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Background Haemodiafilteration (HDF) is a promising new modality of renal replacement therapy (RRT). It is an improvement in the quality of hemodialysis (HD) and thus in the quality of patients’lives. The main obstacle to using HDF is the cost, especially in developing countries. The purpose of this study was to evaluate the benefits of incorporating HDF with different regimens in the treatment of children with end stage renal disease (ESRD). Methods Thirty-four children with ESRD on regular HD in Pediatric Dialysis Unit, Children’s Hospital, Ain Shams University were followed up in 2 phases: initial phase (all patients: HD thrice weekly for 3 months) and second phase, patients were randomized into 2 groups, HDF group and HD group, the former was subdivided into once and twice weekly HDF subgroups. Evaluation using history, clinical and laboratory parameters at 0, 3, 9 and 18 months was carried out. Results On short term, we found that the HDF group was significantly superior to HD group regarding all clinical and laboratory parameters. Also, twice HDF subgroup was significantly superior to once HDF subgroup. This was confirmed on long term follow up, but the once HDF proved comparable to twice subgroup. Conclusions Incorporating online hemodiafilteration (OL-HDF) in the RRT of children was beneficial in most of the clinical and laboratory parameters measured. It’s not all or non; OL-HDF, even once a week, can improve outcomes of HD without significantly affecting the cost.

Background and Aims Chronic kidney diseases (CKD) in children are a group of diseases that not only affects the kidneys but also all systems of the body particularly causing anemia, bone diseases and failure to thrive in that age group. Gastrointestinal tract (GIT) manifestations are not thoroughly highlighted in those patients although they definitely have repercussions on their growth and development. GIT diseases such as celiac disease (CD) has been long linked to renal manifestations either through increasing risk of kidney diseases or as a proved association. The aim of this study was screening for celiac disease and GIT symptoms among pediatric patients with chronic kidney disease. Method A case-control study included 90 CKD patients from Nephrology unit, Children’s Hospital, Ain Shams University, who has been diagnosed for at least 3 months and not receiving steroids or immunosuppressive therapy: 60 patients with end stage renal disease (ESRD) on regular hemodialysis (HD) & 30 with CKD on conservative treatment. Their ages ranged between 2-13 years old, 47 males, 43 females. 200 controls were also enrolled in the study (for GIT manifestations): healthy children with ages ranging from 2-13 years old, 77 males, 123 females within a period of 12 months. All patients & controls were interviewed about GIT manifestations they regularly experience and any GIT troubles they have. All CKD patients were screened for CD by Anti Tissue transglutaminase IgG and IgA blood testing. Results Reviewing the most significant GIT symptoms among patients, we found that 86.7% had mucoid diarrhea, 77.8% had abdominal distension, 75.6% had anorexia, 64.4% had epigastric pain, 51.1% had watery diarrhea, 30% had nausea, 30% had vomiting, and 25.6% had constipation. None suffered from hematemesis, melena or bloody diarrhea. GIT symptoms were significantly more pronounced in CKD patients compared to controls and even more in ESRD patients than CKD patients. All patients were negative for CD screening by Anti Tissue transglutaminase IgG and IgA. No significant correlations were seen between Anti Tissue transglutaminase IgG and IgA and age, sex, anthropometric measures (except for BMI), biochemical results (except for s. ferritin) or eitiology of renal disease were observed. Conclusion GIT troubles are more pronounced in children with CKD compared to age and sex matched healthy controls. CD is not particularly prevalent among CKD pediatric patients compared to the known percentage among this age population.

Background: Lupus nephritis (LN) is more common and more severe is pediatric systemic lupus erythematosus (pSLE). Endothelial protein C receptor (EPCR) is an inducer of anti-apoptotic pathways in endothelial cells. Recent studies have taken elevated anti-injury biomarkers as EPCR into consideration regarding their roles to antagonize LN. Objectives: to evaluate the membrane expression of endothelial protein C receptor (mEPCR) in the renal microvasculature in pediatric patients with LN. Methods This study was conducted on 25 patients with pSLE following up at

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