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Review article: Use of renal registry data for research, health-care planning and quality improvement: what can we learn from registry data in the Asia-Pacific region?

Lim TO, Goh A, Lim YN, Morad Z

Nephrology (Carlton), 2008 Dec;13(8):745-52.
PMID: 19154324 DOI: 10.1111/j.1440-1797.2008.01044.x

We review renal registry data from the Asia-Pacific region with an emphasis on their uses in health care and in dialysis care in particular. The review aims to demonstrate the information value of registry data. While renal registry provides a useful data resource for epidemiological research, there are severe methodological limitations in its application for analytical or therapeutic research. However, it is the use of renal registry data for public health and health-care management purposes that registry really comes into its own, and it is primarily for these that governments have invested in national patient and disease registries. We apply data from several renal registries in the Asia-Pacific region to illustrate its wide application for planning dialysis services, for evaluating dialysis practices and health outcomes, with a view to improving the quality of dialysis care. In the course of preparing the review, we have found that the quality and accessibility of renal registry data were highly variable across the region. Given the value of renal registry, every country in the Asia-Pacific region should establish one or should ensure that their current registries are better resourced and developed. Greater data sharing and collaboration among registries in the region could help advance the nephrology to serve our patients better.

Matched MeSH terms: Kidney Diseases/economics; Kidney Diseases/ethnology; Kidney Diseases/mortality; Kidney Diseases/therapy*
Plasma, aqueous and vitreous homocysteine levels in proliferative diabetic retinopathy

Lim CP, Loo AV, Khaw KW, Sthaneshwar P, Khang TF, Hassan M, et al.

Br J Ophthalmol, 2012 May;96(5):704-7.
PMID: 22353698 DOI: 10.1136/bjophthalmol-2011-301044

To compare homocysteine (Hcy) concentration in the blood plasma, vitreous and aqueous of eyes with proliferative diabetic retinopathy (PDR) against control, and to investigate associations between Hcy concentration in blood plasma with that of aqueous and vitreous in these two groups.

Matched MeSH terms: Kidney Diseases/blood
Fulltext The use of interventional radiology in ruptured solitary kidneys

Lei CC, Khairullah A, Zulfiqar A, Samad AS

Med J Malaysia, 1992 Dec;47(4):320-2.
PMID: 1303487

This case report illustrates how a life-threatening renal bleeding which has failed to be controlled by open surgery can be elegantly managed by a minimally invasive technique of interventional radiology. It also allows maximal conservation of renal tissue so that the patient can avoid chronic dialysis or renal transplantation.

Matched MeSH terms: Kidney Diseases/radiography*; Kidney Diseases/therapy
Aqueous extract of Senecio candicans DC induce liver and kidney damage in a sub-chronic oral toxicity study in Wistar rats

Lakshmanan H, Raman J, Pandian A, Kuppamuthu K, Nanjian R, Sabaratam V, et al.

Regul Toxicol Pharmacol, 2016 Aug;79:25-34.
PMID: 27177820 DOI: 10.1016/j.yrtph.2016.05.010

Senecio candicans DC. (Asteraceae) is used as a remedy for gastric ulcer and stomach pain in the Nilgiris, district, Tamil Nadu. The present investigation was carried out to evaluate the sub-chronic toxicity of an aqueous extract of Senecio candicans (AESC) plant in Wistar albino rats. The study was conducted in consideration of the OECD 408 study design (Repeated Dose 90-Day Oral Toxicity Study in Rodents) and the extract was administered via gavage at doses of 250, 500 or 750 mg/kg body weight per day for 90-days. Hematological, biochemical parameters were determined on days 0, 30, 60 and 90 of administration. Animals were euthanized after 90 d treatment and its liver and kidney sections were taken for histological study. The results of sub-chronic study showed significant increase (P

Matched MeSH terms: Kidney Diseases/blood; Kidney Diseases/chemically induced*; Kidney Diseases/pathology
Therapeutic effect of pectin on octylphenol induced kidney dysfunction, oxidative stress and apoptosis in rats

Koriem KM, Arbid MS, Emam KR

Environ Toxicol Pharmacol, 2014 Jul;38(1):14-23.
PMID: 24860957 DOI: 10.1016/j.etap.2014.04.029

Octylphenol (OP) is one of ubiquitous pollutants in the environment. It belongs to endocrine-disrupting chemicals (EDC). It is used in many industrial and agricultural products. Pectin is a family of complex polysaccharides that function as a hydrating agent and cementing material for the cellulose network. The aim of this study was to evaluate the therapeutic effect of pectin in kidney dysfunction, oxidative stress and apoptosis induced by OP exposure. Thirty-two male albino rats were divided into four equal groups; group 1 control was injected intraperitoneally (i.p) with saline [1 ml/kg body weight (bwt)], groups 2, 3 & 4 were injected i.p with OP (50 mg/kg bwt) three days/week over two weeks period where groups 3 & 4 were injected i.p with pectin (25 or 50 mg/kg bwt) three days/week over three weeks period. The results of the present study revealed that OP significantly decreased glutathione-S-transferase (GST), glutathione peroxidase (GPx), catalase (CAT), reduced glutathione (GSH), glutathione reductase (GR) and superoxide dismutase (SOD) levels while increased significantly lipid peroxidation (MDA), nitric oxide (NO) and protein carbonyls (PC) levels in the kidney tissues. On the other hand, OP increased serum urea and creatinine. Furthermore, OP increased significantly serum uric acid but decreased significantly the kidney weight. Moreover, OP decreased p53 expression while increased bcl-2 expression in the kidney tissue. The treatment with either dose of pectin to OP-exposed rats restores all the above parameters to approach the normal values where pectin at higher dose was more effective than lower one. These results were supported by histopathological investigations. In conclusion, pectin has antioxidant and anti-apoptotic activities in kidney toxicity induced by OP and the effect was dose-dependent.

Matched MeSH terms: Kidney Diseases/chemically induced; Kidney Diseases/drug therapy*; Kidney Diseases/metabolism; Kidney Diseases/pathology
Fulltext Impact of pre-dilution and flushing on continuous renal replacement therapy

Koh KH

Singapore Med J, 2006 Sep;47(9):785-95.
PMID: 16924361

Infusing the replacement solution before the filter (pre-dilution) and regular flushing have not been accounted for in conventional mathematical equations. Their effects on various continuous renal replacement therapy (CRRT) parameters, such as ultrafiltration fraction and urea clearance, have not been well studied. We incorporated these parameters into mathematical equations to help in understanding and prescribing CRRT.

Matched MeSH terms: Kidney Diseases/therapy*
Clinical notes. I. Enteric fever in children. II. Kidney disease in the tropics

Kirk J

Journal of the Malaya Branch of the British Medical Association, 1905.

Matched MeSH terms: Kidney Diseases
Effect of antisense oligodeoxynucleotides for ICAM-1 on renal ischaemia-reperfusion injury in the anaesthetised rat

Kiew LV, Munavvar AS, Law CH, Azizan AN, Nazarina AR, Sidik K, et al.

J Physiol, 2004 Jun 15;557(Pt 3):981-9.
PMID: 15047774

An antisense oligodeoxynucleotide (As-ODN) to the 3' untranslated region of the mRNA sequence expressing the intracellular adhesion molecule-1 (ICAM-1) was employed to determine ICAM-1's role in renal ischaemia-reperfusion injury in the rat. Wistar-Kyoto rats receiving i.v. either lipofectin-As-ODN (As-ODN group), lipofectin-reverse ODN (Rv-ODN group) or lipofectin (ischaemia control group) 8 h prior to study were anaesthetized and subjected to 30 min of renal artery occlusion. Renal haemodynamic and excretory parameters were monitored before and after renal ischaemia. On termination of the study renal tissue was subjected to histological and Western blot analysis. Renal blood flow decreased in the 3 h post-ischaemia period in the ischaemia control and Rv-ODN groups, but was maintained in the As-ODN group. Glomerular filtration rate was depressed initially but gradually increased to 10% above basal levels in the ischaemia control and Rv-ODN groups, but was below basal levels (20%) in the As-ODN group. There was a three- to fourfold increase in sodium and water excretion following ischaemia in the ischaemia control and reverse-ODN groups but not in the As-ODN treated group. The As-ODN ameliorated the histological evidence of ischaemic damage and reduced ICAM-1 protein levels to a greater extent in the medulla than cortex. These observations suggested that in the post-ischaemic period afferent and efferent arteriolar tone was increased with a loss of reabsorptive capacity which was in part due to ICAM-1. The possibility arises that the action of ICAM-1 at vascular and tubular sites in the deeper regions of the kidney contributes to the ischaemia-reperfusion injury.

Matched MeSH terms: Kidney Diseases/drug therapy*; Kidney Diseases/pathology; Kidney Diseases/physiopathology
Fulltext Renal biopsies in Johor: a 7-year study

Khoo JJ

Malays J Pathol, 2001 Dec;23(2):101-4.
PMID: 12166589

Consecutive renal biopsies received from 1994 to 2000 in Johor Bahru were reviewed. There were 441 cases, of which 407 were adequate biopsies (92.3%). Lupus nephritis formed the largest diagnostic entity (126 cases, 31.0%). This reflected the high prevalence of systemic lupus erythematosus (SLE) patients in Malaysia. The most common histological pattern of lupus nephritis was diffuse proliferative glomerulonephritis: WHO Class IV (96 cases, 76.2%). Other diagnostic entities were minimal change disease (28.5%), proliferative glomerulonephritis (10.6%), IgA nephropathy (9.8%), focal glomerulosclerosis (4.9%), membranous glomerulonephritis (4.4%), transplant rejection (3.9%), end stage nephropathy (3.4%) and others (3.4%). The morphological pattern of renal biopsies in Johor was similar to that reported in the University Hospital Kuala Lumpur.

Matched MeSH terms: Kidney Diseases/epidemiology; Kidney Diseases/pathology*
Fulltext Alpha1B-adrenoceptors mediate adrenergically-induced renal vasoconstrictions in rats with renal impairment

Khan MA, Sattar MA, Abdullah NA, Johns EJ

Acta Pharmacol Sin, 2008 Feb;29(2):193-203.
PMID: 18215348 DOI: 10.1111/j.1745-7254.2008.00727.x

This study examined whether alpha1B-adrenoceptors are involved in mediating adrenergically-induced renal vasoconstrictor responses in rats with pathophysiological and normal physiological states.

Matched MeSH terms: Kidney Diseases/physiopathology*
Fulltext Robust model of systemic inflammation through Lipopolysaccharide

Khan H., Aamir K., Arya A.

Malaysian Journal of Medicine and Health Sciences, 2019;15(102):50-50.
MyJurnal

Introduction: Systemic inflammation is the major clinical problem which is constellation of communicable and non-communicable infection equipped with acute to chronic inflammation. It may lead to unfavourable conditions for instance, systemic inflammatory syndrome, burns and sepsis. Systemic inflammation might rotate the steering towards vital clinical maladies including cardiomyopathy, neuroinflammation, hepatitis, liver and kidney diseases and even diabetes. In order to elucidate the molecular insights in these clinical implications, there is an intensive need
to design rodent model of systemic inflammation having close association with systemic inflammatory conditions in humans. Methods: Presently, lipopolysaccharide (LPS) induced systemic inflammatory rodent model is widely established, reproducible and acceptable among scientists. In this model animals are treated with intraperitoneal injection of LPS ranging from 1-10 mg/kg which leads to instant release of proinflammatory cytokines to provide robust model of systemic inflammation in order to elucidate pathological conditions and their in-depth mechanism to uncover the new anti-inflammatory therapeutic targets. Conclusion: Robust model would open new window to explore anti-inflammatory activities of phytochemicals, small molecules and drug candidates along with crosstalk of different signaling pathways at molecular level.

Matched MeSH terms: Kidney Diseases
Exudative Retinal Detachment due to Coats Disease in a Teenager with Senior-Loken Syndrome: Case Report and Review of Literature

Khairil-Ridzwan KK, Azian A, Hanizasurana H, Shatriah I

Cureus, 2019 Apr 15;11(4):e4460.
PMID: 31205846 DOI: 10.7759/cureus.4460

Senior-Loken syndrome is a rare disorder that presents in the first two decades of life. It commonly manifests with nephronophthisis and retinal dystrophy. We describe a teenager who had end-stage renal failure presenting with bilateral visual impairment due to retinal dystrophy with concomitant unilateral Coats disease and exudative retinal detachment. The patient was treated with a combination of endolaser photocoagulation and external drainage of the subretinal fluid. The final visual acuity remained poor in both eyes. Options of treatment in this challenging situation is discussed in this case report.

Matched MeSH terms: Kidney Diseases, Cystic
Focal Segmental Membranoproliferative Glomerulonephritis: A Histological Variant of Denys-Drash Syndrome

Karmila AB, Yap YC, Appadurai M, Oh L, Fazarina M, Abd Ghani F, et al.

Fetal Pediatr Pathol, 2021 Apr;40(2):113-120.
PMID: 31707902 DOI: 10.1080/15513815.2019.1686788

Introduction: Denys-Drash Syndrome (DDS) consists of a triad of pseudohermaphroditism, Wilms'tumor and nephropathy. This condition may manifest as a complete triad or in an incomplete form; with either one or a combination of the above features. The characteristic glomerular abnormality in DDS is diffuse mesangial sclerosis (DMS).Case report: We report two cases of DDS with focal membranoproliferative glomerulonephritis (MPGN). Both of our cases were males with ambiguous genitalia. They had a similar heterozygous germline mutation in exon 9 of WT1, c.1180C>T, p.R394W; a known mutation hotspot for DDS. Case 1 had nephropathy at the age of 4 years and Case 2 at 2.5 years with different rates of progression to end-stage renal failure. Conclusion: Our findings, in combination with other reports, illustrate the clinicopathological heterogeneity of DDS. There are no universal recommendations for optimal management of patients with DDS due to the inability to accurately predict affected individuals' progress.

Matched MeSH terms: Kidney Diseases*
Saving lives together

Karen A

World Hosp Health Serv, 2015;51(1):26-30.
PMID: 26058289

Established 20 years ago with a single dialysis center assisting only 20 patients with 6 hemodialysis machines, Medicare has grown leaps and bounds to assist thousands of poor patients to obtain a highly subsidized rate for quality treatment. Millions of ringgit raised via various fundraising projects and events have been well utilized to serve the growing number of kidney patients in Malaysia who simply cannot bear the exorbitant cost of treatment. Staying true to its mission, Medicare extends its assistance to needy kidney patients and their families, who indirectly have become part of the Medicare family.

Matched MeSH terms: Kidney Diseases/etiology; Kidney Diseases/therapy*
Fulltext Estimating glomerular filtration rate in adult kidney transplant recipients in the Asian population

Kamaruzaman L, Mohd R, Zaki FM, Hod R, Aziz AA

Saudi J Kidney Dis Transpl, 2019 6 30;30(3):587-596.
PMID: 31249222 DOI: 10.4103/1319-2442.261331

Estimation of glomerular filtration rate (GFR) in renal transplant patients is often assessed by application of creatinine-based equations. The aim was to correlate the estimated GFR (eGFR) using creatinine-based equations [Cockroft-Gault, Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Nankivell] with gold standard 51Cr-EDTA in kidney transplant patients in the Asian population. This is a single-center, cross-sectional study involving adult renal transplant patients. Background demographic data, medications, office blood pressure, and baseline investigations were taken. Correlations between measured GFR and eGFR were analyzed and Pearson's correlation coefficients, bias, and accuracy were assessed. Thirty-seven renal transplant patients with a mean age of 46 ± 13 years were recruited. Majority were Chinese (68%), Malay (24%), and Indian (8%). The median duration of the transplant was 84 (interquartile range 60,132) months. The mean measured GFR was 71 ± 21 mL/min/1.73 m2. Cockroft-Gault and CKD-EPI has the best correlation with 51Cr-EDTA with Pearson correlation coefficients of 0.733 (P <0.001) and 0.711 (P < 0.001), respectively. All formulae showed >80% accuracy with eGFR lies between 30% of the measured value. CKD-EPI and MDRD had the greatest accuracy with 89.2% each. Clinician may use any of these three serum creatinine-based equations to estimate GFR in kidney transplant recipients.

Matched MeSH terms: Kidney Diseases/diagnosis*; Kidney Diseases/ethnology; Kidney Diseases/physiopathology
Fulltext Rhabdomyolysis and acute renal failure following a switchover of therapy between two fibric acid derivatives

Kamaliah MD, Sanjay LD

Singapore Med J, 2001 Aug;42(8):368-72.
PMID: 11764054

Drug induced myopathy has been reported with the use of fibric acid derivatives, hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors and nicotinic acid. Over the last three decades, hypolipemiants like fibric acid derivatives and statins have been increasingly recognised as causes of rhabdomyolysis and acute renal failure especially during combination therapy and in the presence of underlying renal impairment. We report two cases of bezafibrate-induced rhabdomyolysis in patients with underlying coronary artery disease and pre-existing renal impairment. Both patients developed rhabdomyolysis leading to acute renal failure soon after their hyperlipidaemia treatment was changed from gemfibrozil to bezafibrate. There were no intercurrent illnesses or co-administration of other lipid lowering drugs in both patients. Even though both drugs belong to the same fibric acid derivatives group, these patients developed the complication only after a switchover of therapy.

Matched MeSH terms: Kidney Diseases/complications
Fulltext Effect of oral administration of ethanolic extract of Vitex negundo on thioacetamide-induced nephrotoxicity in rats

Kadir FA, Kassim NM, Abdulla MA, Yehye WA

BMC Complement Altern Med, 2013 Oct 30;13:294.
PMID: 24499255 DOI: 10.1186/1472-6882-13-294

BACKGROUND: Oxidative stress due to abnormal induction of reactive oxygen species (ROS) molecules is believed to be involved in the etiology of many diseases. Evidences suggest that ROS is involved in nephrotoxicity through frequent exposure to industrial toxic agents such as thioacetamide (TAA). The current investigation was designed to explore the possible protective effects of the leaves of Vitex negundo(VN) extract against TAA-induced nephrotoxicity in rats.
METHODS: Twenty four Sprague Dawleyrats were divided into four groups: (A) Normal control, (B) TAA (0.03% w/v in drinking water), (C) VN100 (VN 100 mg/kg + TAA) and (D) VN300 (VN 300 mg/kg + TAA). Blood urea and serum creatinine levels were measured,supraoxide dismutase (SOD), catalase (CAT) and malondialdehyde (MDA) levels of renal tissue were assayed. Histopathological analysis together with the oxidative stress nicotinamide adenine dinucleotide phosphate (NADPH) oxidase p22phox in kidney sections were examined in all experimental groups.
RESULTS: Blood urea and serum creatinine levels were increased in TAA group as a result of the nephrotoxicity compared to the VN100 and VN300 groups where, the levels were significantly decreased (p

Matched MeSH terms: Kidney Diseases/chemically induced; Kidney Diseases/drug therapy*; Kidney Diseases/enzymology; Kidney Diseases/metabolism
Fulltext Von Hippel–Lindau disease

Juhara Haron, Siti Noorul Arisah Bt Muhamad Nor

Malays Fam Physician, 2017;12(1):29-31.
MyJurnal

Von Hippel–Lindau (VHL) disease is a rare autosomal dominantly inherited multisystem disorder
characterised by the development of a variety of benign and malignant tumours. We report a case of
VHL disease that was inherited by a daughter from her father, who both presented at a young age
with progressive headache and were found to have a posterior fossa haemangioblastoma (HB) on
magnetic resonance imaging (MRI). Multiple benign pancreatic and renal cysts were also noted in
both patients.

Matched MeSH terms: Kidney Diseases, Cystic
Ischemia-Modified Albumin, Creatinine, And Paraoxonase-1 Levels in Serum of Patients Undergoing Intravenous Contrast-Enhanced Computed Tomography and Its Association with Contrast-Induced Nephropathy

Jha C, Ullas Kamath S, Dash S, Prabhu Attur R, Ramachandra L, Shenoy Kallya R

Rep Biochem Mol Biol, 2019 Apr;8(1):72-78.
PMID: 31334291

Background: Following contrast-enhanced computed tomography (CECT) contrast-induced nephropathy (CIN) may occur in patients with renal insufficiency or diabetes. Creatinine, the most common marker of CIN, may not be an accurate measure of damage and is affected by many non-renal factors. Our aim was to evaluate ischemia-modified albumin (IMA) as an early CIN marker and correlate it with paraoxonase-1 (PON-1) and creatinine before and after CECT.
Methods: Forty-eight adult patients scheduled for intravenous CECT, regardless of indication or body region for CECT, were included in this prospective study. Venous blood samples were obtained 12-24 hours before and after contrast media (CM) administration. Ischemia-modified albumin and PON-1 were estimated using methods described by Bar-Or et al. and Dantoine et.al., respectively. Creatinine was estimated on an automated analyzer.
Results: Significant differences in IMA (P < 0.001) and PON-1 (P < 0.001) levels were found between pre- and post-CECT samples, while the difference for creatinine was not significant (p = 0.073). No correlation was found between IMA and PON-1 or IMA and creatinine in either the pre- or post-CECT samples.
Conclusion: After CM administration patients are subjected to oxidative stress and/or ischemia, as revealed by elevated IMA and decreased PON-1 levels; however, creatinine levels, most commonly estimated to assess reduced renal function, did not reflect the condition accurately. IMA may be a sensitive marker for CIN but further studies are required to confirm its usefulness.

Matched MeSH terms: Kidney Diseases
The relevance of CYP2D6 genetic polymorphism on chronic metoprolol therapy in cardiovascular patients

Ismail R, Teh LK

J Clin Pharm Ther, 2006 Feb;31(1):99-109.
PMID: 16476126

CYP2D6 polymorphisms are well described in normal populations but there are few data on its clinical significance. We therefore investigated the influence of CYP2D6 polymorphism on steady-state plasma concentrations and apparent oral clearance of metoprolol in patients with cardiovascular diseases.

Matched MeSH terms: Kidney Diseases/drug therapy; Kidney Diseases/metabolism

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