Nephro-Urology Monthly
Volume:12 Issue: 3, Aug 2020

Urolithiasis is a disorder that has a high prevalence in the population. Also, lithiasic patients have biochemical alterations that predispose them to the formation of stones. The knowledge of these alterations may be useful for future preventive interventions.

The objectives were to describe the metabolic characteristics of patients with oxalocalcic lithiasis, identifying the most frequent biochemical alterations, and their variation with different demographic variables. In this way, we can prevent the formation of the lithiasis before it appears, instead of treating it once established.

A descriptive cross-sectional study of serum and 24 hour-urine parameters in patients with oxalocalcic lithiasis was performed. The most frequent biochemical alterations were described, and their association with age, sex, and body mass index (BMI) were assessed.

In this study, 100% of the 151 patients had biochemical alterations, the most frequent being hypocitraturia (84.7%), hypercalciuria (51.7%), and urinary pH decrease (44.4%). There were differences according to sex, age, and BMI with regard to the biochemical alterations. Hypouricemia, hypouricosuria, hypophosphaturia and hypomagnesuria were more frequent in women. Men had a higher percentage of hyperzinquemia, hyperphosphaturia, and excess of urinary urea. Urine density in men was slightly higher than in women. A higher percentage of hyperphosphaturia, excess urinary urea, and excess of serum urea was found in overweight patients. Patients not overweight showed a higher percentage of hypouricemia and hypomagnesuria. Urinary density was slightly higher in overweight patients. Urinary volume was higher in middle-aged subjects.

Patients with oxalocalcic lithiasis have biochemical alterations that may predispose to stone formation. These alterations vary with sex, age, and BMI.

There is a lack of consensus regarding the role of oral antibiotics following hypospadias repair.

The study aimed to evaluate the role of oral antibiotic use following stented Tubularized incised plate urethroplasty (TIPU) in the prevention of bacteriuria and urinary tract infections (UTIs).

A prospective study was conducted on 40 patients undergoing stented TIPU for coronal hypospadias between January 2014 and December 2016. The average age of the subjects was 13.2 months at the time of surgery, ranging from 11 to 16 months. The patients were divided into two groups. Group A consisted of 20 patients receiving oral antibiotics until urethral catheter removal, whereas group B consisted of 20 patients without any oral antibiotics postoperatively.

The two groups were followed for three years. The urethral catheter was removed eight days postoperatively in the two groups. In group A, the patients received oral antibiotics as long as the catheter was left in situ. Urine samples were collected from the patients and sent for analysis and culture at the time of stent removal and after three weeks. The results showed that 3/20 (15%) patients from group A had pyuria and bacteriuria, while all of them had negative urine culture results. On the other hand, in group B, 8/20 (40%) patients had pyuria and bacteriuria (P > 0.05), and four (20.0%) patients had positive urine cultures for Escherichia coli (P < 0.05), sensitive to co-trimoxazole. None of the patients in the two groups had febrile UTI.

The use of oral antibiotics for patients following stented TIPU reduces pyuria and significantly decreases positive urine culture results and the risk of UTI after surgery

Cystic Fibrosis (CF) is a systemic autosomal disorder and themost important chronic lung disease in children. Oxalate is the end product of vitamin C metabolism, which increases the risk of kidney stones, urinary bladder stones, and calcium deposits in CF patients.

Considering the increased mineral excretion and the rate of stone formation in the urinary tract, examining the excretion of minerals will greatly help resolve clinical problems.

This descriptive-analytical study was performed on CF and healthy children in Gorgan in 2018 - 19. In this study, 40 CF children and 40 healthy children were randomly selected. After obtaining informed consent from the parents of the children, a random urine sample was collected to evaluate urine minerals. Children with abnormal urinary mineral excretion underwent ultrasonography. The data were analyzed by SPSS 18 using descriptive indices (mean ± SD, frequency, and percentage) and statistical tests (independent t-test, chi-square test, and nonparametric tests).

Out of 80 CF and healthy children, 34 were girls, and the rest was boys. The mean age of the patients was 4.34 ± 3.38. The age difference was not significant between the groups (P > 0.05). The mean urinary levels of phosphorus, uric acid, magnesium, and citrate were 0.87 ± 1.01, 1.16 ± 0.68, 0.23 ± 0.18, 2.37 ± 3.13 mg/mg of creatinine. In the pediatric patient group, respectively (P < 0.001). The mean urinary calcium level in CF patients was 0.28 ± 0.39, which was lower than that in the healthy group. The mean urinary oxalate level was 0.13 ± 0.20 in CF patients, which was higher than that in the healthy group (P > 0.05). Hyperoxaluria, hyperuricosuria, hypomagnesiuria, and hypocitraturia occurred in 35, 30, 62, and 7.5% of the CF patients, respectively. Among the urinary minerals studied, hyperoxaluria was found to be a major determinant of stone formation risk in CF. No correlation was observed between the formation of stones and the rate of excretion of minerals (P > 0.05).

In summary, CF patients are at an increased risk of developing citrate and calcium stones compared to the healthy group, which is associated with hyperuricosuria, hypocitraturia, and hyperoxaluria.

Fabry disease is a genetic disorder caused by the deficiency of the lysosomal α-galactosidase A enzyme. This failure generates the storage of globotriaosylceramide in different cells with a progressive multi-organ involvement.

To report the prevalence of glomerular hyperfiltration in Fabry disease patients and the association with clinical variables.

Adult patients (≥ 18 years) at the moment of FD diagnosis were evaluated. The variables studied were: central and peripheral nervous system compromise, presence of arterial hypertension, cardiac arrhythmia, left ventricular hypertrophy, albuminuria/proteinuria, cornea verticillata, gastrointestinal involvement, treatment with inhibitors of the renin-angiotensin-aldosterone system, deafness, and presence of angiokeratomas.

Forty-eight adults with Fabry disease (35.9 ± 11.7 years), 28 women (58.3%), and 20 men (41.7%) were analyzed. Nine (18.8%) patients with glomerular hyperfiltration, including six females and three males (mean age: 28.8 years), were detected. A significant association between and central nervous system (P = 0.021) and peripheral nervous system (P = 0.001) compromise, cardiac arrhythmia (P = 0.001), cornea verticillata (P = 0.009), and gastrointestinal involvement (P = 0.009) was observed. However, no association was found between glomerular hyperfiltration and proteinuria or treatment with inhibitors of the renin-angiotensin-aldosterone system.

This research showed a higher prevalence of glomerular hyperfiltration in the younger group and a significant association between glomerular hyperfiltration and some typical manifestations of classic Fabry patients. Although more studies are needed, it is concluded that other mechanisms than glomerular hyperfiltration, like injury by glycosphingolipids deposit into the filtration barrier, might influence the protein loss in Fabry nephropathy

Hemodialysis patients require self-care training to manage their problems. To understand the effectiveness of different educational methods, it is necessary to evaluate these methods using knowledge, attitude, and practice assessment tool.

The current study aimed to compare the effects of group discussion and teach-back self-care education on the knowledge, attitude, and performance of hemodialysis patients.

This quasi-experimental study is conducted on 67 patients who were undergoing hemodialysis via fistula for at least 6 months. Using the convenient sampling method, the patients were randomly allocated into two groups: teach-back training (n = 34), and group discussion (n = 33). Both groups were provided with three sessions of self-care training on nutrition, activity, and fistula care by the researcher. Considering the teaching materials, patients in the teach-back group were taught individually to ensure complete comprehension of the information. On the other hand, subjects in the group discussion were exposed to the teaching materials in the form of group training. Data were collected before and one month after providing the training sessions.

In this study, the majority of patients in both groups were married men with an average age of 52 years. Following education, knowledge, attitude, and performance increased in both groups. However, the teach-back method (113.88 ± 4.13) had a higher impact on the attitude of patients than group discussion (110.48 ± 5.68) (P = 0.009).

Teach-back education increased the knowledge, performance, and attitude of patients. It is, therefore, recommended to use this method for patients with negative attitudes toward treatment and disease.

Pulmonary artery hypertension (PAH) is linked with morbidity and mortality in hemodialysis (HD) patients. The relationship between serum parathyroid hormone (PTH) and PAH is still a subject of debate.

The goal of the present study was to assess the association between PTH and PAH among HD patients.

This was a cross-sectional study that assessed HD patients in a tertiary hospital in Mashhad, Iran. Echocardiography was performed for all patients to measure pulmonary artery pressure (PAP) and ejection fraction. Laboratory data, including serum calcium, phosphorus, vitamin D, serum albumin, and alkaline phosphatase, were extracted from patient documents. The statistical tests included independent t-test, Mann-Whitney, chi-squared test, and logistic regression.

A total of 78 patients (43 males and 35 females) participated in this study. The mean age was 37.25 ± 11.98 years old. There was a significant difference in the PAH distribution pattern between hyperparathyroidism and normal PTH groups (P = 0.003). PAH was significantly related to hyperparathyroidism (P = 0.004, OR = 4.557), age (P = 0.033, OR = 0.944), and calcium level (P = 0.005, OR = 0.336). After adjusting for other variables, the odds ratio for the relationship between PAH and hyperparathyroidism increased to 7.593.

The findings of this study supported the possible link between hyperparathyroidism, serum calcium level, and PAH in HD patients.

Nowadays, the quality of life of hemodialysis patients has decreased, which doubled the need for educational interventions.

The current study investigated the effect of positive thinking training on different dimensions of quality of life of hemodialysis patients.

This is a controlled clinical trial study conducted on 70 hemodialysis patients in Fasa, Fars province, in 2019. The patients were selected using the simple sampling method. Then, they were divided into two groups of intervention (n = 35) and control (n = 35). After obtaining informed consent, the researchers asked the participants to complete the SF-36 Quality of Life Questionnaire. The intervention group was trained positive thinking skills in 8 workshop sessions; each lasted for 90 minutes. Data were analyzed using SPSS version 20. To analyze the data, statistical tests such as chi-square, Kolmogorov-Smirnov, independent, and t-test were used.

The mean and standard deviation of the patients’ quality of life in the intervention group increased from 35.95 ± 10.07 to 55.98±11.71 (P < 0.001). The changes in patients’ quality of life before and after the intervention were also assessed in 8 dimensions, which showed that the quality of life of the patients did not change significantly in terms of physical function (P = 0.42) and physical pain (P = 0.62), but for other dimensions, it was significantly increased (P < 0.001).

Positive thinking training improved the quality of life of hemodialysis patients, particularly in the dimensions of the emotional role, emotional health, energy and vitality, social performance, and general health is recommended.

Pyelonephritis as a life-threatening infection often leads to renal scarring, which presumably controls by minerals.

The aim of this study was pyelonephritis treatment by vitamin A in children.

In the current study,106 cases from Imam Reza pediatric clinic and Amir-Kabir Hospital, considered a study group. Children divided into groups with or without urinary incontinence. Demographic data, clinicalmanifestations, and urinary biomarkers were evaluated and then statistically analyzed.

Our data showed that there is a statistical difference between study groups in terms of dysuria (P = 0.001), abdominal pain (P = 0.001), frequency (P = 0.003), incontinency (P = 0.001), urgency (P = 0.002), intermittency (P = 0.004) and fever (P = 0.002).

It has been assumed that vitamin A as a therapeutic agent could be used in children with vesicoureteral reflux induced by Pyelonephritis and congenital anomalies.