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Register a new userRenal Biopsy in Patients with low level of Proteinuria
خزعة الكلية عند مرضى البيلة البروتينية المنخفضة
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Tishreen University ورقة بحثية
Publication date
2013
fields
Medicine
and research's language is
العربية
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إن التشخيص المبكر والدقيق للاعتلال الكبي الكلوي البدئي أو الثانوي يسمح بمقاربة علاجية مناسبة مما يحسن إنذار المرض بشكل ملموس. تعدّ خزعة الكلية أهم أداة تشخيصية لتحديد طبيعة الأذية الكلوية . أهمية البحث وأهدافه: تهدف هذه الدراسة إلى تحديد الوقت الذي نضطر فيه لإجراء خزعة الكلية عند المرضى الذين يعانون من بيلة بروتينية < 1500 ملغ / بول 24 ساعة ، في غياب القصور الكلوي الحاد acute renal failure (ARF). وجد لدينا 16 من 50 حالة مرضية أجري لهم خزعة كلية في الفترة من 2011 -2013 في مشفى الأسد والمواساة الجامعيين في دمشق، وكانت البيلة البروتينية لديهم < 1500 ملغ /24 ساعة ، مع وظيفة كلوية طبيعية . نسبة الاناث إلى الذكور 1:3. خمسة مرضى ( 31.25% ) شُخّص لهم اعتلال كلوي غشائي MN ، 3 حالات ( 18.75%) FSGS ، حالتان (12.5% ) كان لديهم MCD ، حالة (6.25%) MPGN، و5 حالات ( 31.25%) اعتلال كلوي ذئبي LN منها حالة نمط I ، حالتان نمط مشترك (III+V ) وحالة IV+V ، و حالة نمط V. ثمانية مرضى عانوا من بيلة بروتينية فقط دون بيلة دموية عند إجراء الخزعة ، مريضان (25%) شُخّص لديهم MN، واثنان FSGS ، و مريض (12.5%) MCD ، و ثلاثة مرضى (37.5%) شخص لهم LN . البيلة البروتينية ≤ 500 ملغ / بول 24 ساعة وجدت عند 3 مرضى بنسبة 18.75% عانوا من MN,MCD,MPGN . تبين نتائج دراستنا وجود أذية كلوية واضحة ( MN –FSGS- MPGN-LN) لدى المرضى المتابعين في هذه الدراسة مما يسوغ أهمية إجراء الخزعة الكلوية في مثل هذه الحالات بشكل روتيني وباكر.
Early and accurate detection of kidney involvement in primary and secondary glomerulopathy, and therapeutic regimen mayimprove outcomes. Renal biopsy is required for definitive diagnosisof renal disease. This study investigated whether patients with proteinuria < 1500 my/24 h without ARF have significant renal disease and should be biopsied. 50 patientsunderwent kidney biopsies during 2011-2013 in Al-Assad University Hospital and Al-Mousah University Hospital in Damascus. Sixteen of them have 24-h urine protein < 1500 mg andnormal kidney function.Female to male ratio was 3:1. Five patients(31.25%) have MN, 3 patients (18.75%) have FSGS, 2 patients (12.5%) have MCD, one case (6.25%) MPGN, and finely 5 patients (31.25%) have LNfrom which there is a case with class I,2 cases with class III(superimposed classV),and a case with IV(superimposed classV), and one case with class V.Out of 8 patients without hematuria at the time of biopsy, 2 (25%) had MN, 2 (25%) had FSGS,one patient(12.5%) MCD, 3 patients(37.5%) had LN.Three patients (18.75%) hadproteinuria <500 mg/24 h, andwere diagnosed with (MN,MCD,MPGN).Our findings showa significant renal involvement(MN-FSGS-MPGN-LN), whichreveals the importanceof conducting biopsyearly and routinely in the patient population.
References used
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Back pound: Patients with end stage renal disease (ESRD) and lower urinary tract anomalies (LUTA) are often considered high risk for renal transplantation.
Methods and subjects: To evaluate the degree of risk, we have reviewed our experience of 17 p
atients with (ESRD) and (LUTA). The study was carried out in Almoussat university hospital, between 5/ 2003 and 5/2009. After a detailed urological assessment, the patients had been undergone either non-continent cutaneous diversion (Bricker) (Two patients) or continent cutaneous diversion with bladder augmentation (14 patients), before renal transplantation.
Results: The patient and graft survival rates were 84.62% and 100%, respectively. The presence of an ileal conduit did not adversely affect graft survival. And the commonest complication was persistent urinary tract infection, which occurred in all patients (100%), but didn’t cause any graft loss. However two patients died because of systemic infections and their graft function was
good.
Conclusion: Renal transplantation is a satisfactory option for patients with ESRD due to LUTA, but it is important to carry out detailed urological assessment prior to the transplant procedure.
Renal diseases are an important medical subject because of their prevalence, so to know frequency of glomerular diseases in Syria and compare it with international studies we studied 261 renal biopsies over a period (1/1/2007–31/12/2012), in Al As
sad Hospital of the University in Damascus, investigated by light microscopy immunofluorescence. One hundred and ten cases (59.8%) were primary glomerulonephritis from 184 cases of glomerular disease focal/segmental glomerulosclerosis FSGS was the most common type of primary glomerulonephritis found (30.9%) of primary glomerulonephritis), followed by membranous nephropathy(MN) in 29.1 % , IgAnephropathy (IgAN) in 10%, then membranoproliferative glomerulonephritis (MPGN) and minimal change disease(MCD) 9.1% and, crescentic glomerulonephritis (CerGN) in 6.4% and finally postinfectious glomerulonephritis (PIGN) 5.5 % of the secondary glomerulonephritis were (74 cases constituting 40.2% of the biopsies) lupus nephritis(LN) was the most frequently diagnosed disease (85.1% of secondary glomerulonephritis) diabetic nephropathy (DN) was found in 8.1% of cases amyloidosis (AMD) in 6.8%.
vascular complications are impotent after kidney Transplantation, They
influence on patient and graft survival . There are a lot of factors that play are a role in incidence of these
vascular compilations as technical and anatomical ones .
the aim
is to determine the incidence of vascular complications in kidney transplant
patients in addition to signs and symptoms related to these complications, diagnosis modalities,
management and results.
Compliance of treatment regimens considers one of the challenge the end-stage renal
disease patients, because of its highly cost related to medication, sessions, diets and the life
style modification.
Objective: to assess the compliance of end-sta
ge renal disease patients with
treatment regimens. Setting: The study was carried out in all the hemodialysis departments
in the governmental hospitals in Lattakia. These were Al-Assad Hospital- Public Lattakia
Hospital- Military Hospital- Jablah Public Hospital- Al-Kurdaha Public Hospital- Al-Hafa
Public Hospital. Subjects: the study consisted 230 patients of the hemodialysis department
in the time of study from the first of November to April 2014. Tool: patients were
interviewed individually to collect the necessary data using tool I, their compliance with
treatment regimen were assessed using tool II. Results: only 2.17% of the patients were
compliance with prescribed treatment regimen. Their compliance was affected by some
factors like the hospital where they got sessions, monthly income, and with the date of
beginning treatment.
Purpose: Lacunar infarcts is an important stroke subgroup with unique clinical and
pathologic features, but risk factors for lacunar infarcts have been rarely documented. To
address this matter, we studied 65 patients had lacunar infarction at Depa
rtment of
Neurology , Tishreen University Hospital , Lattakia , Syria , and 65 controls during the
period between May 2017 – May 2018 .
Methods: We obtained information concerning risk factor exposure status among the
patients by a structured questionnaire , we recorded age , sex , blood pressure , glucose ,
heart diseases , cigarette smoking , alcohol drinking , physical exercise for patiens and
controls .We do laboratory tests and ECG and echocardiography and CT brain or MRI .
Results: Significantly increasing the risk of lacunar stroke were hypertension
(P-value=0.0001) and (OR=9.9), Current smokers (P-value=0.002) and (OR=5.2), diabetes
(P-value=0.001) and (OR=5.3) , whereas frequent physical exercise was associated with a
significantly decreased risk) P-value=00001( and (OR=2.6). There was no risk of
lacunar stroke associated with heart disease (P-value=0.6) (OR=0.8) , high cholesterol (Pvalue=
1) and (OR=1) , alcohol drinking (P-value=0.7) and (OR=0.8).
Conclusions: Patients with hypertension or diabetes, current smokers, those who
have not heart disease, are at a higher risk of lacunar stroke, whereas those who undertake
regular physical exercise may be at lower risk.
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