MyMedR

Kidney Function Alters the Relationship between Postoperative Troponin T Level and Death

Walsh M, Wang CY, Ong GS, Tan AS, Mansor M, Shariffuddin II, et al.

J Am Soc Nephrol, 2015 Oct;26(10):2571-7.

PMID: 25711126 DOI: 10.1681/ASN.2014060536

Cardiac troponin T (cTnT), even at low concentrations, is a risk factor for 30-day mortality in patients undergoing noncardiac surgery, but it is uncertain whether that risk is generalizable to patients with poor kidney function. We, therefore, evaluated the relationship between cTnT concentration and kidney function on the outcome of 30-day mortality in a post hoc analysis of a prospective cohort study of patients undergoing noncardiac surgery. cTnT was measured for 3 days after surgery and considered abnormal if the peak was ≥0.02 ng/ml. Of the included 14,037 patients, 267 (1.9%) patients died within 30 days of surgery. The adjusted hazard ratios for death with an abnormal cTnT concentration were 4.37 (95% confidence intervals [95% CI], 3.21 to 6.22), 6.15 (95% CI, 2.95 to 140.9), 6.30 (95% CI, 3.12 to 21.23), 1.33 (95% CI, 0.56 to 4.85), and 1.46 (95% CI, 0.46 to 9.21) for eGFR≥60, 45 to <60, 30 to <45, 15 to <30, and <15 ml/min per 1.73 m(2) or on dialysis, respectively. Compared with patients with eGFR≥60 ml/min per 1.73 m(2), the adjusted hazard ratio was significantly lower for patients with eGFR=15 to <30 ml/min per 1.73 m(2) (interaction P value=0.02). Redefining abnormal cTnT concentration as ≥0.03 ng/ml or a change of ≥0.02 ng/ml did not alter results. Because the risk associated with postoperative cTnT levels may be different for patients with eGFR<30 ml/min per 1.73 m(2), additional research is required to determine how to interpret perioperative cTnT values for patients with low kidney function.

Matched MeSH terms: Kidney/physiopathology*

Fulltext Ureteral stricture formation after ureteroscope treatment of impacted calculi: a prospective study

Fam XI, Singam P, Ho CC, Sridharan R, Hod R, Bahadzor B, et al.

Korean J Urol, 2015 Jan;56(1):63-7.

PMID: 25598938 DOI: 10.4111/kju.2015.56.1.63

Urinary calculi is a familiar disease. A well-known complication of endourological treatment for impacted ureteral stones is the formation of ureteral strictures, which has been reported to occur in 14.2% to 24% of cases.

Matched MeSH terms: Kidney/ultrasonography

Fulltext A comparison of donor and control group quality of life

Tumin M, Abdul Talib Abdul Mutalib M, Mohd Satar N, Abdullah N, Chong CS, Ng KP, et al.

Ann. Transplant., 2014;19:112-8.

PMID: 24584108 DOI: 10.12659/AOT.889490

Informed consent of prospective donors should include information about the quality of life (QoL) of existing donors, especially those within the relevant country. This study aimed to provide information on Malaysian organ donors' QoL relative to a control group.

Matched MeSH terms: Kidney Transplantation/psychology*

A national survey of renal replacement therapy prescribing practice for acute kidney injury in Malaysian intensive care units

Jamal JA, Mat-Nor MB, Mohamad-Nor FS, Udy AA, Lipman J, Roberts JA

Nephrology (Carlton), 2014 Aug;19(8):507-12.

PMID: 24802363 DOI: 10.1111/nep.12276

To describe renal replacement therapy (RRT) prescribing practices in Malaysian intensive care units (ICU), and compare this with previously published data from other regions.

Matched MeSH terms: Acute Kidney Injury/therapy*

Perception of quality of life amongst end stage renal failure patients undergoing haemodialysis

Ho SE, Ho CC, Norshazwani N, Teoh KH, Ismail MS, Jaafar MZ, et al.

Clin Ter, 2013;164(6):499-505.

PMID: 24424213 DOI: 10.7417/CT.2013.1627

AIMS: The objective of the study was to examine the quality of life amongst the end stage renal disease (ESRD) haemodialysis patients in Malaysia.

MATERIALS AND METHODS: A cross sectional descriptive study was conducted on 72 ESRD patients at a Dialysis Centre in Malaysia. The modified KDQOL-SF™ subscales, kidney disease-targeted scale and 36 item health survey scale questionnaires were used.

RESULTS: The overall health rating was 66.73 ± 11.670 indicating good quality of life. There was no significant difference between quality of life for the different domains according to gender (p >0.05). However, there were significant differences between quality of life in the domain of burden of kidney disease. Physical functioning deteriorated significantly with age (p=0.012) while social functioning was lowest in the 50-65 years age group (p=0.037). Those who had no morbidities had significantly better scores on the effects of kidney (p=0.036), burden of kidney disease (p=0.011) and physical functioning (p=0.025).

CONCLUSIONS: Patients undergoing haemodialysis have been found to have good quality of life despite having ESRD. It is therefore of paramount importance to constantly monitor the standard of care for these patients to enable them to live their life to the fullest.

Matched MeSH terms: Kidney Failure, Chronic/therapy*

Fulltext Continuing challenges in haemodialysis treatment

Morad Z

Med J Malaysia, 2012 Apr;67(2):145-6.

PMID: 22822631

Matched MeSH terms: Kidney Failure, Chronic/complications*

Fulltext Acute renal failure and posterior reversible encephalopathy syndrome following multiple wasp stings: a case report

Loh HH, Tan CHH

Med J Malaysia, 2012 Feb;67(1):133-5.

PMID: 22582570 MyJurnal

Wasp stings can present in various ways, ranging from mild self-limiting illness to severe multi organ failure with a potentially fatal outcome. We report a case of multiple wasp stings leading to acute renal failure needing prolonged dialysis support and posterior reversible encephalopathy syndrome.

Matched MeSH terms: Acute Kidney Injury/etiology*

Characterization of Prototheca wickerhamii isolated from disseminated algaemia of kidney transplant patient from Malaysia

Mohd Tap R, Sabaratnam P, Salleh MA, Abd Razak MF, Ahmad N

Mycopathologia, 2012 Mar;173(2-3):173-8.

PMID: 21948061 DOI: 10.1007/s11046-011-9469-8

Prototheca wickerhamii isolated from blood of 61-year-old kidney transplant patient was described. Although it is classified as an alga (genus Chlorella), the disease, protothecosis, is included under mycoses because of its clinical pathological presentations. Colony characteristics of P. wickerhamii are indistinguishable from other yeast-like organisms like Cryptococcus and Candida. Fortunately, commercial identification system for yeast can be used to identify this organism to the species level. Electron microscopy demonstrated "morula" or daisy-like appearance of its endosporulating sporangia. The organism was sensitive to amphotericin B by E test method. Even though human protothecosis is uncommon, it cannot be ignored because it is emerging as an opportunistic infection in immunosuppressed individuals. To our knowledge, this is the first reported case of disseminated algaemia due to P. wickerhamii in Malaysia.

Matched MeSH terms: Kidney Transplantation/adverse effects*

Fulltext Hymenolepis nana in a renal transplant recipient: to treat or not to treat?

Syafinaz AN, Hamat RA, Malina O, Siti NM, Niazlin MT, Jamal F

Med J Malaysia, 2011 Aug;66(3):259-60.

PMID: 22111454 MyJurnal

A case of hymenolepiasis in a renal transplant recipient. Issues discussed include the benefit of anti-parasitic agents as well as the preventive measures.

Matched MeSH terms: Kidney Transplantation*

Erythema nodosum-like lesions in a renal transplant recipient

Yap FB, Lee BR

Arch Dermatol, 2011 Jun;147(6):735-40.

PMID: 21690541 DOI: 10.1001/archdermatol.2011.128-a

Matched MeSH terms: Kidney Transplantation/adverse effects*

Special focus on the role of α(1D)-adrenoreceptors in the assessment of renal tubular sodium re-absorptive responses in spontaneously hypertensive rats subjected to high sodium diet

Kazi RN, Sattar MA, Abdullah NA, Khan MA, Rathore HA, Abdulla MH, et al.

Yakugaku Zasshi, 2011 Mar;131(3):431-6.

PMID: 21372540

α(1D)-adrenoceptors are involved in the genesis/maintenance of hypertension in spontaneously hypertensive rats (SHR). This study aims to investigate the role of α(1D)-adrenoceptors in the antinatriuretic and antidiuretic responses in SHR subjected to high sodium (SHRHNa) and normal sodium (SHRNNa) intake for six weeks. Renal inulin clearance study was performed in which the antinatriuretic and antidiuretic responses to phenylephrine were examined in the presence and absence of α(₁D)-adrenoceptors blocker BMY7378. Data, mean±S.E.M. were subjected to ANOVA with significance at p<0.05. Results show that feeding SHR for six weeks with high salt did not cause any change in blood pressure. SHRHNa had higher (all p<0.05) urine flow rate (UFR), fractional and absolute excretion of sodium (FE(Na) and U(Na)V) compared to SHRNNa. Phenylephrine infusion produced significant reduction in UFR, FE(Na) and U(Na)V in both SHRHNa and SHRNNa. The antidiuretic and antinatriuretic responses to phenylephrine in both groups were attenuated in the presence of BMY7378. Moreover, the antidiuretic and antinatriuretic responses to phenylephrine and BMY7378 were independent on any significant changes in renal and glomerular hemodynamics in both groups. Thus we conclude that high sodium intake did not bring any further increase in blood pressure of SHR, however, it results in exaggerated natriuresis and diuresis in SHRHNa. Irrespective of dietary sodium changes, α₁-adrenoceptors are involved in mediating the antinatriuretic and antidiuretic responses to phenylephrine in SHR. Further, high sodium intake did not significantly influence the functionality of α(₁D)-adrenoceptors in mediating the adrenergically induced antinatriuresis and antidiuresis.

Matched MeSH terms: Kidney Tubules/metabolism*

Adverse drug events in hospitalized patients with chronic kidney disease

Hassan Y, Al-Ramahi RJ, Aziz NA, Ghazali R

Int J Clin Pharmacol Ther, 2010 Sep;48(9):571-6.

PMID: 20860910

BACKGROUND AND OBJECTIVE: Adverse drug events (ADEs) are a common cause of hospitalization and in-hospital complications. The aim of this study was to determine the rates, types, severity and preventability of pre-admission and in-hospital ADEs in patients with chronic kidney disease (CKD).

METHODS: This study was conducted at the nephrology unit at Penang General Hospital. A random sample of 300 adult patients with CKD was included. Medical records and charts were reviewed by a clinical pharmacist every work day to find any evidence of errors or complications related to drug use. If a suspected ADE was found, further investigations were carried out to assess the causality, severity and preventability of the event.

RESULTS: A total of 159 ADEs were reported in 122 (40.7%) of the patients. We found 86 suspected pre-admission ADEs in 68 (22.7%) of the patients. These were either the cause of admission for some patients or discovered by the initial physical examination and laboratory investigations. During hospitalization, 64 (21.3%) patients had 73 suspected ADEs. Out of the total 159 suspected ADEs, it was highly probable that 31 events were due to medication, while 61 were of lower probability, and 67 were merely possible. A total of 48 (30.2%) events was considered preventable. 46 events (28.9%) were serious, 93 (58.5%) were less serious and 20 (12.6%) were insignificant. The medication classes most frequently involved in ADEs were diuretics, antibacterials, drugs used for diabetes mellitus, antithrombotic agents, mineral supplements and antihypertensive drugs.

CONCLUSION: ADEs are very common in hospitalized CKD patients, and some of these events are preventable. The service of a clinical pharmacist may help to reduce ADEs.

Matched MeSH terms: Kidney Failure, Chronic/drug therapy*

Fulltext Development of a kidney TeleUltrasound consultation system

Hassan A, Ibrahim F

J Digit Imaging, 2011 Apr;24(2):308-13.

PMID: 20386951 DOI: 10.1007/s10278-010-9283-8

This paper presents the development of kidney TeleUltrasound consultation system. The TeleUltrasound system provides an innovative design that aids the acquisition, archiving, and dissemination of medical data and information over the internet as its backbone. The system provides data sharing to allow remote collaboration, viewing, consultation, and diagnosis of medical data. The design is layered upon a standard known as Digital Imaging and Communication in Medicine (DICOM). The DICOM standard defines protocols for exchanging medical images and their associated data. The TeleUltrasound system is an integrated solution for retrieving, processing, and archiving images and providing data storage management using Structured Query Language (SQL) database. Creating a web-based interface is an additional advantage to achieve global accessibility of experts that will widely open the opportunity of greater examination and multiple consultations. This system is equipped with a high level of data security and its performance has been tested with white, black, and gray box techniques. And the result was satisfactory. The overall system has been evaluated by several radiologists in Malaysia, United Arab Emirates, and Sudan, the result is shown within this paper.

Matched MeSH terms: Kidney/ultrasonography*

Grossly delayed graft function in a living related kidney transplant recipient: a case report

Thye YL, Lim SK, Wong CM, Keng TC, Chong YB, Tan SY

Transplant Proc, 2008 Sep;40(7):2435-6.

PMID: 18790259 DOI: 10.1016/j.transproceed.2008.07.051

Delayed graft function is a potentially challenging problem especially in cadaveric kidney transplant recipients. It adversely impacts long-term graft survival. It is rarely seen in living kidney transplants. Recovery of graft function usually occurs within a month. The chances of recovery of graft function diminish with further prolongation of delayed function. In fact, recovery of graft function after 3 months has rarely been described, we report herein recovery of graft function after 132 days of nonfunction in a living related kidney transplant.

Matched MeSH terms: Kidney Failure, Chronic/surgery

Fulltext Acute anuric renal failure following jering bean ingestion

Wong JS, Ong TA, Chua HH, Tan C

Asian J Surg, 2007 Jan;30(1):80-1.

PMID: 17337378

Djenkol beans or jering (Pithecellobium jeringa) is a traditional delicacy consumed by the local population in Malaysia. Jering poisoning or djenkolism is characterized by spasmodic pain, urinary obstruction and acute renal failure. The underlying pathology is an obstructive nephropathy, which is usually responsive to aggressive hydration and diuretic therapy. We present a case of djenkolism following ingestion of jering. The patient required urgent bilateral ureteric stenting following the failure of conservative therapy. Healthcare providers need to recognize djenkolism as a cause of acute renal failure and the public educated on this potential health hazard.

Matched MeSH terms: Acute Kidney Injury/chemically induced*

Post renal transplant Castleman's disease resolved after graft nephrectomy: a case report

Al Otaibi T, Al Sagheir A, Ludwin D, Meyer R

Transplant Proc, 2007 May;39(4):1276-7.

PMID: 17524952

Angiofollicular lymphoid hyperplasia (Castleman's disease) is a lymphoproliferative process thought to be mediated by overexpression of II interleukin-6. Castleman's disease has two variants: Castleman's disease has two variants: Hyaline vascular type and plasma cell variant (multicentric Castleman's disease). The hyaline vascular type tends to be localized, and the plasma cell variant shows more systematic signs and carriers a worse clinical prognosis. Castleman's disease is associated with B-cell lymphoma, Kaposi sarcoma, Human herpes virus 8 (HHV-8), and Epstein-Barr virus. Castleman's disease have been described thrice post kidney transplant. In this report, we document the course of a renal recipient who developed the plasma cell variant of Castleman's disease at 16 months after failure of his allograft and return to dialysis. He displayed clinical resolution of this complication after graft nephrectomy. To our knowledge, this is the first case where the disease manifestations disappeared after graft removal. Our patient experienced chronic renal allograft rejection which may have driven all the systematic manifestations of multicentric castleman's disease and possibly reactivated a latent HHV-8 infection. In this case immunohistochemical testing for HHV-8 was not available to prove a role for this agent.

Matched MeSH terms: Kidney Transplantation/adverse effects*

Microwave-stimulated formaldehyde fixation of experimental renal biopsy tissues: computerised morphometric analysis of distortion artefacts

Looi LM, Loh KC

Malays J Pathol, 2005 Jun;27(1):23-7.

PMID: 16676689

Although microwave irradiation has been used in the histopathology laboratory for several years, there has been minimal published experimental data on its effects on the technical and staining quality of histological sections. Furthermore, it has not been clear whether the advantages gained in reduction of fixation and staining duration has been at the expense of increasing architectural distortion to the tissues. We report here our experience with computerised morphometric analysis to investigate glomerular artifacts caused by microwave-stimulated fixation of renal tissues. 39 rat and 33 human autopsy kidney samples were subjected to (1) fixation in neutral buffered formaldehyde (control), (2) microwave-stimulated fixation followed by neutral buffered formaldehyde, and (3) neutral buffered formaldehyde followed by microwave irradiation. In addition, the effect of post-fixation in 70% ethanol was also investigated. Microwave irradiation was delivered through a dedicated laboratory microwave oven at 80% power and at 55 degrees C for 3 minutes. The different fixation methods were compared with regards to shrinkage (distortion) to glomerular structures (glomeruli and Bowman's spaces) on H and E sections, as determined by morphometric image analysis using a temporary assembled-system consisting of a trinocular microscope, a digital video camera and personal computer. A FlashPoint VGA 3.3 film-grabber card was used to capture images for morphometric analysis by using a Scion Image program. Morphometric analysis of glomerular structures showed that microwaves caused more shrinkage to the area bounded by the Bowman's capsule than the glomerulus proper, but post-fixation with ethanol reduced this shrinkage. These findings have implications on the logistics of tissue preparation of renal biopsies in clinical practice.

Matched MeSH terms: Kidney Glomerulus/cytology*

Fulltext A case of acute kidney injury by near-drowning

Amir A, Lee YL

Malays Fam Physician, 2013;8(3):34-6.

PMID: 25893056 MyJurnal

Acute kidney injury following immersion or near-drowning is rarely described and no data from Malaysia have been found. We report a case of acute kidney injury following a near-drowning event. A 20-year-old man who recovered from near-drowning in a swimming pool 5 days earlier presented to our clinic with abdominal pain, anorexia, nausea and polyuria. Dipstick urinalysis showed a trace of blood. The serum creatinine level was 10-fold higher than the normal range. A bedside ultrasound showed features suggestive of acute tubular necrosis. He is then referred to the hospital with the diagnosis of acute kidney injury with the possibility of acute tubular necrosis secondary to near-drowning. We suggest that any patient presenting after immersion or near-drowning to be should assessed for potential acute kidney injury.

Matched MeSH terms: Kidney Tubular Necrosis, Acute; Acute Kidney Injury

Quality of life in cadaver and living-related renal transplant recipients in Kuala Lumpur hospital

Chiu SF, Wong HS, Morad Z, Loo LH

Transplant Proc, 2004 Sep;36(7):2030-1.

PMID: 15518734

To examine the quality of life in cadaver (CAD) and living-related (LRRT) renal transplant recipients.

Matched MeSH terms: Kidney Transplantation/psychology*

Comparison of patient survival between various subgroups among renal transplant patients: a single center experience

Go KW, Teo SM

Transplant Proc, 2004 Sep;36(7):2046-7.

PMID: 15518740

To compare patient graft survival between various subgroups among renal transplant patients.

Matched MeSH terms: Kidney Transplantation/mortality

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