Occurrence of Carpal Tunnel Syndrome in Chronic Hemodialysis Patients | Chapter 10 | Medical Science: Trends and Innovations Vol. 7

Background: Despite significant advances in hemodialysis (HD) practice, carpal tunnel syndrome (CTS) remains a clinical concern among patients. Carpal tunnel syndrome (CTS) is a well-known manifestation of dialysis-related amyloidosis, mainly caused by the deposition of β2- microglobulin in the carpal tunnel. It is considered the most common mononeuropathy in endstage renal disease (ESRD) patients.

Aim: This study aimed to evaluate the prevalence of CTS and identify factors associated with its occurrence in chronic HD patients.

Methods: A cross-sectional study was conducted in December 2017, including consenting chronic HD patients with a dialysis vintage of at least three months, at a reference state center in Oujda, Eastern Morocco. CTS diagnosis was based on reported symptoms, clinical signs, and positive Tinel and Phalen manoeuvres. Symptomatic patients underwent electromyography (EMG) on non-dialysis days, performed by the same neurologist under standardized conditions. Data were analyzed using SPSS version 20.0 for Windows. Chi-square or Fisher exact tests were used for analyzing the correlation among categorical variables.

Results: A total of 112 chronic HD patients meeting the inclusion criteria were enrolled. CTS was diagnosed and confirmed by nerve conduction studies in 8.04% of patients. Diabetic nephropathy was the most common underlying nephropathy, observed in 36.3% of CTS cases. Patients with CTS were older (mean age: 52.99 ± 11.32 vs. 48.4 ± 12.6; p=0.002), predominantly male (63.6% vs. 55.4%; p=0.03), and active smokers in 18.5% of cases. CTS patients also had a longer HD duration (95.8 ± 15.75 vs. 82.11 ± 17.22 months; P<0.001). Additionally, CTS was significantly associated with a higher prevalence of diabetes mellitus (36.3% vs. 13.8%; p<0.001), hepatitis C virus (HCV) infection (18.18% vs. 2.97%; p=0.02), and reduced urine output (<100 ml/day: 27.2% vs. 3.98%; P=0.003). Multivariate logistic regression analysis revealed that HCV infection (OR: 1.45, 95% CI: 1.17–1.87, p=0.034), prolonged HD vintage (OR: 1.95, 95% CI: 1.89–3.65, P<0.001), and urine output <100 ml/day (OR: 1.72, 95% CI: 1.03–2.57, P=0.01) were independently associated with CTS.

Conclusion: This cross-sectional study highlights that prolonged dialysis vintage, HCV infection, and loss of residual renal function are key factors associated with CTS in chronic HD patients. The surgical release procedure of the wrist is an effective treatment method. Further research is needed to elucidate the underlying mechanisms and pathogenesis of CTS in this patient population.

 

Author (s) Details

 

Intissar Haddiya
Department of Nephrology, Dialysis and Renal Transplantation, Mohamed VI University Hospital, University Mohamed First, Oujda, Morocco.

 

Hicham Yacoubi
Department of Orthopaedics, Mohamed VI University Hospital, University Mohamed First, Oujda, Morocco.

 

Fatima Zahra Berkchi
Hassan II Center for Chronic Diseases, Oujda, Morocco.

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v7/3682

Clinical Presentation of Renal Disease in Children: The Role of the Pediatrician and Primary Care Physician | Chapter 1 | Current Innovations in Medicine and Medical Science vol. 1

 The main cause of morbidity in children is renal illness. The prevention of chronic kidney disease depends heavily on the early detection and treatment of renal illness in children (CKD). Early detection and treatment of these diseases are crucial since many causes of CKD in children, such as congenital abnormalities of the kidney and urinary system and urinary tract infection, may be prevented. Pediatricians and primary care doctors should be knowledgeable about the different ways that paediatric renal disorders present themselves and should be highly suspicious of any asymptomatic patients. Congenital anomalies of the kidney and urinary tract (CAKUT), signs and symptoms of renal disease, abnormal urinalysis, urinary tract infection, water, electrolyte, and acid-base disturbances, glomerular disease, renal tubular disorders, hypertension, nephrotic syndrome, and decreased renal function are all possible in patients with renal disease. Pediatricians and primary care doctors may begin the evaluation and treatment of paediatric renal disease depending on how comfortable they are doing so. A paediatric nephrologist should be consulted for patients who require collaboration or invasive tests, have serious renal disease or diminished renal function, or have anxious parents.

Author(s) Details:

Amin J. Barakat,
Department of Pediatrics, Georgetown University Medical Center, Washington, DC, United States.

Please see the link here: https://stm.bookpi.org/CIMMS-V1/article/view/8100

Assessment of Risks for Renal Dysfunction: An Approach towards Light to Moderate Drinking and Therapeutic Doses of Acetaminophen | Chapter 20 | Current Practice in Medical Science Vol. 1

This study examined the kidney's response to therapeutic doses of acetaminophen (APAP) and light-to-moderate alcohol use while controlling for conditions including hypertension, diabetes, and obesity that might increase the kidney's susceptibility to APAP and/or alcohol toxicity. The study was a secondary data analysis of the 2003–2004 National Health and Nutrition Examination Survey (NHANES). Odds ratios (OR) and 95 percent confidence intervals (CI) were generated from multiple logistic regression models by further controlling for potential predisposing factors like namel to compare the likelihood that people who ingested therapeutic doses of APAP and light–moderate amounts of alcohol, compared to those who did not, would have kidney dysfunction. Even after controlling for hypertension, diabetes, and obesity, respondents who reported using therapeutic doses of APAP and light-to-moderate amounts of alcohol had statistically significant higher odds of developing renal dysfunction [OR(95 percent CI) = 1.64(1.28-2.10) self-report, 2.18(1.81-2.63) SCr, 4.60(3.03-7.00) BUN, 3.14(2.42-4.07) GFR, and 1.71(1.36-2.14) ALBCR]. On the kidney, APAP and alcohol were thought to have harmful effects. Unknown threshold dosages exist at which these effects start to manifest. The results of this study indicate that even therapeutic dosages of APAP and light to moderate amounts of alcohol may have negative health effects when drunk together. Given that many individuals may be exposed to both APAP and alcohol, this study brings to light a crucial public health issue. The findings could have an impact on health policy. We also investigated the possible effects of conditions that may make the kidney more vulnerable to APAP and/or alcohol toxicity, such as hypertension, diabetes, and obesity.

Author(s) Details:

Harrison Ndetan,

Department of Epidemiology and Biostatistics, School of Community and Rural Health, University of Texas Health Science Center, 11937 US Hwy 271, Tyler, TX 75708, United States of America.

Marion W. Evans Jr,

Department of Food Science, Nutrition, and Health Promotion, 105 Herzer Building, Box 9805, Mississippi State, MS 39762, United States of America.

Ashwani K. Singal,

Division of Gastroenterology and Hepatology, Department of Medicine, University of Alabama Birmingham, 1720 2nd Ave, South, BDB 380, Birmingham, AL 35294-0012, United States of America.

Lane J. Brunner,

Ben and Maytee Fisch College of Pharmacy, University of Texas, Tyler, 3900 University Blvd, Tyler, TX 75799, United States of America.

Kirk Calhoun,

University of Texas Health Science Center, 11937 US Hwy 271, Tyler, TX 75708, United States of America.

Karan P. Singh,

Department of Epidemiology and Biostatistics, School of Community and Rural Health, University of Texas Health Science Center, 11937 US Hwy 271, Tyler, TX 75708, United States of America.

George Einstein,

University of Science, Arts and Technology (USAT), Olveston, Montserrat.

Orien Tulp,

University of Science, Arts and Technology (USAT), Olveston, Montserrat.

Please see the link here: https://stm.bookpi.org/CPMS-V1/article/view/7339

Acute Glomerulonephritis: A Study of Histo-Clinical Correlation of Patients at Tertiary Care Centre, India | Chapter 7 | Highlights on Medicine and Medical Science Vol. 15

The abrupt development of hematuria, proteinuria, and red blood cell casts is known as acute glomerulonephritis. Hypertension, edoema, and decreased renal function are frequently present in this clinical presentation. Acute glomerulonephritis can occur as a result of a primary renal disease or as a side effect of other illnesses.

The goal of this research was to look at the clinical and histological correlations of acute glomerulonephritis in hospitalised patients.

Materials and Methods: This was a two-year prospective study conducted at GMC Jammu from January 2012 to January 2014.

The study enlisted the participation of 80 patients. A total of 80 individuals with clinically suspected acute glomerulonephritis were hospitalised (AGN). Nine individuals had a positive response to medical treatment. A total of 56 patients had their kidneys biopsied. On further investigation, 10 patients were identified with chronic glomerulonephritis based on renal biopsies and were ruled out. Acute glomerulonephritis was identified in 46 cases after renal biopsies.

On histological examination, patients with clinical manifestations such as edoema, hematuria, and hypertension have more evidence of acute glomerulonephritis. The most common entity is PSAGN.

Author (s) Details

Vinod Kumar
Department of Medicine, GMC Doda, JK, India.

Ritu Bhagat
Department of Pathology, GMC Doda, JK, India.

Ahmer Javid Azad
Department of Medicine, GMC Doda, JK, India.

View Book :- https://stm.bookpi.org/HMMS-V15/article/view/2468

Approach of Kidney Disease in Dogs and Cats | Book PI International

Chronic kidney disease is one of the great challenges in daily life of veterinary doctors, and the lack of knowledge on this subject leads us to question on how we can generate early diagnoses and thus, more effective therapeutic treatments. To what extent can treating kidney disease be effective if the mechanisms with which the kidney works are unknown?. We know that under normal conditions the kidney nephrons of dogs and cats are prepared to maintain homeostasis in the body, this mechanism is most often sustained until advanced stages of disease. In chronic kidney disease, regardless of the type of initial injury, the frames of the different diseases are usually degenerative, chronic and progressive, and the damage caused to the kidneys is irreversible, thus deteriorating the glomeruli, tubules and interstitium, culminating with nephron death and progressive decrease in glomerular filtration rate; This condition causes the animal to manifest clinical symptoms when there is a change from the phase of the disease to insufficiency. In the disease, morphophysiological adaptations are established that allow the kidneys to maintain balance in the body; when these adaptations attend a critical point in company with the exacerbation of the compensatory mechanisms, the onset of functional deficit is generated, initially characterized by the incapacity of the renal tubule to concentrate urine, generating polyuria with compensatory polydipsia, finally rendering the kidneys insufficient to maintain homeostasis, frame known as kidney failure, a condition in which more than 75% of the kidneys are not functional; clinically at this stage there is not to much to do. This book was produced with the purpose of make easier to the small animal clinician, understand the functioning, diagnosis and treatment of the renal system. 

Author(s) Details

Dr. Pedro Pablo Martinez Padua
Betel Center of Veterinary Specialties, Bogotá, Colombia.

View Book :- http://bp.bookpi.org/index.php/bpi/catalog/book/209