No abstract

The development of formulas estimating glomerular filtration rate (eGFR) from serum creatinine and cystatin C and accounting for certain variables affecting the production rate of these biomarkers, including ethnicity, gender and age, has led to the current scheme of diagnosing and staging chronic kidney disease (CKD), which is based on eGFR values and albuminuria. This scheme has been applied extensively in various populations and has led to the current estimates of prevalence of CKD. In addition, this scheme is applied in clinical studies evaluating the risks of CKD and the efficacy of various interventions directed towards improving its course. Disagreements between creatinine-based and cystatin-based eGFR values and between eGFR values and measured GFR have been reported in various cohorts. These disagreements are the consequence of variations in the rate of production and in factors, other than GFR, affecting the rate of removal of creatinine and cystatin C. The disagreements create limitations for all eGFR formulas developed so far. The main limitations are low sensitivity in detecting early CKD in several subjects, e.g., those with hyperfiltration, and poor prediction of the course of CKD. Research efforts in CKD are currently directed towards identification of biomarkers that are better indices of GFR than the current biomarkers and, particularly, biomarkers of early renal tissue injury.

Membrane composition and characteristics, modality (convective versus diffusive), blood flow rates and substitution fluid rates in HDF play a significant role in the efficient removal of β2M from the body in both diffusive and convective dialysis.

No abstract

Objectives: To describe the demographic, clinical features, diagnostic and procedure results, organ involvement and outcomes in patients with disseminated tuberculosis (TB). Patients and methods:This retrospective observational study was conducted at Hamad general hospital in Qatar. It involved all patients 15 years of age or older who were admitted to Hamad general hospital with disseminated TB from January 1, 2006 to December 31, 2010. Results:We enrolled 100 patients. There were 74 (74%) males and the mean age (±SD) of patients was 31.3±12.2. The most common presenting symptom was fever (95%). Fifteen (15%) patients had other underlying medical conditions; the most common being diabetes mellitus 7 (7%), while two patients had human immunodeficiency virus (HIV) infection. The tuberculin skin test was positive in 42 (42%) patients. Sputum and gastric lavage examination were performed in 84 (84%) and 9 (9%) patients respectively while bronchoscopy was performed on 32 (32%) cases.Most patients 94 (94%) completed their treatment in Qatar whereas (3%) left the country before completion. The in-hospital mortality rate was 3% (3 patients). Systemic corticosteroids were prescribed for 36 (36%) cases and 15 patients had complications, the most being tuberculoma 9/23 (39.1%). Drug toxicity was noted in 17 (17%) patients, including hepatitis, optic neuritis and hyperurecemia. Only presence of underlying medical conditions was found to be an independent predictor of mortality.Conclusions: Disseminated TB has a non-specific clinical picture, gives rise to high morbidity and mortality and therefore demands a high index of suspicion to promptly diagnosis and initiate timely treatment.