Abstractthis setting will not be diagnostically useful. In retrospective studies of non-insulin dependent diabetes melBackground. Several studies had suggested that nondiabetic renal disease (NDRD) was common among litus (NIDDM ) patients with renal involvement, from 12-81% of their renal lesions were non-diabetic renal non-insulin dependent diabetes mellitus (NIDDM ) patients with renal involvement. diseases (NDRD), with different spectrum of diseases identified in different series [4][5][6][7][8][9]. Such retrospective Methods. We prospectively studied the prevalence of NDRD among a Chinese NIDDM population. Renal studies are apparently biased and tend to selectively include patients with clinical presentations thought not biopsy specimens were evaluated with light-, immunohistological and electron-microscopy. The cohort in keeping with diabetic glomerulosclerosis. Also, for patients found to have NDRD, different predicting consisted of 51 patients who had NIDDM and proteinuria >1 g/24 h.factors have been identified in these series, including late age of onset of DM [4], absence of neuropathy Results. Patients with both isolated diabetic nephropathy (DN, n=34) and NDRD (n=17) had compar- [4,5], absence of retinopathy [4,5] and presence of other systemic diseases [4]. However, these factors able duration of DM, creatinine clearance, serum creatinine, albumin and glycosylated haemoglobin were found to have variable predictive values in different series. In a limited number of prospective studies levels, as well as incidences of retinopathy, neuropathy and hypertension. Significantly more patients with of NIDDM patients with renal involvement, from 23-39% of patients were found to have NDRD NDRD had microscopic haematuria (P=0.043) or non-nephrotic proteinuria (P=0.004). IgA nephro- [10][11][12]. However, only the absence of retinopathy and autonomic neuropathy were found to be useful pathy accounted for 59% of the NDRD identified. Conclusions. In this study, microscopic haematuria clinical markers [10]. Overall, it remains unclear whether one is to offer biopsy for all such patients, or and non-nephrotic proteinuria predicted the presence of NDRD among NIDDM patients presenting with should indeed reserve biopsy for those patients with atypical features associated with proteinuria, i.e. renal disease.sudden onset, haematuria, acute renal insufficiency, extra-renal manifestations, and absence of retinopathy Key words: microscopic haematuria; non-diabetic renal disease; non-insulin dependent diabetes mellitus; non- [13]. We have performed a prospective study to clarify the issue in our local population where little data exist. nephrotic proteinuria Subjects and methods Patients

Manystudies have shown that kidney transplant recipients have a higher incidence of cancers when compared with general population. However, most data on the posttransplant malignancies (PTM) are derived from Western literature and large population-based studies are rare. There is also lack of information about the posttransplant cancer-specific mortality rate. We conducted a population-based study of 4895 kidney transplants between 1972 and 2011, with data from the Hong Kong Renal Registry. Patterns of cancer incidence and mortality in our kidney transplant recipients were compared with those of the general population using standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs) respectively. With 40 246 person-years of follow-up, 299 PTM was diagnosed. The SIR of all cancers was 2.94 (female 3.58 and male 2.58). Non-Hodgkin lymphoma (NHL), kidney, and bladder cancers had the highest SIRs. The overall SMR was 2.3 (female 3.4 and male 1.7) and the highest SMR was NHL. The patterns of PTM differ among countries. Increases in cancer incidence can now translate into similar increases in cancer mortality. NHL is important in our kidney transplant recipients. Strategies in cancer screening in selected patient groups are needed to improve transplant outcomes.

BackgroundHungry bone syndrome (HBS) is an important postoperative complication after parathyroidectomy for severe secondary hyperparathyroidism (SHPT). There is, however, little data in the literature on its detailed clinical course, and the associated risk factors remain controversial.MethodsWe did a single-center retrospective study on 62 consecutive dialysis patients who underwent total parathyroidectomy for SHPT to examine the risk factors, clinical course and outcome. Data on demographic characteristics, perioperative laboratory parameters including serum calcium, phosphate, alkaline phosphatase (ALP) and parathyroid hormone (PTH), drug treatment for SHPT and operative details of parathyroidectomy were collected.ResultsSeventeen (27.4%) patients developed severe postoperative hypocalcemia with HBS. The serum calcium dropped progressively while serum ALP rose after operation until 2 weeks later when serum calcium reached the trough and serum ALP peaked. Serum phosphate also fell but stabilized between 4 and 14 days. The total postoperative calcium and vitamin D supplementation was significantly larger, and hospital stay was significantly longer in the group with HBS as compared with those without HBS. Young age, high body weight, high preoperative ALP level, and low preoperative calcium level independently predicted the development of HBS while preoperative PTH and use of cinacalcet or paricalcitol did not.ConclusionHBS was common after total parathyroidectomy in patients with SHPT, and it is important to closely monitor the postoperative serum calcium, phosphate and ALP levels in the following 2 weeks, especially for those at risk. The implications of our findings on perioperative management are discussed.

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