Nephro-Urology Monthly
Volume:12 Issue: 1, Feb 2020

 Stroke is one of the leading causes of mortality in the dialysis population. Although there is plenty of literature available for cardiovascular risk factors in dialysis patients, very few studies have focused on cerebrovascular events and Indian data are sparse.

 This study was undertaken to address some of these shortcomings.

 This is a matched cohort study. There were 30 cases with intracranial bleeding (ICB) in hemodialysis patients whose clinical profiles were compared with 60 matched controls with no ICB and the data was analyzed.

 The common cause of chronic kidney disease (CKD) was diabetes. Event BP was high but not significantly. Serum albumin values were lower in patients than in controls (2.65 vs. 3.15 g/dL). The common site of bleeding in our study was intraparenchymal (60%), followed by subdural hematoma (30%). Mortality was 76.7% in one month. Although the incidence of bleeding was slightly more in the thrice-weekly dialysis group, the difference was not significant. The diabetic status of ICB patients was poorly controlled.

 Hemodialysis patients have multiple risk factors for ICB and low serum albumin could be one of them. These patients have high short-term mortality (76.7%). There was a slightly increased incidence of ICB in patients who underwent thrice-weekly dialysis and those with poor glycemic control. This needs a systemic study with larger sample size and longer follow-up.

 Vitamin D may have a beneficial effect on the kidney tissue and in children with nephrotic syndrome.

 The aim of this study was evaluation the efficacy of vitamin D consumption on nephrotic syndrome condition.

 This assessment is a clinical trial study in which 30 patients with nephrotic syndrome were included in the study. In addition to the usual treatment of nephrotic syndrome, vitamin D injections were also used, in which vitamin D was administered as a 300,000 unit ampule, with a volume of one cc, dissolved in 5 cc of olive oil and injected. Two months later, the level of vitamin D and the nephrotic syndrome status was evaluated and the two indicators were compared.

 Mean and standard deviation of the age was 3.05 ± 9.37 years, 16 patients (53.3%) were male and 14 cases (46.7%) were female. Regarding the response to treatment, 3 patients (20%) had mild, 10 patients (66.6%) had moderate and 2 patients (14%) had severe nephrotic syndrome. In the group with normal levels of vitamin D, 3 patients (20%) had mild, 11 (73.3%) patients moderate and 1 patient (6%) had severe nephrotic syndrome.

 Based on our results, vitamin D consumption did not have a considerable effect on improving the clinical status of patients with nephrotic syndrome.

 Sonographic evaluation of the kidneys is a key diagnostic step in determining kidney disorders. Previous studies have suggested that sonographic evaluation helps clinicians in determining the causes of either acute or chronic renal diseases.

 The present study aimed to assess the role of ultra-sonography in acute and chronic renal pathologies.

 In this study, 29 patients with parenchymal kidney disease referred to Nephrology Department of Imam Reza Hospital, Tabriz, Iran, participated. The patients’ demographic information, internal diseases, kidney diseases, and other medical conditions were recorded. Then the Doppler and gray scale sonography were performed for both kidneys. Biopsies were taken from patients and were then compared with sonographic findings. The data were analyzed with SPSS software version 22.

 According to pathologic findings, 69% of renal diseases was acute, and 31% of the diseases were chronic. According to the results of Gray Scale ultrasonography, there was a significant correlation between parenchyma thickness, cortex echogenicity (qualitative), medula echogenicity (qualitative and quantitative), and corticomedullary differentiation (quantitative) with pathologic findings (P < 0.05). Furthermore, no significant correlation was observed between the length of the kidney, cortex echogenecity (quantitative), and cortico-medullary differentiation (qualitative) with pathological findings (P < 0.05). In addition, there was a significant correlation between RI and pathologic findings based on Doppler ultrasonography (P < 0.05).

 According to the results of this study, ultrasonography and color Doppler would be useful as an assistance and non-invasive method for the diagnosis and differentiation of the conflict site and the type of pathology involved in all parenchymal kidney disorders

 Varicocele is an important cause of infertility in men. Some studies have suggested that because of the similar pathologic processes involved in chronic venous diseases and varicocele, saphenofemoral insufficiency is an example of chronic venous disease, which causes varicose veins in the lower extremity. It is thought that there may be a relation between saphenofemoral abnormality and the emergence of varicocele, but this relation is not backed by sufficient evidence.

 In this prospective diagnostic study, a total of 50 patients suffering from varicocele and 50 control patients were included. Ultrasonography was performed to determine the emergence of saphenofemoral insufficiency (SFI).

 Mean age of patients in the varicocele group and the control group was 32.4 ± 8.44, and 34.9 ± 6.39, respectively. Out of 50 patients being included in the study with varicocele, 8 had left sided SFI and 9 had right sided SFI, while in the control group, 4 patients were diagnosed with SFI, 2 on each side. The difference between the two groups was statistically significant. There was no relation between the time from diagnosis of varicocele, side of varicocele and the existence of saphenofemoral insufficiency.

 Saphenofemoral insufficiency was shown to be significantly related to varicocele, and can be a sign of probability of emergence or re-emergence of varicocele, and further can be used in clinical examination to guide clinicians in diagnosing varicocele.

 A different degree of severity of inflammation was detected in the bladder biopsy specimens; however, the cellular mechanisms of inflammation in interstitial cystitis/bladder pain syndrome (IC/BPS) and the processes leading to tissue damage and fibrosis are not yet completely clear.

 The aim of this study was to determine the leukocyte and mast cell infiltration to the bladder tissue in various experimental models of IC/BPS.

 Various IC/BPS models have been generated using white New Zealand rabbits. Animals were divided into 4 groups depending on the type of the model: (1) The introduction of 0.5% HCl into the bladder; (2) The introduction of urine taken from the bladder into the wall of the bladder; (3) The introduction of 0.9% NaCl; (4) Intact animals. The number of cells in the tissues of the bladder was evaluated in points and histological analysis of the tissues of the bladder wall was performed. The analysis was carried out after 14 days of modeling.

 Mast cells were determined only in groups 1 and 2 (P < 0.001). In the 2nd group, developing necrosis and mixed inflammatory infiltration, giant, necrotic, multinucleated histiocytes were noted. In group 3, tissue edema and single scattered lymphocytes were noted.

 The association of high inflammatory cell infiltration in the chemical version of the IC/BPS model and mast cell infiltration with impaired bladder integrity has been established.
 

 CNS toxoplasmosis may involve patients receiving immunosuppressive drugs. Due to sharing common symptoms, it is difficult to distinguish neurotoxoplasmosis from other CNS disorders. This report investigated an unusual neurotoxoplasmosis in a patient with glomerulonephritis receiving rituximab.

 The clinical case was a 23-year old male patient admitted with fever, vomiting, and acute progressive headache. He received rituximab (375 mg/m2 body surface area for four doses) and prednisolon (1 mg/kg) for diffuse proliferative glomerulonephritis (DPG) two months ago. The MRI results showed subretinal mass, and multifocal brain and retinal abscesses. The possible symptoms of toxoplasmosis were treated with vancomycin, ceftriaxone, metronidazole, and cotrimoxazole.

 In patients treated with rituximab, neurological manifestations can be a definitive diagnosis for cerebral toxoplasmosis. Since it is a serious and even fatal disease, patients with unknown neurological symptoms should receive empirical treatment.