Renal Infection Research Articles

The appropriate dose of thymoglobulin induction therapy inkidney transplantation.

Thymoglobulin is used effectively as an induction agent in kidney transplantation, but there is no consensus on the optimal dose. In order to delineate the safest effective dose, an open-labeled randomized clinical trial was designed. In this study, 90 adult kidney transplant recipients (KTR) were randomized before transplantation in three groups to receive thymoglobulin: Arm A (4.5mg/kg in 3days), Arm B (4.5mg/kg single bolus dose), and Arm C (6mg/kg in 3days). Renal function, infections, and rate of readmissions were evaluated during the first post transplantation year. Ninety adult kidney recipients were enrolled (51% deceased donor). No significant statistical difference was found in acute rejection episodes or type of rejection between these groups, although patients in Arm A showed more severe histopathologic changes according to Banff 2013 criteria, in renal biopsies (P=.03). At the first month after transplantation serum Cr was lower (P=.001) and GFR was higher (P=.04) in Arm A, but there was no significant difference among the three groups at 3, 6, and 12 months post-transplant. Although all regimens showed the same efficacy regarding the rate of rejection episodes, 3-day 4.5mg/kg Thymoglobulin had significantly fewer complications.

Diagnostic methods for the detection of leptospira spp.

Leptospirosis is a bacterial zoonoses distributed worldwide. It can undertake any animalspecies, maintaining the agent in the nature via renal chronical infection of carriers animals,which can secrete the organism through the urine into the environment, being able to infectother animals and the human. Regarding Leptospira spp., diagnostic techniques have helpedunderstand important eco-epidemiological aspects such as environmental serovar distributionand new hosts, in addition to improve the clinical diagnosis of the disease. This review focuseson present diverse techniques used in leptospirosis diagnosis to biological samples, includingsome studies on practical applications for the molecular detection of Leptospira spp.,reinforcing the importance of the knowledge and the choice of the correct technique in thediagnosis of the disease.

Metabolic pathway of 4-pyridone-3-carboxamide-1β-d-ribonucleoside and its effects on cellular energetics

4-pirydone-3-carboxamide-1β-d-ribonucleoside (4PYR) is an endogenous nucleoside that could be converted to triphosphates, diphosphates, monophosphates and an analogue of NAD − 4PYRAD. Elevated level of these compounds have been reported in chronic renal failure, cancer and active HIV infection. However, little is known about the effect on cell functionality and the metabolic pathways. This study tested effects of 4PYR in different cell types on nucleotide, energy metabolism and clarified enzymes that are involved in conversions of 4PYR.We have found that human neuroblastoma cells, human malignant melanoma cells, human adipose-derived stem cells, human bone marrow-derived stem cells, human dermal microvascular endothelial cells and human embryonic kidney cells, were capable to convert 4PYR into its derivatives. This was associated with deterioration of cellular energetics. Incubation with 4PYR did not affect mitochondrial function, but decreased glycolytic rate (as measured by extracellular acidification) in endothelial cells. Silencing of adenosine kinase, cytosolic 5′-nucleotidase II and nicotinamide nucleotide adenylyltransferase 3, blocked metabolism of 4PYR. Incubation of endothelial cells with 4PYR decreased AMP deaminase activity by 40%.The main finding of this paper is that human cells (including cancer type) are capable of metabolizing 4PYR that lead to deterioration of energy metabolism, possibly as the consequence of inhibition of glycolysis. This study, it was also found that several enzymes of nucleotide metabolism could also contribute to the 4PYRconversions

Pediatric Stevens-Johnson syndrome and toxic epidermal necrolysis in the United States

Little is known about the epidemiology of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in children. We sought to determine the morbidity, mortality, and comorbid health conditions of SJS and TEN in US children. This was a cross-sectional study of the 2009 to 2012 Nationwide Inpatient Sample, which contains a representative 20% sample of all US hospitalizations. Sociodemographics, inflation-adjusted cost, length of stay, comorbidities, and mortality were analyzed using descriptive statistics and multivariate regression analyses. The incidences of SJS, SJS-TEN, and TEN were a mean 5.3, 0.8, and 0.4 cases per million children per year in the US, respectively. Prolonged length of stay and higher costs of care (SJS: 9.4±0.6days, $24,947±$3171; SJS-TEN: 15.7±1.5days, $63,787±$8014; TEN: 20.4±6.3days, $102,243±$37,588) were observed compared with all other admissions (4.6±0.1days, $10,496±$424). Mortality was 0% for SJS, 4% for SJS-TEN, and 16% for TEN. In regression models, predictors of mortality included renal failure (adjusted OR [aOR] 300.28, 95% confidence interval [CI] 48.59->999.99), malignancy (aOR 54.33, 95% CI 9.40-314.22), septicemia (aOR 30.45, 95% CI 7.91-117.19), bacterial infection (aOR 20.38, 95% CI 5.44-76.36), and epilepsy (aOR 5.56, 95% CI 1.37-26.2). Data regarding treatment were not available. Date of diagnosis of comorbidities was not present, precluding temporal analysis. Pediatric SJS/TEN poses a substantial health burden in the United States.

Analysis of the association between Mycobacterium tuberculosis infection and Immunoglobulin A nephropathy by early secreted antigenic target 6 detection in renal biopsies: a prospective study

ABSTRACTObjectives: Immunoglobulin A nephropathy (IgAN) is the most frequent cause of primary renal disease, and clarifying the pathogenesis of IgAN is of great importance for its diagnosis and treatment. It is well known that Mycobacterium tuberculosis (MTB) can infect the urinary tract and result in the typical symptoms of cystitis. However, MTB can also affect the kidney more insidiously. Patients may present with glomerular disease, and sometimes with advanced renal failure. This study was to investigate the association between MTB infection and IgA nephropathy (IgAN), and the early diagnosis of MTB-mediated IgAN by means of early secreted antigenic target 6 (ESAT-6) detection in renal biopsies.Methods: One hundred and twenty patients were divided into 3 groups: a renal tuberculosis (RTB) group, a glomerulonephritis without MTB infection (GN-TBI) group and a glomerulonephritis with MTB infection (GN+TBI) group. Morning urine samples were collected for MTB culture. Immunohistochemistry for ESAT-6 expression in renal tissues was performed.Results: The incidence rate of IgAN in the GN+TBI group was 66.7%, which was significantly higher than that of the GN-TBI group. In the GN+TBI group, the ESAT-6 expression was positively associated with IgAN incidence. There was a statistical association between the positive expression of ESAT-6 and the incidence of IgAN. The sensitivity and specificity of urine MTB culture in diagnosing renal MTB infection was 23.3% and 100% respectively, while the sensitivity and specificity of ESAT-6 detection was 100% and 91.1% respectively. Compared with urine MTB culture, the sensitivity of ESAT-6 detection was significantly increased.Conclusion: MTB infection might be associated with the occurrence of IgAN, and ESAT-6 detection in renal tissues may be helpful for the early diagnosis of MTB-mediated IgAN.

Prevalence of anemia in renal insufficiency among HIV infected patients initiating ART at a hospital in Northeast Ethiopia

BackgroundAnemia is a strong predictor of mortality and poor quality of life among persons with either renal impairment or HIV infection. In this study, we investigated the prevalence of anemia and its association with renal insufficiency among HIV infected patients initiating ART at a hospital in Northeast Ethiopia.MethodsIn this retrospective cohort study, records of 373 patients on ART were selected in Dessie Referral hospital, South Wollo, Northeast Ethiopia from September 2010 to August 2013. Socio-demographic and clinical characteristics of the study patients were collected using standardized data extraction instrument. The abbreviated 4-variable Modification of Diet in Renal Disease (MDRD) study equation was used to estimate renal function (GFR) from serum creatinine. SPSS version 20.0 statistical software was used for data analysis.ResultsThe prevalence of anemia at the time of ART initiation was 34.4%; with 20.5, 12.3 and 1.6% mild, moderate and severe anemia, respectively. Renal insufficiency was present in 27.9% of patients and was associated with a high prevalence of anemia (74%). The prevalence of anemia increased with stage of insufficiency, from 23.7% in stage 1 to 100% in stage 4. Impaired renal function (eGFR < 60 mL/min/1.73 m2) was associated with a higher risk of all forms of anemia; i.e., mild (AOR = 3.96; 95% CI: 2.76–5.69), moderate (AOR = 2.21; 95% CI: 1.16–4.19) and severe anemia (AOR = 5.89; 95% CI: 1.02–12.03).ConclusionHIV infected patients with renal insufficiency had a higher prevalence of anemia compared to patients with normal renal function. Thus, screening of these patients for anemia and renal insufficiency at base line should be critical not only to reduce mortality but also to improve clinical outcomes.

Proton pump inhibitor - side effects and complications oflong-term proton pump inhibitor administration

Proton Pump Inhibitors are among the most common drugs taken. The indication is for treatment of heartburn, reflux disease, prophylaxis and treatment of peptic ulcers, in combination with NSAIDs and steroids as well as H. pylori-eradication. PPI's are widely used, even with non-specific symptoms. This certainly has to do with good tolerability and a previously considered low side effect profile. At the moment, there is growing evidence that the long-term intake of PPI's may not be as safe as assumed. In addition to interactions with some drugs, including platelet aggregation inhibitors, recent studies have shown an increased risk of myocardial infarction, interstitial nephritis, chronic renal injury, infections, vitamin deficiencies and electrolyte shifts as well developing dementia.

Urinary tract infection in children: Current aspects of etiological diagnosis and treatment

The paper gives an update on the etiology and pathogenetic mechanisms for developing renal infection in children. It describes the clinical features of urinary tract infection. The diagnostic criteria based on the data of comprehensive studies confirming the source of urinary tract infection, as well as structural and functional criteria for changes in tubulointerstitial tissue, by involving the pyelocaliceal system and renal blood and lymph vessels are discussed. The authors propose an etiologic approach to diagnosis and treatment in terms of the pathogenetic mechanisms of urinary tract infection and a morphofunctional approach to predicting the course and to choosing the management tactics for children with renal infection.

CEUS: Renal Applications

Unlikely with CECT, CEUS can be applied in patients with renal impairment or allergic reaction. CEUS can be used in cases of renal ischemia, renal infections, renal trauma, for the differentiation of solid renal masses and pseudo-tumors, and for the characterization of complex cystic masses. Renal pseudo-tumors, such as column of Bertin and dromedary hump, can often be evaluated with conventional ultrasound alone. CEUS can be performed directly after the conventional US and may show similar finding of same enhancement pattern as the normal parenchyma. The differentiation of Bosniak IIF and III cystic masses are important in management and prognosis. CEUS is a sensitive method to depict internal enhancement and structure within the cystic masses. Several studies have shown high concordance (74∼86%) between CEUS and CECT in the Bosniak classification of complex renal cysts. CEUS is helpful in detection of small renal masses. Although there remained controversy, several reports suggested usefulness of CEUS in characterization of solid renal tumors. CEUS is also useful in the monitoring of renal lesions treated by percutaneous ablation therapies. The other renal application of CEUS is evaluation of transplanted kidney. CEUS can easily detect vascular problem of transplanted kidneys including aneurysm and infarction. Several studies reported that CEUS in patients with acute rejection may show delayed parenchymal enhancement compared with patients with acute tubular necrosis. The potential further renal applications may include evaluation of vascular or traumatic insults and follow-up after anti-angiogenic therapy of renal tumors.

The Role of Doppler Ultrasound in Renal Imaging

This presentation will discuss the sonographic appearance of the following: 1. Scanning techniques 2. Renal Vascular Problems 3. Renal Trauma 4. Obstructive Uropathy 5. Renal Infections

Implementation of a Vancomycin AUC Monitoring Program: Peaks and Pitfalls

Background Accuracy of vancomycin trough monitoring has come into question. We evaluated an area under the curve (AUC) monitoring protocol and 3 different dosing calculators at a single center.Methods Adult inpatients with vancomycin AUC monitoring from 5/2016–1/2017 were included. We excluded those with peaks drawn less than 1 hour after infusion. AUC was calculated with Sawchuck–Zaske (SZ) methodology. This was compared with two publicly available online calculators: ClinCalc and UCSF’s infectious disease monitoring program (IDMP). Paired t-tests were used to compare AUCs from ClinCalc and IDMP to SZ. We collected renal function, infection, microbiology, and dosing data. Clinical outcomes included survival to discharge, discharge disposition, rate of acute kidney injury (AKI) per Risk-Injury-Failure-Loss-End Stage Renal Disease criteria, and bacterial clearance.Results29 subjects were included. Median age was 48 years, 59% were male, median weight was 80.4 kg. Median daily dose was 3000 mg (32.4 mg/kg). No patient had renal impairment at baseline. Skin and soft-tissue infections were most common, 11 (38%). Six subjects had bacteremia, 2 had confirmed endocarditis. MRSA was isolated in 14 cases (48%). Median duration of vancomycin was 11 days. Mean 24 hour AUC (standard deviation) was 654 (203) mg/L for SZ, 536 (278) mg/l for ClinCalc (P = 0.02) and 556 (187) mg/L (P = 0.004) for IDMP. AUC differences of at least 30% compared with SZ were identified in 14 (48%) and 6 (21%) subjects evaluated with ClinCalc and IDMP respectively. AKI occurred in three subjects: two risk and one injury. All survived to discharge; 52% discharged home, 41% to a skilled nursing facility, 7% left against medical advice. Twenty (69%) had bacterial clearance, 2 (7%) had persistently positive cultures, 7 (24%) were treated empirically.Conclusion Vancomycin AUC varies with calculation methodology. The SZ method was impacted by dose and duration of infusion. ClinCalc showed greater variability in higher weight patients. ClinCalc and IDMP calculated lower AUCs than SZ, and recommended higher doses to target an AUC:MIC ratio of at least 400. As institutions adopt vancomycin AUC monitoring, awareness of calculator variation is critical due to impact on dose selection and risk of toxicity to patients.Disclosures All authors: No reported disclosures.

ОЦЕНКА ЭФФЕКТИВНОСТИ РЕНТГЕНЭНДОВАСКУЛЯРНОГО ЛЕЧЕНИЯ БОЛЬНЫХ ОБЛИТЕРИРУЮЩИМ АТЕРОСКЛЕРОЗОМ АРТЕРИЙ НИЖНИХ КОНЕЧНОСТЕЙ С ПРОТЯЖЕННЫМИ ОККЛЮЗИЯМИ ПОВЕРХНОСТНОЙ БЕДРЕННОЙ АРТЕРИИ

The article presents 2-year results of endovascular treatment of 68 patients with peripheral arterial disease, chronical limb ischemia stage 2B-4 (by Fontain-Pokrovsky), with the vascular lesions of type D according to TASC II classification, which is characterized by long, over 20 cm occlusion of the superficial femoral artery, popliteal artery involvement and/or arteries of the lower leg. The rationale to perform endovascular recanalization and stenting of extended occluding lesions of the arteries infrainguinal segment in our study were the results of the analysis of the literature data on the treatment of patients with occlusions of the femoro-popliteal segment, namely the development of postoperative complications after femoral-popliteal bypass surgery, such as lymphorrhea, primary thrombosis of the bypass, bleeding, acute renal failure and infection complications; occlusion of femoro-popliteal bypass grafts at 2 years after surgery reaching 60%, the need to perform repeated operations in 45% of patients; prolonged postopera-tive rehabilitation and therefore low quality patients. Analyzing treatment results testified the effectiveness and safety of endovascular method. Technical success of recanalization, angioplasty and stenting of arteries was successfully performed in all patients. Restenosis occurred in 13 patients (15%) at 1 year. After 2 years restenosis was revealed in another 4 patients. Primary patency during the first year of follow-up was 74.7 per cent, for 2 years - 72%. Secondary patency after 2-year follow-up after performing balloon angioplasty in patients with restenosis segment was 100%. Fatal complication of retroperitoneal bleeding developed in 1 patient. The overall incidence of complications was 6%. Most patients were discharged after 3 days. We continue to accumulate clinical observation and study long-term results of endovascular treatment of patients with peripheral arterial disease, with the vascular lesions of type D according to TASC II classification.

Risk factors for hypoglycemia in the elderly: A cross-sectional analytical study

Background: Hypoglycemia is a side effect of stringent diabetes control especially in the geriatric population above sixty, who constitute approximately 90 million of the Indian population. This study was undertaken to explore the risk factors of hypoglycemia in elderly inpatients. Methods: Fifty patients who were found to have hypoglycemia either at admission or while admitted were enrolled. Their risk factors were compared with fifty age- and sex-matched inpatients admitted to medical wards who did not experience hypoglycemia. Results: The duration of diabetes was significantly longer (12.2 ± 7.9 vs. 9.4 ± 6.7 years; P = 0.023) in the group which experienced hypoglycemia. The mean glycated hemoglobin was significantly lower in the group which experienced hypoglycemia (6.73 ± 1.02 vs. 7.57 ± 1.39; P = 0.001). Of the fifty patients who developed hypoglycemia 26 were asymptomatic. Infection and renal failure were significantly higher in the study group. On multivariate analysis, infection was the only significant precipitating factor. Conclusion: With stringent blood glucose control elderly patients are at high risk of hypoglycemia. The risk is higher if the patients have renal failure and infection. Attempts should be made to identify such patients and to tailor their diabetic therapy to prevent hypoglycemic episodes.

Renal Allograft Aspergillus Infection Presenting With Obstructive Uropathy: A Case Report

BackgroundIsolated renal allograft aspergillosis is rare and usually presents with fever and decreased glomerular filtration rate. Presentation with obstructive uropathy caused by aspergillus fungal balls is much less common. We report a young male patient who presented with obstructive uropathy secondary to isolated renal allograft aspergillus infection 6 weeks after transplant. He was treated with nephrectomy and antifungal medications. Case presentationA 29-year-old Saudi male patient had a recent living non-related kidney transplantation in Pakistan. Early Post-transplant course was complicated by acute cellular rejection (Banff Class IB) which was managed successfully with pulse steroid and anti-thymocyte globulin. The patient presented again to our emergency room on fortieth day post-transplant with a complaint of decreased urine output and passing white particles in his urine. This presentation was three Three weeks after treatment for cellular rejection, the urine fungal culture showed growth of Aspergillus fumigatus, and ultrasound imaging of the allograft kidney revealed mild to moderate hydronephrosis with echogenic materials within the renal pelvis. Biopsy of the transplanted kidney showed severe necrotizing granulomatous inflammation and fungal elements consistent with aspergillus species. The patient was given voriconazole as an antifungal agent and was weaned from immunosuppressive medication. The patient eventually required intermittent hemodialysis and underwent surgical allograft nephrectomy. ConclusionSuboptimal environmental and infection prevention and control precautions can explain this type of infection. It is important for clinicians to have a high index of suspicion and to investigate for fungal infection as a rare cause of obstructive uropathy in high-risk patients.

Urinary tract infection and vesicoureteric reflux

Urinary tract infection (UTI) is one of the common causes of hospital visit in infants and children. Vesicoureteral reflux (VUR) predisposes to UTI and renal scarring. VUR is usually diagnosed after an episode of UTI. VUR is the most common underlying etiology responsible for febrile UTIs or pyelonephritis in children. Along with the morbidity of pyelonephritis, long-term sequelae of recurrent renal infections include renal scarring, proteinuria, and hypertension. Treatment is directed toward the prevention of recurrent infection through the use of continuous antibiotic prophylaxis during a period of observation for spontaneous resolution or by surgical correction. In children, bowel and bladder dysfunction (BBD) plays a significant role in the occurrence of UTI and the rate of VUR resolution. Effective treatment of BBD leads to higher rates of spontaneous resolution and decreased risk of UTI.

Toll-Like Receptor 11: Role in Post-Transplantation Renal Infections

Uropathogenic microorganisms interact with the intestinal tract mucosa, which activate immune cell responses through the Toll-like receptors (TLRs). TLRs are single, membrane-spanning, non-catalytic proteins and it has significant role in the innate immune system. Recent studies have demonstrated that TLRs expressed in sentinel cells such as dendritic and macrophages cells that recognize structurally conserved molecules derived from microorganisms. Interestingly, the massive infection of the kidney observed in the TLR11 knockout mice, which indicate the hypothesis that TLR11 provides a barrier that prevents uropathogenic bacteria from infecting specifically the post-transplantation kidneys.

In-Hospital Outcomes of Patients with Thoracic and Abdominal Aortic Aneurysm Who Underwent Surgical, Endovascular and Conservative Medical Management

Background: Aortic aneurysm is a life-threatening condition related to its catastrophic complications of rupture and dissection that warrants consideration of early surgical repair. The decision to intervene for aortic disease remains a challenging decision because of the concomitant high-risk factors and comorbid illnesses as well as increased morbidity and mortality related to it. Methods: We performed a retrospective cohort study that included 275 patients with thoracic and abdominal aortic aneurysms with indication/s for intervention seen at January 2012 to December 2015. The population was divided into three groups, namely, surgical, endovascular or hybrid and medical management groups, respectively. Outcome measured included in-hospital mortality, cardiovascular, cerebrovascular, pulmonary and renal complications, embolic events and infection. Results: Seventy-six percent of the patients underwent surgical repair, 16% underwent endovascular or hybrid strategy and 8% received conservative medical management. The overall mortality rate was 16.36%, with a significant higher in-hospital mortality in the medical group (p=0.001). Infection rate was highest in the surgical group (54.07%, p=0.001). The rates of cardiovascular events (p=0.069), neurologic complications (p=0.094), renal failure (p=0.082), respiratory failure (p=0.908), and embolic events (p=0.381) were similar between the groups. Multivariate logistic regression analysis for in-hospital mortality showed that strategies of endovascular repair were not associated with significant survival benefit (adjusted OR 0.987; 95% CI 0.22 – 4.44; p=0.986). Conclusion: Prompt evaluation for early aortic aneurysm intervention either by open surgery or endovascular procedure is needed because of high mortality related to medical management of large aortic aneurysms. A strategy of endovascular and/or hybrid repair was not associated with significant reduction in in-hospital mortality when compared to open surgery, but evaluation of intermediate and long-term outcomes is warranted. The use of endovascular or hybrid technique can be considered a feasible alternative to surgical repair especially in high-risk patients. Keywords: open surgical repair, endovascular, medical management, thoracic aortic aneurysm, abdominal aortic aneurysm, 30-day mortality.

The impact of peripheral nerve blocks on perioperative outcome in hip and knee arthroplasty-a population-based study.

The role of anesthesia techniques on perioperative outcomes on a population level has recently gained widespread interest. Although mainly neuraxial vs general anesthesia has been addressed, population-level data on the impact of peripheral nerve blocks (PNBs) are still lacking. Therefore, we investigated the association between PNB use and outcomes using retrospective data on 1,062,152 recipients of hip and knee arthroplasties (total hip arthroplasty [THA]/total knee arthroplasty [TKA]) from the national Premier Perspective database (2006-2013). Multilevel multivariable logistic regression models measured associations between PNB use and outcomes. Complications included cardiac, pulmonary, gastrointestinal and renal complications, cerebrovascular events, infections, wound complications, thromboembolic complications, inpatient falls, and mortality. Resource utilization variables included blood transfusions, intensive care unit admissions, opioid consumption, cost, and length of stay. Overall, 12.5% of patients received a PNB, with an increase over time particularly among TKAs. Peripheral nerve block use was associated with lower odds for most adverse outcomes mainly among patients with THA. Notable beneficial effects were seen for wound complications (odds ratio 0.60 [95% confidence interval, 0.49-0.74]) among THA recipients and pulmonary complications (odds ratio 0.83 [95% confidence interval, 0.72-0.94]) in patients with TKA. Peripheral nerve block use was significantly (P < 0.0001) associated with a -16.2% and -12.7% reduction in opioid consumption for patients with THA and TKA, respectively. In conclusion, our results indicate that PNBs might be associated with superior perioperative population-level outcomes. In light of the inability to establish a causal relationship and the presence of residual confounding, we strongly advocate for further prospective investigation, ideally in multicenter, randomized trials, to establish the potential impact of PNBs on outcomes on a population level.

Étude Rétrospective Des Atteintes Rénales Toxiques Medicamenteuses Au Centre Hospitalier Universitaire De Yaoundé (2009-2014)

Background: Renal drug toxicity are affections that attacking the renal parenchyma as a result of the consumption of drug substance. In Cameroon, anarchic consumption of medicinal drug subsequent of a growth in unauthorised sales drug increase the risk of developing these pathologies. Objective: This study aims at describing and laying the epidemiological profile of drug-induced toxic renal diseases in Yaoundé University Teaching Hospital over the last 6 years (2009 – 2014). Materials and methods: A retrospective cross-sectional study was carried out from the 1st of July to the 30th of November 2015, at the polyvalent reanimation service and the haemodialysis unit of the Yaoundé University Teaching Hospital. With the aid of a questionnaire, the files of patients consulted and hospitalised in these services over a period of 6 years (1st January 2009 to 31st December 2014) were examined. Included in this study, patients suffering from renal drug toxicity. The data input, treatment and analysis were carried out with the help of Epi Info 7 and SPSS 22 software. Results: Forty-four (44) cases renal drug diseases representing 18.3% of the 240 files examined were noted. The average age of the patients was 48±18 years and varied between 11 and 87 years. The male sex constituted the majority of the suffers cases with a sex ratio of 2.67 (M/F). Acute renal infections with frequency of 65.9%, were most dominant of drug affections. Traditions concoctions (50%), gentamycin (11.4%) and paracetamol (9.1%) were the most incriminating drug in the occurrence of these renal drug affecting. The evolution was noted by a 43% complete recovery against a 14% death. Conclusion: Renal drug toxicities represent a non-negligible proportion of the renal affection ailments in the specialised centres like Yaoundé University Teaching Hospital. The elaboration and putting into action a sensitization plan for populations on the proves necessary, as this would help improve pharmacovigilance and also reduce the consumption of illicit drugs to a greater extent responsible for renal problems.

Everyday Practice

Urinary tract infections are one of the most common causes of imaging in a typical radiology practice on a daily basis and are a great concern for the patient and referring physician. There is an overlap in imaging findings in some of the renal infections, but many urinary tract infections have characteristic imaging features. Patients with uncontrolled diabetes mellitus or immune compromised status are at high risk for urinary tract infection, and in these patients, symptoms often are subtle; hence, urgent imaging is required to rule out life-threatening complications. Common and uncommon urinary tract infections with relevant imaging findings and clinical relevance will be described and illustrated.