Introduction: The kidneys are fundamental organs for survival and the progressive loss of their functions causes the loss of regulatory, excretory and endocrine functions, essentially affecting the entire balance of the organism. Chronic Kidney Disease (CKD) is considered a complex disease and a worldwide public health problem with the number of patients continuously increasing, even in the pediatric population. CKD often progresses to end-stage requiring Renal Replacement Therapy (RRT). Kidney transplantation is the treatment of choice to maximize the survival, growth, and development of pediatric patients, however, if dialysis is necessary, Peritoneal Dialysis (PD) is a high-quality and low-cost RRT modality preferred therapy for children and adolescents with End-Stage Kidney Disease (ESKD). In this scope, this study aimed to carry out an integrative review of the survival and the epidemiological, clinical, social and economic profile of children and adolescents with PD. Methods: It is an integrative review whose data collection was carried out between January 2019 and January 2021 following the methodology suggested by the literature, using a validated data collection instrument. The following health science descriptors (DECs) from the VHL portal (virtual health library) were used: children, adolescents, chronic peritoneal dialysis, survival and epidemiology. Results: Thirty-five studies were selected and evaluated using the Critical Appraisal Skills Program (CASP). The level of evidence of the articles was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) scale. Survival and epidemiological, social, economic and clinical aspects of pediatric PD in Brazil and worldwide have been described and reviewed. Conclusions: The complexity and costs involved in the care of pediatric patients in RRT impact their survival. Mortality and morbidity are higher than in healthy children and life expectancy is considerably lower. ESKD is more severe in the pediatric population and interferes with general development, weight and height gain, regulation of mineral metabolism and causes definitive cardiovascular calcifications. Kidney transplantation is the treatment of choice to maximize the survival, growth and development of pediatric patients. However, if dialysis is necessary PD is the first-choice modality in this population. Unfortunately, data are scarce in the literature on its survival and its epidemiological, social, economic and clinical aspects.

Pregnancy induces marked changes in the cardiovascular and plasma volume regulatory systems. By the end of the first trimester of gestation, the kidneys show marked glomerular hyperfiltration, resulting in a decrease in the patient’s serum creatinine with advancing gestational age [1].

Renal Cell Carcinoma (RCC), is the 9th most common cancer in the United States. The major classifications of RCC include clear cell (ccRCC), papillary (pRCC) and chromophobe (chRCC). Treatment for the localized disease includes resection or ablation with curative intent, or surveillance if these procedures are not feasible. Unfortunately, about one-third of patients will present with metastatic disease at the time of diagnosis and there are currently no reliable biomarkers to guide clinical decision-making. There is growing evidence that epigenetics plays a role in kidney cancer tumorigenesis and aggressiveness and new strategies for biomarker development are emerging. For example, DNA methylation patterns may be useful in distinguishing different types of RCCs and for distinguishing malignant kidney neoplasms from benign tumors. Epigenetic changes in RCC have also been associated with poorer response to treatment and have the potential to be novel drug targets in the treatment of mRCC. Here we discuss the epigenetics of RCC and the corresponding clinical implications.

We describe a young man of 37 years with a transient but marked Oligoasthenoteratozoospermia (OAT) syndrome due to severe covid infection with the perfect recovery of semen parameters along with recovery of general health. Setting district general hospital: Intervention none. We review the role of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2 virus), the role of Angiotensin-Converting Enzyme 2 (ACE-2), Angiotensin 1-7 (Ang 1-7) and propose that it is potentially involved in a cause and effect mechanism of injury.

Background: Chronic hemodialysis patients have higher cardiovascular morbidity compared to the general population. A number of studies have suggested that patients undergoing hemodialysis with polymethylmethacrylate (PMMA) membranes have a better outcome compared to other membranes. Methods: We performed a retrospective, multicenter study to evaluate the impact of PMMA membranes compared to other types of membranes on clinical parameters considered important risk factors for the development of cardiovascular disease in chronic kidney disease patients. Results: The study included 104 patients (52 patients on PMMA and 52 patients on other membranes) from ten dialysis centers, monitored for 24 months. HDL cholesterol (mg/dL) increased significantly in the PMMA group (41.4 ± 10.8 to 44.1 ± 13.5, p = 0.0467), but not in the control group (41.8 ± 13.8 to 39.4 ± 9.6, p = 0.8628). At 24 months total cholesterol and triglycerides (mg/dl) were significantly lower in the PMMA group than in the control group (142.4 ± 43.8 vs. 166.1 ± 43.4, p = 0.0321 and 106 (76.5-176) vs. 170 (118-254), p = 0.014), respectively. Serum creatinine (mg/dL) increased significantly from baseline to 24months in the PMMA group (9.20 ± 2.5 to 9.47 ± 2.3, p = 0.0291), but not in the patients treated with other membranes (8.39 ± 2.6 to 8.37 ± 2.3, p = 0.2743). In addition creatinine was significantly higher in the PMMA group compared to the other group (9.47 ± 2.3 vs. 8.37 ± 2.3, p = 0.0493). WBCs (109/L) increased significantly in the control group (6151 ± 1846 to 6672 ± 1872, p = 0.0457) but not in the PMMA group (6326 ± 2113 to 6152 ± 1832, p = 0.8981). At 24 months platelets (109/L) and CRP (ng/dL) were significantly lower in the PMMA group compared to the control group (185 (144-222) vs. 210 (173-259), p = 0.0498 and 0.70 (0.30-1.59) vs. 3.76 (0.46-10.2), p = 0.023, respectively). Iron and transferrin (μ g/dL) decreased signifi cantly in the patients treated with other membrane (62.5 ± 30.4 to 52.6 ±19.0, p = 0.0113 and 178 (157-218) to 170 (124-203), p = 0.0019, respectively), but not in the PMMA group. Conclusion: This retrospective study of data from 104 patients shows a favorable effect of PMMA on clinical variables considered relevant for the development of atherosclerosis in hemodialysis patients.

Background: Chronic Renal Failure (CRF) is a general health problem having a genuine effect on the quality of life of the patients experiencing hemodialysis. Objectives: The aim and objectives of this cross-sectional study was to evaluate the effect of dialysis on the quality of life of patients with End Stage Renal Failure (ESRF). Methodology: Sample of 103 Patients Undergoing hemodialysis were included in study from two hospitals (public sector) of Quetta Pakistan. Information was gathered by the fruition of a self-utilized survey a part of KDQOL-SF fusing the instrument of the SF-36 survey of health and an extra poll so as to incorporate demographics. Writing survey depended on studies, audits and articles got from global information bases concerning the quality of life of individuals with end stage renal failure. Result: A total of 103 responses were collected out of which 54 (53.4%) were males and 49 (47.6%) were females with the mean age between 30 and 45 (38.8%) years old. Majority of the patients were in a Moderate state of health 56 (54.4 %) and 33(32%) were those who had Bad health state, while 14 (13.6%) patients with Good quality of health. Majority of the patients were not at all bothered by dryness of skin (27.2%), itchy skin (39.8%), lack of appetite (32%), washed out or exhausted (39%), soreness of muscles (35%), pain in their joints (32%), easy brouising (45.6%), sleepiness at the day time (42.7%), cramps during dialysis (60.2%) and after dialysis (36.9%), stiffness of joints (33%), back pain (31.1%), numbness in hands or feet (37.9%), bone aches (30.1%), muscle pain (41.7%), headache (26.2%), stomach problem or nausea (31.1%), shortness of breath (43.7%), faintness or dizziness (64.1%), hot or cold spells (36.9%), trouble concentration (52.4%), trouble in getting breath (52.4%), blurred vision (42.7%), chest pain (52.4%), swelled ankles (34%), loss of tast 3 (35.9%), clotting or other access site problems (62.1%) and majority of the patients were extremely bothered by lack of strength (36.9%), weakness and fatigue (51.5%), excessive thirst (41.7%), dryness of mouth (34%), trouble in sleeping (37.9%), head ach (26.2%). Majority of the patients were somewhat bothered by high blood pressure (19.4%) and low blood pressure (13.6%). Conclusion: Specific variables, such as age, gender, social support, income, the quality of life of the patients is effected either negatively or positively by education physical functioning health and disease symptoms. Particular factors, for example, age, gender, social support, income, education, physical working wellbeing and ailment side effects can influence either decidedly or adversely the quality of patients life.

From the establishment of nearly universal health coverage for end stage renal disease in 1972 to 2021, the primary treatment modality has been in-center hemodialysis despite significant advances in home therapies such as peritoneal dialysis and home hemodialysis. There are many theories as to why peritoneal and home hemodialysis lack so far behind in prescriptions with profitability and or a patient’s compliance or support leading the logical explanations. But 2020 was a different year with the surge in COVID-19 cases.

We report a case of a 63-year-old female presenting with abdominal pain, who suffered a dramatic deterioration in her condition following a diagnosis of bilateral renal infarcts on imaging. Within days she had developed widespread aneurysmal dilatation, dissection and thrombosis of the intra-abdominal arterial tree, requiring emergency transfer to a tertiary vascular centre for treatment of polyarteritis nodosa. She responded well to intravenous cyclophosphamide and is now receiving treatment on an outpatient basis.