EPO and low Hb levels (ESA hyporesponsive) had significantly higher risk of mortality (aHR 2.42, 95% CI 1.41-4.19, p=0.001). The high ERI group also had 36% higher incidence of hospitalisation (IRR 1.36, 95% CI 1.20-1.54, p<0.001) compared to low ERI group. The independent predictors of high ERI were female gender, low albumin, high ferritin, low transferrin saturation %, low BMI, high KT/V, high acuity status and increased hospital admissions in the exposure period. Conclusions: High ERI levels are associated with increased risk of allcause mortality and hospitalisation in incident HD patients. Lack of data on inflammatory markers is a study limitation.

diffusion and improve outcomes in sepsis-related AKI patients. The current study is aimed to assess the differential impact of post-dilution online hemodiafiltration on renal recovery, as compared to conventional high flux hemodialysis in non-critically ill CA-AKI patients with systemic inflammatory response syndrome (SIRS). Methods: The current study is a single-center, open-label, prospective, interventional, randomized trial done at the Department of Nephrology, PGIMER, Chandigarh, India. The trial was registered in the clinical trial registry of India bearing registration number CTRI/2017/09/009675. Noncritically ill hospitalized patients with a diagnosis of CA-AKI with SIRS were included in the study. Eligible patients were randomized to receive either online hemodiafiltration (OL-HDF) in post-dilution mode or conventional high-flux hemodialysis (HF-HD). The primary objective was to assess the feasibility to conduct the trial at larger scale and to observe any difference in dialysis independence at 30 days. Secondary objectives were to assess independently the improvement in the inflammatory milieu in terms of change in the quick sequential organ failure assessment (qSOFA) score, plasma Interleukin-6 (IL-6) level and bio-impedance based phase angle during the first week of dialysis initiation. Results: Eighty consecutive patients were enrolled as per sample size calculation. Baseline epidemiological, clinical and laboratory characteristics were comparable. Tropical illness, envenomation, rhabdomyolysis, and acute pancreatitis were among the common aetiologies. The mean total convective volume delivered per session in the intervention arm was 17.8 Litres. 83.3% in control and 71.1% in the intervention arm recovered their renal function and became dialysis independent at discharge or 30 days (p¼0.189). Time to renal recovery, hours spent on renal replacement therapy, intensive care unit (ICU) transfer rate and length of hospitalization were not different between both the groups (p>0.05) (Table1). No survival benefit of post-dilution OL-HDF was observed at discharge (p>0.05). Significant reduction in the cytokine (IL-6) concentration (Figure 1), improvement in qSOFA score and phase angle were observed at the end of the first week (of dialysis initiation) in both the arms. Conclusions: The current study does not support the notion of preferential utilization of post-dilution OL-HDF over conventional high flux HD in CA-AKI with SIRS. It urges to plan a larger trial to answer the raised concerns in a more generalizable manner.

Femoral neck fracture occurring after an epileptic seizure is a rare and under-diagnosed injury. The majority of the reported cases in literature are old patients with osteoporosis. Younger patients present several risk factors of osteopenia and the treatment remains controversial. We present an outcome of a 23 years old patient with unilateral femoral neck fracture occurring during an epileptic seizure and we discuss the associated multiple risk factors of osteopenia and osteonecrosis of the hip. The patient was brought to the emergency department of Teaching Hospital of Kamenge (CHUK) complaining of pain in his left hip that had been progressing for one month after an epileptic seizure. There is a history of HIV infection since birth and epileptic seizures with ongoing treatments for both diseases. Despite the high risk of avascular necrosis, the treatment choice has been influenced by the patient's age and a conservative surgery by internal fixation with Dynamic Hip Screw has been made. Unfortunately, this treatment early resulted in osteonecrosis of the hip since HIV infection itself and the highly active anti-retroviral therapy increase its risk.

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Background: Increasing resistance to antimicrobials is a worldwide problem. The aim of our study was to determine the pathogens and antimicrobial susceptibility of bacteria causing urinary tract infection (UTI) in children. Methods: This is a prospective cohort study conducted over a 10-month period with 101 children hospitalised at Kamenge University Hospital for acute UTI. The infections were confirmed by Kass urinalysis criteria, and culture and susceptibility antibiotic tests were performed for isolated microbial agents. Results: Frequency of UTI in the overall population of children hospitalised at Kamange University Hospital was 8.4%. Of the 101 children with UTIs, 87 (86.1%) were under the age of 24 months. Diagnosis of pyelonephritis (82%) was the most common, followed by cystitis (18%). Escherichia coli (82%) was the most frequent pathogen causing UTI. We found E coli and Klebsiella pneumonia to be resistant to aminopenicillins (100%), cotrimoxazole (98.2%, 100%), Augmentin (amoxicillin/clavulanic acid) (70.5%, 80%), cefotaxime (45.8%, 28.6%), cefuroxime (36.8 to 45.5%, 50%), fluoroquinolones (33.3 to 53.6%, 28.6 to 50%), gentamicin (27.5%, 20%), and nitrofurantoin (9.3%, 50%). Conclusion: E coli is the main causal agent of UTI in childhood with a high resistance to antibiotics. Appropriate antibiotics for empiric therapy should be based on local circulating bacterial strains and resistance profiles.