فهرست مطالب

Kidney Diseases - Volume:11 Issue: 1, Jan 2017

Iranian Journal of Kidney Diseases
Volume:11 Issue: 1, Jan 2017

  • تاریخ انتشار: 1395/11/21
  • تعداد عناوین: 12
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  • Morteza Arab, Zozani, Mitra Mahdavi, Mazdeh, Edris Hasanpoor, Djavad Ghoddoosi Nejad, Mobin Sokhanvar, Edris Kakemam Pages 1-11
    Introduction. The aim of this systematic review and meta-analysis was to evaluate the efficacy-related events and adverse events of 2 different doses of everolimus in kidney transplant recipients.
    Materials and Methods. The Cochrane, PubMed, and Google Scholar databases were searched for randomized controlled trials published by the end of 2015 on the use of everolimus in kidney transplant recipients at doses of 1.5 mg/d and 3 mg/d. Two independent reviewers assessed the studies for quality and eligibility and extracted the data. The relative risk (RR) and 95% confidence interval (CI) for treated efficacy-related events and adverse events were collected to calculate pooled measures.
    Results. A total of 8 articles describing 7 randomized controlled trials (n = 2148 participants) were included in this study. The overall RR in adverse event outcomes was significantly in favor of the lower dose of everolimus (RR, 0.96; 0.95% CI, 0.93 to 0.99; P Conclusions. The result of this systematic review and meta-analysis showed that the overall outcomes of adverse events and graft loss were better with everolimus, 1.5 mg/d, than with everolimus, 3 mg/d, when combined with other kidney transplantation medications.
    Keywords: everolimus, adverse events, efficacy, related events, kidney transplantation
  • Shan Lu, Dong Liu, Jing Xiao, Genyang Cheng, Xiaoxue Zhang, Zhangsuo Liu, Zhanzheng Zhao Pages 12-17
    Introduction.Henoch-Schönlein purpura nephritis (HSPN) mainly affects children and is less common in adults, but its associated pathological changes are severe in adults, in whom it results in a poor prognosis. This study aimed to analyze the clinical and pathological characteristics of HSPN in adults and to identify the correlations among them.
    Materials and Methods. Clinical and pathological data from139 patients older than 18 years of age who had been diagnosed with HSPN and had received renal biopsy at our center from January 2012 to November 2014 were collected and were grouped according to the different conditions and analyzed retrospectively.
    Results. The 139 HSPN patients included 74 men and 65 women, with an average age of 39.17 ± 15.87 years. The pathological grade was IIIa in most of the patients, and moderate proteinuria was the most common clinical type. Kidney failure and 24-hour total urinary protein, serum uric acid, cystatin C, and β2-microglobulin levels were positively correlated with the pathological grade and activity (P Conclusions. The clinical characteristics of the adult HSPN patients were correlated with the severity of the renal pathology. It is feasible to predict renal pathological changes according to the clinical manifestations of adult HSPN patients.
    Keywords: clinical manifestations, HenochSchönlein purpura nephritis, pathological features, renal biopsy
  • Orhan Tezcan, Ahmet Caliskan, Sinan Demirtas, Celal Yavuz, Mahir Kuyumcu, Yusuf Nergiz, Abdulmenap Guzel, Oguz Karahan, Seyhmus Ari, Sevda Soker, Ibrahim Yalinkilic, Kenan Ahmet Turkdogan Pages 18-22
    Introduction. Hyperbaric oxygen (HBO) treatment is steadily increasing as a therapeutic modality for various types of diseases. Although good clinical outcomes were reported with HBO treatment for various diseases, the multisystemic effects of this modality are still unclear. This study aimed to investigate the renal effects of HBO experimentally.
    Materials and Methods. Fourteen New Zealand White rabbits were divided into 2 groups randomly as the control group and the study group. The study group received HBO treatment for 28 days (100% oxygen at 2.5 atmospheres for 90 minutes daily) and the control group was used to obtain normal renal tissue of the animal genus. After the intervention period, venous blood samples were obtained, and renal tissue samples were harvested for comparisons.
    Results. Normal histological morphology was determined with Masson trichrome staining and periodic acid-Schiff staining in the control group. Atrophic glomerular structures, vacuolated tubule cells, and degeneration were detected in the renal samples of the study group with Masson trichrome staining. Additionally, flattening was observed on the brush borders of the proximal tubules, and tubular dilatation was visualized with periodic acid-Schiff staining. The histopathologic disruption of renal morphology was verified with detection of significantly elevated kidney function laboratory biomarkers in the study group.
    Conclusions. Our findings suggests that HBO has adverse effects on renal glomerulus and proximal tubules. However, the functional effects of this alteration should be investigated with further studies.
    Keywords: hyperbaric oxygen, renal system, histopathology
  • Ibrahim Silfeler, Harun Alp, Bayram Ali Dorum, Emel Nacar, Selda Arslan, Veli Uygur Pages 23-28
    Introduction. Paraquat is a commonly used highly toxic herbicide. Despite many studies on detoxification of paraquat, an efficient and safe antidote has not been introduced for toxic cases in human being. The aim of this study was to investigate the effect of ellagic acid (EA) on paraquat-induced kidney hazards in rats.
    Materials and Methods. Sixty rats were randomly assigned as controls and 5 treatment groups (n = 10 each) receiving EA only, paraquat at doses of 15 mg/kg and 45 mg/kg, and paraquat at the same doses plus EA. Paraquat was intraperitoneally injected and the EA was orally given. Kidney tissues were stained with hematoxylin-eosin for histopathologic investigation.
    Results. Pathologic scoring showed that paraquat at the higher dose was associated with higher scores than the in the controls, EA group, and the high-dose paraquat group with EA treatment (P Conclusions. This study showed the protective effects of EA against paraquat-induced nephrotoxicity histologically. Ellagic acid provided significant improvement in glomerular and tubular structure.
    Keywords: ellagic acid, intoxication, kidney, paraquat
  • Raziyeh Aghakhani, Mahboobeh Nasiri, Dariush Irani Pages 29-35
    Introduction. Nephrolithiasis is a common multifactorial kidney disease with worldwide distribution. Compelling evidence, regarding the function of kidney in maintaining the body homeostasis, suggests the role of oxidative stress in the pathogenesis of nephrolithiasis. Glutathione peroxidase 1 is a major antioxidant enzyme, preventing oxidative damage to renal cells by detoxifying hydrogen and lipid peroxides, which may involve in its pathogenesis. The purpose of the present study was to determine the possible association of glutathione peroxidase 1 gene (GPX1) proline-to-leucine substitution at amino acid 198 (Pro198Leu polymorphism) with the risk of developing nephrolithiasis in south Iranian patients.
    Materials and Methods. Association of Pro198Leu polymorphism in exon 2 of GPX1 gene was investigated in 150 patients with nephrolithiasis and 184 healthy age-, sex-, and ethnically-matched control group using polymerase chain reaction-restriction fragment length polymorphism.
    Results. Regression analysis demonstrated that the frequency of the genotypes carrying at least 1 Leu allele, in both dominant and codominant model for this allele, was significantly higher in patients compared with the controls. However, significant association was found neither with wild-type allele, nor with polymorphic allele with the risk of nephrolithiasis.
    Conclusions. Findings of our study provide potential support in favor of the role of oxidative stress in the pathogenesis of nephrolithiasis in patients from south of Iran. The results indicate that GPX1 may be a key player in nephrolithiasis development.
    Keywords: glutathione peroxidase 1, polymorphism, oxidative stress, nephrolithiasis
  • Behnood Abbasi, Reza Ghiasvand, Maryam Mirlohi Pages 36-43
    Introduction. Even with the ultimate medical management, more than one-third of diabetic patients develop diabetic nephropathy. To our knowledge, there is no study that has examined the effect of probiotic soy milk on kidney function in type 2 diabetic patients with nephropathy. This clinical trial aimed to assess the effects of consumption of probiotic soy milk, compared with conventional soy milk, on kidney-related indexes in patients with diabetic nephropathy.
    Materials and Methods. In a randomized double-blinded placebo-controlled trial, 44 patients were randomly assigned to receive 200 mL/d of either soy milk containing Lactobacillus plantarum A7 or conventional soy milk for 8 weeks. Primary endpoints included urinary albumin excretion, estimated glomerular filtration rate, interlukin-18, serum sialic acid, and serum creatinine. Fasting blood samples and morning fasting spot urine samples were collected at the beginning and after 8 weeks for evaluation of biochemical parameters.
    Results. Forty patients completed the study. Administration of probiotic soymilk resulted in a significant reduction in albuminuria (P = .03), serum creatinine (P Conclusions. Probiotic soy milk was safe and well-tolerated by patients with diabetic nephropathy for 8 weeks. Probiotic soy milk also improved indexes of kidney function in type 2 diabetic patients with nephropathy.
    Keywords: diabetic nephropathy, probiotics, glomerular filtration rate, soy milk
  • Kyubok Jin, Nosratola D. Vaziri Pages 44-49
    Introduction. Cyclophillin A has emerged as a novel mediator of oxidative stress and inflammation and a major player in cardiovascular disease, diabetes mellitus, viral infections, and neurodegenerative and thrombotic disorders. Cyclophillin A is released by certain cell types spontaneously or in response to inflammatory mediators, hypoxia, oxidative stress, and hyperglycemia. Many of these conditions are either present or frequently occur in patients with end-stage renal disease and can stimulate release of cyclophillin A, thereby amplifying systemic inflammation. To our knowledge, the effect of end-stage renal disease and dialysis modalities on circulating cyclophillin A has not been previously investigated. This study tested the hypothesis that extracellular cyclophillin A is elevated in patients maintained on hemodialysis and peritoneal dialysis.
    Materials and Methods. Cyclophillin A, high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-α, and lipid levels were measured in the fasting plasma samples from 20 hemodialysis and 20 peritoneal dialysis patients, and 20 age- and sex-matched controls.
    Results. Plasma cyclophillin A concentration in the patients on hemodialysis (105.3 ± 6.2 ng/mL) and peritoneal dialysis (106.8 ± 9.0 ng/mL) were significantly higher than that in the control group (29.7 ± 4.1 ng/mL). This was associated with significant elevation of high-sensitivity C-reactive protein, interleukin-6, and tumor necrosis factor-α. Plasma cyclophillin A concentration showed direct correlations with high-sensitivity C-reactive protein, interleukin-6, and tumor necrosis factor-α, and an inverse correlation with high-density lipoprotein cholesterol concentration.
    Conclusions. Plasma cyclophillin A concentration is markedly elevated and positively correlates with the markers of systemic inflammation in hemodialysis and peritoneal dialysis patients.
    Keywords: cyclophillin A, atherosclerosis, hemodialysis, peritoneal dialysis, chronic kidney disease, inflammation, diabetes mellitus, oxidative stress
  • Mehdi Mahmudpour, Jamshid Roozbeh, Ghanbar Ali Raiss Jalali, Maryam Pakfetrat, Shahrokh Ezzat Zadegan, Mohammad Mehdi Sagheb Pages 50-55
    Introduction. Uremic pruritus is one of the most common disabling symptoms in patients with end-stage renal disease. We aimed to study the effect of montelukast sodium for the treatment of uremic pruritus lasting more than 3 months in patients undergoing hemodialysis and compare it with placebo.
    Methods and Materials. Eighty patients undergoing hemodialysis at 3 centers in Shiraz, Iran, were recruited to a randomized double-blinded controlled trial to receive 10 mg of montelukast or placebo, daily for 30 days. To assess the severity of pruritus, a visual analogue scale and the Detailed Pruritus Score, based on a combined score of severity and distribution of pruritus and sleep disturbance, were used. Sleep disturbance, severity, and distribution scores were added up to calculate the patient's final score at the start and the end of the study.
    Results. The mean reduction of visual analogue scale score was significantly greater in the montelukast group (2.73 ± 2.03) compared to that in the placebo group (5.47 ± 2.37, P Conclusions. Montelukast can be an add-on therapy in uremic pruritus, especially when pruritus is refractive to other treatments.
    Keywords: pruritus, uremia, hemodialysis, montelukast
  • Mohsen Nafar, Shiva Samavat, Alireza Khoshdel, Behrang Alipour Abedi Pages 56-65
    Introduction. Both anemia and high doses of erythropoietin have been associated with increased mortality among dialysis patients. This study was conducted to evaluate the effective dose of erythropoiesis-stimulating agents.
    Materials and Methods. This multicenter nationwide cross-sectional study assessed adult patients on hemodialysis for at least 3 months from 80 hemodialysis centers in Iran. Demographic data, erythropoietin dose, and laboratory data were collected.
    Results. A total of 7009 prevalent hemodialysis patients were enrolled. Fifty-five percent of the patients had their hemoglobin levels within the target values. In those with a hemoglobin level of 8 g/dL to 10 g/dL, an erythropoietin dose of 10000 IU/wk to 12000 IU/wk led to a significant increase in hemoglobin level. A mean erythropoietin dose of 7700 IU/wk was effective in maintaining the target hemoglobin of 10 g/dL to 12 g/dL during a 3-month follow-up period. Improvement in hemoglobin level was associated with male sex, diabetes mellitus, and hemodialysis adequacy, and its deterioration with lower parathyroid hormone, calcium-phosphorus product, and creatinine levels; malnutrition; transfusion; and angiotensin-converting enzyme inhibitors and angiotensin receptor blockers (R2 = 29.1%, P Conclusions. Data suggested that an estimated erythropoietin dose of 66.5 IU/kg/wk for each 1 g/dL hemoglobin level below the target could be used as a guide for prescription. A dosage of about 8000 IU/wk could help maintaining hemoglobin within the target. A longitudinal study is needed to estimate the required erythropoietin dose.
    Keywords: anemia, erythropoietin, end, stage renal disease, hemodialysis, hemoglobin
  • Mojgan Jalalzadeh, Mohammad Hassan Ghadiani Pages 66-69
    Treatment of snakebite complications is challenging, as it is difficult to distinguish what kind of antivenins should be used. Kidney failure as a result of rhabdomyolysis or hemolysis may happen due to accumulated fluids that increase the pressure in the abdomen. This case report describes acute kidney failure probably due to intra-abdominal hypertension following an unknown bite.
    Keywords: snakebite, acute kidney injury, abdominal compartment syndrome, intraabdominal pressure
  • Laurynas Rimsevicius, Diana Sukakiene, Giedre Tamulyte, Greta Kirkilaite, Marius Miglinas Pages 70-73
    Psoriasis vulgaris is not frequently seen in patients with renal replacement therapy, especially in patients on peritoneal dialysis. Dialysis also has been reported to improve psoriatic skin lesions with a much higher response rate for peritoneal dialysis than haemodialysis. Conversely, we present a case of a man who developed psoriasis after 16 months of peritoneal dialysis. Discontinuation of icodextrin as a possible factor provoking systemic inflammation had no impact on the course of the disease. In this report, we review the existing studies and counsel caution against optimistic expectations of benefits from dialysis in patients with psoriasis.
    Keywords: peritoneal dialysis, hemodialysis, psoriasis