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Introduction. Postoperative atrial fibrillation (POAF) is a frequent arrhythmic complication in cardiac surgery. Studies of this potential complication have not been able to elucidate its etiology nor to identify the predictors of its occurrence. The objective of the study was to evaluate the predictive role of renal dysfunction for POAF in patients undergoing cardiac surgery interventions. We also aimed to determine the role of renal dysfunction in improving diagnostic accuracy of Hypertension, Age, Transitory attack/stroke, Chronic obstructive pulmonary disease, Heart failure (HATCH) score for POAF. Material and methods. This prospective monocentric observational study included 178 consecutive patients who underwent cardiac surgery interventions in the State University Clinic of Cardiac Surgery of Skopje, Republic of North Macedonia, between September 2017- September 2018. Patients were divided in two groups, according to the absence or occurrence of POAF. HATCH score was calculated and recorded for each patient. A new R-HATCH score was derived by addition of renal dysfunction to the existing HATCH score and its predictive value for POAF was tested and compared to HATCH. Results. POAF occurred in 90 of 178 patients (50.56%). The average eGFR in the group developing POAF was significantly lower, 78.4±26.9 vs 93.0±29.0 ml/min/1,73m2 (p=0.0005). Patients with GFR

Introduction: Tenofovir-based antiretroviral therapy places HIV-infected patients at high risk of renal dysfunction. Therefore, we evaluated if the incidence of renal dysfunction in adults HIV positive patients with long term tenofovir-based regimen use is higher than in those without Tenofovir use.Methods: we performed a retrospective cohort analysis of 834 HIV positive patients at the counselling and testing center at Ronald Ross General Hospital. Patients´ records in data management software called SMARTCARE from 2008 to 2012 were reviewed to compare renal function between patients on tenofovir-containing regimen (447) with non-Tenofovir containing regimen (387). We evaluated glomerular filtration rate using creatinine clearance, serum creatinine, urea and exposure to TB medication, Cotrimoxazole use and CD4 cell count. Multivariable logistic regression was used to determine the factors associated with renal dysfunction. We report multivariable hazard ratios, risk ratios and linear outcomes with predictors retained if P less than 0.05. Potential predictor variables included in the multivariable models were age, sex, weight, serum creatinine and treatment with tenofovir.Results: the CD4 cell count, urea, anti-TB medication, Co-trimoxazole use, education level, employment status and creatinine clearance were similar at baseline between the two groups. Tenofovir-exposed patients had a relative increase in serum creatinine (P less than 0.04) and decline in creatinine clearance at 18 months during treatment (P less than 0.16)) relative to non-tenofovir exposed patients; Tenofovir exposed patients had a risk of developing renal dysfunction more than the non-tenofovir-exposed group (OR: 4.5, 95% CI, -1.71-10.7, P less than 0.032). Further, serum creatinine μmol/L increase (OR: 0.1, 95% CI, -0.43-(-0.40, p less than 0.02)), age per year-increase (OR: 0.75, 95% CI -1.28-(-0.34), P less than 0.01), body weight per 1 kg-increase (OR: 0.65, 95% CI, 0.015-1.07, P less than 0.04) and gender are risk factors to renal dysfunction.Conclusion: tenofovir-based therapy is associated with decline in renal function, with most developing mild renal dysfunction. The need for close renal monitoring of patients initiated on tenofovir by using creatinine clearance is recommended and use of less renal toxic Tenofovir-Alafenamide (TAF) analogue.

Résumé: La greffe de cellules souches hématopoïétiques est le traitement de choix de plusieurs pathologies hématologiques, notamment malignes. Les complications potentielles de cette modalité thérapeutique comprennent une dysfonction rénale précoce et tardive. La dysfonction rénale précoce, généralement réversible est le plus souvent due à une nécrose tubulaire aiguë (syndrome de lyse tumorale, toxicité de l’infusion de moelle osseuse conservée, sepsis, médicaments néphrotoxiques), une maladie veino-occlusive hépatique ou une maladie du greffon contre l’hôte. La dysfonction rénale chronique est souvent multifactorielle, secondaire essentiellement à la toxicité endothéliale du conditionnement (« néphropathie de la greffe de moelle ») et à la toxicité des inhibiteurs de la calcineurine. Les lésions histologiques rénales ressemblent à celles de la microangiopathie thrombotique. De rares cas de syndrome néphrotique ont été rapportés après greffe de cellules souches hématopoïétiques, notamment sous forme d’une glomérulonéphrite extramembraneuse associée à une maladie du greffon contre l’hôte. Les moyens thérapeutiques d’une dysfonction rénale après greffe de cellules souches hématopoïétiques sont limités, mais la greffe rénale est toujours possible en cas d’insuffisance rénale terminale. [Copyright &y& Elsevier]

Unlabelled: The coexistence of essential hypertension (EH) in type 2 diabetic (T2D) patients greatly enhances chronic kidney disease., Objectives: To assess the acute renal dysfunction in two cohorts of diabetic-hypertensive subjects. The inaugural pathology for each group is either T2D or EH., Patients and Methods: The study was undertaken on 506 subjects who were divided in 5 groups according to age and sex: diabetic, hypertensive, diabetic- hypertensive (DH and HD) and healthy groups. Patients were phenotyped regarding their cardiometabolic syndrome (CMS) profile using the NCEP/ATPIII criteria and cardiorenal syndrome (CRS) according to the International kidney foundation. Hypertension was defined as systolic (SBP) and diastolic (DBP) blood pressure ≥ 140/90 mmHg, respectively. Insulin resistance (IR) was assessed by Homa-IR model. Glomerular filtration rate (GFR) by creatinine clearance. CMS and CRS parameters were determined on Cobas®. The SBP and DBP measurements by electronic blood pressure using Omron 705 CP® type., Results: IR was found in all diabetics and hypertensive patients. Dyslipidemia are correlated to % body fat mass accretion in all groups. In DH group, the renal disorder is confirmed by decreased GFR (30%) and increased microalbuminuria (> 30 mg/24h); associated with increased NT-pro BNP and plasma aldosterone depletion., Conclusion: Several biomarkers are necessary to detection kidney disease and renal failure prevention in diabetic patients to hypertensive state. The renal dysfunction was significantly related to T2D-EH disease.

Hematopoietic stem cell transplantation is a widely used therapeutic modality for many, mainly malignant, diseases. Toxicities of this procedure include acute and chronic renal dysfunction. Acute renal failure, generally reversible is due to acute tubular necrosis (tumor lysis syndrome, marrow-infusion toxicity, sepsis, nephrotoxins), hepatic veno-occlusive disease or acute graft-versus-host disease. Chronic renal failure is often multifactorial, caused by conditioning-associated endothelial cell toxicity (bone marrow transplant nephropathy) and calcineurin inhibitors toxicity. Renal pathologic findings are somewhat similar to thrombotic microangiopathy, with sometimes systemic disease. Rare cases of nephrotic syndrome have been described after hematopoietic stem cell transplantation, mainly membranous nephropathy, associated with graft-versus-host disease. Therapeutic options for renal dysfunction after hematopoietic stem cell transplantation are limited but kidney transplantation is possible in case of end-stage renal disease., (Copyright © 2014. Published by Elsevier SAS.)

Background: The aim of this study was to determine the prevalence of kidney disease in patients newly diagnosed as HIV-positive in Brazzaville and to identify the associated risk factors., Methods: Descriptive and analytical study of patients diagnosed with HIV infection at the Ambulatory Treatment Center in Brazzaville, Republic of Congo, from January 1, 2009, through December 31, 2010. Estimated glomerular filtration rate (eGFR) was assessed with the Modification of Diet in Renal Disease equation (MDRD-GFR), and kidney disease was defined by an eGFR less than 60 mL/min/1.73 m(2). We conducted a univariate and then a multivariate logistic regression analysis to determine the factors associated with kidney disease in this population., Results: The study included 562 patients newly identified as HIV-infected, 66.13% of whom were women. Their median age was 38.84 years interquartile range (IQR): 33.18-46.23) and their median body mass index (BMI) 20.31 kg/m(2) (IQR: 17.97-22.89). Their median CD4 count was 192 cells/mm(3) (IQR: 81-350), and 70.8% were at WHO stage III/IV. Finally, the median MDRD-GFR was 95.59 (IQR: 78.76-114.92) mL/min/1.73 m(2) and 8.5% had a GFR less than 60 mL/min/1.73 m(2), that is, moderate impairment of kidney function. The only factor associated with kidney disease in the multivariate analysis was a BMI less than 18.5 kg/m(2) (adjusted odds ratio: 2.54, 95% confidence interval: 1.25-5.15, p = 0.01)., Conclusions: The prevalence of kidney disease in patients newly diagnosed with HIV in Brazzaville is relatively high. The only factor associated with it in the multivariate analysis was a BMI less than 18.5 kg/m(2).