International Journal of Advances in Nephrology Research

Study of the Spectrum of Pathological Findings in Renal Transplant Recipients with an Asymptomatic Slow Rise in Serum Creatinine at a Tertiary Care Centre in North India

Niranjan Gogoi, Megha Agarwal , Arjun Agarwal , Rakesh Gupta, Dhananjai Agarwal — Sat, 06 Jan 2024 00:00:00 +0000

Background: Chronic allograft dysfunction, characterized by a progressive increase in serum creatinine levels after kidney transplantation, poses a significant challenge in renal transplant recipients.

Aim: This study aimed to assess the spectrum of pathological findings in renal transplant recipients with an asymptomatic slow rise in serum creatinine.

Methodology: A hospital-based cross-sectional study was conducted, including patients who underwent kidney transplantation and exhibited a creeping rise in creatinine within 3 months to one year. Renal biopsies were performed, and the samples were analysed using various techniques.

Results: Among 30 patients included in the study, a high prevalence of acute tubular necrosis20%(n=6), active antibody-mediated rejection20%(n=6),chronic active antibody-mediated rejection20%(n=6), chronic allograft injury10%(n=3), chronic T cell-mediated rejection10%(n=3), acute cellular rejection10%(n=3), membranous nephropathy(n=1), C3 glomerulonephritis(n=1), and cortical necrosis(n=1) was observed. The timing of biopsy post-transplantation and donor HLA mismatch were also evaluated.

Conclusion: These findings emphasize the importance of early detection and proper management of pathological conditions contributing to chronic allograft dysfunction to improve long-term outcomes following kidney transplantation.

Assessment of Creatinine and Urea in Individuals with Various ABO Blood Types at Madonna University

Johnkennedy Nnodim , Alabi Olubunmi — Fri, 19 Jan 2024 00:00:00 +0000

ABO blood types have historically been mainly linked to organ transplantation and blood transfusion compatibility. Beyond their traditional use in transfusion medicine, ABO blood types may also be associated with other elements of health and illness, according to new study. This study's objective is to assess the creatinine and urea concentrations in subjects at Madonna University who belong to various ABO blood groups. The study included one hundred and seventy-eight (178) Madonna University students. Urease Berthelot's method was used to measure urea, while Modified Jaffe's slot reaction method was used to determine creatinine. The ABO blood grouping system was used to determine ABO blood groups. The results were presented as mean ± SD. Data obtained from the study were analyzed using independent sample t-test and one-way analysis of variance which was used to compare mean, values and considered significant at p<0.05 and non-significant at p>0.05. The study's findings indicate that among the blood types, those with blood type AB have the highest mean levels of creatinine (1.095±0.1513 mg/dl) and urea (32.96±7.815 mg/d). In addition, the mean urea level in males is 29.07±5.506 mg/dl and in females it is 28.85±6.411 mg/dl. Males have a mean creatinine level of 0.908±0.1662 mg/dl while females have a mean level of 0.847±0.2032 mg/dl. Notably, the creatinine p-value (p=0.029*) demonstrates statistical significance and points to a variable in creatinine levels associated to gender. Notably, among the blood types, those aged 36 to 45 have the greatest mean levels of creatinine (0.902±0.0273 mg/dl) and urea (28.46±0.763 mg/dl). Notably, age did not significantly differ at any level (p>0.05). In conclusion, blood type AB persons consistently differ significantly from blood types A, B, and O. They also consistently show the highest levels of urea and creatinine among all blood types. This indicates that Blood group AB probably have higher urea and creatinine levels, it is advised that they be constantly watched for any kidney-related problems.

Assessment of Kidney and Liver Functions in Post COVID-19-Vaccinated Individuals in Rivers State, Nigeria

Obisike, U. A., Tamuno, C. B., Waribo, H. A., Elekima, I. — Thu, 08 Feb 2024 00:00:00 +0000

Aim: To assess kidney and liver functions in COVID-19-vaccinated individuals in Rivers State, Nigeria

Study Design: Cross-sectional Observational study.

Place and Duration of Study: Polar Precision Laboratories, Port Harcourt, Nigeria, between May and November 2022.

Methodology: This study was carried out on 50 apparently healthy subjects; both males and females of which 30 were COVID-19-vaccinated subjects and 20 were non-vaccinated, which were used as control subjects. The studied subjects had previously received three types of vaccines: AstraZeneca, Pfizer and Moderna. The study analyzed kidney function parameters: [Creatinine (Cr), Urea(U), Sodium (Na⁺), Potassium (K⁺), Chloride (Cl^-) and Bicarbonate (HCO3^-)] and liver function parameters: [aspartate amino transaminase (AST), alanine amino transaminase (ALT), alkaline phosphatase (ALP), Total Protein, Albumin, Direct bilirubin and Total bilirubin], using colorimetric methods except for ALP in which kinetic method was employed. Statistical analysis of the data obtained was done using GraphPad Prism version 9.0.4 of Apple Macintosh HD Big Sur (version 11.0) and p values < 0.05 were considered statistically significant.

Results: It was observed that the mean ± SD for COVID-19 vaccinated subjects and non-vaccinated subjects were as follows: for renal function indices: Urea: 4.11 ± 1.03mmol/l and 3.95 ± 0.73mmol/l respectively, Cr: 100.7 ± 21.04mmol/l and 98.25 ± 15.33mmol/l respectively. Na+: 138.9 ± 4.80mmol/l and 142.7 ±3.65mmol/l respectively. K⁺: 4.49±0.63mmol/l and 3.17 ±0.20mmol/l respectively. Cl-: 101.0 ± 4.21mmol/l and 104.1 ± 3.14mmol/l respectively. HCO3-: 25.88 ± 3.32mmol/l and 26.74 ± 2.07mmol/l respectively. The result for liver function parameters were as follows: AST: 7.36 ± 5.16U/l and 8.08 ± 2.99U/l respectively, ALT: 2.90 ± 0.90U/l and 2.20 ± 0.62U/l respectively. ALP: 116.9 ± 36.30U/l and 118.5 ± 32.52U/l respectively. Alb.: 40.95 ± 2.49g/l and 38.90 ± 4.22g/l respectively. TP: 65.88 ± 3.40g/l and 68.05 ± 3.88g/l respectively. D.Bil: 2.147 ± 0.780µmol/l and 2.185 ± 0.502µmol/l respectively. T.Bil.: 7.31 ± 2.33µmol/l and 7.q3 ± 1.52µmol/l respectively. Comparison between the kidney function parameters for COVID-19 vaccinated and non-vaccinated subjects was not significant (p > 0.05) for urea, creatinine and HCO^3-, but was significant (p < 0.05) for AST, ALP, direct, total bilirubin, ALT, Alb and total protein.

Conclusion: From this study, it can be inferred that the COVID-19 vaccine had no negative effect on the liver and kidneys, but merely altered some biochemical parameters.

Evaluation of Dyslipidaemia and Atherogenic Index in Patients with Chronic Kidney Disease in a Nigerian Tertiary Health Facility

Fri, 23 Feb 2024 00:00:00 +0000

Background: Chronic kidney disease (CKD) is a global health concern associated with significant morbidity and mortality. Dyslipidaemia is a common complication of CKD, contributing to cardiovascular events. This study aims to assess dyslipidaemia and the atherogenic index in CKD patients at various stages in a tertiary health facility in Southern Nigeria.

Methods: A cross-sectional case-control study was conducted, enrolling 200 participants, including 50 healthy individuals as controls and 150 CKD patients (stages 3 to 5). Exclusion criteria encompassed viral hepatitis, HIV, malignancy, life-threatening illnesses, liver diseases, and cerebrovascular diseases. Ethical approval and informed consent were obtained. Sociodemographic and clinical data were collected using a self-administered questionnaire. Blood samples were analyzed for urea, creatinine, triglycerides, total cholesterol, and HDL-Cholesterol. Calculations included LDL, VLDL, LDL/HDL ratio, and the atherogenic index. eGFR was measured using the MDRD equation. Statistical analysis utilized SPSS (version 22.0) with one-way ANOVA.

Results: CKD patients exhibited significant alterations in renal parameters compared to controls (p < 0.05). The lipid profile of CKD patients showed elevated total cholesterol, reduced HDL-Cholesterol, increased LDL-Cholesterol, elevated LDL/HDL ratio, elevated VLDL-Cholesterol, and elevated triglycerides (p < 0.05). Atherogenic index significantly increased with advancing CKD stages (p < 0.05).

Conclusion: This study highlights the prevalence of dyslipidaemia in CKD patients, with a notable increase in the atherogenic index as the disease progresses. These findings underscore the importance of monitoring lipid profiles in CKD patients for cardiovascular risk assessment. Further research is warranted to explore interventions targeting dyslipidaemia in this population.

Assessment of the Effect of Acute Malaria on Some Renal Function Parameters amongst Port Harcourt Residents, Rivers State, Nigeria

Obisike, U.A, Buochuama, S.T., Monsi, T.P. — Tue, 16 Apr 2024 00:00:00 +0000

Aim: To assess some kidney function parameters in Port Harcourt residents with varying malaria parasite densities.

Study Design: Observational study.

Place and Duration of Study: Rivers State University Teaching Hospital and Department of Medical Laboratory Science, Rivers State University, Port Harcourt, between September and December 2023.

Methodology: The study population comprised of one hundred (100) individuals within the ages of 21-60 years randomly sampled within Port Harcourt metropolis. A total of seventy apparently (70) healthy subjects, which comprised of 32 males and 38 females who served as control and a total of thirty (30) malaria infected subjects, which comprised of 16 males and 14 females were sampled and served as test subjects. Data was obtained from subjects using a questionnaire to obtain consent and socio-demographic information. Blood samples were collected via venipuncture and analyzed for malaria using thick and thin blood films and also estimated for serum urea, creatinine and electrolytes (Sodium, Potassium, Chloride and Bicarbonate). Statistical analysis was done using GraphPad prism Version 10 for Windows and results were presented as mean ± STD and p<0.05 was considered statistically significant.

Results: There were more males with malaria in this study (n=17) than females (n=14) but was not statistically significant. Age group 21-30 years had more malaria cases (17 cases) compared to age groups 31-40 years (4 cases), 41-50 years (3 cases), 51-60 years (6 cases), but this was not statistically significant. Urea and creatinine levels were higher in malaria-infected (test) subjects, than the control group, but there was no significant difference statistically. Na+ and K+ levels were significantly decreased in test subjects than in the control subjects and were considered statistically significant. Cl- levels showed a decrease in test subjects when compared to the control and HCO3- levels showed an increase in test subjects when compared to the control but were also not statistically significant. Pearson’s correlation analysis was also carried out on malaria-infected subjects and there were strong correlations between urea and creatinine (>0.5) but was not statistically significant. Na+ and K+ also revealed a weak correlation but were statistically significant.

Conclusion: The study showed that varying malaria parasite densities lead to an increase and decrease in some kidney function parameters and severe malaria can lead to hyponatremia and hypokalemia leading to renal impairment.