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Oct 2025 DOI 10.14302/issn.2329-9487.jhc-25-5726
Okwunu Abah RoseCorresponding author
Background Hypertension in adolescents has been shown to tracks into adulthood, as well as causing premature cardiovascular and renal diseases. Objectives To determine the prevalence of elevated blood pressure and hypertension among adolescents of ages 10-19 years old attending secondary schools in Benue South, Nigeria; characterise their demographics and determine factors associated with the development of high blood pressure. Materials and Methods A cross-sectional descriptive study of secondary school adolescents selected through multistage sampling from across three Local Government Areas of Benue South, Nigeria. All the participants had their blood pressure measured using mercury sphygmomanometer and their height and weight taken for the calculation of their body mass index. A dipstick urinalysis with was carried out on their urine samples. Data analysis was with SPSS version 25. Results Atotal of 260 adolescents were studied, males were 132 (50.8%) and the mean age was 13.65 ±2.01 years. The prevalence of elevated blood pressure and hypertension was 5.4% and 2.3% respectively. Fifteen females (75.0%) had elevated blood pressure/hypertension as against five males (25%) and it was statistically significant. Adolescents in mid-adolescence age (60.0%) and lower social class (70.0%) had higher rate of high blood pressure. Significant proteinuria (+) was found among eleven (55.0%) of those with high blood pressure. Conclusion The prevalence of elevated blood pressure and hypertension among the adolescents was 5.4% and 2.3% respectively; being female, within mid-adolescence age and from lower social class are associated factors. Recommendation Regular blood pressure measurement should be part of school health programme.
Sep 2024 DOI 10.14302/issn.2574-4488.jna-24-5219
V. Liang KellyCorresponding author
Primary membranous nephropathy (MN) is due to autoantibodies to phospholipase A2 receptor (PLA2R Ab). It is unclear whether COVID-19 vaccines can trigger flares of glomerular diseases such as primary MN. There have been increasing reports of glomerular diseases presenting or flaring after receipt of COVID-19 vaccines. We present a patient with primary MN who developed nephrotic syndrome after receiving her second mRNA-1273 COVID-19 vaccine with positive PLA2R Ab. Renal biopsy confirmed primary MN. She was treated for her primary MN flare with rituximab in a manner similar to non-vaccine-associated MN, which led to significant reduction in both PLA2R Ab level and proteinuria. This case adds to the growing literature on MN flares after receipt of mRNA COVID-19 vaccines. Close follow-up of patients with primary MN and other glomerular diseases after COVID-19 vaccination is warranted. Further research is needed to determine the pathophysiology behind vaccine-induced MN flares and whether there is a potential association between exposure to SARS-CoV-2 antigens and loss of tolerance to the PLA2R antigen.
Feb 2016 DOI 10.14302/issn.2574-4488.jna-15-712
Bernieh BassamCorresponding author
Nephrology, Department of Internal Medicine, Tawam Hospital, Al-Ain, United Arab Emirates.
Background Dapagliflozin; the new oral hypoglycemic agent; is a sodium-glucose cotransporter-2 (SGLT2) inhibitor that acts by inhibiting glucose reabsorption in the proximal tubule of the nephron. Main reported side effects are osmotic diuresis, dehydration, urinary tract and genital infections. Here, we report a case of acute bilateral hydronephrosis after the introduction of dapagliflozin. Case Presentation A 52 year old nurse lady, with 15 year history of type2 diabetes mellitus (T2 DM) complicated by type4-renal tubular acidosis, hypertension, proteinuria, and hyperlipidemia. Patient had two episodes of UTI’s in 2011 required full urologic work up, were successfully treated with simple courses of oral antibiotics. CT pyelography done in 2011 was normal. Dapagliflozin was added to her therapeutic regimen in March 2015. Results Within 48 hours after starting dapagliflozin, she reported increased urine output. Ten days later; she developed severe bilateral loin and lower back pain, followed by suprapubic pain, dysuria and fever. Urine analysis and cultures confirmed E. coli urosepsis. Renal US revealed echogenic kidneys with 12 mm bilateral hydronephrosis, normal ureters and urinary bladder. Discontinuation of dapagliflozin in April 2015 resulted in resolution of symptoms. Repeat CT of the abdomen in July 2015 revealed no hydro nephrosis. Conclusions This is the first case report of reversible bilateral hydronephrosis after the use of dapagliflozin. The cause of hydronephrosis, could be explained by over-diuresis and/or by the unmasking of underlying subclinical obstruction in both uretero-pelvic junctions (UPJ).
Dec 2015 DOI 10.14302/issn.2372-6601.jhor-14-397
Gabbay EzraCorresponding author
Division of Adult Nephrology,
Immunotactoid glomerulopathy (ITG) is a rare cause of chronic kidney disease (CKD) and end-stage-renal-disease (ESRD). It is often associated with monoclonal gammopathy and/or hematologic malignancy. We report a patient originally diagnosed with ITG in 1998. He presented with nephrotic-range proteinuria, hypertension, and a gradual decline in glomerular filtration rate. A published case report of this patient at the time the disease was originally diagnosed described only a small peak of IgM paraprotein without lymphoma or plasma cell dyscrasia. He was diagnosed with monoclonal gammopathy of unknown significance. He later developed ESRD and initiated hemodialysis in 2004. Fourteen years after the diagnosis of ITG and MGUS was made he developed headache, lymphadenopathy, borderline splenomegaly, thrombocytopenia, and coagulopathy. Workup revealed a very high level of monoclonal IgM-kappa (4390 mg/dL),and low grade B-cell lymphoma, consistent with lymphoplasmacytic lymphoma, leading to a diagnosis of Waldenstrom’s macroglobulinemia (WM). He died shortly thereafter of complicated gram-negative sepsis. To our knowledge this is the first report of WM associated with ITG. The patient's course illustrates that plasma cell dyscrasia and lymphoma can present many years after the original diagnosis of ITG is made and that continued vigilance for these conditions is warranted.