فهرست مطالب

Iranian Journal of Kidney Diseases
Volume:8 Issue: 4, July 2014

  • تاریخ انتشار: 1393/05/19
  • تعداد عناوین: 20
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  • Monir Sadat Hakemi Pages 261-262
  • Gnanasambandan Ramanathan, Ramprasad Elumalai, Soundararajan Periyasamy, Bhaskar Lakkakula Pages 265-277
    Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited disease of the kidneys and is marked by progressive cyst growth and decline in kidney function, resulting in end-stage renal disease (ESRD). Hypertension is thought to be a significant modifying factor in the progression of renal failure in ADPKD. A number of genetic variations involved in renin-angiotensin-aldosterone system (RAAS) pathway genes have clinical or physiological impacts on pathogenesis of hypertension-induced ESRD in ADPKD. Information on RAAS pathway gene polymorphisms and their association with ESRD and ADPKD, published till March 2013, was collected using MEDLINE search. The present review deals with RAAS gene polymorphisms focused on hypertension-induced ESRD in ADPKD in different populations. The results were inconclusive and limited by heterogeneity in the study designs and the population stratification. In lieu of applying next generation sequencing technologies to study complex diseases, it is also possible to apply the same to unravel the complexity of ESRD in ADPKD.
  • Mohsen Shamsi, Farshid Haghverdi, Saeed Changizi Ashtiyani Pages 278-285
    The present survey aims at studying the opinions of three famous medical scholars in history (Rhazes, Avicinna, and Jorjani) on the diagnosis of diseases via urine examination and their compatiblity with modern science. Refering to original authentic sources in traditional medicine, including Al-Hawi (The Virtuous Life), Zakhireh-i Kharazmshahi (Thesaurus of the Shah of Khwarazm), and Al-Canon fi al Tibb (The Canon on Medicine), we compared the ideas of the authors with modern medicine. In traditional medicine, physicians would pay attention to the methods of urine collection and urinary features such as color, consistency, volume, frequency, odor, and foam as the means of diagnosis, all of which still serve as the bases for today''s diagnostic approach. Moreover, symptoms of the diagnosis of the disease through urine are consistent in tradition and modern medicine; some examples are blood in the urine (hematuria), decreased urine output (oliguria), change in urine color together with headache (Alport syndrome), diluted urine (tubular dysfunction in reabsorption of water or initial polydipsy), and urinary floor with tiny bubbles (one of the main symptoms of proteinuria).
  • Sidy Mohamed Seck, Dominique Doupa, Lamine GuÉye, Issa Ba Pages 286-291
    Chronic kidney disease (CKD) is an emerging worldwide epidemic but few data are available in African populations. This study assessed prevalence of CKD in adults living Saint-Louis, northern Senegal. In a population-based survey between January and May 2012, 1037 adults living in Saint-Louis were assessed. Sociodemographical, clinical, and biological data were collected during household visits. Glomerular filtration rate was estimated using the 4-variable Modification of Diet in Renal Disease equation. Factors associated with CKD were identified by multivariate regression analysis. The mean age of participants was 47.9 ± 16.9 years. The majority of the participants lived in urban areas (55.3%) and had school education (65.6%). The overall prevalence rates of hypertension, diabetes mellitus, and obesity were 39.1%, 12.7%, and 23.4% respectively. Prevalence of CKD was 4.9% (95% confidence interval, 3.5% to 6.2%) and 0.9% had an estimated glomerular filtration rate less than 30 mL/min/1.73 m2. Before the study, 23% of the patients were aware of their disease. In multivariable logistic analysis, presence of CKD was significantly associated with hypertension and age. This study shows that CKD is frequent in adult population of Northern Senegal. A kidney health program is urgently needed to reduce the disease burden in both urban and rural areas.
  • Houshang Najafi, Mohammad Reza Firouzifar, Omid Shafaat, Saeed Changizi Ashtiyani, Nasser Hosseini Pages 292-298
    Introduction
    This study aimed to investigate the protective effect of aerial parts of the Tribulus terrestris L extract on acute kidney injury (AKI) induced by ischemia for 30 minutes and reperfusion for 24 hours in rats.
    Materials And Methods
    Ten male Sprague-Dawley rats in the AKI and 10 in the Tribulus terrestris groups received the extract solvent and extract of the plant (11 mg/kg), respectively, for 13 days (oral administration). On day 14, ischemia for 30 minutes and reperfusion for 24 hours were induced on the rats. In the last 6 hours of the reperfusion period (24 hours), urine samples were collected in metabolic cages. At the end of this period, blood samples were also taken to determine plasma urea nitrogen, creatinine, and electrolyte concentrations. The kidney tissues were collected for measuring the level of oxidative stress and histological studies. They were compared with the sham operation group and a control group with normal diet and no operation.
    Results
    In the Tribulus terrestris group, the increase in plasma creatinine and urea nitrogen concentrations was significantly less following reperfusion, and their values reached the same level as that in the sham group. Creatinine clearance and urine osmolarity in the Tribulus terrestris group was higher in comparison with the AKI group, whereas sodium absolute excretion, fractional excretion of potassium, oxidative stress, and cellular damages were less.
    Conclusions
    Oral administration of Tribulus terrestris extract for 2 weeks can decrease kidney functional disturbance, oxidative stress, and cellular damages following reperfusion injury in rats.
  • Se Jin Park, Eun-Mi Ahn, Tae-Sun Ha, Jae Il Shin Pages 299-309
    Introduction
    The aim of our study was to determine whether β-catenin, a subunit of the cadherin protein complex in the podocyte cytoskeleton, would be altered by hyperglycemia and advanced glycation endproducts (AGE) in glomerular epithelial cells and podocytes in vitro.
    Materials And Methods
    Rat glomerular epithelial cells and mouse podocytes on bovine serum albumin-coated or AGE-coated plates with normal (5 mM) and high (30 mM) glucose doses were cultured and examined for the distribution of β-catenin using confocal microscopy and changes in β-catenin production by western blotting and reverse transcription-polymerase chain reaction, at 48 hours, 4 weeks, and 10 weeks.
    Results
    Immunofluorescent staining revealed that β-catenin and α-actinin were colocalized around the cell membrane, and that β-catenin staining was most intense along the capillary loops, but moved internally toward the inner actin filaments in the presence of AGE and hyperglycemia. In western blot analysis, AGE and hyperglycemia significantly decreased the amount of β-catenin proteins by 31.5% at 48 hours, compared with normal control conditions (P <. 01). The expression for β-catenin mRNA in AGE and hyperglycemia was also decreased by 59.6% at 24 hours, compared with that of normal glucose conditions (P <. 01). No significant changes were seen in the osmotic controls.
    Conclusions
    Our results suggest that AGE and hyperglycemia may induce the cytoplasmic redistribution of β-catenin and inhibit the production of β-catenin at the transcriptional and posttranslational levels, which may result in the development of kidney dysfunction in diabetic conditions.
  • Anthonet Ndidi Ezejiofor, Chinna Nneka Orish, Orish Ebere Orisakwe Pages 310-313
    Introduction
    The nephroprotective effect of the aqueous extract of Costus afer leaves was evaluated in male albino Wistar rats with gentamicin-induced kidney injury.
    Materials And Methods
    In a 2-phase study, 30 weight-matched male Albino Wistar rats were divided into 6 groups of 5 animals to receive gentamicin, 90 mg/kg/d (except for the control group) for 7 days in the first phase to induce kidney injury. The second phase was treatment of rats with 375 mg/kg, 750 mg/kg, and 1125 mg/kg of aqueous extract of Costus afer leaves. One group received Silymarin only. Body weight, daily fluid and feed intakes, and serum levels of creatinine, urea, and electrolytes were monitored on a weekly basis, and renal histology was evaluated at the end of the study.
    Results
    The aqueous extract of Costus afer significantly increased the feed intake and fluid intake in a dose dependent manner when compared with the gentamicin-treated group. Low and medium doses of the extract reversed the deleterious effect of gentamicin on the kidney. The extract also significantly decreased the absolute kidney weight and relative kidney weight when compared with the corresponding weights in the gentamicin-treated group. Costus afer significantly decreased serum sodium, blood urea, and serum creatinine levels and significantly increased serum potassium level in gentamicin-induced nephrotoxic rats.
    Conclusions
    Aqueous extract of Costus afer leaves may attenuate gentamicin-induced nephrotoxicity in rats.
  • Xiaohui Bian, Na Liu, Yu Bai, Liqiang Zheng, Ping He, Xuesong Su, Feng Du, Xu Yang, Detian Li Pages 314-320
    Introduction
    Prior studies evaluating the relationship between leptin and outcomes in chronic kidney disease patients have shown conflicting results. Our aim was to evaluate the association of serum leptin with all-cause and cardiovascular disease (CVD)-related mortality in stable maintenance hemodialysis patients.
    Materials And Methods
    We carried out an observational prospective cohort study of 53 patients on maintenance hemodialysis. The follow-up period was 5 years. Leptin levels were measured at baseline before the start of a hemodialysis session. Proportional hazards models were used to evaluate the relationship between leptin and all-cause and CVD-related mortality.
    Results
    During the follow-up period, 26 patients (49.1%) died. Fifteen of 26 deaths (57.7%) were attributable to CVD. Cox proportional hazards analysis showed that a leptin level equal to or greate than the median value (3.45 ng/mL) was associated with lower mortality rates (hazard ratio, 0.211; 95% confidence interval, 0.062 to 0.723; P =. 01) after multivariable adjustment for potential confounders. However, leptin was not an independent risk factor for CVD-related mortality.
    Conclusions
    There was a converse association between the serum leptin concentration and mortality in stable maintenance hemodialysis patients. Low serum leptin concentration is an independent risk factor of all-cause mortality in stable maintenance hemodialysis patients, but may not be linked with CVD-related mortality.
  • Jamal S. Al Wakeel Pages 321-328
    Introduction
    This study aimed to investigate effects of fasting during the Ramadan month among chronic kidney disease (CKD) and hemodialysis patients.
    Materials And Methods
    A prospective study was carried out on patients seen between August and November 2010 at two hospitals of King Saud University. Volunteers from among patients with CKD and hemodialysis patients were evaluated for kidney function and complications before, during, and after 14-hour daily Ramadan fasting for 30 days. A modified schedule for medication and dialysis regimen was provided to the participants.
    Results
    Thirty-nine CKD patients (41.0% in stage 3 and 43.6% in stage 4) were included. There were no differences in the laboratory and clinical variables before, during, and after the fasting month. Thirty-two hemodialysis patients with a mean duration of dialysis of 4.4 ± 3.7 years were also included in the study. There was a significant increase in erythrocyte count, serum creatinine, blood urea, serum phosphorus, serum albumin, and serum uric acid levels during the fasting period. Hyperkalemia developed in 25.0% and 15.6% of the hemodialsysis patients during and after the fasting period and hyponatremia in 15.6% and 28.0%, respectively. Forty-six percent of the patients developed hypertension and 36.7% fluid overload. No adverse events requiring hospital admission were observed.
    Conclusions
    Fourteen-hour fasting for one month was tolerated by CKD and hemodialysis patients, although there were considerable changes among hemodialysis patients in some of the blood chemistry variables. No serious adverse events occurred.
  • Shokoufeh Savaj, Javad Savoj, Mitra Ranjbar, Foroogh Sabzghabaei Pages 329-332
    Introduction
    Tuberculosis reactivation is one of significant complications after transplantation. Tuberculin skin test (TST) has been the major available screening test in end-stage renal disease patients, but it is associated with a low accuracy. Recently, an interferon-γ release assay (IGRA) has been approved as a substitution test in diagnosis of Mycobacterium tuberculosis infection. This study aimed to compare the ability of the TST and IGRA in the diagnosis of latent tuberculosis in hemodialysis patients and investigate risk factors of having positive test results.
    Materials And Methods
    Forty-seven hemodialysis patients underwent the IGRA and TST tests. Demographic data and blood samples were collected and chest radiography was done for all participants.
    Result
    Abnormal chest radiography was reported in 24% of the study group. The IGRA and TST were positive in 11 (23.4%) and 20 patients (43.5%), respectively. The agreement coefficient (kappa) between the IGRA and TST was 0.31 (P<. 05). Positive TSTs were significantly associated with male sex and abnormal chest radiography. Diabetes mellitus was a risk factor for a positive IGRA result (P=. 01).
    Conclusions
    The IGRA test is not a sensitive test for detection of latent tuberculosisin hemodialysis patients residing in high-prevalence areas. We suggest that assessment of cellular immunity response in end-stage renal disease patient be a priority before reliance on the IGRA test result.
  • Diana Taheri, Neda Soleimani, Mehdi Fesharakizadeh, Shahaboddin Dolatkhah, Mahmood Kabiri, Abolfazl Gholipour Pages 333-335
    Inflammatory myofibroblastic tumor (IMT) is a rare neoplasm mostly seen in the lungs, but also in extrapulmonary sites. The most common genitourinary site of IMT is the bladder, but it may rarely be seen in the kidneys. We report a case of a 15-year-old girl presented with flank pain and hematuria, in which computed tomography scan revealed a mass in the left kidney. The patient underwent left nephrectomy for a diagnosis of Wilms tumor. Further assessment of the tissue demonstrated a pathologic diagnosis of IMT. Despite improvements in imaging technology, the preoperative diagnosis of IMT remains difficult and surgery is the only way for the diagnosis and treatment. Considering the role of the pathologic examination in making the definite diagnosis of IMT, we should be aware of this entity and it must be considered in the differential diagnoses.
  • Masoumeh Mohkam, Shirin Shohadaii, Farshid Kompani, Hamid Reza Aghadoost, Seyed Ali Hojati, Nasrin Esfandiar Pages 336-340
    Tuberous sclerosis complex (TSC) is a multisystemic inherited autosomal dominant disease characterized by the development of hamartomas in the brain and kidneys. In about 2% of patients, polycystic kidney disease is present, which may result in different stages of renal insufficiency. Acute kidney failure has not been reported in infants with TSC. We report a female infant with TSC who was admitted to hospital with pyelonephritis, acute kidney injury, and polycystic kidney disease.
  • Mohammad Amin Fallahzadeh, Mohammad Kazem Fallahzadeh, Ali Derakhshan, Eslam Shorafa, Yusof Mojtahedi, Bita Geramizadeh, Mohammad Hossein Fallahzadeh Pages 341-343
    A 9-year-old boy presented with fever not responding to antibiotic therapy and elevated blood urea and serum creatinine levels. The patient developed microangiopathic hemolytic anemia and thrombocytopenia during the hospital stay. Kidney biopsy confirmed the diagnosis of atypical hemolytic uremic syndrome (HUS). The patient had sufficient urine output, normal blood pressure, and no evidence of peripheral edema during the whole course of his disease. Serum levels of anti-Epstein-Barr virus immunoglobulin M was elevated, indicating the possible role of Epstein-Barr virus infection in inducing atypical HUS in this patient. The patient underwent hemodialysis with dramatic response. He was discharged with normal kidney function after a few days. Kidney function and platelet count were normal 12 months after the initial presentation. This case report shows that atypical hemolytic uremic syndrome could have unusual presentations such as the absence of oliguria, hypertension, and edema, with rapid recovery and good prognosis.
  • Farrokhlagha Ahmadi, Azin Mohebi-Nejad Pages 344-345
  • Mohammad, Reza Ardalan, Hamid Nasri Page 348
  • Farzanehsadat Minoo, Masume Nouri, Simin Dashti-Khavidaki Pages 349-351
  • Editor, Ijkd Page 352