Abstract: Background: The prevalence of renal stones in pediatric population is increasing in Pakistan, to minimize the adverse outcomes of renal stone disease accurate diagnosis and proper management is necessary. Objective: This study aim to evaluate the risk factors of partial stone clearance after mini-PCNL in the pediatric population of Pakistan. Materials and Methods: This is a retrospective, cross-sectional study conducted at Godhra Hospital, Karachi, during 2021, patients diagnosed with single or multiple renal stones requiring PCNL were enrolled in the study, Guy’s stone score was used as a prediction method for complete clearance. SPSS version 22 was used to analyze the data, chi-square test was used to assess the significance of the data keeping a p-value ≤0.05 as significant. The risk estimation was analyzed with the help of the odds ratio test. Result: A total of 234 participants with mean age of 6.4 ± 4.8 years were enrolled. Stone clearance was reported 203 (86.7%) and 31 (13.2%) residual fragments. 09 (3.8%) out of the residual stone group needed intervention for complete clearance while the remaining were reported as stone free after 4 weeks with METs. The mean residual stone size was 0.7 ± 0.3, upon assessing the determinants maximum patients had Staghorn (> 4) cms stone size with 7 (2.9%) of patients out of 13 (5.5%). The odds of having partial clearance were reportedly positive with 2.34 in staghorn ≥ 4cms stone size and 1.62 in Grade IV Guy’s stone score. Conclusion: Stone size ≥ 4.0 cm and staghorn calculi present in all calyces are independent risk factors for partial stone clearance after Mini-PCNL.

Determinants of Partial Stone Clearance after Mini-PCNL in the Pediatric Population

Introduction: Chronic kidney disease (CKD) and its associated complications, such as anemia and secondary hyperparathyroidism (SHPT), pose significant challenges to global healthcare systems. This study explores the demographic and clinical characteristics of 284 kidney failure (KF) patients undergoing hemodialysis, in an effort to shed light on the possible association between anemia and SHPT. A proven connection between the two could theoretically influence the management plans for CKD patients, with the hopes of achieving lower morbidity and/or mortality in this patient group. Methods: A retrospective, cross-sectional, real-world data analytical study was conducted at a hemodialysis center in Tbilisi, Georgia, encompassing a sample size of n = 284 patients on maintenance hemodialysis. The data analyzed was extracted from patients’ medical records. Results: According to our results, the prevalence of anemia was strikingly high at 82.04%, underlining its substantial burden within this patient population. Our analysis revealed a notable systemic association between anemia and SHPT, particularly when considering hemodialysis vintage. However, our final analysis model revealed no statistically significant association between anemia and intact parathyroid hormone (iPTH) levels. Conclusion: Our study revealed a significant systemic relationship between anemia and SHPT when hemodialysis duration was considered, despite initial analyses showing no direct association. Future research should focus on longitudinal and multi-center studies to better understand this relationship, aiming to enhance the care and management of CKD patients on hemodialysis.

The Relationship Between Anemia and Parathyroid Hormone Levels in Patients With Kidney Failure Undergoing Hemodialysis Treatment in Georgia

End-stage renal disease (ESRD) patients are mostly managed with maintenance hemodialysis (MHD). ESRD patients on MHD also present with many complications, such as anemia, hyperparathyroidism, and hepatitis prevalence. This study depicts the real-world scenario of anemia among MHD and end-stage renal disease patients in the Pakistani population. A retrospective, multicentric, and real-world data analytical study was conducted at 4 dialysis centers in Pakistan. The study had a sample size of n = 342 patients on maintenance hemodialysis. The data were gathered from the medical records of patients. Data analysis was performed using STATA Version 16. Statistical significance was gauged at a 0.05 level of significance. According to our results, the mean age of the patients was 45 (±15) years. Most of the patients were male (n = 234, 68.4%), whereas 58.1% of the patients were maintained on twice-weekly hemodialysis. The most commonly reported comorbidities were hypertension and diabetes mellitus. The frequency of dialysis (P < 0.01) and comorbidities (P = 0.009) had a significant association with anemia in MHD patients. The majority of the patients had hyperparathyroidism (52%) with anemia. Upon performing binary logistic regression, multivariate analysis displayed a similar odds value for having anemia in patients with every additional month in the duration of hemodialysis (OR 1.01, P = 0.001), the odds of anemic patients having a positive antihepatitis-C antibody (OR 2.22, P = 0.013), and the odds of having anemia in patients in the age category below 45 years (OR 1.93, P = 0.013). In conclusion, the study results depict that every additional month in the duration of hemodialysis, age (<45 years), and positive anti-HCV antibody status, these variables were more likely to have anemia in our study MHD patients. While in our final multivariate model, no statistically significant association was observed between hyperparathyroidism and anemia.

/pdf/association-of-anemia-with-parathyroid-hormone-levels-and-8h0ckgup.pdf

Association of Anemia with Parathyroid Hormone Levels and Other Factors in Patients with End-Stage Renal Disease Undergoing Hemodialysis: A Cross-Sectional, Real-World Data Study in Pakistan

Objective:
To determine the frequency of neglected renal calculi in patients with acute kidney injury.
Material and Methods:
This was a descriptive study conducted at the division of nephrology, Lady Reading Hospital Peshawar, from 26/09/2021- 26/03/2022. Data was collected from 214 patients with acute kidney injury (AKI). Detailed clinical history was taken to confirm the patient did not know about the presence of previous stone disease. After confirming the acute kidney injury, bio-chemical investigations including serum urea, serum creatinine, serum calcium, urine analysis, and radiological investigation i.e. ultrasound KUB, X-ray KUB.  When needed IUV and CT scan KUB was also done for the confirmation of the renal stones. 
Results: 
In this study, the mean age was 52 years ± 13.81. Sixty-seven percent of patients were male, while 33% were female. Twelve percent of patients had neglected renal calculi, while 88% of patients didn’t have neglected renal calculi. 
 
Conclusion:
Our study concluded that 12% of patients presented with Acute Kidney Injury at a tertiary care hospital had neglected renal stones. 
Keywords: Neglected renal calculi, Acute Kidney Injury.
 

The prevalence of neglected renal stone among patients presented with acute kidney injury to a tertiary care hospital

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Association of Anemia with Parathyroid Hormone Levels and Other Factors in Patients with End-Stage Renal Disease Undergoing Hemodialysis: A Cross-Sectional, Real-World Data Study in Pakistan

The prevalence of neglected renal stone among patients presented with acute kidney injury to a tertiary care hospital