Reviews


New Emerging SARS-CoV-2 Virus; Structure, Function, and Bioinformatics Analysis

Milad Hosseinpour, Reza Safari Dizaj, Ehsan Sohrabi, Saba Abbasi Dezfouli, Reihane Khorasanian, Ali Zekri

Journal of Pediatric Nephrology, Vol. 8 No. 3 (2020), 20 July 2020 , Page 1-11
https://doi.org/10.22037/jpn.v8i3.30836

The novel coronavirus, known as a Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is a single-stranded RNA virus, from which structural and some accessory proteins are encoded. It seems that this newly emerged virus uses the ACE2 receptor to enter the cells in the human body. SARS-CoV-2 undergoes an intense immunological pressure in humans, and this generates mutations to bypass the immune system. Some mutations have been detected in this virus genome, which can induce a change in viral potency. By performing pathway enrichment analysis over those genes and identifying relevant protein-protein interactions (PPIs), we were able to list essential pathways affected in infected cells. In this review, we mainly discuss genetic, intracellular mechanisms, diagnosis and feasible therapeutic targets of this novel coronavirus.

A Review of Coronavirus Disease (COVID-19) in Children

Alireza Ghodsi, Anoush Azarfar, Sara Ghahremani

Journal of Pediatric Nephrology, Vol. 8 No. 3 (2020), 20 July 2020 , Page 1-6
https://doi.org/10.22037/jpn.v8i3.31060

Abstract:


Since December 2019, an outbreak of coronavirus disease 2019 (COVID-19) with a high morbidity and mortality rate has spread globally and affected all age groups. Children can carry and transmit the novel coronavirus, but usually do not develop severe disease. The number of children who contracted coronavirus disease 2019 has increased significantly; however, compared to adults, there have been fewer reported cases of COVID-19 in the pediatric population. This review is mainly about the epidemiological features, clinical findings, laboratory tests, imaging, and treatment recommendations in children with COVID-19 disease.

COVID-19 in Renal Transplantation

Ali Derakhshan

Journal of Pediatric Nephrology, Vol. 8 No. 3 (2020), 20 July 2020 , Page 1-4
https://doi.org/10.22037/jpn.v8i3.30807

During the end of 2019 a group of patients with pneumonia were described in Wuhan city of china with progression to ARDS with variable outcome. Mortality rate was higher in the oldest and in those with comorbid conditions. Kidney transplant recipients as a group of immunocompromised hosts are believed to be a high risk group in case of infection by SARS-CoV-19 virus with unfavorable outcome. On the other hand cytokine storm with its severe inflammatory response as a major risk factor of mortality may be prevented by ongoing immunosuppressive therapy .Our knowledge about the pathophysiology and treatment options of COVID-19 in kidney transplant recipients are growing on daily bases and at the time being is derived mainly from the few published case reports, reviews and some society guidelines in the published literature.

Background : Screening for anomalies in the antenatal period has resulted in a rapid surge in the identification of fetal hydronephrosis, which forms a formidable task for the treating physician.


Summary: Pelvi-ureteric junction obstruction ranks the foremost among the children with antenatally diagnosed hydronephrosis. The dilemma of whether a dilated pelvicalyceal system is obstructed, and in need of surgical intervention to salvage from renal impairment, is a relevant point in the post-natal management of hydronephrosis detected antenatally.


Key message: Majority of Hydronephrosis detected antenatally would require observation and the renal units identified to have obstruction need to be followed up with appropriate decision making on the need for surgery.

Percutaneous Kidney Biopsy Under Guidance of Ultrasound, A Point of Care Ultrasound Gift: A Review article

Afagh Hassanzadeh Rad , Hamidreza Badeli

Journal of Pediatric Nephrology, Vol. 8 No. 3 (2020), 20 July 2020 , Page 1-5
https://doi.org/10.22037/jpn.v8i3.31311

After the application of autopsy as the only method for assessing pathophysiology of renal disease, over 50 years ago, the kidney biopsy has become an essential tool for diagnosis and management of renal diseases. To perform an appropriate kidney biopsy, some steps should be considered. In this review, the authors aimed to mention thorough details regarding percutaneous kidney biopsy under the guidance of ultrasound.

Original Research Papers


Continuous Ambulatory Peritoneal Dialysis in Children: Experience from a Tertiary Care center of Bangladesh

Abdullah Al Mamun, Md. Habibur Rahman, Tahmina Jesmin, Saimul Huque, Afroza Begum, Golam Muin Uddin, Ranjit Ranjan Roy

Journal of Pediatric Nephrology, Vol. 8 No. 3 (2020), 20 July 2020 , Page 1-5
https://doi.org/10.22037/jpn.v8i3.30716

Background:

Continuous ambulatory peritoneal dialysis (CAPD) is the most commonly used modality of renal replacement therapy (RRT) in children in different parts of the world. There is a paucity of published experience of CAPD in children from developing countries and also from Bangladesh.

Methods:

We retrospectively studied children with end-stage renal disease (ESRD) that had been on CAPD from January 2014 to December 2018 in a tertiary care center of Bangladesh, over the past 5 years. The objective was to assess the clinical and biochemical profile, complications encountered and outcome of children on maintenance CAPD.

Result:

Seven patients with ESRD were analyzed, mean age was 103months (range 28-168 month), 4 were male and three were female. CAPD was done in 2014 to a 7year old girl and subsequently 6 patients underwent CAPD. Outcome analysis of CAPD showed that only 6 episodes of peritonitis occurred among these 7 patients. Their follow up parameters showed that they are performing very well in context of growth, biochemical parameters and albumin level but one patients died due to sepsis and poor adherence.

Conclusion:

It can be concluded from these series of CAPD patients that CAPD could be a good choice of RRT in children in Bangladesh. It can reduce the uremic features as well as improve health status

Echocardiographic Assessment of Systolic Myocardial Dysfunction in Children with Chronic Kidney Disease

Abdullah Al Mamun, Md. Habibur Rahman, Tahmina Jesmin, Saimul Huque, Afroza Begum, Golam Muin Uddin, Ranjit Ranjan Roy

Journal of Pediatric Nephrology, Vol. 8 No. 3 (2020), 20 July 2020 , Page 1-6
https://doi.org/10.22037/jpn.v8i3.30694

Background and Aim: Chronic Kidney Disease (CKD) is associated with significantly increased morbidity and mortality.  Cardiovascular causes contribute to the large proportion of morbidity and mortality in this group. The aim of the current study was to assess systolic myocardial dysfunction of the heart in children with chronic kidney disease (stage V).


Methods: This cross-sectional study was carried out in a tertiary center from January 2018 to December 2018. Children aged 1 to 18 years having chronic kidney disease (stage V) were included in the study. All the patients underwent color Doppler echocardiography for the evaluation of cardiac abnormalities. Age and sex-matched healthy children with no clinical evidence of renal and cardiovascular disease were taken as a comparison group.


Results: Out of Thirty children with Chronic kidney disease (stage V), 21(70%) were male and 9 (30%) female. Echocardiographic findings revealed a statistically significant difference in case of CKD patients group and a comparison group in relation with left atrium (LA), left ventricular internal diameter in diastole (LVIDd), left ventricular internal diameter in systole (LVIDs), interventricular septum in diastole (IVSd), interventricular septum in systole (IVSs), left ventricular posterior wall thickness in diastole (LVPWd) and left ventricular posterior wall thickness in systole (LVPWs) (p<0.001) but no difference in relation to FS and EF (p-0.934 & p-0.754 respectively).


Conclusion: It can be concluded from the present study that children with chronic kidney disease are prone to develop left ventricular structural abnormality but systolic functional changes are less frequent.

Background and Aim: Asymptomatic microscopic hematuria (AMH) in children has been known as a troublesome clinical condition which demands a patient to visit a physician. This study aimed to investigate the role of a specific diet on the amelioration of AMH in children.


Methods: The current analysis was carried out in children ranging from 6 months to 14 years. This before and after research study was performed to evaluate the effects of certain diet on the treatment of pediatric AMH. Renal function tests, kidney ultrasonography and urinary assessments were performed and patients with AMH were enrolled in this query. Study group was ordered to consume a specific hypoallergenic diet. The number of urinary red blood cells was compared before and after diet. Data were analyzed using SPSS. A value of P < 0.05 was considered significant.


Results: Our special diet was effective in the treatment of stable microscopic hematuria in 72% of study group. Statistically, after a special diet, there was a significant decrease in the number of red blood cells in urine test (P <0.001).


Conclusion: Specific hypoallergenic diet was effective in treatment of AMH in children. Reducing urinary red blood cell counts has been linked to the effectiveness of diet in the management of stable microscopic hematuria.

Evaluation of Microbial Resistance Pattern in Children with Urinary Tract Infection in Bushehr between 2017 and 2018

Khadijeh Ghasemi, Sahar Montazeri, Mehdi Mahmoudpour, Nader Shakibazad, Mohammadreza Fariborzi, Kamal Rouzbehani

Journal of Pediatric Nephrology, Vol. 8 No. 3 (2020), 20 July 2020 , Page 1-5
https://doi.org/10.22037/jpn.v8i3.31409

Background and Aim: Urinary tract infection is one of the most common childhood illnesses that can lead to complications such as hypertension and kidney failure. The aim of this study was to evaluate microbial resistance and sensitivity and to determine the relationship between urinary tract abnormalities and prior antibiotic use with microbial resistance.


Methods: This is a descriptive-analytic study on 90 patients with a positive urine culture. Urine culture samples were taken using one of the sampling methods (midstream clean catch, catheterization, urine bag, suprapubic aspiration) and ultrasonography was requested for all patients to evaluate urinary system abnormalities. Also, a history of prior antibiotic use was asked and recorded.


Results: Of all patients, 55.6% showed E.coli and 44.4% showed other bacteria in urine culture. 97.7% of patients' cultures were sensitive to imipenem, 82.2% to nitrofurantoin, and 77.8% to cefixime. 65% of patients' cultures showed resistance to nalidixic acid, 56.7% to co-trimoxazole, and 38.9% to ceftriaxone. There was a significant relationship between cefixime and amikacin antibiotic resistance with abnormal ultrasound and there was a significant relationship between antibiotic resistance to cefixime, ceftriaxone, co-trimoxazole, and duration of prior antibiotic use (p-value <0.05).


Conclusion: The most common pathogen in UTI was E.coli. The highest sensitivity was to imipenem, nitrofurantoin, and cefixime, and the highest resistance was to nalidixic acid, co-trimoxazole, and ceftriaxone. There was a relationship between urinary tract abnormalities and prior antibiotic use with microbial resistance, so it is suggested to use kidney ultrasound in all patients with urinary tract infection.

Case Reports


In the early era, survival from Wilm’s tumor (WT) was less than 10% compare to today's date which has a 90% chance of survival. Multimodal therapy, enhanced surgical techniques, effective chemotherapy regimens and radiation therapy in treatment protocols have revolutionized the survival rates. As the advancement continues, molecular basis and targeted therapies are being considered for risk stratification and better treatment. Particularly important is evaluation of molecular abnormalities that confer to poor prognosis, so that intensification of chemotherapy and radiotherapy can be done to achieve maximum remission. The aim of this article is to highlight the importance of p53 and a morphological spectrum that have been associated with prognosis in WT.

Lupus Nephritis in a Patient with Past History of Henoch Schönlein Purpura

Mojtaba Fazel, Fatemeh Nili, Seyed Reza Raeeskarami, Maassoumeh Akhlaghi, Mojgan Faraji-Goodarzi, Mastaneh Moghtaderi , Parvin Akbari Asbagh

Journal of Pediatric Nephrology, Vol. 8 No. 3 (2020), 20 July 2020 , Page 1-5
https://doi.org/10.22037/jpn.v8i3.30962

Systemic lupus erythematosus is an autoimmune disease associated with systemic involvement. Various organs including skin, kidneys, joints, heart, and central nervous system, may be affected. One of the serious organ damages in SLE is renal involvement as lupus nephritis, which occurs in 50-75% of children with SLE. Approximately 6-12% of pediatric SLE may develop other conditions, such as JIA, JDM, and polymyositis, scleroderma, and Crohn's disease. Henoch schönlein purpura (HSP) is another disease that accompanies with SLE. There have been several reports of HSP as the primary manifestation of SLE. In this report, we aim to highlight lupus nephritis as the first presentation of SLE and its association with HSP in our patient, a 6-year-old boy with lupus nephritis and past history of HSP 4 years before initiating of SLE.

Brief Reports


Incorporating Real Time Ultrasound Guidance to Kidney Biopsy by the Nephrologist: An Educational Video

Afagh Hassanzadeh Rad , Hamidreza Badeli

Journal of Pediatric Nephrology, Vol. 8 No. 3 (2020), 20 July 2020 , Page 1-2
https://doi.org/10.22037/jpn.v8i3.31288

Kidney biopsy is an important technique for diagnosis and management of patients with kidney diseases. Real-time US with guided renal biopsy is a consolidated method. This method obtained over 90% of adequate samples. Even reduction of complications has been obtained from blind technique (10%) to an ultrasound-guided method (2-6%). in this article authors aimed to show a video to visualize a sample of kidney biopsy under guidance of US on a 14-year-old girl.