Hypertension and chronic kidney disease in Asian populations.

The countries of Asia are home to multiple ethnicities. There are ethnic differences in diet, culture, and attitudes towards health screening, access to care, and treatment of chronic diseases. Chronic kidney disease (CKD) and end-stage kidney disease (ESKD) have rising incidence and prevalence due to increased affliction with non-communicable diseases of diabetes and hypertension. To prevent the expensive complications of ESKD, one of the most important risk factors to control is hypertension in patients with CKD. We performed a narrative review on the prevalence of CKD in patients with hypertension, the prevalence and control of hypertension in patients with CKD, and the dietary sodium intake in CKD populations.

Results of the endovascular treatment system for occluded native arteriovenous fistula.

BACKGROUND: Arteriovenous fistula is the definitive vascular access for patients on long-term haemodialysis. The aim of this study is to present the techniques and results of the Endovascular Treatment System that we have developed for managing the occluded native arteriovenous fistula. METHODS: The current study is a retrospective chart review on all patients who presented with an occluded native arteriovenous fistula and underwent attempted recanalization between 1 January 2005 and 31 December 2014. RESULTS: A total of 130 patients were included in the study. Post-intervention primary access patency was 83.8% at 6 months, 78.7% at 12 months, 64.6% at 2 years and 59.6% at 3 years. Post-intervention assisted access patency in fistulas-in-use was 86.5% at 6 months, 81% at 12 months, 66.8% at 2 years and 61.2% at 3 years. Post-intervention secondary patency for all cases was 84.7% at 6 months, 80.2% at 12 months, 66.1% at 2 years and 62% at 3 years. Post-intervention secondary patency in fistula-in-use was 91.1% at 6 months, 90% at 12 months, 85% at 2 years and 74.6% at 3 years. Access survival nor patency differed significantly when incisional thrombectomy was compared to angioplasty with or without stenting with access survival of 91.2% and 92.5% at 12 months and access patency of 82.9% and 89.7% at 12 months (P = 0.834 and P = 0.898, respectively). CONCLUSIONS: In autologous arteriovenous thrombosed fistulae, the use of endovascular techniques to revive the access is a viable and safe technique to employ in most cases.

IgG4-Related Kidney Disease: A Curious Case of Interstitial Nephritis with Hypocomplementemia.

IgG4-related kidney disease has been relatively newly recognized over the last two decades as a combination of an autoimmune and allergic disorder, with elevated serum IgG4 level and hypocomplementemia among its characteristic features. Here we report the case of a man with interstitial nephritis presenting with acute kidney injury and hypocomplementemia but normal serum IgG4 level and provide a literature review of IgG4-related kidney disease. This case highlights the importance of IgG4-related kidney disease as an important differential diagnosis in any patient presenting with a clinical syndrome mimicking acute interstitial nephritis with hypocomplementemia. A high index of suspicion with a low threshold for performing a native kidney biopsy would be paramount as patients do respond well to corticosteroid therapy.