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Objective: To determine the efficacy of alpha keto-analogues in the management of chronic kidney disease at a tertiary care hospital. Study Design: Quasi-experimental study. Place and Duration of Study: Nephrology Department, Armed Forces Institute of Urology, Rawalpindi from Jul to Dec 2020. Methodology: A total of 300 patients of chronic kidney disease stage 3 and 4, not dependent on hemodialysis were included in the study. They were divided into two groups with matched age, gender and duration of chronic kidney disease. Group-I received the routine treatment of chronic kidney disease with low protein diet while group-II received alpha keto-analogue in standard dose in addition to routine treatment of chronic kidney disease with low protein diet. Estimated glomerular filtration rate was assessed at the baseline and after six months. Results: Out of 300 patients 151 (50.3%) were males while 149 (49.7%) were female patients. 110 (36.7%) patients had stage-3 disease while 190 (63.3%) had stage-4 chronic kidney disease. Mean difference of eGFR in group-I was 3.17 ± 3.19 mL/min/ 1.73m2 while mean difference of eGFR in group-II was 1.16 ± 1.52 mL/min/1.73m2 (p-value<0.001). Conclusion: Alpha keto-analogues emerged as an efficacious short-term option in reducing the progression of chronic kidney disease in our study. Use of this option in addition to routine treatment and low protein diet was related to significant improvement in renal functions.

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Objective: To compare the estimated glomerular filtration rate (eGFR) assessed through the CKD-EPI equations based on creatinine, Cystatin C and creatinine-Cystatin C levels for estimating kidney function among patients with diabetes. Study Design: Cross-sectional analytical study. Duration and Place of Study: Nephrology Department, Armed Forces Institute of Urology, Rawalpindi Pakistan, from Aug 2020 to Mar 2021. Methodology: A total of 70 patients were recruited. Serum samples were collected for creatinine and Cystatin C levels and 24 hours of urine for creatinine clearance. The eGFR values were calculated using the creatinine, Cystatin C and combined creatinine-Cystatin C CKD-EPI equations and compared with 24 hours of urinary creatinine clearance. Results: A total of 22 (31.4%) patients had early stage, while 48 (68.6%) had late-stage chronic kidney disease (CKD). The highest Spearman correlation coefficient was found for eGFR CKD-EPIcr-cys (rho=0.844), followed by CKD-EPIcys (rho= 0.835) and CKD-EPIcr (rho=0.709). Conclusion: CKD-EPIcr-cys is the most accurate, recommended method of calculating eGFR.

Introduction  This study was conducted to evaluate the clinical characteristics and severity of COVID -19 in hemodialysis patients at  from 1st March 2020 to 15th August 2020. Methodology It was a prospective and Cross Sectional Observational Study. We collected data prospectively that includes all patients on maintenance hemodialysis and reviewed clinical characteristics  of those with laboratory-confirmed COVID-19 between March 1and August 15, 2020. Results  39 out of 268 dialysis dependent patients had  COVID-19. Mean age of patients was 55.9yrs. Only 35.8% patients were symptomatic. 15 out of 39 were having mild  disease,12  had moderate and 12  had severe disease. Females (54.5%)  were found to be  more affected  than males(45.5%). Dry cough was the commonest symptom (53.8%) followed by fever (46.1%) and abdominal pain(18.1%).  Patients with multiple comorbidities were found to have severe disease. Conclusion We concluded that patients receiving maintenance hemodialysis are susceptible to COVID-19 and that hemodialysis centers are  high risk for spread of infection. Isolating  patients with COVID-19  can help in preventing the spread of COVID-19.