Conventional hemodialysis (HD) is the most common treatment modality used for renal replacement therapy. The concept of HD is based on the diffusion of solutes across a semipermeable membrane. Hemofiltration (HF) is based on convective transport of solutes; hemodiafiltration (HDF) is based on combined convective and diffusive therapies.
View Article and Find Full Text PDFSummary We report a case of a 56-year-old woman with a high-grade diffuse large B-cell lymphoma who unexpectedly developed toxic plasma levels of methotrexate (MTX) following the first cycle of rituximab-cyclophosphamide, hydroxydanorubicin, oncovin, prednisolone (R-CHOP) with a high-dose MTX chemotherapy protocol. She also developed non-oliguric acute kidney injury secondary to MTX nephrotoxicity. We elected to treat her with online-haemodiafiltration (HDF) and this proved to be efficient with a dramatic response.
View Article and Find Full Text PDFMany patients with established end-stage renal disease on maintenance dialysis as a result of lupus nephritis are young females in their reproductive years. We report two such patients dialyzed with on-line hemodiafiltration who developed reactivation of lupus disease activity only when they conceived after initial systemic lupus erythematosus burnout. We believe that the flare was triggered by both efficient dialysis and hormonal changes during pregnancy.
View Article and Find Full Text PDFPreserved anatomical integrity of the anterior abdominal wall is considered important in the presurgical evaluation of a patient who is being considered for placement of a peritoneal dialysis (PD) catheter. Diastasis recti abdominis (DRA) is the excessive widening or separation between the two bellies of the rectus abdominis muscle. The separation can occur anywhere along the linea alba and at times has been found to span the entire length from the xiphosternal angle to the pubic bone.
View Article and Find Full Text PDFSaudi J Kidney Dis Transpl
July 2010
Rupture of the spleen is a life threatening condition. We report a 40-year-old fe-male patient, a known case of lupus nephritis receiving hemodialysis, who developed spontaneous rupture of the spleen during the course of her illness. The patient was managed conservatively with gradual regression of hematoma without further complications.
View Article and Find Full Text PDFIn this report we present two cases of acute renal failure in paroxysmal nocturnal hemoglobinuria (PNH) patients, who both eventually recovered their renal function. We also highlight some of the possible pathophysiological changes, which may contribute to renal failure in patients with PNH.
View Article and Find Full Text PDFSaudi J Kidney Dis Transpl
October 2012
Background: The incidence of Kaposi's sarcoma (KS) in Sudanese renal transplant recipients is not known.
Methods: We retrospectively assessed the prevalence of KS in 30 Sudanese renal transplant recipients followed for 16 years.
Results: Four patients (13.
We describe a female patient who received double pediatric (en bloc) kidney transplants. She presented initially with fever of unknown origin 3 months after transplantation; 5 months after surgery, she presented with obstruction of one ureter followed by obstruction of the other. After 9 months she developed posttransplant lymphoproliferative disorder in both kidneys.
View Article and Find Full Text PDFBackground: Hepatitis C virus (HCV) is a major cause of hepatitis in hemodialysis (HD) patients. Routes other than blood transfusion play a role in the spread of HCV in HD patients. Molecular studies of HCV implicate nosocomial transmission of the virus in HD units.
View Article and Find Full Text PDFNephrol Dial Transplant
November 1998
Nocardia is a serious opportunistic infection in renal transplant recipients and nocardial brain abscess in these patients has a high mortality. In addition to antimicrobial therapy, treatment usually involves craniotomy and excision of the abscess. We describe a renal transplant recipient maintained on cyclosporine and prednisone developing Nocardia Asteroides brain abscess.
View Article and Find Full Text PDFKaposi's sarcoma (KS) and non-Hodgkin's lymphoma are frequent complications of renal transplantation that usually occur as separate entities. We describe a young woman who simultaneously developed Kaposi's sarcoma and lymphoma after kidney transplantation. Immunosuppression consisted of cyclosporine and prednisone with normal serum creatinine.
View Article and Find Full Text PDFBackground: This study investigates the association between human herpesvirus eight (HHV8) and Kaposi's sarcoma (KS), the most common cancer occurring in renal transplant recipients in Saudi Arabia.
Methods: A cross-sectional study of seroreactivity to HHV8 antigens in posttransplant KS patients from a tertiary care hospital in Riyadh, Saudi Arabia, and in control subjects without KS was conducted. Seroreactivity rates were determined using immunoblotting assays to detect antibodies to two lytic cycle HHV8 antigens: p40, an antigen found in infected cells, and sVCA, an HHV8-encoded small viral capsid antigen expressed in Escherichia coli.
Purpose: To compare the yield and complications of ultrasound-guided gun-biopsy and manual Tru-Cut techniques in percutaneous renal biopsy.
Material And Methods: A total of 448 biopsies were reviewed. They comprised 124 manual and 131 gun-biopsies in native kidneys, and 111 manual and 82 gun-biopsies in transplant kidneys.
The performance of two new hepatitis C virus antibody (anti-HCV) assays (a third-generation immunoglobulin (Ig)G recombinant immunoblot assay (RIBA 3.0) and hepatitis C virus core IgM (HCV IgM) in the prediction of hepatitis C viremia in hemodialysis patients was compared with that of a second-generation IgG recombinant immunoblot assay (RIBA 2.0).
View Article and Find Full Text PDFThe pharmacokinetics of total and free (ultrafilterable) platinum were investigated in a patient with cervical cancer with ureteric obstruction who, at the time of carboplatin administration, appeared to have a mild renal impairment (i.e., creatinine clearance 1 mL/s), but developed an acute renal failure shortly thereafter, which required hemodialysis.
View Article and Find Full Text PDFRenal transplantation offers patients with end-stage renal disease the best opportunity for rehabilitation and long-term survival. However, there is a critical shortage of transplantable kidneys worldwide. This plays well into the hands of transplanters and entrepreneurs involved in commercial renal transplantation, particularly in India.
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