bluuebunny/crossref_metadata_2025 huggingface dataset:
The combined effect of Algomed and a quadruple herbal brew of Iranian traditional medicine on the severity and outcome of COVID-19; a randomized controlled clinical trial recruiting inpatients
Authors: Eskandarian Rahimeh , Bagheri Bahador , Zahmatkesh Mehrdad , Malek Farhad , Darban Mahboubeh , Memarian Mohammad , Gohari Ali , Sarabi Mohammad Amir , Mirmohammadkhani Majid
Published: May 2022

Introduction: Given the importance of coronavirus disease 2019 (COVID-19) as a worldwide issue and its health, psychological and social effects and some serious complications and consequences, it needs to find appropriate treatment for this emerging disease. Objectives: To evaluate the effectiveness of combination of Algomed and Mentha longifolia, Matricaria recutita, Althaea rosea and Malva sylvestris on the severity and outcomes of COVID-19. Patients and Methods: In a Randomized clinical trial we included 68 participants with confirmed COVID-19 through PCR tests and/or CT scan, who were admitted to non-ICU wards. The intervention group received four 300-mg Algomed tablets daily, and the quadruple herbal brew three times a day additionally while the control group received routine treatments. The brew was prepared using a large teabag containing 6 g of the four herbs (2 g of Mentha longifolia, 2 g of M. recutita, 1.4 g of Malva sylvestris and 0.6 g of A. rosea). The patients were compared daily from their admission to the end of the third day in terms of clinical and para-clinical symptoms, and outcomes. Results: The two groups were not significantly different in terms of age (P=0.657) and gender (P=0.798). The median and inter-quartile range of length of stay were respectively 3 and 2-4 days in the intervention group and 5 and 3-9 days in the controls, significantly higher in the control group (P<0.001). Comparing the two groups in terms of the difference between the third and the first day values showed a significant difference in white blood cells count, a reduction of 432.9 in the intervention group vs. an increase of 65.5 in the controls (P=0.049). Except for diarrhea, which happened more in the control group (P=0.020), the two groups were not significantly different in terms of other variations. Conclusion: The present study results indicated the effects of a combination of Algomed and the brew of M. longifolia, M. recutita, A. rosea and Malva sylvestris on reducing the length of stay. It is suggested that the findings of this research should be confirmed by more detailed study with bigger sample size. It is also recommended that same or similar research should be conducted in different geographic locations of the world to confirm the outcome of this research. The main limitation of this study is that it was performed only on hospitalized patients who had a milder form of the disease in terms of disease severity. Therefore, the benefits of the interventions cannot be generalized to all patients. Trial Registration: Registration of trial protocol has been approved by Iranian Registry of Clinical Trials (#IRCT20151228025732N51, https://en.irct.ir/trial/46828, ethical code#IR.SEMUMS.REC.1398.325).
Evaluation the expression of insulin and insulin receptor-beta (IR-β) in sperm of infertile male with failed intracytoplasmic sperm injection (ICSI)
Authors: Alizadeh Fateme , Hemadi Masoud , Saki Ghasem , Gavahi Akram , Moramezi Farideh , Valizadeh Armita
Published: May 2022

Introduction: Most infertility treatment centers are currently using semen analysis to differentiate between fertile and infertile individuals. Recent studies have evaluated the expression and secretion of independent insulin and related beta receptor (IR-β) in mammals’ ejaculated spermatozoa such as humans and pigs, and its effect on motility parameters capacitation and acrosomal reaction. Objectives: This study aimed to investigate the expression of insulin, IR-β and the parameters of sperm and DNA fragmentation index (DFI) in men with intracytoplasmic sperm injections (ICSI) failed. Patients and Methods: This study was conducted on 15 men with unknown infertility with a history of unsuccessful ICSI and 10 fertile men. After collecting samples, sperm parameters (concentration and motility), sperm DNA fragmentation and expression of insulin and IR-β genes were investigated. To assess DFI from SDFA kit and to review the expression, the genes were analyzed via RT-PCR method. Data were analyzed statistically by t-test and covariance tests. Results: Based on the findings of this research, the concentration and percentage of motility in infertile men with a history of unsuccessful ICSI was significantly lower than fertile individuals, moreover, the amount of DNA fragmentation significantly increased in infertile men with a history of unsuccessful ICSI compared to fertile men (P < 0.05). Insulin expression in the sperm of infertile men with a failed ICSI history was significantly lower than fertile men (P < 0.05); however, the IR-β expression rate was not significantly different between the two groups. Conclusion: Evaluation of insulin gene expression can be helpful as a good marker for identifying infertility with an unknown cause.
Mixed cryoglobulinemia; a rare presentation of Waldenström macroglobulinemia
Authors: Ribeiro Catarina Isabel , Santos Clara , Almeida Clara , Melo Teresa , Tente David , Fernandes João Carlos
Published: May 2022

Type II mixed cryoglobulinemia is a systemic disease mediated by immune complexes. Renal involvement is present in almost one third of the cases and the membranoprolifer-ative pattern is the most common histological presentation. In turn, in Waldenström macroglobulinemia, renal impairment is rare, with few cases of associated cryoglobu-linemia being reported. The authors present the case of a patient with type II mixed cry-oglobulinemia associated with Waldenström macroglobulinemia diagnosis.
Renal transplantation in a patient with MHY9-related disease; a case report
Authors: Zununi Vahed Sepideh , Niknafs Bahram , Noshad Hamid , Tolouian Ramin , Mohajel Shoja Mohammadali , Tolouian Audrey , Ardalan Mohammadreza
Published: May 2022

MYH9-related diseases (MYH9-RD) are clinically represented by thrombocytopenia, large platelets, proteinuria and various degrees of renal dysfunction. We present a 25-year-old male with thrombocytopenia, large platelets, renal dysfunction and proteinuria. Gene sequencing of whole exons of MYH9 gene confirmed the diagnosis of MYH9-related disorder and revealed single nucleotide polymorphisms (SNPs) in the introns 13 (rs3752462) and 14 (rs2413396) and a mutation in exon 26 of MYH9 gene. Our result supported the possibility of non-coding SNPs involvement in the pathogenicity of the MYH9-RD disease and successful renal transplant in this patient.
Renal arteriovenous malformation in a 14-year old girl with gross hematuria
Authors: Emad Momtaz Hossein , Abbasian Paria
Published: May 2022

Renal arteriovenous malformation (AVM) is a rare cause of gross hematuria in children and adolescents that may present so acute and severe hematuria, leading to significant anemia in patients. We present a 14-year old girl with acute massive gross hematuria with no history of trauma or coagulation defect. Although AVM not common, it should be included in the differential diagnosis of gross hematuria in children and adolescents.
Unusual association of Gitelman syndrome with early diagnosis and glomerular proteinuria; a case report
Authors: Gutiérrez Roberto , Fortunato Marcela , Vigliano Carlos , Toniolo María Fernanda , Espinoza Álvaro , Raffaele Pablo Miguel
Published: May 2022

Gitelman syndrome is an autosomal recessive hereditary tubulopathy whose main alteration is at the sodium-chloride symporter in the distal convoluted tubule, characterized by metabolic alkalosis, normotension, hypokalemia, hypomagnesemia and hypocalciuria. Proteinuria and glomerular hyperfiltration (especially at the beginning of clinical course) are not characteristic manifestations of this disease. We present the case of a 25-year-old female with recent diagnosis of Gitelman syndrome who presented with hyperfiltration and glomerular proteinuria, leading to a renal biopsy, which showed hypertrophy of juxtaglomerular apparatus and mesangial proliferation. In electron microscopy focal podocyte detachment was evidenced, which was compatible with secondary focal segmental glomerulosclerosis (FSGS). This case of association of tubulopathy with secondary glomerulopathy of early presentation, shows the final pathway in this disease, when generating sustained renal ischemia due to the increased activity of renin-angiotensin-aldosterone system (RAAS). Renal biopsy and electron microscopy proved to be useful to define prognosis, early recognition of progression and adjust treatment in this patient.
The effects of calcitriol on microalbuminuria in patients with type 2 diabetes mellitus; a double-blind randomized clinical trial
Authors: Askari Maryam , Ghadiri-Anari Akram , Jaafarinia Asma , Kharazmi Shadab , Hemayati Roya
Published: May 2022

Introduction: Diabetes mellitus (DM) is a metabolic disorder appearing as a main public health problem nowadays. Objectives: This study aimed to evaluate the effect of calcitriol on microalbuminuria in patients with type 2 DM (T2DM). Patients and Methods: This double-blind randomized clinical trial was performed on 38 patients with T2DM who had micro- albuminuria. These patients were randomly classified into two groups of treatment and control. The treatment group received calcitriol 0.25 μg daily since the control group received a placebo. Duration of treatment was three months. In baseline, serum creatinine (Cr), fasting blood sugar (FBS), glycated hemoglobin (HbA1c), cholesterol (Chol), triglyceride (TG), low-density lipoprotein (LDL-c), high-density lipoprotein (HDL-c), and micro-albuminuria were measured. Patients were followed up for three months. P<0.05 was set as a significant level. Results: In baseline, two groups did not differ significantly in terms of serum Cr, FBS, HbA1c, Chol, TG, HDL-c, LDL-c, and micro-albuminuria (P> 0.05). After the intervention, there was no significant difference between the two groups regarding the median of serum Cr, FBS, HbA1c, Chol, TG, LDL-c, HDL-c, and microalbuminuria. The median of microalbuminuria in the treatment and control groups was decreased at 46 mg/g and 11 mg/g, respectively. The difference in median of micro-albuminuria was not statically significant between the two groups; however, a significant difference was detected in the treatment group before and after the intervention (P=0.03). Conclusion: Administration of calcitriol could reduce micro-albuminuria after three months. Therefore, the addition of calcitriol to angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) in patients with T2DM and micro- albuminuria may have a beneficial effect on reducing their proteinuria. Trial Registration: The trial protocol was approved by the Iranian Registry of Clinical Trials (identifier: IRCT2016091429812N; https://en.irct.ir/trial/23865, ethical code; IR.SSU.Rec.65415).
The effect of proton-pump inhibitor and ranitidine on the reduction of serum magnesium level and blood pressure in chronic hemodialysis patients with hypotension; a double-blind clinical trial
Authors: Mohammadi Kebar Sousan , Hoseininia Saeed , Pourfarzi Farhad , Saeedi Elham , Matin Somaieh
Published: May 2022

Introduction: Hypomagnesaemia secondary to the use of proton-pump inhibitor (PPI) is associated with the reduction of blood pressure. Objectives: To determine the effect of PPI and ranitidine on the reduction of serum magnesium level and blood pressure in chronic hemodialysis patients with hypotension. Patients and Methods: In this double-blind randomized clinical trial, 44 hemodialysis patients who met the requirements entered the study. First, blood sample was taken from each of the patients and their serum magnesium level as well as their blood pressure was checked and recorded. Then, the patients in the intervention group received daily doses of ranitidine placebo (150 mg) and pantoprazole (40 mg) and those in the control group received daily doses of pantoprazole placebo (40 mg) and ranitidine (150 mg) for three months. After the intervention, blood samples were taken again in order to assess the patients’ serum magnesium level. The obtained data were fed into SPSS Software and analyzed. Results: The mean age of the patients was 60.14±12.98 years. Moreover, 63.6% of the total patients were female. In the group of patients who had received pantoprazole, diastolic pressure reduced significantly at the end of the study as compared to the beginning of the study. Moreover, in the patients receiving pantoprazole indicated a significant reduction of magnesium at the end of the study as compared to the beginning of the study. Conclusion: In this study, a significant relationship was also observed between the use of PPI and hypomagnesemia in hemodialysis patients. Trial registration: The trial protocol was approved in the Iranian Registry of Clinical Trials (identifier: IRCT20150808023559N19; https://en.irct.ir/trial/42478, ethical code# IR.ARUMS. REC.1398.295).
A rare presentation of extragonadal germ cell tumor; massive pericardial effusion with impending tamponade
Authors: Beheshti Monfared Mahmoud , Ghaderi Hamid , Ansari Aval Zahra , Hekmat Manouchehr , Mirjafari Seyedeh Adeleh , Beheshti Monfared Reza
Published: May 2022

The clinical manifestations of extragonadal germ cell tumor (EGGCT) depend on its location and are often caused by compression on surrounding structures. Pericardial effusion is absolutely rare as an initial clinical manifestation for this tumor. We report a 31-year-old man presenting to the emergency department with dyspnea. Two-dimensional echocardiography revealed a massive pericardial effusion with impending tamponade. The patient was immediately transferred to the operating room where a cardiac surgeon drained bloody effusion. A mediastinal mass measuring 173×105×105 mm was accidentally noticed during COVID-19 work-up. Fine core needle biopsy of the mass led to the diagnosis of a germ cell tumor, which was treated appropriately. This study shows the importance of proper work-up in pericardial effusion cases with chest CT-scan as an important part of it.
Kidney biopsy; challenges with peri-procedural management
Authors: Nguyen Lawrence , Souccar Sami , Zuckerman Jonathan E. , Chen Joline L. T. , Katrivesis James , Abi-Jaoudeh Nadine , Lee Lisa X , Reddy Uttam , Baraghoush Afshan , Morrison Debra E. , Li Xiaodong , Wang Beverly , Lau Wei Ling
Published: May 2022

Native kidney biopsies are high-risk for bleeding complications due to the vascularity of the kidney and the inability to compress the biopsy site within a deep retroperitoneal location. Recommended parameters to minimize bleeding risk include a platelet count above 100 x 109 /L, hemoglobin above 10 g/dL, systolic blood pressure <140 mm Hg, and minimizing the number of biopsy cores. In this paper we present patient cases to discuss management of other factors pertinent to kidney biopsy planning including interruption of anticoagulation, treatment of anxiety which can elevate blood pressure, and use of Doppler. Undiagnosed chronic kidney disease can affect triaging of tissue to light, immunofluorescence and electron microscopy, as sclerosed glomeruli are difficult to visualize in fresh cores. It is recommended to have a back-up retrieval protocol in place to obtain immunofluorescence and electron microscopy results, in the event that only limited kidney tissue was acquired for light histology. A collaborative effort between nephrology, interventional radiology and pathology is essential to optimize the diagnostic yield while minimizing bleeding risk with kidney biopsies. Of paramount importance is physician judgment of whether there is an acceptable balance of benefits/risks to proceed with a kidney biopsy.
A rare case of adenovirus infection in post renal transplant patient
Authors: Kottangal Gittwa Vatsaraj , Nalumakkal Seethalekshmy Vijayan , Nalumakkal Vijayan Smitha
Published: May 2022

Human adenovirus is a linear, non-enveloped, double-stranded DNA virus that can cause opportunistic infections. Typically, adenovirus infections result in self-limiting respiratory, gastrointestinal or ocular infections. However, it can cause severe disseminated disease in immunocompromised patients, especially in post-transplant recipients. In kidney transplant recipients, adenovirus infections have an incidence of up to 4.1%, usually manifested as hemorrhagic cystitis and tubulointerstitial nephritis, in the first three months post-transplant. Renal biopsy shows necrotizing granulomatous interstitial nephritis and other features consistent with the viral infection. Investigations like immunohistochemistry and polymerase chain reaction (PCR) help in confirmation of the diagnosis. Resolution of the disease with the reduction in immunotherapy alone supports the role of immunosuppression as a risk factor for adenovirus infection.
Spectrum of histopathological findings in pediatric renal biopsies; a five-year single center experience in Egypt
Authors: Hamza Wael Mostafa , Fayed Ahmed , Shaker Amr Mohamed , El Nokeety Mahmoud Mohamed
Published: May 2022

Introduction: Medical renal diseases stand as one of the major health problems in pediatric age group considering its morbidity/mortality and the subsequent management plans. Objectives: In this manuscript, the spectrum of histopathological patterns of medical nephropathic lesions in Egyptian pediatric patients over duration of five years is reported with clinical indications. Patients and Methods: We conducted a retrospective study for analysis of our pathological reports of renal needle biopsies during the period from January 2014 until January 2019. One hundred and sixteen cases were included. Results: The most commonly encountered pediatric renal pathology was minimal change disease (27.59%), followed by congenital glomerular diseases (22.41%), focal segmental glomerulosclerosis (12.93%), and thrombotic microangiopathy (7.76%). The most common clinical indication for biopsy was nephrotic syndrome (37.07%) followed by impaired renal functions with elevated serum creatinine (21.55%). In addition, we report very rare histological findings in few cases including infantile nephropathic cystinosis, Barakat syndrome and C3 glomerulopathy. Conclusion: Minimal change disease and congenital glomerular diseases accounted for half of pediatric renal pathologies in the study population. The most common clinical indication for renal biopsy was nephrotic syndrome. Electron microscopic examination and genetic studies are mandatory for proper evaluation of pediatric nephropathies.
"Double whammy" to the kidneys: an unusual etiology of acute kidney disease
Authors: Jayaprakash Varadharajan , Suganya Muthukaruppaiah , Karthick Dhanasekaran , Kurien Anila Abraham , Padmanabhan Raghavan
Published: May 2022

Severe rhabdomyolysis could lead to myoglobinuria and acute kidney injury (AKI). Acute interstitial nephritis (AIN) is commonly caused by drugs. AIN per se can cause ‘severe’ AKI. Renal recovery is delayed when several factors are involved in the pathogenesis of AKI. Survivors of AKI require long-term follow-up. Here, we report a case where both severe rhabdomyolysis and drug-induced AIN contributed to ‘severe’ dialysis-requiring AKI. Renal biopsy was diagnostic and showed characteristic features. Steroid therapy for AIN resulted in partial recovery.
Urinary podocin; is it a valuable disease activity biomarker in patients with lupus nephritis?
Authors: Behairy Maha A. , ElShaarawy Abdelbassit , Bawady Somia , Elsayed Fatma , Bichari Walid A
Published: May 2022

Introduction: Podocyturia can be considered as a noninvasive marker for evaluation and follow up of glomerular disease progression. Objectives: In this study, we aimed to assess the clinical utility of urinary podocin as an index of lupus nephritis activity. Patients and Methods: This cross-sectional study included 45 patients with systemic lupus erythematosus (SLE). Patients were subdivided into three groups: group (I) 10 SLE, patients without clinical or laboratory evidence of lupus nephritis (LN), which were assessed by Systemic Lupus Activity Measure (SLAM) score of the disease activity. Group (II), which included 15 patients with evident active LN before starting the immunosuppressive induction treatment and group (III) which is consisted of 20 patients with LN in partial or complete remission. Urinary podocin assay was conducted by enzyme-linked immunosorbent assay enzyme-linked immunosorbent assay (ELISA) technique. Results: There was a statistically significant difference between the studied groups regarding urinary podocin levels. The mean of urinary podocin (ng/mL) was (2.29 ± 0.71, 37.20 ± 14.38, 10.5 ±2.30; P≤0.001) in the three groups consecutively, with significant decrease of urinary podocin in LN patients after remission versus high level in patients with active LN. Highly significant positive correlations were found between urinary podocin and global SLAM activity (r = 0.852; P≤ 0.001), SLAM-Renal score (r= 0.854; P≤0.001), urine albumin to creatinine ratio, (mg/g) (r=0.895; P≤0.001). Highly significant negative correlations of urinary podocin and C3 (r=0.803; P≤ 0.001), C4 (r= -0.760; P≤0.001) and eGFR (r = -0.759; P≤0.001) were detected. Conclusion: Urinary podocin as non-invasive biomarker is significantly correlated to SLE disease activity and LN activity measured by global SLAM clinical score with both high sensitivity and specificity. Urinary podocin can be also considered as a prognostic marker in the management of LN patients.
Kidney outcomes of immune-complex associated mesangiocapillary glomerulonephritis in patients with and without HIV
Authors: Inusah Abdul-Jalil , Coetzee Liezel , Bates William , Chothia Mogamat-Yazied
Published: May 2022

Introduction: HIV-associated kidney diseases continue to be a major problem in South Africa. Objectives: We aimed to determine the kidney outcomes of immune-complex associated mesangiocapillary glomerulonephritis (MCGN) in patients with and without HIV. Patients and Methods: A retrospective cohort study was conducted on all adult patients with a kidney biopsy diagnosis of immune-complex associated MCGN from 1 January 2000 to 31 December 2016. We compared the proportion of HIV-positive and HIV-negative patients that reached the composite endpoint of either doubling of the serum creatinine or end-stage kidney disease. Cox proportional hazards models were employed to examine the association between the composite endpoint and predictor variables. Results: A total of 79 patients were included of which 20 (25.3%) were HIV-positive. Twentyfour patients (30.4%) reached the composite endpoint. The cumulative proportions reaching the composite endpoint at one and four years were 25.3% and 30.4% with no difference between HIVpositive and HIV-negative patients (45.0% versus 25.4%, respectively; P= 0.10). Multivariable Cox proportional hazards model identified estimated glomerular filtration rate at biopsy (hazard ratio [HR] = 0.92; 95% confidence interval [CI]: 0.84-1.00, P=0.04) and proteinuria at follow-up (HR = 1.60; 95% CI: 1.21-2.11, P<0.01) as predictors of the composite endpoint at one-year. On survival analysis, there was no difference in the composite endpoint for HIV status (P=0.09; log-rank). Conclusion: Immune-complex associated MCGN continues to be a common histopathological pattern of injury at our center. Due to late presentation, kidney outcomes remain poor, regardless of HIV status.
Membranous nephropathy with collapse in a HIV negative patient; a case report with a 34-month follow-up
Authors: Costa Luisa Lemos , Rodrigues Ana Isabel , Ferreira Carolina , Lima Carla Pereira , Sousa Tânia Couto , Viana Helena , Góis Mário , Lemos Sérgio Silva
Published: May 2022

Membranous nephropathy (MN) is a common cause of nephrotic syndrome (NS) in nondiabetic adults. Collapsing nephropathy (CN) is a morphological pattern that is usually classified as a variant of focal segmental glomerulosclerosis (cFSGS). The simultaneous presence of both MN and CN is rare and their combination usually foresees an unfavorable outcome. Herein, we describe a case report of a patient with PLA2 R-associated MN with collapse, its treatment and clinical course.
Relation of serum aluminum level to uremic pruritus in end-stage renal disease patients on maintenance hemodialysis
Authors: Sarhan Iman Ibrahim , Tawfik Ahmed Mohamed , El Said Tamer Wahid , Abd El Aziz Abd El Azim Mahmoud Nady , Hussein Hussein Sayed
Published: May 2022

Introduction: Uremic pruritus is a common discomfort in end-stage renal disease patients on long-term hemodialysis. It negatively affects patients’ quality of life and is associated with increased mortality. The pathogenesis of uremic pruritus is complex. Aluminum is a toxic metal and common human allergen that causes an immune reaction in patients on hemodialysis. Aluminum is hypothesized to play a vital role in the pathogenesis of uremic pruritus. Controlling serum aluminum levels is still critical for patients on long-term hemodialysis. Objectives: To determine the prevalence of hyperaluminemia and assess its correlation with uremic pruritus in patients on long-term hemodialysis. Patients and Methods: We conducted a case-control study on 90 patients on long-term hemodialysis at the dialysis units of Ain Shams university hospitals. We used the 5-D itch scale numerical rating system to determine the presence and severity of pruritus in our study participants. We collected blood samples to estimate blood urea nitrogen levels pre- and post-dialysis, as well as the measured urea reduction ratio, serum creatinine, hemoglobin level, intact parathyroid hormone, ionized calcium, serum phosphate levels, iron study and serum aluminum levels. Results: Our study showed no statistically significant differences between the pruritic and non-pruritic study groups (median values 9.78 [6.48–11.72] and 9.13 [6.3–10.4] for the pruritic and non-pruritic groups, respectively; P = 0.32). Conclusion: The serum aluminum levels of our study participants were higher than the normal levels in humans. Patients in the pruritic group had higher levels than those in the non-pruritic group. However, aluminum levels were not significantly associated with either the presence or severity of pruritus in patients on long-term hemodialysis.
Giardiasis mimicking acute abdomen in a renal transplant patient; a clinical and diagnostic challenge
Authors: Tiwari Vaibhav , Gupta Anurag , Gupta Pallav , Rana Devender Singh
Published: May 2022

Background: Intestinal infection in the post-transplant period is a common source of morbidity and mortality. Diarrhea with or without abdominal pain, bloating, nausea and vomiting constitute the most common symptomology which guides the clinician towards appropriate treatment, but what happens when the clues are few? Case Presentation: We report a case of recent renal allograft recipient who presented with severe abdominal pain without diarrhea or fever. After undergoing various tests, the diagnosis was finally clinched by jejunal biopsy since, it is supported by stool polymerase chain reaction. Conclusions: This case highlights a common organism like giardia can have a varied presentation. This case mimicking almost as an acute abdomen while can present with a diagnostic challenge.
Isolation and characterization of exosomes derived from supernatant of rabbit kidney tubular cells culture
Authors: Fakhredini Fereshtesadat , Mansouri Esrafil , Orazizadeh Mahmoud
Published: May 2022

Introduction: Different vesicles are created by the cells into extra-cellular space, of which researchers mostly considered exosomes. In fact, the vesicles are secreted by each cell type and are found in the body fluids like urine, blood and breast milk and consist of a certain ingredient of proteins, RNA, lipids and DNA. Objectives: The present study attempted to examine the exosomes derived from tubular cells of the rabbit kidney. Materials and Methods: Exosomes have been derived from rabbit kidney tubular cell line (RK13Cs) supernatant by ultracentrifugation centrifugation treatment techniques. In the next stage, RK13Cs-Exo has been validated by the dimension, morphology and certain bio-markers through the transmission electron microscopy (TEM) and scanning electron microscopy (SEM), Zetasizer nano-analysis, atomic force microscopy (AFM) and western blotting. Results: The morphology of RK13Cs-Exo under TEM and SEM revealed that they have been vesicles shaped like a sphere ~150 nm. Zetasizer nano also indicated that RK13Cs-Exo size has been nearly 50 to 100 nm. Atomic force microscopy image of RK13Cs-Exo showed distinct spherical particles in size range between 50 and 100 nm, corresponding to the TEM. According to the western blotting outputs, exosome markers CD63 and CD9 have been expressed in the RK13Cs-Exo. Conclusion: Tubular cells of the rabbit kidney synthesize large amounts of exosomes under critical environmental conditions, which can extract the produced exosomes. According to the characterization of derived exosomes, they are ideal vehicles for drug delivery.
Prevalence and determinants of depression, anxiety and stress among the Iranian older people with type 2 diabetes
Authors: Namjoo Shamsedin , Mirzaei Masoud , Foroughan Mahshid , Ghaedamini Harouni Gholamreza , Aboubakri Omid
Published: May 2022

Introduction: Mental disorders (depression, anxiety and stress) cause disability and aggravate various diseases, including diabetes mellitus and its common complication such as diabetic nephropathy. Objectives: The current study aimed to investigate the prevalence of mental health disorders (depression, anxiety and stress) and their associated factors among the Iranian older people with type 2 diabetes mellitus (T2DM). Patients and Methods: In this cross-sectional study, 501 subjects with T2DM and 551 subjects without T2DM were selected by a multistage stratified sampling method from Yazd Greater Area, Iran. Delphi method and experts panel were used for selection of priorities of effective factors. The obtained data were analyzed using the chi-square test and Stata software version 14. A P value of ≤0.05 was considered statistically significant. Results: The prevalence of moderate to severe depression and anxiety was 51.9% and 61.9%, among diabetic, 22% and 33.4% among non-diabetic groups, respectively. According to multiple logistic regression analysis results in diabetics group specified female gender (OR=1.97, 95% CI=1.03-3.75), poor sleep quality (OR=1.08, 95% CI=1.02-1.15), decreased social support (OR=0.89, 95% CI=0.54-1.68), and body mass index (BMI) ≥30 kg/m² (OR=1.6, 95% CI=1.2-5.63) for depression, as well as female gender (OR=2.97, 95% CI=1.5- 5.87), BMI ≥30 kg/m² (OR=2.69, 95% CI=1.22-5.96), and decreased social support (OR=0.87, 95% CI=0.78-0.98) for anxiety as the predicting characteristics. Conclusion: The present research findings revealed a significantly higher prevalence of depression and anxiety in older people with T2DM rather than older people without T2DM. Therefore, appropriate interventions such as screenings and psychiatric evaluations are necessary to diagnose and treat depression and anxiety in this population, especially the females to avoid diabetic complications like diabetic kidney disease.
Effect of melatonin on C-reactive protein and lipid profile of hemodialysis patients
Authors: Zahed Nargessadat , Pouyamehr Marjan , Taherkhani Adineh
Published: May 2022

Introduction: Cardiovascular disease is one of the major causes of death in hemodialysis patients. Lipid metabolism abnormalities and increased inflammatory factors are related factors. In recent studies, melatonin inhibits dyslipidemia and reduces inflammatory factors by inhibiting LDL-C oxidation. The purpose of this study was to evaluate the effect of melatonin supplement on hyperlipidemia and C-reactive protein (CRP) level in hemodialysis patients. Objectives: We aimed to determine the effect of melatonin on CRP and lipid profile of hemodialysis patients. Patients and Methods: Among 200 hemodialysis patients, only 28 patients fulfilled the inclusion criteria to enroll in the study. Patients were treated with melatonin supplements 3 mg/d at bedtime for 12 weeks. Serum lipid profile and CRP levels were measured after 12 weeks. Five patients were excluded, 2 patients underwent kidney transplantation, and three patients did not cooperate. The Wilcoxon signed-rank test was used to compare the two groups according to the number of participants (less than 30) and study type (pre-test and post-test). P <0.05 was considered as the level of significance. Results: A total of 23 patients completed the treatment protocol. Participants was composed of 13 male and 10 female. The participants’ mean age was 30.6± 11.6 years. After treatment mean total cholesterol levels decreased from 139.95±35.49 mg/dL to 131.13 ± 34.96 mg/dL (P=0.194) which was not statistically significant. However, the decrease in serum triglyceride level was statistically significant (P=0.004). Plasma HDL-C increased significantly after treatment (P=0.032). Serum CRP levels did not change. Conclusion: Melatonin supplement improves serum triglyceride and HDL-C levels in hemodialysis patients but has no effect on total cholesterol and CRP in hemodialysis patients. Trial Registration: This randomized controlled trial was registered by the Iranian Registry of Clinical Trials (identifier: IRCT20200308046724N1; https://en.irct.ir/trial/46407, ethical code; IR.SBMU.RETECH.REC.1397.687).
Evaluation of pulmonary hypertension and its relationship with serum parathyroid hormone levels in hemodialysis patients
Authors: Eskandarian Rahimeh , Jafari Soheila , Mir Mohammadkhani Majid , Yarmohamadi Maliheh , Alizadeh Sani Zahra , Behjati Mohaddeseh , Alizadehsani Roohallah , Shariful Islam Sheikh Mohammed
Published: May 2022

Introduction: Pulmonary hypertension is a progressive and severe disease associated with left or right ventricular dysfunction and is common in patients under hemodialysis. One of the factors in its development is parathormone but this relationship is unclear. Objectives: In this study, the difference between serum levels of parathyroid hormone (PTH) in hemodialysis patients with and without pulmonary artery hypertension (PAH) was investigated. Patients and Methods: We conducted a cross-sectional study among hemodialysis patients referred to a tertiary hospital in Iran. Characteristics of coronary artery and pulmonary arteries were recorded by echocardiography. The laboratory data were measured and recorded. Statistical analysis was performed at 95% confidence level and with a significance level of less than 5%. Results: Of 65 enrolled patients, 41 had normal pulmonary artery pressure, and 24 had pulmonary hypertension. The mean age in patients with and without pulmonary hypertension was significantly different (P=0.010). There was no significant difference in serum PTH levels between patients with and without pulmonary hypertension (P=0.496). The mean serum levels of calcium, albumin, triglyceride, and cholesterol in two groups of patients with and without pulmonary hypertension was not significantly different (P=0.906). Conclusion: In our study, no significant correlation between pulmonary hypertension and PTH was detected. The prevalence of pulmonary arterial hypertension in our study was relatively high, suggesting the need to pay attention to pulmonary hypertension in hemodialysis patients
NR3C1 gene polymorphisms in adult patients with nephrotic syndrome
Authors: Ahmadian Elham , Hejazian Seyyedeh Mina , Vahedi Leila , Khakpour Amirhassan , Jalalat Jalal , Zununi Vahed Sepideh , Ardalan Mohammadreza
Published: May 2022

Introduction: Glucocorticoids therapy is a selective treatment strategy for cases with nephrotic syndrome (NS). Objectives: Due to the lack of positive response of all patients to therapy and the dependency of biological effects of glucocorticoids on its receptors (GR), here, the association of the NR3C1 gene (N363S, BclI, GR-9β, and ER22/23EK) polymorphisms with the response to glucocorticoids was investigated in patients with NS. Patients and Methods: In this study, 55 patients with primary NS including 29 steroid-responder (SS) and 26 steroid-resistant (SR) and also 30 healthy individuals were recruited. The polymorphisms of NR3C1 gene were studied by PCR and sequencing of the amplified fragments and the results were compared between the groups. Results: A3669 SNP was observed in 8.7% (n=2) of patients with SRNS and 6.3% (n=2) of responders (P=0.560). In 40.7% of steroid-responsive patients (n=11) and 21.4% of patients with SRNS (n=6), BclI polymorphism was detected that was not statistically significant (P=0.098). The N363S and ER22/23EK polymorphisms were not detected in the studied groups. No significant differences were observed between the frequency of the studied polymorphisms between the different subtypes of NS; focal and segmental glomerulosclerosis (FSGS), membranous glomerulonephritis (MGN), and control group. Conclusion: The NR3C1 gene N363S, BclI, GR-9β, and ER22/23EK polymorphisms do not affect the steroid responsiveness and the pathogenesis of NS in Azari adult patients with primary NS. Other polymorphisms within NR3C1 gene need to be explored in large cohorts.
A case report to a successful surgical treatment of non-catheter dependent benign prostatic hyperplasia as a cause of non-dilated obstructive uropathy
Authors: Fijasri Nurul Hafiez , Mohamed Daud Mohamed Ashraf , Wan Zain Wan Zainira , Hashim Isa Merican Siti Rahmah , Mohamad Ikhwan Sani
Published: May 2022

Large benign prostatic hyperplasia (BPH) that obstructs the urinary bladder neck was a known cause of acute renal dysfunction. However, it is rare to get renal impairment in a non-dilated upper tract caused by BPH. We are reporting a case of a man who presented to our urology unit with remarkable renal impairment due to concurrent BPH, with no evidence of a dilated system. The patient is a 65-year-old man who presented to our urology unit for the complaints of severe irritative and obstructive symptoms of the lower urinary tract for the past few months. Initial renal function test showed severe renal impairment and ultrasound of kidney urinary and bladder (KUB) revealed normal bilateral kidneys with no evidence of hydronephrosis bilaterally. The patient subsequently underwent transurethral resection of the prostate (TURP) in our centre and his kidney function instantaneously returned to normal before discharging home. Dilated urinary system in obstructive uropathy does not always correspond to the degree of obstruction as in our case. Thus, immediate intervention to release obstruction in a non-dilated urinary system due to bladder neck obstruction is recommended.
COVID-19 and kidney failure; a mini-review to recent evidence
Authors: Jahangiri Dorsa , Mojtahedi Zahra , Moonesan Mohammad Reza
Published: May 2022

In COVID-19 infection, most of the renal disturbances are due to acute tubular necrosis. Renal dysfunction occurs in severe COVID-19 infection and is usually secondary to sepsis, cytokine storm, and hypotension. Other conditions, such as exacerbated inflammatory responses, dehydration, hypoxia, hypercoagulability, endothelial damage, pneumonia, septicemia, drug nephrotoxicity, and myocardial dysfunction also contribute to renal failure.
Assessment of the effect of adding furosemide to antihypertensive treatment on postpartum hypertension in women with preeclampsia; a randomized clinical trial
Authors: Jahed Bozorgan Tayebeh , Azadi Pegah , Dehghani Zahra
Published: May 2022

Introduction: One of the probable mechanisms of hypertension that may occur in women with preeclampsia after delivery is returning of interstitial and extravascular fluid into the bloodstream. Objectives: The present study aimed to investigate the effect of furosemide to control postpartum hypertension in women with preeclampsia. Patients and Methods: This randomized clinical trial was conducted on 116 patients with preeclampsia with a blood pressure (BP) of more than 150/100 mm Hg in the first 24 hours after delivery. Patients were randomly divided into two groups of nifedipine (taking 10 mg tablets every 8 hours) and nifedipine plus furosemide (nifedipine plus 20 mg furosemide tablet once daily). Patients were monitored until the fifth day after delivery. After the first 48 hours, patients with a BP lower than 150/100 mm Hg were discharged from the hospital and the treatment continued at home. Results: Systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP) were significantly reduced in all patients and in each group on the first to fifth days after delivery. On the second day, DBP in the nifedipine group was significantly lower (P=0.005). On the third to fifth days, SBP in the nifedipine plus furosemide group was significantly lower (P<0.05), while DBP did not change (P>0.05). On the third and fourth days, MAP was significantly lower in the nifedipine plus furosemide group (P<0.05), however it was not significantly different on the fifth day (P=0.383). The need for additional medication to control BP was higher in the nifedipine group than in the nifedipine plus furosemide group. BP became normal (less than 120/80 mmHg) in 74 patients (68%) within five days after delivery; which was more popular in the nifedipine plus furosemide group (P<0.001). Conclusion: The findings of the present study showed that inclusion of furosemide in nifedipine regimen was associated with a further reduction in SBP and MAP. Furosemide also reduced the need for additional medication to control BP and increased the frequency and speed of reaching toward normal BP. Trial Registration: The trial protocol was approved by the Iranian Registry of Clinical Trials (identifier: IRCT20191031045289N2; https://irct.ir/trial/49806, ethical code; IR.SBMU.MSP. REC.1399.067).
Furosemide stress test predicts acute kidney injury progression in intensive care unit
Authors: Jayakrishna Murthy Srivatsava , Venugopal Lakshminarayana , Jayaprakash Varadharajan , Padmanabhan Raghavan , Sreedhar Sailapathy
Published: May 2022

Introduction: Clinical tools to predict acute kidney injury (AKI) in intensive care unit (ICU) are lacking. Objectives: This prospective study was conducted to assess the utility of furosemide stress test (FST) to predict AKI and its progression to severe stages and requirement of hemodialysis (HD). Patients and methods: Patients in AKI stage I or II were given a standardized dose of frusemide as per protocol. The study cohort included 62 patients. Response to FST was assessed by urine output (UOP) at 2 hours. Study patients were subsequently divided into two groups, those with UOP >200 mL (group A) and those with UOP <200 mL (group B). Results: Group A constituted 71% (n=44) of cases. Of them, 2 (4.54%) patients progressed to AKI Network (AKIN) stage III. Group B constituted 29% of cases (n=18). Of them, 12 (66%) cases progressed to AKIN stage III. In group A, 4.5% (n=2) of cases required HD. In comparison, 55% (n=10) of group B patients required HD during the hospital stay. Mortality rate was 6.8% (n=3) in group A and 33.3% (n=6) in group B. The duration of stay was more in the patients with UOP <200 mL group compared to UOP >200 mL group. Conclusion: FST may be a reliable predictor of AKI progression to severe stages and requirement of dialysis in ICUs.
The role of remote ischemic preconditioning in preventing contrast-induced nephropathy following invasive coronary angiography; a randomized controlled trial
Authors: Peighanbari Mohammadmehdi , Raffieijelodar Hoda , Shafii Zahra
Published: May 2022

Introduction: Remote ischemic preconditioning (RIPC) is now proposed as an effective approach for preventing contrast-induced nephropathy (CIN); however, the results on its efficacy have already remained uncertain. Objectives: We aimed to assess the beneficial effects of RIPC in preventing CIN in patients undergoing coronary angiography (CA) followed by angioplasty. Patients and Methods: One hundred patients candidate for elective CA and coronary angioplasty, moderate to high risk for CIN were randomized into two groups including the group which planned for RIPC, and the control group. The overall prevalence rate of CIN was assessed and compared across the two groups. Results: The two groups were matched for demographics, cardiovascular risk profiles and laboratory parameters. The prevalence of CIN in RIPC group was 14.0% and in the control group was 26.0% indicating no statistical difference between the two groups (P = 0.105). Requiring dialysis was also planned for 0.0% and 2.0% respectively with no difference (P = 0.500). Conclusion: RIPC may not prevent CIN in patients who are candidate for invasive CA. Trial Registration: The study was approved in the Iranian Registry of Clinical Trials (identifier: IRCT20171230038144N1; https://www.irct.ir/trial/28715, ethical code: IR.IUMS. FMD.REC 1396.9311171014).
Predictors of hope in Iranian patients undergoing hemodialysis
Authors: Moghaddam Zeabadi Sakineh , Ranjbaran Mehdi , Rashvand Farnoosh , Rostampourromdasht Akram , Hosseinigolafshani Seyedehzahra
Published: May 2022

Introduction: Patients undergoing hemodialysis (HD) are more vulnerable to mental, physical and spiritual disorders. These disorders may have a significant impact on their treatment process and quality of life (QoL). Given the importance of some experiences in these individuals, such as daily spiritual experiences and life expectancy, evaluating their predictive role seems necessary. Objectives: This study was conducted to determine the role of daily spiritual experiences and some demographic variables in predicting the level of hope among HD patients. Patients and Methods: In this cross-sectional study, the predictive role of daily spiritual experiences and some demographic variables in the level of hope in 262 HD patients were evaluated. The demographic variables checklist, the Daily Spiritual Experiences Scale (DSES), and the Adult Hope Scale were employed for data collection. Results: Analysis with multiple linear regression showed that the variables of gender, level of education, duration of diagnosis of renal failure, number of HD per week and daily spiritual experiences predicted 31% of the level of hope changes in HD patients. Conclusion: Nurses and provincial health care providers can help HD patients to promote their spiritual wellbeing and hope. This can be achieved by applying a holistic care approach as well as emphasizing the spiritual aspect of care and its predictive demographic variables.
IL1RN VNTR Polymorphism and kidney damage in sickle cell anemia patients
Authors: Bhaskar LVKS , Pattnaik Smaranika
Published: May 2022

Introduction: Sickle cell anemia (SCA) is a chronic illness associated with acute and chronic hemolytic anemia, recurrent vaso-occlusion episodes, intense pain, progressive multiple organ damage, and early mortality. Inflammation plays a significant role in the pathophysiology of SCA. Elevated levels of pro-inflammatory cytokines are involved in worsening the degree of kidney damage in SCA patients. Objectives: The present study aimed to assess whether IL1RN VNTR polymorphism is associated with kidney damage in patients with SCA. Patients and Methods: We have investigated 190 SCA patients (104 with Normal kidney function and 86 with kidney damage). Creatinine-based estimated glomerular filtration rate (eGFR) was calculated to assess kidney function. Interleukin-1 receptor antagonist gene (IL1RN) variable number tandem repeats (VNTR) genotypes were analyzed using PCR-electrophoresis. The association between IL1RN-VNTR and kidney damage was evaluated by using χ2 test. Odds ratios (OR) and 95% CI were calculated. The relationship between kidney damage and fetal hemoglobin (HbF) and their interaction with IL1RN-VNTR genotypes, was investigated using a Mantel-Haenszel (M-H) stratified analysis. Results: There were no significant differences in genotype frequencies between SCA patients with or without kidney damage (P=0.107). Furthermore, no significant interactions between IL1RN VNTR and HbF on determining kidney damage were found. Conclusion: These results conflict with the biological plausibility that interleukin levels modulate SCA pathophysiology and may deserve further exploration.