فهرست مطالب

Kidney Diseases - Volume:12 Issue: 2, Mar 2018

Iranian Journal of Kidney Diseases
Volume:12 Issue: 2, Mar 2018

  • تاریخ انتشار: 1397/02/08
  • تعداد عناوین: 10
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  • Giorgina B. Piccoli, Mona Alrukhaimi, Zhi-Hong Liu, Elena Zakharova, Adeera Levin, World Kidney Day Steering Committee Pages 65-77
    Chronic kidney disease affects approximately 10% of the world's adult population; it is within the top 20 causes of death worldwide, and its impact on patients and their families can be devastating. The World Kidney Day and the International Women's Day coincide in 2018, thus offering an opportunity to reflect on the importance of women's health, and specifically their kidney health, on the community and the next generations, as well as to strive to be more curious about the unique aspects of kidney disease in women so that we may apply those learnings more broadly. Girls and women, who make up approximately 50% of the world's population, are important contributors to society and their families. Gender differences continue to exist around the world in access to education, medical care, and participation in clinical studies. Pregnancy is a unique state for women, offering an opportunity for diagnosis of kidney disease, but also a state where acute and chronic kidney diseases may manifest, and which may impact future generations with respect to kidney health. There are various autoimmune and other conditions that are more likely to impact women, with profound consequences for child bearing and the fetus. Women have different complications on dialysis than men, and are more likely to be donors than recipients of kidney transplants. In this editorial, we focus on what we do and do not know about women's kidney health and kidney disease, and what we might learn in the future to improve outcomes worldwide.
  • Shapour Badiee Aval, Yalda Ravanshad, Anoush Azarfar, Hassan Mehrad-Majd, Shatila Torabi, Sahar Ravanshad Pages 78-83
    Introduction. Uremic pruritus is characterized by an uncomfortable and unlimited sensation which leads to scratch, which strongly reduces the quality of life. Pruritus is a common symptom in patients with end-stage renal disease. Various clinical trial studies have examined the effects of acupuncture and acupressure on treatment of uremic pruritus. This systematic review meta-analysis aimed to evaluate the effectiveness based on published studies.
    Materials and Methods. An electronic literature search was conducted to identify appropriate trial studies. The results for continuous outcomes were presented as weighted mean difference, with 95% confidence intervals.
    Results. A total of 5 articles, including 6 trials, were enrolled in this systematic review. Only 3 of the six trial studies used a visual analogue scale score for assessing pruritus and acupressure for intervention regime, which were considered for meta-analysis. The combined results showed that acupuncture or acupressure was effective in treatment of uremic pruritus (pooled mean difference, -1.994; 95% confidence interval, -2.544 to -1.445).
    Conclusions. This study confirms that using acupuncture and acupressure is effective in treatment of uremic pruritus. However, further vigorous studies are needed to verify these findings.
    Keywords: systematic review, meta-analysis, acupuncture, acupressure, pruritis, kidney disease
  • Akram Ranjbar, Nejat Kheiripour, Hassan Ghasemi, Mohammad Ali Seif Rabiei, Farahnaz Dadras, Farhad Khoshjou Pages 84-90
    Introduction. Oxidative stress has a well-known role in diabetic nephropathy, and mitochondria are the major source of reactive oxygen species production. This study aimed to assess the effect of tempol, a superoxide dismutase mimetic agent, on mitochondrial antioxidant enzymes and cell viability in diabetic nephropathy.
    Materials and Methods. Adult male Wistar rats were divided into 4 groups of 7 animals. Diabetes mellitus was induced by injection of streptozotocin in 2 groups, the rat in one of which were also treated with tempol for 4 weeks. Another group without diabetes mellitus received tempol, and the last group was the control. At the end of the treatment period, the kidney mitochondria were isolated and their antioxidant enzymes, including superoxide dismutase, glutathione peroxidase, and catalase were assessed. Malondialdehyde, total antioxidant capacity, and kidney cells viability were studied, as well.
    Results. The diabetic group was significantly different compared with the control group in malondialdehyde, catalase, and glutathione peroxidase activities. Superoxide dismutase and total antioxidative capacity did not show any significant differences among the four groups. Moreover, the diabetic group treated with tempol had significantly different glutathione peroxidase level and kidney cells viability, compared to the other diabetic group (P Conclusions. Diabetic nephropathy induces changes in mitochondrial antioxidative biomarkers and cells viability, some of which can be modified by tempol administration in rats.
    Keywords: diabetes mellitus, nephropathy, superoxidedismutase, malondialdehyde, catalase, lutathione peroxidase, tempol
  • Li Zhou, Di Yao, Songqing Zhao, Yuzhang Jiang, Weiping Lu Pages 91-98
    Introduction. A variety of molecular pathways, such as generation of advanced glycation end products, inflammation, and oxidative stress, are involved in the development of diabetic nephropathy (DN). Recently, a protective effect of omega-3 polyunsaturated fatty acids on the kidney has been reported. This study aimed to determine serum docosahexaenoic acid (DHA) level and its association with inflammation factors in patients with DN.
    Materials and Methods. One hundred patients with type 2 diabetic mellitus were divided into 3 groups of non-DN, early DN, and clinical DN, based on 24-hour urinary albumin levels. Hemoglobin A1c, biochemical indicators, β2-microglobulin, and 24-hour urine albumin levels were assessed. Enzyme linked immunosorbent assay was applied to determine the serum concentrations of DHA, advanced glycation end products, fractalkine, superoxide dismutase, and tumor necrosis factor-α.
    Results. Lower serum DHA and superoxide dismutase and higher serum β2-microglobulin and 24-hour urine albumin levels were associated with clinical DN, compared to no DN and early DN. The reductions in serum DHA levels were different among the patients with early and clinical DN, stratified by sex, body mass index, and serum lipid levels. Serum DHA significantly correlated positively with superoxide dismutase and negatively with fractalkine and tumor necrosis factor-α in the patients with DN.
    Conclusions. Docosahexaenoic acid may suppress the expression and secretion of fractalkine through inhibiting the tumor necrosis factor-α signaling pathway in DN patients, which improves inflammation and oxidative stress of the kidney, and in turn, delaying the development of DN.
    Keywords: diabetic nephropathy, omega-3 polyunsaturated fatty acids, docosahexaenoic acid, fractalkine, inflammation, oxidative stress
  • Zohreh Naji Ebrahimi Yazd, Sara Hosseinian, Mohammad Naser Shafei, Alireza Ebrahimzadeh Bideskan, Nazanin Entezari Heravi, Soghra Parhizgar, Samira Shahraki, Zahra Samadi Noshahr, Somayeh Mahzari, Abolfazl Khajavi Rad Pages 99-106
    Introduction. Nephropathy is an important side effect of doxorubicin. The aim of the current study was to investigate the protective effect of Plantago major extract against doxorubicin-induced functional and histological damage in rat's kidney.
    Materials and Methods. Sixty Albino rats were randomly divided into 6 groups. Doxorubicin, 5 mg/kg, was injected intravenously on the 7th day of the study. Animals were treated with dexamethasone, 0.9 mg/kg, vitamin E, 100 mg/kg, and P major extract, 600 mg/kg and 1200 mg/kg, for 7 days before and 4 weeks after doxorubicin administration. Glomerular filtration rate, urea clearance, and urine glucose concentration were determined on the 1st day and 1, 2, 3 and 4 weeks after doxorubicin injection. Histological changes were also examined and the end of the study.
    Results. Doxorubicin caused significant decreases in glomerular filtration rate and urea clearance and significant glycosuria and kidney damage. Urea clearance in the rats treated with P major showed no significant change between different days of the experiment. Administration of dexamethasone, vitamin E, and low- and high-dose P major significantly improved the glycosuria and kidney tissue damage.
    Conclusions. These findings suggested that hydroalcoholic extract of P major protected renal tissue against doxorubicin-induced nephropathy. The protective effects of P major on renal lesions associated with doxorubicin may be due to its antioxidant and anti-inflammatory actions.
    Keywords: Plantago major_doxorubicin_vitamin E dexamethasone_nephropathy_animal study
  • Heba Mostafa Ahmed, Dina Ahmed Ezzat, Noha A. Doudar, Mai Adel Pages 107-111
    Introduction. Early diagnosis of minimal change disease (MCD) is challenging in nephrotic children. CD80 is a protein expressed on the surface of podocytes associated with nephrotic syndrome and it is implicated in the induction of proteinuria. This study aimed to investigate the use of urinary CD80 for the diagnosis of MCD.
    Materials and Methods. Urinary CD80 levels were evaluated in 36 children with nephrotic syndrome and normal glomerular filtration rate. They were divided into three groups of MCD (n = 21), focal segmental glomerulosclerosis (n = 9), and other glomerulopathies (n = 6). The MCD group was subdivided into 2 of those with remission (n = 11) and those in the active stage (n = 10). Forty healthy children were included as controls.
    Results. The urinary CD80 level was significantly higher in the MCD group (3.5 ± 2.1 ng/mg creatinine) than in the focal segmental glomerulosclerosis group (1.2 ± 0.5 ng/mg creatinine, P Conclusions. Urinary CD80 levels were significantly higher in the children with MCD than in the controls and patients with other causes of nephrotic syndrome.
    Keywords: minimal change disease, focal segmental glomerulosclerosis, CD80, child
  • Yan-Ping Wei, Xing-Gu Lin, Rong-Quan He, Juan Shen, Si-Long Sun, Gang Chen, Qiu-Yan Wang, Jian-Feng Xu, Zeng-Nan Mo Pages 112-119
    Introduction. Nonalcoholic fatty liver disease (NAFLD) has been reported to have effects on kidney diseases; however, a link between NAFLD and urinary calculi remains to be confirmed. This study was conducted on a male population based on our previous Fangchenggang Area Male Health and Examination Survey in Guangxi, China in order to estimate the frequency of urinary calculi and assess the association between NAFLD and urinary calculi while controlling for possible confounders.
    Materials and Methods. This was a population-based cross-sectional study conducted in the Fangchenggang region in Guangxi, China. The diagnoses of NAFLD and urinary calculi were made by ultrasonography. Clinical and laboratory findings were analyzed to investigate whether NAFLD was a risk factor for urinary calculi.
    Results. A total of 3719 men were enrolled (age range, 17 to 88 years). Slightly more than a quarter (26.5%) of the participants were diagnosed with NAFLD. The percentage of urinary calculi in all participants was 6.9%, and the percentage of NAFLD patients with urinary calculi (8.4%) was significantly higher than that among patients without NAFLD (6.4%, P Conclusions. Our results showed that NAFLD was associated with a higher incidence of urinary calculi in this cohort and NAFLD might represent a risk factor for urinary calculi.
    Keywords: nonalcoholic fatty liver disease, urinary calculus, China
  • Shokoufeh Savaj, Seyedeh Ghazal Hosseini, Ahad J. Ghods Pages 120-122
    Introduction. Non-human leukocyte antigen antibodies are an independent risk factor for acute rejection in kidney transplant recipients. Among them, angiotensin II receptor type 1 (ART1) antibodies can induce various effects, but their clinical importance in kidney transplant recipients has not been properly explained. This study aimed to evaluate the effect of ART1 antibodies on allograft function and hypertension in stable kidney transplant recipients.
    Materials and Methods. Eighty-one kidney recipients from non- human leukocyte antigen antibodies-matched donors with stable allograft function were examined for estimated glomerular filtration rate (Chronic Kidney Disease-Epidemiology Collaboration formula) and ART1 antibodies (measured using an enzyme-linked immunosorbent assay method). The result was considered positive if the anti-ART1 level was greater than 17 U/mL.
    Results. The mean age of the participant was 51.1 ± 11.9 years with the mean time from transplantation was 83.5 ± 6.5 months. Fifteen recipients (18.5%) had a high ART1 antibodies level. Those with low titers of ART1 antibodies had better allograft function. The mean estimated glomerular filtration rate was 63.0 ± 13.7 mL/min in those with low ART1 antibodies and 42.3 ± 13.9 mL/min in those with high ART1 antibodies (P Conclusions. A high level of ART1 antibodies was a risk factor for allograft function; however this indicator was not correlated with hypertension in our study.
    Keywords: kidney transplantation, kidney allograft function, angiotensin II receptor antibody
  • Francisco E. Rodr, Iacute, Guez Castellanos, Francisco Dom, Iacute, Nguez Quintana, Virgilia Soto Abraham, Eduardo Mancilla Urrea Pages 123-131
    Introduction. Kidney transplantation is considered the ideal treatment for end-stage renal disease. Acute rejection can influence graft survival. The aim of this study was to propose a classification system for acute rejection based on factor analysis.
    Materials and Methods. Data were collected from kidney transplant recipients with acute rejection diagnosis based on standard histological variables, the presence of peritubular eosinophils, and immunolabeling for lysozyme and myeloperoxidase in kidney tissue. Factor analysis was employed for data reduction and generation of a new case classification, with orthogonal rotation as a strategy to simplify factors, and principal component analysis was used as an extraction method.
    Results. Seventy-nine kidney biopsies were obtained from 74 patients. The total population was divided into humoral rejection (39.2%), cellular rejection (34.1%), and mixed acute rejection (26.7%). No significant differences were found between the three groups in clinical and biochemical variables. We extracted 4 factors using factor analysis. The 1st factor was characterized by the presence of capillaritis, plasma cells infiltration, tubulitis, and inflammation. The 2nd factor included positivity for lysozyme and myeloperoxidase, while the 3rd factor included the presence of eosinophils and glomerulitis. The 4th component consisted of the presence of C4d and endarteritis. The cases belonging to the 3rd factor showed the greatest increase in serum creatinine. The cases belonging to the 4th factor exhibited greater urinary excretion of proteins.
    Conclusions. This proposal of classification of acute rejection could contribute to evaluate the prognosis of kidney transplant recipients.
    Keywords: kidney transplantation, acute rejection, factor analysis
  • Min Jeong Kim, Joo Hui Kim, Il Young Kim, Soo Bong Lee, In Seong Park, Mi Yeun Han, Harin Rhee, Sang Heon Song, Eun Young Seong, Ihm Soo Kwak, Dong Won Lee Pages 132-134
    Preeclampsia is the most common cause of proteinuria with hypertension during pregnancy. Primary kidney disease and kidney disease secondary to systemic disorders may rarely occur during pregnancy, resulting in proteinuria. A 34-year-old woman was admitted to our hospital with abdominal distention and lower extremity edema. The pregnancy was terminated at the 24th week of gestation due to preterm labor. Even after the delivery, proteinuria and renal deterioration continued to progress. The M-peak was not found on serum and urine protein electrophoresis. The serum free light chains assay showed absolute elevation of lambda chains at 1013.9 mg/L with a decreased kappa to lambda ratio of 0.05. Kidney biopsy revealed light chain deposition disease with lambda light chain deposits on immunofluorescence. Bone marrow examination was compatible with multiple myeloma. To our knowledge, this is the first reported case of light chain deposition disease associated with multiple myeloma during pregnancy.
    Keywords: light chain deposition disease, multiple myeloma, pregnancy, proteinuria