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Saudi Journal of Kidney Diseases and Transplantation
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   1996| July-September  | Volume 7 | Issue 3  
    Online since March 12, 2008

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Acute Renal Failure Following Snake Bite: Case Report and Review
Mohammed Al-Homrany
July-September 1996, 7(3):309-312
We present an adult male patient who presented with history of having been bitten by a snake. Despite administration of antivenom and adequate hydration, he developed acute renal failure secondary to disseminated intravas-cular coagulation and rhabdomyolysis. He improved with daily hemodialysis and at discharge had normal renal function. Although we did not perform a renal biopsy on him, the clinical course was highly suggestive of acute tubular necrosis. The pathogenesis, pathology, as well as therapy of renal involvement following venomous snake bite is discussed.
  8,737 616 -
Blood Pressure Among School Children in Jordan
Taleb A Switty, Bassam H Shaheen, Muin S Habashneh, Zuhair Kelani, Issa A Hazza
July-September 1996, 7(3):283-290
A prospective study was carried out over a three-year period (1993-95) on 4469 school children drawn from 20 different schools in rural areas of Jordan. There were 2592 males and 1877 females aged between 6-16 years. The height, weight, systolic and diastolic blood pressure (BP) were recorded for both sexes followed by complete clinical examination. The BP was recorded according to the criteria laid down by the second task force on BP in children, using mercury sphygmomanometers, in sitting position and in the right arm. Data were analyzed and the percentiles were calculated for each age-group in both sexes. Both systolic and diastolic BP had positive correlation with age, height, weight and body surface area. There were no differences in the systolic BP for both sexes of corresponding age, while there was a difference in the diastolic. The upper limits of normal, 90th percentile, systolic/diastolic pressures were 116/76, 122/80, 128/81 and 139/86 in children aged 6-8 years, 9-11 years, 12-14, and 15-16 years respectively, with prevalence of 13.35% (n = 596). The lower limits of hypertension, 95th percentile, for systolic/diastolic pressures were 122/81, 126/83, 134/84, and 142/88 mm Hg in each of the same age-groups respectively, with prevalence of 6.85% ( = 306), while for severe hypertension, 99th percentile, for the same age-groups the values were 131/86, 134/87, 145/89 and 154/90 mm Hg respectively, with prevalence of 1.95% (n = 87). The findings in this study were consistent with international data. We emphasize the need for regular check up of BP in our children. Also, further studies are necessary including other areas of Jordan and smaller age-group children.
  4,704 278 -
Sarcomatoid Renal Cell Carcinoma Associated with Renal Schistosomiasis: A Case Report and Review of Literature
Maha I Arafah
July-September 1996, 7(3):305-308
A 77 year old Saudi male admitted to the surgical unit of our hospital because of a left renal mass. A diagnosis of left renal carcinoma was subsequently made and a left nephrectomy was performed. Histological examination of the nephrectomy specimen showed a renal cell carcinoma containing a large sarcomatoid component. In addition, numerous schistosoma ova, some of them calcified, were identified within the carcinomatous part of the tumor. To the best of knowledge, this is the first report of simultaneous renal schistosomiasis and sarcbmatoid renal cell carcinoma.
  3,393 249 -
Thyroid Function in Children with Chronic Renal Failure
Nagi Abu El-Hana, Sana El Shaikh, Faissal A.M Shaheen
July-September 1996, 7(3):297-300
This study was undertaken to test the thyroid function in non-dialyzed children with chronic renal failure (CRF). Sixteen children with CRF and 12 healthy children who served as controls were studied for their thyroid function status. We found a significant increase in the serum thyroid stimulating hormone (TSH) level and a significant decrease in serum Triiodo thyronine (T3) levels in children with CRF as compared to the healthy children (p < 0.001). No significant difference was found between children with CRF and healthy children as regards serum thyroxine (T4) and serum free T4 (FT4) (p > 0.2). There was a weak negative correlation between hemoglobin concentration and serum TSH (r = - 45) as well as between blood urea nitrogen and serum T3 (r= -0.30) in children with CRF. These results suggest that children with CRF commonly have a state of biochemical hypothyroidism although they are clinically euthyroid. Early renal transplantation is indicated to correct such metabolic defects.
  2,899 365 -
Hepatorenal Syndrome
Paul Sweny
July-September 1996, 7(3):277-282
The hepatorenal syndrome (HRS) is a common complication of advanced liver disease. Careful management can reduce the risk of this functional renal failure developing in the vulnerable group of patients. Potentially nephrotoxic agents (drugs, x-ray contrast, etc.) need to be avoided wherever possible. It is likely that sympathetic overactivity, endotoxin, nitric oxide and endothelin, together with perturbed arachidonic acid metabolism, are closely involved in pathogenesis. Many of the associated abnormalities in HRS can be explained on the basis of an inadequate effective arterial blood volume and the resulting attempts at compensatory homeostasis. Medical management is disappointing, but trans-cutaneous intra-hepatic portal systemic shunting may help. Successful orthotopic liver transplantation is curative.
  2,813 275 -
Cyclosporine A Induced Hyperkalemia in a Renal Allograft Recipient
Mohamad Ghnaimat, Nabil Akash, Mohamad El-Lozi
July-September 1996, 7(3):315-316
  2,093 180 -
Renal Replacement Therapy in Yemen
Abdul-Karim Sheiban, A Yehia, Yassin A.K Mohamed, AR Hajar
July-September 1996, 7(3):313-314
In this report we present the current status of dialysis and transplantation in Yemen. The reported incidence of end stage renal disease (ESRD) in one region of Yemen was estimated as 385 per million population (PMP) per year. The total population of Yemen is also estimated as 16,000,000. Peritoneal dialysis was started in 1980, while hemodialysis was started in 1981. At present there are around 36 hemodialysis machines distributed in the large cities of Yemen. Intermittent peritoneal dialysis is commonly used; however, continuous ambulatory peritoneal dialysis has been out of practice since 1992. Renal transplantation has not yet been started in Yemen; however, at present there are 327 transplant patients being followed up in it. The majority of patients had their grafts from living non related donors abroad. In our experience, such transplantations were associated with high morbidity and mortality, in addition to acquisition of serious, potentially lethal extra-renal medical problems. We believe that there is a wide shortage of renal services in Yemen. Establishing a National Kidney Foundation to organize these services may be helpful.
  2,005 250 -
Is There an Advantage in Adding Azathioprine to Prednisone and Cyclosporine in Kidney Transplant Recipients?
Magdi Hussein, Jacob Mooij, Haysam Roujouleh
July-September 1996, 7(3):291-296
Some recent studies have raised doubts about the advantage of adding azathioprine to cyclosporine and prednisone ("triple therapy") in kidney transplant patients. We reviewed the charts of 53 patients followed at our center after they received a living non-related kidney transplant in India. Thirty-eight patients used "triple therapy" (cyclosporine, prednisone and azathioprine) and 15 patients "double therapy" (cyclosporine and prednisone). A multi-variate analysis was used to study the differences in gender, age, follow-up period, number of patients with at least one acute rejection episode, number of significant infections, cyclosporine dosage and trough levels, prednisone dosage, transplant function, and graft loss due to rejection. There was no difference in the number of acute rejections or graft loss due to rejection in both treatment groups. Although the mean cyclosporine levels at 6, 12 and 24 months and the mean dosage at 6 and 12 months were significantly lower in the triple therapy group, there was no significant differences in these parameters between the patients with and without rejection. The cyclosporine levels at the time of rejection were also not different from the levels in the patients without rejection. The results support other reports suggesting that azathioprine does not seem to add to the immunosuppressive effect, as it is not associated with a lower incidence of acute rejections or an improved graft survival.
  2,015 188 -
Vesicoureteral Reflux in Children. Experience in Riyadh, Saudi Arabia
Othman A Al Mohrij, Abdullah A Al Zaben, Sand Al Rasheed
July-September 1996, 7(3):301-304
There are a few reports about the size of the problem of vesicoureteral reflux (VUR) in developing countries. We attempted in our study to assess the experience of this problem in children in a tertiary care medical center in the period between June 1983 till June 1993. VUR was diagnosed in 24 patients, of whom 71% were boys. The mean age of the patients was 36.5 months; seven (29%) of them were below one year of age. The commonest presentation was urinary tract infection. E. coli was the most common organism and was resistant to the first chpice chemoprophylaxis in 50% of cases. Urine culture was also positive in 37.5% of children who were grossly asymptomatic. Ultrasound study failed to detect VUR in 25% of cases. There were eleven patients with mild to moderate reflux (grades I, II, III) of whom 9% required ureter reimplantation by open surgery. Eleven patients had severe reflux (grades IV,V) of whom 72% required the same procedure. Post-operatively, of the nine patients who had reimplantation, seven (77.5%) had successful surgery and maintained normal renal function after a mean duration of follow up of 30 months (range from 6 to 84 months), one patient developed end-stage renal disease, and one patient was lost to follow-up. We conclude that VUR is not uncommon in early childhood. Early referral of severe cases for surgical reimplantation is recommended.
  1,952 215 -
How Long Should a Patient with Kidney Transplant Continue on Immunosuppressive Drugs ?
Abdul-Karim A Sheiban
July-September 1996, 7(3):317-318
  1,236 158 -
Adding Color and Flavor
P Thirumalaikolundu Subramanian
July-September 1996, 7(3):319-319
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