Abstractthis setting will not be diagnostically useful. In retrospective studies of non-insulin dependent diabetes melBackground. Several studies had suggested that nondiabetic renal disease (NDRD) was common among litus (NIDDM ) patients with renal involvement, from 12-81% of their renal lesions were non-diabetic renal non-insulin dependent diabetes mellitus (NIDDM ) patients with renal involvement. diseases (NDRD), with different spectrum of diseases identified in different series [4][5][6][7][8][9]. Such retrospective Methods. We prospectively studied the prevalence of NDRD among a Chinese NIDDM population. Renal studies are apparently biased and tend to selectively include patients with clinical presentations thought not biopsy specimens were evaluated with light-, immunohistological and electron-microscopy. The cohort in keeping with diabetic glomerulosclerosis. Also, for patients found to have NDRD, different predicting consisted of 51 patients who had NIDDM and proteinuria >1 g/24 h.factors have been identified in these series, including late age of onset of DM [4], absence of neuropathy Results. Patients with both isolated diabetic nephropathy (DN, n=34) and NDRD (n=17) had compar- [4,5], absence of retinopathy [4,5] and presence of other systemic diseases [4]. However, these factors able duration of DM, creatinine clearance, serum creatinine, albumin and glycosylated haemoglobin were found to have variable predictive values in different series. In a limited number of prospective studies levels, as well as incidences of retinopathy, neuropathy and hypertension. Significantly more patients with of NIDDM patients with renal involvement, from 23-39% of patients were found to have NDRD NDRD had microscopic haematuria (P=0.043) or non-nephrotic proteinuria (P=0.004). IgA nephro- [10][11][12]. However, only the absence of retinopathy and autonomic neuropathy were found to be useful pathy accounted for 59% of the NDRD identified. Conclusions. In this study, microscopic haematuria clinical markers [10]. Overall, it remains unclear whether one is to offer biopsy for all such patients, or and non-nephrotic proteinuria predicted the presence of NDRD among NIDDM patients presenting with should indeed reserve biopsy for those patients with atypical features associated with proteinuria, i.e. renal disease.sudden onset, haematuria, acute renal insufficiency, extra-renal manifestations, and absence of retinopathy Key words: microscopic haematuria; non-diabetic renal disease; non-insulin dependent diabetes mellitus; non- [13]. We have performed a prospective study to clarify the issue in our local population where little data exist. nephrotic proteinuria Subjects and methods Patients

This report summarizes the discussions of the International Society of Nephrology (ISN) 2004 Consensus Workshop on Prevention of Progression of Renal Disease, which was held in Hong Kong on June 29, 2004. Three key areas were discussed during the workshop: (1) screening for chronic kidney disease; (2) evaluation and estimating progression of chronic kidney disease; and (3) measures to prevent the progression of chronic kidney disease. Fifteen consensus statements were made in these three areas, as endorsed by the participants of the workshop. The ISN can make use of and take reference to these statements in formulating its policy for tackling chronic kidney disease, a disease with significant global impact.

IntroductionIncidental durotomies are usually managed conservatively. However, 1.8% of patients require surgical dural repair for CSF leak. There are limited data available regarding the use of epidural blood patches (EBP) for persistent CSF leaks secondary to incidental durotomies. This case series aims to evaluate the efficacy of targeted EBPs under fluoroscopic guidance in the treatment of incidental durotomies.MethodsFour patients with incidental durotomies after spine surgeries (one cervical decompression, one revision of L5-S1 decompression and fusion, and two lumbar decompressions) were included in this series. These patients did not respond to conservative management and subsequently underwent EBPs. Magnetic resonance imaging (MRI) images were reviewed to confirm and identify the sites of CSF leak prior to the EBPs. We targeted the sites of CSF leak with fluoroscopic guidance. All four patients received an EBP with an 18-gauge epidural needle placed under fluoroscopic guidance. In some cases, epidural catheters were used to further target the sites of CSF leak. Contrast was used to confirm the appropriate placements of the needles and catheters. Approximately 5–14 mL of autologous blood was injected through the needles or catheters to the sites of dural leak.ResultsThree lumbar and two cervical EBPs were performed in four patients (two females and two males). Their age ranged from 44 to 73 years old. Two out of three patients who had lumbar EBP reported complete resolution of symptoms following EBP. The patient who had cervical epidural patches did not have improvement in her symptoms.ConclusionThis case series demonstrated that targeted EBP can be an effective treatment for CSF leak from incidental durotomies. However, dural tears in the cervical region may be more difficult to treat. Larger scale studies are required to evaluate efficacy of EBP in the treatment of symptomatic incidental durotomies.

Objective To compare the therapeutic efficacy of daily oral levofloxacin plus intermittent intraperitoneal (IP) vancomycin (group 1) versus daily IP netromycin and intermittent IP vancomycin (group 2) in the primary treatment of peritonitis complicating continuous ambulatory peritoneal dialysis (CAPD). Design A randomized multicenter prospective openlabel comparative clinical study. Setting University and Hospital Authority hospitals in Hong Kong. Patients All CAPD patients who developed bacterial or culture-negative peritonitis beyond 28 days of a previous episode and without evidence of septicemia, associated tunnel infection, or known sensitivity to trial medications were accepted into the clinical trial. Results A total of 101 patients entered the trial. The primary cure rate was 74.5% for group 1 and 73.6% for group 2. Baseline culture results appeared to influence the clinical outcome: the primary cure rate for culture negative, gram-positive, and gram-negative episodes was 83.3%, 78.6%, and 42.9% for group 1 and 69.1 %, 76.9%, and 71.3% for group 2, respectively. The primary cure rate also varied considerably among individual centers and was particularly noticeable in group 1. In the latter group, it correlated closely with in vitro levofloxacin resistance which in turn correlated closely with previous exposure to fiuoroquinolones. Conclusion Oral levofloxacin in combination with intermittent IP vancomycin has comparable efficacy to IP netromycin combined with intermittent IP vancomycin as primary treatment in CAPD peritonitis, but is simpler and more cost-effective to administer. It may be recommended as primary therapy in centers with relatively low exposure and, therefore, low background resistance to fiuoroquinolones.