The newer and potent immunosuppressive agents have successfully reduced the risk of rejection after kidney transplantation, but the development of cardiovascular diseases, infections, and malignancy is major factors limiting their success. Posttransplantation malignancy is the second most common cause of death in renal transplant recipients after cardiovascular disease; it is expected that mortality due to malignancy may become the most common cause of death within the next two decades. This study is designed to evaluate the incidence, risk factors, and types of malignancies occurring after renal transplantation and their impact on patient and graft survival. A total of 2288 patients underwent living donor renal allotransplantation in the Urology and Nephrology Center, Mansoura University, during the period between 1975 and 2011. Among these patients, 100 patients developed posttransplantation malignancy. Patients were categorized into five major groups according to their type of malignancy; Kaposi's sarcoma (KS), non-Kaposi's skin tumors (non-KS), posttransplant lymphoproliferative disorders (PTLD), solid tumors, and genitourinary and reproductive system (GU and RS). Overall, the incidence of cancer in renal transplant recipients was 4%. There were 83 male (83%) and 17 female patients (17%). The most frequent cancer was KS seen in 33 patients (33%). The lowest median time to development of cancer was observed in KS (35 months). The highest median time to development of cancer was observed in PTLD (133 months). The best graft survival was observed in PTLD and the worst in non-KS tumors. The best patient survival was observed in KS and the worst in GU and RS tumors. Azathioprine-based regimen was associated with a higher rate of cancer. The number of patients who died was 65 (65%). Our results indicate that the occurrence of malignancy has an important impact on short- and long-term graft and patient survival.

Background: Percutaneous coronary intervention (PCI) may be complicated by contrast-induced acute kidney injury (CI-AKI). The current study aimed to evaluate the pre-contrast hemogram-derived indices as early predictors for CI-AKI after PCI. Methods: A case-control study involved 54 patients who underwent PCI, divided into Group I (27 patients with no CI-AKI), and Group II (27 patients with CI-AKI). After the history taking, examination and routine laboratory investigations, the pre-contrast hemogram-derived indices were calculated; neutrophil / lymphocyte ratio (NLR), platelet / lymphocyte ratio (PLR), neutrophil / platelet ratio (NPR), monocyte / lymphocyte ratio (MLR), eosinophil / lymphocyte ratio (ELR), and systemic immune-inflammation (SII) index (platelet count × (neutrophil count / lymphocyte count). Results: There were significantly higher pre-contrast leucocytes, neutrophils, NLR (p˂0.001) (HS), MLR, PLR, NPR, ELR, and SII in group II than in group I (p˂0.05). The ROC analysis showed a significant predictive value for pre-contrast NLR (92.8% sensitivity & 51.3% specificity), NPR (42.8% & 86.4%), and SII (53.5% & 81.1%), MLR (85.7% & 43.2%), and ELR (50% & 78.3%). The odds ratios (OR) for pre-contrast hemogram-induced indices as predictors for CI-AKI, with confidence interval (CI) 95% were as follows; NLR OR (2.12), CI (0.71-6.31); PLR OR (2.11), CI (0.71-6.26); SII OR (2.96), CI (0.96-9.11); MLR OR (2.89), CI (0.95-8.72); ELR OR (3.4), CI (1.11-10.4); NPR OR (2.5), CI (0.82-7.53); RDW OR (2.12), CI (0.71-6.31). Conclusion: Hemogram-derived indices including pre-contrast SII, NLR, NPR, and MLR may be useful early predictors for CI-AKI after PCI.

Background: Hepatorenal syndrome (HRS) may result from decreased renal perfusion in advanced liver cirrhosis patients. Copeptin is co-secreted with the arginine vasopressin (AVP) and is increased in patients with decompensated liver cirrhosis, however, limited studies associated Copeptin with HRS.Objective: This study aimed to evaluate serum Copeptin as a predictor of HRS in advanced liver cirrhosis patients. Patients and Methods: A case-control study had been carried out on a total of 40 subjects divided into; Group 1: 20 decompensated cirrhotic patients with HRS, Group 2: 10 decompensated cirrhotic patients with normal kidney function, and Group 3: 10 healthy controls. The following had been made; history taking, clinical examination, laboratory investigations: complete blood picture, liver function tests, coagulation profile, serum sodium, and creatinine. Serum Copeptin was measured using an enzyme-linked immunosorbent assay (ELISA). Results: Serum Copeptin levels; mean ±SD in pmol/L were significantly increased in group 1 (HRS) (7.3±1.11) compared to group 2 (3.6±0.99) and group 3 (2.3±0.31) (P˂0.001). Serum Copeptin levels positively correlated with serum creatinine, prothrombin time, total bilirubin (P˂0.05), and negatively correlated with serum albumin (P˂0.05), and sodium (P˂0.001), with no correlation with other parameters. The receiver operating characteristic (ROC) curve for serum Copeptin validity as a predictor of HRS in advanced liver cirrhosis patients, at a cutoff of 3.99 pmol/L showed 95.1% sensitivity, 70.2% specificity, and 85.1% accuracy. Conclusion: Serum Copeptin may predict HRS in advanced liver cirrhosis with high sensitivity and specificity.

Background: A common consequence of diabetes is diabetic kidney disease (DKD). Increased Lp-PLA2 plasma levels have been related to higher risk of development of DKD in type 2 diabetes patients. Objective: To illustrate the significance of using lipoprotein phospholipase A2 as potential early biomarker for detecting diabetic nephropathy among type 2 diabetic patients.

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