Objective: To determine the frequency of medical complications after renal transplantation in recipients. Study Design: Prospective Cohort study. Setting: Nephrology Unit, Bahawal Victoria Hospital, Bahawalpur. Period: December 2018 to March 2022. Material & Methods: All patients undergoing renal transplant during the study period were included. Patients unwilling to be part of this study or losing follow-ups were excluded. At the time of enrollment, all patients underwent pre-transplant work-up and routine investigations. Baseline characteristics of renal transplant recipients and donors were noted while frequency of post renal transplant medical complications was also noted. Results: In a total of 39 renal transplant recipients, 32 (82.1%) were male while the mean age was 30.31±7.21 years. Mean duration of dialysis before transplantation was 6.81±5.15 months (ranging between 0-24 months). Mean age of the live donors was 35.90±9.36 years. Mean duration of follow up was 26.15±11.62 months. Renal graft dysfunction was reported in 10 (25.6%) patients. Most common medical complications reported in post-transplantation period were sepsis 19 (48.7%), anemia 19(48.7%), secondary polycythemia 10 (25.6%), CMV infection 4 (10.3%) and new onset diabetes mellitus 3 (7.7%). Mortality was reported in 2 (5.1%) renal transplant recipients and the cause of mortality in both those patients was sepsis. Conclusion: Medical complications are common after renal transplantation. Sepsis being more common in 1st6-months post-transplant period. Early recognition and management of these complications is essential for decreasing mortality and morbidity of patients.
Objectives: Acquired cystic renal disease is known complication of End stage renal disease and hemodialysis and is also a precursor to renal cell carcinoma in patients who are on long term maintenance hemodialysis. Study Design: Cross Sectional study. Setting: Bahawal Victoria Hospital, Bahawalpur-Pakistan. Period: Jan 2019 to June 2019. Material & Methods: Patients on maintenance hemodialysis were evaluated using ultrasound for acquired cystic renal disease. Results: The study included 220 patients who were on maintenance hemodialysis. The male to female ratio was 2.01:1. Most common causes of renal failure were Diabetes Mellitus and Renal stone Disease (22.3%) each. Acquired cystic renal disease was found in 45 (20.5%). The difference of frequency of acquired cystic renal disease was statistically significant in age groups & anemia. Conclusions: Acquired cystic renal disease is common complication of End stage renal disease and maintenance hemodialysis. Regular monitoring with ultrasound needs to be done for those patients who are on maintenance hemodialysis for more than 3 years.
One of the risk factor of cardiovascular disease in patients of maintenance hemodialysis is abnormalities in lipid profile. Deranged levels of cholesterol are related to increased risk of cardiovascular mortality and morbidity in hemodialysis patients. Objectives: To determine the frequency of dyslipidemia under going maintenance hemodialysis at BVH, Bahawalpur. Study Design: Cross Sectional study. Setting: Dialysis unit at Bahawal Victoria Hospital, Bahawalpur. Period: January to May 2019. Material & Method: A total of 220 patients who were undergoing maintenance hemodialysis at dialysis unit BVH, Bahawalpur were included in the study. Pre-dialysis blood samples were taken for assessment of Sr. Cholesterol (Total), Sr. Triglycerides & Sr. HDL and were sent to Chemical Pathology Lab of QAMC, Bahawalpur on same day for processing. Results: Out of 220 patients, most of the patients were male (66.8%), history of smoking was present in 7.3% & mean duration of dialysis was 27.12 + 25.85 months. The mean of Sr. Cholesterol (Total), Sr. Triglycerides, Sr. HDL were 155.51+37.72 mg/dl, 135.54+89.27 mg/dl & 35.22+7.77 mg/dl respectively. Dyslipidemia was present in 80% of patients with most common being low HDL (71.8%). Conclusion: Patients of maintenance hemodialysis are having significant number of dyslipidemia leading to inflammation, accelerated atherosclerosis and increased cardiovascular events.
Background Accurate estimation of the donor’s glomerular filtration rate (GFR) is crucial for not only ensuring the medical appropriateness of the donor but also for the prediction of future allograft performance. The aim of this study was to compare the GFR estimation formulas and 24-hour urine creatinine clearance with diethylene triamine pentaacetic acid (DTPA) renal scan GFR. Methods This cross-sectional study was done at the Department of Nephro Urology Dialysis & Renal Transplantation, Bahawal Victoria Hospital, Quaid e Azam Medical College, Bahawalpur, Pakistan from September 2018 to September 2021. A total of 92 potential healthy live-related kidney donors of both genders, aged 18 to 60 years having body mass index below 35 kg/m 2 were included. GFR was calculated with modification of diet in renal disease (MDRD), Cockcroft-Gault (CG), chronic kidney disease epidemiology (CKD-EPI) equations as well as by 24-hour urine creatinine clearance. DTPA renal scan was done to record GFR findings. GFR was compared using analysis of variance (ANOVA) among different methods. Results Out of a total of 92 individuals, 49 (53.3%) were male and 43 (46.7%) female. Mean age and BMI were noted to be 34.62±10.57 years and 24.40±2.71 kg/m 2 , respectively. Statistically significant differences existed between various methods of GFR estimation (p<0.001). Mean GFR as per DTPA renal scan findings was noted to be 97.32±9.39 ml/min/1.73 m 2 . Difference of 31.48±20.81, 27.37±21.1, 23.38±6.38, 15.52±37.52 was noted in estimated GFR (ml/min/1.73 m 2 ) with CG formula, MDRD formula, EPI-CKD formula and 24-hour urine creatinine clearance respectively when compared with DTPA renal scan findings. The highest proportion of patients was seen with normal GFR with DTPA renal scan findings as 83 (90.2%) individuals while 24-hour urine creatinine clearance observed these to be 59 (64.1%), CG EPI-CKD formula 44 (47.8%), MDRD formula 39 (42.4%) and 40 (43.5%) with CG formula. Conclusion None of the GFR estimation methods resulted in similar findings. With reference to the DTPA renal scan, 24-hour urine creatinine clearance was the closest GFR estimation followed by CKD-EPI and MDRD equations.
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