The Correlation Between Urine Specific Gravity and Urine Osmolality in Patients with Hyponatremia

Range of urine osmolality can usually be predicted by multiplying the last two digits of urine sp.gr. by a factor of 30 and 40 (conventional formula)

Incidence of De Novo Post-Transplant Malignancies in Thai Adult Kidney Transplant Recipients: A Single-Center, Population-Controlled, Retrospective Cohort Study at the Highest Volume Kidney Transplant Center in Thailand

Kidney transplant recipients (KTRs) are at increased risk of developing de novo post-transplant malignancies (PTMs), with regional differences in types with excess risk compared to the general population. A single-center, population-controlled, retrospective cohort study was conducted at a tertiary care center in Thailand among all adults who underwent their first kidney transplant from 1986 to 2018. Standardized incidence ratios (SIRs) of malignancy by age, sex, and place of residence were obtained using data from the National Cancer Registry of Thailand as population control. There were 2,024 KTRs [mean age, 42.4 years (SD 11.4); female patients, 38.6%] during 16,495 person-years at risk. Of these, 125 patients (6.2%) developed 133 de novo PTMs. The SIR for all PTMs was 3.85 (95% CI 3.22, 4.56), and for pooled solid and hematologic PTMs, it was 3.32 (95% CI 2.73, 3.99). Urothelial malignancies had the largest excess risk, especially in women [female SIR 114.7 (95% CI 66.8, 183.6); male SIR 17.5 (95% CI 8.72, 31.2)]. The next two most common cancers were non-Hodgkin’s lymphoma and skin cancer [SIR 20.3 (95% CI 13.6, 29.1) and 24.7 (95% CI 15.3-37.8), respectively]. Future studies are needed to identify the risk factors and assess the need for systematic screening among PTMs with excess risk in KTRs

Urinary neopterin in patients with systemic lupus erythematosus

Abstract Concentrations of neopterin were measured in urine specimens from 35 patients with active and eight with inactive systemic lupus erythematosus (SLE). Compared with those of apparently healthy controls, neopterin concentrations were higher in patients with active disease (P less than 0.001) and with inactive disease (P less than 0.01), those in patients with active disease being significantly higher than those in patients with inactive disease (P less than 0.001). The correlation between the neopterin concentration and evidence of disease activity was good. All of the patients with clinically active SLE had increased neopterin, but for only 37.5% (three of eight) did the neopterin concentration exceed the upper normal limit during clinical remission. The increase in neopterin concentration did not correlate with clinical courses or severity of renal function. Moreover, serial determinations of neopterin in active SLE patients showed a rapid decrease of initially high concentration, paralleling a decline of clinical activity after initiation of medical therapy. Thus, urinary neopterin may be a useful marker for monitoring disease activity in SLE patients.</jats:p

Co-existing post-transplant membranous nephropathy and diabetic nephropathy: A case report

AbstractMembranous nephropathy (MN) is a glomerular disease commonly found in transplanted kidneys. The natural history of MN post-transplant is unpredictable and spontaneous remission is uncommon. Diabetic nephropathy (DN) is also commonly seen in patients with prolonged new onset diabetes mellitus after transplant (NODAT). However, there have been no previous reports of co-existing MN and DN in transplanted kidneys. We herein report a case of a 53-year-old male with early post-transplant proteinuria and microscopic hematuria due to MN with subsequent clinical spontaneous remission. Due to the early onset of disease after transplant and presence of serum anti-phospholipase A2 receptor (anti-PLA2R) antibody, the evidence suggests primary recurrent MN in this patient. He was then diagnosed with NODAT, with fair glycemic control with oral hypoglycemic agents. Sixteen years after remission, he developed recurrent proteinuria and progressive impairment of renal function. The allograft biopsy revealed both MN and DN. Both diseases may have contributed to the development of glomerular pathology in this patient