Acute kidney injury due to an interaction between simvastatin and cyproterone

Statins are commonly prescribed medications in patients who have cardiovascular disease. In this case report an important aspect of drug interactions involving one of the statins routinely prescribed is described. The patient in the case below developed rhabdomyolysis and subsequent Acute Kidney Injury (AKI) due to an interaction between simvastatin and cyproterone which had been prescribed for management of prostatic cancer. The AKI was severe and required Renal Replacement Therapy (RRT) in the form of haemodialysis. Renal function fortunately improved with the patient able to stop dialysis. He however remained with residual renal impairment and now has Chronic Kidney Disease (CKD). It is important always when prescribing to review the current medications a patient is taking and to assess for potential drug-drug interaction

Variability of oxidative stress biomarkers in hemodialysis patients

Oxidative stress biomarkers may have a role in the future to assist clinical decisions regarding the use of antioxidant therapies and their efficacy. The aims of this study were to evaluate the within and between-individual variability of plasma oxidative stress biomarkers and investigate factors affecting their variability. Plasma F2-isoprostanes and protein carbonyls were measured in 14 hemodialysis patients every 2 weeks for 10 weeks. Within-individual coefficients of variation (CVs) were isoprostanes = 30.4% (range = 6.1–66.7%) and protein carbonyls = 16.3% (8.4–29.5%). Between-individual CVs were isoprostanes = 34.4% (28.9–40.2%) and protein carbonyls = 19.5% (15.6–24.5%). There were no significant (p > 0.05) relationships between the oxidative stress biomarkers and dietary antioxidant intake, medications, clinical and demographic parameters

Body mass index and noninfectious comorbidity in HIV-positive patients commencing antiretroviral therapy in Zimbabwe.

OBJECTIVES The aim of the study was to describe the prevalence of elevated body mass index (BMI) in a cohort of treatment-naïve people living with HIV (PLWH) and to investigate the association of BMI with CD4 count and noninfectious comorbidities including hypertension and renal impairment. METHODS A retrospective cohort study of 1598 PLWH at the Newlands Clinic in Harare, Zimbabwe was carried out. Data were extracted from the medical records at baseline and 6 months after initiation of treatment. The univariate association between BMI and CD4 count was assessed and multiple regression models were used to predict factors associated with loss of renal function and change in CD4 count at 6 months. RESULTS Overweight and obesity (BMI ≥ 25 kg/m2 ) were prevalent in this cohort (34%), as was the presence of hypertension (18%). Higher BMI was associated with a higher CD4 count at baseline and 6 months (B = 0.28 and 0.24, respectively; P < 0.001 for both), adjusted for age and sex. The presence of hypertension independently predicted loss of renal function at 6 months (B = -15.31; P < 0.001), adjusted for BMI, CD4 count and sex. High BMI itself was also independently associated with a decline in renal function (B = -0.41; P = 0.003), adjusted for other significant variables. CONCLUSIONS We demonstrate a high prevalence of overweight/obesity and hypertension in an urban cohort of PLWH in Zimbabwe. Higher BMI was associated with a higher CD4 count, both before and 6 months after commencing antiretroviral therapy; it was also associated with loss of renal function in this cohort

The importance of trust in procurement practices and its impact on business performance: an empirical investigation from the perspective of the buyer-supplier Dyad

This article investigates the importance of trust in procurement practices and its impact on business performance from the perspective of the buyer-supplier Dyad within Zimbabwe's banking industry. This study was exploratory in nature and used a case study methodology. The study involved 22 cases in the banking industry, with a total of 44 interviews being conducted. Findings revealed that 29 dimensions across 7 trust attributes in buyer-supplier procurement practices had an impact on business performance for firms in Zimbabwe's banking industry