Objectives: Large amounts of healthcare data are now generated via patient health records, record... more Objectives: Large amounts of healthcare data are now generated via patient health records, records of diagnosis and treatment, smart devices, and wearables. Extracting insights from such data can transform healthcare from a traditional, symptom-driven practice into precisely personalized medicine. Dialysis treatments generate a vast amount of data, with more than 100 parameters that must be regulated for ideal treatment outcomes. When complications occur, understanding electrolyte parameters and predicting their outcomes to deliver the optimal dialysis dosing for each patient is a challenge. This study focused on refining dialysis dosing by utilizing emerging data from the growing number of dialysis patients to improve patients’ quality of life and well-being.Methods: Exploratory data analysis and data prediction approaches were performed to gather insights from patients’ vital electrolytes on how to improve the patients’ dialysis dosing. Four predictive models were constructed to p...
Introduction: Acute focal bacterial nephritis is an underdiagnosed condition. It clinically resem... more Introduction: Acute focal bacterial nephritis is an underdiagnosed condition. It clinically resembles acute pyelonephritis. If unrecognized and undertreated, it may progress into complications (kidney abscess and scars). Contrast-enhanced computed tomography (CT) reveals specific images of the disease and is considered the gold standard to make the diagnosis. Case Report: A 63-year-old male patient with solitary kidney presented with symptoms compatible with acute pyelonephritis. Kidney ultrasound was not conclusive. Because of persisting high-grade fever not resolving after 48 hours of antibiotics, a contrast-enhanced CT was then performed, and the diagnosis of acute focal bacterial nephritis was made. A repeat CT after three weeks of intravenous (IV) antibiotics showed marked improvement of the intrarenal lesions, and a fourth week of IV antibiotics was dispensed.Conclusion: Diagnosing acute focal bacterial nephritis is important (particularly in a patient with solitary kidney). T...
Diabetic kidney disease (DKD) is a severe irreversible complication of diabetes mellitus that fur... more Diabetic kidney disease (DKD) is a severe irreversible complication of diabetes mellitus that further disturbs glucose metabolism. Identifying metabolic changes in the blood may provide early insight into DKD pathogenesis. This study aims to determine blood biomarkers differentiating DKD from non-diabetic kidney disease in the Emirati population utilizing the LC-MS/MS platform. Blood samples were collected from hemodialysis subjects with and without diabetes to detect indicators of pathological changes using an untargeted metabolomics approach. Metabolic profiles were analyzed based on clinically confirmed diabetic status and current HbA1c values. Five differentially significant metabolites were identified based on the clinically confirmed diabetic status, including hydroxyprogesterone and 3,4-Dihydroxymandelic acid. Similarly, we identified seven metabolites with apparent differences between Dialysis Diabetic (DD) and Dialysis non-Diabetic (DND) groups, including isovalerylglycine ...
rocalcinosis cases in adults treated in our department from January 1986 to October 2020 Results:... more rocalcinosis cases in adults treated in our department from January 1986 to October 2020 Results: 26 cases were diagnosed at a mean age of 35.28 years old with extremes ranging from 11 to 79 years old. The sex ratio M/F was 1. More than half of the patients had a family history of urolithiasis. Nephrocalcinosis was suspected following renal colic in 13 cases, a polyuropolydipsic syndrome in 4 case, a hypokaliemia in 2 case, an urolithiasis in 2 case and a renal impairment in 2 case. In 3 case, the diagnosis was made fortuitly with an ultrasonography. The etiologies found were: familial distal tubular acidosis (6 cases), distal tubular acidosis caused by Sjögren’s syndrome (4 cases), primitive oxalosis (3 case), Cacci Ricci syndrome (3 cases), familial hypomagnesemia hypercalciuria (2 case), Dent syndrome (1 case) and no causes found (7 cases). Follow-up showed stabilization of renal function in 18 cases and the evolution into chronic kidney disease in 6 cases: 2 of them requiring renal replacement therapy after 5 years and the other died. Conclusions: Nephrocalcinosis is prevalent both in children and adults. Its etiologies are numerous. Most of the metabolic disorders are genetic. The diagnosis of nephrocalcinosis requires a deep investigation with a global clinical assessment, laboratory tests and radiological evaluation. The final objective is to prevent ESKD. No conflict of interest
The presentation of COVID-19 pneumonia in kidney transplant recipients is similar to that of the ... more The presentation of COVID-19 pneumonia in kidney transplant recipients is similar to that of the general population. However, in the former, it may have a worse clinical course. We report a kidney transplant patient affected by COVID-19 pneumonia whose condition worsened 9 days after the initial presentation. As no therapeutic guidelines on the subject are currently available, here we share our approach in the management of the immunosuppressive medications and the antiviral therapy and compare them to the scarce available data. We also expose the use of tocilizumab in our patient with excellent results.
Canadian Journal of Kidney Health and Disease, 2019
Rationale:Acute focal bacterial nephritis (AFBN) has mainly been reported in pediatrics. It may b... more Rationale:Acute focal bacterial nephritis (AFBN) has mainly been reported in pediatrics. It may be an underdiagnosed condition in adults because it resembles acute pyelonephritis (APN) in its clinical presentation.Presenting concerns of the patients:Two young women (25 and 27 years old, respectively) presented with complaints compatible with a diagnosis of APN. However in both, fever was of high grade, persistent for several days in spite of antibiotic administration, and there was demonstrated worsening of the inflammatory biomarkers. A contrast-enhanced computed tomography (CECT) led to the diagnosis in both cases.Diagnoses:Contrast-enhanced computed tomography reveals the most sensitive and specific images of AFBN. This includes wedge-shaped lesions with decreased enhancement, which may be focal or multifocal.Interventions (including prevention and lifestyle):Antibiotic therapy for at least 3 weeks.Outcomes:Resolution of AFBN was obtained after 3 weeks of antibiotics.Lessons lear...
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia
We evaluated our experience with renal transplantation to determine its safety and efficacy. Of t... more We evaluated our experience with renal transplantation to determine its safety and efficacy. Of the 47 renal transplants performed at our institution from June 1992 to December 1995, 29 were performed from living related donors and 18 from cadaveric donors. The age of the patients ranged from 17 to 65 years with a mean age of 32.2 years. Patient survival, allograft survival and the incidence of complications were used as determinants of successful outcome. Patient survival was 100% for both groups. The allograft survival was 100% for living related donor recipients, with 90% of the cases having normal graft function and 96% for cadaveric recipients with 78% of the cases having normal graft function after a mean follow-up of 24 months (range 3 to 42 months). The incidence of complications encountered was similar to that reported from European and North American renal transplant centers. Our study shows the safety and efficacy of the renal transplantation program in the Eastern Provin...
Objectives: Large amounts of healthcare data are now generated via patient health records, record... more Objectives: Large amounts of healthcare data are now generated via patient health records, records of diagnosis and treatment, smart devices, and wearables. Extracting insights from such data can transform healthcare from a traditional, symptom-driven practice into precisely personalized medicine. Dialysis treatments generate a vast amount of data, with more than 100 parameters that must be regulated for ideal treatment outcomes. When complications occur, understanding electrolyte parameters and predicting their outcomes to deliver the optimal dialysis dosing for each patient is a challenge. This study focused on refining dialysis dosing by utilizing emerging data from the growing number of dialysis patients to improve patients’ quality of life and well-being.Methods: Exploratory data analysis and data prediction approaches were performed to gather insights from patients’ vital electrolytes on how to improve the patients’ dialysis dosing. Four predictive models were constructed to p...
Introduction: Acute focal bacterial nephritis is an underdiagnosed condition. It clinically resem... more Introduction: Acute focal bacterial nephritis is an underdiagnosed condition. It clinically resembles acute pyelonephritis. If unrecognized and undertreated, it may progress into complications (kidney abscess and scars). Contrast-enhanced computed tomography (CT) reveals specific images of the disease and is considered the gold standard to make the diagnosis. Case Report: A 63-year-old male patient with solitary kidney presented with symptoms compatible with acute pyelonephritis. Kidney ultrasound was not conclusive. Because of persisting high-grade fever not resolving after 48 hours of antibiotics, a contrast-enhanced CT was then performed, and the diagnosis of acute focal bacterial nephritis was made. A repeat CT after three weeks of intravenous (IV) antibiotics showed marked improvement of the intrarenal lesions, and a fourth week of IV antibiotics was dispensed.Conclusion: Diagnosing acute focal bacterial nephritis is important (particularly in a patient with solitary kidney). T...
Diabetic kidney disease (DKD) is a severe irreversible complication of diabetes mellitus that fur... more Diabetic kidney disease (DKD) is a severe irreversible complication of diabetes mellitus that further disturbs glucose metabolism. Identifying metabolic changes in the blood may provide early insight into DKD pathogenesis. This study aims to determine blood biomarkers differentiating DKD from non-diabetic kidney disease in the Emirati population utilizing the LC-MS/MS platform. Blood samples were collected from hemodialysis subjects with and without diabetes to detect indicators of pathological changes using an untargeted metabolomics approach. Metabolic profiles were analyzed based on clinically confirmed diabetic status and current HbA1c values. Five differentially significant metabolites were identified based on the clinically confirmed diabetic status, including hydroxyprogesterone and 3,4-Dihydroxymandelic acid. Similarly, we identified seven metabolites with apparent differences between Dialysis Diabetic (DD) and Dialysis non-Diabetic (DND) groups, including isovalerylglycine ...
rocalcinosis cases in adults treated in our department from January 1986 to October 2020 Results:... more rocalcinosis cases in adults treated in our department from January 1986 to October 2020 Results: 26 cases were diagnosed at a mean age of 35.28 years old with extremes ranging from 11 to 79 years old. The sex ratio M/F was 1. More than half of the patients had a family history of urolithiasis. Nephrocalcinosis was suspected following renal colic in 13 cases, a polyuropolydipsic syndrome in 4 case, a hypokaliemia in 2 case, an urolithiasis in 2 case and a renal impairment in 2 case. In 3 case, the diagnosis was made fortuitly with an ultrasonography. The etiologies found were: familial distal tubular acidosis (6 cases), distal tubular acidosis caused by Sjögren’s syndrome (4 cases), primitive oxalosis (3 case), Cacci Ricci syndrome (3 cases), familial hypomagnesemia hypercalciuria (2 case), Dent syndrome (1 case) and no causes found (7 cases). Follow-up showed stabilization of renal function in 18 cases and the evolution into chronic kidney disease in 6 cases: 2 of them requiring renal replacement therapy after 5 years and the other died. Conclusions: Nephrocalcinosis is prevalent both in children and adults. Its etiologies are numerous. Most of the metabolic disorders are genetic. The diagnosis of nephrocalcinosis requires a deep investigation with a global clinical assessment, laboratory tests and radiological evaluation. The final objective is to prevent ESKD. No conflict of interest
The presentation of COVID-19 pneumonia in kidney transplant recipients is similar to that of the ... more The presentation of COVID-19 pneumonia in kidney transplant recipients is similar to that of the general population. However, in the former, it may have a worse clinical course. We report a kidney transplant patient affected by COVID-19 pneumonia whose condition worsened 9 days after the initial presentation. As no therapeutic guidelines on the subject are currently available, here we share our approach in the management of the immunosuppressive medications and the antiviral therapy and compare them to the scarce available data. We also expose the use of tocilizumab in our patient with excellent results.
Canadian Journal of Kidney Health and Disease, 2019
Rationale:Acute focal bacterial nephritis (AFBN) has mainly been reported in pediatrics. It may b... more Rationale:Acute focal bacterial nephritis (AFBN) has mainly been reported in pediatrics. It may be an underdiagnosed condition in adults because it resembles acute pyelonephritis (APN) in its clinical presentation.Presenting concerns of the patients:Two young women (25 and 27 years old, respectively) presented with complaints compatible with a diagnosis of APN. However in both, fever was of high grade, persistent for several days in spite of antibiotic administration, and there was demonstrated worsening of the inflammatory biomarkers. A contrast-enhanced computed tomography (CECT) led to the diagnosis in both cases.Diagnoses:Contrast-enhanced computed tomography reveals the most sensitive and specific images of AFBN. This includes wedge-shaped lesions with decreased enhancement, which may be focal or multifocal.Interventions (including prevention and lifestyle):Antibiotic therapy for at least 3 weeks.Outcomes:Resolution of AFBN was obtained after 3 weeks of antibiotics.Lessons lear...
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia
We evaluated our experience with renal transplantation to determine its safety and efficacy. Of t... more We evaluated our experience with renal transplantation to determine its safety and efficacy. Of the 47 renal transplants performed at our institution from June 1992 to December 1995, 29 were performed from living related donors and 18 from cadaveric donors. The age of the patients ranged from 17 to 65 years with a mean age of 32.2 years. Patient survival, allograft survival and the incidence of complications were used as determinants of successful outcome. Patient survival was 100% for both groups. The allograft survival was 100% for living related donor recipients, with 90% of the cases having normal graft function and 96% for cadaveric recipients with 78% of the cases having normal graft function after a mean follow-up of 24 months (range 3 to 42 months). The incidence of complications encountered was similar to that reported from European and North American renal transplant centers. Our study shows the safety and efficacy of the renal transplantation program in the Eastern Provin...
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