childhood renal disorders in Iraqi children. The papers of Aamir Jalal Al-Mosawi included 12 research papers, 2 case report, one case series, three review articles, and at least 31 conferences’ abstracts. Conclusion: Aamir Jalal Al-Mosawi is perfectly regarded as the undisputable pioneer of pediatric nephrology in Iraq. In 2008, the web site “Medical talks” listed Aamir Jalal Al-Mosawi with the famous physicians in history for describing a new model for the treatment of chronic renal failure.

An Evaluation of Nephrology Literature for Transparency and Reproducibility Indicators: Cross-Sectional Review

IntroductionReproducibility is critical to diagnostic accuracy and treatment implementation. Concurrent with clinical reproducibility, research reproducibility establishes whether the use of identical study materials and methodologies in replication efforts permits researchers to arrive at similar results and conclusions. In this study, we address this gap by evaluating nephrology literature for common indicators of transparent and reproducible research.MethodsWe searched the National Library of Medicine catalog to identify 36 MEDLINE-indexed, English-language nephrology journals. We randomly sampled 300 publications published between January 1, 2014, and December 31, 2018.ResultsOur search yielded 28,835 publications, of which we randomly sampled 300 publications. Of the 300 publications, 152 (50.7%) were publicly available, whereas 143 (47.7%) were restricted through paywall and 5 (1.7%) were inaccessible. Of the remaining 295 publications, 123 were excluded because they lack empirical data necessary for reproducibility. Of the 172 publications with empirical data, 43 (25%) reported data availability statements and 4 (2.3%) analysis scripts. Of the 71 publications analyzed for preregistration and protocol availability, 0 (0.0%) provided links to a protocol and 8 (11.3%) were preregistered.ConclusionOur study found that reproducible and transparent research practices are infrequently used by the nephrology research community. Greater efforts should be made by both funders and journals. In doing so, an open science culture may eventually become the norm rather than the exception.

Scientific Publication Productivity and Research Activities of Iraqi Pediatricians in the Field of Pediatric Nephrology: A Bibliometric Analysis.

Abstract Background: Bibliometrics is increasingly used to assess the quantity and quality of scientific research output in many research fields throughout the world. This study aims to update Iraqi pediatricians’ research productivity in the field of nephrology using bibliometric methods and analysis of the contribution of Iraqi pediatricians to the field of pediatric nephrology literature. Methods: Papers published by Iraqi pediatricians’ in the field of pediatric nephrology were retrieved from “Web of Science” and “PubMed”. The number and types of papers and author’s h-index (Hirsch index) were analyzed. Papers published by researchers other than pediatricians such urologic surgeons and basic sciences researchers were not included in this study. Results: A total of 53 papers were found published in a total of 11 journals including Pediatric Nephrology, Therapy (Clinical practice), Journal of Tropical Pediatrics, Journal of Nephrology and Renal Transplantation, Urology, Clin Exp Nephrol, American Journal of Medical Genetics A, The Open Urology and Nephrology Journal and Acta Paediatrica, Archives of Disease in Childhood and Saudi Journal of Kidney Disease and Transplantation. The vast majority of papers, 49 (92.4 %) were published by Aamir Jalal Al-Mosawi. Only four our papers [Etiological and clinical patterns of childhood urolithiasis in Iraq (2005). Profile of renal diseases in Iraqi children: A single-center report (2015), Hypertension in hemodialyzed children (2016), The predictive factors for relapses in children with steroid-sensitive nephrotic syndrome (2016)] were published by authors other than Aamir Jalal Al-Mosawi and was carefully examined and found to include unreliable, non-authentic and largely misleading information. The work of Aamir Jalal Al-Mosawi represented the authentic reliable source about childhood renal disorders in Iraq. The work of Aamir Jalal Al-Mosawi provided a comprehensive knowledge about childhood renal disorders in Iraqi children. The papers of Aamir Jalal Al-Mosawi included 12 research papers, 2 case report, one case series, three review articles and at least 31 conferences’ abstracts. Conclusion: Aamir Jalal Al-Mosawi is perfectly regarded as the undisputable pioneer of pediatric nephrology in Iraq.

Editorial note: welcome to Volume 22 and the year 2019

On behalf of the Editorial Board of the African Journal of Nephrology (AJN), I wish all readers, contributors and reviewers a happy and successful 2019. We have successfully completed our third year as an online Journal. We sincerely thank everyone who contributed to this achievement. With your support, we will achieve more milestones. I wish to take this opportunity to remind all our readers and contributors that AJN is the official journal of the African Association of Nephrology (AFRAN). During 2019, AFRAN, in partnership with the Kenya Renal Association, will convene its biennial congress in Mombasa, Kenya, from 25–29 September. Let us give Professor Were, AFRAN President-Elect, and the Kenya Renal Association all the support they need. Through our participation, we will ensure that the AFRAN congress is a great success. This year, the nephrology calendar is fully loaded. Besides various local and regional congresses, including the AFRAN Congress, at the global level the World Congress of Nephrology will be held in Melbourne, Australia, from 12–15 April 2019. World Kidney Day is also fast approaching. It will be celebrated as usual, on the second Thursday of March, 14 March 2019. The theme this year is “Kidney Health for Everyone Everywhere”. In Volume 21 in 2018, AJN published excellent original articles from various regions of Africa, including East, West and Southern Africa. The proceedings of the 2018 South African Renal Congress are also part of AJN Volume 21. Of note, also in Volume 21, the publication of the 2016 South Africa Renal Registry Annual Report gives a picture of renal replacement therapy in an African country. In 2019, in Volume 22, AJN expects to continue to publish excellent original articles as well as review articles to display research outputs from our contributors. We invite researchers to continue to submit their best work, and nephrology societies to submit the proceedings of their local and regional congresses. Once again, Happy 2019 and we look forward to seeing you in Melbourne in April and Mombasa in September! KARIBUNI SANA AFRAN Congress in Kenya! Alain G Assounga Editor-in-Chief

Editorial introductions

Editorial introductions

Utility of Transthoracic Echocardiograms in Patients with Chronic Kidney Disease Living in Western Sydney

Background: Chronic Kidney Disease (CKD) is associated with adverse cardiac remodelling, most notably left ventricular (LV) hypertrophy and LV diastolic dysfunction, [1Dubin R. Application of echocardiographic data in patients with chronic kidney disease.Current Opinion in Nephrology and Hypertension. 2018; 27: 283-288Google Scholar, 2Hung K. Echocardiographic Characteristics of Chronic Kidney Disease: The Taiwanese Experience.Journal of Medical Ultrasound. 2015; 23: 14-16Crossref Scopus (2) Google Scholar, 3Liu Y. Su C. Song E. Tsai W. Li Y. Tsai L. Chen J. Sung J. The role of echocardiographic study in patients with chronic kidney disease.Journal of the Formosan Medical Association. 2015; 114: 797-805Crossref Scopus (10) Google Scholar] the presence of which has been associated with adverse cardiovascular outcomes [[4]Pakfetrat M. Roozbeh J. Nikoo M. Asem Z. Malekmakan L. Nikoo M. Common echocardiography findings in pretransplant dialysis patients and their associations.Hong Kong Journal of Nephrology. 2013; 15: 68-74Abstract Full Text Full Text PDF Scopus (1) Google Scholar]. Despite this, transthoracic echocardiography (TTE) is not routinely performed in this population, limiting opportunities for early effective intervention. The aim of our study was to evaluate local trends in utility of TTE studies in patients with CKD. Methods: Patients attending the Nephrology Clinics at Blacktown Hospital from Jan-2014 to Dec-2016 were evaluated. Patients who were referred for TTE studies in the course of their care were assessed and the indications for referral were categorised and evaluated. Results: 1179 patients (mean age 66.47 ± 16.88; 55% males) were assessed of which 386/1179 (33%) received TTE studies. The most common indication for TTE referral was for evaluation of dyspnoea 178/386 (46%) followed by evaluation of cardiac function following acute coronary syndrome (n = 129, 32%). In patients with dyspnoea, 147/178 (83%) patients had clinical findings of fluid overload on clinical assessment and 95/178 (53%) had findings of impaired LV systolic function (LVEF< 50%) on TTE. Other indications for TTE referral include arrhythmia (n = 30, 8%), evaluation of cardiac murmur (n = 21, 5%), pre-operative evaluation (n = 11, 3%) and sepsis (n = 26, 7%) A total of 177/386 (45.9%) patients had more than 1 TTE, with 100/386 (25.9%) having 2 or more TTE within 12 months. Conclusions: Our findings suggest that TTE studies are commonly performed in patients with CKD and for various indications, but with a significant proportion of studies occurring only after an adverse cardiovascular outcome.

Editorial Note: Welcome to Volume 21 and the year 2018

African Journal of Nephrology (AJN) has completed a full year of operation as a web-based journal. After addressing a few teething problems, the journal is now running smoothly. I wish to thank reviewers, readers and the members of the editorial board for having participated in this endeavour. On behalf of the editorial board, I wish to thank all colleagues who have chosen to submit their valuable work to our journal. A special welcome and thanks to contributors who have submitted their manuscript in French, with an English abstract. They ensure that AJN remains a representative vehicle for nephrology research output in Africa. Volume 20, for the year 2017, has now given way to Volume 21, which will include publications throughout the year 2018. As a tribute, I wish to summarize few highlights of Volume 20. The story of the African Association of Nephrology (AFRAN) by Prof Rashad Barsoum, the founding president of AFRAN, is a very good record of the development of nephrology in Africa. The review of renal physiology in patients with potassium disorders by Prof Mitch Halperin and the review of focal and segmental glomerulosclerosis by Prof John Feehally are excellent updates of the two topics. Original articles and case reports from contributors from various African regions are testament to the active production of nephrology knowledge in Africa. Finally, congress proceedings of the AFRAN Congress in March 2017 in Yaounde (Cameroon) and of the Southern African Transplantation Society Congress in September 2017 in Durban (South Africa) are excellent records of high quality nephrology meetings in Africa. As we are continuing to digitize and preserve our past, I wish to invite everyone to read our archive of publications. I urge everyone who may have copies of old AJN issues or manuscripts that are missing in the archive, to forward them to us to ensure that we make all our past papers available online. In the beginning, AJN started as a newsletter, published by the late Prof Salma Suleiman of Sudan. To complete the AJN archive, we hope to include the past newsletters as a tribute to the late Prof Suleiman. We urge anyone having any copies of the newsletter to forward it to AJN. As in Volume 20 in 2017, Volume 21 will consist of a single issue and include all publications for 2018. They will be added throughout the year as they are accepted for publication. We should expect exciting reviews by experts as in our previous volumes as well as special articles. For our legacy project that was started by Prof Rashad Barsoum, first AFRAN President, we will request the subsequent AFRAN presidents to each submit a review of the period of their tenure. As in the past, we expect to publish original articles as well as interesting case reports, and we encourage regional and national societies to submit the abstracts from their conference proceedings for publication. Finally, I wish to take this opportunity to express my best wishes for the year 2018 to all contributors, reviewers and readers. Alain G Assounga Editor-in-Chief

Fifty years of hemodialysis access literature: The fifty most cited publications in the medical literature.

Objectives The modern era of hemodialysis access surgery began with the publication in 1966 by Brescia et al. describing the use of a surgically created arteriovenous fistula. Since then, the number of patients on chronic hemodialysis and the number of publications dealing with hemodialysis access have steadily increased. We have chronicled the increase in publications in the medical literature dealing with hemodialysis access by evaluating the characteristics of the 50 most cited articles. Methods We queried the Science Citation Index from the years 1960-2014. Articles were selected based on a subject search and were ranked according to the number of times they were cited in the medical literature. Results The 50 most frequently cited articles were selected for further analysis and the number of annual publications was tracked. The landmark publication by Dr Brescia et al. was unequivocally the most cited article dealing with hemodialysis access (1109 citations). The subject matter of the papers included AV fistula and graft (9), hemodialysis catheter (9), complications and outcomes (24), and other topics (8). Most articles were published in nephrology journals (33), with fewer in surgery (7), medicine (7), and radiology (3) journals. Of the 17 journals represented, Kidney International was the clear leader, publishing 18 articles. There has been an exponential rise in the frequency of publications regarding dialysis access with 42 of 50 analyzed papers being authored after 1990. Conclusion As the number of patients on hemodialysis has increased dramatically over the past five decades, there has been a commensurate increase in the overall number of publications related to hemodialysis access.

Editorial note

As the official journal of the African Association of Nephrology (AFRAN), the African Journal of Nephrology (AJN) publishes research on kidney diseases by African and other researchers. AJN has reached a significant milestone in this first issue of Volume 20. This is the first issue which was prepared and published using our new web-based platform. We wish to take this opportunity to thank the editorial board, the reviewers and the authors for their role in the successful migration to the new platform. To mark this milestone, and to coincide with the March 2017 AFRAN/AFPNA Congress in Cameroon, we are delighted to publish a special article on the history of AFRAN by Professor Rashad Barsoum, one of the co-founders of AFRAN. Contributions to the success of AFRAN by the International Society of Nephrology, and by colleagues from Europe, America and Africa, are acknowledged. This is an illustrated story of our association told by its founding president, which is now immortalised in AJN. This issue also features an original article reporting on malignant kidney tumours in Port Harcourt, Nigeria. Nephroblastoma and renal cell carcinoma remain the leading kidney malignancies, as also reported worldwide. Finally, two interesting case reports conclude this issue: a case of IgG4-related nephropathy and a successful pregnancy in a patient on chronic haemodialysis.

The story of the African Association of Nephrology (AFRAN)

The African Association of Nephrology was founded in Cairo on 28 February 1987, during the ISN-sponsored “African Kidney and Electrolytes Conference”, being hosted and co-sponsored by the Egyptian Society of Nephrology. Twenty-five physicians interested in kidney disease, from 13 African countries, constituted the core assembly that selected a steering committee composed of five members, representing the five geographical zones in Africa. The committee proposed the name the African Association of Nephrology (AFRAN), approved its logo, defined its mission, and drafted its constitution. All were ratified at the first General Assembly meeting held in London in July of the same year. The steering committee was re-elected to continue as the Executive Committee for the first cycle and mandated to set the scene for future meetings, publications and programmes. AFRAN congresses have been held regularly ever since, triennially for three cycles, then biennially with a few exceptions. Scientific meetings including Continuing Medical Education activities and hands-on workshops addressing local kidney and electrolyte disorders, have been held in most African countries, with generous logistical and financial support by the International Society of Nephrology (ISN). The abstracts of the first congress were published in Kidney International. Meeting proceedings were usually distributed by hand, thanks to representatives of pharmaceutical companies in the various African countries. A quarterly newsletter was edited and published in the Sudan, upgraded to a journal (the African Journal of Nephrology) in 1997 and self-published from Egypt until the editorial office moved to South Africa in 2012. A registry of nephrologists and dialysis units in Africa was compiled and published from Algeria in 1989, then updated in the Sudan a few years later. More recently, an African Renal Registry was established, now hosted in South Africa. Numerous fellowships were offered by the better-off countries to their emerging neighbours, being sponsored by international organizations, mainly the ISN. Joint research has been conducted mainly through these fellowships. By its 10th birthday, AFRAN had encompassed all African countries, to become the official pan-African federation of national renal societies. The ISN initiatives for supporting the developing world, originally operated under the umbrella of the Commission for the Global Advancement of Nephrology (COMGAN), were instrumental in supporting AFRAN’s foundation and sustainability. Besides the ISN, AFRAN became affiliated to many other regional and all national societies of nephrology, which qualified it to serve as the principal liaison between African nephrology and that in the rest of the world.

Factors associated with the Journal Impact Factor (JIF) for Urology and Nephrology Journals.

ABSTRACTPurpose:The Journal Impact Factor (JIF) is an index used to compare a journal's quality among academic journals and it is commonly used as a proxy for journal quality. We sought to examine the JIF in order to elucidate the main predictors of the index while generating awareness among scientific community regarding need to modify the index calculation in the attempt to turn it more accurate.Materials and Methods:Under the Urology and Nephrology category in the Journal Citations Report Website, the top 17 Journals by JIF in 2011 were chosen for the study. All manuscripts’ abstracts published from 2009-2010 were reviewed; each article was categorized based on its research design (Retrospective, Review, etc). T and correlation tests were performed for categorical and continuous variables respectively. The JIF was the dependent variable. All variables were then included in a multivariate model.Results:23,012 articles from seventeen journals were evaluated with a median of 1,048 (range=78-6,342) articles per journal. Journals with a society affiliation were associated with a higher JIF (p=0.05). Self-citations (rho=0.57, p=0.02), citations for citable articles (rho=0.73, p=0.001), citations to non-citable articles (rho=0.65, p=0.0046), and retrospective studies (rho=-0.51, p=0.03) showed a strong correlation. Slight modifications to include the non-citable articles in the denominator yield drastic changes in the JIF and the ranking of the journals.Conclusion:The JIF appears to be closely associated with the number of citable articles published. A change in the formula for calculating JIF to include all types of published articles in the denominator would result in a more accurate representation.

Editorial Pediatric Nephrology: An Update

I am indeed privileged to serve as Guest Editor to this special issue of the Open Urology and Nephrology Journal on pediatric nephrology. I am also appreciative to the distinguished panel of authors for their contribution and for presenting the most recent clinical advances in various aspects of the specialty. Pediatric nephrology is rapidly evolving. Over the last few decades we have witnessed a rapid change in nosology, etiology, pathogenesis and treatment of renal disease. We have seen advances in renal and urinary tract imaging as well as more precise use of novel urinary biomarkers to define the type and degree of renal injury, both acute and chronic. We now have better understanding of factors contributing to normal and abnormal renal development, particularly the progenitors of renal development and regeneration, delivery of progenitor cell therapeutics, and the role of epigenetics [1]. Multi center pan-national and international clinical studies have helped to put together clinical guidelines to diagnose and manage renal disease. In this issue, we will discuss few, but important recent clinical developments in pediatric nephrology. While performing renal ultrasound and voiding cystourethrogram (VCUG) was once a routine, the American Academy of Pediatrics (AAP) and the National Institute for Health and Clinical Excellence (NICE) are now recommending a marked reduction in the imaging of children under age 2-3 with febrile urinary tract infection (UTI) [2]. Both AAP and NICE also agree that prophylactic antibiotic treatment should not be routinely used in these children even those with major vesicoureteral reflux (VUR). Presently, the AAP recommends that infants (2-24 months of age) with a febrile UTI undergo renal and bladder ultrasonography as a routine screen, and reserve VCUG for patients with recurrent UTI or with evidence of anatomic abnormality on ultrasound. In 2014, and only three years after this recommendation, the results of the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) study was published [3]. According to this study, antibiotic prophylaxis does indeed prevent UTI recurrence in young children with VUR, but at the cost of increased antibiotic resistance, and with unclear benefits in preventing 뀀ഀȠ

Safety and efficacy of low molecular weight heparin (enoxaparin sodium) in comparison with standard unfractionated heparin for haemodialysis anticoagulation

In this issue of the African Journal of Nephrology (AJN Vol 18, No 1) we publish original articles ranging from the prevalence of chronic kidney disease in an African population in general, to the role of HIV in kidney disease. An elegant study of fractionated heparin use in haemodialysis is also presented. Continuous ambulatory peritoneal dialysis is an important modality of renal replacement to be considered in Africa in view of its ease of operation. However, beware of potential complications including sclerosing peritonitis as reported in Cape Town (South Africa). As in the past, this issue covers a wide variety of topics with contributions from diverse authors from south to west and North Africa. On behalf of the editorial board, I wish to take this opportunity to thank all of the authors and reviewers who have contributed to this issue of the journal, as well as to the readers for their sustained interest in the African Journal of Nephrology . Prof A. Assounga, Editor-in-chief

Contrast-induced acute kidney injury – A review focusing on prophylactic strategies

Contrast-induced acute kidney injury is the third leading cause of intrahospital acute kidney disease, accounting for 11% of all cases. It is associated with a worse prognosis on the short- and long-term, as well as with extended hospital stay and increase in health-care costs. As the number of diagnostic and interventional angiographies and computerized tomography increases in clinical practice and higher doses of contrast media are administered to sicker and older patients, contrast-induced acute kidney injury is an increasing problem. Contrast-induced acute kidney injury is a unique form of acute kidney injury in that its risk factors are known and its timing predictable. This makes room for the implementation of prophylactic measures in patients at risk.Several articles were searched in nephrology journals (“American Journal of Kidney Disease”, “Journal of the American Society of Nephrology”, “Clinical Journal of the American Society of Nephrology”, “Kidney International” and “Nephrology Dialysis Transplantation”) for a global view on contrast-induced acute kidney injury and prophylactic strategies. Subsequently, individual searches were made on MEDLINE® database for randomized controlled trials and meta-analyses on each prophylactic strategy encountered.Several approaches to contrast-induced acute kidney injury prevention have been reported, of which vigorous hydration and the use of non-ionic contrast media are the most important. The administration of oral N-acetylcysteine is also a popular strategy in virtue of its favorable risk/benefit profile. Statins have also been reported as protective against contrast-induced acute kidney injury. The authors review the disease and studied prophylactic interventions, presenting a practical approach to the prevention of contrast-induced acute kidney injury.