Pattern Of Kidney Disease Research Articles

Pattern of Kidney Disease Among Hypertensive Patient Attending Cardiac Clinics in Dar-Es Salaam

Pattern of Kidney Disease Among Hypertensive Patient Attending Cardiac Clinics in Dar-Es Salaam

Pattern of Kidney Disease among Children Admitted in a Tertiary Health Institution in South West Nigeria—A 7-Year Review

Pattern of Kidney Disease among Children Admitted in a Tertiary Health Institution in South West Nigeria—A 7-Year Review

POS-824 PATTERN OF RENAL DISEASES IN THE PAEDIATRIC RENAL CLINIC, KORLE BU TEACHING HOSPITAL

The pattern of kidney diseases among paediatric patients may differ globally due to environmental and inherited factors. The Paediatric Renal Clinic, Korle Bu Teaching Hospital, is a major referral clinic for children with renal diseases in the southern part of Ghana. There is no published data on the pattern of diseases seen in this clinic. Our objective was to determine the pattern of renal diseases seen at the Paediatric Renal Clinic of Korle Bu Teaching Hospital. In this retrospective study, we reviewed the data of all patients registered at the Paediatric Renal Clinic of Korle Bu Teaching Hospital from April 2017 to April 2019. The data was analyzed using SPSS© version 24. 226 patients were registered during the period. Mean age was 6.6 years ± 3.8 years [range 2 weeks to 19 years], with a male predominance (62.8% male, 32.7% female). M:F ratio was 1.7:1. The pattern was NS -148(65.5%); CAKUT -29(12.8%); AGN-25(11.1%); AKI-12(5.3%); CKD -7(3.1%) and others- 5(2.2%). The male predominance is higher among patients with AGN (M: F = 2.5:1) and NS (M: F = 1.8:1). Concerning steroid response among patients with NS, 123 (83.1%) were steroid sensitive, 13(8.6%) were steroid dependent, 11(7.9%) were steroid resistant while 1(0.7%) was frequently relapsing. NS response to steroids was not associated with gender (p= 0.237). Multicystic dysplastic kidney disease was the commonest CAKUT accounting for 31% of all CAKUT. The high steroid sensitivity in our study population could be explained by the close monitoring and follow-up of patients that happen in our clinic. It probably reflects the decreasing burden of some of the viral aetiologies of NS, especially as our immunization coverage increases. It could also be due to undetermined genetic factors. The commonest diagnoses in our paediatric renal clinic during the study period were NS, CAKUT and AGN. As NS is a chronic relapsing and remitting disease requiring multidisciplinary management, there is the need to include a comprehensive service in the renal clinic. Our study population showed high steroid sensitivity among patients with NS. Therefore, it is recommended that whenever a patient does not show steroid sensitivity, he/she should be closely monitored to exclude non-adherence to therapy

Pattern of kidney diseases in Northern India: an overview through histopathological findings in biopsy-proven cases

BackgroundA kidney biopsy is being increasingly performed for the diagnosis of renal diseases. It is a reasonably safe procedure that helps not only to reach the correct diagnosis based on histopathological findings but also helps in predicting the clinical course and outcome. The pattern of kidney diseases varies not only in far apart geographical regions but also in the same country. This study was done to evaluate the demographic pattern and spectrum of kidney diseases in renal biopsy-proven cases in an admitted patient of a tertiary care hospital of northern India.ResultsThe mean age of patients was 41.3 years ± 18.39 years, and the male-to-female ratio was 1.7:1. The most common indication for biopsy in this study was nephrotic syndrome (40.5%). The primary glomerular disease was most common, accounting for 57.5% of cases. Membranous nephropathy (MN) was the most frequently observed histopathological diagnosis not only in the primary glomerular disease category (22.9%) but of all cases (13.2%) as well. Among secondary cases, diabetic nephropathy was most frequent, constituting 43.4% cases. Interstitial and vascular diseases accounted for 18.8% and 1.8% of total cases, respectively. While minimal change disease (MCD) was the most common diagnosis in < 18-year age group, membranous nephropathy was most common above this age. Regarding the gender factor, membranoproliferative glomerulonephritis had an equal distribution among both genders, while MCD had a female preponderance.ConclusionsPrimary glomerular disease is the predominant kidney disease in northern India with MN being the most common histopathological diagnosis. The spectrum of kidney diseases varied with patient’s age and gender.

Spectrum of biopsy proven renal disease in South Asian children: Two decades at a tropical tertiary care centre.

We report findings from a large single centre paediatric renal biopsy cohort in South Asia. We analyzed all renal biopsies performed on children aged ≤18 years between 1996 and 2015 at our centre. The clinical characteristics and histological diagnosis pertaining to each case, distribution of renal diseases in children with various clinical presentations, and changes in the pattern of kidney disease during the study period were analyzed. A total of 1740 paediatric kidney biopsies were performed during the study period. The mean age was 12.8 ± 4.9 years (8 months to 18 years) and the male: female ratio was 1.5:1. The most common indication for renal biopsy was nephrotic syndrome (63.2%) followed by acute nephritic syndrome (13%). Minimal change disease was the most common cause of nephrotic syndrome while endocapillary proliferative glomerulonephritis (65.7% infection related), remained the commonest cause of acute nephritic syndrome. IgA nephropathy was the commonest cause of chronic kidney disease. Contrary to trends in European paediatric cohorts, the frequency of lupus nephritis increased over the two decades of the study, while that of endocapillary proliferative glomerulonephritis did not show any appreciable decline. This study provides the largest data on biopsy proven renal disease in children from South Asia published till date and highlights important differences in the spectrum and trends of kidney disease compared to data from other regions.

Pattern of Pediatric Kidney Diseases in a Tertiary Care Center in Northeast India: a 5-year Retrospective Analysis

Introduction: The pattern of kidney diseases in children may vary from place to place and is not documented in most parts of India including ours. Documenting the spectrum may be important as it can have several uses.Materials and Methods: This hospital-based retrospective descriptive study was done over a 5-year period. Results: Out of 8257 admissions, 556 renal admissions occurred in 326 children which accounted for 6.7% of all admissions. The mean age of the children admitted with kidney disease was 9.9±4.9 years with a gender ratio of 1:1.02. The most common diagnosis at discharge was postinfectious glomerulonephritis (n= 103, 31.6%), closely followed by nephrotic syndrome (n=98, 30.1%). Glomerulonephritis other than PIGN comprised 9.8% of the cases (n=32). Other diagnoses in a descending order were urinary tract infection (n=36, 11.0%), chronic kidney disease (n=8.0%), AKI (n=14, 4.2%), congenital anomalies of the kidney and urinary tract (CAKUT) (n=10, 3.1%), calculus (n=5, 1.5%) and others (0.9%).Conclusions: Postinfectious glomerulonephritis was the most common cause of renal admission in our series. Glomerular diseases constituted three quarters of all renal diseases. The load of tubular disorders was very low. Keywords: Chronic Kidney disease; Post streptococcal glomerulonephritis; Nephrotic Syndrome; Child.

Healthy Dietary Patterns and Risk of Mortality and ESRD in CKD: A Meta-Analysis of Cohort Studies.

Patients with CKD are advised to follow dietary recommendations that restrict individual nutrients. Emerging evidence indicates overall eating patterns may better predict clinical outcomes, however, current data on dietary patterns in kidney disease are limited. This systematic review aimed to evaluate the association between dietary patterns and mortality or ESRD among adults with CKD. Medline, Embase, and reference lists were systematically searched up to November 24, 2015 by two independent review authors. Eligible studies were longitudinal cohort studies reporting the association of dietary patterns with mortality, cardiovascular events, or ESRD. A total of seven studies involving 15,285 participants were included. Healthy dietary patterns were generally higher in fruit and vegetables, fish, legumes, cereals, whole grains, and fiber, and lower in red meat, salt, and refined sugars. In six studies, healthy dietary patterns were consistently associated with lower mortality (3983 events; adjusted relative risk, 0.73; 95% confidence interval, 0.63 to 0.83; risk difference of 46 fewer (29-63 fewer) events per 1000 people over 5 years). There was no statistically significant association between healthy dietary patterns and risk of ESRD (1027 events; adjusted relative risk, 1.04; 95% confidence interval, 0.68 to 1.40). Healthy dietary patterns are associated with lower mortality in people with kidney disease. Interventions to support adherence to increased fruit and vegetable, fish, legume, whole grain, and fiber intake, and reduced red meat, sodium, and refined sugar intake could be effective tools to lower mortality in people with kidney disease.

Stability and Species Specificity of Renal VEGF-A Splicing Patterns in Kidney Disease.

Vascular endothelial growth factor A (VEGF-A) is essential for maintaining the glomerular filtration barrier. Absolute renal levels of VEGF-A change in patients with diabetic nephropathy and inflammatory kidney diseases, but whether changes in the renal splicing patterns of VEGF-A play a role remains unclear. In this study, we investigated mRNA splicing patterns of pro-angiogenic isoforms of VEGF-A in glomeruli and whole kidney samples from human patients with kidney disease and from mouse models of kidney disease. Kidney biopsies were obtained from patients with acute rejection following kidney transplantation, patients with diabetic nephropathy, and control subjects. In addition, kidney samples were obtained from mice with lupus nephritis, mice with diabetes mellitus, and control mice. The relative expression of each VEGF-A splice variant was measured using RT-PCR followed by quantitative fragment analysis. The pattern of renal VEGF-A splice variants was unchanged in diabetic nephropathy and lupus nephritis and was stable throughout disease progression in acute transplant rejection and diabetic nephropathy; these results suggest renal VEGF-A splicing stability during kidney disease. The splicing patterns were species-specific; in the control human kidney samples, VEGF-A 121 was the dominant isoform, whereas VEGF-A 164 was the dominant isoform measured in the mouse kidney samples.

Kidney disease in elderly South Africans

Life expectancy is low in many African countries due to several factors including the ongoing HIV epidemic. However, the global increase in life expectancy has translated to more elderly patients living with chronic kidney disease (CKD). The patterns of kidney disease in the elderly have never been described from sub-Saharan Africa. This study was a retrospective study of 111 elderly patients (age ≥ 60 years) who had a renal biopsy performed at the Groote Schuur Hospital in Cape Town between 1st January 2000 and 31st December 2009. The mean age of patients at time of biopsy was 66.3 ± 5.7 years (males: 66.4 ± 5.6; females: 66.3 ± 5.9 years). Primary glomerular diseases were seen in 38.7%, secondary glomerular diseases in 36.0%, tubulointerstitial diseases in 17.1% and diseases classified as miscellaneous in 8.1% of all patients. Nephrotic syndrome was the most common indication for the performance of a renal biopsy (48.6%). Membranous lomerulonephritis (MGN) was the most common type of disease observed (14.4%) and was significantly more frequent in males than in females (p = 0.029). Other common histological diagnoses included diabetes nephropathy (12.6%), chronic glomerulonephritis (5.4%), and lupus nephritis (4.5%). HIV associated nephropathy (HIVAN) was only seen in 1 patient (0.9%). The patterns of renal disease currently seen in elderly South Africans closely resembles that reported from other countries but is at complete variance with the pattern reported in the general population of South Africa in which HIV plays a significant role.

Sjögren's syndrome with ANCA-associated crescentic extramembranous glomerulonephritis

A 49-year-old woman with a 1-year history of Sjögren's syndrome was diagnosed with cutaneous leukocytoclastic vasculitis and necrotizing crescentic membranous glomerulonephritis. Antineutrophil cytoplasmic antibodies targeting myeloperoxidase were found. She reported a transient episode of nephritis 4 years earlier. This pattern of kidney disease is not typical of Sjögren's syndrome. Methylprednisolone boluses followed by oral glucocorticoid therapy were given in combination with mycophenolate mofetil. Renal function stabilized after 2 months, and tests for anti-myeloperoxidase reverted to negative.