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Multiple bilateral renal abscesses in a previously healthy young patient

Tang RY, Cheong BM

Med J Malaysia, 2017 08;72(4):250-251.
PMID: 28889140 MyJurnal

The incidence of renal abscesses is not common. Patients usually have risk factors like diabetes mellitus or an underlying condition which predisposes to urinary tract infections. We report a case of a previously healthy young girl with multiple bilateral renal abscesses. Ultrasonography revealed multiple renal abscesses with a possible differential diagnosis of polycystic kidney disease with infected cysts. No renal calculi were seen. CT-scan of kidneys confirmed the diagnosis. Blood and urine cultures were repeatedly negative. She was treated with two weeks of intravenous antibiotics followed by another four weeks of oral Ciprofloxacin. No surgical intervention was carried out. Repeated ultrasound at six months showed complete resolution of all the renal abscesses.

Matched MeSH terms: Kidney Diseases/diagnosis*; Kidney Diseases/drug therapy
Fulltext Partially Reversible Acute Renal Cortical Necrosis Secondary to Hyperhomocysteinemia - A Case Report and Literature Review

Tan W, Abd Ghani F, Seong Lim CT

Indian J Nephrol, 2019 8 20;29(4):288-290.
PMID: 31423065 DOI: 10.4103/ijn.IJN_153_18

Acute renal cortical necrosis (ACN) is a potentially fatal renal condition. Our objective is to report a case of ACN in a young man who had developed premature atherosclerotic vascular disease and required intermittent hemodialysis support. His renal biopsy showed diffuse cortical necrosis. Subsequently, 2 weeks after the renal insult, he developed a cardioembolic stroke and was anticoagulated with low-molecular-weight heparin. Thrombophilia screen revealed elevated serum homocystein and he was treated with folate supplement and vitamin B12 injection. With these treatments, he had partial renal recovery and became dialysis independent. In conclusion, this is a rare case of ACN, which may have occurred as a complication of hyperhomocysteinemia.

Matched MeSH terms: Kidney Diseases
Polycystic kidneys and liver in two siblings with other severe congenital abnormalities

Tan KL, Thomas MA

Med J Malaya, 1970 Sep;25(1):46-9.
PMID: 4249495
Matched MeSH terms: Polycystic Kidney Diseases/genetics*
Fulltext Novel calcium infusion regimen after parathyroidectomy for renal hyperparathyroidism

Tan JH, Tan HC, Loke SC, Arulanantham SA

Nephrology (Carlton), 2017 Apr;22(4):308-315.
PMID: 26952689 DOI: 10.1111/nep.12761

AIM: Calcium infusion is used after parathyroid surgery for renal hyperparathyroidism to treat postoperative hypocalcaemia. We compared a new infusion regimen to one commonly used in Malaysia based on 2003 K/DOQI guidelines.
METHODS: Retrospective data on serum calcium and infusion rates was collected from 2011-2015. The relationship between peak calcium efflux (PER) and time was determined using a scatterplot and linear regression. A comparison between regimens was made based on treatment efficacy (hypocalcaemia duration, total infusion amount and time) and calcium excursions (outside target range, peak and trough calcium) using bar charts and an unpaired t-test.
RESULTS: Fifty-one and 34 patients on the original and new regimens respectively were included. Mean PER was lower (2.16 vs 2.56 mmol/h; P = 0.03) and occurred earlier (17.6 vs 23.2 h; P = 0.13) for the new regimen. Both scatterplot and regression showed a large correlation between PER and time (R-square 0.64, SE 1.53, P

Matched MeSH terms: Kidney Diseases/complications*; Kidney Diseases/diagnosis
Fulltext First molecular detection and complete sequence analysis of porcine circovirus type 3 (PCV3) in Peninsular Malaysia

Tan CY, Opaskornkul K, Thanawongnuwech R, Arshad SS, Hassan L, Ooi PT

PLoS One, 2020;15(7):e0235832.
PMID: 32706778 DOI: 10.1371/journal.pone.0235832

Porcine circovirus type 3 (PCV3) is a newly emerging virus in the swine industry, first reported recently in 2016. PCV3 assembles into a 2000 bp circular genome; slightly larger than PCV1 (1758-1760 bp), PCV2 (1766-1769 bp) and PCV4 (1770 bp). Apart from being associated with porcine dermatitis and nephropathy syndrome (PDNS), PCV3 has been isolated from pigs with clinical signs of reproductive failures, myocarditis, porcine respiratory disease complex (PRDC) and neurologic disease. Given that PCV3 is increasingly reported in countries including Thailand and U.S. with whom Malaysia shares trade and geographical relationship; and that PCV3 is associated with several clinical presentations that affect productivity, there is a need to study the presence and molecular characteristics of PCV3 in Malaysian swine farms. Twenty-four commercial swine farms, three abattoirs and retail shops in Peninsular Malaysia were sampled using convenience sampling method. A total of 281 samples from 141 pigs, including 49 lung archive samples were tested for PCV3 by conventional PCR. Twenty-eight lung samples from wild boar population in Peninsular Malaysia were also included. Nucleotide sequences were analyzed for maximum likelihood phylogeny relationship and pairwise distances. Results revealed that PCV3 is present in Peninsular Malaysia at a molecular prevalence of 17.02%, with inguinal lymph nodes and lungs showing the highest molecular detection rates of 81.82% and 71.43% respectively. Despite wide reports of PCV3 in healthy animals and wild boars, no positive samples were detected in clinically healthy finishers and wild boar population of this study. PCV3 strain A1 and A2 were present in Malaysia, and Malaysian PCV3 strains were found to be phylogenetically related to Spanish, U.S. and Mexico strains.

Matched MeSH terms: Kidney Diseases/veterinary; Kidney Diseases/virology
Fulltext Lithium neurotoxicity

Suraya Y, Yoong KY

Med J Malaysia, 2001 Sep;56(3):378-81.
PMID: 11732087

Inspite of the advent of newer antimanic drugs, lithium carbonate remains widely used in the treatment and prevention of manic-depressive illness. However care has to be exercised due to its low therapeutic index. The central nervous system and renal system are predominantly affected in acute lithium intoxication and is potentially lethal. The more common side effect involves the central nervous system. It occurs early and is preventable. We describe three cases of lithium toxicity admitted to Johor Bahru Hospital, with emphasis on its neurological preponderance.

Matched MeSH terms: Kidney Diseases/chemically induced
Medical aspects of haematuria

Suleiman AB

Ann Acad Med Singap, 1987 Apr;16(2):238-9.
PMID: 3688799

Haematuria is always a significant finding that requires proper evaluation, and investigations may need to be initiated based on an adequate history. A careful urine microscopy of the urine using phase contrast microscopy is essential, and may predict the source of the haematuria based on red cell morphology, and point the direction that appropriate investigation should take. Infection tumours, obstruction; and calculi account for most cases of gross haematuria in adults. In paediatric patients, the causes of gross haematuria are readily apparent in half of the cases, but further investigations are necessary in the other half. All cases of haematuria require prompt evaluation and appropriate investigations to ensure correct and early treatment.

Matched MeSH terms: Kidney Diseases/complications; Kidney Diseases/diagnosis
Potential action of Rumex vesicarius (L.) against potassium dichromate and gentamicin induced nephrotoxicity in experimental rats

Subramaniyan V, Shaik S, Bag A, Manavalan G, Chandiran S

Pak J Pharm Sci, 2018 Mar;31(2):509-516.
PMID: 29618442

To determine the ameliorative potential of the active fraction from different extracts of Rumex vesicarius against potassium dichromate and gentamicin induced nephrotoxicity in experimental rats and its possible mechanism of action. Both sex wistar rats were divided into 6 groups (n=6/group) were fed with a control, potassium dichromate and gentamicin supplemented with different extracts at the doses of 200 and 400mg/kg respectively. Oral administration of EERV offered a significant (p<0.01 and p<0.001) dose dependent protection against PD and GN induced nephrotoxicity. Potassium dichromate and gentamicin nephrotoxicity assessed in terms of body weight, kidney weight, creatinine, urea, uric acid, BUN, albumin and total protein. Thus the present study revealed that EERV phytochemical constituents play an important role in protection against kidney damage.

Matched MeSH terms: Kidney Diseases/chemically induced; Kidney Diseases/prevention & control*
Fulltext Mefenamic Acid induced nephrotoxicity: an animal model

Somchit MN, Sanat F, Hui GE, Wahab SI, Ahmad Z

Adv Pharm Bull, 2014 Dec;4(4):401-4.
PMID: 25436198 DOI: 10.5681/apb.2014.059

PURPOSE: Nonsteroidal anti-inflammatory drugs (NSAIDs) are used for the treatment of many joint disorders, inflammation and to control pain. Numerous reports have indicated that NSAIDs are capable of producing nephrotoxicity in human. Therefore, the objective of this study was to evaluate mefenamic acid, a NSAID nephrotoxicity in an animal model.
METHODS: Mice were dosed intraperitoneally with mefenamic acid either as a single dose (100 or 200 mg/kg in 10% Dimethyl sulfoxide/Palm oil) or as single daily doses for 14 days (50 or 100 mg/kg in 10% Dimethyl sulfoxide/Palm oil per day). Venous blood samples from mice during the dosing period were taken prior to and 14 days post-dosing from cardiac puncture into heparinized vials. Plasma blood urea nitrogen (BUN) and creatinine activities were measured.
RESULTS: Single dose of mefenamic acid induced mild alteration of kidney histology mainly mild glomerular necrosis and tubular atrophy. Interestingly, chronic doses induced a dose dependent glomerular necrosis, massive degeneration, inflammation and tubular atrophy. Plasma blood urea nitrogen was statistically elevated in mice treated with mefenamic acid for 14 days similar to plasma creatinine.
CONCLUSION: RESULTS from this study suggest that mefenamic acid as with other NSAIDs capable of producing nephrotoxicity. Therefore, the study of the exact mechanism of mefenamic acid induced severe nephrotoxicity can be done in this animal model.

Matched MeSH terms: Kidney Diseases
Renal diseases in pregnancy: a clinical review and appraisal

Sinnathuray TA

Med J Malaya, 1971 Jun;25(4):253-6.
PMID: 4261295
Matched MeSH terms: Kidney Diseases*; Kidney Diseases, Cystic/complications
Spontaneous extravasation of contrast medium associated with acute renal colic

Singh J, Young WB

Med J Malaysia, 1974 Jun;28(4):244-7.
PMID: 4279004
Matched MeSH terms: Kidney Diseases/radiography*
Fulltext Polycystic kidney disease concurrent with feline parvovirus and bacterial infections in domestic shorthair cat: a case report

Sim Lam PPL, Reduan MFH, Jasni S, Shaari R, Shaharulnizim N, Nordin ML, et al.

Comp Clin Path, 2020 Sep 28.
PMID: 33013278 DOI: 10.1007/s00580-020-03170-4

Feline polycystic kidney disease (PKD) is an inherited disorder caused by the mutation of PKD1 gene that eventually lead to the development of chronic kidney disease. The latter condition causes hypertension and eventually progress into congestive heart failure. Feline parvovirus (FPV) is a highly contagious and often fatal disease infecting cats and other members of Felidae. An 8-month-old female domestic shorthair cat was presented with complaint of wound dehiscence a day after ovarian hysterectomy procedure. The wound at the suture site appeared necrotic, purulent with foul smell. The cat was found to have diarrhoea during the fixation of suture breakdown and, later, was tested positive with parvovirus infection. Complete blood count revealed anaemia, neutrophilia, lymphopenia and thrombocytosis. Biochemistry profiles showed hypoproteinaemia and elevated of urea and creatinine. The cat was hospitalised, and symptomatic treatments were given. During hospitalisation, the cat showed symptoms of polydipsia and polyuria and found dead 2 days later. Post-mortem findings demonstrated the cat had oral ulceration, thoracic effusion, fibrinopleuropneumonia, pericardial effusion, left ventricular hypertrophy and right ventricular dilation, chronic passive liver congestion, mesenteric lymphadenomegaly, intestinal haemorrhage, adrenomegaly and polycystic kidney. Histopathological evaluation revealed fibrinous pleuropneumonia, pulmonary atelectasis, emphysema and oedema, hypertrophic cardiomyopathy, hepatic necrosis, splenic necrosis, intestinal necrosis, renal necrosis and renal polycystic. Staphylococcus aureus and Escherichia coli were isolated from bronchus swab and intestinal segment, respectively. Polymerase chain reaction (PCR) revealed parvovirus infection. The cat was definitely diagnosed with polycystic kidney disease concurrent with parvoviral and secondary bacterial infections.

Matched MeSH terms: Polycystic Kidney Diseases
Fulltext Moxibustion (ArtemisiaPlant at Acupuncture Point) as Alternative Therapy in Hypertension: A Promising Approach

Siddiqui MJ, Kamarudin MFB, Mohammed Al-Shami AK, Mat So'ad SZ, Jamshed SQ

J Pharm Bioallied Sci, 2017 Oct-Dec;9(4):279-281.
PMID: 29456380 DOI: 10.4103/jpbs.JPBS_24_17

Hypertension is a pathological condition in which the blood pressure is higher than under normal physiological conditions, i.e., 140/90 mmHg or higher. Blood pressure is measured as the force exerted by the blood pumped by the heart against the walls of arteries (aorta) and distributed throughout the body. Use of complementary and alternative medicine as a cure for hypertension is a common phenomenon because of the high risk of cardiovascular complications and kidney diseases caused by conventional Western medicine. It is reported that high blood pressure causes ~49% of myocardial infarction and 62% of strokes. Effective treatment of hypertension is restricted by adverse effects and cost of the medication. Moxibustion is the application of heat by burning a small bundle of tightly bound moxa, to targeted acupoint, and sometimes it is used along with acupuncture. Encouraging results have been reported on randomized trials indicating the efficacy of moxibustion. But more controlled clinical trials are required to further establish the potential efficacy of moxibustion approach in hypertension.

Matched MeSH terms: Kidney Diseases
Diazinon-induced oxidative stress and renal dysfunction in rats

Shah MD, Iqbal M

Food Chem Toxicol, 2010 Dec;48(12):3345-53.
PMID: 20828599 DOI: 10.1016/j.fct.2010.09.003

Diazinon (O,O-diethyl-O-[2-isopropyl-6-methyl-4-pyrimidinyl] phosphoro thioate), an organo-phosphate insecticide, has been used worldwide in agriculture and domestic for several years, which has led to a variety of negative effects in non target species including humans. However, its nephrotoxic effects and mechanism of action has not been fully elucidated so far. Therefore, the present study was aimed at evaluating the nephrotoxic effects of diazinon and its mechanism of action with special reference to its possible ROS generating potential in rats. Treatment of rats with diazinon significantly enhances renal lipid peroxidation which is accompanied by a decrease in the activities of renal antioxidant enzymes (e.g. catalase, glutathione peroxidise, glutathione reductase, glucose-6-phosphate dehydrogenase, glutathione S-transferase) and depletion in the level of glutathione reduced. In contrast, the activities of renal γ-glutamyl transpeptidase and quinone reductase were increased. Parallel to these changes, diazinon treatment enhances renal damage as evidenced by sharp increase in blood urea nitrogen and serum creatinine. Additionally, the impairment of renal function corresponds histopathologically. In summary, our results indicate that diazinon treatment eventuates in decreased renal glutathione reduced, a fall in the activities of antioxidant enzymes including the enzymes involved in glutathione metabolism and excessive production of oxidants with concomitant renal damage, all of which are involved in the cascade of events leading to diazinon-mediated renal oxidative stress and toxicity. We concluded that in diazinon exposure, depletion of antioxidant enzymes is accompanied by induction of oxidative stress that might be beneficial in monitoring diazinon toxicity.

Matched MeSH terms: Kidney Diseases/chemically induced*; Kidney Diseases/metabolism; Kidney Diseases/pathology
Fulltext Sequence-Specific Detection of Aristolochia DNA - A Simple Test for Contamination of Herbal Products

Sgamma T, Masiero E, Mali P, Mahat M, Slater A

Front Plant Sci, 2018;9:1828.
PMID: 30619401 DOI: 10.3389/fpls.2018.01828

Herbal medicines are used globally for their health benefits as an alternative therapy method to modern medicines. The market for herbal products has increased rapidly over the last few decades, but this has in turn increased the opportunities for malpractices such as contamination or substitution of products with alternative plant species. In the 1990s, a series of severe renal disease cases were reported in Belgium associated with weight loss treatment, in which the active species Stephania tetrandra was found to be substituted with Aristolochia fangchi. A. fangchi contains toxic aristolochic acids, which have been linked to kidney failure, as well as cancers of the urinary tract. Because of these known toxicities, herbal medicines containing these compounds, or potentially contaminated by these plants, have been restricted or banned in some countries, but they are still available via the internet and in alternate formulations. In this study, a DNA based method based on quantitative real-time PCR (qPCR) was tested to detect and distinguish Aristolochia subg. Siphisia (Duch.) O.C.Schmidt species from a range of medicinal plants that could potentially be contaminated with Aristolochia material. Specific primers were designed to confirm that Aristolochia subg. Siphisia can be detected, even in small amounts, if it is present in the products, fulfilling the aim of offering a simple, cheaper and faster solution than the chemical methods. A synthetic gBlock template containing the primer sequences was used as a reference standard to calibrate the qPCR assay and to estimate the copy number of a target gene per sample. Generic primers covering the conserved 5.8S rRNA coding region were used as internal control to verify DNA quality and also as a reference gene for relative quantitation. To cope with potentially degraded DNA, all qPCR primer sets were designed to generate PCR products of under 100 bp allowing detection and quantification of A. fangchi gBlock even when mixed with S. tetrandra gBlock in different ratios. All proportions of Aristolochia, from 100 to 2%, were detected. Using standards, associating the copy number to each start quantity, the detection limit was calculated and set to about 50 copies.

Matched MeSH terms: Kidney Diseases
Adverse effects of cytotoxics-platinum agents

Selvaratnam G, Philips RH, Mohamed AK, Radzi A

Adverse Drug React Toxicol Rev, 1997 Aug;16(3):171-97.
PMID: 9512763
Matched MeSH terms: Kidney Diseases/chemically induced; Kidney Diseases/prevention & control
Fulltext An Asian validation of the TIMI risk score for ST-segment elevation myocardial infarction

Selvarajah S, Fong AY, Selvaraj G, Haniff J, Uiterwaal CS, Bots ML

PLoS One, 2012;7(7):e40249.
PMID: 22815733 DOI: 10.1371/journal.pone.0040249

Risk stratification in ST-elevation myocardial infarction (STEMI) is important, such that the most resource intensive strategy is used to achieve the greatest clinical benefit. This is essential in developing countries with wide variation in health care facilities, scarce resources and increasing burden of cardiovascular diseases. This study sought to validate the Thrombolysis In Myocardial Infarction (TIMI) risk score for STEMI in a multi-ethnic developing country.

Matched MeSH terms: Kidney Diseases/epidemiology
Fulltext Cardiovascular risk factor treatment targets and renal complications in high risk vascular patients: a cohort study

Selvarajah S, van der Graaf Y, Visseren FL, Bots ML, SMART study group

BMC Cardiovasc Disord, 2011;11:40.
PMID: 21729268 DOI: 10.1186/1471-2261-11-40

To determine if recommended treatment targets, as specified in clinical practice guidelines for the management of cardiovascular disease, reduces the risk of renal complications in high risk patient populations.

Matched MeSH terms: Kidney Diseases/blood; Kidney Diseases/etiology*; Kidney Diseases/therapy*
Chronic nephrotoxicity of anti-inflammatory drugs used in the treatment of arthritis

Segasothy M, Chin GL, Sia KK, Zulfiqar A, Samad SA

Br J Rheumatol, 1995 Feb;34(2):162-5.
PMID: 7704463

We determined the consumption of non-steroidal anti-inflammatory drugs (NSAIDs) and the prevalence of chronic renal impairment and renal papillary necrosis (RPN) in patients with various types of arthritis. Ninety-four patients with chronic arthritis who had consumed more than 1000 capsules and/or tablets of NSAIDs were studied. Renal profiles and radiological investigations such as intravenous urogram (IVU), ultrasonography (US) and computed tomography (CT) were performed to look for evidence of RPN. Twelve patients did not complete the study. Ten of the 82 patients who had completed the study (12.2%) had radiologic evidence of RPN. Five out of 53 patients (9.4%) with rheumatoid arthritis, three out of 11 patients (27.3%) with gouty arthritis and two out of seven patients (28.6%) with osteoarthritis had RPN. Renal impairment (serum creatinine levels of 125-451 mumol/l) was found in 20 patients (24.4%). The patients had consumed 1000-26,300 capsules and/or tablets over a period ranging from 1 yr to more than 30 yr. Patients with chronic arthritis who consume excessive amount of NSAIDs are at risk of developing RPN and chronic renal impairment.

Matched MeSH terms: Kidney Diseases/chemically induced*
Computed tomography and ultrasonography: a comparative study in the diagnosis of analgesic nephropathy

Segasothy M, Abdul Samad S, Zulfiqar A, Shaariah W, Morad Z, Prasad Menon S

Nephron, 1994;66(1):62-6.
PMID: 8107955

Computed tomography (CT) and ultrasonography (US) were performed in 40 patients who had consumed excessive quantities of analgesics (> 1 kg) to compare their value in the diagnosis of analgesic nephropathy (AN). The computed tomography and sonographic features were renal papillary calcifications. Renal papillary necrosis (RPN) was documented in 20 of 40 patients by US and in 14 of 40 patients by CT. In 11 patients, both US and CT were positive. In 9 patients, US was positive whilst CT was negative. In 3 patients, CT was positive whilst US was negative. Prevalence of RPN was 50% using US and 35% using CT. Using US as a gold standard, sensitivity of CT was 55%, specificity 85%, positive predictive value 78.6% and negative predictive value 34.6%. Percent agreement with CT and US was 70%. Cohen's kappa statistic adjusting for chance agreement was 40%. Based on these results, it is found that US yielded a higher percentage of positive cases of RPN.

Matched MeSH terms: Kidney Diseases/chemically induced

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