BACKGROUND: Uremic stomatitis is often unfamiliar to healthcare professionals. This study presents five cases of uremic stomatitis, providing a comprehensive analysis of their demographic distribution, clinicopathological features, and management strategies based on existing literature.
METHODS: Data were collected from centers across Brazil, Argentina, Venezuela, and Mexico. Electronic searches were conducted in five databases supplemented by manual scrutiny and gray literature.
RESULTS: The series consisted of three men and two women with a mean age of 40.2 years. Lesions mostly appeared as white plaques, particularly on the tongue (100%). The median blood urea level was 129 mg/dL. Histopathological analysis revealed epithelial changes, including acanthosis and parakeratosis, with ballooned keratinocytes in the suprabasal region. Oral lesions resolved subsequent to hemodialysis in three cases (75%). Thirty-seven studies comprising 52 cases of uremic stomatitis have been described hitherto. Most patients were male (65.4%) with a mean age of 43.6 years. Clinically, grayish-white plaques (37.3%) and ulcers/ulcerations (28.9%) were common, particularly on the tongue (30.9%). Hemodialysis was performed on 27 individuals. The resolution rate of oral lesions was 53.3%.
CONCLUSIONS: Earlier recognition of uremic stomatitis, possibly associated with long-term uremia, holds the potential to improve outcomes for patients with undiagnosed chronic kidney disease.

Lower urinary tract obstruction (LUTO) is a rare fetal condition associated with significant perinatal morbidity and mortality. Herein, we report a neonatal case of LUTO with anal atresia complicated by anhydramnios and pulmonary hypoplasia. After treatment for severe postnatal respiratory distress, the neonate underwent vesicostomy and colostomy. Postoperatively, respiratory status and renal function improved. This case highlights a unique feature where a large rectovesical fistula channeled fetal urine into the colon, which minimized obstructive damage to the urinary tract and preserved renal morphology. Fetal colonic dilatation and numerous enteroliths indicate urine influx into the intestinal tract. Our case suggests the importance of recognizing such exceptions in complete LUTO to predict postnatal outcomes diagnosed in utero.

UNASSIGNED: Primary type 2 hyperoxaluria is a very rare genetic disorder,1,2 where in the progression to renal failure was assumed to be insidious and not very common.3 PH2 is due to deficient glyoxylate reductase/hydroxypyruvate reductase (GRHPR),1,2 which was thought to have extra-hepatic production also.4 The progression to renal failure in these patient subgroups is well documented in the Literature and the role of SLK (simultaneous liver and kidney transplantation) has not been clearly established.8.
UNASSIGNED: We present a case report of a young girl with PH2, who successfully underwent SLK, with evidence of reduction in the urine oxalate levels post SLK.
UNASSIGNED: PH2, though a rare genetic disease, has a proven potential to progress to chronic renal failure requiring transplantation, renal transplantation alone has not shown any benefit, these patients can be offered SLK as a primary treatment option, to improve the outcomes, this needs further validation with consensus and studies.

Sagliker syndrome (SS) is an extremely rare disorder that manifests in patients with advanced chronic kidney disease (CKD) undergoing programmed hemodialysis as a renal replacement therapy. Treatment of secondary hyperparathyroidism (SHPT) in these patients is still challenging. The main clinical manifestations of SS include craniofacial and fingertip deformities, dental anomalies, gingival hyperplasia, short stature, hearing loss, neurological and psychiatric impairment. The etiology and pathogenesis of SS in patients with SHPT require further clarification. However, mutations in the GNAS1, FGF23, and FGFR3 genes were described in some patients, suggesting a possible role of genetic predisposition to the syndrome. The preferred therapeutic approach for SS is surgery, but the volume of the operation is debated. The main surgical strategies include total, subtotal parathyroidectomy, or total parathyroidectomy with autotransplantation of the parathyroid gland (PG). Unfortunately, parathyroidectomy does not contribute to the regression of significant skeletal deformities. We present a unique clinical case of a patient with classical features of SS, recurrent tertiary hyperparathyroidism (THPT) after total parathyroidectomy due to intrathyroidal parathyroid carcinoma (PC).

UNASSIGNED: To identify the association between the changes in intestinal microflora and renal function in patients with chronic renal failure (CRF).
UNASSIGNED: This retrospective case-control study included 50 patients with CRF (study group), admitted to the Clinical Laboratory Department of Shenzhen People\'s Hospital from March 2021 to May 2022, and 50 healthy individuals (control group). The association between the distribution of intestinal microflora and the glomerular filtration rate (GFR), levels of serum creatinine (SCr), blood urea nitrogen (BUN), and serum cystatin C (CysC) were analyzed.
UNASSIGNED: Intestinal microflora of CRF patients had significantly higher levels of Enterococci compared to the control group (p-Value <0.05), while the levels of Bifidobacterium spp. and Escherichia coli were lower in the study group (p-Value <0.05). GFR was lower, and the levels of BUN, SCr, and CysC were higher in the study group compared to the control group (all p-Value <0.05). GFR, BUN, SCr and CysC levels in the study group negatively correlated with the levels of Bifidobacterium spp. and Lactobacillus spp. (r<0, P<0.05), and positively correlated with the abundance of Enterococcus spp. and Escherichia coli (r>0, P<0.05) in the intestinal microflora.
UNASSIGNED: Changes in intestinal microbiota are associated with a significant decrease in GFR and a marked increase in serum levels of renal function indicators, and alterations in the balance of intestinal microbiota may lead to further aggravation of the renal function damage in patients with CRF.

The capability of the urinary tract to undergo metaplastic changes such as squamous, intestinal, glandular, mucinous, or ciliated epithelium in renal pelvis has been previously reported, which hypothetically is due to the mechanical irritation of the transitional epithelium. However, transitional metaplasia is a rare presentation in the collecting ducts. The aim of this paper was to report this type of extremely rare metaplasia and to inform pathologists that they may encounter this kind of metaplasia. A 25-year-old man, a known case of vesicoureteral reflux (VUR), referred to the Imam Reza Hospital; affiliated to the Mashhad University of Medical Sciences, for bilateral nephrectomy. Gross evaluation of bilateral nephrectomy specimens showed atrophic kidneys and dilated pelvicalyceal systems. The light microscopic evaluation showed transitional metaplasia in the background of chronic pyelonephritis, confirmed by GATA3 nuclear immunohistochemical stain. In this study, we presented a rare case of a renal collecting duct with transitional epithelial lining replacing the normal epithelium as a metaplastic change, with the hypothesis that previous medical history including VUR, or hemodialysis could be the trigger for the metaplastic change, which should be confirmed by further studies.

BACKGROUND: In relation to the different and important roles of the beta2 integrins, we have revisited the expression of polymorphonuclear leukocyte CD18 in several clinical disorders, at baseline and after in vitro activation.
METHODS: we have examined subjects with type 1 diabetes mellitus, vascular atherosclerotic disease, type 2 diabetes mellitus without and with macrovascular complications, chronic renal failure on conservative treatment, essential hypertension, deep venous thrombosis, acute ischemic stroke and subjects with venous leg ulcers.
METHODS: unfractioned leukocyte suspension was prepared according to the Mikita\'s method, while the leukocyte were separated into mononuclear and polymorphonuclear cells with a Ficoll-Hypaque medium. Using specific monoclonal antibody, the CD18 expression was evaluated with cytofluorimetric analysis, using FACScan (Becton Dickinson) be Cellquest software; the activation in vitro with PMA was effected according to modified Yasui and Masuda methods.
RESULTS: in type 1 diabetes mellitus, at baseline CD18 is under expressed in comparison with normal control, and not changes after PMA activation were observed; in subjects with vascular atherosclerotic disease, in type 2 diabetes mellitus CD18 is over expressed at baseline but does not vary after activation; in subjects with chronic renal failure, essential hypertension and in subjects with acute ischemic stroke the CD18 up-regulate at baseline compared to normal control, and it increases further after activation; in subjects with deep venous thrombosis the CD18 expression is not different from control group at baseline, but it increases after activation; finally, in subjects with venous leg ulcers the CD18 is normally expressed at baseline, and it does not change after PMA activation.
CONCLUSIONS: in the different clinical disorders, the trend of this integrin subunit provides some specific information, useful to select the best therapeutic strategy in clinical practice.

Infective endocarditis (IE) caused by methicillin-resistant Staphylococcus aureus (MRSA) is usually life threatening and difficult to treat. Contezolid is a newly approved oxazolidinone antimicrobial agent showing potent activity against MRSA. We successfully treated a case of refractory IE caused by MRSA with contezolid in a 41-year-old male patient. The patient was admitted due to recurrent fever and chills for more than 10 days. He had chronic renal failure for more than 10 years and under ongoing hemodialysis. The diagnosis of IE was confirmed by echocardiography and positive blood culture of MRSA. Antimicrobial therapy with vancomycin combined with moxifloxacin, and daptomycin combined with cefoperazone-sulbactam failed in the first 27 days. Moreover, the patient had to take oral anticoagulant after removal of tricuspid valve vegetation and tricuspid valve replacement. Contezolid 800 mg was added orally every 12 hours, to replace vancomycin, for its anti-MRSA activity and good safety profile. Temperature normalized after the contezolid add-on treatment for 15 days. No relapse of infection or drug-related adverse reaction was reported at 3-month follow-up since the diagnosis of IE. This successful experience serves as motivation for a well-designed clinical trial to confirm the utility of contezolid in managing IE.

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BACKGROUND: Extradural arachnoid cyst (KAED) is a rare and benign condition, accounting for approximately 1 % of all spinal expansive lesions. The pathogenesis of KAED is uncertain and appears to be multifactorial. Spinal compression symptoms are rarely indicative, and KAED is usually discovered incidentally. MRI is the radiological test of choice as it allows for precise characterization of the cyst. Early identification and management of KAED is crucial to prevent complications and ensure timely intervention.
METHODS: A 7-year-old girl with a nomadic lifestyle presented with sphincterian disorders without any other neurological abnormalities. Further investigation, including biological tests, revealed chronic kidney failure. A spinal MRI identified an intra-spinal extradural dorso-lumbar arachnoid cyst extending from D10 to L1, located posteriorly. The cyst was promptly removed with favorable postoperative outcomes. The patient was discharged with a treatment of vitaminocalcic and martial supplementation for his chronic renal insufficiency and a regular follow-up in consultation.
UNASSIGNED: Arachnoid cyst is a rare benign condition that can be discovered incidentally (Agnoli et al., 1982; Chan et al.; 1985). The symptoms are the results of compression exerted by the cyst on the cord and they vary according to the level of compression of the spinal cord or the nerve roots, but the symptomatic form is a situation which remains rarely described (Charisseauj et al., 1992). In this particular case, the cyst was identified due to a series of symptoms related to acute renal insufficiency, which exacerbated pre-existing chronic renal insufficiency. This was further complicating untreated sphincter disorders. This highlights the significance of timely diagnosis and treatment to prevent severe complications that may otherwise develop from a benign condition. With early intervention, favorable outcomes can be achieved in most patients (Kendall et al., 1982).
CONCLUSIONS: With the advancement of neuroimaging and the widespread availability of MRI as the gold standard, extradural arachnoid cysts (KAED) can now be incidentally discovered in asymptomatic patients. Once diagnosed, surgical intervention is typically recommended to prevent irreversible neurological damage. Further research is needed to better understand the pathogenesis of KAED and establish optimal diagnosis and treatment strategies, particularly in pediatric patients, for this rare condition.