Clinical Presentation and Treatment Outcomes of Pregnancy-Related Acute Kidney Injury among Pregnant Women Admitted at the Benjamin Mkapa Hospital in Tanzania

Background: Globally, PRAKI is among the leading causes of death in pregnant women. The prevalence, causes and outcome of this condition vary among countries due to differences in environmental, socioeconomic, and health delivery systems. The common causes that have been reported in several studies are PIH, Haemorrhages and Sepsis while the outcomes may be either complete renal recovery, progression to CKD and hence dialysis dependency or death. This study aimed at determining clinical presentation and treatment outcomes of Pregnancy-Related Acute Kidney Injury in Pregnant women admitted at the Benjamin Mkapa Hospital, Dodoma, Tanzania. Results: Out of 4007 pregnant women who were admitted to the maternity ward 51 pregnant women were found to have PRAKI. Of those with PRAKI, 74.5% were between 21 to 25 years. The leading causes of PRAKI were PPH 12 (23.53%), Eclampsia 12 (23.53%), and pre-eclampsia 12 (23.5%). Hemodialysis therapy was provided to 22 (43.1%) patients, 15 (29.4%) individuals recovered spontaneously with medical management and 14 (27.5%) missed haemodialysis therapy due to various reasons. The mortality due to PRAKI was 17 (33.3%). Conclusion and Recommendation: Pre-eclampsia/eclampsia and post-partum haemorrhage were found to be the main causes of PRAKI. The mortality related to PRAKI is high and Hemodialysis therapy is vital help to prevent deaths for pregnant women with PRAKI. Pregnant women who develop acute kidney injury should be followed closely and a nephrologist should be consulted early. Early referral should be done by the lower level facilities for all at-risk pregnant women to a specialized multidisciplinary health facility.

Regulating and tonifying spleen and kidney traditional Chinese medicine in the treatment of chronic uric acid nephropathy: A systematic review

Objective:To systematically evaluate the efficacy and safety of traditional Chinese medicine for regulating spleen and kidney.Methods:We developed a search strategy and then retrieved the database including CNKI,Wanfang data knowledge service platform,VIP journals resource integration service platform,PubMed,Embasefor randomized controlled trial of regulating spleen and kidney traditional Chinese medicine compared with conventional western medicine in the treatment of chronic uric acid nephropathy.The search deadline was set to June 30,2020.For the included literature,we applied the cochrane collaboration network risk bias assessment tool to evaluate the methodological quality,and evaluated the level of evidence according to GRADE standards.Quantitative data was analyzed by RevMan5.3 software,and trial sequential analysis method was used to analyze its efficiency.Results:A total of 709 cases in 10 articles were included.Compared with the control group,the related traditional Chinese medicine group improved the effective rate[RR=1.45,95%CI(1.32,1.58)],reduced the level of UA[MD=-36.24,95%CI(-41.03,-31.45)],BUN[SMD=-1.27,95%CI(-1.47,-1.07)]and SCR[MD=-36.33,95%CI(-55.79,-16.87),P=0.0003],the difference between the two groups was statistically significant(P<0.05).There was no evidence that a significant adverse reaction occurred.The results of TSA analysis showed that the Chinese medicine group had definite evidence for improving the efficiency.According to the GRADE evaluation criteria,the efficiency,UA,BUN and SCR outcome indicators were extremely low-quality evidence.Conclusions:Traditional Chinese medicine for regulating spleen and kidney in the treatment of chronic uric acid nephropathy improved efficiency,reduced the level of UA,BUN,SCR.Meanwhile,the therapy was proved to be safe.Nevertheless,the conclusions need further high-quality evidence to support.

Theoretical Discussion on Treatment of Cubital Tunnel Syndrome Based on Theory of Liver,Spleen and Kidney

Cubital tunnel syndrome is a disease in which ulnar nerve is compressed by its surrounding tissues,and its main clinical manifestations are pain,sensory disturbance and dyskinesia.Its incidence rate is the second highest among peripheral nerve entrapment diseases,and it is one of the common clinical diseases.The theory of liver,spleen and kidney can guide the treatment of cubital tunnel syndrome with traditional Chinese medicine and acupuncture.By discussing the traditional Chinese medicine(TCM)pathogenesis and treatment principles of cubital tunnel syndrome,it provides modern medical theoretical support for TCM treatment of cubital tunnel syndrome.

Clinical characteristics and treatment compounds of obesity-related kidney injury

Disorders in energy homeostasis can lead to various metabolic diseases,particularly obesity.The obesity epidemic has led to an increased incidence of obesityrelated nephropathy(ORN),a distinct entity characterized by proteinuria,glomerulomegaly,progressive glomerulosclerosis,and renal function decline.Obesity and its associated renal damage are common in clinical practice,and their incidence is increasing and attracting great attention.There is a great need to identify safe and effective therapeutic modalities,and therapeutics using chemical compounds and natural products are receiving increasing attention.However,the summary is lacking about the specific effects and mechanisms of action of compounds in the treatment of ORN.In this review,we summarize the important clinical features and compound treatment strategies for obesity and obesityinduced kidney injury.We also summarize the pathologic and clinical features of ORN as well as its pathogenesis and potential therapeutics targeting renal inflammation,oxidative stress,insulin resistance,fibrosis,kidney lipid accumulation,and dysregulated autophagy.In addition,detailed information on natural and synthetic compounds used for the treatment of obesity-related kidney disease is summarized.The synthesis of detailed information aims to contribute to a deeper understanding of the clinical treatment modalities for obesity-related kidney diseases,fostering the anticipation of novel insights in this domain.

A review of the treatment of ankylosing spondylitis from liver and kidney

Ankylosing spondytitis is a kind of arthropathy of rheumatic immune disease. The pathogenesis of ankylosing spondytitis is not very ctear in current medicat research. Because of the recurrence of the disease and the prolongation of the disease, the quality of tife of the patients has been seriously affected. Traditional Chinese medicine has tong known its etiotogy and pathogenesis, and it is very effective in ctinicat treatment. Based on the theory of traditional Chinese medicine and modern physicians' understanding of its etiotogy and pathogenesis, and starting from the function and characteristics of tiver and kidney, this paper explores the basis of treating ankylosing spondytitis from tiver and kidney, with a view to providing new ideas for the ctinicat treatment of ankylosing spondytitis.

TCM Treatment of Rheumatoid Arthritis by Supplementing the Kidney and Invigorating the Blood Circulation

The therapeutic effects in treating the intermediate and late rheumatoid arthritis by supplementing the kidney and invigorating blood circulation were observed. In the 43 cases of the treatment group, No. 2 Qu Feng Shi Ling capsules (祛风湿灵胶囊2号) and Fenbid (芬必得) were prescribed, while in the 39 cases of the control group Lei Gong Teng Tablets (雷公藤总甙片) and Fenbid were given. The results showed that the total effective rate in the treatment group was more satisfactory than that in the control (P<0.05 or P<0.01). With less toxic effects, the former could better improve the local swelling and lower the blood viscosity.

Summary and Prospect of Treating Ulcerative Colitis by Warming the Kidney and Strengthening the Spleen

The method of warming the kidney and strengthening the spleen is widely used in the treatment of ulcerative colitis (UC) with significant curative effect.This paper reviews the relevant literature in recent years.

Analysis of Traditional Chinese Medicine Syndromes and Treatment Laws of Diabetic Kidney Disease and the Action Mechanism of High-Frequency Chinese Herbs in the Treatment of Diabetic Kidney Disease Based on Real-World Study

Objective Our objective was to analyze the traditional Chinese medicine(TCM)syndrome and treatment laws of diabetic kidney disease(DKD)and the action mechanism of high-frequency Chinese herbs in the treatment of DKD based on realworldstudy.MethodsThe data of patients with DKD who had been treated in the First Hospital Affiliated to Henan Universityof ChineseMedicine from January1,2014to December 31,2021 were retrospectively analyzed through the hospital information management system.The contents of the cases were statistically analyzed using IBM SPsS Statistics 25 software,and the laws of DKDtreatment were summarized.Network pharmacology and molecular docking were used to analyze the action mechanism of high-frequency Chinese herbs in the treatment of DKD.ResultsThe data of a total of 1,201 patients with DKD were included,involving 72 kinds of TCM syndromes.Nine disease nature elements and six disease location elements were extracted,involving 405 Chinese herbs.The top five high-frequency Chinese herbs were Baizhu(Atractylodis Macrocephalae Rhizoma),Fuling(Poria),Huangqi(Astragali Radix),Chuanxiong(Chuanxiong Rhizoma),and Danshen(Salviae Miltiorrhizae Radix et Rhizoma).Thirty kinds of Chinese herbs with the frequency of≥100 were mainly deficiency-tonifying herbs and blood-activating and stasis-eliminating herbs.The medicinal properties were mainly warm and mild,and the medicinal flavors were sweet and bitter mostly.For the meridian tropism,the main meridian tropism of these herbs is spleen meridian and lung meridian.The clustering method.

Clinical course and outcome of adult patients with primary focal segmental glomerulosclerosis with kidney function loss on presentation

BACKGROUND Kidney function loss or renal insufficiency indicated by elevated creatinine levels and/or an estimated glomerular filtration rate(eGFR)<60 mL/minute/1.73 m²at presentation in patients with primary focal segmental glomerulosclerosis(FSGS)is commonly seen as a poor prognostic marker for kidney survival.However,a pre>vious study from our center suggested this may be due to hemodynamic factors.AIM To observe the clinical and biochemical parameters,treatment response,kidney survival,and overall outcomes of adult patients with primary FSGS presenting with kidney function insufficiency.METHODS This retrospective observational study was conducted at the Department of Nephrology,Sindh Institute of Urology and Transplantation,Karachi,Pakistan,from January 1995 to December 2017.During this period,401 biopsy-proven primary FSGS patients were identified,of which 98(24.4%)presented with kidney function loss or renal insufficiency defined as eGFR<60 mL/minute/1.73 m²at presentation and were studied in detail.RESULTS Among the 98 patients with renal function loss on presentation,the mean age was 30.9 years±13.6 years with a male-to-female ratio of 2.5:1.The mean serum creatinine level was 2.2 mg/dL±1.3 mg/dL and mean eGFR 37.1 mL/minute/1.73 m2±12.8 mL/minute/1.73 m2.The mean 24-hour urinary protein excretion was 5.9 g/day±4.0 g/day,and the mean serum albumin was 2.1 g/dL±1.0 g/dL(median:1.5 g/dL).The mean systolic blood pressure(BP)was 132.7 mmHg±19.8 mmHg,and the mean diastolic BP was 87.4 mmHg±12.7 mmHg.Steroid treatment was given to 81(82.6%)of 98 patients for an average duration of 19.9 weeks±14.4 weeks,with a mean total steroid dose of 4.4 g±1.5 g.Treatment response showed that 20(24.6%)patients achieved complete remission,9(11.1%)achieved partial remission,and 52(64.1%)did not respond.The baseline eGFR was significantly lower in the non-responsive group(P=0.006).The distribution of FSGS variants was also significantly different among steroid-responsive and non-responsive groups(P=0.012).CONCLUSION Renal function loss in FSGS patients at presentation does not necessarily indicate irreversible kidney function loss and a significant number of patients respond to appropriate treatment of the underlying disease.

Impact of the adherence to medical treatment on the main urinary metabolic disorders in patients with kidney stones

Objective:To assess the effect of the adherence to medical treatment on urinary parameters in the 24-h metabolic study of patients with kidney stones.Methods:A retrospective,longitudinal,descriptive,and observational study was carried out by reviewing the hospital electronic medical record from 2014 to 2018.The adherence to drug treatment was measured 6 months after its initiation,and the numerical values of the metabolic studies were compared.Wilcoxon tests were performed to compare the difference before and after treatment.Results:Ninety patients were evaluated,with 73.3% of adherence.The 180-day overall adherence rate was 61.2% in patients treated with a single drug and 85.4% in patients treated with multiple drugs.There is a statistically significant increase in citrate levels in patients with good adherence in comparison with non-adherent patients(p=0.031 vs.p=0.528).Conclusions:Medical treatment and dietary measures in patients with kidney stones have an initial impact at 6 months on the values of the main urinary metabolic alterations that predispose to calculi formation;the most significant is seen in those patients with adherence to medical treatment for hypocitraturia.

Proteomics analysis of IBS-D with spleen and kidney yang deficiency

Objective:To investigate the molecular mechanism underlying the development of diarrhea-predominant irritable bowel syndrome (IBS-D) with spleen and kidney yang deficiency (SKYD) using a proteomics approach.Methods:Male Sprague-Dawley rats (n =22) were divided into IBS-D (n =12) and normal control (n =10) groups.SKYD was then modeled in IBS-D rats by a combination of acetic acid enema,bondage,rectal dilation,tail stimulation,and Senna gavage.Colon tissue samples were subsequently collected and examined by Q Exactive mass spectrometry to identify differentially expressed proteins between the two groups.Results:The occurrence of SKYD/IBS-D was associated with ribosomal protein S23 (Rps23),protein phosphatase 2 catalytic subunit alpha (Pp2a),and growth factor receptor-bound protein 2 (Grb2),which are involved in the ribosome,neurotrophin signaling,and Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling pathways.Conclusion:These data suggest that SKYD/IBS-D pathophysiology likely involves inflammation,cell growth,apoptosis,stress granule formation,immune activation,loss of epithelial cell integrity,and visceral hypersensitivity.

Discussion on the treatment of Alzheimer's disease from the spleen based on intestinal flora

Alzheimer's disease(AD)is a clinically common degenerative disease of the central nervous system with a complex pathogenesis,which seriously endangers the physical and mental health of the elderly.In recent years,a large number of studies have shown that the intestinal flora can regulate the central nervous system through the brain-gut axis,thereby participating in the occurrence and development of AD.AD belongs to the category of"dementia"and"forgetfulness"in traditional Chinese medicine.It is caused by internal injury of seven emotions,old age and chronic illness,which can cause insufficient blood,deficiency of kidney essence,and blockage of phlegm and blood.To use,treat more from the heart,liver and kidney.We believe that phlegm turbidity blocking the orifice is the key to the pathogenesis of AD.It should be treated from the spleen,and according to the characteristics of the pathogenesis,the method of warming the spleen and dredging the collaterals and resuscitation is proposed to prevent AD.This article takes the intestinal flora as the starting point to discuss the research progress of treating AD from the spleen.

The latest research progress of traditional Chinese medicine in the treatment of early and middle femoral head necrosis

At present,the development of orthopedics,the conservative treatment of femoral head necrosis in the early and middle stages is still a difficult problem.With the progress of osteonecrosis,it may deteriorate into irreversible bone destruction,affecting the hip joint and even causing severe disability of the hip.In traditional medicine,femoral head necrosis belongs to the category of"bone erosion"and"bone erosion".As a common disease in orthopedics,the treatment difficulty is relatively large.In the view of Chinese medicine,the pathogenesis of femoral head necrosis is kidney deficiency,stagnation and so on.Clinically,most doctors use the principle of promoting blood circulation,tonifying kidney and strengthening spleen.In the early and middle femoral head necrosis,traditional Chinese medicine treatment methods are more diverse and economical,and have always been valued by the modern medical community.This study reviews the latest research progress of traditional Chinese medicine in the treatment of early and mid-stage femoral head necrosis,in order to provide more basis for clinical medical research and related disease treatment.

Multidisciplinary Approach to Drug-Drug Interactions between Tacrolimus and Sofosbuvir/Velpatasvir and Glecaprevir/Pibrentasvir in Kidney Transplant Patients during Hepatitis C Treatment:A Case Series Report

The direct acting antivirals(DAAs)are now the standard of care for hepatitis C virus(HCV)treatment with high and effective sustained virologic responserate(SVR)and great safety profile,including solid organ transplant patients.There are increasing reports showing DAAs are effective with high SVR rates and safety profile in kidney transplant recipients.There are reports on drug-drug interaction(DDI)between tacrolimus with DAAs.However,data remain lacking on potential DDIs between tacrolimus and DAA regimens and the management process.This case series reports three kidney transplant patients on tacrolimus who were successfully treated for HCV with multidisciplinary approach,although there was DDI between tacrolimus with sofosbuvir/velpatasvir and glecaprevir/pibrentasvir,which required tacrolimus dose adjustment to maintain therapeutic level during and after DAA treatment.Such DDIs should be aware of and closely monitored by pharmacist and physicians with tacrolimus dose adjustment as needed during and right after DAA treatment in post-kidney transplant patients.

Polycystic Ovary Syndrome-Related Infertility Based on the Theory of“Liver and Kidney Homology”

Polycystic ovary syndrome(PCOS)is an endocrine disorder caused by hypothalamic-pituitary-ovarian(HPO)axis dysfunction.In the field of gynecology and reproduction,PCOS has emerged as both a research hot spot and a challenging area of study.According to Chinese medicine,this disease is related to kidney deficiency,phlegm and dampness obstruction,blood stasis and interconnection,Chong pulse impassability,the lack of Ren pulse,and the loss of uterine nourishment,all of which affect the normal development and maturation of eggs as well as the duration at which menstrual blood stores.In this paper,based on the theoretical basis of“liver collects blood,regulates the flow of qi,and is the master of drainage,”we explore the rationality of the treatment of this disease from the perspective of“liver and kidney have the same origin”and the development of PCOS-related infertility in relation to dysfunctional internal organs.We also explore the feasibility of treatment from the perspective of“liver and kidney homology,”expand the ideas for treatment,as well as develop and innovate the application of organ identification in PCOS in relation to infertility.

Regulative Effects of Auricular Acupuncture,Moxibustion and Chinese Herbs on Immunologic Function in the D-Galactose-induced Aging Mouse

Objective:To observe the regulative effect of auricular acupuncture, moxibustion and Chinese herbs on immunologic function in the D-galactose-induced aging mouse and to probe the feasibility and possible mechanisms for delaying aging, so as to provide experimental basis for acupuncture, moxibustion and Chinese herbs for delaying aging. Methods: Aging mouse model was established by subcutaneous injection of D-galactose, and treated by auricular acupuncture, auricular acupuncture plus moxibustion, and auricular acupuncture plus Chinese herbs respectively for 6 weeks and then serum interleukin-2 (IL-2) and IL-6 contents and splenic lymphocyte transformation rate were compared among the groups. Results: Compared with the young group, the serum IL-2 level and the splenic lymphocyte transformation rate significantly decreased and the IL-6 level significantly increased in the aging mouse. After treatment by auricular acupuncture, auricular acupuncture plus Chinese herbs, especially auricular acupuncture plus moxibustion, the serum IL-2 level and the splenic lymphocyte transformation rate significantly increased, and the IL-6 level significantly decreased as compared with the model group. Conclusions: Combined application of auricular acupuncture, moxibustion and Chinese herbs can improve the decline or dysfunction of immunological function in the aging organism to a certain extent.

Clinical trial with traditional Chinese medicine intervention ''tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment'' for chronic hepatitis B-associated liver failure

AIM:To study the clinical efficacy of traditional Chinese medicine(TCM)intervention"tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment"("TTK")for treating liver failure due to chronic hepatitis B.METHODS:We designed the study as a randomized controlled clinical trial.Registration number of Chinese Clinical Trial Registry is Chi CTR-TRC-12002961.A total of 144 patients with liver failure due to infection with chronic hepatitis B virus were enrolled in this randomized controlled clinical study.Participants were randomly assigned to the following three groups:(1)a modern medicine control group(MMC group,36patients);(2)a"tonifying qi and detoxification"("TQD")group(72 patients);and(3)a"tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment"("TTK")group(36patients).Patients in the MMC group received general internal medicine treatment;patients in the"TQD"group were given a TCM formula"tonifying qi and detoxification"and general internal medicine treatment;patients in the"TTK"group were given a TCM formula of"TTK"and general internal medicine treatment.All participants were treated for 8 wk and then followed at 48 wk following their final treatment.The primaryefficacy end point was the patient fatality rate in each group.Measurements of various virological and biochemical indicators served as secondary endpoints.The one-way analysis of variance and the t-test were used to compare patient outcomes in the different treatment groups.RESULTS:At the 48-wk post-treatment time point,the patient fatality rates in the MMC,"TQD",and"TTK"groups were 51.61%,35.38%,and 16.67%,respectively,and the differences between groups were statistically significant(P<0.05).However,there were no significant differences in the levels of hepatitis B virus DNA or prothrombin activity among the three groups(P>0.05).Patients in the"TTK"group had significantly higher levels of serum total bilirubin compared to MMC subjects(339.40μmol/L±270.09μmol/L vs 176.13μmol/L±185.70μmol/L,P=0.014).Serum albumin levels were significantly increased in both the"TQD"group and"TTK"group as compared with the MMC group(31.30 g/L±4.77g/L,30.72 g/L±2.89 g/L vs 28.57 g/L±4.56 g/L,P<0.05).There were no significant differences in levels of alanine transaminase among the three groups(P>0.05).Safety data showed that there was one case of stomachache in the"TQD"group and one case of gastrointestinal side effect in the"TTK"group.CONCLUSION:Treatment with"TTK"improved the survival rates of patients with liver failure due to chronic hepatitis B.Additionally,liver tissue was regenerated and liver function was restored.

Small renal masses in kidney transplantation:Overview of clinical impact and management in donors and recipients

Kidney transplantation is the best replacement treatment for the end-stage renal disease.Currently,the imbalance between the number of patients on a transplant list and the number of organs available constitutes the crucial limitation of this approach.To expand the pool of organs amenable for transplantation,kidneys coming from older patients have been employed;however,the combination of these organs in conjunction with the chronic use of immunosuppressive therapy increases the risk of incidence of graft small renal tumors.This narrative review aims to provide the state of the art on the clinical impact and management of incidentally diagnosed small renal tumors in either donors or recipients.According to the most updated evidence,the use of grafts with a small renal mass,after bench table tumor excision,may be considered a safe option for high-risk patients in hemodialysis.On the other hand,an early small renal mass finding on periodic ultrasound-evaluation in the graft should allow to perform a conservative treatment in order to preserve renal function.Finally,in case of a renal tumor in native kidney,a radical nephrectomy is usually recommended.

Pharmacoepidemiologic study of association between apparent treatment resistant hypertension, cardiovascular disease and interaction effect by sex and age

BACKGROUND A limited number of studies have been conducted to test the magnitudes of the association between apparent treatment resistant hypertension(aTRH)and risk of cardiovascular disease(CVD).AIM To investigate the association between aTRH and risk of CVD and examine whether sex and age modify this association.METHODS We applied an observational analysis study design using data from the United States Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial(ALLHAT).ALLHAT recruited participants(n=25516)from 625 primary care settings throughout the United States,Canada,Puerto Rico,and United States Virgin Islands,aged 55 and older with hypertension and at least one additional risk factor for heart disease.aTRH was assessed from the year 2 visit.CVD event was defined as one of the following from the year 2 follow-up visit:Fatal or non-fatal myocardial infarction,coronary revascularization,angina,stroke,heart failure,or peripheral artery disease.Cox proportional hazards regression was used to examine the effect of aTRH on CVD risk.Potential modifications of sex and age on this association were examined on the multiplicative scale by interaction term and additive scale by joint effects and relative excess risk for interaction.RESULTS Of the total study participants(n=25516),5030 experienced a CVD event during a mean of 4.7 years follow-up.aTRH was associated with a 30%increase in risk of CVD compared to non-aTRH[hazards ratio(HR)=1.3,95%CI:1.19-1.42].Sex and age modified this relationship on both multiplicative and additive scales independently.Stratified by sex,aTRH was associated with a 64%increase in risk of CVD(HR=1.64,95%CI:1.43–1.88)in women,and a 13%increase in risk of CVD(HR=1.13,95%CI:1.01–1.27)in men.Stratified by age,aTRH had a stronger impact on the risk of CVD in participants aged<65(HR=1.53,95%CI:1.32–1.77)than it did in those aged≥65(HR=1.18,95%CI:1.05–1.32).Significant two-way interactions of sex and aTRH,and age and aTRH on risk of CVD were observed(P<0.05).The observed joint effect of aTRH and ages≥65 years(HR=1.85,95%CI:1.22–2.48)in males was less than what was expected for both additive and multiplicative models(HR=4.10,95%CI:3.63–4.57 and 4.88,95%CI:3.66–6.31),although three-way interaction of sex,age,and aTRH on the risk of CVD and coronary heart disease did not reach a statistical significance(P>0.05).CONCLUSION aTRH was significantly associated with an increased risk of CVD and this association was modified by both sex and age.Further studies are warranted to test these mechanisms.

Clear Cell Sarcoma of the Kidney-A Case Report

Clear cell sarcoma of the kidney （CCSK） is a rare and highly malignant tumor which is usually confused with other kidaey tumors We experienced such a patient and present report this.