- Medical School Societies Contact/Information
- Publication Ethics and Publication Malpractice Statement
- Journals
- Volume 3 - Issue 2
- Volume 3 - Issue 1
- Volume 3 - Supplement 2
- Volume 3 - Supplement 1
- Volume 2 - Issue 2
- Volume 2 - Issue 1
- Volume 1 - Issue 2
- Volume 1 - Issue 1
- Online Publications [Epub]
- Letters to the Editor & Personal Views
Volume 3 - Issue 2
Scottish Universities Medical Journal 2014: Volume 3, Issue 2
Please find below the list of articles and their abstracts. Individual articles can be downloaded from the links provided.
Download entire SUMJ Vol3 - Issue 2 as a PDF
Recognition of Acute Kidney Injury (Editorial)
Lloyd D Hughes (5th year MBChB, University of Dundee & Associate Editor Scottish Universities Medical Journal)
Editorial for Volume 3 Issue 2 of the Scottish Universities Medical Journal.
Cite this article as:
Hughes LD (2014). Recognition of Acute Kidney Injury. Scottish Universities Medical Journal. 3 (2). p. 4
Management of Acute Kidney Injury: Advice for the Acute Receiving Unit
Fiona AI Duthie (MRC Clinical Research Fellow, University of Edinburgh) & Jeremy Hughes (Professor of Experimental Nephrology & Honorary Consultant Nephrologist, University of Edinburgh)
Abstract:
Acute kidney injury (AKI) is a common condition that is associated with significant morbidity
and mortality. The term describes a syndrome, formerly known as acute renal failure, which
is characterised by a rapid loss of renal excretory function, over hours to days. AKI is can
occur in patients under the care of any medical or surgical specialty, and it is important that
all clinicians are aware of its prognostic implications and the need for rigorous care. This
article aims to provide a framework for approach to the care of patients with AKI in the
Acute Receiving Unit, with consideration of the potential underlying cause and initial
investigations and management.
Cite this article as:
Duthie FAI & Hughes J (2014). Management of Acute Kidney Injury: Advice for the Acute Receiving Unit. Scottish Universities Medical Journal. 3 (2). p. 6-16
Valganciclovir‐Induced Leucopenia in Renal Transplant
Recipients treated with Mycophenolate Mofetil
Mohammed A Waduud (Foundation Year 1 Doctor, MBChB BMedSci (Hons)), Margaret McMillan (Consultant Nephrologist, NHS Greater Glasgow and Clyde) & Professor Alan Jardine (Professor of Renal Medicine & Head of Medicine, University of Glasgow)
Abstract:
Objective
Cytomegalovirus (CMV) is a viral infection commonly affecting renal transplant recipients.
Current guidelines recommend the prophylactic treatment of patients at risk from CMV with
oral Valganciclovir (VGC), however, myelotoxic side effects have been reported. The severity
of leucopenia is reported to be increased when used in conjunction with Mycophenolate
Mofetil (MMF), although some studies have shown conflicting evidence.
Method
Retrospective analysis of patient clinical data, post‐renal‐transplant, was performed.
Patients included were treated with; MMF and VGC [MMF(+)VGC(+)], MMF but not VGC
[MMF(+)VGC(‐)], no MMF but with VGC [MMF(‐)VGC(+)] and, neither MMF or VGC [MMF(‐
)VGC(‐)]. Blood results and other relevant data were collected from clinical databases.
Results
In total, data from 61 patients were analysed. 13 patients were MMF(+)VGC(+), 48 patients
were MMF(+)VGC(‐), 5 patients were MMF(‐)VGC(+) and 12 patients were MMF(‐)VGC(‐). Of
these, 6 MMF(+)VGC(+) patients and 3 MMF(+)VGC(‐) patients were leucopenic within the
first 3 months post‐renal‐transplant (p=0.001). This difference was not apparent in patients
that were not treated with a MMF regime.
Conclusion
Patients treated with MMF and VGC are at a significantly higher risk of leucopenia when
compared to patients not treated with MMF and VGC in the first 3 months post‐renal‐
transplant.
Cite this article as:
Waduud MA, McMillan M & Jardine A (2014). Valganciclovir‐Induced Leucopenia in Renal Transplant
Recipients treated with Mycophenolate Mofetil. Scottish Universities Medical Journal. 3 (2). p. 17-21
Renal Function After Unilateral Nephrectomy
Stephen KD Hamilton (5th year MBChB, University of Edinburgh), Grant D Stewart (Consultant Urologist, NHS Lothian), Alan McNeill (Consultant Urologist, NHS Lothian), Antony CP Riddick (Consultant Urologist, NHS Lothian) and Richard Phelps (Consultant Nephrologist, NHS Lothian)
Abstract:
BACKGROUND: It is clear that Chronic Kidney Disease (GFR <60mls/min) is associated with
reduced life expectancy, partly due to an increased risk of cardiovascular disease. To
consider the implications for the selection of total versus partial unilateral nephrectomy, we
compared retrospectively the renal function of patients undergoing either operation in
Lothian.
METHODS: Details were collated across NHS Lothian for 1165 patients. Blood results pre‐
and post‐nephrectomy could be retrieved for 334 patients (Group 1). Blood results were also
available from at least 6 months post surgery for 194 patients (Group 2). Renal function was
estimated using the Abbreviated Modification of Diet in Renal Disease formula.
RESULTS: Overall within group 1, total/partial nephrectomy patients’ GFR fell by
14.35ml/min/1.73m2, (95%CI 11.98‐16.72) with post‐nephrectomy GFR <60mls/min in
34.1%. Within group 2, patients’ GFR fell by a mean of 14.09ml/min/1.73m2, (95%CI 10.93‐
17.24) with new GFR <60mls/min in 36.1%. Comparing partial versus total nephrectomy, the
mean reduction in GFR and occurrence of post‐nephrectomy GFR <60mls/min was
8.13ml/min/1.73m2, 16.7% and 14.73ml/min/1.73m2, 35.4% respectively in group 1. The
odds ratio for post‐nephrectomy GFR <60mls/min was 2.7 (95%CI 1.4‐5.3). Group 2 included
too few partial nephrectomy patients for comparison.
CONCLUSION: Smaller reductions of GFR after partial versus total unilateral nephrectomy
are of magnitudes that are significant for overall life expectancy in large cohorts, and
possibly relevant for patients with indications for nephrectomy and longer life expectancy.
Patients who undergo nephrectomy should have their renal function assessed at least 6
months post‐surgery to detect new GFR <60mls/min and trigger appropriate evaluation.
Cite this article as:
Hamilton SKD, Stewart GD, McNeill A, Riddick ACP & Phelps R (2014). Renal Function After Unilateral Nephrectomy. Scottish Universities Medical Journal. 3 (2). p. 22-31