Journal of nephropathology
Volume:1 Issue: 1, Apr 2012

Implication for health policy/practice/research/medical education:Nephropathology is a rapidly evolving field which is at the forefront of modern research because of the growing epidemic of kidney disease throughout the world. Kidneys also constitute the most common solid organs for transplantation in patients suffering from end-stage renal disease (ESRD). As a result, renal transplant pathology has similarly emerged as one of the leading domains of the subspecialty of nephropathology.

Implication for health policy/practice/research/medical education:World kidney day on 8 March 2012 provides a chance to reflect on the success of kidney transplantation as a therapy for end-stage renal disease that surpasses dialysis treatments for the quality and quantity of life and for cost effectiveness. The ISN and the Transplantation society have pledged to work together in coordinated joint global outreach programs to help establish and grow appropriate kidney transplant programs in low- and middle-income countries utilizing their considerable joint expertise. World kidney day 2012 provides a focus to help spread this message to governments, all health authorities and communities across the world.

Implication for health policy/practice/research/medical education: Urinary tract infection (UTI) represents the commonest genitourinary diseases particularly in developing countries. Moreover the emergence of multi-drug resistance among the strains causing UTI is a great cause of concern. Furthermore، UTIs are particularly important because their occurrence may be associated with some congenital abnormality of urinary tract which may lead to recurrent infections causing damage to the urinary tract. Thus، prevention is the best strategy for avoiding complications.

Context: Turmeric (Curcuma longa) is a wild plant of the ginger family native to tropical South Asia. Evidence Acquisitions: Directory of Open Access Journals (DOAJ)، Google Scholar، Pubmed (NLM)، LISTA (EBSCO) and Web of Science have been searched. Emerging evidence indicate that turmeric/curcumin inhibits cytokines and TGF-β production. From the various factors involved in the genesis of chronic kidney disease and pathogenesis of primary and secondary glomerulonehritis، TGF-β has emerged as a key factor in the cascade of events. Leading to glomerulosclerosis، tubulointerstitial fibrosis and end-stage renal disease. considering the inhibitory effect of turmeric/curcumin on cytokines and TGF-β، it seems wise to assume that supplementary turmeric/curcumin might be a candidate remedy for chronic kidney disease and possibly prevention of subsequent end stage renal disease.

Context: In the meadow of medical sciences substituting a diseased organ with a healthy one from another individual، dead or alive، to allow a human to stay alive could be consider as the most string event. In this article we review the history of transplantation، mechanisms of rejection، nephro-neurotoxicity of tacrolimus and cyclosporin in organ transplantations. Evidence Acquisitions: Directory of Open Access Journals (DOAJ)، Google Scholar، Pubmed (NLM)، LISTA (EBSCO) and Web of Science have been searched. The first reference to the concept of organ transplantation and replacement for therapeutic purposes appears to be to Hua-To (136 to 208 A. D)، who replaced diseased organs with healthy ones in patients under analgesia induced with a mixture of Indian hemp. In 1936، the first human renal transplant performed by Voronoy in Russia. The first liver transplant in humans was performed on March 1، 1963 by Starzl in Denver، USA. Medawar was the first to assert that rejection was an immunological response، with the inflammatory reaction due to lymphocyte infiltration. Consequently، rational immunosuppressive therapies could inhibit deleterious T-cell responses in an antigen specific manner. Searching related to the history of organ transplantation from mythic to modern times suggests that، to prevent graft rejection، minimize nephro and neuro toxicity monitoring of immunosupressive concentrations could provide an invaluable and essential aid in adjusting dosage to ensure adequate immunosuppression.

There is a limited knowledge about the morphological features of IgA nephropathy (IgAN)in the middle east region. The objective of this study was to evaluate the spectrum of histopathological findings in IgAN patients at our laboratory.Patients and At this work, an observational study reported which was conducted on IgAN patients using the Oxford-MEST classification system. In this survey, of 102 patients 71.6 % were male. The mean age of the patients was 37.7 13.6 years. Morphologic variables of MEST classification was as follows; M1: 90.2 %, E: 32 %, S: 67 % also,T in grads I and II were in 30% and 19% respectively, while 51% were in grade zero. A significant difference was observed in segmental glomerulosclerosis (P=0.003) and interstitial fibrosis/tubular atrophy frequency distribution (P= 0.045), between males and females. Furthermore, it was found that mesangial hypercellularity was more prevalent in yonger patients. Moreover, there was a significant correlation between serum creatinine and crescents (P<0.001). There was also significant correlation of serum creatinine with segmental glomerulosclerosis (P<0.001). Higher prevalence of segmental glomerulosclerosis and interstitial fibrosis/ tubular atrophy, as the two of, four variables of Oxford-MEST classification of IgAN in male patients further attests that male gender is a risk factor in this disease.In this study the significant correlation between serum creatinine and crescent was in an agreement with previous studies and suggests for the probable accomodation of extracapillary proliferation as a new variable in MEST system.

Urinary tract infection (UTI) is the third most common infection in human. New resisted strains of uropathogens have been developed due to different factors such as widespread use of antibiothics. We conducted this study to assess the recent pattern and susceptibility of uropathogens. This descriptive cross-sectional study was carried on 32600 ambulatory patients urine samples from six laboratories from 2008 to 2010 in Ahvaz، Khuzestan. Of those، 3000 positive culture were found. Data including underlying disease، pregnancy، catheterization and drug history were gathered by questionnaire. Susceptibility of pathogens to eight antimicrobial agents was determined. Mean age of patients was 33. 87 3. 80 years and 84. 9% of them were female. The results showed that، E. coli، Kelebsiella and Enterobacter were the most common pathogens (73. 5%، 13. 8% and 6. 6%، respectively). E. coli was susceptible to Ciprofloxacin، Amikacin، and Nitrofurantoin in 76. 9%، 76. 4% and 76. 1% of cases، respectively. Klebsiella was more susceptible to Ciprofloxacin، Ceftizoxim and Amikacin in 81. 1%، 79. 9% and 87. 7% of positive cultures. Enterobacter was most susceptible to Ciprofloxacin (71. 7%)، but completely resistant to Ampicillin unexpectedly. E. coli and other isolates were more sensitive to Gentamicin، Amikacin and Ciprofloxacin compared to the other antibiotics tested and therefore these may be the drugs of choice for the empiric treatment of community-acquired UTI in our region.

Granulomatosis with polyangiitis (Wegener''s) is a systemic necrotizing vasculitis. Cardiac involvement in Wegener''s has rarely been reported. In this study the echocardiographic findings of granulomatosis with polyangiitis (GPA) in a patient is described. The case was a 45 years old man admitted to the hospital with a 3 months history of persistent fever and sinusitis. Mild left and right ventricular enlargements as well as three small masses in the right ventricular cavity were identified in echocardiography. One mass was attached to the tricuspid valve and the other two masses were attached to the right septum. Pulmonary artery hypertension (45mmHg) was also reported. The masses responded dramatically to plasma exchanges in combination with steroid therapy، followed by oral cyclophosphamid and low-dose steroid therapy. In the kidney biopsy، 8 out of 11 golomeruli contained fibrous crescents along with sclerotic lesions. Spleen has 140 mm diameter with multiple echo-free lesions and coarse parenchyma in abdominal ultrasound. Serum C-ANCA=671، P-ANCA=1. 7 (normal= up to 15U/mL). The diagnosis of granulomatosis with polyangiitis (Wegener''s) was established. Presence of three small masses in right ventricular cavity and pulmonary artery hypertension in association with the spleen lesions were an uncommon presentation of GPA. GPA should be considered in the differential diagnosis of any nonspecific illnesses with cardiac involvement.