Background: Renal stone (RS) is a highly prevalent disease in our societies and is mostly secondary to lifestyle habits. HIV<sub>1</sub> patients often experience RS, although specific risk factors are not...Background: Renal stone (RS) is a highly prevalent disease in our societies and is mostly secondary to lifestyle habits. HIV<sub>1</sub> patients often experience RS, although specific risk factors are not known. Despite other priorities, comprehensive work-up should be offered to avoid recurrences (50% risk in 5 years). Purpose and Methods: The aim of the study is to describe how to handle RS in persons living with HIV<sub>1</sub> and to suggest how the understanding of mechanisms involved in stone composition helps customize therapy and prevent recurrences. We prospectively performed a complete work-up in a cohort of 23 prevalent HIV<sub>1</sub> patients referred to our highly-specialized center by HIV physicians. Results: Inclusion was secondary to a colic episode with spontaneous elimination of the stone (74%), bilateral (67%), not obstructive (67%);53% underwent urologic interventions. Mean age was 34 ± 16 years old and BMI was 22.5 ± 3 (one-third with metabolic syndrome). History of RS showed only one episode (22%), >one (74%) or >4 (4%). Estimated GFR was 78 ± 24 ml/min/1.73m<sup>2</sup> (mean Cr 101 ± 24 μmol/L), and 5 were classified CKD stage 3. Stone analysis was only available for 7 patients and in 6/7 patients, and calcium metabolism was fully explored (2 absorptive hypercalciuria, 4 renal primitive hypercalciuria). Retained mechanism for RS was uric acid dependent for one, oxalic acid dependent for three and calcium dependent for three. Very few patients were exposed to known environmental risk factors for RS, 3 were/had been exposed to darunavir and 3 to atazanavir, 1 to efavirenz, 1 to acetazolamide, 2 to allopurinol. Conclusion: RS in HIV<sub>1</sub> patients is mostly not related to ARV. Understanding of renal stone composition is critical to prevent recurrences by offering specific dietetic counselling and therapy. The role of HIV physicians is important due to the high prevalence of RS in the context of HIV disease.展开更多
Renal transplantation remains the most effective treatment of End Stage Renal Failure (ESRF). In this cross sectional study we explore the reasons behind refusal of renal transplantation among adults’ Sudanese haemod...Renal transplantation remains the most effective treatment of End Stage Renal Failure (ESRF). In this cross sectional study we explore the reasons behind refusal of renal transplantation among adults’ Sudanese haemodialysis patients. The subjects of the study are ESRF adults’ patients on regular haemodialysis treatment in 15 haemdoialysis centres in Khartoum/Sudan. All patients who are on regular haemodialysis were interviewed by questionnaire to explore the reasons of refusal of renal transplantation. A total of 1583 ESRF adults’ patients on regular haemodialysis have been participated in the study, 381 (24.1%) patients refused kidney transplantation. The mean age of patients refusing kidney transplantation was (58.5 + 15.1 years);77.4% of them were ≥50 years old, 59.2% were males and 88.1% were unemployed, patients older than 50 years old and unemployed are tend to refuse renal transplantation展开更多
Sickle Cell Disease (SCD) in adults is one of the causes of renal abnormalities and Chronic Kidney Disease (CKD). In this retrospective study, we explore the renal manifestations among adult SCD patients. The subjects...Sickle Cell Disease (SCD) in adults is one of the causes of renal abnormalities and Chronic Kidney Disease (CKD). In this retrospective study, we explore the renal manifestations among adult SCD patients. The subjects of the study are all adult patients diagnosed with sickle cell anaemia and admitted as to the Academy Charity Teaching Hospital, Khartoum/Sudan during the period (01/01/2015-31/12/2015). All adult SCD patients’ medical files have been reviewed focusing on personal and clinical data in addition to presence or absence of renal manifestations, a total of 51 adult patients with SCD have been admitted to Academy Charity Teaching Hospital, Khartoum/ Sudan. 11 patients have renal manifestations (21.5%). The mean age ± SD of SCD patients with renal manifestations was 20.2 ± 1.9 years, 63.6% were males, the mean Hb level was 6.9 ± 0.99 gm/dl, proteinuria was present among 81.8% of patients, followed by haematuria (36.4%) and End Stage Renal Failure (ESRF) (18.2%). Further prospective studies are needed to explore the renal abnormalities among adult SCD patients.展开更多
文摘Background: Renal stone (RS) is a highly prevalent disease in our societies and is mostly secondary to lifestyle habits. HIV<sub>1</sub> patients often experience RS, although specific risk factors are not known. Despite other priorities, comprehensive work-up should be offered to avoid recurrences (50% risk in 5 years). Purpose and Methods: The aim of the study is to describe how to handle RS in persons living with HIV<sub>1</sub> and to suggest how the understanding of mechanisms involved in stone composition helps customize therapy and prevent recurrences. We prospectively performed a complete work-up in a cohort of 23 prevalent HIV<sub>1</sub> patients referred to our highly-specialized center by HIV physicians. Results: Inclusion was secondary to a colic episode with spontaneous elimination of the stone (74%), bilateral (67%), not obstructive (67%);53% underwent urologic interventions. Mean age was 34 ± 16 years old and BMI was 22.5 ± 3 (one-third with metabolic syndrome). History of RS showed only one episode (22%), >one (74%) or >4 (4%). Estimated GFR was 78 ± 24 ml/min/1.73m<sup>2</sup> (mean Cr 101 ± 24 μmol/L), and 5 were classified CKD stage 3. Stone analysis was only available for 7 patients and in 6/7 patients, and calcium metabolism was fully explored (2 absorptive hypercalciuria, 4 renal primitive hypercalciuria). Retained mechanism for RS was uric acid dependent for one, oxalic acid dependent for three and calcium dependent for three. Very few patients were exposed to known environmental risk factors for RS, 3 were/had been exposed to darunavir and 3 to atazanavir, 1 to efavirenz, 1 to acetazolamide, 2 to allopurinol. Conclusion: RS in HIV<sub>1</sub> patients is mostly not related to ARV. Understanding of renal stone composition is critical to prevent recurrences by offering specific dietetic counselling and therapy. The role of HIV physicians is important due to the high prevalence of RS in the context of HIV disease.
文摘Renal transplantation remains the most effective treatment of End Stage Renal Failure (ESRF). In this cross sectional study we explore the reasons behind refusal of renal transplantation among adults’ Sudanese haemodialysis patients. The subjects of the study are ESRF adults’ patients on regular haemodialysis treatment in 15 haemdoialysis centres in Khartoum/Sudan. All patients who are on regular haemodialysis were interviewed by questionnaire to explore the reasons of refusal of renal transplantation. A total of 1583 ESRF adults’ patients on regular haemodialysis have been participated in the study, 381 (24.1%) patients refused kidney transplantation. The mean age of patients refusing kidney transplantation was (58.5 + 15.1 years);77.4% of them were ≥50 years old, 59.2% were males and 88.1% were unemployed, patients older than 50 years old and unemployed are tend to refuse renal transplantation
文摘Sickle Cell Disease (SCD) in adults is one of the causes of renal abnormalities and Chronic Kidney Disease (CKD). In this retrospective study, we explore the renal manifestations among adult SCD patients. The subjects of the study are all adult patients diagnosed with sickle cell anaemia and admitted as to the Academy Charity Teaching Hospital, Khartoum/Sudan during the period (01/01/2015-31/12/2015). All adult SCD patients’ medical files have been reviewed focusing on personal and clinical data in addition to presence or absence of renal manifestations, a total of 51 adult patients with SCD have been admitted to Academy Charity Teaching Hospital, Khartoum/ Sudan. 11 patients have renal manifestations (21.5%). The mean age ± SD of SCD patients with renal manifestations was 20.2 ± 1.9 years, 63.6% were males, the mean Hb level was 6.9 ± 0.99 gm/dl, proteinuria was present among 81.8% of patients, followed by haematuria (36.4%) and End Stage Renal Failure (ESRF) (18.2%). Further prospective studies are needed to explore the renal abnormalities among adult SCD patients.
