AF is common in haemodialysis patients. The incidence of major haemorrhage was over three times that of cerebrovascular accidents. Guideline recommendations for anticoagulation in AF in the general population may not be appropriate for the haemodialysis population.

We describe three cases of subcutaneous phaeohyphomycosis developing in the lower limbs of renal transplant recipients shortly after transplantation. Each case presented with dark-colored nodules that subsequently ulcerated. Histopathologic examination revealed dematiaceous fungal hyphae with a surrounding granulomatous reaction. The fungi were subsequently identified as Alternaria alternatum in two cases and Phialophora richardsiae in one case. In one case, the lesions resolved during a prolonged (6-month) course of itraconazole without the requirement for surgical excision. In the other two cases, combined medical and surgical treatment resulted in cure. A review of the literature on phaeohyphomycosis is presented.

Concurrent ANCA and anti-GBM disease is rare. The mortality rate is high. Aggressive immunosuppression with steroids, cyclophosphamide and plasma exchange can induce remission and preserve renal function. Long-term monitoring for relapses should occur.

Despite the existence of strongly evidence-based guideline recommendations, there was wide variation in adherence to these recommendations between PD units which might contribute to PD-related infection rates, which varied widely between units. Although individual patient characteristics may account for some of this variability, inconsistencies in the processes of care to prevent infection in PD patients also play a role.

For patients undergoing coronary artery bypass grafting, pre-existing renal dysfunction predisposes to the development of ARF, this is associated with prolonged hospitalization and increased mortality.

Anti-GBM disease is a rare condition, which is not overrepresented among indigenous people. With aggressive therapy the prognosis has improved; however, the morbidity and mortality of this condition remain significant.

Aggresomes are inclusion bodies for misfolded/aggregated proteins. Despite the role of misfolded/aggregated proteins in neurological disorders, their role in cancer pathogenesis is poorly defined. In the current study we aimed to investigate whether aggresomes-positivity could be used to improve the disease subclassification and prognosis prediction of pediatric medulloblastoma. Ninety three pediatric medulloblastoma tumor samples were retrospectively stratified into three molecular subgroups; WNT, SHH and non-WNT/non-SHH, using immunohistochemistry and Multiplex Ligation Probe Amplification. Formation of aggresomes were detected using immunohistochemistry. Overall survival (OS) and event-free survival (EFS) were determined according to risk stratification criteria. Multivariate Cox regression analyses were carried out to exclude confounders. Aggresomes formation was detected in 63.4% (n = 59/93) of samples. Aggresomes were non-randomly distributed among different molecular subgroups ( P = 0.00002). Multivariate Cox model identified aggresomes’ percentage at ≥20% to be significantly correlated with patient outcome in both OS (HR = 3.419; 95% CI, 1.30–8.93; P = 0.01) and EFS (HR = 3; 95% CI, 1.19–7.53; P = 0.02). The presence of aggresomes in ≥20% of the tumor identified poor responders in standard risk patients; OS ( P = 0.02) and EFS ( P = 0.06), and significantly correlated with poor outcome in non-WNT/non-SHH molecular subgroup; OS ( P = 0.0002) and EFS ( P = 0.0004).

These guidelines were developed before the uptake of the GRADE framework by the KHA-CARI Guidelines organization. Accordingly, the writers have followed an adapted version of the NHMRC evidence rating system published in 1999. 1 A description of the ratings applied to the evidence is shown in Table 1. Guideline Recommendations are based on Level I or II evidence and Suggestions for Clinical Care are based on Level III or IV evidence. SCOPE OF GUIDELINEThis guideline addresses issues relevant to the development, prevention and management of peritonitis and catheterrelated infections in peritoneal dialysis patients. PERITONITIS AND CATHETER-RELATED INFECTIONS IN PERITONEAL DIALYSIS PATIENTSRecurrent or severe exit site infections (ESI) and peritonitis are a problem with peritoneal dialysis (PD) and represent the major causes of Tenckhoff catheter removal and PD technique failure. Peritonitis is the most common complication of PD. Up to one-third of all PD peritonitis episodes lead to hospitalization 2 and 5-10% of cases end in patient death. 3 ESI are associated with a greatly increased risk of subsequent peritonitis and when ESI and peritonitis occur together, catheter removal occurs in approximately 50% of cases. 4 The influence of peritoneal dialysis systems and solutions on the incidence of peritonitis and catheter-related infections Guideline recommendationsa. Disconnect systems of continuous ambulatory peritoneal dialysis (CAPD) result in lower rates of peritonitis than 'spike' systems and this older system should no longer be used (Evidence level I). b. Twin bag systems have lower rates of peritonitis than Y-disconnect systems and are recommended as the preferred CAPD technique (Evidence level I). c. There is insufficient high level evidence (one adequate small RCT only) to support a difference in peritonitis rates when biocompatible fluids are used compared with standard dextrose solutions in PD patients (Evidence level II). Suggestions for clinical care• The choice of APD or CAPD regimens in PD patients should not be influenced by a possible effect on peritonitis rates.• The choice of conventional or biocompatible PD solutions should not be unduly influenced by potential benefits in peritonitis rates until stronger evidence becomes available. bs_bs_banner Nephrology 19 (2014) 69-71