Calcific Uremic Arteriolopathy in Peritoneal Dialysis Populations

Calciphylaxis or calcific uremic arteriolopathy is an infrequent complication of end stage kidney disease. It is characterized by arteriolar medial calcification, thrombotic cutaneous ischemia, tissue necrosis often leading to ulceration, secondary infection and increased mortality rates. Current, multimodality treatment involves local wound care, well-controlled calcium, phosphate and parathyroid hormone levels and combination therapy with sodium thiosulfate and hyperbaric oxygen therapy. This combination therapy may be changing the historically poor prognosis of calcific uremic arteriolopathy reported in the literature. Peritoneal dialysis is considered a risk factor based on limited publications, however this remains to be proven. Clinical presentation, diagnosis, pathogenesis and treatment of calcific uremic arteriolopathy in these patients are no different from other patients manifesting with this condition

Effect of soil breeding and soil amendments on soil physical properties, rice yield and economics in crusted Alfisol

The impact of soil breeding and soil amendments on soil physical properties, rice yield, and economics under crusted Alfisols (red soil) was investigated in a field experiment at the Agricultural College and Research Insti- tute, Tanjore, Tamil Nadu, India. The study was conducted for three consequetive years (2020–2023). There were totally nine treatments, comprising of clay, sand, and manure alone and their combinations and lime were replicated thrise. In the first year of the experiment, the treatments were imposed as per schedule and thoroughly mixed with surface soil. Every year, sunnhemp was raised as the first-season crop and incorporated in-situ at flowering prior to transplanting of rice. The results indicated that application of FYM 12.5 t ha-1+ clay 100.0 t ha-1+ coarse sand 100.0 t ha-1 (T8) recorded highest growth and yield attributes, viz., plant height (94.26 cm), number of productive tillers (16.53), grain yield (3.981 t ha-1 ), and straw yield (5.250 t ha-1 ) of rice and B:C ratio of 1.66. Further, application of FYM 12.5 t ha-1+ clay 100.0 t ha-1+ coarse sand 100.0 t ha-1 reduced soil bulk density (1.31 Mg m-3 ), increase in pore volume (45.40 %), soil infiltration rate (3.62 cm h-1 ) and hydraulic conductivity (3.02 cm h-1 ). However, this was on par with application of FYM 12.5 t ha-1+ clay 50.0 t ha-1+ coarse sand 50.0 t ha-1 (T7)

End-stage kidney disease due to haemolytic uraemic syndrome - outcomes in 241 consecutive ANZDATA Registry cases

Extent: 11p.Background: The aim of this study was to investigate the characteristics and outcomes of patients receiving renal replacement therapy for end-stage kidney disease (ESKD) secondary to haemolytic uraemic syndrome (HUS). Methods: The study included all patients with ESKD who commenced renal replacement therapy in Australia and New Zealand between 15/5/1963 and 31/12/2010, using data from the ANZDATA Registry. HUS ESKD patients were compared with matched controls with an alternative primary renal disease using propensity scores based on age, gender and treatment era. Results: Of the 58422 patients included in the study, 241 (0.4%) had ESKD secondary to HUS. HUS ESKD was independently associated with younger age, female gender and European race. Compared with matched controls, HUS ESKD was not associated with mortality on renal replacement therapy (adjusted hazard ratio [HR] 1.14, 95% CI 0.87-1.50, p = 0.34) or dialysis (HR 1.34, 95% CI 0.93-1.93, p = 0.12), but did independently predict recovery of renal function (HR 54.01, 95% CI 1.45-11.1, p = 0.008). 130 (54%) HUS patients received 166 renal allografts. Overall renal allograft survival rates were significantly lower for patients with HUS ESKD at 1 year (73% vs 91%), 5 years (62% vs 85%) and 10 years (49% vs 73%). HUS ESKD was an independent predictor of renal allograft failure (HR 2.59, 95% CI 1.70-3.95, p < 0.001). Sixteen (12%) HUS patients experienced failure of 22 renal allografts due to recurrent HUS. HUS ESKD was not independently associated with the risk of death following renal transplantation (HR 0.92, 95% CI 0.35-2.44, p = 0.87). Conclusions: HUS is an uncommon cause of ESKD, which is associated with comparable patient survival on dialysis, an increased probability of renal function recovery, comparable patient survival post-renal transplant and a heightened risk of renal transplant graft failure compared with matched ESKD controls.Wen Tang, Janaki Mohandas, Stephen P McDonald, Carmel M Hawley, Sunil V Badve, Neil Boudville, Fiona G Brown, Philip A Clayton, Kathryn J Wiggins, Kym M Bannister, Scott B Campbell and David W Johnso