Journal of nephropathology
Volume:13 Issue: 1, Jan 2024

Contrast-related acute renal failure is a multifactorial condition that involves oxidative stress, inflammation, and direct tubular toxicity. Risk factors for contrast-induced nephropathy comprise pre-existing kidney dysfunction, diabetes mellitus, advanced age, congestive heart failure, hypotension, anemia, and volume depletion. Preventive measures include identifying high-risk patients and implementing preventive measures such as adequate hydration, minimizing contrast use, and avoiding using contrast media in patients with pre-existing renal dysfunction. The systemic inflammation score is a promising tool for predicting contrast-associated acute kidney injury (CAAKI) in patients undergoing contrast-enhanced imaging procedures. Further studies are needed to validate the use of SIS in clinical practice and to better understand the underlying mechanisms of inflammation in (CA-AKI).

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of coronavirus disease 2019 (COVID-19) which is associated with nonspecific respiratory syndromes, varying from mild symptoms of upper airway to required mechanical ventilation hypoxemia. A unique feature of this disease is COVID-19-associated coagulopathy (CAC) that linked with disease severity and hospital mortality. These patients have a profound hypercoagulable state and in patients with severe type arterial and venous thrombotic events are frequent. Abnormal coagulation parameters such as activated partial thromboplastin time (aPTT) were observed in patients with COVID-19. Regarding the above finding it could be considered as a reason to avoid anticoagulation at the both doses of therapeutic and prophylactic. A prolonged aPTT may indicate a coagulation factor deficiency or inhibitor of coagulation, which can be specific (antibody to factor VIII) or nonspecific (lupus anticoagulant, LA). LA can affect laboratory tests of blood coagulation, but is not usually associated with bleeding; however, it can be associated with thrombotic risk as a part of the antiphospholipid syndrome. In a phospholipid concentration-dependent manner LA recognizes a type of antiphospholipid antibodies (aPLs) that prolong clotting tests. In patients with antiphospholipid syndrome (APS) LA is considered as one of the laboratory criteria representing a significant risk factor of both thrombosis and pregnancy morbidity. Similarities between some of the pathophysiological features of COVID-19 and APS has been focused in several reports particularly in the most severe form, catastrophic APS. This study aimed to evaluate the effect of LA on the incidence of thrombophilia in patients with COVID-19, as well as its impact on the inflammation and finally the mortality final rate.

Hypertension is considered a significant and highly prevalent public health problem. Due to the wide application of the medicinal herb Nigella sativa in managing this condition, the present study aims to evaluate the effect of N. sativa consumption on reducing blood pressure (BP) levels using a systematic review and meta-analysis approach.

Multiple online databases, including PubMed, Scopus, Cochrane, Web of Science, and the Google Scholar search engine, were searched using standard keywords to identify relevant articles up to May 9, 2022. Data were analyzed using STATA 14 software, and the significance level was taken as P<0.05 for all tests.

From the total of 12 reviewed studies with a sample size of 854, the consumption of N. sativa powder (SMD: -0.46; 95% CI: -0.63, -0.30) and N. sativa oil (SMD: -2.04; 95% CI: -2.75, -1.34) lowered the systolic BP (SBP) levels. The consumption of N. sativa powder (SMD: -0.45; 95% CI: -0.63, -0.28) and N. sativa oil (SMD: -2.31; 95% CI: -3.05, -1.57) altered the diastolic BP (DBP) level. Then, the standard effect sizes of N. sativa consumption on triglyceride (SMD: -0.14; 95% CI: -0.29, 0), LDL-C (SMD: -0.35; 95% CI: -0.54, -0.17), HDL-C (SMD: 0.01; 95% CI: -0.14, 0.16) and FBS (SMD: -0.36; 95% CI: -0.58, -0.15) levels were measured.

Nigella sativa consumption showed a higher impact on reducing SBP than DBP levels. In addition, the consumption of N. sativa oil was more effective in lowering BP levels than N. sativa powder. Hence, further research is suggested to evaluate and compare the effectiveness of N. sativa oil and powder.

Hyperphosphatemia is an independent risk factor for mortality in chronic kidney disease (CKD) patients.

This systematic review and meta-analysis aimed to investigate the effect of Sevelamer on serum phosphorus levels in CKD and hemodialysis patients.

The data were obtained after searching the international databases of Cochrane, PubMed, Scopus, Web of Science, and the Google Scholar search engine until February 28, 2023. The heterogeneity of articles was assessed using the I2 index. The data were analyzed in STATA 14, and P values < 0.05 were considered significant.

A total of 22 articles were assessed with a total sample size of 3221. Sevelamer reduced calcium levels in CKD and hemodialysis patients compared with those in the comparison group (standardized mean difference [SMD]: -0.67; 95% CI: -1.23, -0.11); however, sevelamer had no significant effect on serum parathyroid hormone (PTH) levels (SMD: 0.07; 95% CI: -0.39, 0.54) and Ca × P product (SMD: -0.20; 95% CI: -0.41, 0). A significant decrease in serum phosphorus level was observed in patients who had taken sevelamer for a maximum of 12 weeks compared with the comparison group (SMD: -0.27; 95% CI: -0.54, -0.01); however, no significant decrease in serum phosphorus level was observed in patients who had taken sevelamer for more than 12 weeks. A significant decrease in serum phosphorus level was observed in sevelamer users compared to placebo group members (SMD: -0.36; 95% CI: -0.68, -0.05).

The administration of sevelamer reduced serum phosphorus levels in CKD and hemodialysis patients compared with those in the placebo group in the short term. Therefore, physicians are recommended to prescribe sevelamer for a maximum period of three months. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO website (ID: CRD42023406804).

Treatment of mild to moderate hypokalemia is a high potassium-containing diet and oral pharmaceutical potassium products. However, several medical centers in Iran use injectable dosage forms orally, which is not a confirmed method by reliable guidelines.

This study investigated the advantages and side effects of oral tablets versus injection vials of potassium chloride orally. Patients and

This descriptive-analytical cross-sectional study was performed from March 2022 to June 2022. Thirty patients received tablets (“potassium chloride tablet” group), and thirty patients received injection vials (“potassium chloride vials orally” group) of potassium chloride orally. The variables, including age, gender, clinical side effects, and serum level of potassium, were regularly recorded.

The mean duration of serum potassium normalization was 42.00 hours for the “potassium chloride tablet” group and 84.57 hours for the “potassium chloride vials orally” group. The mean total potassium intake was 127.20 mEq/L in the “potassium chloride tablet” group and 280.03 mEq/L for the “potassium chloride vials orally” group. No significant difference was observed in gastrointestinal complications, including esophagitis, bloating, stomach ache, and nausea. None of the patients have required endoscopy due to esophagitis.

Our result suggested that prescribing oral potassium chloride tablets has superior benefits over injection vials. However, more detailed research is needed to reveal the other aspects of this problem.

The patients undergoing maintenance hemodialysis (MHD) who are affected with COVID-19 may be at a higher risk for severe disease and complications. Considering the current COVID-19 pandemic, there is a need for studies investigating the various aspects of COVID-19 in patients with MHD.

The present study aimed to identify the risk factors associated with higher COVID-19- related mortality in patients under MHD. Patients and

The present retrospective study included 90 patients under MHD who were hospitalized with COVID-19 and diagnosed using the reverse transcription polymerase chain reaction (RT-PCR) from March 20, 2020, to December 20, 2020.

The participants’ mean age was 57.5±18.61 years, and 49 patients (54.4%) were men. Moreover, 35 patients (38.9%) were expired due to COVID-19. The most common underlying diseases included diabetes mellitus, hypertension and cardiovascular diseases. The patients expired due to COVID-19 had a significantly higher chance of needing oxygen therapy, mechanical ventilation, and intensive care unit admission compared to survived patients. Moreover, a significant negative relationship between mineral-multivitamin supplementation and COVID-19-related mortality was detected. The prevalence of dyspnea was significantly higher in the expired patients compared to survived patients.

The COVID-19 patients under MHD are high-risk for severe disease and mortality. Therefore, hemodialysis centers should establish strict preventive measures.

Galangin (3,5,7 tri-hydroxy flavone), naturally active flavonoid is derived from the rhizomes of Alpinia officinarum is proven to be effective antioxidant, anti-inflammatory, anticancer. However, protective effects of galangin in chronic renal failure (CRF) is not explored.

This study is aimed to investigate the nephroprotective activity of galangin in adenineinduced CRF rats.

Adenine induced rats were administered galangin 20 mg/kg and 40 mg/kg body weight (BW) serum renal and hepatic parameters, and renal antioxidant-lipid peroxidation parameters, histological studies were carried out. The mechanism of action was investigated by flow cytometry.

Galangin has normalized serum renal and hepatic parameters, reduced oxidative stress and lipid peroxidation. Histopathology confirms nephroprotection. The percentage number of cells expressing transforming growth factor beta (TGF-β) was reduced with galangin treatment.

Galangin exerts nephroprotection in adenine induced CRF by inhibiting TGF-β expression.

Defined as the destruction of the skeletal muscle wall and the release of cellular contents into the bloodstream, rhabdomyolysis has been reported as a complication for some forms of vaccines. On the other hand, the COVID-19 pandemic has led to the extensive production and use of several vaccines against SARS-CoV-2, meanwhile, the side effects of these vaccines are gradually being reported. Up to now, few cases of rhabdomyolysis due to COVID-19 vaccination have been reported in the studies. The present study intended to report two cases of rhabdomyolysis due to vaccination with Oxford/Astra Zeneca COVID-19 vaccines. The patients were two men aged 70 and 75 years old who presented to a healthcare facility with weakness, myalgia, nausea, and vomiting for about ten days after receiving their first dose of the Oxford/AstraZeneca COVID-19 vaccine. Patients had elevated levels of creatine phosphokinase (CPK), which were 5540 IU/L and 18760 IU/L in patients, respectively.