فهرست مطالب
Journal of nephropathology
Volume:1 Issue: 3, oct 2012
- تاریخ انتشار: 1391/08/21
- تعداد عناوین: 18
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Page 134Context: Dietary antioxidants are important in protecting against human diseases. Oxidative stress, a non- traditional risk factors of cardio-vascular disease is far more prevalent in chronic kidney disease (CKD) patients than in normal subjects.Evidence Acquisitions: Directory of Open Access Journals (DOAJ), Google Scholar, Pubmed (NLM), LISTA (EBSCO) and Web of Science have been searched.ResultsOxidative stress could be a consequence of an increase in reactive oxygen species as well as a decrease in antioxidant defenses. Among the important factors that can be involved in triggering oxidative stress is insufficient dietary intake of antioxidants. Malnourished CKD patients are reported to have more oxidative stress than well nourished ones..ConclusionsMoving beyond the importance of assessment of dietary protein and energy in pre dialysis CKD patients to the assessment of dietary antioxidants is of utmost importance to help combat enhanced oxidative stress levels in such patients.Keywords: Dietary antioxidants, Oxidative stress, Chronic kidney disease
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Page 143Context: Angiotensin converting enzyme (ACE) gene encodes ACE, a key component of renin angiotensin system (RAS), plays an important role in blood pressure homeostasis by generating the vasoconstrictor peptide angiotensin II. Evidence Acquisitions: Directory of Open Access Journals (DOAJ), Google Scholar, Pubmed (NLM), LISTA (EBSCO) and Web of Science have been searched.ResultsThe presence of ACE insertion/deletion (I/D) polymorphism affects the plasma level of ACE. ACE DD genotype is associated with the highest systemic and renal ACE levels compared with the lowest ACE activity in carriers of II genotype.ConclusionsIn this review focus has been performed on the study of ACE I/D polymorphism in various populations and its influence on the risk of onset and progression of diabetic nephropathy. Also, association between ACE I/D polymorphism and response to ACE inhibitor and angiotensin II receptor antagonists will be reviewed. Further, synergistic effect of this polymorphism and variants of some genes on the risk of development of diabetic nephropathy will be discussed.Keywords: ACE I, D polymorphism, ACE activity, Diabetic nephropathy, ACE inhibitors, Angiotensin II receptor blockers
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Page 155Mucormycosis, although said to be less common than candidiasis and aspergillosis is becoming increasingly associated with many co-morbid conditions and immunosuppression. Renal involvement, rarely reported previously, has also been documented with increasing frequency in recent times in both diseased as well as apparently healthy individuals. The kidneys may be involved in disseminated disease or have an isolated involvement for unexplained reasons. The manifestations are very serious particularly in patients with bilateral renal mucormycosis who often develop acute kidney injury and usually have a fatal outcome. The diagnosis of the renal mucormycosis is based on renal histology sections of renal biopsy or nephrectomised kidneys. Imaging with computerised tomography with contrast is of tremendous help in early identification of these cases before histological diagnosis. Once diagnosis is established, prompt treatment with antifungal medication, including Amphotericin-B (and its lipid formulations) and posaconazole, and removal of infected tissue is necessary to save from otherwise fatal infection.Keywords: Mucorales, Renal mucormycosis, Acute kidney injury
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Page 160Although genetic admixture has recently occurred among different ethnic groups with the increased rates of migration to big cities, information about HLA allele distribution in different ethnic groups in Iran may still be helpful to improve the selection of transplantation donor candidates from certain ethnic groups which are genetically closer to the recipient. Because the data reported by Einollahi et al. reflect a large HLA disparity among Iranian kidney recipients, any improvement could play a small yet important role in organ transplantation.Keywords: HLA molecules, Graft rejection, Organ transplantation
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Page 164BackgroundHLA typing analysis is important in renal transplant patients.ObjectivesWe made a plan to determine the most frequent HLA antigens in Iranian kidney transplant patients.Patients andMethodsIn a retrospective cross sectional study, HLA patterns were defined in 512 kidney transplant recipients (67% male and 33% female) from different transplant centers of Tehran, Iran between 2008 and 2011 by microcytotoxicity assay.ResultsThe studies samples were of different ethnic groups of the Iranian kidney transplants. Considerable variations were observed in each HLA sub class. A2, A1, A3, A24 and A26 were the most frequent HLA-A antigens. Among HLA-B, the predominant antigens were B35; B13, B15, B13 and B18. The most frequent HLA-DR antigens were DR 4, DR11, DR1, DR3 and DR15. DQ1 showed the highest frequency and followed by DQ3 and DQ2.ConclusionsThese results showed considerable heterogeneity in both HLA class I and class II antigens, which reflects recent admixture of this group with neighboring Middle East populations.Keywords: HLA typing, Prevalence, Iranian kidneys transplant patients
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Page 170BackgroundIn dialysis patients, chronic infections have been associated with cachexia and anorexia.ObjectivesThis study was carried out to determine the association between Helicobacter pylori (HP) infection and body mass index (BMI) in hemodialysis (HD) patients.Patients andMethodsNinety eight patients were divided into two groups of negative (group 1) and positive (group 2), for HP. BMI of all patients was measured at the beginning and in group2 after six months following eradication of HP. Before dialysis, various paraclinical parameters were checked at the same intervalsResultsFifty-nine patients were enrolled in group 1 and 39 patients in group 2. The means of BMI in groups 1 and 2 were 23.4±3.7 and 25.8±4.4kg/m2, respectively. Prior to the study, there was no significant difference for BMI, duration of HD and paraclinic data between two groups. Group 2 took anti HP therapy and eradication occurred in 30 of them. In this group six months after eradication of HP, the BMI was significantly decreased from 25.02±4.4 to 24.4±4.0 kg/m2 (P= 0.001). Also six months following the eradication of HP, the mean of serum albumin level was significantly declined from 4.2 to 3.7 g/L (P<0.001). There was also significant decrease in cholesterol (P=0.001), blood urea nitrogen (P=0.005) and calcium (P=0.02). However, significant increase in hemoglobin level was also seen (P=0.03).ConclusionsThe results of this study show that eradication of HP has an impact on BMI. The results need to be investigated with larger cases.Keywords: Hemodialysis, H. pylori infection, Body Mass Index
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Page 177BackgroundChronic kidney disease (CKD) is an overwhelming illness in children. Considering the importance of CKD in pediatric age group, in addition to the racial and ethnic differences in prevalence and etiology of CKD, epidemiologic studies are recommended. The majority of the results regarding the incidence of CKD have been achieved from studies on hospitalized children.ObjectivesThis study evaluates the incidence and etiology of chronic renal failure (CRF) in children in a tertiary care center in Isfahan, the second large province of Iran.Patients andMethodsA retrospective analysis of medical record data of children less than 19 years old, hospitalized for CKD at St Alzahra hospital, Isfahan, Iran, during the period of November 2001 until December 2011 was made. A total of 268 eligible cases were recruited. Patients were categorized into 5 groups according to glomerular filtration rate (GFR) and KDOQI guideline.ResultsOut of 268 patients, 144 patients were male (54%). The mean and median of age was 11.01± 0.39(SD) years and 12.5 years, respectively. Approximately 55% of patients had either systolic and/or diastolic hypertension. The most frequent etiology of CKD was glomerular diseases (34%) followed by reflux nephropathy (16.7%). Most patients (74.8%) had GFR less than 15 ml/min/m², when diagnosed. Anemia was the most prevalent laboratory abnormality (85%). Small-size kidneys were seen in 65.8% of patients. Kidney replacement therapy (either hemo- or peritoneal dialysis) was applied for 72.3% of the patients. The transplantation rate average was 7.2 per million children population. The annual incidences of CKD (mostly advanced stages) were 5.52 per million population (PMP) and 16.8 per million children population, respectively. The all cause of mortality rate was 18.4%. Younger age was the only independent predictor of mortality (p=0.005).ConclusionsWe concluded that glomerular diseases are the leading cause of CKD in our patients. In addition, the annual incidence of CKD is considerably high.Keywords: Children, Chronic kidney disease, Hypertension, Incidence, Prevalence
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Page 183BackgroundEnuresis is defined as the repeated voiding of urine into clothes or bed at least twice a week for at least 3 consecutive months in a child who is at least 5 yr of age and has a high prevalence in school aged children. In primary enuresis (PE) children have never gained control over urination or has been dry for<6months. While in secondary enuresis children have developed incontinence after a period of at least 6 months of urinary control.ObjectivesThe aim of this study was to investigate a possible relation between PE and sacral ratio (SR) in 5-9 aged children.Materials And Methods118 children with aged 5-9 year were enrolled in this case-control study. All them were divided into two aliquots groups of 59 patients. The case study (children with PE) and the control (children without PE) groups were matched in age and sex. SR based on antero-posterior plain radiograms of pelvis was calculated. Results were then analyzed using Chi square and student t-test as appropriate.ResultsThere were no significant differences between the two groups regarding age and gender. Mean SR in case and control group was 0.89 and 0.90, respectively. Moreover, there was no significant difference between the two groups (p=0.82). Only 1 child (1.6%) in case group showed abnormal SR while this was 7 children (11.9%) in the control groupConclusionsThis study showed that, there was no significant difference between children with PE and those without PE in terms of SR. However, multicenter and larger sample size is recommended for definite decision of this finding.Keywords: Sacral ratio, Sacral abnormalities, Enuresis, Child
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Page 190BackgroundCisplatin (CP) is widely used in clinic to treat the solid tumors. However, CP is associated with some major side effects including nephrotoxicity, hepatoxicity, and testicular toxicity.ObjectivesTo found, which of the toxicities is the first side effect of CP.Materials And Methodswe conducted a pilot research on 12 adult male Wistar rats.ResultsOne week after CP administration, the induced toxicity was observed clearly in kidney tissue. The only abnormality that observed in testis tissue was very small degree of hyaline casts. However, no damage and other abnormality were detected in the liver tissue.ConclusionsAccording to these findings, in clinic, first special attention must be made on kidneys during chemotherapy with CP. However, the duration of experiment is suggested to be extended to obtain hepatoxicity or testicular toxicity model in experimental animal in laboratories. Moreover, different dose of CP should be used to study the first side effect in animal model.Keywords: Nephrotoxicity, Hepatoxicity, Cisplatin, Toxicity
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Page 194BackgroundFabry disease is caused by an X-linked recessive inborn error of glycosphingolipid metabolism with deficient activity of a lysosomal enzyme, alpha-galactosidase A (α-GalA).Case PresentationA 46 year-old man with progressive kidney disease showed on kidney biopsy electron microscopic evidence of Fabry disease. The patient had no systemic manifestations of Fabry disease, despite residual α-GalA activity, therefore genetic testing was done by direct DNA sequencing, demonstrating a new GAL A gene mutation (C174G-exon 3). After three years of enzyme replacement therapy (agalsidase beta) treatment, a second biopsy was done. Although there was demonstrable clearance of intracellular inclusions, remarkable podocyte activation was evident.ConclusionsThis report represents an unusual renal variant of Fabry disease and provides histologic data on long-term follow up after enzyme replacement therapy.