ABSTRACT
Background and Objectives: Hepatitis C and chronic kidney disease [CKD] are major global health problems and are highly prevalent in Pakistan. There is limited information on prevalence of hepatitis C in patients with CKD not yet on dialysis. The objective of this study was to determine the frequency of hepatitis C in hospitalized chronic kidney disease patients at a tertiary care center in Pakistan
Methods: The study design was cross-sectional in nature. Patients between ages of 20-80 years with CKD not previously on renal replacement therapy and who were admitted to nephrology ward at a tertiary care facility were included. Hepatitis C was tested using 3[rd] generation enzyme linked immunosorbent assay [ELISA]. Hepatitis C RNA was tested by polymerase chain reaction [PCR] in patients with positive ELISA
Results: A total of 180 patients were included in the study. Mean age of patients was 48.7 +/- 14.9 years. Of all patients, 105 [58.3%] were males and 75 [41.7%] were females, 152 [84.4%] had hypertension, 113 [62.8%] had diabetes mellitus and 26 [14.9%] had known cardiovascular disease. Mean eGFR of patients was 11.4 +/- 9.4 ml/min/1.73 m2. Of all patients with CKD, 49 [27.2%] had hepatitis C test positive by ELISA. Hepatitis C PCR testing was done in 39 patients with hepatitis C ELISA positive status and 29 [74.4%] tested positive. Risk factors and clinical characteristics of patients with and without positive hepatitis C antibody by ELISA were similar
Conclusion: A significant proportion of hospitalized CKD patients have hepatitis C. Strict universal infection control measures should be implemented in nephrology wards to prevent transmission of hepatitis C infection
ABSTRACT
Objective: To determine any clinical features associated with an abnormal ultrasound in patients with suspected nephrolithiasis in an out-patient setting
Methods: The study design was cross-sectional in nature. The study was conducted at an out-patient nephrology department of a tertiary care facility over a 3 month period. Patients included in the study were 18-80 years old, who presented with unilateral flank or costovertebral angle pain with or without other clinical features suggestive of renal or ureteric calculus based on clinician's judgement. Every patient's history was reviewed to obtain information on age, gender, location and radiation of pain, onset, severity and nature of pain, associated urinary and systemic symptoms and past history of nephrolithiasis. An ultrasound was considered to be abnormal if there was documented presence of renal or ureteric stone and/or unilateral hydronephrosis
Results: A total of 209 patients were included in the study. Of these patients, 126 [60.3%] were males and 83 [39.7%] were females, 60 [28.7%] had prior history of nephrolithiasis. Ultrasound was abnormal in 110 patients [52.9%]. On a multivariate logistic regression analysis, only past history of nephrolithiasis [OR 3.3, 95% CI 1.65-6.7] was associated with an abnormal ultrasound
Conclusion: In the absence of any significant clinical predictors use of ultrasound is justified in patients with suspected nephrolithiasis especially in those with prior history of stones