Revista de nefrología y terapéutica

The Greek word prophylaxis means "to guard or prevent beforehand." In Pediatric Urology, antibiotic prophylaxis is the attempt to prevent urinary tract infections (UTIs) in children who are predisposed to them, such as those with vesicoureteral reflux (VUR) and hydroureteronephrosis. Antibiotic prophylaxis for paediatric urologic conditions has both demonstrated benefit and demonstrated harm. Antibiotic prophylaxis for all children with VUR, as well as those with all grades of hydronephrosis (HN) and hydroureteronephrosis, is at best unnecessary and at worst harmful. The full impact of prophylactic antibiotics on the developing and ageing body, for better or worse is unknown. Over the last two decades, increased public and physician awareness of the truth of previous statements has resulted in a more selective approach to the use of prophylactic antibiotics. Although it was previously thought that most children with conditions such as VUR or hydronephrosis were at high risk of UTI and thus would benefit from continuous antibiotic prophylaxis (CAP), data from multiple studies has shown otherwise.

Specialist co-location in primary care has been proposed as a strategy to reduce care fragmentation, inefficiency, and cost. A systematic review and meta-analysis were conducted to assess the impact of co-located specialty care models in primary care settings. Methods: Through February 2015, Ovid Medline In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus were searched. A manual search of the bibliographies of the included studies was carried out. Randomized controlled trials (RCTs) and observational studies reporting on the following outcomes in physically co-located specialties in primary care were included: patient satisfaction; provider satisfaction; health care access and utilization; clinical outcomes; and costs.

Chronic kidney disease (CKD) is a global public health problem with high morbidity and mortality, from cardiovascular complications. CKD is a progressive and irreversible deterioration of kidney function with complex pathophysiological and pathogenetic pathways due to diverse etiologies and risk factors. Progression of CKD has a common complex and interrelated immunological and metabolic pathway resulting in inflammation and oxidative stress processes. This progression manifests clinically as irreversible functional and structural damage. The primary aim of therapeutic intervention in CKD management is delay progressive loss of function, and to prevent and manage complications. Recent approaches to slowing CKD progression include therapy with sodium-glucose cotransporter 2 inhibitor (SGLT2) and gut microbiome modulation with probiotics, based on beneficial clinical outcomes of metabolic, immunological, inflammatory, and hemodynamic changes associated with CKD progression. Despite comparable mechanisms of action in slowing CKD progression, these two classes of medications differ in their safety profile, treatment effect on CKD stages, and patient population group. The focus of this review is how to differentiate SGLT2 from probiotics as novel therapeutic agents targeting CKD progression from the perspective of CKD severity, patient group and safety profile. This may be a valuable guide for future strategic planning and decision making in clinical development programs of therapeutic interventions in CKD progression.

Introduction: Cardiovascular complications are very lethal in chronic haemodialysis patients. They are the leading cause of mortality in this population, which is 3 to 20 times higher than in the general population of the same age group. Our work aimed to determine the frequency of cardiovascular complications in our patients.

Patients and methods: We conducted a two-month looking-forward study of descriptive and analytical purpose in the haemodialysis centre of Ziguinchor regional hospital. Data were collected through a questionnaire providing information on epidemiological, clinical and paraclinical parameters. All patients underwent an electrocardiogram and a trans-thoracic cardiac echocardiogram after the dialysis session.

Results: The mean age of the patients was 41.14 years and 57.14% of the patients were hypertensive. Exertional dyspnea was the main clinical manifestation in 47.61% and 28.57% of patients had electrical left ventricular hypertrophy. On echocardiography, concentric LVH was found in 47.61% of patients.

Conclusion: Chronic haemodialysis patients are at risk of common and lethal cardiovascular complications. The management requires a monitoring with periodic paraclinical examinations to prevent complications.

Introduction: The presence of donor-specific antibodies (DSAs) against HLA molecules is a risk factor for humoral rejection after kidney transplantation. The introduction of the complement-dependent cytotoxicity (CDC) test has been a major step forward in excluding high-risk donoracceptor combinations.

Objective: To find out profile of positive Cross match Reports among pretransplant patients.

Design: Case series design.

Settings: Shahid Dharma Bhakta National Transplant Centre, Bhaktapur.

Subjects : Patient who had positive cross match reports from Oct 16, 2021 to May 13, 2022.

Method: List of patients prepared who are being prepared for renal transplant Process in duration of six months. There were 46 such pair prepared for transplant and with positive cross match reportsEnumerative sampling technique was used for data collection.

Results: The current study depicits that there is significant statistical association between PRAI and DSAII report of pretransplant pair. i.e, (P: 0.002). There is strong statistical association between CDC and PRAII report of pretransplant pair. (p:0.000). There is statistical association between DSA I and COVID 19 infection of pretransplant pair. (p:0.033). There is statistical association between DSA II and COVID infection report of pretransplant pair. (p:0.008).

Conclusion: Introduction: The presence of donor-specific antibodies (DSAs) against HLA molecules is a risk factor for humoral rejection after kidney transplantation. The introduction of the complement-dependent cytotoxicity (CDC) test has been a major step forward in excluding high-risk donor-acceptor combinations.