MATERIALS AND METHODS: Retrospective data were obtained for 36 patients with CKD stage 4 and 5 after parathyroid surgery, correlating albumin-corrected serum calcium with the infusion rate of calcium gluconate. Calcium flux was characterised along with excursions out of the target calcium range of 2 to 3 mmol/L. With this data, an improved titration regimen was constructed.
RESULTS: Mean peak efflux rate (PER) from the extracellular calcium pool was 2.97 mmol/h occurring 26.6 hours postoperatively. Peak calcium efflux tended to occur later in cases of severe POH. Eighty-one per cent of patients had excursions outside of the target calcium range of 2 to 3 mmol/L. Mean time of onset for hypocalcaemia was 2 days postoperatively. Hypocalcaemia was transient in 25% and persistent in 11% of patients.
CONCLUSION: A simple titration regimen was constructed in which a 10% calcium gluconate infusion was started at 4.5 mL/h when serum calcium was <2 mmol/L, then increased to 6.5 mL/h and finally to 9.0 mL/h if calcium continued falling. Preoperative oral calcium and calcitriol doses were maintained. Blood testing was done 6-hourly, but when a higher infusion rate was needed, 4-hourly blood testing was preferred. Monitoring was discontinued if no hypocalcaemia developed in the fi rst 4 days after surgery. If hypocalcaemia persisted 6 days after surgery, then the infusion was stopped with further monitoring for 24 hours.
METHODS: A 17-item questionnaire was developed to assess nutrition practices and administered to dialysis managers of 150 HD centers, identified through the National Renal Registry. Nutritional outcomes of 4362 patients enabled crosscutting comparisons as per dietitian accessibility and center sector.
RESULTS: Dedicated dietitian (18%) and visiting/shared dietitian (14.7%) service availability was limited, with greatest accessibility at government centers (82.4%) > non-governmental organization (NGO) centers (26.7%) > private centers (15.1%). Nutritional monitoring varied across HD centers as per albumin (100%) > normalized protein catabolic rate (32.7%) > body mass index (BMI, 30.7%) > dietary intake (6.0%). Both sector and dietitian accessibility was not associated with achieving albumin ≥40 g/L. However, NGO centers were 36% more likely (p = 0.030) to achieve pre-dialysis serum creatinine ≥884 μmol/L compared to government centers, whilst centers with dedicated dietitian service were 29% less likely (p = 0.017) to achieve pre-dialysis serum creatinine ≥884 μmol/L. In terms of BMI, private centers were 32% more likely (p = 0.022) to achieve BMI ≥ 25.0 kg/m2 compared to government centers. Private centers were 62% less likely (p
METHODS: We conducted a cross-sectional study to assess the correlation between HCV Ag and HCV RNA and to identify the prevalence of active HCV infection among HCV seropositive HD patients from dialysis centres across West Malaysia from July 2019 to May 2020. Pre-dialysis blood was taken and tested for both HCV Ag and HCV RNA tests. HCV Ag was tested with Abbott ARCHITECT HCV Ag test.
RESULTS: We recruited 112 seropositive HD patients from 17 centres with mean age of 54.04 ± 11.62 years, HD vintage of 14.1 ± 9.7 years, and male constitute 59.8% (67) of the study population. HCV Ag correlates well with HCV RNA (Spearman test coefficient 0.833, p 3000 IU/mL, HCV Ag had a higher sensitivity of 95.1% and greater correlation (Spearman test coefficient 0.897, p
METHODS: A literature search was undertaken to identify biopsy registries for medical kidney diseases. These data were supplemented with information from personal contacts and from registry websites. A questionnaire was sent to all identified registries, investigating age of registries, scope, method of coding, possible mapping to international terminologies as well as self-reported problems and suggestions for improvement.
RESULTS: Sixteen regional or national kidney biopsy registries were identified, of which 11 were older than 10 years. Most registries were located either in Europe (10/16) or in Asia (4/16). Registries most often use a proprietary coding system (12/16). Only a few of these coding systems were mapped to SNOMED CT (1), older SNOMED versions (2) or ERA-EDTA PRD (3). Lack of maintenance and updates of the coding system was the most commonly reported problem.
CONCLUSIONS: There were large gaps in the global coverage of kidney biopsy registries. Limited use of international coding systems among existing registries hampers interoperability and exchange of data. The study underlines that the use of a common and uniform coding system is necessary to fully realize the potential of kidney biopsy registries.