This article aims to bring to the fore, issues regarding the interface of psychiatry and renal failure. Depression, anxiety, suicide and delirium are common complications observed in patients with renal failure. Pharmacological management of these problems need stringent monitoring on part of the psychiatrist. This article examines the various complications that may be observed in patients with renal failure while discussing treatment approaches and also emphasizing the need for interdisciplinary team work in improving the quality of life of patients with renal failure and those on dialysis.

The ability of Wormwood ( Artemisia absinthium L.) extract (A.Ab) to restore membrane-bound enzymes like Na⁺-K⁺-ATPase, Ca⁺⁺-ATPase, Mg⁺⁺-ATPase, and oxidative damage induced by lead were investigated. Rats were exposed to lead acetate (750 ppm) for 11-weeks and treated during 4-weeks with A.Ab. Lipid levels, ATPase activity, thiobarbituric acid reactive substances (TBARS), and proteins carbonyl were estimated. In liver and kidney, lead acetate inhibited membrane-bound enzymes and increased ( P < 0.05) the levels of cholesterol, triglycerides, free fatty acids, phospholipids, TBARS, and carbonyl proteins. After 4 weeks, the intoxicated group who received A.Ab showed a significant reduction in TBARS and carbonyl levels in liver and kidney compared to group exposed to lead. A.Ab restored the levels of membrane-bound enzymes and lipid levels to near normal. These results indicate that aqueous Wormwood extract had a significant antioxidant activity and protect liver and kidney from the lead-induced toxicity.

Background: Nephrotic dyslipidemia is a risk factor for the development of systemic atherosclerosis; and may aggravate glomerulosclerosis and enhance progression of glomerular disease. We aimed to assess the efficacy and safety of Monascus purpureus Went rice vs. fluvastatin therapy in the management of nephrotic dyslipidemia. Materials and Methods: Seventy-two patients with persistent idiopathic nephrotic syndrome (NS) with secondary dyslipidemia were included. They were randomly allocated into three age and sex-matched groups. The first group comprised 20 cases and were given M. purpureus Went rice in a dose of 600 mg twice/day for 1 month then once daily, the second group comprised 30 cases were given fluvastatin in a daily dose of 20 mg. The remaining 22 received no antidyslipidemic therapy and constituted a control group. All of these patients were subjected to thorough laboratory investigations including renal function tests and lipogram. Moreover, the neuromuscular status was evaluated with electromyography and nerve conduction velocity. Results: Our results showed that both fluvstatin and M. purpureus Went rice were well tolerated with no evidence of significant side effects including neuromuscular functions. Both of them significantly reduced cholesterol after 6 months and 1 year. Conclusion: Monascus purpureus Went rice is safe, effective, and economic treatment strategy for nephrotic dyslipidemia.

Aims: This study aimed to elucidate the early renal changes in diabetes mellitus (DM) with and without clinical symptoms related to renal damage. Methods: Renal biopsy was studied in 25 patients (14 with microalbuminuria and 11 with albuminuria) both by light and electron microscopies (LM and EM, respectively) for renal changes and morphometry was performed to study glomerular and tubular basement membranes (GBM and TBM, respectively) width using a Soft Imaging System GmBH (analysis 3). Results: A significant increase was noted in the mean GBM and TBM thickness in both the preclinical and clinical groups compared to the control group. The changes in the TBM were noted to be predominant in both preclinical and clinical patients. Conclusions: This study indicates the importance of morphometric evaluation of the GBM and TBM width in the elucidation of early renal damage in diabetic nephropathy, especially in the absence of LM changes. The significance of identification of early renal changes using morphometric techniques for better management of these patients requires further studies.

Nephrogenic fibrosing dermatopathy (NFD) is a systemic disorder of unknown etiology. Recent reports have associated the development of NFD with the use of gadolinium-enhanced magnetic resonance imaging (MRI). Here, we present the case of an adolescent with end-stage renal disease who died of biopsy-proven NFD and also developed cardiac calcification and clinical manifestations of pulmonary fibrosis with pulmonary hypertension. Only five cases of NFD have been reported in children, all of which were prior to the information regarding the consequences of using gadolinium. Here, we report a patient with NFD who received gadolinium while on chronic hemodialysis, 16 months prior to the onset of symptoms. Because he succumbed to this disease, we stress on the importance of eliminating the use of gadolinium-enhanced MRI examinations in children with impaired kidney function until the etiology of NFD is clarified

Kidney disease frequently complicates malignancy and its treatment. The spectrum of renal disease in cancers includes acute kidney injury, chronic kidney disease and tubular disorders. Thrombotic microangiopathy (TMA) is an uncommon initial clinical presentation of malignancies. Renal failure is an extremely rare feature of cancer-associated TMA syndromes in the absence of chemotherapy. Here, we report a patient who presented to the hospital for the first time with TMA and severe renal failure requiring hemodialysis and was diagnosed with gastric adenocarcinoma.

Hepatitis A runs a benign course in children, but may have atypical presentations in adults. Very rarely acute renal failure complicates nonfulminant hepatitis A. We report a patient with nonfulminant acute viral hepatitis A with multiorgan involvement. Patient had biopsy proven acute interstitial nephritis, acute pancreatitis, acute myocarditis and required hemodialysis for 6 weeks.

Cryoglobulinemia is an uncommon cause of renal disease and often occurs in patients with hepatitis C virus (HCV) infection. We report a case of membranoproliferative glomerulonephritis in a patient with cryoglobulinemia, which was not associated with HCV infection or any identifiable etiology.