Need for a Jordanian national registry of chronic renal disease

There is sparse information on Chronic Kidney Disease [CKD] in developing countries which harbor the vast majority of the population with End Stage Renal Disease [ESRD]. Data for children are inaccurate, with frequent underreporting of CKD. With the escalating incidence of chronic kidney disease, it becomes obvious that there is a need for a Jordanian National Renal Registry [JNRR]. This should be accomplished by the Ministry of Health, after establishing a national kidney foundation. The Jordanian Society of Nephrology should be actively involved. The Registry should have representatives from the universities, government, armed forces, and private sectors. The registry should be considered as a national treasure

Haemolytic uraemic syndrome in Jordan [report of two cases and review of the literature]

Haemolytic Uraemic Syndrome [HUS] was seen in two children at Jordan university hospital during the last year. Bloody diarrhoea was the presenting feature in both patients. Microangiopathic haemolytic anaemia, thrombocytopenia and acute renal failure were present in both. A aggressive supportive medical treatment using blood transfusion, fresh frozen plasma, and anti-platelets drugs were utilized. Peritoneal dialysis was used in one patient. Complete recovery of kidney function and normalization of the haematological picture were achieved in both patients

Benefits of recombinant human erythropoietin on the anemia of chronic renal failure in patients maintained on hemodialysis

Five patients with end stage renal disease and uremic anemia maintained on twice weekly hemodialysis were treated with recombinant human erythropoietin, their mean hemoglobin was 7.12 g/dl with a range of 6-7.9 g/dl. The erythropoietin was given intravenously as a bolus with increasing doses within the range of 50-100 unit/dose/Kg/for 12 weeks. All patients showed an increase in both the number of the erythrocytes and the hemoglobin concentration. In four patients the hemoglobin level increased to a mean of 11.04 g/dl [normal range 10.1-12.5 g/dl] while in the fifth patient the hemoglobin increased to 8.6 g/dl. In addition all patients experienced significant improvement in their well-being as well as in their quality of life. Apart from one episode of flu-like syndrome that was observed in one patient, none of the five patients developed any significant complications

Effects of recombinant human erythropoietin [rHuEPo] on haemostasis in patients maintained on chronic hemodialysis

The effects of recombinant erythropoietin on Haemostasis were studied in 5 patients with end stage renal disease maintained on haemodialysis. Results showed significant shortening of the bleeding time together with an increase in the levels of both factors II and X. No changes were observed in the natural anticoagulants, Protein C, Protein S, Anti-thrombine III, and the fibrinolysis inhibitors

Acute renal failure in Jordanian children

Thirty-two children with acute renal failure [ARF] were seen at Jordan University Hospital [JUH] during the last two and a half years. Seventeen were boys and 15 were girls. Seven were infants, and the ages of the remaining 25 children ranged between 1-15 years. Twenty-seven were oliguric, 4 non-oliguric and 1 was anuric. The etiologies of acute renal failure were as follows : Pre-renal ARF 5 patients; renal 23; post-renal 1 and renal vein thrombosis in 3. The causes of ARF of renal etiology were as follows : Acute glomerulonephritis 10; acute tubular necrosis 6; acute urate nephropathy 3; hemolytic uremic syndrome 3 and one patient with acute interstitial nephritis secondary to ampicillin. Dialysis support was needed in 8 patients; 5 peritoneal and 3 hemodialysis. Complete recovery of kidney function was achieved in 23 patients; partial recovery in 3, and no recovery in one patient with rapid progressive glomerulonephritis [RPGN], who required chronic dialysis. Five patients died, 4 of them were oligo-anuric

Reno-vascular hypertension in Jordanian children: successful treatment by aorto-renal by-pass

Four young Jordanian children were seen at Jordan University Hospital [JUH] with severe hypertension. Two of them presented with malignant hypertension and both were encephalopathic. All four have normal kidney function digital substraction intravenous angiography [DIVA] documented the presence of unilateral renal artery stenosis in two, bilateral renal artery stenosis in one patient and coarctation of the abdominal aorta with left renal artery stenosis in the fourth. Differential renal vein renin determination was done in one patient and was predictive of surgical curability. Surgical correction of the stenotic lesions resulted in cure of the hypertension in the four children

Acute renal failure in Saudi Arabia [retrospective analysis of 100 cases

One hundred cases of Acute Renal Failure [ARF] were seen over 3[1/2] years at the Al-Hada Hospital, Taif, Saudi Arabia. Sixty patients were males and 14 were children less than 12 years of age. Pre-renal azotemia was seen in 21 patients, renal azotemia in 68, post-renal [obstructive uropathy] in 10 and there was one patient with bilateral renal vein thrombosis. Non-oliguric ARF [urine output more than 400cc/day] was observed in 30 patients, while the other 70 had oliguric ARF. Twenty-four patients required dialysis support and twenty of them were oliguric. Twenty-five patients died during the acute illness, most of them were oliguric. Seventy-five patients are still alive and of these 71 have either normal or slightly compromised kidney function, while four patients continue to need chronic dialysis support

Recurrent hydrothorax in chronic intermittent peritoneal dialysis: successful treatment with intrapleural tetracycline

Recurrent Hydrothorax complicating peritoneal dialysis has been considered a major limiting factor for continuing peritoneal dialysis. In few instances this problem required a change in the dialytic modality. Such a change may not be acceptable to patients. We report here the successful treatment of recurrent hydrothorax with intrapleural tetracycline instillation in a blind patient who is being maintained for two years on chronic intermittent peritoneal dialysis [CIPD] One similar case has been reported, in a patient who was maintained on continuous ambulatory peritoneal dialysis [CAPD]

Plasma exchange in glomerulonephritis: report of two cases and review of the literature

Plasma exchange and immunosupressive drug therapy has been used successfully in the treatment of two patients with acute crescentic glomerulonephritis and renal failure. One patient has IgG-lgA polyclonal mixed cryoglobulinemia secondary to chronic lympocytic leukemia and was treated by Plasmapheresis using Haemonetic Model 30. The second patient has Idiopathic Rapid Progressive Glomerulonephritis [RPGN], and was treated with Membrane Plasma Separation using Ashai Plasmaflo H-05. In both the plasma was substituted with Fresh Frozen Plasma [FFP], and 0.9 Normal Sodium chloride solution, 50% each. Both patients required supportive hemodialysis treatments. Normal kidney function was achieved in both patients