Nephro-Urology Monthly
Volume:9 Issue: 6, Nov 2017

PSA is the most routine marker to detect prostate cancer, but due to its low specificity that can lead to a number of unnecessary biopsies, there is great need for an alternate method. Can PCA3 be one of these methods? PCA3 is overexpressed in prostate cancer, not in benign conditions such as prostatitis (unlike PSA). Because of its efficacy (being more sensitive and specific in comparison with PSA), this biomarker could be a very useful and promising method for the early detection of prostate cancer, especially in combination with other tests such as TMPRSS2-ERG gene fusion.

Recent prophylactic treatment options and diagnostic tools show a suboptimal improvement in patients with renal angiomyolipoma (AML). This study was an attempt to review management strategies applied before invasive options. An extensive research on medical databases such as PubMed and Scopus was performed from 1999 to 2016 using the following keywords: ‘kidney’, ‘renal’, and ‘angiomyolipoma’. All related studies on patients treating with conservative or minimally-invasive procedures were included. However, reports on surgical treatments were excluded. Treatment strategies have been selected based on outcomes resulting from computed tomography (CT) and magnetic resonance (MR) imaging. Fat content and tumor size are the most common used indications for AMLs. Unenhanced CT and chemical shift imaging provide good evidence in case of fat-poor AMLs. Chemical analysis and percutaneous biopsy are recommended in case of a diagnostic challenge. A tumor size of 6 cm or larger in diameter might necessitate invasive treatment, while AMLs patients with tumors around 4 cm may require prophylactic treatment. Of all treatment options, embolization indicated a high risk of reintervention. Moreover, everolimus and sirolimus as 2 inhibitors of mammalian target of rapamycin (mTOR) have been evaluated in clinical trials and demonstrated promising outcomes. In conclusion, advances in imaging techniques along with mTOR inhibitors and embolic materials potentiate functional outcomes in AMLs.

Nocturnal enuresis is a symptom with probably multiple etiologic factors and a high prevalence. Conventional therapies is expensive and complicated, since the effect of calcium on voiding dysfunction was approved. Therefore, to the current study aimed at evaluating the therapeutic effect of hydrochlorothiazide on primary monosymptomatic nocturnal enuresis (PMNE).
The current study was conducted based on the interviews with patients. Morning urine test was evaluated in children with PMNE detection and specific gravity Findings: There was a statistically significant difference regarding the frequency of nocturnal enuresis between the 2 groups (P = 0.0001). Also, both groups were matched by age (P = 899) and gender (P = 607).
Hydrochlorothiazide can be used as an effective and safe therapeutic option for treatment of primary monosymptomatic nocturnal enuresis.

Patients who undergo radical nephrectomy are considered as single kidney. In addition, most patients will develop CKD due to reduced kidney function. In this study, we monitored and compared kidney function results in patients with kidney tumors who had radical or partial nephrectomy.
This cross sectional study was conducted on 129 patients who were admitted to hospital from 2007 to 2012. There were 122 cases that had a radical nephrectomy and 7 patients who underwent a partial nephrectomy. The CKD was defined as eGFR In the first year of the follow up, there were 0% and 19.2% (P = 0.3) of patients with eGFR Radical nephrectomy is a risk factor for developing CKD. Therefore, radical nephrectomy should only be considered if the size and location of the tumor are not suitable for a partial nephrectomy.

Depression, anxiety, and stress are very common among hemodialysis patients. The aim of this study was to investigate effects of aromatherapy using the damask rose oil on depression, anxiety, and stress in these patients.
In a clinical trial that was performed in 2015, 60 patients under hemodialysis treatment were randomly allocated to two groups of control and intervention each consisting of 30 subjects. The DASS21 scale was used to measure the rates of depression, anxiety, and stress before and four weeks after intervention. In the intervention group, the patients were asked to inhale the damask rose oil with a constant density of 2% from a piece of cloth smeared with three drops for an hour. In the control group, only the usual, standard care was applied.
The comparison of the mean scores before and after the intervention in the two groups showed that after intervention, the depression, anxiety, and stress scores significantly decreased in the damask rose group (P ≤ 0.05).
Inhalation aromatherapy using the damask rose oil can decrease depression, anxiety, and stress in hemodialysis patients.

Crescentic extra-capillary glomerulonephritis (ECGN) is a diagnostic and therapeutic emergency. In black Africans, little data are available on this lesion. This study aimed at determining the clinical/biological and evolutionary patterns of ECGN and identifying factors of poor prognosis.
This was a retrospective study conducted over a period of 5 years. All patients with extra-capillary proliferation of ≥ 50% in Bowman’s space upon kidney biopsy were involved. The researchers compared 2 groups of patients: group A (patients, who fully recovered from renal function after 3 months of treatment) and group B (patients developing signs of chronic renal insufficiency) in order to identify factors responsible for a poor renal prognosis.
Forty cases of crescentic glomerulonephritis were found in 750 kidney biopsies, i.e. a prevalence of 5.33%. The mean age of the patients was 33.9 ± 16.65 years, with a gender ratio of 0.53. Upon admission, 85% of cases had renal insufficiency, with oligoanuria present in 62.5%. By employing light microscopy, the crescents were found to be cellular in 60%, fibro-cellular in 32.5%, and fibrous in 7.5%. The etiologies were mainly lupus in 32.5% of cases, followed by ANCA-related vasculitis in 27.5% of cases, and infectious causes in 17.5% of cases. Outside of the infectious context, basic treatment relied on immune suppression combining corticosteroids and cytotoxic drugs. The evolution was marked by transition to a chronic state in 72.7% of cases; 18.2% of patients recovered normal renal function. The factors responsible for a poor renal prognosis were oligoanuria (P = 0.0008), high creatinine level upon admission (P = 0.0001), use of hemodialysis (P = 0.0001), and evidence of fibro-cellular and fibrous crescents (P = 0.013).
Crescentic glomerulonephritis was relatively common in the current patients. The etiology was dominated by lupus in the study’s context. This rapidly causes chronic renal failure, hence explaining the interest in early management.

Transplantation of kidneys with anatomical variations like horseshoe kidneys is underused. Shortage of organs should make surgeons explore alternatives to using this type of allografts. A review of current literature, focused on the evaluation of these organs and surgical technique was performed. Our experience with two cases is presented, describing surgical technique and management of local complications. Results at long term follow-up are reported and compared with available series . Transplantation of horseshoe kidneys is technically feasible, with optimal results at follow-up. Evaluation of this kind of organs is necessary to increase the pool of kidneys available for transplantation. However, anatomic and surgical details should be considered and experienced transplantation teams must assume this type of surgery.