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Background: Patients with chronic kidney disease (CKD) are at a common risk for contrast-induced acute kidney damage (CI-AKI) because of various complications. Intravenous N-acetylcysteine (NAC) in high doses (1200mg) is considered more effective than its conventional dose (600mg) to prevent CIN and related complications. Objective: The study aimed to compare the effectiveness of high dose versus standard dose of intravenous N-acetylcysteine (NAC) in the prevention of Acute Kidney Injury in patients with chronic kidney disease.Material & Methods:A total of 60 (sixty) patients diagnosed with CKD went to coronary angiography and/or percutaneous coronary intervention (PCI) were selected by simple random technique and categorized into two groups – Group A (30 patients) received high dose NAC (1200mg) and Group B (30 patients) – received standard dose NAC (600mg). For evaluation of renal damage serum creatinine level for at least >3 months, renal imaging revealed bilateral small echogenic kidneys, eGFR (<60 to 15ml/min/1.73m², measured by MDRD formula) and also by ACR >30 mg/gm, associated with IHD, admitted for percutaneous intervention (PCI) were taken in account. Statistical analysis was done by SPSS version 20 with taking 95% confidence interval. The quantitative data were expressed as mean and standard deviation and qualitative data were expressed as frequency distribution and unpaired t-test, Chi-square test, and Fisher exact analytic test were done.Results:The observed mean age group of the patients was 65 ± 8 years and 62 ± 7 years in group A and group B respectively with male predominance in both groups. Primary renal disease diabetic nephropathy (DN) more (36.66%) in group A than in group B (30.00%) but patients with Hypertensive nephropathy were the same (33.33%) in both groups. After interventions, S. Creatinine (mg/dl) level, e, GFR (ml/min/1.73m²), were statistically significant in cases of group A patients (P-value 0.001& 0.003 correspondingly) compared to group B Patients (P-value 0.075 & 0.001 respectively). Again, the mean of pre-intervention S. Creatinine was 1.7 ±0.5 in group A whereas this was 1.9 ± 0.8 (p-value, 0.599) in group B and after 48 hours of intervention this was 1.6 ± 0.5 and 2.0 ± 0.5 (p-value, 0.697) In group A and group B respectively. Overall, no patients were detected with nephropathy for high dose NAC whereas 27 (90%) out of 30 had developed CIN in standered dose.Conclusion:High-dose N-acetylcysteine (1200mg) is more potent and effective than the standard dose (600mg) in reducing contrast-induced acute kidney injury (CI-AKI) in patients with CKD.
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Objective: In this study our main objective is to evaluate effectof serum IgE level between frequent relapse and infrequentrelapse nephrotic syndrome in children.Methodology: This Cross-sectional comparative studyconducted at the Department of Paediatric Nephrology,Bangabandhu Sheikh Mujib Medical University (BSMMU) andDepartment of Paediatrics, Dhaka Medical College Hospital,Dhaka from February 1, 2010 to October 1, 2010. During thestudy, 60 children were included in the study according tojudgmental or purposive sampling method and they weregrouped as follows: Group A (n = 30): Frequent RelapseNephrotic Syndrome (FRNS), Group B (n= 30): InfrequentRelapse Nephrotic Syndrome (IFRNS).Results: During the study, majority (60%) were of age groupA, 2-5. On the other hand in group-B, majority (66.8%) were ofage groups 2-5 years followed by (16.7%) were of age group 6-9 years and 5 (16.6%) were of age group 10-15 years. Duringrelapse of the disease serum immunoglobulin E (IgE) level wasapproximately 3.5 times higher in group A than that of group Bwhich was 1573.60IU/ml (SD ±197.01) vs. 438.46IU/ml (SD±51.6).Conclusion: From our study we can conclude that, that serumIgE level in frequent relapse nephrotic syndrome wassignificantly higher (P < 0.001) in comparison to infrequentrelapse nephrotic syndrome in children during both relapse andremission irrespective of history of atopy. So serum IgE levelmight have an influence for the occurrence of relapse inchildhood idiopathic nephrotic syndrome