A patient registry is the collection of uniform data (clinical and others) to evaluate specified outcomes for a population defined by a particular disease or therapy (target disease or therapy) and that serves one or more predetermined scientific, clinical, or policy purposes. Our aim is to establish a renal database for hemodialysis patients (as a first step) that would help in providing the optimal health care to improve quality of life and prolong survival. Egyptian renal data system (ERDS) was established out of the firm belief that delivering a clear picture of the incidence, prevalence, and outcomes of hemodialysis-related problems in Egypt is the needed action to identify the real magnitude of the problem. ERDS is the Egyptian national registry of nephrology patients. It was founded and is run by the Egyptian Society of Nephrology and Transplantation (ESNT), the only official Egyptian Non-Governmental Organization representing nephrologists and officially managing some issues of the nephrology specialty in Egypt. ERDS until now registers data about patients with End stage kidney disease (ESKD) on chronic hemodialysis, but the plan is to include more patient groups in the future. Two types of data were collected; data about the dialysis units as a whole and data specific to each patient. Data entered by all units were exported from the digital system as a .csv file that can be opened by Microsoft Excel. Data analysis was carried out by Microsoft Excel functions and Microsoft Power Business Intelligence. Results were represented by different sectors.

Background To assess the trends of biowaste generation under an unique model of hemodialysis services -Hub and Spoke model. Materials and Methods Biowaste generation including the liquid, solid, recyclable and nonrecyclable wastes are calculated per session of dialysis and tehn calculated per number of sessions in each centre. Biowaste was weighed accordingly using wighing machines normalised to the weight of the material weighed. Results Total waste generated per session was 1007 gm in a maintenance dialysis session and 528 gm in an acute dialysis session. Of this, plastic waste was 847gm and 382 gm in respective units, nonplastic waste was 146 and 160 gm respectively. Based on the number of session in acute unit and maintenance unit, total waste generated in acute unit per day was 18.48 kg and 12.22 kg (plastic, nonplastic) and in maintenance unit, it was 65.45 and 54.05 kgs. Conclusions There is high generation of biowaste in dialysis units with 280–295 tonnes/year. Its the need of hour to plan for green dialysis by bringing in eco-friendly recyclable biowaste.

Background Cognitive impairment is a common problem in patients with end-stage renal disease (ESRD). The aim of this work was to study the effect of ESRD on cognitive function in children and adolescents on regular hemodialysis (HD), and to identify the possible risk factors affecting their cognitive function. The patients selected were those with ESRD on regular HD attending Alexandria University Children’s Hospital, between January 2017 and December 2018. Patients and methods Cognitive function was assessed using the Stanford-Binet Intelligence Scale: 4th edition. At initial assessment, total intelligence quotient (IQ) and its four subdivisions (abstract visual reasoning, quantitative reasoning, short-term memory, and verbal reasoning) were measured for each patient. This was repeated for each patient after 1 year. Statistical analysis used Data was collected and analyzed using the SPSS (Statistical Package for the Social Sciences) program for statistical analysis (vs 21). Results In all, 47 and 41 patients were included in the first and second assessments, respectively. There was a statistically significant decrease in total IQ and its four subdivisions between the first and second assessments. Total IQ and its four subdivisions showed a negative correlation with patients’ age, age of onset of ESRD, age at start of HD, duration of ESRD, and duration of HD. Conclusions ESRD has a negative effect on cognitive function in children and adolescents with ESRD, and this continues to progress despite regular HD. Age of onset of ESRD, age upon starting HD, and duration of ESRD and HD are risk factors for decreased cognitive function in patients with ESRD on HD.

Background Acute kidney injury (AKI) in pregnancy is still a frequent health problem in developing countries. The aim of our study is to assess the prevalence and outcome of AKI secondary to obstetric complications during the third trimester of pregnancy and the puerperium Patients and methods A retrospective study conducted on 80 patients presented with AKI secondary to obstetric complications during the third trimester of pregnancy and the puerperium. All patients were recruited from the National Institute of Nephrology and Urology in Cairo during the period from June 2014 to June 2016. Data was collected from the unit database and patient medical charts including patient’s history and examination findings during admission, laboratory parameters on admission including complete blood count and routine chemistry, hospital course, treatment received including renal replacement therapy and maternal and fetal outcomes. Results Our observational study included 80 patients presented with AKI during late pregnancy and the puerperium. Mean maternal age was 32±6 years and mean gestational age at presentation was 27±9 weeks. Mean serum creatinine was 7.7±2.4 mg/dl. Most of the patients who developed AKI did not receive antenatal care 67.5% (n=54). Also, more than half of the patients had a previous history of preeclampsia 52.5% (n=42). The median duration of hospital stay was 13 (6–51 interquartile range) days. Five (6%) patients underwent renal biopsy; 55 (69%) patients received hemodialysis as a renal replacement therapy while five patients received plasma exchange. The main etiology of AKI in our study was ischemic acute tubular necrosis 50% (n=40). Five (8%) patients developed chronic kidney disease and three patients (4%) progressed to end-stage renal disease. Maternal mortality was 4% (n=3) and fetal mortality was 74% (59 fetus). Conclusion AKI in late pregnancy and puerperium still presents as a health problem in developing countries. Most patients with AKI had a history of preeclampsia. Also, most of them had not received proper antenatal care. Improvement of the antenatal care is crucial for early detection and prevention of such problems.

Background Hyperphosphatemia can lead to detrimental effects such as cardiovascular calcification, renal osteodystrophy, secondary hyperparathyroidism, and increased mortality. The neutrophil-to-lymphocyte ratio (NLR) in chronic kidney disease (CKD) patients provides information on the inflammation status, used as a marker of poor prognosis in several disorders such as malignancies, CKD, and myocardial infarction. To study the impact of hyperphosphatemia on NLR and on the inflammatory state in patients with stage 5 CKD under maintenance hemodialysis. Patients and methods This observational cross-sectional study was carried out in Benha University Hospitals on 100 patients on maintenance hemodialysis who were recruited and subjected to careful history, clinical examination, and NLR; serum phosphorus was done with different inflammatory markers. Patients who had significant infection, malignancy, and who had undergone parathyroidectomy were excluded. Results The mean±SD age of the studied group was 61.28±13.7, 40% were males. There were two (2%) with hypophosphatemia, 44 (44%) with normal phosphate, 34 (34%) with mild hyperphosphatemia, and 20 (20%) with severe hyperphosphatemia. There was high statistically significant difference between categories of serum phosphate as regards white blood cell, neutrophil, NLR, and platelets. There was high statistically significant difference between categories of serum phosphate as regards erythrocyte sedimentation rate and C-reactive protein (CRP), and statistically significant difference as regards serum albumin and serum intact-parathyroid hormone. There was positive significant correlation between serum phosphorus and both CRP and NLR (P<0.001). Conclusion There is high prevalence of hyperphosphatemia in hemodialysis patients. Hyperphosphatemia was associated with higher intact-parathyroid hormone, white blood cell, neutrophil, NLR, CRP, and platelets.

Background Screening is an important strategy to address the burden of chronic kidney disease (CKD) in diabetic population. International clinical guidelines recommend CKD screening for individuals with risk factors such as diabetes using laboratory assessments of glomerular filtration rate (GFR) and urine albumin excretion. To assess the implementation and outcomes of screening programs for CKD in type 2 diabetic patients. Patients and methods A cross-sectional study was conducted that included 200 adult type 2 diabetic patients in Alagouza Hospital. Patients on hemodialysis and those with type 1 diabetes mellitus were excluded. Patients were screened for CKD using urinary albumin/creatinine ratio and average estimated glomerular filtration rate. Patients with CKD were further investigated for extrarenal diabetic complications such as peripheral vascular disease and cardiovascular complications. Results Overall, 55% of the studied patients were males, with a mean age of 60.09±8.55 years. Among diabetic complications, nephropathy was the most common (53%), followed by history of neuropathy (44.5%), and retinopathy evidenced in fundus examination (34.516%). History of stroke presented in 17.5% of patients. Peripheral neuropathy, retinopathy, and stroke history were more common in nephropathic patients compared with patients without nephropathy (62/27, 61/8, and 22/13, respectively). Patients with evidenced nephropathy who were further investigated for extrarenal diabetic complications showed peripheral vascular disease in 32.1% (34 patients), with three patients undergoing amputation. Heart failure and ischemic changes were seen in 17.9% (19 patients). Conclusion Screening of diabetic nephropathy in patients with type 2 diabetes mellitus helps in early treatment and avoids its more serious complications such as progression to end-stage renal disease and other extrarenal diabetic complications.

Background Angiodysplasias (ADs) are vascular ectasias not associated with any familial syndrome, cutaneous lesions, or systemic vascular disease. They are the most common vascular malformations of the gastrointestinal tract in the general population with a prevalence of 0.82%. Most AD occurring in the general population are detected in patients older than 60 years of age, although presentation in patients with chronic kidney disease (CKD) can be earlier. The aim was to correlate AD with serum magnesium level in patients with CKD stage 5D under maintenance hemodialysis. Patients and methods This study included 60 patients with CKD stage 5D on maintenance hemodialysis. Upper and lower gastrointestinal tract endoscopy was done for all patients in Kafr Elsheikh University Hospital in a cross-sectional ‘prospective study,’ and all laboratory investigations were done. Results The mean age of patients with CKD was 49.03±14.66 years. There was a statistically significant increase in Mg among patients with AD and those without AD. This study showed that there were statistically significant negative correlations between Mg and parathyroid hormone. Conclusion AD is one of the common causes of gastrointestinal bleeding in all population and is the most common cause of bleeding in patients with CKD. Hypermagnesemia is associated with AD in patients with CKD.