Rhabdomyolysis is a clinical syndrome characterized by necrosis of skeletal/striated muscle tissue and the release of intracellular elements into circulation, dominated by markedly elevated creatine kinase (CK) levels, myoglobinuria, and muscle weakness. Among the drugs that cause rhabdomyolysis, statins are most well-known, but many other drugs and their interactions can also trigger it. Polypharmacy nowadays represents a significant clinical challenge, especially in elderly patients and those with chronic illnesses. Combination of multiple drugs can lead to serious adverse effects. This paper presents a case in which the interaction between statins, ezetimibe, cyclosporine and clarithromycin led to the development of clinically significant rhabdomyolysis. Caution when prescribing medications, regular therapy reviews, and the use of available interaction-checking tools are key to preventing such adverse events.
Renal cell carcinoma (RCC) has a relatively high rate of metastasis which carries a grave prognosis, yet the location and presentation of metastatic disease can be quite unpredictable. We present a case of metastatic clear cell RCC presenting with nonspecific gastrointestinal symptoms before imaging revealed hepatoduodenal fistulization and multiple masses concerning for abscess vs metastases. Subsequent biopsy revealed an uncommon tumor marker profile. The ultimate diagnosis depended on piecing together the patient's clinical history, current presentation, and histopathological features.
Introduction: Chronic kidney disease (CKD) remains a major public health problem in sub-Saharan Africa, often underdiagnosed due to its silent progression. This study aims to estimate the prevalence of kidney disease markers and identify associated factors in the general adult population of Brazzaville. Methods: A cross-sectional survey was conducted in 2024 among 1629 adults aged ≥ 18 years. Data collected included sex, age, blood glucose, blood pressure, body mass index (BMI), serum creatinine, proteinuria (PU), and hematuria (HU). The presence of a renal marker was defined as serum creatinine ≥ 14 mg/L, proteinuria, and/or hematuria. Multivariate logistic regression was used to determine associated factors. Results: The overall prevalence of renal involvement was 25.3%. The most common abnormalities were proteinuria (31.9%) and elevated serum creatinine (17.5%). Significantly associated factors were male sex (OR = 1.68; 95% CI [1.38-2.05]), age > 65 years (OR = 1.71; 95% CI [1.16-2.53]), and overweight/obesity (OR = 1.37; 95% CI [1.10-1.71]). Conclusion : A quarter of the adult population of Brazzaville has at least one marker of kidney disease. These results, well above regional averages, highlight the urgent need to implement targeted screening and prevention strategies, particularly among older and overweight men.
Vitamin B12 deficiency is a significant concern among patients with end-stage renal disease undergoing dialysis. However, there hasn’t been extensive research conducted on this particular patient group. The reported incidence rates vary widely, ranging from 20% to 90%, reflecting the complexity of its diagnosis. Dialysis patients often face multiple nutritional deficiencies, including a lack of essential vitamins, due to factors such as dietary restrictions, impaired absorption, and nutrient loss during dialysis. Diagnosing vitamin B12 deficiency in these patients is challenging, and addressing it is crucial to prevent complications and improve their overall quality of life. This review paper delves into the available body of evidence on vitamin B12 deficiency in dialysis patients, examining the contributing risk factors, diagnostic challenges, potential complications, and available treatment options. It provides a well-rounded perspective on the topic, making it a valuable resource for researchers, healthcare practitioners, and policymakers interested in addressing the nutritional needs of dialysis patients.
CliNiCal ReSeaRCH Check for updatesIn the cohort who developed hypomagnesemia, demographic features, clinical characteristics and associated risk factors were explored.This is thought to be helpful in identifying the high risk population of HD patients who may need frequent monitoring targets. Methods Location and the population
Background: Chronic kidney disease (CKD) is a noncommunicable disorder that causes a progressive decline in kidney function, leading to complications such as metabolic disorders that can increase the risk of heart diseases.Metabolic syndrome (MetS) is a significant global health issue characterized by a combination of factors like high blood pressure, central obesity, abnormal lipid levels, and elevated blood sugar levels.As such, this research conducted in Northwest Ethiopia sought to determine the prevalence of MetS and its related factors among CKD patients within the Ethiopian population.Method: An institutional cross-sectional study was carried out at the renal clinic in FHCRH located in Bahir Dar, Ethiopia.Data collection was done through face-to-face interviews using a structured questionnaire.Blood pressure and anthropometric parameters were measured following standard procedures.Approximately 5 ml of serum was exploited for analyzing lipid profiles and fasting blood glucose levels using an automated chemistry analyzer.Statistical analysis of all data was conducted using the Statistical Package for the Social Sciences (SPSS) software version 25.A significance level of P < 0.05 was considered statistically significant.Result: A total of one hundred CKD patients participated in the study, resulting in a response rate of 100%.The findings indicated that approximately 16.1% (95% CI: 8.02-27.67) of males and 21.1% (95% CI: 9.55-37.32) of females were found to have MetS, with an overall prevalence of around 18% (95% CI: 11.03-26.95).Analysis of the individual components of MetS revealed that most components were more prevalent in females, except for elevated fasting blood glucose, which was higher among males.The most common component among all participants was increased waist circumference (21%), while elevated triglycerides had the lowest prevalence at 14%. Conclusion:In conclusion, this study underscores the significant prevalence of MetS among CKD patients in Northwest Ethiopia.It emphasizes the critical need for early detection, prevention, and effective management strategies for MetS in CKD patients, particularly those with a family history of these conditions and older age.
The aim of the present study was to compare of the effects of different dialysis modalities on the short-term survival rate of hemodialysis patients with AMI. We retrospectively analyzed 68 hemodialysis patients with AMI between January 2014 and April 2023. General clinical information were collected from patients. Kaplan-Meier plots was employed to analyze the impact of different dialysis modalities on short-term survival rate. Risk factors for short-term mortality rate were further analyzed using logistic regression.
Adequacy and quality goals in dialysis units are mainly focused on laboratory targets, and although their clinical relevance is not questionable, they overlook the importance of patients' experiences and preferences. We aim to evaluate the health-related quality of life in peritoneal dialysis patients using the 5-level EQ-5D questionnaire and assess the relationship between the health state and the current standard criteria of quality in dialysis.
Methamphetamine is an easily available drug worldwide with an estimated 24.7 million active users in 2015 survey while in Malaysia is around 66.4% which are 85,707 people out of total 129,092 drug abuser [1] in 2022. It is sold illegally and common presentation is related to central nervous system like psychosis. There is a case in which the patient presented with chest pain after ingesting a high amount of amphetamine tablets with normal conscious level and electrocardiogram (ECG) finding but had kidney impairment and high creatine kinase level (CK) most likely rhabdomyolysis.
Light chain deposition disease (LCDD) is a rare condition that is characterized by the deposition of monoclonal immunoglobulin light chains in glomerular and tubular basement membranes. We report the case of a 72-year-old male with long-standing and stable chronic kidney disease (CKD) presumably due to hypertension.
Renal transplantation is the best treatment for the replacement of renal function. The majority of dermatological complications related to renal failure regress after transplantation. Nevertheless, the chronic and powerful systemic immunosuppression, gave rise to a series of mucocutaneous manifestations, hence the need for a systematic and regular follow-up in dermatology [1].
The increasing consumption of alcohol is becoming a significant global health problem. Alcohol intoxication is reported to be the cause of 3 million deaths per year worldwide. One of the causes of alcohol intoxication is methanol, which usually occurs as a result of consuming bootleg liquor. A 41-year-old man was brought to dr. Soebandi Hospital Jember with sudden loss of consciousness and sudden blindness after consuming Lapen Jamu. The patient had metabolic acidosis, optic neuritis, and acute renal failure. Management in this case was carried out by stopping the formation of toxic metabolites, correction of metabolic acidosis, and supportive therapy according to symptoms.
Acute thrombotic microangiopathies (TMA) represent an heterogeneous group of diseases, including complement-mediated hemolytic uremic syndrome (CM-HUS). CM-HUS results from an alternative complement pathway dysregulation as a result of mutations in complement factors or antibodies against these factors. It is important to exclude secondary causes of TMA before establish CM-HUS as a final diagnosis.
A male in his 70s with a history of hypertension, ulcerative colitis, diabetes mellitus, elbow melanoma with axillary lymphadenopathy status post excision on nivolumab therapy (completed 12/13 doses), presented after outpatient bloodwork revealed elevated creatinine within the context of one week of diffuse, watery diarrhea. Patient's baseline creatinine one month ago was .82, but on admission it was 6.77 mg/dL. He denies changes in urination, hematuria, or dysuria. On admission, labs were significant for potassium of 5.5 mmol/L, blood urea nitrogen of 92 mg/dL (26 previously), and creatinine 6.77 mg/dL (0.82 one month prior).
Treatment of viral hepatitis C in chronic kidney disease patients with glomerular filtration rate < 30 ml/min/1.73 m2 remains a challenge in countries with combinations containing only sofosbuvir. We investigated the efficacy and safety of sofosbuvir based regimens in patients infected with hepatitis C virus and stage 4 and 5 chronic kidney disease.
Acute kidney injury (AKI) is associated with increased mortality in pediatric intensive care unit (PICU) patients. Early detection of AKI helps clinicians to manage promptly. Renal angina index (RAI) is established from changes in serum creatinine and condition of patients.
