Hepatitis C virus infection is highly prevalence in chronic hemodialysis (HD) patients. The present study will compare prevalence of HCV positive population in difference countries where there are great contrasts in and diversity of care available to patients who have end stage renal disease. All serum samples of the 100 patients were tested for HCV antibodies, using third-generation enzyme immunoassay. The prevalence of anti-HCV was correlated with a history of blood transfusion and with duration of hemodialysis. HCV prevalences were 88% of Surabaya group and 6% of Juntendo Group, respectively. In Surabaya Group, prevalence of HCV positive was high and the risk factors are not only those of the Juntendo Group, but also a combination of poor living conditions, frequent blood transfusions, and lack of adherence. Much needs to be studied about the role of universal screening and effective techniques for primary prevention in Surabaya Group
Introduction: Diabetic kidney disease (DKD), as a diabetes mellitus type 2 (DMT2) complications, is getting more prevalent nowadays. Inflammation is one of the renal injury mechanisms evaluated through the surge in in TNF-α and NF-κβ expression. Impaired expression of gluten transporter 1 (GLUT1) and GLUT2 reduces glucose uptake. DBLS3233 is a novel anti-diabetes agent and Indonesian herbal product responsible for glucose control and upregulation of insulin signal transduction. We performed an experiment on DLBS3233 to examine the response of TNF-α and NF-κβ and the expression of GLUT 1 and GLUT2. Methods: A total of 30 adult male Wistar rats were randomly divided into six groups (n=5 per group): nondiabetic rats in the control group (group 1); untreated diabetic rats (group 2); diabetic rats treated with DLBS3233 4,5mg/kgBW (group 3); 9mg/kgBW (group 4); 18mg/kgBW (group 5), and diabetic rats treated with pioglitazone (group 6). Immunohistochemistry was performed to examine the expression of GLUT1 and GLUT2 in the pancreas and expression of TNF-α and NF-κβ in the kidney. The data was then analyzed by ANOVA. Results: In the DBLS3233 group, reduced expression of both TNF-α and NF-κβ was seen through immunohistochemistry, whereas GLUT1 and GLUT2 were intensified compared to untreated groups. From statistical analysis, we obtained significantly lower expression of TNF-α and NF-κβ, as well as enhanced GLUT1 and GLUT2 expression compared to untreated groups (p<0.05). Conclusions: DBLS3233 significantly reduces the inflammatory process and enhances the expression of GLUT1 and GLUT2 diabetic rats.
Background: Numerous oxidative stresses are detected in patients with diabetic kidney disease, resulting in insulin resistance that damages the pancreas and kidney. Renal podocytes insensitive to insulin lead to decreased nephrin and podocin and increased insulin receptor serine. The authors did an experiment on diabetic rats to examine the effect of DLBS3233 on repairing insulin resistance. Materials and Methods: Thirty adult male Wistar rats were randomly divided into six groups (n=5 per group): group of nondiabetic rats as a negative control (group 1); untreated diabetic rats (group 2); diabetic rats treated with DLBS3233 4.5 mg/kg BB (group 3); 9 mg/kg BB (group 4); 18 mg/kg BB (group 5); and diabetic rats treated with pioglitazone (group 6). The authors checked Homeostatic Model Assessment for Insulin Resistance to corroborate insulin resistance prior to DLBS3233 administration in diabetic rats. Immunohistochemistry was performed to examine the expression of renal antimalondialdehyde (MDA) antibodies, nephrin, podocin, and insulin receptor serine. The data were analyzed using analysis of variance and the t-test. Result: In the DBLS3233 group, immunohistochemistry showed enhanced expression of renal nephrin and podocin, as well as diminished expression of anti-MDA antibody, along with decreased insulin receptor serine. From statistical analysis, anti-MDA antibodies and insulin receptor serine showed lower expression, whereas the expression of nephrin and podocin were enhanced compared to untreated groups (P<0.05). Conclusion: DLBS3233 reduces oxidative stress by decreasing MDA and improves insulin resistance by increasing the expression of renal nephrin and podocin as well as decreasing insulin receptor serine.
Background : Urinary tract tuberculosis (TB) is one type of extrapulmonary TB. The prevalence in developed countries is around 15-20% of all cases of extrapulmonary TB.1 The insidious onset and non-specific constitutional symptoms of urinary tuberculosis often lead to delayed diagnosis and rapid progression to a non-functioning kidney.2-3 The only way to limit renal function loss and destruction is by early diagnosis and therapy.4Case: 34-year-old woman, came with complaints of urinary pain accompanied by right flank pain 10 months prior. Patient also had complaint of weight loss but ignoring complaints of night sweats. Patient repeatedly diagnosed as a urinary tract infection and received many kinds of antibiotic therapy but her complaints were not getting better. Urine production was about 1700 cc/24 hours. From general physical examination, there was a lack of nutritional status with BMI 17.1 kg/m2. Vesicular lung sound without rhonchi heard in both lung fields. From the urinalysis examination there were pyuria and haematuria without bacteriuri. Laboratory examination showed value of BUN was 17 mg/dl and creatinine 0.9 mg/dl. From aerob urine culture we found sterile urine. But we found positive result of Mycobacterium tuberculosis (MTB) urine cultures which was sensitive to isoniazid, rifampicin, pyrazinamide, and ethambutol. Abdominal ultrasound showed severe ecstasis of right pelviocalyceal system without stones,mass, nor cyst. We had additional data from intravenous pyelogram (IVP) which showed a non-visualized dextra pelviocalyceal system and delayed bladder emptying function at 120th minutes. From computed tomography stonographic, we found severe right hydronephrosis, proximal to distal right hydroureter, and thickening of bladder wall (± 1.61 cm) on the right antero-lateral side. To find out the cause of thickening of bladder wall, we did bladder biopsy which showed the mononuclear inflammatory cell stroma. Patients were diagnosed with urinary tract TB and received category 1 of oral anti tuberculosis therapy (Rifampicin, Isoniazid, Pyrazinamid, and Ethambutol) for 12 months and underwent right DJ stent implantation to manage the ectasys.Conclusion : Urinary tract TB often showed unspecified complaints and can be suggested as recurrent urinary tract infections. Early diagnosis and optimal management were needed to prevent anatomical and functional complications.
Background The survival outcome of transplant patients have improved in the past three decades. The short and long term survival of grafts and patients are still being widely studied. Many factors affect the survival rate such as age, gender, diabetes mellitus, and immunosuppressive therapy. Objective The study aimed to provide patients' survival rates 1, 3, and 5 years after transplant. Methods The study used a descriptive approach to 67 kidney transplant patients undergoing outpatient treatment from 1996 to 2016. The data collected were analyzed using SPSS with the Kaplan-Meier curve to observe the survival rate. Result: The survival rate of patients in 1, 3, and 5 years were 100%, 97%, and 94% respectively. The survival rate in geriatric and non-geriatric patients in the first year post-transplantation was both 100%, the third year post-transplantation survival rate was 100% and 94.7%, and the five year post-transplantation survival rate were 100% and 89.5%. The survival rate of patients receiving tacrolimus vs cyclosporine were both 100% in the first year, 97.1% vs 97% in the third year, and 97.1% vs 90.9% in the fifth year after transplant. Conclusion The survival rate of kidney transplant patients in 1, 3, and 5 years after transplant were 100%, 97%, and 94%. Geriatric patients and patients who received tacrolimus have the tendency for a higher survival rate. Further study with a bigger sample and appropriate design is needed to determine the risk factors for kidney transplant patients' survival.
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