Global Journal of Urology and Nephrology

Research Article of Global Journal of Urology and Nephrology Ultrafiltration (UF) Effectiveness on intradialytic hypertension (IDH) in chronic hemodialysed patients in a nephrology unit in Dakar: UF-IDH clinical trial Ba Bacary 1, Faye Moustapha 1, Keita Niakhaleen 1, Lemrabott Ahmed Tall 1, Seck Sidy Mohamed 2, Faye Maria 1, Mbengue Mansour 1, Diagne Seynabou 1, Ba Mamadou Aw 1, Dieng Ahmed 1, Kane yaya 3, Diouf Boucar 1, Niang Abdou 1, Ka Elhadji Fary 1 1Department of Nephrology, Dialysis and Renal Transplantation of Aristide Le Dantec University Hospital, Cheikh Anta Diop University, Dakar, Senegal. 2Department of nephrology and dialysis of the Military Hospital of Ouakam, Gaston Berger University of Saint Louis, Senegal. 3Departement of nephrology and dialysis of the regional hospital of Ziguichor, Assane Seck university of Ziguinchor, Senegal. Introduction Progressive ultrafiltration (UF) could improve IDH. The aim of this work was to evaluate the effectiveness of progressive UF in the management of IDH. Methods This randomized clinical trial in two groups: interventional group A (UF, n = 12) and control group B (n = 12), was conducted in chronic hemodialysis patients with IDH. A first phase of cross-sectional collection of BP before and after dialysis, during 2 weeks, made it possible to obtain this cohort of 24 patients. A progressive decrease in basal weight of 0.25 kg per session as a function of hemodynamic tolerance was achieved in group A. The primary endpoint, the proportion of patients with disappearance of IDH, was assessed at baseline end of the 4th and 8th week. Results At the 4th week, the IDH disappeared in 83.3% and 41.7% of the patients of the group A and B respectively with a hazard ratio (HR) at 0.29; IC 95 = [0.14-0.59]; p = 0.035. At the 8th week, the IDH was missing in 72.7% and ...

Research Article of Global Journal of Urology and Nephrology Intrinsic factors affecting incidence of urolithiasis in diabetic patients –A preliminary case-control study Kalpesh Saswade1, Maria Tom2, Lekshmi Hareendran2, Vishnu Kamalasanan2, Ganesh Sonawane1, Rohan Kumar1, Praveen Singh1, Biju S Pillai3, Krishna Moorthy H4 1Resident, Department of urology, Lourdes Hospital, Kochi, Kerala, India; 2Department of Pharmacy Practice, St. Joseph’s college of pharmacy, Cherthala, Kerala,India; 3 Consultant, Department of urology, Lourdes Hospital, Kochi, Kerala, India; 4Senior Consultant and Head,  Department of urology, Lourdes Hospital, Kochi, Kerala, India There has been a steep rise in incidence of urolithiasis in recent years. Recent studies have revealed an increased prevalence of urolithiasis in patients with Diabetes Mellitus (DM). The role of various intrinsic factors of diabetic patients such as Body Mass Index (BMI), level of glycemic control, baseline kidney function and mode of treatment of DM which can influence incidence of urolithiasis still remains uninvestigated. This case control study was taken up to evaluate these intrinsic factors affecting the incidence of urolithiasis in patients with DM. The case group included diabetic patients with urolithiasis and the control group included age matched diabetic patients without urolithiasis. We concluded that Higher BMI and higher serum creatinine level in diabetic patients were associated with increased incidence of urolithiasis whereas other intrinsic factors such as age, sex, duration of DM and the level of glycemic control did not have any influence on it. Keywords: Diabetes mellitus, Urolithiasis, BMI, Intrinsic factors ...

Research Article of Global Journal of Urology and Nephrology Accuracy of Prostate Specific Antigen Density in Predicting Prostate Cancer- A single-centre UK experience Rahul Pandya#, Ayesha Butt#, Andrei Bancu, S I Miakhil Urology, North West Anglia NHS trust   # Co-lead author Introduction and objectives: PSA has been a useful tool in identifying prostate cancer since its discovery. However relying on this alone can lead to unnecessary over investigation as it can be falsely raised in other conditions. PSA density is a possible enhanced marker for prostate biopsy indication, however it is not standard practice or recommended in national guidelines. Previous studies have shown that PSA density is most useful when the PSA is in the range of 4-10. We aim to study the effectiveness of PSA density at detecting prostate cancer within that range as well as outside that range. Methods: Retrospective single centre study at Peterborough City Hospital including 500 patients who had a MRI prior to prostate biopsy between July 2017 to July 2018. Patients undergoing repeat biopsy already on a cancer pathway were excluded. PSA density was calculated by dividing PSA from the prostate volume recorded on the MRI. A cut of value of PSA density was chosen at 0.15 and 0.10. Results: Data from 500 patients with a mean age of 65 and mean PSA of 10.7 (PSA range 0.32 to 99). 251 (50.2%) patients had cancer on histology with 152 having clinically significant cancer. Mean PSA density was 0.11ng/ml/cm3 with benign histology, 0.36ng/ml/cm3 for all cancer and 0.48ng/ml/cm3 for clinically significant cancer. Overall the mean PSA density in prostate cancer was found to be 0.15. Sensitivity of PSAD at detecting all prostate cancer at cutoff of 0.10 with PSA 4-10 was 76% and 88% for clinically significant prostate cancer (Gleason 7>). The negative predictive value ...

Review Article of Global Journal of Urology and Nephrology Heat Stress Nephropathy and Cardiovascular Surgery-Associated Renal Failure: Similarities and Implications Puneet Dhawan, MD, Timothy L. Van Natta, MD, MS Department of Surgery, Los Angeles County Harbor-UCLA Medical Center, Torrance, CA Climate changes associated with global warming are producing challenges increasingly relevant to clinicians. Rising temperatures and extended heat waves are associated with a growing incidence of a recently described condition termed heat sensitivity nephropathy. Considering all causes of acute kidney injury and chronic kidney disease, those producing renal dysfunction consequent to cardiovascular surgery may most closely overlap those tied to kidney disease following excessive chronic or acute heat exposure. In this review, heat sensitivity nephropathy and cardiovascular surgery related renal injury are characterized and compared. While both are global in distribution, the former has highest prevalence in remote, rural areas and difficult to study and quantify. Renal injury following cardiovascular surgery, occurring by contrast in relatively controlled settings, is more amenable to evaluation of diagnostic approaches, prognostic indicators, and potential treatments. Such findings may ultimately apply not only to surgically-related kidney damage but to heat sensitivity nephropathy as well. Despite many studies addressing post-cardiovascular surgery renal failure, no single management method has emerged as definitively superior. Nonetheless, reasonably standardized worldwide conduct of cardiac and vascular surgery provides fertile conditions for research that could lead to improved diagnostic and therapeutic approaches. Such findings may ultimately apply to not only surgically-related renal injury but perhaps also to heat sensitivity nephropathy. Instead of anticipating discovery of major isolated preventative or treatment methods applicable to either cause of renal failure, it is more realistic that a series of marginally successful measures employed in combination will engender the most nearterm progress. Potentially complimenting currently available options is biomarker analysis that may better guide both renal ...