Outcomes of Different Immunosuppressive Regimen in Adult Biopsy Proven Idiopathic Focal Segmental Glomerulosclerosis: A Retrospective Analysis at a Single Center.

Treatment of focal segmental glomerulosclerosis (FSGS) is frustrating, especially for steroid-resistant FSGS. Different immunosuppressive agents have been used with inconsistent outcome. We analyzed the data in our FSGS patients who, in addition to steroid, were treated with cyclosporine (CYA), cyclophosphamide (CYP), and mycophenolate mofetil (MMF) along with the long-term follow-up.

Clinical Characteristics and Outcomes of Coronavirus Disease 2019 Infection of In-center Hemodialysis Patients: An Experience of a Dialysis Center from Pakistan.

Much has now been learned about the coronavirus disease 2019 (COVID-19) in the general population, but data for hemodialysis (HD) patients are limited. This is the first study of COVID-19 disease in patients undergoing maintenance HD in Pakistan. We studied the epidemiological, clinical, laboratory, radiological characteristics, and outcomes of a cohort of HD patients that contracted COVID-19 in our HD center from the first confirmed case on May 12, 2020, until September 9, 2020.

"No" to placebo-controlled trials of Covid-19 vaccines.

Recently the WHO Ad Hoc Expert Group proposed that it is ethical to continue placebo-controlled Covid-19 vaccine trials in countries where vaccines are not available even if this vaccine is marketed and being used elsewhere. The reason for this proposal is the usual scientific argument claiming that these trials are the most efficient method to obtain reliable results, and individuals in these countries will continue to get the local standard of care, meaning no vaccination, and thus participants are not being left worse off. We refute this argument on two counts.

Comparison of Adequacy of Dialysis between Single-use and Reused Hemodialyzers in Patients on Maintenance Hemodialysis.

Objective: To compare adequacy of dialysis between single-use and reused dialyzer in order to ascertain whether reuse of dialyzers provides adequate dialysis and thereby enable provision of effective yet affordable renal replacement therapy in resource-limited countries.

Study Design: Observational cross-sectional study.

Place And Duration Of Study: Department of Nephrology, The Kidney Centre, Postgraduate Training Institute (TKC-PGTI), Karachi, from December 2017 to February 2018.

Clinical Characteristics of Patients on Long-term Hemodialysis.

Objective: To study the clinical characteristics of patients on hemodialysis for more than ten years in order to highlight the modifiable factors that may improve survival in low socioeconomic status.

Study Design: Observational cross-sectional study.

Place And Duration Of Study: Department of Nephrology, The Kidney Centre Postgraduate Training Institute (TKCPGTI), Karachi, from November 2017 to January 2018.

Frequency of pregnancy-related complications causing acute kidney injury in pregnant patients at a tertiary care hospital.

Acute kidney injury (AKI) in pregnancy is associated with significant maternal morbidity and mortality. Several studies from worldwide have shown different frequencies of the causes of pregnancy-related AKI (PRAKI). The present study aimed to provide local data on frequency of causes of PRAKI.

Risk factors of hospitalization among chronic kidney disease patients in tertiary care hospitals - A single-center experience.

Chronic kidney disease (CKD) affects health and life of patients. They confront anemia, hypertension, infections and cardiovascular disease. Due to these health issues, they are at risk of repeated hospitalizations.

Prevalence of subclinical hypothyroidism in patients with chronic kidney disease on maintenance hemodialysis.

The prevalence of subclinical hypothyroidism (SHT) has been reported to be much higher in patients with chronic kidney disease (CKD) than in the general population. SHT has been identified as a strong predictor of mortality and a risk factor for cardiovascular disease in CKD. The study aimed to provide local data on the prevalence of SHT in CKD patients on maintenance hemodialysis (MHD).

Acute Kidney Injury Secondary to Rhabdomyolysis: A Rare Presentation of Chikungunya Fever.

Chikungunya fever is an arthropod-borne viral illness characterised by high grade fever and incapacitating arthralgias. It is considered benign; however, in the recent outbreaks, several complications have been reported worldwide. We report a case of male patient with Chikungunya fever, possibly contracted from infected mosquitoes endemic in Karachi, Pakistan.

Reusing dialyzer in low income countries: A good cost saving tactic with complex ethics.

Despite almost universal practice of dialyzer reuse from the earliest days of haemodialysis, reusing dialyzer always remains a controversial issue and several ethical concerns have been raised. Some of the important are safety of reuse over single use, informed consent of the patient, conflict of interest on the part of physician or manufacturer, fiscal responsibility and environmental stewardship. Indeed, at the beginning of this century, there was a drastic shift of practice in favour of single use in developed countries due to availability of biocompatible haemodialyzers, at favourable price.

More hostile dyslipidaemia in chronic kidney disease patients on maintenance haemodialysis than on conservative management.

Objective: To study the pattern of dyslipidaemia in patients with stage-V chronic kidney disease on conservative management and those on maintenance haemodialysis.

Methods: This comparative observational study was conducted at the Jinnah Postgraduate Medical Centre, Karachi, from February to July, 2008, and comprised stage-V chronic kidney disease patients. The patients were divided in two groups.

Comparison of total direct cost of conventional single use and mechanical reuse of dialyzers in patients of end-stage renal disease on maintenance hemodialysis: A single center study.

Reusing dialyzers is almost universal in developing countries to reduce the cost of hemodialysis (HD). Economic benefits of dialyzer reuse, when estimated only on the basis of the dialyzer and its consumables are very significant and attractive. In this study, we compared the cost of mechanical reuse of dialyzer considering all of the direct costs (medications, dialyzer, and its consumables, disinfection fluid, and hospitalization if any) in HD treatment, which if significantly different between single use and reuse, can nullify the obvious cost benefits.

Clinical and Biochemical Parameters of Hemodialysis Patients Before and During Islamic Month of Ramadan.

Introduction: Month of Ramadan bring many changes in life style, especially the diet of Muslims all over the world among both fasting and nonfasting individuals. Hemodialysis patients are kept on restricted diet because of fluid and electrolytes imbalance. The aim of this study was to compare changes in the clinical and biochemical parameters in fasting and nonfasting hemodialysis patients during the Ramadan.

Type of immune and complement deposits and response of immunosuppressive treatment on Membranoproliferative Glomerulonephritis -- a single centre experience.

Objective: To see the response of steroid and cyclophosphamide if membranoproliferative glomerulonephritis is classified by pattern of immune and complement deposits.

Methods: The retrospective study was conducted at The Kidney Centre, Karachi, and comprised patients treated for membranoproliferative glomerulonephritis between 1996 and 2013. Records of patients who were not treated with immunosuppressive medications were excluded.

Mortality trend among hemodialysis patients during the islamic month of Ramadan: a 24 years retrospective study.

Objective: The effect of month of Ramadan on the mortality in hemodialysis patients, and to compare it with that in all other Islamic months.

Study Design: A descriptive study.

Place And Duration Of Study: Hemodialysis Unit, The Kidney Center, Karachi, from January 1989 to December 2012.

Dialyzer reuse: justified cost saving for south Asian region.

In spite of controversies, dialyzer reuse has remained an integral part of hemodialysis because of lower cost, good overall safety record, and improved membrane biocompatibility. Reuse declined in developed countries from the beginning of this century because of mass production of hemodialyzers at favourable price with better biocompatible membrane. Abandoning dialyzer reuse became challenging in South Asian region, where more than 40% of the population live below the International Poverty Line of $1.

Azotemia protects the brain from osmotic demyelination on rapid correction of hyponatremia.

Osmotic demyelination syndrome (ODS) is a dreadful, irreversible and well-recognized clinical entity that classically occurs after rapid correction of hyponatremia. However, it has been observed that when hyponatremia is rapidly corrected in azotemic patients by hemodialysis (HD), patients do not necessarily develop ODS. We studied the effect of inadvertent rapid correction of hyponatremia with HD in patients with azotemia.