Revista de nefrología y terapéutica

Background: The objective of this study was to investigate the accuracy of diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) as a diagnostic test for acute pyelonephritis (APN) in children.

Methods: Among inpatients under 15 years of age in a primary care setting, we retrospectively reviewed the medical records for 29 febrile children subjected to DWIBS to confirm or exclude APN. To assess the diagnostic value of DWIBS, the subjects were divided into 13 patients clinically diagnosed with APN and 16 non-APN patients. DWIBS findings were divided into positive, indeterminate, and negative based on visual observation.

Results: Likelihood ratios for positive, indeterminate, and negative prediction were 6.15 (95% CI, 1.90–19.97), 0.49 (95% CI, 0.13–1.83) and 0.14 (95% CI, 0.03–0.65), respectively.

Conclusions: This study is the first to estimate the accuracy of DWIBS for the detection of APN. Initial DWIBS is a sensitive method for the diagnosis of APN and can improve diagnostic performance.

The primary goal of this invited commentary is to update recent scientific progress, understanding, knowledge gained and also several clinical advances made since the very first review that was published from our commercial efforts in the year 2012 (Title: Probiotics, Prebiotics and Synbiotics: Gut and Beyond in Gastroenterology Research and Practice). The use of probiotics and prebiotics is generally well recognized towards digestive, gut and immune health. However, Kibow Biotech is a R&D Biotech company involved in novel and niche application of probiotics and prebiotics as a dietary supplement in stabilization of Gut Microbiome towards Chronic Kidney Disease (CKD).

Antimicrobial resistance is a growing worldwide problem. Urinary tract infection (UTI) is not an exception. Therefore, it is crucial to regularly update the bacterial flora spectrum data and the efficacy of the recommended empiric treatment to make timely and appropriate amendments where necessary.

This observational study was comprised in July-November 2014, when family physicians across Latvia submitted the anonymous patient data on recurrent UTI treatment in their practice. Anonymous patients’ electronic data files were received, 113 of those met the inclusion criteria and were further analyzed.

Bacterial flora spectrum in Latvian adult recurrent UTI population was fairly consistent with data from other European countries, with Escherichia coli identified in 66 (58.41%) cultures, of those as monoculture in 55 (58,51%) and as combined culture in 11 (11.70%) cases. Combined cultures without Escherichia coli were obtained in 28 (29.79%) cases.

Sensitivity against Nitrofuran derivatives (NFDs) was present in 88 cases (91.49% of total cultures); Escherichia coli resistance against NFDs was found in only 4 cases (6.06% of Escherichia coli cultures).

The current first-choice empiric treatment of recurrent UTI by NFDs may stay unchanged. Particular NFD used in Latvia (Furamags®) is safe, well-tolerated and effective first-line UTI treatment choice.

Background: Vitamin D is an essential component of skeletal development. Although hypovitaminosis D has been widely observed, little data for vitamin D status in pediatric patients with chronic kidney disease (CKD) has been reported. The aim of this study was to assess the prevalence of abnormal vitamin D status and analyze factors associated with inadequate 25(OH) vitamin D (25(OH)D) levels in children with CKD.

Methods: Serum 25(OH)D levels and other parameters associated with vitamin D status were evaluated by a cross-sectional study of pediatric patients with predialysis CKD stage 2-5 at Samsung Medical Center located in Seoul, Republic of Korea. Vitamin D deficiency and insufficiency were defined as a serum 25(OH)D level < 20 ng/mL and 20- 30 ng/mL, respectively.

Results: Of the 113 pediatric patients with CKD, vitamin D deficiency or insufficiency was found in 77.8% of the patients and 54.9% had a diagnosis of vitamin D deficiency with a serum 25(OH)D levels below 20 ng/mL. An increasing prevalence of vitamin D deficiency in advanced CKD was observed Age and PTH levels were negatively associated with 25(OH)D levels in pediatric CKD patients.

Conclusion: This study demonstrated that a prevalence of 25(OH)D insufficiency and deficiency are common in children with CKD. The age effect on abnormal vitamin D status was observed in pediatric patients with CKD, and future studies to adjust the guideline for vitamin D supplementation according to the age is needed.

Bile cast nephropathy, or cholaemic nephrosis is a rare cause of acute renal injury with only a few cases that have been reported.
In this article, we present a patient with acute transient liver injury, autoimmune haemolytic anaemia and oligouric acute kidney injury. Kidney biopsy had confirmed presence of bile casts with evidence of acute tubular injury.