MyMedR

Paracetamol: a cause for analgesic nephropathy and end-stage renal disease

Segasothy M, Suleiman AB, Puvaneswary M, Rohana A

Nephron, 1988;50(1):50-4.

180 patients with end-stage renal disease (ESRD) on maintenance dialysis and those who had undergone renal transplantation were questioned retrospectively. 14 patients had consumed excessive quantities of analgesics (greater than 1 kg) prior to the institution of long-term dialysis or transplantation. Sonographic examination done on these patients indicated that 7 had renal papillary necrosis (RPN). The sonographic features were renal papillary calcifications surrounding the central sinus in a complete or incomplete garland pattern. In 5 of these patients RPN is attibutable to the excessive consumption of paracetamol. We have earlier reported 10 cases of RPN due to excessive consumption of paracetamol. Thus 15 cases of RPN attributable to paracetamol consumption (1.0-15.3 kg over a period ranging from 3 to 23 years) have been documented. It is concluded that paracetamol may assume an increasingly important role in the causation of analgesic nephropathy (AN) and ESRD.

Matched MeSH terms: Kidney Diseases/chemically induced*; Kidney Diseases/diagnosis; Kidney Failure, Chronic/chemically induced*; Kidney Failure, Chronic/therapy

Fulltext Resveratrol Supplementation Protects Against Nicotine-Induced Kidney Injury

Ramalingam A, Santhanathas T, Shaukat Ali S, Zainalabidin S

Int J Environ Res Public Health, 2019 11 12;16(22).

PMID: 31726798 DOI: 10.3390/ijerph16224445

Prolonged exposure to nicotine accelerates onset and progression of renal diseases in habitual cigarette smokers. Exposure to nicotine, either via active or passive smoking is strongly shown to enhance renal oxidative stress and augment kidney failure in various animal models. In this study, we investigated the effects of resveratrol supplementation on nicotine-induced kidney injury and oxidative stress in a rat model. Male Sprague-Dawley rats were given nicotine (0.6 mg/kg, i.p.) alone or in combination with either resveratrol (8 mg/kg, i.p.), or angiotensin II type I receptor blocker, irbesartan (10 mg/kg, p.o.) for 28 days. Upon completion of treatment, kidneys were investigated for changes in structure, kidney injury markers and oxidative stress. Administration of nicotine alone for 28 days resulted in significant renal impairment as shown by marked increase in plasma creatinine, blood urea nitrogen (BUN) and oxidative stress. Co-administration with resveratrol however successfully attenuated these changes, with a concomitant increase in renal antioxidants such as glutathione similar to the conventionally used angiotensin II receptor blocker, irbesartan. These data altogether suggest that targeting renal oxidative stress with resveratrol could alleviate nicotine-induced renal injury. Antioxidants may be clinically important for management of renal function in habitual smokers.

Matched MeSH terms: Kidney/drug effects; Kidney Diseases/chemically induced*; Kidney Diseases/prevention & control; Kidney Function Tests

Fulltext Apocynin and catalase prevent hypertension and kidney injury in Cyclosporine A-induced nephrotoxicity in rats

Tan YC, Abdul Sattar M, Ahmeda AF, Abdul Karim Khan N, Murugaiyah V, Ahmad A, et al.

PLoS One, 2020;15(4):e0231472.

PMID: 32298299 DOI: 10.1371/journal.pone.0231472

Oxidative stress is involved in the pathogenesis of a number of diseases including hypertension and renal failure. There is enhanced expression of nicotinamide adenine dinucleotide (NADPH oxidase) and therefore production of hydrogen peroxide (H2O2) during renal disease progression. This study investigated the effect of apocynin, an NADPH oxidase inhibitor and catalase, an H2O2 scavenger on Cyclosporine A (CsA) nephrotoxicity in Wistar-Kyoto rats. Rats received CsA (25mg/kg/day via gavage) and were assigned to vehicle, apocynin (2.5mmol/L p.o.), catalase (10,000U/kg/day i.p.) or apocynin plus catalase for 14 days. Renal functional and hemodynamic parameters were measured every week, and kidneys were harvested at the end of the study for histological and NADPH oxidase 4 (NOX4) assessment. Oxidative stress markers and blood urea nitrogen (BUN) were measured. CsA rats had higher plasma malondialdehyde (by 340%) and BUN (by 125%), but lower superoxide dismutase and total antioxidant capacity (by 40%, all P<0.05) compared to control. CsA increased blood pressure (by 46mmHg) and decreased creatinine clearance (by 49%, all P<0.05). Treatment of CsA rats with apocynin, catalase, and their combination decreased blood pressure to near control values (all P<0.05). NOX4 mRNA activity was higher in the renal tissue of CsA rats by approximately 63% (P<0.05) compared to controls but was reduced in apocynin (by 64%), catalase (by 33%) and combined treatment with apocynin and catalase (by 84%) compared to untreated CsA rats. Treatment of CsA rats with apocynin, catalase, and their combination prevented hypertension and restored renal functional parameters and tissue Nox4 expression in this model. NADPH inhibition and H2O2 scavenging is an important therapeutic strategy during CsA nephrotoxicity and hypertension.

Matched MeSH terms: Kidney/drug effects; Kidney/physiopathology; Acute Kidney Injury/chemically induced*; Acute Kidney Injury/prevention & control

Fulltext Expression of protease activated receptor-2 is reduced in renal cell carcinoma biopsies and cell lines

Morais C, Rajandram R, Blakeney JS, Iyer A, Suen JY, Johnson DW, et al.

PLoS One, 2021;16(3):e0248983.

PMID: 33765016 DOI: 10.1371/journal.pone.0248983

Expression of the protease sensing receptor, protease activated receptor-2 (PAR2), is elevated in a variety of cancers and has been promoted as a potential therapeutic target. With the development of potent antagonists for this receptor, we hypothesised that they could be used to treat renal cell carcinoma (RCC). The expression of PAR2 was, therefore, examined in human RCC tissues and selected RCC cell lines. Histologically confirmed cases of RCC, together with paired non-involved kidney tissue, were used to produce a tissue microarray (TMA) and to extract total tissue RNA. Immunohistochemistry and qPCR were then used to assess PAR2 expression. In culture, RCC cell lines versus primary human kidney tubular epithelial cells (HTEC) were used to assess PAR2 expression by qPCR, immunocytochemistry and an intracellular calcium mobilization assay. The TMA revealed an 85% decrease in PAR2 expression in tumour tissue compared with normal kidney tissue. Likewise, qPCR showed a striking reduction in PAR2 mRNA in RCC compared with normal kidney. All RCC cell lines showed lower levels of PAR2 expression than HTEC. In conclusion, we found that PAR2 was reduced in RCC compared with normal kidney and is unlikely to be a target of interest in the treatment of this type of cancer.

Matched MeSH terms: Kidney Neoplasms/genetics; Kidney Neoplasms/metabolism*; Kidney Neoplasms/pathology*; Kidney Tubules/pathology

Fulltext Prevalence and management of anemia in pre-dialysis Malaysian patients: A hospital-based study

Salman M, Khan AH, Adnan AS, Sulaiman SA, Hussain K, Shehzadi N, et al.

Rev Assoc Med Bras (1992), 2016 Nov;62(8):742-747.

PMID: 27992014 DOI: 10.1590/1806-9282.62.08.742

Objective:: Anemia, a common complication of chronic kidney diseases (CKD), is involved in significant cardiovascular morbidity. Therefore, the objective of our study was to investigate the prevalence and severity of anemia in pre-dialysis patients, as well as to determine the predictors of anti-anemic therapy.

Method:: A retrospective, observational study was conducted on adult pre-dialysis patients receiving treatment at the Hospital Universiti Sains Malaysia from January 2009 to December 2013.

Results:: A total of 615 eligible cases were included. The mean age of patients was 64.1±12.0 years. The prevalence of anemia was 75.8%, and the severity of anemia was mild in 47.7% of the patients, moderate in 32.2%, and severe in 20%. Based on morphological classification of anemia, 76.9% of our patients had normochromic-normocytic anemia whereas 21.8 and 1.3% had hypochromic-microcytic anemia and macrocytic anemia, respectively. Oral iron supplements were prescribed to 38.0% of the patients and none of the patients was given erythropoietin stabilizing agents (ESA) or intravenous iron preparations. In logistic regression, significant predictors of anti-anemic preparation use were decreased hemoglobin and hematocrit, and advanced stages of CKD.

Conclusion:: The results of the present study suggest that the prevalence of anemia in pre-dialysis patients is higher than currently accepted and it is found to be correlated with renal function; prevalence increases with declined renal function. An earlier identification as well as appropriate management of anemia will not only have a positive impact on quality of life but also reduce hospitalizations of CKD patients due to cardiovascular events.

Matched MeSH terms: Kidney/physiology*; Kidney/physiopathology; Kidney Failure, Chronic/etiology; Kidney Failure, Chronic/therapy*

Comparative effectiveness and safety of various treatment procedures for lower pole renal calculi: a systematic review and network meta-analysis

Lee SW, Chaiyakunapruk N, Chong HY, Liong ML

BJU Int, 2015 Aug;116(2):252-64.

PMID: 25381743 DOI: 10.1111/bju.12983

To compare the effectiveness of various treatments used for lower pole renal calculi.

Matched MeSH terms: Kidney Calculi/surgery*

Re: Intrarenal and extrarenal autonomic nervous system redefined: A. Lusch, R. Leary, E. Heidari, M. A. Liss, Z. Okhunov, A. Perez-Lanzac De Lorca, J. Huang, J. Wikenheiser and J. Landman. J Urol 2014; 191: 1060-1065

Das S, Suhaimi FH

J Urol, 2014 Oct;192(4):1299-300; discussion 1300.

PMID: 25043648 DOI: 10.1016/j.juro.2014.04.100

Matched MeSH terms: Kidney/innervation*

Fulltext Melioidosis and peritoneal dialysis related peritonitis

Wong KW

Med J Malaysia, 2013 Apr;68(2):179-80.

PMID: 23629573 MyJurnal

We report a case of melioidosis presenting as peritonitis in a patient on continuous ambulatory peritoneal dialysis (CAPD). A 47-year-old man, a lorry driver, with end-stage renal disease due to diabetes mellitus on CAPD presented in PD-related peritonitis. He was started on intraperitoneal cloxacillin and ceftazidime, and changed to intraperitoneal vancomycin and meropenam after day 5 due to nonresponse. Burkholderia pseudomallei was identified from the dialysate culture. He was treated with intraperitoneal meropenam for two weeks, and IV ceftazidime for 4 weeks. He responded, and the Tenckhoff catheter was not removed. He was discharged well and continued on oral sulfamethoxazole/trimethoprim for six months. This patient had done his PD exchanges in a lorry.

Matched MeSH terms: Kidney Failure, Chronic/therapy

Fulltext Magnetic resonance urography in duplex kidney with ectopic ureteral insertion

Thambidorai CR, Anuar Z

J Indian Assoc Pediatr Surg, 2011 Jul;16(3):115-7.

PMID: 21897576 DOI: 10.4103/0971-9261.83500

This is a report on the use of magnetic resonance urography (MRU) in a 6-year-old girl who presented with urinary incontinence. She had a left duplex kidney with poorly functioning upper moiety and ectopic insertion of the dilated upper pole ureter. MRU has been shown to be superior to conventional imaging techniques in delineating poorly functioning moieties of duplex kidneys and ectopic ureters.

Matched MeSH terms: Kidney; Kidney Diseases

Fulltext Abdominal aortic aneurysm in a renal transplant patient

Naresh G, Zainal AA

Med J Malaysia, 2008 Mar;63(1):73-4.

PMID: 18935743 MyJurnal

Repair of an abdominal aortic aneurysm in a renal transplant recipient poses many different problems due to warm ischaemia to the grafted kidney. This is a case of 50-year-old gentleman who had a pervious renal transplant with abdominal aortic aneurysm. To reduce the effects of warm ischaemia on the transplanted kidney, an axillo unifemoral bypass was done prior to aneurysm repair. This ensured continued perfusion to the transplanted kidney. The post operative period was complicated by Methicillin Resistant Staphyloccus Aureus infection of the graft.

Matched MeSH terms: Kidney Transplantation*

Fulltext Renal autotransplantation after an iatrogenic left ureteric injury

Neo EN, Zulkifli Z, Sritharan S, Lee BC, Nazri J

Med J Malaysia, 2007 Jun;62(2):164-5.

PMID: 18705455

We report a case of renal autotransplantation performed successfully for an iatrogenic ureteric injury with loss of 9 cm of ureteric length. The surgical options available for management of ureteric injuries are discussed, varying from a simple re-anastomosis to the more complex renal autotransplantation.

Matched MeSH terms: Kidney Transplantation*

Acute polyhydramnios causing bilateral obstructive hydronephrosis and impaired renal function

Valayatham V, Kakarla A, Rymer J

J Obstet Gynaecol, 2007 Oct;27(7):736-7.

PMID: 17999311

Matched MeSH terms: Kidney/physiopathology*

Perspectives on the nutritional management of renal disease in Asia: people, practice, and programs

Karupaiah T, Morad Z

J Ren Nutr, 2007 Jan;17(1):93-6.

PMID: 17198942

The high prevalence of end-stage renal disease (ESRD) in many Asian countries is attributed to diabetes and hypertension. Health care expenditure in relation to per capita income and government share of this expenditure vary among Asian countries and are affected by large populations and the poverty factor. The impact of ESRD on nutritional management in Asia reveals the need for clinicians to balance the requirements for higher standards of dietetic practice as they implement optimal care algorithms with the goal of improving outcomes, against the backdrop of staffing limitations, limited expertise in renal nutrition practice, and cultural diversity among Asian people. This paper discusses current aspects of dietetic practice and the likelihood that a change in practice is required if dietitians are to play an active role in preventing or slowing down ESRD.

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

Fulltext The utilization of an index for serum globulin compensation in diseases associated with decreased serum albumin

Al-Joudi FS, Wahab NA

Med J Malaysia, 2004 Oct;59(4):495-501.

PMID: 15779582 MyJurnal

The albumin globulin ratio (A/G ratio) is meant to represent the ratio of alterations in serum proteins, since, in liver disease, globulins (G) rise following serum albumin (SA) decrease. pathophysiological value, its' use has been limited. Alternatively, we have developed an index, the globulin compensation index (GCI) to measure the changes in serum globulins when albumin is decreased. The index is calculated as follows: G - 25 / 35 - SA. The GCI has been tested using retrospective patients' data from the Hospital Universiti Sains Malaysia. Analysis of the data shows that the GCI may be of potential value in showing the actual serum protein status, especially in cases where globulins are decreased along with albumin. Furthermore, globulin rise in cases with reduced albumin was found in 72.3% of cases of hepatic diseases, whereas this finding occurred in up to 32.3% of cases of non-hepatic, systemic diseases.

Matched MeSH terms: Kidney Diseases/blood

Fulltext Accuracy of ultrasound versus computed tomography urogram in detecting urinary tract calculi

Salinawati B, Hing EY, Fam XI, Zulfiqar MA

Med J Malaysia, 2015 Aug;70(4):238-42.

PMID: 26358021 MyJurnal

AIM: To determine the (i) sensitivity and specificity of ultrasound (USG) in the detection of urinary tract calculi, (ii) size of renal calculi detected on USG, and (iii) size of renal calculi not seen on USG but detected on computed tomography urogram (CTU).
METHODS: A total of 201 patients' USG and CTU were compared retrospectively for the presence of calculi. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value of USG were calculated with CTU as the gold standard.
RESULTS: From the 201 sets of data collected, 59 calculi were detected on both USG and CTU. The sensitivity and specificity of renal calculi detection on USG were 53% and 85% respectively. The mean size of the renal calculus detected on USG was 7.6 mm ± 4.1 mm and the mean size of the renal calculus not visualised on USG but detected on CTU was 4 mm ± 2.4 mm. The sensitivity and specificity of ureteric calculi detection on USG were 12% and 97% respectively. The sensitivity and specificity of urinary bladder calculi detection on USG were 20% and 100% respectively.
CONCLUSION: This study showed that the accuracy of US in detecting renal, ureteric and urinary bladder calculi were 67%, 80% and 98% respectively.
Study site: Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur

Matched MeSH terms: Kidney Calculi*

Effects of CYP3A5 Genetic Polymorphism on the Pharmacokinetics of Tacrolimus in Renal Transplant Recipients

Mac Guad R, Zaharan NL, Chik Z, Mohamed Z, Peng NK, Adnan WA

Transplant Proc, 2016 Jan-Feb;48(1):81-7.

PMID: 26915847 DOI: 10.1016/j.transproceed.2016.01.001

BACKGROUND: The aim of this study was to compare the within-patient variability trough levels (Co), dose-adjusted Co, and dose requirements of Prograf and Advograf with CYP3A5 polymorphisms in Malaysia renal transplant recipients.
METHODS: Stable post-renal transplantation patients switched from Prograf to Advograf were retrospectively identified from University Malaya Medical Centre (n = 28). Co and concomitant tacrolimus dose 6 months preconversion and postconversion were examined. CYP3A5 was genotyped using reverse transcriptase polymerase chain reaction. Wilcoxon signed rank test and Mann-Whitney U test were used to compare Co and dose between formulations and according to genotypes.
RESULTS: There was a significant difference in the whole-blood tacrolimus Co between the 2 groups (6.16 ± 1.74 ng/mL vs 4.90 ± 1.06 ng/mL; P = .0001). The mean daily maintenance dose of Prograf was 3.9 ± 2.0 mg/kg (0.06 mg/kg/d), which was reduced to 3.3 ± 1.7 mg/d (0.04 mg/kg/d) with Advograf (P = .01). The mean maintenance dose of tacrolimus required for those with CYP3A5*1/*1 (high-expressive) was significantly higher than those with CYP3A5*1/*3 (intermediate-expressive) and CYP3A5*3/*3 (low-expressive) (P < .01) for both formulations. Comparing those with CYP3A5*1/*1, the average dose-adjusted Co was significantly higher in patients with CYP3A5*3/*3 with Advograf (P < .05).
CONCLUSIONS: The requirement for daily maintenance dose was higher in those with CYP3A5*1/*1 variants in both tacrolimus formulations in the Malaysian patients. Furthermore, those with CYP3A5*3/*3 demonstrated significantly higher dose-adjusted Co with Advograf.

Matched MeSH terms: Kidney; Kidney Transplantation

Fulltext An unusual presentation of renal parenchymal malacoplakia

Teh GC, Chong WL, Manorammah L, Mah PKK, Abdullah K

Med J Malaysia, 2000 Jun;55(2):263-4.

PMID: 19839157

Matched MeSH terms: Kidney/pathology*

Acute renal failure following multiple wasp stings

Thiruventhiran T, Goh BL, Leong CL, Cheah PL, Looi LM, Tan SY

Nephrol Dial Transplant, 1999 Jan;14(1):214-7.

PMID: 10052513

Matched MeSH terms: Kidney Tubular Necrosis, Acute/etiology; Kidney Tubular Necrosis, Acute/pathology; Kidney Tubules/pathology; Acute Kidney Injury/etiology*; Acute Kidney Injury/pathology

Fulltext Mixed lymphocyte culture (MLC) test and living related donor kidney transplantation

Suleiman AB, Mohd Zaher ZM, Chan SH, Awang H

Med J Malaysia, 1984 Mar;39(1):56-8.

PMID: 6239969

The MtC tests performed prospectively was correlated with graft survival in 73 living, related grafts. The MLC was expressed as the relative response (RR), and graft survival assessed at six months, one year and two years. The l-haplotype matched grafts with high RR had poorer graft survival at one and two years than those with low RR, but this difference was not statistically significant.

Matched MeSH terms: Kidney Transplantation*

Fulltext Experience with 395 extracorporeal shockwave lithotripsy in the treatment of renal and ureteric calculi

Tan HM, Cheung HS

Med J Malaysia, 1990 Jun;45(2):113-7.

PMID: 2152014

Three hundred and ninety five cases in 358 consecutive patients (male-232, female-126) with renal and ureteric stones were treated with extracorporeal shockwave lithotripsy (ESWL) from March to November 1988. They either had ESWL alone, or in combination with stone manipulation or debulking percutaneous nephrolithotripsy (PCNL). Seventy five percent of the stones were found in the pelvicalyceal system and 25% in the ureter. Seventy-six percent of the stones were less than 25mm size. Two hundred and ninety (79%) cases were followed up to three months. Two hundred and forty nine (85.9%) cases were stone free and 36 (12.4%) had residual sand less than 3mm size. Five (1.7%) cases failed to fragment with ESWL monotherapy and were salvaged by either percutaneous or ureteroscopic intervention. None of the cases required any open surgery intervention.

Matched MeSH terms: Kidney Calculi/therapy*

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