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Transient D-Penicillamine-Induced Nephrogenic Diabetes Insipidus during Treatment of a Patient with Cystinuria —D-Penicillamine-Induced Nephrogenic Diabetes Insipidus

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Open Journal of Nephrology 2023年第4期13卷 378-384页

作者： Kamel El-Reshaid Shaikha.a.-bader Department of Medicine Faculty of Medicine Kuwait University Kuwait City Kuwait Department of Medicine Nephrology Unit Amiri Hospital Ministry of Health Kuwait City Kuwait

Background: Diabetes insipidus (DI) is a rare disorder cha.a.terized by inappropriate polyuria.a.d hypo-osmolar urine. It is caused by inadequate production of antidiuretic hormone, in response to hypotha.a.ic osmoreceptor-stimulation, from the pituitary gland (central DI) or resistance to its action at terminal distal convoluted tubules and collecting ducts (nephrogenic DI). Most cases of nephrogenic DI are caused by drugs, especially chronic lithium use. The Case: A 46-year-old man manifested such a disorder 8 months following d-Penicillamine (d-P) therapy for cystinuria. The drug was discontinued and the patient was ma.a.ed conservatively with high fluid intake, diet low in protein and salt as well as alkalization of urine with Urolyte U to a pH > 7.5. Six weeks later, such side effect disappeared. Our patient had developed such phenomenon: a) without significant liver or renal disease to account for cumulative toxicity, and b) with a conventional dosage range of d-P. Such isolated toxicity indicates inherited a predisposition to this side effect. Conclusion: DI is a potential side effect of d-P therapy that is nephrogenic in site, transient in prognosis and an isolated phenomenon likely to reflect genetic predisposition.

关键词： Diabetes Insipidus D-Penicillamine Cystinuria Genetic Side Effect

The Beneficial Effect of Renin-Angiotensin-Aldosterone System Blockade in Treatment of Hypertension, Resistant to Conventional Antihypertensives, in Patients on Maintenance Hemodialysis

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Open Journal of Nephrology 2023年第2期13卷 67-73页

作者： Kamel El-Reshaid Shaikha.a.-bader Department of Medicine Faculty of Medicine Kuwait University Kuwait City Kuwait Department of Nephrology Amiri Hospital Ministry of Health (Kuwait) Kuwait City Kuwait

Background: Hypertension (HTN) is present in up to 90% of end stage kidney disease (ESRD) patients irrespective of the etiology of their kidney disease. Moreover, it is an important modifiable risk factor for progression to ESRD and its overall cardiovascular morbidity and mortality. Objective: to evaluate, prospectively, the role of Renin-Angiotensin-Aldosterone System blockade (RAAS) in HTN, resistant to 3 conventional antihypertensives, in patients on maintenance hemodialysis (MHD). Patients and methods: A total of 52 such patients were treated with Ramipril and 5 with Losartan after intolerable cough/shortness of breath following Ramipril-use. None of the patients had fluid depletion, renal artery stenosis and primary endocrinopathy. The study group was compared to a matched control group of MHD patients with normal blood pressure following 3 drugs-combination therapies. Results: All patients, with resistant HTN, had significant activation of RAAS system prior to treatment compared to inactive one in the control group. In those with resistant HTN, control of HTN, was established within 2 weeks of therapy and was associated with suppression of the RAAS. Such therapy was associated with minor side effects. Conclusion: Our study has shown that RAAS blockade is safe and effective in controlling such resistant HTN in MHD patients.

关键词： ACEI Aldosterone Angiotensin ARB Hemodialysis Hypertension Renin Resistant Hypertension

Rituximab Therapy for Persistent, Severe and Extensive Idiopathic Bullous Pemphigoid

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Journal of Cosmetics, Dermatological Sciences and Applications 2023年第1期13卷 76-83页

作者： Shaima.a.-bader Kamel El-Reshaid a.a. Al-Ha.a. Dermatology Center Kuwait Department of Medicine Faculty of Medicine Kuwait University Kuwait

Background: Idiopathic Bullous Pemphigoid (IBP) is a rare blistering autoimmune disease. Its morbidity and mortality have remained high owing to complications of extensive skin involvement as well as its conventional steroid therapy. We reviewed the medical literature and found indicators of an autoimmune etiology for its pathogenesis triggering genetically predisposed patients. Objective: to evaluate, prospectively, the role of Rituximab (R) therapy in its persistent, severe and extensive form. Patients and methods: A total of 12 patients, with disease duration of 6 ± 1 months, were treated with yearly R infusions (1 g followed by 1 g 2 weeks later). Results: Significant clinical improvement was achieved as documented by decrease in total score of Bullous Pemphigoid Disease Area Index from 60 ± 3 to 6 ± 2 that persisted for 26 ± 11 months of follow up. Moreover, IBP autoantibodies (anti-BP 180 and anti-320 IgG) levels fell from to 91 ± 3 and 81 ± 2 to 8 ± 2 and 9 ± 2, respectively. Conclusions: R is a safe and effective treatment for severe IBP and such response further confirms its autoimmune pathogenesis.

关键词： Bullous Pemphigoid Rituximab Treatment BP Autoantibodies Bullous Pemphigoid Disease Area Index

A Problem-Solving in a Case of Medullary Nephrocalcinosis

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Open Journal of Nephrology 2022年第2期12卷 214-221页

Medullary Nephrocalcinosis (MNC) is defined as calcium deposition in tubular basement membrane and interstitium of the kidney medulla. It is 20 times more common than cortical one. In this case report, we present a 12-year-boy who presented with persistent nocturnal enuresis for 8 years. Physical examination and routine tests were normal except for microscopic hematuria. Renal ultrasound showed extensive MNC. Twenty-four-hour urine collection revealed normal mineral metabolic screen with low urinary excretion of calcium, phosphorous, magnesium and uric acid yet high for oxa.a.es. Hence, and based on the above-mentioned da.a. certain metabolic disorders were ruled out: 1) hyperpa.a.hyroidism, 2) excessive intake of vitamin D, 3) hypercalcemia, 4) hypercalciuria, 5) hyperuricemia, 6) hyperuricosuria, 7) hypocitraturia, 8) cystinuria, 9) lysinuria.a.d 10) distal renal tubular acidosis were ruled out. Subsequently, urine testing showed high concentration of glycolate with low glycerate and 4-hydroxy-2-oxogluta.a.es establishing diagnosis of type 1 primary hyperoxaluria (PH I). Further confirmatory tests included: 1) kidney biopsy which showed typical crystals deposition, 2) liver biopsy that confirmed deficiency of the liver-specific peroxisomal enzyme a.a.ine: glyoxylate aminotransferase (AGXT), and 3) full gene a.a.ysis that confirmed gene mutation. In conclusion, our case report provides practical algorithm for establishing diagnosis in MNC which is not renal-limited and its prognosis depends upon the underlying etiology.

关键词： Hypercalcemia Hypercalciuria Medullary Nephrocalcinosis Mutation Primary Hyperoxaluria

Diet in Renal Diseases: An Art of Science

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Open Journal of Nephrology 2024年第3期14卷 361-374页

作者： Kamel El-Reshaid Shaikha.a.-bader Department of Medicine Faculty of Medicine Kuwait University Kuwait City Kuwait Department of Nephrology Jaber Hospital Ministry of Health Kuwait City Kuwait

Purpose of Review: Chronic kidney disease (CKD) is associated with a limited ability to excrete fluids, electrolytes, uremic toxins and other end-products of ca.a.olism. Studies on adverse renal outcomes with dietary patterns are limited. Methods: Comprehensive search in PubMed of papers published until June 2024 describing prospective cohort studies on renal nutritional therapy (RNT) with at least 3 years of follow up. Results: RNT should include adequate yet limited amounts of calories, fluids, protein, lipids, sodium, potassium, and phosphorus. RNT is an adjuvant to specific drug-therapy in 1) certain complications viz. fluid overload, anemia.a.d renal osteodystrophy, and 2) specific kidney diseases viz. glomerulopathies, tubulopathies, polycystic kidney disease, calcium oxa.a.es urolithiasis and cystinuria, as well as 3) types of renal failure viz acute and chronic and its treatment viz. hemodialysis, peritoneal and transplantation. Conclusion: RNT is patient-specific and should be systematically planned to delay the progression of CKD as well as to prevent and treat its complications.

关键词： Calories Diet Disease Electrolytes Fluid Kidney Lipids Nutrition Protein Vitamins

Sequential Combination Diuretic-Therapy for Massive Fluid Overload in Furosemide-Refractory Patients with Diabetic Kidney Disease

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Open Journal of Nephrology 2021年第2期11卷 265-272页

Patients with renal disease are at risk of fluid overload which esca.a.es as the disease progresses. In the present study, we evaluated the efficacy of sequential combination diuretic-therapy (SCDT) in ma.a.ement of massive fluid overload in Furosemide-refractory renal patients. The added diuretics were Spironolactone 25 mg daily for 3 days, to those without risk of hyperkalemia, followed by Hydrochlorothiazide 25 mg/Metolazone 5 mg daily for 3 more days. Excluded patients were those with 1) acute renal disease, 2) echocardiographic evidence of: a) left ventricular ejection fraction a.a.d hyponatremia which improved with dietary compliance. Moreover, hyperkalemia improved after subsequent addition of Thiazide/Metolazone. SCDT led to significant (p < 0.001) increase in fractional excretion of sodium and decrease in body weight and sPAP. In conclusion;SCDT is a safe and efficacious measure to control fluid overload in patients with renal diseases.

关键词： Aldactone Diabetes Mellitus Echocardiography Fluid Overload Furosemide Hydrochlorothiazide Kidney Disease Metolazone Spironolactone

The Effect of the Hot Springs at the Umm Qeis Archaeological Site and Museum

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Journal of Environmental Science and Engineering(B) 2015年第7期4卷 359-367页

作者： Raed Algha.a.i Ramzi Alrousan Malek bader Department of Cultural Resources Ma.a.ement Queen Rania Faculty for Tourism and Heritage The Hashemite UniversityZarqa 330127 Jordan Department of Sustainable Tourism Queen Rania Faculty for Tourism and Heritage The Hashemite University Zarqa 330127Jordan

Several recent studies have pointed out that northern parts of Jordan are exposed to high levels of the effect of the hot spring, which is widely known to have severe impacts on health, vegetation and structures. North Jordan has a wealth of ancient heritage including six out of the ten Decapolis Cities. Air pollution that comes out from the hot springs is alleged to deteriorate and erode buildings, structures, statues and monuments through acid deposition. Therefore, this research was conducted to assess air quality at Ga.a.a, the capital of the ancient Decapolis and suggest mitigation measures that have to be adopted in order to save the ancient heritage a.a.nst further deterioration. Measurements revealed that most criteria.a.r pollutants including sulfur dioxide, nitrogen dioxide and carbon monoxide attain corresponding national ambient air quality standards. Atmospheric concentrations of NO are strongly linked to the amount of 03. Simultaneous exposure to SO2 and NO2 demonstrated that a ca.a.ytic reaction takes place which increases the rate of sulphate production after 30 h exposure.

关键词： Decapolis Ga.a.a air pollution sulfur dioxide nitrogen oxides carbon monoxide ground ozone.

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磁共振血管成像在主动脉疾病中的应用

放射学实践 1994年第2期9卷 80-84页

作者： bader,C 钱骏同济医科大学附属协和医院

随着相应的检测序列和后处理程序的应用，磁共振血管成像（ＭＲＡ）的重要性已与日俱增。在具确切适应证的情况下，还可进一步精缩阶梯式的诊断过程。

关键词： NMR 成像主动脉疾病

Numerical Study of Fisher’s Equation by Finite Difference Schemes

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Applied Mathematics 2017年第8期8卷 1100-1116页

作者： bader Saad Alshammari Daoud Suleiman Mashat Department of Mathematics Numerical Analysis King Abdulaziz University Jeddah Saudi Arabia

This research paper represents a numerical approximation to three interesting equations of Fisher, which are linear, non-linear and coupled linear one dimensional reaction diffusion equations from population genetics. We studied accuracy in term of L∞ error norm by random selected grids along time levels for comparison with exact results. The test example demonstrates the accuracy, efficiency and versatility of the proposed schemes. It is shown that the numerical schemes give better solutions. Moreover, the schemes can be easily applied to a wide class of higher dimension non-linear reaction diffusion equations.

关键词： Forward in Time and Centre in Space (FTCS) Taylor’s Series Crank Nicolson Douglas Scheme