Comparative Study in Sexual Function between Male Renal Transplant Recipient and ESRD Patients on Hemodialysis

Background erectile function is greatly affected in patients with chronic renal failure which manifest itself with various grades of erectile dysfunction which is reflected on physical and psychosocial health of the patients which has a significant impact on quality of life (QOL). Purpose to evaluate erectile function in CRF patients on regular hemodialysis versus post renal transplant patients. Patients and Methods the study included 50 patients recruited from urology and nephrology outpatient clinic in El Zaitoon and Naser Institute Hospitals during a period of 6 months. The 50 patients were divided into two groups: chronic kidney disease group (DIALYSIS) and renal transplant group (TRANSPLANT). Results the domains concerning the sexual performance of IIEF-5 showed that in our study erection function domain showed better results in renal transplantation group (p < 0.003) with median(IQR) in the CKD and renal transplant patients 10(40%) and 15(60%) respectively. Conclusion successful kidney transplantation can significantly improve ED in CKD patients, especially in individuals with a shorter time on dialysis. Changes in sex hormone levels may contribute to this improvement in ED.

URINARY LEAD CONCENTRATION IN CHRONIC KIDNEY DISEASE PATIENTS AT NEPHROLOGY CLINIC IN SABAH

Presently, scientific knowledge on the association between urinary lead concentration and renal profile is limited, especially on the characteristic of urinary lead that could aggravate existing kidney disease. This study aims to determine the concentration of urinary lead with serum creatinine and blood urea nitrogen in chronic kidney disease patients and to identify the influences of confounding factors and the blood pressure on the chronic kidney disease patients. Graphite Furnace Atomic Absorption Spectrometer was used to determine the urinary lead concentration. The differences and correlation of urinary lead with serum creatinine, blood urea nitrogen and diastolic blood pressure between the chronic kidney disease patients and control groups were assessed using Mann Whitney U and Spearman correlation tests. Our findings indicated a significantly higher urinary lead concentration in the chronic kidney disease group compared to the control group (p-=0.002). Nevertheless, there is a weak relationship between urinary lead with serum creatinine, blood urea nitrogen and diastolic blood pressure in the chronic kidney disease group (r values: -0.123, 0.101, and 0.127). In addition, sociodemographic factors did not influence the concentration of urinary lead (p>0.05). The urinary lead concentration in the chronic kidney disease group is not substantial, thus the evidence of urinary lead accumulation in chronic kidney disease group who have yet to start renal replacement therapy is inconclusive.

The Dose per Fraction May be correlated with Late Kidney Toxicity after Total Body Irradiation: a Single Institution Experience

Background: The purpose of the present study was to retrospectively evaluate the subacute or late toxicities in the kidney, lung, and liver after two total body irradiation regimens, 12 Gy in 6 fractions (group A) and 12 Gy in 4 fractions (group B). Methods: Forty-two patients who underwent total body irradiation (group A, n=32; group B, n=10) between June 1997 and June 2013 were included in the present study. The median follow up period was 60 months (range: 3–219 months) for the patients in group A and 143 months (range: 5–220 months) for the patients in group B. We evaluated the renal, pulmonary, and hepatic toxicities using the Common Terminology Criteria for Adverse Events version 4.0. Results: There were 4 cases of chronic kidney disease (group A, n=1; group B, n=3). Although the cumulative incidence of chronic kidney disease differed significantly between the two total body irradiation regimens (p=0.014), the pulmonary and hepatic toxicities did not differ to a statistically significant extent. Conclusion: The present study suggests that a higher dose per fraction caused a higher incidence of chronic kidney disease.

Incidence of tuberculosis in nondialysis-requiring CKD patients

Background: Tuberculosis is a common infection of chronic kidney disease patients in developing countries.Methods: A retrospective study of 2960 non-dialysis requiring chronic kidney disease patients was made to determine the incidence and understand the demographic features of patients that lead to the development of tuberculosis on the basis of cell count, routine, ADA estimation, ZN stain, culture and PCR.Results: Between Jan 2000 and March 2017, the incidence of tuberculosis in no dialysis-requiring chronic kidney disease group was 10.3% in which pulmonary tuberculosis was 3.9% while extrapulmonary tuberculosis was 6.4%. Among extrapulmonary tuberculosis, 52% positivity was seen in pleural effusion, 16.40% in ascetic fluid, 10.10% in lymphnodes, 7.4% in urinary tract, and 3.7% in CSF, 2.6% in pericardial fluid, 1.6% in adrenal tissue and 1.1% in spine. ZN stain was positive in 48.6%, culture isolated mycobacterium 98.3%, PCR 93.4%, the mean ADA levels was 22.90+11.24 IU/ml and 60.49+07.24 IU/ml in CSF and body fluids respectively. Outcome analysis revealed 15.4% mortality rate in diagnosed tuberculosis cases while maximum loss of life was seen in diabetic patients.Conclusions:In the present study we observed 10.3% incidence of tuberculosis among nondialysis-requiring chronic kidney disease patients. Extrapulmonary form of tuberculosis predominates over pulmonary form. Unusual presentation and lococalization of symptoms should not be overlooked. Prompt and early diagnosis of tuberculosis is especially required in endemic areas.