Introduction: Obstructive Uropathy which refers to the structural and functional change impeding the normal urine flow is one of the common cause of renal failure . It has diverse effect on normal renal function as well as there is also diversity on its etiology and outcome Material & methods: Total 108 patients who came to Nephrology OPD with various degree of renal dysfunction resulting from Obstruction of Urinary tract was included in the study. Result : Among the patients 65% were male and their mean age was 51±13.5 years . Common clinical features were loin pain (41%) ; vomiting (30%) ; edema (26%) ; Oligourea (46%) & LUTS (19%). Common etiologies of Obstruction was BEP (28.7%);Urolithiasis(24%); Cervical malignancies(11%); Congenital abnormalities (13%) & stricture urethra(12%). About 37% patients had to under go RRT. Conclusion : Specific strategies to target improvements in early diagnosis renal recovery and patients survival are needed in this patient group. Bangladesh Journal of Urology, Vol. 22, No. 2, July 2019 p.132-135

Background:The stiffness of the large elastic arteries increase the morbidity and mortality. The purpose of the present study was to estimate the risk of aortic stiffness among end stage renal disease patients on maintenance haemodialysis. Methods:This cross-sectional study was carried out in the a period of two years. Chronic kidney disease in stage 5 ] patients older than 18 years on maintenance haemodialysis (MHD) for more than 3 months were designated as case group and age and sex matched non CKD patients were considered as control group. Serum calcium, serum albumin, serum phosphate and iPTH were estimated by semi-automated biochemistry analyzer from the Department of Biochemistry of NIKDU, Dhaka and NICVD, Dhaka. Plain Xray abdomen in lateral view was performed for all patients.Result: A total number of 100 patients were enrolled for this study of which 50 patients were in end stage renal disease (ESRD) group and the rest 50 patients were in non-CKD group. Mean (±SD) aortic stiffness index was significantly higher (P<0.001) among ESRD population (3.27±1.70) compared to non CKD group of population (2.00±0.73). Mean (±SD) serum calcium (corrected) level was significantly high (P<0.001) in ESRD patients (9.79±0.87) compared to non CKD group of population (9.13±0.70). Mean (±SD) serum phosphate level was significantly higher (P<0.001) in ESRD patients (5.71±0.96) compared to non CKD group of population (4.20±0.59). However, mean (±SD) iPTH level showed no significant difference between ESRD (25.33±51.98) and non CKD group of population (38.53±19.52). Conclusion:In conclusion, aortic stiffness is significantly higher among ESRD subjects.

aren't differences between the comorbidity examined. The days of stay in-hospital of patients of group A was of days 7.00 (IQR 5.00-10.25) and it was statistically inferior with respect to the stay in-hospital of patients' group B that was of 9.00 days (IQR 7.00-13.0) (p<0.0001). In the group A the GFR correlate to days of stay in-hospital (-,248; p¼,000). This don't occur in the group B (-,06; p¼,469). (TAB1) Bringing back to normal for GFR between 11 and 30 (GFR Group A 16.74ml/min IQR 14. p¼,701) into the two group there are the different during the hospitalization days (group A 7.00 IQR 5.50-10.00; group B 9.50 IQR 7.00-12.75; p<0.007). (TAB.2) In a subanalysis that analyzes in hypertensive patients and in non-hypertensive patients the role of serum potassium, our study shows a different in the days of hospitalization between the group B and the group A. (TAB 3; TAB 4). The risk of a re-hospitalization is of 1,131 in 9 month; 1,223 in 12 month; 1,237 in 18 month. Conclusions: The frequency of hyperkalemia in the patients that stay in-hospital don't seem associated to utilization of RAAS-blocker. Our study shows that the value of K, outmoded the cut-off of5,1 mmol/L, bring about a augmentation of the duration of the period of hospitalization and the risk of a re-hospitalization, also in low Hyperkalemia. Others analysis are needed to understand if it is awkward to more serious clinical conditions or to a not suitable therapeutic approach of hyperkalemia even if light.

Background: Diabetic nephropathy is the most important cause of the end-stage renal disease (ESRD). The aim of the study is to evaluate the effect of spironolactone 25 mg once daily in addition to losartan 50 mg once daily for 12 weeks for proteinuria reduction in diabetic nephropathy.Methods: This is a prospective clinical trial was carried out in the department of nephrology, national institute of kidney diseases and urology (NIKDU), Dhaka, Bangladesh from March 2015 to April 2016. A total of 60 patients attended the study considering inclusion and exclusion criteria. Proper ethical consent was taken from the relevant. Collected data were classified, edited, and analyzed into the computer for statistical analysis using SPSS version 22.Results: The mean serum creatinine baseline, end of 1st, 4th, 8th, and 12th weeks were significantly low (p<0.05) in the control group and significantly decline (p<0.05) in subsequent follow-up in both Intervention and control groups. The mean serum potassium- baseline, end of 1st, 4th, 8th, and 12weeks were not statistically significant (p>0.05) and significantly increased (p<0.05) in both groups. Improvement of urine albumin creatinine ratio was found 96.7% and 83.3% at end of 12th weeks in both groups respectively. It was observed that mean eGFR-baseline, end of 4th and 12th weeks were statistically significantly higher (p<0.05) in both groups with baseline.Conclusions: The addition of spironolactone 25 mg once daily with losartan potassium 50 mg daily for a 12-week period did not show a significant role in the reduction of proteinuria in diabetic nephropathy patients.

Background: Anaemia is a frequent complication in maintenance hemodialysis (MHD) patients and is associated with increased morbidity and mortality. Altered systemic iron metabolism and functional iron deficiency mainly related to subclinical inflammation makes it difficult to maintain proper control of anaemia. The discovery of hepcidin and it's functions has contributed to a better understanding of iron metabolism disorders in CKD anaemia. Objective: To evaluate the association of serum hepcidin with different iron indices (serum iron, serum ferritin, TIBC and TSAT). Materials and Methods: The study was carried out in the Institute of Kidney Diseases and Urology, Dhaka for a period of six months between July to December 2016. Serum hepcidin-25, current iron markers and other laboratory parameters were measured among study subjects. Absolute and functional iron deficiency patients were identified according to serum ferritin and TSAT. Statistical analysis was performed to find out whether serum hepcidin level significantly differ in MHD patients than healthy controls and also to evaluate it's correlation with other iron indices among MHD patients. Results: Total 88 subjects (fifty MHD patients and thirty eight healthy controls) were enrolled into the study. Serum hepcidin level was significantly higher in MHD patients than healthy controls (19.3 (7.0 - 81.8) ng/ml vs 8.0 (2.4 - 33.6) ng/ml, P value <0.001). Hepcidin has significant positive correlation with ferritin in MHD patients (r=0.480; p=<0.001). Hepcidin was also positively correlated with serum ferritin both in absolute iron deficiency patients (r=0.786; p=0.036) and functional iron deficiency patients (r=0.764; p=0.006). Conclusion: Serum hepcidin level is increased in MHD patients and associated with disturbance of iron metabolism. Hepcidin positively correlates with serum ferritin in MHD patients and may be used similarly as ferritin in guiding iron therapy. Bang Med J Khulna 2021; 54 : 21-25