Nephro-Urology Monthly
Volume:10 Issue: 1, Jan 2018

The insertion of needles in arteriovenous fistula is leading to significant pain in patients undergoing hemodialysis. This study aimed to investigate the effect of pressure at the point of Hugo on pain of needle insertion arteriovenous fistulas in hemodialysis patients.
In this single-group clinical trial, 35 hemodialysis patients in the Besat hospital with convenience sampling was performed. Researcher two minutes before and during insertion of needles in artery fistula area by nurse, acupressure was conducted on the hugo point on other hand. This work was done in 3 sessions. Paired t-test was used to measure pain intensity difference.
There was a significant difference in pain intensity during a routine care and pressure on the Hugo point. The mean pain scores after the Hugo point acupressure was decreased in all 3 phases (P Hugo acupressure points can be used as an effective and low-cost way to reduce the pain of needle insertion in fistulas in patients undergoing hemodialysis.

Although uncontrolled systemic hypertension is associated with poor survival and allograft outcomes in patients after renal transplant, nondipping systolic blood pressure at night is not identified as an independent factor for deterioration of renal function after renal transplant. Therefore, in this study, we aimed to evaluate the prevalence of nocturia and nocturnal polyuria in renal transplant patients.
This cross sectional study included 114 renal transplant patients above 18 years, who were referred to the nephrology clinics of Rasht, Iran in 2016. The patients were asked to collect 24-hour urine samples twice at home, once during the day and once at night. Urine volume, creatinine, sodium, osmolarity, and creatinine clearance of resting and working periods were measured. Monitoring of ambulatory 24-hour blood pressure was performed simultaneously, and findings including the mean arterial pressure (MAP) were evaluated during the day and night. Moreover, dimensions of the transplanted kidney, postvoid residual (PVR) urine, and prostate size were evaluated by ultrasonography.
The analyses showed that 81 (71.1%) patients had nocturia, while 77 (67.5%) patients had nocturnal polyuria. The mean age of the patients with nocturia was significantly higher than that of patients without nocturia (P = 0.003). MAP in patients with nocturnal polyuria was higher than that of patients without nocturnal polyuria. Blood pressure nondipping at night was significantly more common among patients with nocturia and nocturnal polyuria (P Since nondipping blood pressure is associated with more tissue damage and deterioration of renal transplant outcomes, control of hypertension and changes in the time of antihypertensive drug administration (for improving blood pressure dipping at night) may prevent the adverse effects of nondipping blood pressure.

We proposed to investigate the possible effect and association of systemic inflammation (SI) and seminal parameter indicators in chronic hemodialysis patients.
This was a cross-sectional study. All the participants were subjected to a spermiogram with calculation of fertility index (FI), serum C-reactive protein (CRP) level, seminal transferrin (ST) level, as well as evaluation of the hormonal profile (HP). The sample consisting of 60 men (cases) undergoing hemodialysis for more than 6 months was subdivided into 3 groups: group 1 (n = 30, with inflammation, CRP > 5 mg/L), group 2 (n = 30, without inflammation, CRP ≤ 5 mg/L), and group 3 (n = 30, healthy men, CRP ≤ 1).
Age was similar in the 3 groups (P = 0.43). FI, testosterone total and ST levels were significantly lower in the case groups than in the control group (P 0.05). However, it significantly interfered with the FI, HP, and ST level when compared between the case groups and the control group (P 0.05).
The results suggest that the SI alone has no effect and is not associated with the FI or ST level in a patient undergoing chronic hemodialysis.

The aim of this study was to evaluate the management of mineral and bone disorders (MBD) in patients with chronic kidney disease (CKD) in Iran and the extent to which KDIGO goals were met.
This multi-centre observational study was conducted on patients with CKD stages 4, 5, and 5D. Data were collected from a total of 209 patients with no surgical or medical conditions that precluded their participation. This study assessed the frequency of measurements, serum levels of phosphorus (P), calcium (Ca), and parathyroid hormone (PTH), the achievement of the targets recommended by the 2009 KDIGO guidelines, and the presence of vascular/valvular calcification.
The KDIGO targets for P, Ca, and iPTH, were achieved in 47%, 51%, and 18% of the patients with stage 4 5 and in 63%, 50%, and 44% of the patients with stage 5D, respectively. The serum PTH level of 18% of the patients with CKD stage 4 5 was within the recommended range, while it was higher than the recommended level in other patients. Among patients with CKD stage 5D, the serum PTH level was within, below, and above the recommended range in 44%, 39%, and 17% of the patients, respectively. The frequency of the measurement of the blood levels of Ca, P, and PTH were based on the 2009 KDIGO guidelines in 88% of patients. Forty-six percent of cases were screened for vascular/valvular calcification, 30% of whom had calcification at least in one site.
The current status is far from the targets recommended by the current guidelines in the management of CKD-MBD.

Adipsic diabetes insipidus (ADI) is a rare and challenging complication secondary to several neurosurgical procedures. It can lead to severe hyperosmolarity and is associated with high rates of morbidity and mortality. Considering the variable time of thirst sensation recovery, long-term treatment is accompanied with the risk of extreme extracellular osmolality fluctuations. Herein, we report 3 cases of this rare presentation of hypothalamic injury.