Warfarin related nephropathy: the first case report in Thailand.

Warfarin is the most prescribed oral anticoagulant. Adverse renal effect from warfarin therapy are uncommon and Thailand is not acquainted. Warfarin-related nephropathy (WRN) is a newly recognized complication of warfarin treatment, especially in patients with chronic kidney disease.

Clinico-pathological correlation of severe tubulointerstitial fibrosis in glomerular diseases.

Background: Renal histopathology is the best method available to assess chronicity ofglomerular diseases. However renal biopsy is an invasive procedure and is available only in medical schools or tertiary-care hospitals in Thailand. Clinical predictors that discriminate the chronicity index of renal pathology may be valuable for the best timing of biopsy.

Cost-Utility Analysis of Erythropoietin for Anemia Treatment in Thai End-Stage Renal Disease Patients with Hemodialysis.

Objective: To compare the cost utility of using erythropoietin (EPO) to maintain different hemoglobin (Hb) target levels in hemodialysis patients from a societal perspective.

Methods: A Markov model was used to estimate the incremental cost and quality-adjusted life-year of five Hb levels: 9 or less, more than 9 to 10, more than 10 to 11, more than 11 to 12, and more than 12 g/dl. A systematic review of EPO treatment in hemodialysis patients was conducted to estimate transitional probabilities.

Efficacy and hemodynamic outcome of prolonged intermittent renal replacement therapy (PIRRT) in critically ill patients: a preliminary report.

Background: Acute kidney injury (AKI) is frequently part of a multiple-organ dysfunction syndrome presenting in critically ill patients. Prolonged intermittent renal replacement therapy (PIRRT) provides the advantages of both continuous renal replacement therapy (CRRT) in term of hemodynamic stability and the cost-effectiveness of intermittent hemodialysis (IHD). This study aims to study PIRRT in the aspects of efficacy and hemodynamic outcomes.

Buttonhole technique better than area puncture technique on hemostasis and pain associated with needle cannulation.

Background: The buttonhole (constant site) arteriovenous fistulae cannulation technique, in which the inserted needle utilizes exactly the same site and the same angle every dialysis session, offers the advantage of an easier cannulation procedure, less pain associated with cannulation, and fewer complications when compared with the traditional method.

Objective: To compare buttonhole arteriovenous fistula (AVF) cannulation technique with area puncture method on the effect of hemostasis after needle withdrawal and pain during needle puncture.

Material And Method: The duration of hemostasis after needle withdrawal and pain during needle puncture of AVF were prospectively recorded in 21 chronic hemodialysis patients at Siriraj Hospital.

Practical guidelines for automated peritoneal dialysis.

The development of APD technologies enables physician to customize PD treatment for optimal dialysis. Dialysis dose can be increased with APD alone or in conjunction with daytime dwells. Although there is no strong evidence of the advantage over CAPD, APD is generally recommended for patients having a high peritoneal transport, outflow problems or high intraperitoneal pressure (IPP) and those who depend on caregivers for their dialysis.

Acute kidney injury in primary nephrotic syndrome: report of nine cases in Siriraj Hospital.

Acute kidney injury is a rare but important complication of nephrotic syndrome. We demonstrated here nine patients with nephrotic syndrome and oliguric renal failure in Siriraj Hospital during 2007-2009. Renal biopsy was done in every patient.

Nephrotic syndrome in elderly patients: three years experience at Siriraj Hospital.

Background: The population age is being high and nephotic syndrome is a common renal disease.

Objective: To find the etiology and clinical manifestations of nephrotic syndrome in the elderly patients who underwent renal biopsy at Siriraj hospital including management and outcome.

Material And Method: Retrospective study in 76 nephrotic patients whose age > or =50 years and underwent renal biopsy between 2005-2007.

Molecular Approach for Distal Renal Tubular Acidosis Associated AE1 Mutations.

The molecular approaches to distal renal tubular acidosis (dRTA) associated AE1 mutations lead us to understand the genetic and pathophysiological aspects of the acidification defects. An unanticipated high value of the urine-blood (U-B) PCO(2) after NaHCO(3) loading observed in a case of dRTA and southeast Asian ovalocytosis (SAO) might be from a mistarget of the AE1 to the luminal membrane of type A intercalated cells. The mutations of the AE1 gene resulted in SAO and also affected renal acidification function.

Randomized trial comparing pulse calcitriol and alfacalcidol for the treatment of secondary hyperparathyroidism in haemodialysis patients.

Aim: Calcitriol and alfacalcidol are used extensively for the treatment of secondary hyperparathyroidism. Unfortunately, there is limited published data comparing the efficacy and tolerability of both active vitamin D sterols. This study was undertaken to determine whether calcitriol provides a therapeutic advantage to alfacalcidol.

Evidence suggesting a genetic contribution to kidney stone in northeastern Thai population.

Genetic factor may play a role in the pathogenesis of kidney stone that is found in the northeastern (NE) Thai population. Herein, we report initial evidence suggesting genetic contribution to the disease in this population. We examined 1,034 subjects including 135 patients with kidney stone, 551 family members, and 348 villagers by radiography of kidney-ureter-bladder (KUB) and other methods, and also analyzed stones removed by surgical operations.

Proteomic analysis of peritoneal dialysate fluid in patients with different types of peritoneal membranes.

Efficacy of peritoneal dialysis is determined by solute transport through peritoneal membranes. With the use of the peritoneal equilibration test (PET), peritoneal membranes can be classified as high (H), high average (HA), low average (LA), and low (L) transporters, based on the removal or transport rate of solutes, which are small molecules. Whether there is any difference in macromolecules (i.

Effect of short-term folate and vitamin B supplementation on blood homocysteine level and carotid artery wall thickness in chronic hemodialysis patients.

Objective: Hyperhomocysteinemia is an independent risk factor for atherosclerotic vascular disease in chronic hemodialysis patients. This stratified randomized controlled trial was designed to measure the effect of high dose oral vitamin B6, vitamin B12, and folic acid on homocysteine levels, and to evaluate the effect on atherosclerosis as measured by Intima-Media Thickness (IMT) of carotid arteries.

Material And Method: Fifty-four chronic hemodialysis patients with hyperhomocysteinemia were randomized to receive oral 15 mg folic acid, 50 mg vitamin B6, and 1 mg vitamin B12 daily (treatment group) or oral 5 mg folic acid alone (control group) for 6 months.

An analysis of 3,555 cases of renal biopsy in Thailand.

Background: The knowledge of the epidemiology of biopsied renal diseases provides useful information in clinical practice. There are several epidemiologic population-based studies of biopsy-proven nephropathies with detailed clinicopathologic correlations that could be different according to the country analyzed.

Objective: To identify the prevalence of primary and secondary glomerular diseases and to study the trend of the pattern changes of the glomerulopathy in Thailand.

Relationship between hyperhomocysteinemia and atherosclerosis in chronic hemodialysis patients.

Background: Hyperhomocysteinemia is an independent risk factor of coronary artery heart disease (CAHD) and atherosclerosis in a normal population. However, it is still controversial in end-stage kidney disease patients who underwent long-term dialysis. Carotid intima-media thickness (IMT) is the standard non-invasive measurement of atherosclerosis.

Novel compound heterozygous SLC4A1 mutations in Thai patients with autosomal recessive distal renal tubular acidosis.

Background: Mutations in the SLC4A1 gene have been found to cause either autosomal dominant (AD) or autosomal recessive (AR) distal renal tubular acidosis (dRTA). The SLC4A1 mutations causing AD dRTA were reported in white patients, whereas those associated with AR dRTA were often found in Southeast Asia. Here, the authors report additional novel SLC4A1 mutations in 3 patients with AR dRTA from 2 unrelated Thai families.

Kidney stone inhibitors in patients with renal stones and endemic renal tubular acidosis in northeast Thailand.

Distal renal tubular acidosis (dRTA) is generally associated with hypercalciuria, hypocitraturia, and nephrolithiasis. Our intention was to study glycosaminoglycans (GAGS) and nephrocalcin (NC), two well-known crystal growth inhibitors, in a population with endemic dRTA and nephrolithiasis in northeast (NE) Thailand. We studied 13 patients, six with dRTA and seven with nephrolithiasis with normal or undefined acidification function.

Anion exchanger 1 mutations associated with distal renal tubular acidosis in the Thai population.

We have previously demonstrated that compound heterozygous (SAO/G701D) and homozygous (G701D/G701D) mutations of the anion exchanger 1 (AE1) gene, encoding erythroid and kidney AE1 proteins, cause autosomal recessive distal renal tubular acidosis (AR dRTA) in Thai patients. It is thus of interest to examine the prevalence of these mutations in the Thai population. The SAO and G701D mutations were examined in 844 individuals from north, northeast, central, and south Thailand.

A de novo R589C mutation of anion exchanger 1 causing distal renal tubular acidosis.

Anion exchanger 1 (AE1 or SLC4A1) mutations have been reported to cause distal renal tubular acidosis (dRTA), a disease characterized by impaired acid excretion in the distal nephron. We have recently demonstrated homozygous AE1 G701D mutation as a common molecular defect of autosomal recessive (AR) dRTA in a group of Thai pediatric patients. In the present work, we discovered a de novo heterozygous AE1 R589C mutation, previously documented in inherited autosomal dominant (AD) dRTA.

Autosomal recessive distal renal tubular acidosis caused by G701D mutation of anion exchanger 1 gene.

Anion exchanger 1 (AE1 or band 3), encoded by the AE1 or SLC4A1 gene, regulates chloride-bicarbonate exchange in erythrocytes and alpha-intercalated cells of the distal nephron. Defects of AE1 at the basolateral membrane of alpha-intercalated cells may result in the failure of hydrogen ion secretion at the apical membrane, leading to distal renal tubular acidosis (dRTA). Abnormalities of the AE1 gene were previously reported to be associated with autosomal dominant dRTA.