Dense deposit disease (DDD), previously known as membranoproliferative glomerulonephritis type 2, is an extremely rare disease affecting two to three people per million. The rarity of this disease makes it difficult for clinicians to establish evidence-based clinical practices for its management. Here, we report a case of DDD who presented with features of acute nephritic syndrome and did not respond to most of the treatment options available in literature.

IgA nephropathy (IgAN) is the most common noninfectious glomerulonephritis worldwide. Most of the children and young adults with IgAN present with macroscopic hematuria during an upper respiratory or gastrointestinal illness. However, various atypical presentations including overt nephrotic syndrome and rapidly progressive renal injury have been reported. Here, we present a case of IgAN that presented with hypertensive encephalopathy with features of end-stage renal disease as the initial presentation.

Objectives: To identify a better animal model that more closely mimics early renal interstitial fibrosis induced by long-term recurrent urinary tract infection (UTI), as occurs in humans, three different murine models were compared. Methods: Three different murine models of upper UTI were established, including direct injection of bacteria into renal tissues, ascending urinary infection with partial unilateral ureteric obstruction, and repeated infusion of bacteria into the bladder. The histopathology of the kidneys was assessed by hematoxylin and eosin staining. Masson's trichrome staining and immunohistochemistry for α-smooth muscle actin (α-SMA) expression were used for the detection of fibrosis. Results: All three models developed different levels of inflammation in the kidney. However, in contrast to the severe renal interstitial fibrosis in the other two models, the model of repeated infusion of bacteria into the bladder demonstrated early renal interstitial fibrosis by Masson's trichrome staining and immunohistochemistry for α-SMA. Conclusions: The model of repeated infusion of bacteria into the bladder developed low levels of renal interstitial fibrosis, which resembles the early tissue damage in the kidney induced by recurrent UTI s in humans. This model may therefore offer a better way to study the early therapeutic intervention of renal interstitial fibrosis caused by inflammation.

Background and Objectives: Prostate cancer is the second most common cause of cancer and the sixth leading cause of cancer death among men worldwide. In India, it is the second most common cancer in males as per the Indian Council of Medical Research and various state cancer registries. This study was designed to investigate the effect of dyslipidemia, elevated insulin levels, and insulin resistance on the risk of prostate cancer. Materials and Methods: This case–control study was conducted on a total of 200 individuals. Cases were 100 males under the age of 80 (range, 50–80 years), newly diagnosed with histologically confirmed primary adenocarcinoma of the prostate. Controls were 100 age-matched disease-free males, without any complications. Mean ± standard deviation in case and control groups was compared using the unpaired Student's t-test. Pearson's correlation analysis was used to determine the association between variables of interest and prostate-specific antigen (PSA), Homeostasis Model Assessment-Insulin Resistance (HOMA-IR), and body mass index (BMI) among prostate cancer patients. Unadjusted and adjusted odd ratios with 95% CI were calculated using logistic regression models for prostate cancer risk in relation to dyslipidemia and IR. Results: Data showed that serum PSA significantly positively associated with BMI, total cholesterol, triglycerides (TGs), low-density lipoprotein-cholesterol (LDL-C), insulin, HOMA-IR and significantly negatively associated with high-density lipoprotein-cholesterol (HDL-C). HOMA-IR significantly positively associated with BMI, TGs, glucose, and insulin. The binary logistic regression analysis showed a significant adjusted* Odds Ratio (OR) with 95% confidence interval (P < 0.001) between total cholesterol (5.27 [1.87–14.8]), HDL-C (1.73 [1.02–3.42]), TGs (1.24 [1.05–1.37]), HOMA-IR (2.68 [1.53–4.62]), and prostate cancer. Conclusion: This study confirms the association between dyslipidemia, IR, and increased prostate cancer risk.

Background and Objectives: The importance of arteriosclerotic diseases has increased in recent years owing to population aging. Increased in the incidence of catheter intervention and vascular surgery has also resulted in a corresponding increase of cholesterol crystal embolism (CCE). Patients with chronic kidney disease are often diagnosed with arteriosclerotic disease. Although the severity of CCE varies widely, because it exacerbates renal function, treatment options should be established based on CCE severity. Methods: In this retrospective study, we examined 43 patients (37 men and 6 women; mean age, 74.9 ± 7.2 years) who were admitted to our department from 2002 to 2017 because of deteriorating renal functions. We assessed these patients at admission and followed up 1-year later. Results: The causes of CCE included treatment for ischemic heart disease (41.9%), aortic aneurysm (23.3%), and the administration of warfarin (11.6%). Thirty-one patients (72.1%) were diagnosed pathologically. The mean level of creatinine (Cr) at baseline was 1.84 ± 0.83 mg/dL. The mean level of Cr on admission was 4.90 ± 2.2 mg/dL. Steroid therapy was performed in 27 patients (62.8%) and lipoprotein apheresis was performed in one patient (2.3%). During the observational period, 9 patients (20.9%) died and the increase in Cr rates was significantly higher in these individuals (P = 0.0044). After adjustment for various factors, the Cr increase rate was significantly related to mortality (hazard ratio: 2.9581, 95% confidence interval: 1.1179–7.8271, P = 0.0289). Conclusion: The deterioration rate of renal function is associated with mortality in patients with CCE, which is accompanied by renal manifestation.

Background and Objectives: Acute kidney injury (AKI) is one of the major complications of snake envenomation, especially in the developing countries. The most common renal histology in snakebite-induced AKI is acute tubular injury (ATI), but acute interstitial nephritis (AIN) is rarely reported. Materials and Methods: We did a prospective observational study between January 2012 and May 2017 to analyze the demographic, clinical, and laboratory data, response to treatment, and outcome of patients with snakebite-induced AIN. Results: About twenty patients were included in the study with mean follow-up of 24 ± 6 months. Of them, 6 (30%) were males. Mean age was 50.9 ± 22.1 years. All the patients received anti-snake venom. AKI developed after a mean duration of 24.1 ± 11.2 h and 15 patients were oliguric. Cellulitis was seen in 65% of patients, anemia in 65%, leukocytosis and thrombocytopenia in 40%, and coagulopathy in 80%. Mean peak serum creatinine was 7.8 ± 3.2 mg/dL. Peripheral eosinophilia was seen in 7 (35%) patients. All the patients were managed with hemodialysis and all except one received oral steroids. Six patients (30%) progressed to chronic kidney disease (CKD) with mean follow-up creatinine of 1.49 ± 0.8 mg/dL. Conclusion: It is prudent to do renal biopsy in patients with snakebite-induced AKI when there is a suspicion of pathology other than ATI. Identification and treatment of AIN with steroid will avoid progression to CKD which has an impact on growing health burden in tropical countries.

Background and Objectives: The testosterone and estradiol sex hormones are susceptible to significant pathophysiological alterations in children with chronic renal failure under regular hemodialysis, leading to delayed pubertal maturation. This study aims to evaluate the plasma levels of testosterone and estradiol hormones in children and adolescents with end-stage renal disease (ESRD) under regular hemodialysis. Materials and Methods: This study was carried out on 40 children with ESRD under regular hemodialysis (20 males and 20 females) who were attending the Pediatric Department of Tanta University Hospital. Forty children, age- and sex-matched, were chosen and served as controls. All patients and controls were subjected to full history taking, thorough clinical examination including weight, height, body mass index (BMI), mid-arm circumference (MAC), arterial blood pressure, pubertal assessment according to Tanner's classification, routine laboratory investigation including complete blood count, blood urea, blood urea nitrogen, serum creatinine, serum albumin, serum electrolytes (ionized calcium, potassium, and phosphorus), serum total testosterone levels in boys, and serum estradiol levels in girls. Results: The mean values of weight, height, BMI, and MAC of patients' group was significantly lower than that of control group. The total male serum testosterone level in the male patients' group and the serum estradiol level in the female patients' group was significantly lower than that in control group. There were significant positive correlations between the age development and Tanner's stage development, male total serum testosterone level and female serum estradiol levels in both patients and control groups. Conclusions: The pubertal development of children and adolescents with ESRD is usually delayed as proven by decreased serum male total testosterone and female Estradiol hormones levels which suggest a state of hypogonadism. Nutritional therapy especially optimizing protein intake to prevent hypoproteinemia, adequate dialysis and correction of anemia are clinical trials.

Cell phones are a relatively novel and evolving technology. Mobile communication is now essentially ruling in our daily activities through better connectivity and intelligent, smart phone services. While the potential benefits of this technology continue to emerge, so do the potential health risks. There is increasing concern that the use of mobile phones may be associated with decreased semen quality and infertility. The most sensitive tissues to the damaging effects of cell phones are testicular tissues through increased oxidative stress, heating and radiation. Cell phone radiation may negatively affect sperm quality in men by decreasing the semen volume, sperm concentration, sperm count, motility, and viability, thus impairing male fertility. This should be supported by mass media to raise awareness among people regarding the possible health effects of radiofrequency emissions from mobile phones and to minimize its exposure. This study is a brief review of the recent data about the effect of cell phones in male infertility.