Sepsis is a well-recognized complication of nephrotic syndrome.  Systemic inflammatory response syndrome (SIRS) insult in the nephrotic background initiates interplay between inflammation and oxidative stress, leading to septic acute kidney injury (SAKI). Thus, the sepsis-septic shock-AKI sequence ie SAKI develops as a complication of nephrotic syndrome. Data on this subject is lacking. The present study is conducted to know the prevalence, clinical profile, complications and outcomes of this sequence in steroid responsive nephrotic syndrome.

It was an observational cross-sectional study conducted at Dr B C Roy PGIPS, Kolkata, India. Consecutively hospitalised children with steroid responsive nephrotic syndrome below 12 years were included after exclusion of pre-existing chronic kidney disease. Sepsis & septic shock were identified by Sepsis-3 criteria.

Outcomes were development of AKI (identified by KDIGO), morbidity and mortality.

Background: In developing countries, the burden of chronic kidney disease (CKD) is rising due to poor access to early detection and management services. In Ethiopia, little is known about the context specific risk factors and their magnitude particularly the dietary habit of patients is not studied. Therefore, this study aimed to determine the dietary habit and other risk factors of chronic kidney disease in Northeast Ethiopia. We conducted a facility-based unmatched case-control study utilizing quantitative method of data collection. Data was collected on a total of 66 cases and 134 controls using structured questionnaire and anthropometric measurements. Dietary habit were assessed using dietary history questionnaire. Medical history, patient chart review and physical examination were employed using standard procedures.  . To identify independent predictors of chronic kidney disease among adults, we conducted a multivariable logistic regression analysis. About 54.5% cases and 46.3% of controls were female, while 40.9% of cases and 38.8% of controls were within the age group of 36-55. All cases and 128 (95.5%) controls consumed meat. History of hypertension (Adjusted Odds Ratio (AOR) =2.39; 95% Confidence Interval (CI): 1.17 – 4.89), anemia (AOR=2.38; 95% CI: 1.04 – 5.42), type of cooking oil use (AOR=2.10; 95% CI: 1.01 – 4.35) and family history of chronic kidney diseases (AOR=8.77; 95% CI: 3.73 – 20.63) were significantly associated with the odds of having CKD.

Conclusion: History of hypertension, anemia, family history of CKD and palm oil consumption were found to be risk factors for CKD. Meat consumption is high among patients with CKD. Dietary counseling intervention and dietary modifications is important in CKD prevention. Furthermore, routine urinalysis and estimation of glomerular filtration rate (GFR) for all hospitalized patients with hypertension and anemia might help to detect it at earlier stage for a better prognosis.

Background: End-Stage Renal Disease is the last stage of chronic kidney disease where kidney function is declining up to the point that the kidneys can no longer function on their own. ESRD was the seventh leading cause of death in the Philippines in 2018. ESRD patients are prescribed a multi-pharmacological treatment and this contributes to a high pill burden intake. This study aimed to determine the factors affecting the adherence of ESRD patients to hemodialysis and medication therapy in Metro Vigan.

Methods: The study used a descriptive method of research that utilized a questionnaire-checklist and interviews to gather data from the four selected dialysis centers. Total enumeration was used with a total of 70 respondents and was analyzed using frequency and percentage distribution. Results: Findings revealed that majority belong to 61-70 age bracket, college graduates, with family monthly income of Php <10,000, residence was >25 km away from the dialysis units, funded by PhilHealth, commuting on a tricycle. Some patients were not attending dialysis treatment due to transportation and financial problems. Majority were diagnosed in 2017-2019, due to Diabetic Nephropathy and had twice a week dialysis schedule with four hours duration. Majority had high confidence in their doctor’s advice throughout the therapy and said it is highly important to follow their dialysis schedule and medication schedule. Two-thirds of the respondents were taking >5 drugs and almost half of the respondents said that the number of medications was a concern because of its cost. 

Conclusion: The study showed that high level of education, with insurance and with a good physician-patient relationship suggests better adherence to their treatment regimen. In contrast, older age, low household income, more distant residence from the dialysis center, commuters, and high medication intake may result in non-adherence to their hemodialysis and medication therapy. 

Background: Contrast-Induced nephropathy (CIN) is one of the leading causes of acute kidney injury. The most common procedures associated with CIN are coronary angiography and contrast enhanced computed tomography (CT) [1].  The most common definition in use is an increase in serum creatinine (SCr) of >25% of the baseline values occurring following the intravascular administration of contrast media without an alternative explanation [2]. Generation of reactive oxygen species is thought to play a role in the pathogenesis of CIN, hence researches have been conducted into the potential role of antioxidants in the prevention of contrast-induced nephropathy [13]. Vitamin C, a potent antioxidant in humans has the ability to oxidize free radicals, and has been studied in different trials to measure its ability to prevent CIN among patients undergoing coronary angiogram.

Objective: To determine if vitamin C prevents CIN among High-risk patients (Creatinine Clearance <60 ml/min/m2, Diabetics, and on administration of high-volume contrast media).

Methodology: All studies, limited to randomized clinical trials were sought for this analysis through PubMed, the Cochrane Library, ClinicalTrials.gov. Database was searched using the terms “vitamin C”, “Prevention”, “acute kidney injury” and “contrast-induced nephropathy”. Adult patients (40-90 years old) with Creatinine Clearance of <60 ml/min/m2 or baseline creatinine >1.2 mg/dl, Diabetes Mellitus Type II, and were administered with high-volume contrast media (>100ml) undergoing coronary angiogram were included in the study. Exclusion Criteria were patients with normal baseline renal function, without risk factors for CIN, with EGFR < 30 ml/min/m2, with regular intake of Vitamin C and were on dialysis. Statistical data were obtained using Review Manager (RevMan) Version 5.3 freeware program.  P Value was obtained using the Cochran–Mantel–Haenszel test (CMH).  Included patients were given Vitamin C at doses of 1 gram to 3 grams, taken orally or administered intravenously pre-and post coronary angiogram.

Results:  Seven hundred and one (N=701) patients were included in this meta-analysis.  CIN occurred in 3.5% of patients (N=25) in the ascorbic acid group and in 6% of patients (N= 42) in the placebo group (p value of 0.03).

Conclusion: Vitamin C given at doses 1 gram to 3 grams in combination with hydration prior to coronary angiogram may have a significant effect in the prevention of CIN in high-risk patients.

Introduction: Arterio-ureteral fistulae are abnormal connections between an artery and the ureter and carry a high mortality. All patients were treated with a uretral and a endovascular fully covered stent placement.

Objectives: Arterio-ureteral fistulae are abnormal connections between blood vessels and the ureter and most commonly involve the iliac arteries and the ureter. They are rare entities, and only around 200 cases have been reported in the literature. However, the majority of fistulae are secondary, occurring due to radiation or surgery for urological and gynecological cancers, vascular or pelvic surgeries. Our procedure consents include a statement regarding the use of images such as radiographs without patient identifiers for teaching and illustrative purposes. Our institutional policy does not require patient consents for case reports. Case reports are also exempt from institutional board review.

Materials and methods: We present 12 cases of arterio-ureteral fistulae that presented with lifethreatening hematuria. 7 patients were treated successfully with ureteral covered stent placement (Allium ureteral stent 200x9mm) and 5 patients are combined treated with uretral (Allium ureteral stent 200x9mm) and endovascular (Endovascular Stent Graft) covered stents placement. Mean surgery time was 55min (16-95min). The position, continuity and sealing of the stent in the ureter and vessel were documented by radiological contrast imaging.

Results: All patients were treated successfully with ureteral or with combined uretral and endovascular covered stent placement.

Conclusions: In conclusion, ureteral or with combined uretral and endovascular covered stent placement of covered stents is a feasible minimal invasive therapeutic option for the treatment of acute life-threatening hemorrhage due to arterio-uretral fistulae.