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   2009| July-September  | Volume 19 | Issue 3  
    Online since October 15, 2009

 
 
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ORIGINAL ARTICLES
Perturbation in kidney lipid metabolic profiles in diabetic rats with reference to alcoholic oxidative stress
KR Shanmugam, CH Ramakrishna, K Mallikarjuna, K Sathyavelu Reddy
July-September 2009, 19(3):101-106
DOI:10.4103/0971-4065.57106  PMID:20436729
Diabetes is a major threat to global public health, and the number of diabetic patients is rapidly increasing worldwide. Evidence suggests that oxidative stress is involved in the pathophysiology of diabetic complications and alcoholic diseases. The aim of this study is to find out the impact of alcohol on lipid metabolic profiles in kidney tissue under streptozotocin induced diabetic condition. No study has been reported so far on the effect of alcohol on diabetic condition and also with reference to lipid metabolic profiles. Hence, the present study has been designed to elucidate the impact of alcoholism on diabetic condition. Male wistar strain albino rats were randomly divided into four groups: control (saline treated) NC, alcohol-treated (At), diabetic control (DC), and alcohol-treated diabetic rats (D+At). In alcohol-treated diabetic rats, we observed high levels of MDA, total cholesterol, triglycerides, phospholipids and also high levels of blood glucose than other groups. Moreover, degenerative changes of renal cells in alcohol-treated diabetic group were maximized by administration of alcohol as evinced by histopathological examination. This study suggests that alcohol consumption could be an aggravation factor which contributes for the formation of free radicals in diabetic condition. Therefore, consumption of alcohol during diabetic condition is harmful.
  9 4,638 264
Spectrum of childhood nephrotic syndrome in Iran: A single center study
A Safaei, S Maleknejad
July-September 2009, 19(3):87-90
DOI:10.4103/0971-4065.57103  PMID:20436726
Nephrotic syndrome (NS) is a clinical entity characterized by massive loss of urinary protein (primarily albuminuria) leading to hypoproteinemia (hypoalbuminemia) and its result, edema. Hyperlipidemia, hypercholesterolemia, and increased lipiduria are usually associated. Although not commonly thought of as part of the syndrome, hypertension, hematuria, and azotemia may be present. This prospective cross-sectional study was performed on 44 children (with age of onset up to 14 years) with idiopathic nephrotic syndrome (INS) in our center during 2000-2007. The objectives were to study the clinical and biochemical parameters and the histopathological distribution of different subtypes of INS and drug-response pattern in these patients.The study group included 44 children. There were 29 (66%) boys and 15 girls (34%). The mean age was 4.87 ± 3.24 years. Facial edema was found in 42 (95%), microscopic hematuria in 10 (23%), gross hematuria in 2 (4.5%), and hypertension in 5 (11.2%) patients. In children who underwent biopsy, focal segmental glomerulosclerosis was the most common pathologic finding (41%). Other subtypes included minimal change disease in three (18%), membranoproliferative glomerulonephritis in one (5.8%), diffuse proliferative glomerulonephritis in two (11.6 %), membranous glomerulonephritis in one (5.8%), and diffuse mesangial proliferation in three (17.5%) cases. At the time of hospitalization peritonitis was present in five (11.4%), pneumonia and upper respiratory infection (sinusitis) in eight (18%), and cellulites in two (4.5%) patients. Twenty nine patients (66%) were steroid sensitive, 9 (20.5%) steroid resistant, and 6 (13.5%) steroid dependent. Among patients with steroid-sensitive NS, 37% were nonrelapsers, 38.8% frequent relapsers, and 26.4% were infrequent relapsers. Differences seems to exist between season of incidence, suitable response to treatment with corticosteroids, and pathologic findings of biopsy in our study and other studies from Iran and other countries.
  6 3,338 410
CASE REPORTS
Renal transplant in a child with Bardet-Biedl syndrome: A rare cause of end-stage renal disease
AK Hooda, SC Karan, JS Bishnoi, A Nandwani, T Sinha
July-September 2009, 19(3):112-114
DOI:10.4103/0971-4065.57108  PMID:20436731
Bardet-Biedl syndrome (BBS) is a rare cause of renal failure requiring renal replacement therapy. It is an autosomal recessive condition characterized by retinitis pigmentosa, postaxial polydactyly, central obesity, mental retardation, hypogonadism, and renal involvement. We report the first successful renal transplant in a case of BBS from India.
  5 3,881 190
Calciphylaxis in chronic renal failure: An approach to risk factors
W Rezaie, H.A.J.M Overtoom, M Flens, R.J.L Klaassen
July-September 2009, 19(3):115-118
DOI:10.4103/0971-4065.57109  PMID:20436732
We present a case of calcifying panniculitis due to calciphylaxis in a nontherapy compliance 65-year-old man suffering from chronic renal failure. Calciphylaxis, a life threatening condition, is characterized by high calcium Χ phosphate product, presence of calcium crystals in the skin and secondary hyperparathyroidism. The clinical presentation includes painful firm plaques, which could progress to nonhealing ulcers. A review of literature is given with emphasis on identification of risk factors and early diagnosis.
  5 3,293 288
ORIGINAL ARTICLES
Prevalence of lower urinary tract infection in South Indian type 2 diabetic subjects
J Janifer, S Geethalakshmi, K Satyavani, V Viswanathan
July-September 2009, 19(3):107-111
DOI:10.4103/0971-4065.57107  PMID:20436730
This study was done to determine the prevalence of lower urinary tract infection (UTI), the causative pathogens, their antimicrobial pattern, and the recurrence of infection in type 2 diabetic subjects. A total of 1157 (M: F 428: 729) type 2 diabetic subjects were selected for this study. Midstream urine specimens were collected and the culture tests were done by a quantitative method whereas antimicrobial sensitivity was determined by using the Kirby-Bauer method. A significant colony count was seen in 495 (42.8%) subjects and an insignificant count in 350 (30.3%) subjects; there were a few cases of recurrent UTI. Women (47.9%) had a significantly higher prevalence of UTI than men (34.1%) (χ2 = 20.3, P < 0.0001). Except for BMI, UTI was significantly associated with age, duration of diabetes, and poor glycemic control in both sexes. About 533 pathogens of gram positive and gram negative bacilli were isolated from 495 subjects in this study. Escherichea coli (E. coli) was the most commonly found organism. Gram negative pathogens were found to be highly sensitive to sulbactum / cefoperazone and piperacillin / tazobactum. The prevalence of UTI was significantly higher in women than men with E. coli being the major isolated pathogen. Gram negative pathogens were highly sensitive to sulbactum / cefoperazone and piperacillin / tazobactum.
  3 5,287 570
Efficacy and tolerability of lamivudine in hepatitis B infected renal transplant recipients: A single center study
SK Agarwal, SC Tiwari
July-September 2009, 19(3):91-95
DOI:10.4103/0971-4065.57104  PMID:20436727
Hepatitis B virus (HBV) infection in patients on hemodialysis and renal transplantation (RT) usually has an unfavorable course. Lamivudine is a synthetic nucleoside analog with a potent action on HBV replication. There is limited data on lamivudine in renal transplant patients with HBV infection and no published report from India. Present study reports on lamivudine therapy in these patients. Patients with HBV infection taken for RT were included. Hepatitis B surface antigen (HBsAg), hepatitis B envelope antigen (HBeAg), HBV-DNA, and liver biopsy before RT were done in all patients. Lamivudine was given in the dose of 50 mg daily during the dialysis and 100 mg daily following successful transplant. Response was evaluated at one year. Of the 739 adult RTs during study period, 35 (4.7%) had HBV infection. Mean age of patients was 30.7 ± 9.8 (16-55 years) and 88.5% were males. Four (11.4%) patients had HCV coinfection. HCV was not treated in any patient. All patients were HBsAg and HBV-DNA positive, while 27 (77%) were HBeAg positive. Mean ALT was 77.8 ± 90 IU/dl; 11 (31.4%) patients had normal ALT. Mean liver biopsy grade was 5.2 ± 1.5 (3-9) and stage was 0.7 ± 0.6 (0-2). At one year following transplantation, ALT was normal in 27 (77%) cases, HBV-DNA undetectable in 16 (45.7%), HBeAg and HBsAg seroconversion in 8 (22.8%), and 3 (8.6%) cases, respectively. All patients tolerated the drug without any significant side effects. Treatment with lamivudine in dialysis and renal transplant patients is well tolerated and safe with efficacy comparable to patients with normal renal function.
  2 2,522 291
REVIEW ARTICLE
Tumor lysis and acute renal failure in Burkitt's lymphoma: A review on pathophysiology and management
IO Senbanjo
July-September 2009, 19(3):83-86
DOI:10.4103/0971-4065.57102  PMID:20436725
Morbidity and mortality in patients with hematologic malignancies are significantly increased by development of acute renal failure. This is more likely in the developing world where facilities for renal replacement therapy are scarce. This review discusses the pathophysiology of acute renal failure due to tumor lysis syndrome in patients with Burkitt's lymphoma, the commonest hematological malignancy in the pediatric age group in sub-Saharan Africa, and evaluates the possible management options. Tumor lysis can also develop in association with other hematologic malignancies, both spontaneously and following treatment, and these principles are applicable in all such cases.
  2 3,185 480
CASE REPORTS
Renal transplantation in a HIV positive patient
A Mann, P Soundararajan, S Shroff
July-September 2009, 19(3):119-121
DOI:10.4103/0971-4065.57110  PMID:20436733
Historically HIV positive patients were considered a contraindication for renal transplant. After the year 1996, with the introduction of HAART the retropositive patients live longer and therefore end stage organ disease is now an increasingly important cause of mortality and morbidity in these patients. Here we report our experience for the first time in India. A forty nine year old hypertensive female from Africa who was diagnosed chronic kidney disease and retropositive status, progressed to end stage renal disease and underwent live related renal transplant at our centre.
  1 2,144 213
Pseudopheochromocytoma: An uncommon cause of malignant hypertension
SM Seck, EF Ka, A Niang, B Diouf
July-September 2009, 19(3):122-124
DOI:10.4103/0971-4065.57111  PMID:20436734
A 42-year-old black African patient was admitted in the emergency department with severe headache, dizziness, and visual problems. He had been treated for hypertension diagnosed eight months ago after a similar episode. He was taking atenolol 100 mg /day, amlodipine 10 mg/day, and a combination of lisinopril 20 mg/hydrochlorothiazide 12.5 mg daily but experienced several hypertension peaks and hypotension. He adhered to treatment and was neither using traditional herbal medication nor illicit drugs. He did not smoke, but used to drink 1-2 glasses of wine after dinner. At admission, his blood pressure was 235/145 mm of Hg. His body mass index was 25.5 kg/m 2 and the waist/hip ratio was 0.9. Physical examination was unremarkable. Fundoscopic examination revealed hypertensive retinopathy. Biochemical and imaging explorations were compatible with diagnosis of pseudopheochromocytoma. Evolution was favourable after treatment with alpha-1 and beta-blokers.
  1 4,525 218
LETTER TO EDITOR
Kidney transplantation in a patient with HIV disease
LI Gonzalez-Granado
July-September 2009, 19(3):126-126
DOI:10.4103/0971-4065.57113  PMID:20436737
  1 1,140 136
ORIGINAL ARTICLES
Is soluble transferrin receptor a good marker of iron deficiency anemia in chronic kidney disease patients?
S Gupta, B Uppal, B Pawar
July-September 2009, 19(3):96-100
DOI:10.4103/0971-4065.57105  PMID:20436728
Anemia in patients with chronic renal failure is multifactorial with an absolute or functional iron deficiency present in 60-80% of patients. In this study, 102 patients of stage 5 chronic kidney disease (CKD) were enrolled. Thirty six age- and sex-matched anemic patients without any known renal disease were taken as controls. Their sTfR levels were measured with anemia profile.(Fe, TIBC, Ferritin, TSAT). The patients were followed up twice, at four weeks and six months. There was a significant statistical difference in the mean sTfR levels in patients when compared to controls ( P <0 0.01).The mean level of sTfR in CKD patients was 3.23 ± 2.07 mg/l while in controls this was 5.16 ± 3.64 mg/l. sTfR had no statistically significant correlation with the levels of hemoglobin, iron, ferritin, TIBC and TSAT. We conclude that owing to complexity of iron metabolism in CKD, sTfR can not be used as a reliable marker of iron deficiency anemia.
  1 3,966 348
IMAGES IN NEPHROLOGY
Bilateral renal cortical necrosis in acute pancreatitis
G.S.R Krishna, KC Kishore, NP Sriram, VV Sainaresh, AY Lakshmi, V Siva Kumar
July-September 2009, 19(3):125-125
DOI:10.4103/0971-4065.57112  PMID:20436735
  - 1,864 203
LETTER TO EDITOR
Ponticelli regimen and nephrotic syndrome
S Laxminarayana
July-September 2009, 19(3):126-127
DOI:10.4103/0971-4065.57114  PMID:20436736
  - 1,443 221
Indian Journal of Nephrology
Published by Wolters Kluwer - Medknow
Online since 20th Sept '07