فهرست مطالب

Kidney Diseases - Volume:11 Issue: 6, Nov 2017

Iranian Journal of Kidney Diseases
Volume:11 Issue: 6, Nov 2017

  • تاریخ انتشار: 1396/09/18
  • تعداد عناوین: 15
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  • Arash Shadman, Bahar Bastani Pages 395-407
    Introduction. The recent change in the view towards nephrolithiasis from a benign isolated disease to a disorder associated with numerous systemic and chronic conditions has added to the importance of a more thorough and timely diagnostic and therapeutic intervention.
    Materials and Methods. Both original and review articles found via the PubMed search on recent evaluation and management strategies of urinary calculi were reviewed. These resources were integrated with the author's knowledge of the field.
    Results. The emerging evidence attests to the association of nephrolithiasis with many morbid and fatal diseases, such as coronary heart disease, ischemic stroke, hypertension, chronic kidney insufficiency, malignancies, and bone loss, as well as the economic burden of urinary calculus on health system and work force.
    Conclusions. Findings of this review justify a timely and comprehensive workup and dietary-therapeutic measures in order to prevent, treat, and control the associated complications of this condition.
    Keywords: nephrolithiasis, urinary calculus, diagnosis, treatment
  • Shokoufeh Savaj, Maryam Farasatinasab, Atefeh Amouzegar Page 408
  • Davut Akin, Sehmus Ozmen, Mehmet Emin Yilmaz Pages 409-413
    Introduction. It may be difficult to differentiate acute kidney injury from chronic kidney disease in patients with no past medical reports of kidney function. This study aimed to investigate the role of serum hyaluronic acid (HA), which is known as a marker of fibrosis, in differential diagnosis of kidney failure.
    Materials and Methods. A total of 90 patients (52 women and 38 mne) admitted to our renal unit with uremia for the first time were included. Serum HA level was measured. The diagnostic role of the test was investigated using the receiver operator curve curves.
    Results. The mean age of the patients was 54.6 ±17.9 years. The diagnosis was chronic kidney disease (CKD) in 41.1%, acute kidney injury (AKI) in 48.9%, AKI on CKD in 6.7% (3 died without a diagnosis). The mean serum HA was significantly higher in the CKD group (146.1 ± 119.3 ng/mL) than the AKI group (68.9 ± 69.1 ng/mL; P Conclusions. Serum HA level may be used as tool to differentiate AKI from CKD. Further larger studies are warranted to clarify the definite the role of this marker.
    Keywords: hyaluronic acid, chronic kidney disease, acute kidney injury
  • Dina Abdel Razek Midan, Nesreen Gamal Elhelbawy, Mona Salah El-Din Habib, Iman Aly Ahmedy, Rasha Ibrahim Noreldin Pages 414-421
    Introduction. Idiopathic nephrotic syndrome (INS) is a glomerular disease with completely unclear pathogenesis and different responses to steroid therapy. This study aimed to investigate the role of cytokine genes promoter polymorphisms in steroid therapy responses.
    Materials and Methods. One hundred children with INS and 30 healthy controls were studied. Genotyping of TNF-α-G308A single nucleotide polymorphism was done using polymerase chain reaction-restriction fragment length polymorphism method, while of IL-6-G174C single nucleotide polymorphism was done using real-time polymerase chain reaction.
    Results. The IL-6-G174C exhibited a significantly different genotype distribution among the children with INS compared with the controls (GG versus CC, P = .02; GG versus GC, P = .003; odds ratio [OR], 5.83; 95% confidence interval [CI], 1.64 to 20.70; as well as alleles distribution of G versus C, P ? .001; OR, 7.57; 95% CI, 2.28 to 25.17). With regard to TNF-α-G308A genotype, there was no significant difference in genotype distribution of the children with INS compared with the controls, but a significant difference was observed at the alleles level. Comparing the steroid-resistant group with the steroid-sensitive group, significant association was found at genotypic level in case of IL-6-G174C (GG versus CC, P = .03; OR, 5.52; 95% CI, 1.39 to 21.89), but no association was found regarding GG versus GC. At the allelic level of IL-6-G174C, there was no significant association either.
    Conclusions. IL-6-G174C and TNFα-G308A polymorphisms may affect susceptibility to idiopathic nephrotic syndrome and might affect steroid response in INS patients.
    Keywords: idiopathic nephrotic syndrome, interleukin-6, tumor necrosis factor-α, gene polymorphism
  • Abbas Alimoradian, Saeed Changizi-Ashtiyani, Atefeh Ghiasabadi Farahani, Leila Kheder, Razie Rajabi, Akram Sharifi Pages 422-429
    Introduction. Nephrotoxicity is an important side effects of captopril and gentamicin. This study investigated the prophylactic and protective effects of pomegranate juice (PJ) on the kidney exposed to nephrotoxicity induced by these medications.
    Materials and Methods. Wistar male rats received drinking water (groups 1 to 3) or PJ at doses of 4 mL/kg (group 4), 10 mL/kg (groups 5 and 7), and 15 mL/kg (group 6) for 14 days. Captopril and gentamicin were administrated on days 10 and 14 to groups 1 and 2, respectively, while groups 3 to 6 received both. Group 7 did not receive anything. The serum, urine, and renal tissue parameters were measured after the experiment.
    Results. Group 1 (captopril) had a higher malondialdehyde level than groups 4, 5, 6, and 7 with PJ (P Conclusions. The prophylactic consumption of PJ for 14 days could show nephroprotective effects by reducing oxidative stress and potassium depletion. It could also lead to the stabilization of kidney function during this period despite using captopril and gentamicin.
    Keywords: pomegranate, captopril, gentamicin, nephrotoxicity
  • Yueqiang Wen, Huiyuan Li, Peilan Zhou, Lingling Liu, Zebin Wang, Jianbo Liang Pages 430-437
    Introduction. Calcineurin-binding protein 1 (Cabin1) interacts with calcineurin and p53, but its function in renal tubular epithelial cell (RTEC) is unclear. We established 5/6 nephrectomized rats and angiotensin II-induced injury to the RTECs in vitro, to observe the expression of Cabin1 during RTEC injury.
    Materials and Methods. Sprague-Dawley rats were sacrificed at 4 and 8 weeks after 5/6 nephrectomy. Renal pathology and mitochondrial damage were detected by light and electrical microscope. The distribution of E-cadherin and α-smad were detected by indirect immunofluorescence staining. Cabin1 protein expression was detected by Western blot.
    Results. Obvious tubulointerstitial fibrosis was found in the nephrectomized rats at 8 weeks after 5/6 nephrectomy, accompanied by the increasing levels of creatinine, as well as the disruption of E-cadherin and overexpression of α-smad in RTECs. Moreover, the mitochondria became swollen and mitochondrial cristae were disrupted and poorly defined in the RTECs. Compared to the sham-operated rats, Cabin1 protein expression was significantly increased at 8 weeks after 5/6 nephrectomy, while angiotensin II-induced Cabin1 protein expression significantly increased 48 hours after stimulation in normal rat kidney epithelial cells.
    Conclusions. Injury to the RTEC and Cabin1 protein overexpression occurred in a time-dependent manner both in vitro and in vivo. Cabin1 may become a potential molecular target in RTEC injury.
    Keywords: Cabin1, renal tubular epithelial cell, mitochondrial dysfunction, angiotensin II, p53
  • Mohsen Taghizadeh, Alireza Soleimani, Fereshteh Bahmani, Alireza Moravveji, Amir Asadi, Elahe Amirani, Narjes Farzin, Nasrin Sharifi, Afshin Naseri, Majid Dastorani, Zatollah Asemi Pages 438-446
    Introduction. This study aimed to evaluate the effects of mulberry extract administration on markers of insulin metabolism, lipid concentrations, and biomarkers of inflammation and oxidative stress in patients with diabetic nephropathy (DN).
    Materials and Methods. Sixty patients were randomly allocated into 2 groups to receive either 300 mg/d of mulberry extract (n = 30) or placebo (n = 30), twice per day for 12 weeks. Fasting blood samples were taken at the onset of the study and 12 weeks after supplementation to examine markers of insulin metabolism, lipid concentrations, and biomarkers of inflammation and oxidative stress.
    Results. Mulberry extract, compared to placebo, resulted in significant reductions in serum triglycerides (-37.3 ± 64.7 mg/dL versus .0 ± 78.8 mg/dL, P = .03) and very low-density lipoprotein cholesterol (-7.4 ± 12.9 mg/dL versus .6 ± 15.8 mg/dL, P = .03), and a significant increase in high-density lipoprotein cholesterol concentration (.5 ± 4.0 mg/dL versus -2.0 ± 5.0 mg/dL, P = .03). Other significant changes were in serum high-sensitivity C-reaction protein (-2.3 ± 4.5 µg/mL versus -0.1 ± 2.2 µg/mL, P = .02), plasma glutathione (.8 ± 159.7 µmol/L versus -24.2 ± 138.8 µmol/L, P = .005) and malondialdehyde (-0.03 ± 0.5 µmol/L versus .7 ± 1.0 µmol/L, P Conclusions. These findings showed that mulberry extract administration had favorable effects on serum lipids, HSCRP, glutathione, and malondialdehyde levels in DN patients; however, it did not affect markers of insulin metabolism or biomarkers of inflammation and oxidative stress.
    Keywords: mulberry extract, diabetic nephropathy, metabolic status
  • Atefeh Ordooei Javan, Jamshid Salamzadeh, Shervin Shokouhi, Zahra Sahraei Pages 447-455
    Introduction. Nephrotoxicity has been a concern with new dosing regimens of colistin. This study was designed to compare nephrotoxicity of high dose and conventional dose of colistin and the ability of detecting it using neutrophil gelatinase-associated lipocalin (NGAL).
    Materials and Methods. A randomized clinical trial was carried out on 40 patients with multidrug-resistant gram-negative infections assigned into 2 groups to receive high and conventional doses of colistin. Blood samples were taken 4 times for measuring serum NGAL. The incidence of acute kidney injury was also evaluated based on the risk, injury, failure, loss, end-stage renal disease (RIFLE) criteria.
    Results. Baseline levels of NGAL were not significantly different between the patients on the high dose and conventional dose of colistin. The mean NGAL levels on day 10 were 762.14 ± 415.44 pg/mL and 623.67 ± 272.61 pg/mL, respectively. However, between-group analysis did not show a significant difference in the NGAL levels. The prevalence of acute kidney injury was 60% and 15% based on the RIFLE criteria, in the high-dose and conventional-dose groups, respectively (P = .003).
    Conclusions. Although colistin-induced nephrotoxicity was not confirmed with NGAL levels, our findings, however, showed a higher incidence of acute kidney injury associated with high-dose colistin, defined by the RIFLE criteria. Higher levels of NGAL in the acute kidney injury patients were associated with high-dose regimen of colistin.
    Keywords: colistin, neutrophil gelatinase-associated lipocalin, nephrotoxicity
  • Aboalfazl Nazarian, Meisam Hasankhani, Monireh Aghajany-Nasab, Ali Monfared Pages 454-460
    Introduction. Some genetic variations of Klotho have been reported as a risk factor for calcification and hyperphosphatemia in chronic kidney disease. Klotho polymorphism is also associated with outcome in patients receiving hemodialysis. This study aimed to evaluate the relationship between Klotho single nucleotide polymorphism (SNP) and bone metabolism as an early prognostic measure for chronic kidney disease.
    Materials and Methods. Sixty patients receiving hemodialysis and 60 age-matched controls were enrolled in the study of the assessment of 2 types of Klotho polymorphism (G395A and C1818T). Serum biochemical parameters, including calcium, phosphate, urea, creatinine, parathyroid hormone, and 25-hydroxyvitamin D3 were measured.
    Results. The frequency of being A carriers suggested marginal significances between the groups (GA and AA, 30% versus GG, 18.3%, P = .06), but such significant results were not found for the T allele carriers (CT and TT, 76.6% versus CC, 76.6%, P > .99). Homozygote and heterozygote individuals for the A allele at G395A SNP (A allele carriers) were more likely to be on hemodialysis (odds ratio, 1.43; 95% confidence interval, 0.60 to 3.30), but this association was not true for T allele carriers of C1818T SNP. Parathyroid hormone and serum calcium, phosphate, creatinine, and urea showed prominently higher levels in the patients receiving hemodialysis compared with control individuals.
    Conclusions. The A allele of the G395A polymorphism of Klotho, which emerges the higher levels of phosphate, may be associated with the risk of mortality in Iranian patients receiving hemodialysis.
    Keywords: bone metabolism, chronic kidney disease, hemodialysis, Klotho single nucleotide polymorphisms
  • Zuzana Ž, Ilinsk, Aacute, Ivana Dedinsk, Aacutej., Aacute, N. Breza, Ludov, Iacute, T. Laca Pages 461-466
    Introduction. The Kidney Disease: Improving Global Outcomes Clinical Practice Guidelines on the management of bone disease in patients with chronic kidney disease recommend periodic measurement of serum calcium, phosphorus, vitamin D, and parathyroid hormone levels after kidney transplantation, with the frequencies that will vary according to the severity of bone disease and graft function. Paricalcitol, a selective vitamin D receptor activator, is indicated in the prevention and treatment of secondary hyperparathyroidism.
    Material and Methods. We retrospectively evaluated the effect of treatment with paricalcitol among our kidney transplant recipients. We monitored the effect of paricalcitol on bone density; the plasma levels of parathyroid hormone, calcium, and phosphorus; and proteinuria and calciuria. Comparisons were made between these parameters before treatment and 12 months after treatment.
    Results. Eighty-eight kidney transplant recipients with a mean age at the time of transplantation of 47.1 ± 10.5 years were receiving paricalcitol. On average, paricalcitol was included into the treatment for 48 months from transplantation (median, 27 months). The patients had significantly improved bone density (P Conclusions. Paricalcitol is an effective therapy for secondary hyperparathyroidism in kidney transplant recipients.
    Keywords: secondary hyperparathyroidism, kidney transplantation, bone density
  • Alireza Mirzaei, Yousef Ataeipoor, Mojgan Asgari, Mozhdeh Zabihiyeganeh Pages 467-468
    Presentation of rheumatoid arthritis (RA) with renal complications is very rare without articular symptoms. We here report a case of a 23-year-old woman, presenting with the edema of the extremities, no relevant previous medical history, and the features of acute tubular injury in her percutaneous kidney biopsy. Following the incidental notification of a positive rheumatoid factor test, other immunologic tests including anticyclic citrullinated peptide and antimutated citrullinated vimentin were performed, the positive results of which favored the diagnosis of RA. Administration of rituximab led to the complete remission of the disease. Six weeks later, along with steroid dose reduction, the symptoms of arthralgia was observed, which was managed with methotrexate. Nephrotic syndrome could be rarely the first manifestation of RA, and screening of specific RA autoantibodies might be considered as part of diagnostic evaluations in nephrotic syndrome workup.
    Keywords: rheumatoid arthritis, nephrotic syndrome, rituximab
  • Maryam Ghazizadeh, Matin Ghazizadeh, Mohsen Nafar Pages 469-471
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