Searching for the aetiology of chronic renal impairment in patients attending nephrology out-patient clinic of Assiut University Hospital

Seventy-two patients with various medical causes of chronic renal impairment were included in this study. They were subjected to thorough clinical examination and laboratory, imaging and histopathological evaluation. Primary glomerulonephritis was found in one third of the patients, while secondary renal diseases were found in the other two thirds. Schistosomiasis, HCV infection, diabetes mellitus, polycystic kidney disease, hypertension and lupus nephritis were found to be the main causes for secondary renal diseases

Dialysis-induced arrhythmias: Possible role of electrolyte disturbances and myocardial ischaemia

Twenty-five patients on chronic HD were screened with Holter electrocardiogram [ECG] monitoring for arrhythmias. Serum electrolyte levels and ST segment changes during Holter monitoring were studied to evaluate their possible role in the genesis of arrhythmias. Fourteen patients showed ST segment depression diagnostic of myocardial ischemia during the last two hours of HD which disappeared after dialysis and ten of them had arrhythmias. Serum K was significantly decreased to subnormal level at the end than at the start of HD and was also significantly decreased in patients with arrhythmias than those without at the end of HD. Serum Ca was significantly increased at the end than at the start of HD. Serum Mg levels were above normal through the whole HD period. Serum Na levels were within normal through the whole HD period. The levels of Mg and Na showed insignificant differences when measured at the end and at the start of HD. Echocardiographic study demonstrated increased left ventricular mass index in eight patients, all were hypertensives, five of them had PVBs. None of the studied patients had impairment of left ventricular systolic or diastolic functions

Hepatitis B, C and D virus infections in patients and staff in Assiut dialysis unit

Thorough history was taken from 50 HD patients and 30 staff members with special stress on the risk factors that may contribute to hepatitis virus infection in addition to clinical examination, abdominal ultrasound, serological detection of viral markers and liver transaminase estimation. The high percentage of HCV-Ab [74%] and HBs Ag may be due to exposure of uremic patients to various risk factors for virus transmission prior or during HD. The percentage of HCV-Ab [13.3%] in dialysis staff matches that in the community and the absence of HBs Ag could be explained by staff vaccination against HBV

Prevalence of symptomless proteinuria among school children in Assiut

In a trial to assess the prevalence of symptomless proteinuria among healthy rural and urban school children, 3029 subjects of both sexes, aged from 6-12 years were screened using sulphosalicylic acid method. The prevalence rate of proteinuria was 14.5%. It was significantly higher [P < 0.001] in subjects in rural than those in urban areas [16% versus 9.7%]. Within the groups of males, females, those > 8-10 and > 10-12 years of age there was a significant increase in the prevalence rate among chidren from rural areas. In addition, the prevalence rate was significantly increased with increasing age in rural areas. The highest rate was found among children aged > 10-12 years [21.3%] in rural and among those aged 6-8 years [11.8%] in urban areas. However, no significant differences were observed between males and females of the two communities. The prevalence rates of microscopic haematuria and positive urine for schistosoma ova among proteinuric children were significantly higher among subjects in rural than in those in urban areas and within groups of males and females of rural than of urban but no significant differences between both sexes of the two communities. We recommend routine urine analysis annually for all school children and further investigating those with proteinuria

Renal disease associated with rheumatoid arthritis rationale of urinary N-Acetyl-B- glucosaminidase and B2-microglobulin analysis

N-Acetyl-B-D-glucosasminidase [NAG] and B2-microglobulin [B2-MG] are measures of tubular injury, representing abnormalities of different processes involving the renal tubules. When the urinary excretion of these 2 proteins were studied in 32 patients with rheumatoid arthritis and 10 healthy control subjects, a significantly increased excretion of NAG/mg creatinine [p < 0.01] and b2-mg/mg creatinine [p < 0.001] was observed in patients compared to the controls. Patients with active disease had insignificantly higher levels of excreted proteins. Despite the lack of correlation between NAG/creatinine and B2-MG/creatinine with indices of disease activity, the frequency of abnormal excretions of the 2 proteins were higher in patients with active disease. Patients treated with nonsteroidal anti-inflammatory drugs [NSAIDs] had higher NAG/creatinine and B2MG/creatinine than those treated with a combination of NSAIDs and steroids. These findings suggest that the renal affection associated with rheumatoid arthritis is bifactorial from the intrinsic effect of the disease as well as the nephrotoxic action of NSAIDs. Inclusion of at least NAG/creatinine excretion to the routine urinalysis would be beneficial to the patients

Serum lipids and apolipoproteins in bilharzial hepatic fibrosis and post-hepatitis cirrhosis

For all patients and controls serum total cholesterol [TC], serum triglycerides [TG], serum high density lipoprotein cholesterol [HDL-c] were estimated colorimetrically and also serum apolipoproteins [apo A, A1 and B] were assayed by immunodiffusion. BHF and PHC patients showed significant decreases in the mean values of serum TC, TG, HDL-c an apo A, A1 and B compared to controls. Also PHC patients showed significant decreases in serum levels of the same parameters compared to BHF patients. Although the serum levels of HDL-c and apo A1 were significantly decreased in both groups of patients, yet the mean value of apo A1/apo B ratio was higher in both groups compared to controls and the rise was statistically significant in BHF patients and insignificant in PHC patients. Also there was a significant reduction of the serum levels of HDL-c and apo A1 in PHC compared to BHF patients and comparison of the mean value of apo A1/apo B ratio in the two groups was found to be statistically insignificant