Successful treatment of new-onset diabetes mellitus and IgA nephropathy after COVID-19 vaccination: a case report.

De novo glomerular injuries or relapse of nephropathy following COVID-19 vaccine has been reported. Here we present the first case of successful treatment of new-onset diabetes mellitus and biopsy-proven IgA nephropathy after COVID-19 vaccination. A 56-year-old man with no known medical history of renal dysfunction or diabetes mellitus developed both within 3 months after receiving a third dose of inactivated COVID-19 vaccine (Vero cells). His symptoms were characterized by brown urine, severe dry mouth, and excessive thirst. Randomly acquired blood glucose levels exceeded 33.3 mmol/L. A kidney biopsy showed IgA nephropathy. He was started on insulin for glycemic control. After glucocorticoid and cyclophosphamide treatment, oral tablets of repaglinide, combined with acarbose, controlled blood glucose and stabilized kidney function. This case is unique because the kidneys and pancreas were simultaneously affected by the vaccine. Successful treatment of the disease proved that cyclophosphamide combined with glucocorticoids were effective and that blood glucose was successfully controlled. This treatment option could be useful in similar cases in the future.

Is simply washing hands before dialysis procedures sufficient for reducing peritoneal dialysis peritonitis?-A single center study from 2015 to 2020 in Yiwu, China.

INTRODUCTION: The study aimed to improve the qualified rate of hand hygiene and reduce the incidence of peritonitis in peritoneal dialysis (PD) patients. METHODS: A hand hygiene questionnaire was distributed to patients during home visits and outpatient visits in 2015 and 2020. Hand-washing practices were evaluated by collecting cultures from the hands of patients after hand washing, evaluating their household environment, and recording the antimicrobial resistance of pathogenic bacteria. RESULTS: Compared to patients in 2015, patients in 2020 had fewer errors in hand washing (p < 0.05), but the rate of qualification after hand washing was lower (p < 0.01). Furthermore, patients who used hand disinfectants after washing had a higher qualified rate. Coagulase-negative staphylococcus (CNS) was the most common isolated bacteria. From 2015 to 2020, the annual incidence of CNS PD peritonitis did not decrease, while the proportion of methicillin-resistant CNS decreased. CONCLUSION: The use of hand disinfectants after standard hand washing may help reduce the incidence of peritonitis in PD patients.