Prevalence and Risk Factors Associated With Acute Kidney Injury After Transcatheter Aortic Valve Replacement at a Tertiary Hospital in Riyadh, Saudi Arabia.

Background: Despite recent advancements in techniques, peri- and post-procedural complications still pose a significant challenge in the high-risk transcatheter aortic valve replacement (TAVR) patient population. This study aims to investigate and assess the prevalence of acute kidney injury (AKI) following TAVR, and to identify the risk factors associated with its occurrence.

Methods: We conducted the study at King Abdulaziz Medical City, Riyadh, Saudi Arabia from January 2016 to December 2022.

Chronic Kidney Disease Education Class Improves Rates of Early Access Creation and Peritoneal Dialysis Enrollment.

Background Most patients with end-stage kidney disease begin hemodialysis (HD) in an unplanned fashion at a late stage, necessitating the commencement of HD with a temporary venous catheter, the least favorable option. Alternative modalities of kidney replacement therapy (KRT), peritoneal dialysis (PD), and preemptive transplant offer similar or better outcomes than HD at a lower overall cost, and yet they remain underutilized in Saudi Arabia. Early education may help prepare patients with advanced chronic kidney disease (CKD IV and V) to accept their disease and choose a KRT modality that minimizes complications and matches their lifestyle.

Splenic Infarcts and Pulmonary Renal Syndrome in a Young Patient with Double-Positive Anti-GBM and ANCA-Associated Vasculitis.

Double-positive disease, defined by double-seropositivity for serum anti-glomerular basement membrane (GBM) antibodies and anti-neutrophil cytoplasmic antibodies (ANCA) is a rare cause of pulmonary-renal syndrome. Here, we present an exceptional course of a 20-year-old male with seropositivity for anti-myeloperoxidase anti-neutrophil cytoplasmic antibodies and anti-GBM antibody, who presented first with renal impairment due to focal necrotizing crescentic glomerulonephritis. After receiving treatment, he presented two years later with a relapse manifesting with diffuse alveolar hemorrhage and multiple splenic infarcts.

The Performance of Equations That Estimate Glomerular Filtration Rate against Measured Urinary Creatinine Clearance in Critically Ill Patients.

The performance of glomerular filtration rate- (GFR-) estimating equations was studied against creatinine clearance measured by 24-hour urine collection (CrCl) in critically ill patients. . In this substudy of the PermiT trial (https://clinicaltrials.

Diabetic Ketoacidosis in Patients with End-stage Kidney Disease: A Review.

Diabetes mellitus is a highly prevalent disease. Chronic kidney disease is one of its chronic complications, and diabetic ketoacidosis is one of the most dreaded acute complications. The increasing prevalence of diabetes mellitus and renal failure has resulted in physicians increasingly encountering diabetic ketoacidosis in this complicated subgroup of patients.

Multi National Survey of the Advice Given to Muslim Kidney Graft Recipients by Muslim Nephrologists about Lifestyle and Religious Rituals with Potential Medical Risk.

Muslim renal transplant recipients often ask their physicians if performing certain lifestyles or religious obligations may be harmful to their health. Permissibility as advised by an expert Muslim physician is considered as being religiously accepted. A cross-sectional, survey-based study was conducted enquiring what nephrologists would advise their transplant recipients to do, about some lifestyles and religious duties.

A case of advanced chronic kidney disease with severe hypocalcemia, how to safely manage and dialyze?

Patients often present with advanced chronic kidney disease (CKD) complicated with severe hypocalcemia that may be accompanied by electrocardiographic changes. The management of this kind of patients may require hemodialysis (HD). However, initiation of renal replacement therapy in this scenario needs special attention to avoid complications such as cardiac arrhythmias.

Attendees' feedback on king abdulaziz medical city pilot chronic kidney disease education class.

Despite similar or better patient outcomes, peritoneal dialysis and pre-emptive kidney transplantation are underutilized in Saudi Arabia. Moreover, most patients with end-stage renal disease begin dialysis in unplanned fashion necessitating the commencement of dialysis using central venous catheter access. We aimed to investigate if early patient education can help in overcoming these barriers.

Atypical antiglomerular basement membranes disease with nephrotic-range proteinuria, mesangial proliferation, and membranoproliferative glomerulonephritis pattern of injury.

Antiglomerular basement membrane (anti-GBM) disease is an uncommon autoimmune disease characterized by the presence of IgG autoantibodies targeting the alpha-3 chain of type IV collagen. Some of the atypical forms of the disease have been described. Herein, we describe a case of atypical anti-GBM in a 27-year-old Saudi male who presented with lower limb edema, gross hematuria, elevated serum creatinine concentration, and nephrotic-range proteinuria.

Time between peritoneal dialysis catheter insertion and use.

Successful performance of peritoneal dialysis (PD) is predicated upon the presence of a properly functioning catheter. Several techniques are available for placing PD catheters among which peritoneoscopic and laparoscopic techniques are gaining broader acceptance. Once placed, PD catheters may be used immediately with low dialysate volumes and a dry day.

Prolonged duration of peritoneal dialysis catheter embedment does not lower the catheter success rate.

Objective: Since 2000, we have used the Moncrief-Popovich technique as our standard method for peritoneal dialysis (PD) catheter insertion. The subcutaneous portion of the catheter is externalized immediately before initiation of PD. We undertook the present review to investigate whether duration of catheter embedment affects catheter or patient outcome.

The use of vasopressin receptor antagonists in hyponatremia.

Introduction: Considerable data have recently characterized hyponatremia as fairly common in the intensive care and general hospital settings. Moreover, mounting evidence suggests the association of mild degrees of hyponatremia with untoward neurocognitive and musculoskeletal outcomes. A key development in our ability to treat hyponatremia was the introduction and approval of aquaretics (vaptans).

Hyponatremia: diagnosis, complications, and management including V2 receptor antagonists.

Purpose Of Review: Recent studies have consistently demonstrated the common prevalence of hyponatremia in the hospital and intensive care settings, and how it correlates with untoward outcomes. This review discusses the classification, diagnosis, and pathophysiology of hyponatremia and how these agents may influence its management, and also examines the available treatment options and their weaknesses and strengths.

Recent Findings: This review is timely and relevant, as mild degrees of serum sodium lowering may be associated with adverse neurologic and musculoskeletal effects.

Interpretation of renal volume in autosomal dominant polycystic kidney disease and relevant clinical implications.

Autosomal dominant polycystic kidney disease (ADPKD) is the most common life-threatening hereditary disease of the kidney. It presents with progressive enlargement of the kidneys with numerous cysts that distort the parenchyma and result in progressive decline in kidney function. Autosomal dominant polycystic kidney disease is genetically modified with the responsible genes localized to separate loci on chromosome 16 (PKD1 gene), accounting for the majority of ADPKD cases, and chromosome 4 (PKD2 gene), accounting for the remainder.

Angiogenic growth factors correlate with disease severity in young patients with autosomal dominant polycystic kidney disease.

Renal cysts, pain, and hematuria are common presentations of autosomal dominant polycystic kidney disease (ADPKD) in children. Renal function, however, is typically preserved in these patients despite increased renal volume. Since angiogenesis has been implicated in promotion of renal cyst growth in ADPKD, we measured the serum level of various angiogenic factors and early renal structural changes and cardiovascular parameters in 71 patients with ADPKD, with a mean age of 16 years.

Aldosterone: role in edematous disorders, hypertension, chronic renal failure, and metabolic syndrome.

The role of aldosterone has expanded from the hormone's genomic effects that involve renal sodium transport to nongenomic effects that are independent of the effect of aldosterone on sodium transport. The nongenomic effects of aldosterone to increase fibrosis, collagen deposition, inflammation, and remodeling of the heart and blood vessels, however, are markedly increased in the presence of high sodium intake. The genomic effect of aldosterone increases renal sodium transport, but the administration of large doses of aldosterone to normal individuals does not cause edema, relating to the phenomenon of "aldosterone escape"; however, in edematous disorders including cardiac failure, cirrhosis, and nephrotic syndrome, impaired aldosterone escape leads to renal sodium retention and edema formation.

Role of vasopressin and vasopressin receptor antagonists in type I cardiorenal syndrome.

The pathogenesis of cardiac failure involves activation of the neurohumoral axis including stimulation of the sympathetic nervous system, the renin-angiotensin-aldosterone, and nonosmotic vasopressin systems. While these responses are critical in maintaining arterial pressure, they are associated with renal vasoconstriction, as well as sodium and water retention. In advanced circumstances, renal dysfunction and hyponatremia occur with cardiac failure.

Rates and causes of peritonitis in a National Multicenter Continuous Ambulatory Peritoneal Dialysis program in Sudan: first-year experience.

This is a cumulative report of all patients in six centers in Greater Khartoum, all three cities that comprise the capital of Sudan, covering the first year of operation of the National Program. This study evaluates the rates, mechanisms, causative agents and clinical outcomes of peritonitis. We included the data of all 60 patients who underwent CAPD from June 2005 to June 2006.

Peritoneal dialysis in the Sudan.

Background: End-stage renal disease is a significant social and economic burden on the Sudan. Continuous ambulatory peritoneal dialysis (CAPD) was recently introduced as a national service and is provided free of charge by the Federal State. We present here an overview of our experience and outcomes after the first 20 months of operation of the National Program, displaying its organization and patient and technique survival, peritonitis rates, and adequacy parameters of the first patients to undergo CAPD.

Schistosomal colitis without granuloma formation in a kidney transplant recipient.

Background: A 40-year-old male from the White Nile region in Sudan, who had received a kidney transplant 6 years previously, presented with fever, lower abdominal pain and diarrhea stained with blood of 5 months duration. He was on immunosuppressive maintenance therapy, consisting of ciclosporin 75 mg twice daily, prednisolone 10 mg once daily, and azathioprine 75 mg once daily.

Investigations: Laboratory investigations, liver function tests, renal function tests, stool microscopy, stool culture, abdominal ultrasound, and colonoscopy.