Hepatitis B and C virus and nephrotic syndrome

Nephrotic syndrome is a common disorder that affects all age groups. Etiology is variable ranging from infection to malignancy. Lately Hepatitis B and C viruses have been found to have high correlation with Nephrotic syndrome. The microscopic renal picture is different depending upon age groups

Objectives: objective of this study was to determine how prevalent is HBV and HCV in adults with Nephrotic syndrome in this region of Pakistan

Period: jan 1997 to Oct 1998

Setting: allied Hospital PMC, Faisalabad

Material and methods: all patients between age 14 and 60 years who were having Nephrotic syndrome with all known secondary causes having been ruled out, underwent Percutaneous Renal Biopsy

Results: among 50 patients 34 were positive for HCV and 3 were positive for HBV. Commonest microscopic lesion was Membrano-Proliferative Glomerulonephritis

Conclusions: there is high prevalence of HCV in adult Nephrotic syndrome like some other countries

Primary glomerulonephritis and nephrotic syndrome in Pakistan

Renal diseases associated with proteinuria are known for centuries. OBJECTIVS: To determine the pattern of primary glomerulonephritis in adult Pakistani nephrotics. DESIGN: Case study. Period: 1986 - 1996. SETTING: Allied Hospital Medical Unit III Punjab Medical College Faisalabad. PATIENTS AND METHODS: 14 cases [Male - 10, Female - 4]. Male to female ratio 2.5:1. Membranous glomerulonephritis, minimal change glomerulonephritis, focal glomerulosclerosis and focal proliferative glomerulonephritis were 70%, 14%, 7% and 7% respectively. CONCLUSIONS: Sex involvement is similar all over the world. Minimal change glomerulonephritis and focal glomerulonephritis concide with incidence reported all over the world. Prevalence of membranous glomerulonephritis is similar to Western world but higher than Far East. Contrary to membranous glomerulonephritis prevalence of focal proliferative glomerulonephritis is very low in Pakistan as compared to China, Singapore and USSR

Plasma albumen concentration and hyperlipidemia in nephrotic syndrome

Serum cholesterol abnormalities in patients with nephrotic syndrome has long been recognized. However mechanism of this change has been a cause of debate. To find out co-relation of serum albumin and serum cholesterol in nephrotic syndrome. DESIGN: Case study. PERIOD: 1985 - 1995. MATERIAL AND METHODS: 32 Cases [Male-23, Fernale-9]. SETTING: Allied and Divisional Headquarter Hospitals Faisalabad. Serum albumin was normal in two, decreased in 30. Serum cholesterol normal in five, increased in 27. Increased cholesterol with normal albumin in five [16%]. Increased cholesterol with low albumin in 25 [78%], Normal cholesterol with low albumin 2 [6%]. CONCLUSIONS: There is significant negative correlation between serum cholesterol and serum albumin

Acute renal failure, an atypical case

Acute renal failure is defined as rapid deterioration in the excretory functions of the kidney. Biological response to circulating and tissue uremic toxins is a function of their level, rapidity in which this level is achieved and person to person variability. The last named may be an inborn endowment or an acquired capability. We report such a patient who exhibited a very mild response to very high blood urea [731 mg] and acidosis [HCO3 14 meq]. Patient recovered without dialysis. Possible mechanism for this blunted response is also speculated

Acute renal fialure in surgical patients

1. To highlight the occurrence of Acute Renal Failure [ARF] in surgical patients. 2. To identify high risk patients. DESIGN: Retrospective study. SETTING: Department of Surgery Allied Hospital Faisalabad. PERIOD: June 95 to May 96. PATIENTS AND METHODS: 21 patients 11 males [52.38%] and 10 females [47.62%] including 2 children both males [9.52%] Their ages ranged between 8 to 63 years. [mean 35.5 years]. 6 patients [28.57%] presented in acute renal failure [ARF] on admission, whereas the remaining 15 patients [71.43%] developed Acute Renal Failure [ARF] in the postoperative period. 15 patients [71.43%] went into ARF in the postoperative period. Out of these, 8 patients [overall 38.10%] had surgery for malignant disease, 1 patient [4.76% overall] had surgery for obstructive jaundice and 6 patients [28.57% overall] had surgery for kidney/ ureteric stones. The remaining group of patients who presented with ARF on admission included "Crush Syndrome." following skeletal/ soft tissue trauma, 3 patients [14.28%], obstructive uropathy 2 patients [9.52%] and major burns [70%] 1 patient [4.76%]. All patients underwent haemodialysis. Six patients [28.57%] died despite active management

Prevalence of idiopathic hypercalciuria and hyperuricosuria in primary calcium stone formers and beneficial role of low dose aspirin

The calcium stones are the most common renal stones throughout the world. Idiopathic hypercalciuria is the most common metabolic abnormality 30-60% and hyperuricosuria is next common [26.3%]. 1. To compare the international data on the prevalence of idiopathic hypercalciuria and hyperuricosuria with local population.2. To assess the beneficial effect of low dose aspirin in controlling hyperuricosuria. Design: prospective study. Setting: Allied Hospital Faisalabad. Period: Feb1991 to June 1993. Subjects: One hundred twenty eight patients [92 males and 36 females] suffering from renal colic or stone disease without any secondary cause of urinary stone. Complete clinical data, urine analysis and estimation of 24 hours urinary calcium, uric acid and magnesium was performed. Serum urea, creatinine, calcium, phosphorus, and electrolytes estimation was also performed. X- ray chest, abdomen and ultrasound was carried out. Low dose aspirin [150mg per day] was given for three weeks and investigations were repeated. Parameter: Hypercalciuria was defined as 24 hours urinary calcium > 220mg in males and > 180mg in females and hyperuricosuria as urine uric acid > 500mg in males and > 480mg in females. Isolated hypercalciuria was seen in 19.5% males and 19.5% females. Isolated hyperuricosuria was seen in 55.4% males and 50% females. 15% male and 11% females had both abnormalities 25% males and 30% females did not have any abnormality. Conclusions: The prevalence of hypercalciuria [19.5%] is significantly lower while hyperuricosuria level [50- 55%] was significantly higher in our population. Magnesium deficiency was not a contributory factor in our population. Aspirin 150mg per day has shown a significant beneficial effect in lowering urinary uric acid level