MyMedR

Radiological parameters of bleeding renal angiomyolipoma

Koh KB, George J

Scand. J. Urol. Nephrol., 1996 Aug;30(4):265-8.

Angiomyolipomas are rare tumours of the kidney which have a tendency to bleed. We studied the clinical and radiological features of 11 patients from our institution to identify features which may be predictive of a massive haemorrhage. Tumours more than 6 cm in diameter were found to bleed and the demonstration of pseudoaneurysms on contrast CT scanning was associated with massive haemorrhage. We conclude that large angiomyolipomas should be treated to avoid haemorrhage and the detection of pseudoaneurysms should prompt urgent treatment.

Matched MeSH terms: Kidney Neoplasms/complications

Fulltext Spontaneous rupture of renal angiomyolipoma presenting as acute abdomen

Koh KB, Wightman JA, George J

Med J Malaysia, 1996 Mar;51(1):148-50.

PMID: 10967998

Five cases of renal angiomyolipoma which underwent spontaneous rupture are described. These patients presented as an "acute abdomen" for which the diagnosis was not initially apparent. A high index of suspicion is required to make the diagnosis even with modern imaging techniques. The treatment of these tumours is discussed.

Matched MeSH terms: Kidney Neoplasms/diagnosis*

Fulltext Renal vein thrombosis and the nephrotic syndrome

Segasothy M, Kamal A, Pang KS

Med J Malaysia, 1983 Jun;38(2):114-7.

PMID: 6621439

A 31 year old Chinese man developed the nephrotic syndrome, and wasfound to have some of the clinical features of renal vein thrombosis such as a rapid deterioration in renal function and great variability in proteinuria. Radiological studies confirmed the diagnosis of bilateral renal vein thrombosis. The clinical features and pathogenesis of renal vein thrombosis are discussed.

Matched MeSH terms: Kidney/pathology

Fulltext Retrospective study of anaesthesia for renal transplantation during the years 1979 till 1984

Satgurunathan P

Med J Malaysia, 1985 Dec;40(4):271-5.

PMID: 3916211

In this project, a retrospective study regarding the anaesthetic techniques, complications and the relevant monitoring aids needed during the procedure, is made from analysis of the 100 available anaesthetic records of cases done during the five years at the Urology Department, General Hospital, Kuala Lumpur. The total number of cases done during 1979-1984 was 112 but 12 anaesthetic record sheets were missing. The patients requiring renal transplant operation were representative of the end-stage chronic renal failure population of Malaysia with the usual high incidence of cardiovascular and biochemical abnormalities. Except for two cases of epidural anaesthesia, all the other patients received general anaesthesia. Induction was with intravenous barbiturate followed by muscle relaxant, neurolept or narcotic and halothane supplement for maintenance. There were no intraoperative or postoperative deaths due to anaesthetic complications. There were five cases of anaesthetic morbidity of which three cases had inadequate reversal of neuromuscular blocking agents and required postoperative ventilation and two cases had poor respiratory effort and required naloxone supplement. Less serious complications such as allergic manifestations were seen in three cases with use of the new muscle relaxant atracurium. The conclusion was that general anaesthesia using thiopentone for induction, pancuronium bromide for intubation and maintenance of muscle relaxation and neurolept fentanyl/droperidol and halothane supplement, all in doses tailored to the requirements ofa renal failure patient, is a suitable technique of anaesthesia for renal transplant operation. Atracurium, the new muscle relaxant, seems to be a favourable alternative to pancuronium bromide. However, as only five cases in our study received atracurium, further studies would have to be done to support it.

Matched MeSH terms: Kidney Transplantation*

Fulltext Pattern of glomerular disease in Malaysia

Cheong IK, Chong SM, Suleiman AB

Med J Malaysia, 1981 Mar;36(1):3-7.

PMID: 7321935

This paper reviews the pattern of glomeruler disease from 163 renal biopsies performed at the Institute of Urology and Nephrology. Nephrotic syndrome formed the largest group of patients. There is a high prevalence of SLE nephritis in our community. The histopathologic findings in our series were comparable to those from Western countries except for the lower incidence of membranous and membranoproliferative glomerulonephritis.

Matched MeSH terms: Kidney/pathology

Fulltext Intravenous urogram in acute renal failure

Md Ghazali AR, Suleiman AB, Md Alif AK, Thillakanu A

Med J Malaysia, 1981 Jun;36(2):104-7.

PMID: 7343817

Thirty-four case notes of patients in acute renal failure on whom intravenous urograms (IVU) were performed, were reviewed. All patients received high doses of Conray 420 or Urotrast. Delayed films up to 48 hours were routinely done in patients suspected of having obstruction. There were no side effects of the intravenous urogram examination. IVU with high dose contrast material and nephrogram are helpful in differentiating the cause of the acute renal failure, and in excluding outflow obstruction.

Matched MeSH terms: Acute Kidney Injury/radiography*

Fulltext Acute renal failure due to multiple bee stings--case reports

Ramanathan M, Lam HS

Med J Malaysia, 1990 Dec;45(4):344-6.

PMID: 2152058

This report deals with a father and his son who developed acute renal failure following multiple bee stings. The renal lesion in these patients appears to be due to rhabdomyolysis caused by the bee venom. The other mechanisms are also discussed. The need for clinicians to be aware of acute renal failure as a complication of bee stings is stressed.

Matched MeSH terms: Acute Kidney Injury/etiology*

Fulltext 16 cases of acute renal failure due to leptospirosis

Tan DSK, Suleiman AB, Jeyaindran S

Med J Malaysia, 1986 Jun;41(2):152-5.

PMID: 3821611

A study was carried out on 16 cases of leptospirosis with acute renal failure (ARF) detected in adult patients admitted into the Medical and Nephrology wards of the General Hospital, Kuala Lumpur, over a four-year period from 1980 to 1983. Most of the cases were male, Malays and older adults. The predominant infecting serovars were L. celledoni (of the serogroup L. javanica and L. pomona (of the L. pomona serogroup]. All the cases survived, including those who required peritoneal dialysis. The sensitised erythrocyte lysis (SEL) antibody prevalence rate of the chronic renal failure cases (10.4%) was found to be similar to that of the healthy population in West Malaysia (12. 7%), confirming the observation by other workers that leptospirosis is not an important cause of chronic renal failure.

Matched MeSH terms: Acute Kidney Injury/etiology*

Fulltext Analgesic nephropathy as a cause of end-stage renal disease in Malaysia

Segasothy M, Suleiman AB, Hasnah A, Salbiah N, Shaharom CM, Siti Sabzah H, et al.

Med J Malaysia, 1986 Jun;41(2):134-8.

PMID: 3821608

We questioned 180 patients with end-stage renal disease on maintenance haemodialysis, chronic ambulatory peritoneal dialysis and those who had undergone renal transplantation at the Department of Nephrology, General Hospital, Kuala Lumpur. Twelve patients (6.7%) had consumed excessive quantities ofanalgesics prior to the institution of long-term dialysis or transplantation. Primary renal disease was considered to be analgesic nephropathy in seven patients (3.9%); in five patients (2.8%), analgesic abuse could have been a contributory factor to end-stage renal failure. Analgesic nephropathy is hence an uncommon cause of end-stage renal disease in Malaysia. However, it is important to be aware of the problem and to institute preventive measures as the cost of treatment for end-stage renal disease is prohibitive.

Matched MeSH terms: Kidney Failure, Chronic/chemically induced*

Fulltext Locus of control and reaction to illness: a study of patients with chronic renal failure

Boey KW

Med J Malaysia, 1984 Dec;39(4):275-9.

PMID: 6544932

The relationship between locus of control and reaction to illness is empirically examined in a group of patients on haemodialysis for chronic renal failure. Results of the study suggest that patients who perceive themselves as having personal control over life events tend to have stronger feelings that their illness has made them dependent on others. There is also a greater tendency for them to exhibit more information seeking behaviour, and to adopt an active, problem-solving and intellectual approach to cope with their chronic renal failure. Relevance of the findings and implication for treatment outcome are discussed.

Matched MeSH terms: Kidney Failure, Chronic/psychology*

The pathology of the nephrotic syndrome in Malaysians

Prathap K, Looi LM, Lam KL, Wang F, Chua CT

Malays J Pathol, 1983 Aug;6:39-49.

PMID: 6599867

Matched MeSH terms: Kidney Glomerulus/pathology*

Fulltext Ultrasound--a new imaging technique

Md Alif AK

Med J Malaysia, 1980 Jun;34(4):383-6.

PMID: 7219268

Matched MeSH terms: Kidney Diseases/diagnosis

Radiocontrast-induced nephropathy in a pair of xiphaomphalopagus conjoined twins during the neonatal period

Boo NY, Mahmud MN, Samad SA

Acta Paediatr Scand, 1991 6 1;80(6-7):735-7.

PMID: 1867096

One of the babies in a pair of xiphaomphalopagus conjoined twins developed oliguria, transient rise in serum creatinine and persistent nephrogram on the sixth day of life following injection of radiocontrast medium for computerised axial tomography scanning of the urinary system. The other twin was spared but developed hypertension and "dialysed" the oliguric twin. The renal profiles of both neonates subsequently remained normal until they reached adequate weight for surgical separation at a later date.

Matched MeSH terms: Kidney Diseases/chemically induced*

Fulltext Post-hysterectomy choriocarcinoma with pulmonary and renal metastases

Thanikasalam K

Med J Malaysia, 1991 Jun;46(2):187-91.

PMID: 1839425

The propensity of choriocarcinoma to metastasize to lungs, liver and brain is well known. Though theoretically metastases are possible to anywhere in the body, renal metastases are rare. A 56 year old Malay woman who had total abdominal hysterectomy in 1985 for molar pregnancy presented with haemoptysis and dyspnea in 1990. Examination showed she had choriocarcinoma with pulmonary and renal metastases.

Matched MeSH terms: Kidney Neoplasms/secondary

Fulltext Renal size in healthy Malaysian adults by ultrasonography

Wang F, Cheok SP, Kuan BB

Med J Malaysia, 1989 Mar;44(1):45-51.

PMID: 2696868

Two hundred and five healthy Malaysian adults were scanned for the length of their kidneys and the cortical thickness by both the sector real time and linear array static B-scan diagnostic ultrasound. The length of the left kidney was found to measure 105 (98-111) mm for males, and 100 (94-106) mm for females on average from the sector scan and the static B-scan. The right renal length was 102 (96-119) mm for males, and 98 (92-103) mm for females on the average from readings of both scans. The left kidney is longer in length than the right kidney in males and females on both scans. The cortical thickness at the equator of the kidneys of males and females ranges from 12-14 mm. In both sexes, the lengths of the kidneys may be estimated by the distance between the first to the fourth lumbar transverse processes when there is no scoliosis.

Matched MeSH terms: Kidney/anatomy & histology*

Fulltext Living related renal transplantation in Kuala Lumpur

Suleiman AB, Awang H, Proehoeman F, Arshad R

Med J Malaysia, 1982 Sep;37(3):273-5.

PMID: 6757687

Fifty-six living related renal transplants were performed between December 1975 and December 1980. All except eight of the recipients were male. The mean age was 29.5 years. Patient and graft survival were 86 percent and 73 percent at 1 year and 83 percent and 68 percent at 2 years respectively. Infection was the main cause of death and acute and chronic rejection were the main causes of graft failure. The donors were aged between 18 and 72 years old. There were 21 parent and 35 sibling donors. Donor nephrectomies were performed without mortality and our experience so far with the transplantation of kidneys from elderly donors has been encouraging.

Matched MeSH terms: Kidney Transplantation*

Fulltext Peritoneal implantation of ureter in a cadaveric kidney transplant recipient

Tan SY, Lim CS, Teo SM, Lee SH, Razack A, Loh CS

Med J Malaysia, 2003 Dec;58(5):769-70.

PMID: 15190667

We report here a case of a kidney transplant recipient in whom the ureter was initially implanted into the peritoneum. Excessive ultrafiltration volume and reversal of serum vs dialysate creatinine ratio when the patient was recommenced on continuous ambulatory peritoneal dialysis first suggested the diagnosis which was subsequently confirmed by a plain abdominal x-ray demonstrating placement of ureteric stent in the peritoneum. This rare complication was successfully corrected with surgical re-implantation of ureter into the bladder and 5 years later, the patient remains well with good graft function.

Matched MeSH terms: Kidney Transplantation/methods*

Fulltext Protocol of randomized control trial for effectiveness of angiotensin receptor blockers on blood pressure control among euvolemic hypertensive hemodialysis patients

Aftab RA, Khan AH, Syed Sulaiman SA, Khan TM, Adnan AS

Medicine (Baltimore), 2017 Apr;96(14):e6198.

PMID: 28383400 DOI: 10.1097/MD.0000000000006198

INTRODUCTION: Volume overload and the renin-aldosterone-angiotensin system (RAAS) are 2 major factors contributing to hypertension (HTN) among hemodialysis (HD) patients. Although volume-dependent components of HTN can be corrected by appropriate volume removal, a proportion of HD patients experience elevated blood pressure (BP) despite achieving euvolemic and ideal dry weight.

METHOD AND ANALYSIS: A single center, prospective, randomized, parallel design, single-blind trial will be conducted in the Malaysian state of Kelantan among postdialysis euvolemic hypertensive patients that are on regular dialysis at least 3 times a week. The primary outcome of the trial will be to note the effectiveness of losartan (RAAS inhibitor) in reducing systolic BP 140 mm Hg will be randomized using Covariate Adaptive Randomization to standard or treatment arm. Participants in the treatment arm will be given 50 mg of losartan once daily except on dialysis days, whereas the standard arm patients will be prescribed non-RAAS antihypertensive agents. The study participants will be followed for a period of 12 months. A Wilcoxon statistical test will be performed to note the difference in BP from baseline up to 12 months using Statistical Package for the Social Sciences (SPSS) 20.

ETHICAL AND TRIAL REGISTRATION: The study protocols are approved from the Ethical and Research Committee of the Universiti Sains Malaysia (USM/JEPeM/15050173). The trial is registered under the Australia New Zealand Clinical Trial Registry (ACTRN12615001322527). The trial was registered on 2/12/2015 and the 1st patient was enrolled on 10/12/2015. The trial was formally initiated on 16/02/2016.

CONCLUSION: Management of HTN among HD patients requires understanding the primary cause of HTN and treating accordingly. The current trial is an attempt to reduce BP among postdialysis euvolemic but hypertensive patients.

Matched MeSH terms: Kidney Failure, Chronic/complications*

Fulltext Rapid decline of renal function in patients with type 2 diabetes with heavy proteinuria: a report of three cases

Lim CTS, Nordin NZ, Fadhlina NZ, Anim MS, Kalaiselvam T, Haikal WZ, et al.

BMC Nephrol, 2019 01 16;20(1):22.

PMID: 30651084 DOI: 10.1186/s12882-019-1203-7

BACKGROUND: Although there is a large volume of literature regarding the definition and epidemiology of. Type 2 diabetes nephropathy (T2DN). There has been a paucity of data focused on the rate of transition of T2 DN. Based on our personal observation a certain percentage of our incident end stage renal disease (ESRD) patients from T2DN experienced a rapid decline of renal function. Their rapid decline nature of glomerular filtration rate (GFR) of 46 to 60 mL/min per 1.73m2 per year have far exceeded the KDIGO definitions of acute kidney injury (abrupt decrease in kidney function occurring over 7 days or less), acute kidney disease (acute or subacute damage and/or loss of kidney function for a duration of between 7 and 90 days after exposure to an acute kidney injury initiating event (Chawla et al Nat Rev Nephrol 241-57 2017) or even rapid decliner (eGFR declines > 5 mL/min per 1.73m2 per year) (Chawla et al Nat Rev Nephrol 241-57 2017; Andrassy Kidney Int 622-623 2013).

CASE PRESENTATION: We describe here three cases of type 2 diabetic patients that have rapid renal deterioration with rate of decline 46 - 60 mL/min per 1.73m2 per year. All the patients are heavily nephrotic. All of the renal biopsies done showed the classical diabetic changes, hypertensive changes, diffuse tubulointerstitial damage, and interstitial nephritis. All of the patients admitted to taking various form of traditional medications in hope of curing their renal disease.

CONCLUSION: We wish to highlight that type 2 diabetics with massive nephrotic range proteinuria have enhanced risk of rapid renal function deterioration. The patients should be educated about the risks of rapid renal function deterioration when there is presence of heavy proteinuria. High grade proteinuria is likely to inflict the diffuse tubulointerstitial inflammation. The interstitial nephritis could be further worsened by traditional supplements consumption. Timely health education and advice must be undertaken to retard this unwanted rapid renal disease progression.

Matched MeSH terms: Kidney/pathology; Kidney Failure, Chronic/etiology*; Kidney Failure, Chronic/physiopathology; Kidney Failure, Chronic/therapy; Acute Kidney Injury/physiopathology

Diazinon-induced oxidative stress and renal dysfunction in rats

Shah MD, Iqbal M

Food Chem Toxicol, 2010 Dec;48(12):3345-53.

PMID: 20828599 DOI: 10.1016/j.fct.2010.09.003

Diazinon (O,O-diethyl-O-[2-isopropyl-6-methyl-4-pyrimidinyl] phosphoro thioate), an organo-phosphate insecticide, has been used worldwide in agriculture and domestic for several years, which has led to a variety of negative effects in non target species including humans. However, its nephrotoxic effects and mechanism of action has not been fully elucidated so far. Therefore, the present study was aimed at evaluating the nephrotoxic effects of diazinon and its mechanism of action with special reference to its possible ROS generating potential in rats. Treatment of rats with diazinon significantly enhances renal lipid peroxidation which is accompanied by a decrease in the activities of renal antioxidant enzymes (e.g. catalase, glutathione peroxidise, glutathione reductase, glucose-6-phosphate dehydrogenase, glutathione S-transferase) and depletion in the level of glutathione reduced. In contrast, the activities of renal γ-glutamyl transpeptidase and quinone reductase were increased. Parallel to these changes, diazinon treatment enhances renal damage as evidenced by sharp increase in blood urea nitrogen and serum creatinine. Additionally, the impairment of renal function corresponds histopathologically. In summary, our results indicate that diazinon treatment eventuates in decreased renal glutathione reduced, a fall in the activities of antioxidant enzymes including the enzymes involved in glutathione metabolism and excessive production of oxidants with concomitant renal damage, all of which are involved in the cascade of events leading to diazinon-mediated renal oxidative stress and toxicity. We concluded that in diazinon exposure, depletion of antioxidant enzymes is accompanied by induction of oxidative stress that might be beneficial in monitoring diazinon toxicity.

Matched MeSH terms: Kidney/drug effects; Kidney/metabolism; Kidney/pathology; Kidney Diseases/chemically induced*; Kidney Diseases/metabolism; Kidney Diseases/pathology

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