Frequency: Quarterly E- ISSN: 2347-2472 P- ISSN: Awaited Abstracted/ Indexed in: Ulrich's International Periodical Directory, Google Scholar, SCIRUS, getCITED
Quarterly published in print and online "Inventi Impact: Urology & Nephrology (Formerly Inventi Impact: Kidney)" publishes high quality unpublished as well as high impact pre-published research and reviews catering to the needs of researchers and professionals. The journal welcomes papers in all the areas of nephrology practices and clinical research. It encourages submissions of latest findings related to pathogenesis and treatment of kidney diseases, hypertension, acid-base and electrolyte disorders, dialysis therapies, and kidney transplantation.
We report a case of IgG4-related disease presenting both tubulointerstitial nephritis\nand retroperitoneal fibrosis causing acute renal failure in a 63-year-old male. He was\nadmitted to our hospital because of acute renal failure requiring emergent hemodialysis.\nComputed tomography showed a soft-tissue density mass with an irregular\nborder in the retroperitoneum. The mass involved bilateral ureters and had caused\nacute renal failure by bilateral hydronephrosis. Because of a history of uveitis and\nhigh IgG4 levels, we considered a diagnosis of retroperitoneal fibrosis, IgG4-related\ndisease. Kidney biopsy revealed IgG4-related kidney disease with interstitial nephritis.\nAfter relief of urinary obstruction by inserting ureteral catheters into the bilateral\nureters, renal function recovered....
In the decades, since the advent of shockwave lithotripsy, instrumentation and\ntechniques in both ureteroscopic and percutaneous stone management have\nimproved exponentially, leading to both increased success and lower complication\nrates. As a result, there have been some controversies revolving around the\ntherapeutic modality of choice for specific stones in terms of their size and location.\nThis review seeks to provide some clarity to the decision-making process\nwith emphasis on patient comfort and choice and due consideration being given\nto the potential complications associated with the various treatment modalities....
Background: To what extent uric acid (UA) levels and/or metabolic syndrome (Mets) contribute to\nthe onset of chronic kidney disease (CKD) is largely unknown. The present study explores how these\ntwo factors have an association with the new incidence of CKD. Methods: Study design is a cohort\nstudy. A total of 14,485 participants were eligible for the cross-sectional analysis on UA levels and\nthe prevalence of Mets. Among those individuals, 8,223 participants without CKD and 4,839 without\nMets were eligible for the longitudinal analysis of the new incidence of CKD. Parameters monitored\nwere body mass index, systolic and diastolic blood pressure, serum creatinine concentration, estimated\nglolerular filtration rate, lipid profiles, plasma glucose, HbA1c. The primary predictor was the\nlevel of UA and Mets to explain the newly-developed CKD. The observation period was 4 years. Results:\nIn a cross-sectional analysis, higher UA levels were associated with the greater prevalence of\nMets. In addition, UA levels were associated with the numbers of the Mets constituents in both genders.\nIn a longitudinal analysis, higher UA levels were associated with the greater rate of CKD and the\ngreater incidence of Mets. In addition, the incidence of CKD at year 4 was influenced by the presence\nof hyperuricemia, but not by that of the Mets. The odd ratio (OR) to predict the CKD incidence was\n1.42 (95% confidence intervals (CI), 0.52 to 3.78) in the presence of Mets alone, 2.10 (95% CI, 1.36 to\n3.23) in the presence of hyperuricemia alone, and 3.56 (95% CI, 1.55 to 8.21) in the presence of both.\nConclusion: Hyperuricemia has a greater association with the incidence of CKD than Mets does.\nHyperuricemia complicated by Mets is additionally detrimental....
Background: Researchers have developed several equations to predict glomerular filtration rate (GFR) in patients\nwith chronic kidney diseases (CKD). However, there are scarcely any studies performed to discern the best equation\nto estimate GFR in patients with pure obstructive nephropathy. In present study, we assessed the suitability of six\nprediction equations and compared their performance in eGFR evaluation for Chinese patients with obstructive\nnephropathy.\nMethods: A total of 245 adult patients with obstructive nephropathy were enrolled. We evaluated the performance\nof the 3 Modification of Diet in Renal Disease equations (MDRD) (the original MDRD7, 7MDRD; the abbreviated\nMDRD, aMDRD; and re-expressed abbreviated MDRD, re-aMDRD) and 3 Chronic Kidney Disease Epidemiology\nCollaboration equations (CKD-EPI) (CKD-EPI equation based on creatinine alone, CKD-EPIcr; CKD-EPI equation based\non cystatin C alone, CKD-EPIcys; CKD-EPI equation based on combined creatinine-cystatin, CKD-EPIcr-cys). The\nmeasured GFR (mGFR) by 99mTc-DTPA renal dynamic imaging method was used as the reference GFR.\nResults: The mean age of the study population was 51.61 Ã?± 14.17 and 131 were male (53.47 %). The mean\nmeasured GFR was 66.54 Ã?± 23.99 ml/min/1.73 m2. Overall, the CKD-EPIcr-cys equation gave the best performance\nwith the best correlation (R = 0.72) and agreement (âË?â??34.87, 40.83). CKD-EPIcr-cys equation also exhibited the highest\naccuracy (69.39 %, P < 0.01) and diagnostic efficacy (ROCAUC = 0.874) with the smallest bias (2.98, P < 0.01). In the\nsubgroup of the lowest GFR, CKD-EPIcys equation exhibited the highest accuracy (52.69 %) and the smallest bias\n(0.27). In the youngest age subgroup, CKD-EPIcys equation had the highest accuracy (71.64 %) and the smallest bias\n(âË?â??1.24). In other subgroups stratified by GFR, age and gender, CKD-EPIcr-cys equation remained the best\nperformance.\nConclusion: The 3 CKD-EPI equations performed better than the 3 MDRD equations in estimating GFR in Chinese\nobstructive nephropathy patients; while the CKD-EPI equation based on combined creatinine-cystatin C provided\nthe best estimation of GFR....
Background. To measure International Normalized Ratio (INR) in hemodialysis patients with tunneled dialysis catheters (TDCs),\nblood sampling is frequently obtained via the catheter at the start of the session. INR measurements via finger-prick point of care\ntesting (POCT) and via blood sampling taken from the dialysis circuit are evaluated as alternatives. Methods. In 14 hemodialysis\npatients with TDCs, treated with vitamin K antagonists (VKA), INR measurements via POCT were compared with plasma INR\nsamples taken via the catheter at the start of dialysis and via the dialysis circuit after 30 and 60 minutes during 3 nonconsecutive\ndialysis sessions. Results....
Background: There were 800 individual case reports of urogenital foreign\nbodies in the English literature from 1755 to 1999. The use of urogenital\nforeign bodies for sexual pleasure is a common occurrence in todayâ??s population.\nThe aim of this discussion is the management of scrotal injury\ncaused by magnetic urogenital foreign bodies. Case Presentation:\n56-year-old male with scrotal tissue entrapped between two opposed magnet\nrings. Self-reported attempts at removal were unsuccessful and caused\nfor presentation to the emergency department. Additional attempts at removal\nby medical staff unsuccessful in emergency department and therefore\nthe patient proceeded to the operating room. Intraoperatively the use of two\ncardiac magnets allowed for removal without a need for invasive surgical\nprocedure. Conclusion: Cardiac magnets are preferred means of removal for\nentrapped skin between magnetic foreign bodies that could be utilized at the\nbedside....
Introduction: Metformin-associated lactic acidosis (MALA) is a rare but life-threatening condition. Here, we report the outcome of a patient with MALA complicated by acute coronary syndrome. Case presentation: A 47-year-old obese woman of Caucasian ethnicity was admitted for syncope and tachypnea with Kussmaul breathing. She had a type-2 diabetes and was on oral antidiabetic therapy. Hemoglobin A1c was 6.6%. On admission, a severe acute kidney injury (serum creatinine: 1251 μmol/L) with hyperkalemia (7.5 mmol/L) and severe lactic acidosis (ph:7.042, bicarbonate: 9.9 mmol/L, partial pressure of carbon dioxide: 21.8 mmHg, lactate: 20.0 mmol/L) was found. Despite bicarbonate therapy, ph further decreased. Within 2.5 h of admission, a temporary hemodialysis catheter was placed, and one session of a high-efficiency hemodialysis was performed. 8 h after admission, a continuous venovenous hemodiafiltration was initiated and maintained for 2 days. The metformin therapy was stopped. Supplemental oxygen, intravenous catecholamines (4 days) and antibiotic therapy (7 days) were applied. During this therapy of lactic acidosis, an acute coronary syndrome evolved by day 2 after admission and resolved by day 5 in hospital. After recovery, the patient was transferred to a general ward on day 7 and left the hospital on day 11. By discharge, both the acute kidney injury and the acute coronary syndrome were reversible. Conclusion: In the patient with MALA complicated by acute coronary syndrome, the combination of a high-efficiency hemodialysis and, consecutively, continuous venovenous hemodiafiltration led to a favorable outcome....
Background: Currently used biomarkers for acute kidney injury (AKI), namely Ngal, SCr, and BUN, are\r\ninadequate for timely detection of AKI in preterm infants.\r\nMethods: Nuclear magnetic resonance (NMR) spectroscopy-based metabolic profiling was conducted on urines\r\nfrom 20 preterm infants to determine if novel metabolic biomarkers could be identified for early detection of AKI.\r\nUrines were collected from every patient each day for the first 14 days of life. NMR spectra were measured for all\r\nurines and metabolic profiling analysis conducted.\r\nResults: One metabolite, carnitine, increased significantly in urines of three extremely low birth weight (ELBW)\r\ninfants starting on day five of life. The three affected infants either received prolonged antibiotic treatment, extended\r\ntreatment with indomethacin, or both. One ELBW patient who received both treatments and reached the highest\r\nurinary carnitine level died on day 10 of life due to localized gut perforation complicated by suspected AKI.\r\nConclusions: It was concluded that carnitine increased in the three neonates in part due to antibiotic- and/\r\nor indomethacin-induced AKI. It is hypothesized that combined antibiotic and indomethacin treatment promoted\r\nAKI resulting in reduced proximal renal tubule reabsorption of carnitine and that �Ÿ-lactam antibiotics blocked renal\r\ncarnitine uptake by human organic cation transporter, hOCTN2....
Background: Results from randomized phase III trials have shown that thrice-weekly docetaxel added to androgendeprivation\ntherapy (ADT) has a significant impact on the survival of patients with metastatic castration-naïve prostate\ncancer (mCNPC) and established early chemotherapy as part of the standard of care for high-risk disease. Controversy\nremains, however, because some patients experience critical toxicities related to docetaxel. The purpose of the current\nstudy was to evaluate the feasibility and adverse events of biweekly-administered docetaxel in patients with previouslyuntreated,\nhigh-risk mCNPC.\nMethods: The study included 35 consecutive patients with high-risk mCNPC who received ADT plus docetaxel 40 mg/\nM^2. Oral prednisone 5 mg twice daily was also given. Treatment was repeated every two weeks for up to 12 cycles or\nuntil disease progression or unacceptable toxicity occurred. High-risk was defined as bone metastases beyond axial\nskeleton and/or visceral disease.\nResults: The included patientsâ?? median age was 68 years (range: 31-86 years) and 17 (49%) had visceral metastases.\nBiweekly docetaxel was generally well-tolerated; the most commonly observed adverse events, considering those of all\ngrades, included alopecia (74%), nail changes (42%), and constipation (31%). Hematologic adverse events were\ninfrequent, and no patient received hematopoietic growth factors. One patient died after the fourth cycle due\nto respiratory failure, which occurred as a complication of pneumonia. Among the 35 patients, 28 completed\nthe planned 12 cycles of biweekly docetaxel. Prostate-specific antigen response (> 50% decrease from baseline)\nwas recorded in 33 patients (94%), and the radiologic response rate was 49%. Median progression-free survival was\n13.6 months (95% confidence interval: 6.7-20.4).\nConclusion: ADT plus biweekly-administered docetaxel appeared to be tolerated and effective in patients with\nhigh-risk mCNPC....
Background: Patients with end-stage renal disease (ESRD) have multiple comorbid conditions. Obtaining comorbidity\ndata from medical records is cumbersome. A self-report comorbidity questionnaire is a useful alternative. Our aim in this\nstudy was to examine the predictive value of a self-report comorbidity questionnaire in terms of survival in ESRD patients.\nMethods: We studied a prospective cross-sectional cohort of 282 haemodialysis (HD) patients in a single centre.\nParticipants were administered the self-report questionnaire during an HD session. Information on their comorbidities was\nsubsequently obtained from an examination of the patientââ?¬â?¢s medical records. Levels of agreement between parameters\nderived from the questionnaire, and from the medical records, were examined. Participants were followed-up for 18\nmonths to collect survival data. The influence on survival of comorbidity scores derived from the self-report data\n(the Composite Self-report Comorbidity Score [CSCS]) and from medical records data - the Charlson Comorbidity Index\n[CCI] were compared.\nResults: The level of agreement between the self-report items and those obtained from medical records was almost\nperfect with respect the presence of diabetes (Kappa score ? 0.97), substantial for heart disease and cancer (? 0.62 and\n? 0.72 respectively), moderate for liver disease (? 0.51), only fair for lung disease, arthritis, cerebrovascular disease, and\ndepression (? 0.34, 0.35, 0.34 and 0.29 respectively). The CSCS was strongly predictive of survival in regression models\n(Nagelkerke R2 value 0.202), with a predictive power similar to that of the CCI (Nagelkerke R2 value 0.211). The influences\nof these two parameters were additive in the models ââ?¬â?? suggesting that these parameters make different contributions\nto the assessment of comorbidity.\nConclusion: This self-report comorbidity questionnaire is a viable tool to collect comorbidity data and may have a role in\nthe prediction of short-term survival in patients with end-stage renal disease on haemodialysis. Further work is required in\nthis setting to refine the tool and define its role....
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