Zeitschrift für Nephrologie und Therapeutik

The point of this investigation was to assess harm of the kidney with Tc99m-DMSA scintigraphy in kids with Antenatal Hydronephrosis (ANH) and the impact of other postnatal related conclusions on anomalous DMSA discoveries. DMSA scintigraphy in 54 kids (17 young ladies and 37 young men), matured from 2 months to 5 years (middle 11 months) with 66 antenatally recognized hydronephrotic Renal Units (RU) (42 one-sided hydronephrosis: 29 young men and 13 young ladies and 12 two-sided hydronephrosis: 8 young men and 4 young ladies) was finished. Male/female proportion was 2.2: 1; one-sided/respective hydronephrosis proportion was 4:1. Hydronephrosis ordered into three gatherings as indicated by ultrasound estimation of the Antero-back Pelvic Diameter APD): Mild (APD 5-9.9 mm) was available in 13/66 RU, moderate (APD 10-14.9 mm) in 25/66 RU and serious (APD≥15 mm) in 28/66 RU. Basic hydronephrosis was available in 15 RU and postnatal related clinical conclusion were Vesicoureteral Reflux (VUR) in 21, Pelvi Ureteric Junction (PUJ) deterrent in 7, pyelon et ureter duplex in 11, megaureter in 11 and back urethra valves in 1 RU, individually. Static renal scintigraphy was performed 2 to 3 hours after intravenous (iv) infusion of 99m Technetium marked Dimercaptosuccinic corrosive (DMSA) utilizing a portion of 50 ?Ci (1.85 MBq/kg; insignificant portion: 300 ?Ci). Four perspectives (back, left and right back sideways and front) were acquired with a solitary head gamma camera orbiter separated with high goal equal entire collimator. All pictures were put away in a Pegasys PC with a grid size of 256??256. The Relative Kidney Uptake (RKU) between the left and right kidney was determined as a normal number tallies from foremost and back view. Renal pathology was characterized as inhomogenous or central/multifocal take-up deformities of radio pharmaceutical in hydronephrotic kidney or as split renal take-up of <40% and helpless kidney work was characterized as part renal take-up <10%. Unmistakable and expository measurements (SPSS rendition 20.0) were performed. Logical insights inferred the non-parametric Mann-Whitney test for assurance of factually huge distinction between the ordinary and neurotic discoveries on DMSA examine. The default level of noteworthiness was p<0.05. DMSA scintigraphy discoveries in youngsters with ANH were: Decreased or extended kidney with inhomogeneous kidney take-up radiopharmaceutical in 22, unpredictable shape kidney with inhomogeneous amassing of radiopharmaceutical in 3, associated (melded) kidney in 1 patient and ineffectively or nonvisual kidney in 14 RU separately (all out 40/66 renal units with neurotic DMSA finding (60.6%)). Relative aggregation in hydronephrotic kidney was less or equivalent to 40% in 17 renal units, under 10 out of 14 renal units. Inhomogeneous radiopharmaceutical take-up with relative collection over 40% was distinguished in 9 RU. Ordinary kidney morphology with homogeneous gathering of radiopharmaceutical (typical DMSA scintigraphy finding) were found in 26/66 renal units (39.4%). Factually noteworthy relationship between's the level of the hydronephrosis (APD) and DMSA check finding (p<0.001) and between the level of the VUR and DMSA examine finding (p=0.002) was set up. In our examination, other related analysis was not factually associated with obsessive discoveries on DMSA filter. Based on these outcomes we suggest DMSA scintigraphy in the assessment renal pathology in youngsters with ANH. More noteworthy number of patients is required for the estimation of the related determination (other than VUR) impact on the renal parenchymal harm in kids with ANH.

Das kongenitale nephrotische Syndrom ist definiert durch das Vorhandensein von Proteinurie im nephrotischen Bereich, Hypoalbuminämie und Ödemen und beginnt in den ersten drei Lebensmonaten. Es ist normalerweise eine Folge genetischer Mutationen der Komponenten der glomerulären Filtrationsbarriere, obwohl infektiöse Ursachen ausgeschlossen werden müssen. Angeborene Herzfehler sind beim kongenitalen nephrotischen Syndrom äußerst selten, machen weniger als 20 % der Fälle aus und sind meist mit einer Podocin-Mutation verbunden. Wir berichten über ein zwei Monate altes Mädchen, das in den ersten zwei Lebensmonaten Anasarka entwickelte und bei dem ein kongenitales nephrotisches Syndrom diagnostiziert wurde. Infektiöse Ursachen, darunter Malaria, Zytomegalievirus, Toxoplasmose, Syphilis, menschliches Immundefizienzvirus und Röteln wurden ausgeschlossen. Angesichts eines systolischen Herzgeräusches wurde eine Echokardiographie durchgeführt, die einen Vorhofseptumdefekt des Ostium secundum und eine Stenose der Pulmonalarterienäste ergab. Die genetische Analyse zeigte eine homozygote Duplikation einzelner Basenpaare im Exon 20 des NPHS1-Gens (chr19:36332624dupG; Tiefe: 216x), was zu einem Frameshift und einer vorzeitigen Verkürzung der 6 Aminosäuren des Proteins stromabwärts zum Codon 937 (p.Ser937GlnfsTer6; ENST00000378910.5) führte. Dies ist der erste Fall einer NPHS1-Mutation (Nephrin), die mit einer angeborenen Herzerkrankung und einem angeborenen nephrotischen Syndrom assoziiert ist.

Einleitung: Intrinsische nephrotische Störung, gekennzeichnet durch Proteinurie, die kurz nach der Geburt bis zu 3 Monate lang zu klinischen Symptomen führt. Intrinsische nephrotische Störung finnischen Typs bezeichnete ursprünglich eine schwere Form von Proteinurie, die häufig bei finnischen Säuglingen ohne Eiweißersatz und diätetische Unterstützung auftritt. Die typischen Symptome der Hypoproteinämie sind Ödeme, Magenvergrößerung, Aszites, Nabelbruch und vergrößerte Schädelnähte und Fontanellen. Sie gilt als autosomal latente Krankheit, die in Finnland häufiger auftritt (1 von 8.200 Lebendgeburten). Schwere Proteinurie, die bereits in der Fötalperiode beginnt, führt aufgrund von Proteinmangel zu Komplikationen. 80 % der Kinder sind Frühgeburten (vor der 30. Woche), bei einem durchschnittlichen Geburtsgewicht von 2600 Gramm (1500 bis 3500) werden sie in der ersten Woche diagnostiziert, bei 86 %. Die angeborene nephrotische Erkrankung ist mit zahlreichen kleineren funktionellen Problemen wie Hypothyreose, Hypotonie, zentralen Nervensystems oder Stoffwechselstörungen, meist Dyslipidämie, assoziiert. Kleinere kardiovaskuläre Befunde wie Hypertrophie und milde aspiratorische Stenose wurden bei einem Viertel der finnischen Rasse festgestellt. In dieser Studie versuchen wir, dieses Phänomen anhand unserer Fälle zu untersuchen.

Materialien und Methoden: Während 4,2 Jahren von September 2007 bis Januar 2011 wurden in unserem Überweisungsnetzwerk sechs Fälle von angeborener Nierenerkrankung untersucht. Unsere Maßnahmen umfassen die Diagnose vor dem dritten Monat, Hypoalbuminämie (Serumeiweiß unter 2,5 Gramm/Deziliter) und Proteinurie über 50 Milligramm/Kilogramm/Tag als Endpunkt für nephrotische Go-Proteinurie. Fälle im Zusammenhang mit Hepatosplenomegalie und positiven intrauterinen Infektionen wurden in unserer Untersuchung übersehen. Es wurde eine Echokardiographie durchgeführt und die Art der grundlegenden Deformitäten und Grenzen hinsichtlich Shunt-Charakteristiken, Erbrechen und ihrer Winkel wurden neu angeordnet. Ihre Klappenstrukturen wurden detailliert untersucht, indem eine standardmäßige linksparallele Liegeposition mit dem Vingemed-System mit 2,5-Megahertz-Test im apikalen Vierkammerbild verwendet wurde. Die Breite der rechten und linken Kammer wurde anhand der Winkel der Mitral- und Trikuspidalklappen in Millimetern gemessen, was die großen Entfernungen von der seitlichen Masse der rechten Kammer zum Vorhofseptum und von der horizontalen Masse der linken Kammer zum Vorhofseptum bedeutet, wobei der mittlere Trikuspidalwinkel (Winkel zwischen rechter Kammer und rechtem Ventrikel 35–50 mm Quecksilbersäule) und der mittlere (Druckabfall zwischen rechter Kammer und rechtem Ventrikel über 50 mm Quecksilbersäule) in unserer Untersuchung für den Bericht berücksichtigt wurden. Die Aspirationsklappe wurde hauptsächlich im parasternalen Kurzhubbild beurteilt.

Result: During 4.2 years from September 2007 to 2011, six instances of inherent nephrotic disorder alluded to our emergency clinic as a referral medical clinic. Two out of 6 cases analyzed before age of 2 months and 4 out of 6 preceding third months. All gave ascite, whiteness; edema generally kicked the bucket before age of 4 months because of sepsis and intense renal disappointment. Serum egg whites in all cases were under 2 g/dl (mean: 1.3 gram/deciliter), they were conceived in term or close to term pregnancy (mean: multi week of gestational age and 2900 gram weight of birth), the guardians were not related generally (4/6). Tricuspid spewing forth in moderate evaluations was found in 3/6. Pulmonic stenosis were found in 3/6 , in one case it was valvular in other case it was sub pulmonic stenosis and in third it was in fringe parts of pneumonic supply routes that was missed in first attempt. Left ventricular hypertrophy and mitral disgorging was seen in 2 cases

Discussion: Heart contortion along steroid safe nephrotic condition due to podocin change that have some capacity in cardiovascular improvement has been accounted for much of the time 8 yet its heart affiliation depicted once before in a family comprised of four sisters who created steroid safe inborn nephritic disorder created clinical indication of right ventricular surge plot check. In two of the young ladies, affirmation of right ventricular strain was acquired from electrocardiography and chest radiography. In one of the young ladies subpulmonary right ventricular surge lot hindrance was shown at posthumous assessment. Report of minor cardiovascular contortion in one fourth of Finnish patient with gentle utilitarian pneumonic hypertrophy and stenosis, in other report from Malta serious aspiratory stenosis and subaortic stenosis portrayed. As our investigation heart affiliation are regular in innate nephritic disorder as it appears not being coincidental as in two successive kin complex heart basic imperfections fundamentally pulmonic stenosis saw from non related guardians in spite of the fact that in different examinations cardiovascular assessment frequently uncover ventricular hypertrophy however auxiliary deformities are rare12 yet in 6 consanguineous Arabs family heart oddities were seen due to podocin blend deficiency8 in another examination 2 out of 12 patients had heart irregularities chiefly gentle mitral disgorging and left ventricular hypertrophy 13 yet as our examination a few evaluations of heart imperfections can be seen almost taking all things together, and various basic imperfections can be seen in lesser by and large in familial structure, right ventricular hypertrophy occurred in 1 out of 6 and left ventricular hypertrophy in 2 out of 6 patients yet the most significant finding is pulmonic valve stenosis (valvualr or subvalvular) or it might be occurred in fringe some portion of aspiratory course that might be missed from the start without focusing decisively. Tricuspid spewing forth is another normal issue ascribed to expanded aspiratory hypertension in nephrotic disorder that might be found in 7/8 of steroid safe nephrotic condition with delayed disease14 and in moderate to extreme structure is interesting for pneumonic embolism as an inconvenience of nephrotic syndrome.15 As our investigation tricuspid disgorging saw in 3/6 cases may occurred in age as low as fifteenth days.

Schlussfolgerungen: Intrinsische Nierenerkrankungen sind im Iran selten, jedoch ist eine gleichzeitige Erkrankung mit Herz-Kreislauf-Erkrankungen normal. Zahlreiche Herzfehler können in nicht assoziierten Familien in der gleichen Zeit auftreten. Eine Stenose der Atemklappe kann in allen Teilen der subvalvulären, valvulären und Randbereiche der Lungenvenen auftreten, die übersehen werden können. Eine Hypertrophie des linken Ventrikels mit oder ohne Mitralklappeninsuffizienz trat in 2 von 6 Fällen auf, die Hälfte der Patienten kann eine mäßige Trikuspidalinsuffizienz haben, die durch einige Risikofaktoren wie Lungenhochdruck, Embolie oder Pulmonalstenose verursacht wird. Als Hauptrisikofaktoren kann sie zwischen dem 15. und 50. Tag nach der Geburt auftreten.

Abstract: The absence of adherence to treatment in relocate patients is an immediate factor related with the loss of join and even passing. Among the instruments to gauge adherence to treatment is the Simplified Medication Adherence Questionnaire (SMAQ). SMAQ is a brief and basic instrument, in light of inquiries to the patient about his propensity in taking prescription, approved to quantify adherence in patients with kidney relocate. Numerous examinations have been directed to survey adherence to treatment and the repercussion in dismissal in patients with helpless adherence, yet up until this point, we don't have any investigation of this sort in Mexico. The National Medical Center of the West (CMNO) has the most number of instances of kidney transfers in pediatric patients in Mexico, consequently, we thought of it as appropriate to play out this investigation in the number of inhabitants in CMNO. The point of this investigation was to decide the relationship of connection to treatment estimated by the SAMQ in the pediatric patients with a background marked by dismissal to kidney transplantation in our medical clinic. We performed cross-over investigation in pediatric patients with kidney relocate of the Pediatric Hospital of CMNO. We audited the clinical records of the patients that came to catch up on January 2017 and applied the SMAQ to those patients. An aggregate of 89 surveys were applied during the period. The SMAQ demonstrated that patients with useful join were clung to the treatment 96.7%, while patients with useless unite had half treatment adherence. Patients without treatment adherence have a higher danger of relocate brokenness (p<0.001). At the point when adherence to treatment is under 95%, the danger of join brokenness is 39% (p=0.006), contrasted with the individuals who show adherence to treatment of 95% or more. In view of the SMAQ, patients who are not clung to treatment and the individuals who have adherence to immunosuppressive treatment of fewer than 95%, have a higher danger of join brokenness.

Introduction: Non-adherence in relocate patients is, somewhat, an immediate reason for or possibly a factor related with unites misfortune and demise. Non-adherence additionally has repercussions on the personal satisfaction of relocate patients, just as on the wellbeing costs related with the basic illness, ordinarily through requiring a subsequent transfer and dialysis.The evaluated level of relocate patients that are resistant with treatment regimens ranges somewhere in the range of 20% and 54%. In renal transfers, the absence of consistence is assessed to add to 20% of intense dismissals and 16% of join misfortunes. Among the elements related with an absence of adherence to immunosuppressive treatment are age, sadness, stress, the quantity of dosages every day, auxiliary impacts of the immunosuppressive treatment, an absence of trust in the endorsed prescription, low patient independence, having gotten the unite from a live contributor, and a lacking social idea of human services. Due to the clinical significance of adherence, it ought to be firmly checked in routine clinical conventions for strong organs beneficiaries. The degree of adherence is particularly significant in renal transfer beneficiaries, since the pace of patients that don't agree to immunosuppressive treatment conventions is higher in this gathering in those that get different sorts of transfers. Adherence can be estimated utilizing a goal estimation (direct perception of the prescriptions utilized) or through roundabout techniques, for example, estimating the amount of medicine in blood or serum tests, natural markers, or electronic checking. There are likewise emotional estimations, for example, clinical feeling or patient declaration. There is no accord on an ideal method for estimating adherence in clinical practice. Notwithstanding, it was indicated that the consolidated utilization of abstract and aberrant techniques gives an exceptionally touchy measure to evaluating consistence. The Simplified Medication Adherence Questionnaire is a short and straightforward instrument dependent on questions presented legitimately to the patient in regards to his/her medicine taking propensities, which was initially approved for the estimation of adherence in patients on hostile to retroviral treatment. In the field of nephrology, this device has been utilized for assessing consistence with phosphate-restricting treatment in haemodialysis patients, in spite of the fact that it has not been approved for this gathering of patients. In this examination, we present the approval of a SMAQ survey that has been adjusted for use in relocate patients. Our goal was to deliver a device that is appropriate in routine clinical practice, both alone and in blend with aberrant strategies, for recognizing transfer patients that are in danger for rebelliousness with the endorsed immunosuppressive drug, in order to build the control and limit the conceivable unfriendly impacts.

Methods: Our own was an observational epidemiological examination assessing the psychometric properties of the Simplified Medication Adherence Questionnaire in renal transfer recipients.We intended to select a sum of 150 renal join beneficiaries that had experienced kidney relocate in any event one year before their consideration in the investigation. With the goal of expanding the homogeneity of the example and keeping away from the over the top fluctuation related with the immunosuppressive regimens typically utilized in strong organ relocate beneficiaries, we constrained our examination to patients getting tacrolimus, therefore diminishing the potential solutions to those including mixes of this medication with different immunosuppressants usually connected with it. The choice rules utilized were the accompanying: patients 18 years old or more seasoned, with a renal transfer of at any rate 11 months development, and on immunosuppressive treatment with tacrolimus. We additionally believed it to be an essential necessity for investment in the investigation and information assortment that the patient be educated regarding the objectives and strategies for the examination and willful sign the composed educated assent form.The fundamental socio-segment and clinical information were gathered from every patient by the pro specialist. Every patient finished the Morisky-Green scale 16 and the SMAQ, the last including two free meetings did around the same time, one by the master specialist and one by the nursing staff.The Morisky-Green scale is a straightforward scale including just 4 things that ask the patient how he/she agrees to the drug routine endorsed by the specialist. This scale permits us to group patients as agreeable or rebellious. It has been appropriately approved in Spain. The SMAQ survey was created as an alteration of the Morisky-Green poll to gauge adherence to antiretroviral treatment in patients with (AIDS). This survey comprises of six inquiries that assess various parts of patient consistence with treatment: neglect, normal, unfriendly impacts, and a measurement of exclusions. A patient is named rebellious on the off chance that he/she reacts to any of the inquiries with a non-adherence answer, and as far as measurement, if the patient has lost multiple portions during the most recent week or has not taken medicine during in excess of two complete days during the most recent three months. This poll was approved in an example of Spanish patients under treatment with unboosted nelfinavir somewhere in the range of 1998 and 1999. The SMAQ survey subject to approval was a Spanish rendition adjusted for use in relocate patients. The adjustment procedure occurred through master discussions, alongside a patient/master board.

Statistical analysis: The information were gone into a database made explicitly for this reason utilizing STATA factual programming, adaptation 10, which was submitted to ranges and inside intelligibility rules so as to control confusion and/or redresses in the assortment and classification of the information. The starter database included 146 cases got by the end date. Afterward, we performed quality control keeps an eye on the information, investigating and revising any fragmented or inaccurate information. Furthermore, we played out an examination of consistence with the incorporation measures "understanding with a kidney relocate of in any event a year post-relocate development," in light of the period of time between the transfer date and the principal visit for the investigation. This examination prompted the evacuation of two cases that had short of what one year with their transplants. With regard to the investigation, we utilized measurable noteworthiness esteem (α) of 0.05 in all exploratory and logical factual tests. We likewise depicted the example as far as the diverse socio-segment and clinical factors gathered during the investigation. In the examination of the psychometric properties of the SMAQ survey, we considered the between onlooker reproducibility utilizing Cohen's kappa coefficient as a proportion of unwavering quality. In the legitimacy examination, we dissected the relationship between the aftereffects of the survey and the diverse clinical factors identified with adherence. We additionally analyzed the affectability and particularity of the survey (when contrasted with the Morisky-Green scale) in recognizing resistant patients, utilizing the degree of tacrolimus in blood tests as our highest quality level, with sub-target focuses being those under 5ng/ml. At long last, the focalized legitimacy of the review was assessed utilizing an investigation of the relationship between poll scores and those from the Morisky-Green scale. We played out all measurable investigates utilizing STATA factual programming, rendition 10. The breaks down depended on the quantity of sections given for every particular thing, to such an extent that we never doled out qualities â??â??to things with lost qualities. The scores from the surveys, and accordingly the breaks down that included the administration of these scores, were determined uniquely for those patients that had reacted to the entirety of the things for the poll considered.

Result: As we referenced beforehand, the database that we investigated included 144 grown-up patients that had gotten a kidney relocate in any event one year before their incorporation in the examination, and who were experiencing immunosuppressive treatment with tacrolimus. The mean patient age in our example was 50.63 years, and the example was made essentially out of guys. The interim slipped by between the transfer and the primary visit for consideration in our examination was 5.30 years. The base time enrolled was 0.99 years, since one patient was viewed as legitimate as just a couple of days were required so as to follow the 1-year consideration rules. The patients experienced a second transfer in 12.5% â??â??of cases. Tacrolimus was endorsed as an underlying post-relocates immunosuppressive treatment in 84.72% of cases, and 99.31% got steroids. The mean every day portion of tacrolimus endorsed upon incorporation in the investigation was 3.95mg, and mean levels were 6.83ng/ml. In light of as far as possible incentive for tacrolimus of 5ng/ml, 20.14% of patients had sub-target levels. As per the going to doctors shows how patients were ordered by their reactions to the two surveys. As per the SMAQ poll, 39.01% of patients were named rebellious when the study was managed by the specialist, and 41.84% when controlled by the nursing staff. The Morisky-Green scale confirmed that 22.38% of patients were rebellious. For the examination of the psychometric properties of the SMAQ poll, we originally contemplated the degree of concordance between the SMAQ scores for the two unique meetings regulated. As appeared in, the degree of concordance between the outcomes from the meeting with the specialist and the meeting with the medical caretaker was very high, proposing a generally excellent between spectator reproducibility. We inspected the united legitimacy utilizing the relationship between the arrangement created by the SMAQ poll for the two meetings and the score from the Morisky-Green scale. As appeared in, a moderate degree of relationship exists between the two scales. With respect to models legitimacy, this equivalent table shows the negative relationship between adherence as estimated by the SMAQ poll and the ridiculous varieties in immunosuppressive medication levels. There was additionally a practically noteworthy connection between the characterization gave by the SMAQ survey and the going to doctor's impression of the correct consistence with respect to the patient with the immunosuppressive convention. We additionally analyzed the affectability and particularity of the survey in recognizing rebellious patients utilizing the best quality level of the tacrolimus fixation in blood tests. On the off chance that we contrast it with the Morisky-Green scale, the SMAQ survey gives a more prominent affectability and lower particularity, just as a higher level of effectively characterized patients.

Conclusions: In this examination, we endeavored to approve a form of the SMAQ poll so as to acquire a basic instrument for identifying transfer patients that are not consenting to immunosuppressive treatment in typical clinical practice.The survey has satisfactory qualities â??â??of legitimacy and between eyewitness reproducibility. Past investigations demonstrated that the mean resistance with immunosuppressive treatment is 28% in kidney relocate patients, as indicated by understanding declaration. As indicated by the outcomes from our investigation, the adjusted SMAQ has arranged a higher level of rebellious patients than the built up mean, while the Morisky-Green scale ordered a lower number as resistant. The level of resistant patients as per the SMAQ in this examination was likewise higher than the rate from the first approval concentrate for consistence with against retroviral treatment in patients with AIDS, despite the fact that our rate was like distributed qualities â??â??for adherence to phosphate - restricting drug in haemodialysis patients. Utilizing tacrolimus levels in blood tests as our best quality level, the SMAQ poll gives a higher affectability and lower explicitness than the Morisky-Green scale. A higher affectability is profitable in a device, for example, this, since it gives a more prominent intensity of identification of resistant subjects and consequently prompts better clinical development. As a constraint to the examination, we should call attention to that, in spite of the fact that we got a great inclination, the qualities â??â??obtained for affectability and explicitness when contrasted with the characterization utilizing objective/sub-target tacrolimus focuses is far underneath the ideal range for a device of this sort, and beneath the outcomes acquired in the first approval utilizing the outcomes from a prescription observing framework as a best quality level. This is most likely because of the idea of the highest quality level utilized in our examination, since the qualities â??â??obtained utilizing the Morisky-Green scale were likewise far beneath the normal range. We ought to likewise bring up that, in spite of the fact that the outcomes from the SMAQ survey were related with clinical assessment on tolerant adherence, the pace of rebellious patients as indicated by the clinical reports didn't reach 6%, though the rate dependent on the poll surpassed 39 % (22%, as per the Morisky-Green scale). Then again, over 20% of patients had sub-target tacrolimus values â??â??in blood tests. The contrasts between proficient discernment and the outcomes from the tests and dissects are as per the basic under-location paces of helpless adherence in this sort of patient, 18 which shows the requirement for a consistence estimation device that is material in day by day practice for a superior discovery and follow-up of resistant patients. As respects the investigation of the psychometric properties of the survey, the degree of between spectator concordances was higher than that gotten in the first approval of the poll. The survey likewise shows satisfactory joined and standards legitimacy, by being connected with the Morisky-Green scale and the clinical boundaries investigated, which drives us to presume that the adjusted SMAQ poll had sufficient psychometric properties – unwavering quality and legitimacy for recognizing transfer patients that are resistant with immunosuppressant drug in typical clinical practice.

Aneurysmen sind ein häufiges und oft problematisches Problem, das bei arteriovenösen Gefäßzugängen für die Hämodialyse auftritt. Der Zweck dieser Fallstudie besteht darin, das Ausmaß des Problems und die vorgeschlagenen Behandlungsmethoden zu definieren und zu beschreiben. Eine Fallstudie der veröffentlichten Literatur anhand einzelner Fälle soll die relevante Literatur zusammenfassen. Die Definitionen von Aneurysmen sind in der gesamten Literatur widersprüchlich, und daher ist eine systematische Analyse nicht möglich. Sie reichen von subjektiven Beschreibungen bis hin zu quantitativen Definitionen unter Verwendung von Gesamtgröße, relativer Größe und auch Größe plus Merkmale. Rate und Ätiologie sind ebenfalls nicht gut definiert, aber eine Unterteilung in echte Aneurysmen und falsche oder Pseudoaneurysmen kann bei der Planung der Behandlung hilfreich sein, die konservativ, chirurgisch oder radiologisch sein kann. Das Fehlen nützlicher Definitionen und Beschreibungen sowie die Vielzahl der vorgeschlagenen Behandlungsmethoden erschweren es, fundierte, beweisbasierte Entscheidungen zu treffen. Weitere gründliche, gut strukturierte Studien sind erforderlich, um die beste Vorgehensweise für dieses häufige Problem zu bestimmen. Die Zahl der Patienten mit Nierenversagen im Endstadium ist stetig gestiegen und es gab einige Verbesserungen bei den Hämodialyseverfahren, die zu einer erweiterten Zukunft geführt haben. Pseudoaneurysma-Vorfälle wurden mit 2 bis 10 % der Dialysezugangseinheiten angegeben. Sie waren die Ursache für 0,4 bis 1,6 % der Todesfälle bei Hämodialysepatienten (HD) in den USA. 52 % waren auf eine Hauterkrankung mit Zugangskrankheiten zurückzuführen, die die AVF/AVG nicht beeinträchtigten. Um ausreichende Hämodialysemedikamente zu gewährleisten, ist ein gut funktionierender Gefäßzugang (VA) bei Dialysepatienten unerlässlich. VA-Verwirrungen sind häufig und stellen einen wichtigen Grund für Krankenhausaufenthalte bei Hämodialysepatienten dar, wobei 36 bis 39 % der Fälle mit dem Dialysezugang in Zusammenhang stehen [1, 2]. Die mittlere Verweildauer betrug 5,3 ± 4,6 Tage, bei durchschnittlichen Krankenhauskosten von 41.896 ± 20.318 US-Dollar [3]. Unter den zahlreichen Komplikationen, die die Lebensdauer einer VA beeinträchtigen können, stellen Aneurysmen eine kritische Herausforderung dar, die sowohl die arteriovenöse Fistel (AVF) als auch den Patienten gefährdet.

Ich freue mich, das International Journal of Nephrology & Therapeutics (JNT) vorstellen zu dürfen, ein frei zugängliches elektronisches Journal, das ein Online-Kompendium zur Nierenfunktion und zu vorbeugenden und therapeutischen Maßnahmen zu ihrer Überwindung bieten und den Autoren eine Plattform bieten soll, auf der sie Beiträge zum Journal leisten können. Die Redaktion überprüft die eingereichten Manuskripte, um ihre Qualität sicherzustellen. Wir wurden im Jahr 2011 gegründet und das International Journal of Nephrology & Therapeutics (ISSN: 2161-0959) wächst kontinuierlich. Wir freuen uns, bekannt geben zu können, dass im Jahr 2020 alle Ausgaben von Band 10 pünktlich online veröffentlicht wurden und die Printausgaben ebenfalls innerhalb von 30 Tagen nach der Online-Veröffentlichung der Ausgabe herausgebracht und versandt wurden.

Alle veröffentlichten Artikel dieser Zeitschrift sind in der Indexierungs- und Abstracting-Abdeckung von CAS Source Index (CASSI), Index Copernicus, Google Scholar, Sherpa Romeo, Academic Journals Database, GenamicsJournalSeek, JournalTOCs, CiteFactor, Electronic Journals Library, RefSeek, Hamdard University, EBSCO AZ, Directory of Abstract Indexing for Journals, World Catalogue of Scientific Journals, OCLC- WorldCat, Scholarsteer, SWB Online-Katalog, Virtual Library of Biology (vifabio), Publons, Dtufindit, Geneva Foundation for Medical Education and Research enthalten.

Im Kalenderjahr 2020 gingen beim International Journal of Nephrology & Therapeutics insgesamt 30 Artikel ein, von denen 6 Artikel in der Vorprüfung aufgrund von Plagiaten oder Nichteinhaltung des Formats und des Peer-Review-Prozesses abgelehnt wurden. Im Jahr 2020 wurden etwa 16 Artikel zur Veröffentlichung vorgelegt, nachdem sie im Peer-Review-Prozess angenommen worden waren. In den 4 Ausgaben von Band 10, die im Jahr 2020 veröffentlicht wurden, wurden insgesamt 16 Artikel veröffentlicht (durchschnittlich 3 Artikel pro Ausgabe, von denen Artikel von Autoren aus der ganzen Welt veröffentlicht wurden). Insgesamt 30 Forscher aus der ganzen Welt überprüften die 16 in Band 10 veröffentlichten Artikel. Die durchschnittliche Veröffentlichungsdauer eines Artikels wurde weiter auf 14–21 Tage reduziert.

Im Kalenderjahr 2020 traten insgesamt drei Redakteure und zehn Gutachter dem Vorstand von JNT bei und leisteten ihre wertvollen Dienste bei der Erstellung und Veröffentlichung von Artikeln, und ihre wertvollen Gutachterkommentare werden sich positiv auf die Veröffentlichungsqualität der Artikel im Journal auswirken.

Ich möchte diese Gelegenheit nutzen, um den Beitrag des Chefredakteurs und des stellvertretenden Redakteurs bei der Endredaktion der veröffentlichten Artikel und der rechtzeitigen Veröffentlichung der JNT-Ausgaben zu würdigen. Ich möchte auch allen Autoren, Gutachtern, dem Herausgeber, dem Sprachredakteur, den ehrenamtlichen Redakteuren, dem wissenschaftlichen Beirat und der Redaktion von JNT sowie den Amtsträgern für ihre Unterstützung bei der Veröffentlichung des neuen Bandes (Band 10) von JNT für das Kalenderjahr 2020 danken und freue mich auf ihre weitere unermüdliche Unterstützung bei der Veröffentlichung weiterer Ausgaben des International Journal of Nephrology & Therapeutics JNT im geplanten Zeitraum.