Familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) is an autosomal recessive disorder that affect children and young adults. Mutation in gene that coding the tight junction proteins Claudin-16 and Claudin-19(CLDN19) is responsible of this rare disorder. Hypomagnesemia, hypercalciuria, kidney failure and visual impairment (in CLDN 19 gene mutation) are the most common presentations of FHHNC. Here we present a 31-year-old woman with end-stage kidney disease (ESKD) on routine hemodialysis for the past eight years and was referred to Firoozgar nephrology clinic for kidney transplantation. Her past medical history included recurrent kidney stones. Although FHHNC is a rare disease, genetic evaluation recommended in patients with ESKD and concomitant nephrocalcinosis.
{"title":"A Report of Claudin-19 Mutation Causing Nephrocalcinosis and End-Stage Kidney Disease from Iran.","authors":"Shokoufeh Savaj, Saghar Chehrazi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) is an autosomal recessive disorder that affect children and young adults. Mutation in gene that coding the tight junction proteins Claudin-16 and Claudin-19(CLDN19) is responsible of this rare disorder. Hypomagnesemia, hypercalciuria, kidney failure and visual impairment (in CLDN 19 gene mutation) are the most common presentations of FHHNC. Here we present a 31-year-old woman with end-stage kidney disease (ESKD) on routine hemodialysis for the past eight years and was referred to Firoozgar nephrology clinic for kidney transplantation. Her past medical history included recurrent kidney stones. Although FHHNC is a rare disease, genetic evaluation recommended in patients with ESKD and concomitant nephrocalcinosis.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"18 4","pages":"125"},"PeriodicalIF":0.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Peritoneal dialysis utilizes two distinct double-bag exchange systems (ANDY-Disc from Fresenius Medical Care in Bad Homburg, Germany, and DIANEAL from Baxter in Deerfield, IL). These systems are widely used across the globe. The long-term outcomes of peritonitis with different types of treatment are still questionable. Therefore, we conducted a retrospective comparative cohort study to assess the long-term impact of these two distinct exchange procedures on the true peritonitis rate and the technique durability in real-world settings.
Methods: One hundred and twenty patients, treated with a double-bag exchange system in a Songklanagarind Hospital, located in the south of Thailand from January 2009 to December 2020 were included. The primary outcome was the incidence rate of peritonitis by treatment arm (ANDY-disc and DIANEAL). Secondary outcomes included the pathogenic organism causing peritonitis, time to the first peritonitis, and survival technique between the two systems.
Results: The peritonitis rate for patients using the ANDY-disc in continuous ambulatory peritoneal dialysis (CAPD) was 0.28 episodes per patient-year, while the DIANEAL group had a rate of 0.29 episodes per patient-year. There was no difference in the peritonitis rate between the two groups (P = .816). Gram-positive bacterial peritonitis accounted for 33.4% in the ANDY-disc arm and 43.7% in the DIANEAL arm. The 10-year technique survival was 86.1% in the ANDY-Disc group and 73.5% in the DIANEAL group; this did not reach statistical significance.
Conclusion: The ANDY-Disc and DIANEAL exchange systems are comparable in the long-term incidence of peritonitis. Both systems have similar long-term technique survival. However, this should be confirmed by a high-quality trial.
{"title":"Effect of Exchange Systems and Procedure on Long Term Peritonitis in ESKD Patients Undergoing CAPD :A Retrospective Comparative Cohort Study.","authors":"Phongsak Dandecha, Atthaphong Phongphithakchai","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Peritoneal dialysis utilizes two distinct double-bag exchange systems (ANDY-Disc from Fresenius Medical Care in Bad Homburg, Germany, and DIANEAL from Baxter in Deerfield, IL). These systems are widely used across the globe. The long-term outcomes of peritonitis with different types of treatment are still questionable. Therefore, we conducted a retrospective comparative cohort study to assess the long-term impact of these two distinct exchange procedures on the true peritonitis rate and the technique durability in real-world settings.</p><p><strong>Methods: </strong>One hundred and twenty patients, treated with a double-bag exchange system in a Songklanagarind Hospital, located in the south of Thailand from January 2009 to December 2020 were included. The primary outcome was the incidence rate of peritonitis by treatment arm (ANDY-disc and DIANEAL). Secondary outcomes included the pathogenic organism causing peritonitis, time to the first peritonitis, and survival technique between the two systems.</p><p><strong>Results: </strong>The peritonitis rate for patients using the ANDY-disc in continuous ambulatory peritoneal dialysis (CAPD) was 0.28 episodes per patient-year, while the DIANEAL group had a rate of 0.29 episodes per patient-year. There was no difference in the peritonitis rate between the two groups (P = .816). Gram-positive bacterial peritonitis accounted for 33.4% in the ANDY-disc arm and 43.7% in the DIANEAL arm. The 10-year technique survival was 86.1% in the ANDY-Disc group and 73.5% in the DIANEAL group; this did not reach statistical significance.</p><p><strong>Conclusion: </strong>The ANDY-Disc and DIANEAL exchange systems are comparable in the long-term incidence of peritonitis. Both systems have similar long-term technique survival. However, this should be confirmed by a high-quality trial.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"18 4","pages":"212-220"},"PeriodicalIF":0.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Antibody mediated rejection (AMR) is a major challenge in kidney transplantation and adversely affects allograft survival. Oxidative stress (OS) is implicated in AMR pathogenesis by triggering inflammation, apoptosis and fibrosis in the graft tissue. However, the status of OS and antioxidant defense in AMR patients remains unclear. We aimed to evaluate the levels of OS markers and antioxidant enzymes in AMR patients. Methods. We conducted a case-control study involving 22 biopsy-proven AMR patients (test group) and 14 kidney recipients with stable graft function (control group). Serum total oxidant status (TOS), total antioxidant capacity (TAC), total thiol groups, nitric oxide (NO), 8-isoprostane (8-IP) were determined and activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) were measured by spectrophotometric methods.
Results: Data analysis showed significant increases in TOS, TAC and 8-IP levels together with marked reductions in NO and total thiol groups in AMR patients. CAT and GPx activities did not differ between groups, however SOD activity was significantly lower in AMR patients.
Conclusion: Our study showed increased OS and impaired antioxidant defense in AMR patients. NO level may serve as a potential biomarker of OS severity and immune response in AMR. Further studies are required to elucidate the mechanisms and consequences of OS in AMR and to explore the therapeutic potential of antioxidants.
{"title":"Novel Insights into Oxidative Stress and Antioxidant Enzymes in Acute Antibody-Mediated Rejection of Renal Allografts.","authors":"Mohsen Nafar, Iraj Khodadadi, Shiva Kalantari, Heidar Tayebinia, Jamshid Karimi, Shiva Samavat, Nooshin Dalili, Somaye-Sadat Heidari","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Antibody mediated rejection (AMR) is a major challenge in kidney transplantation and adversely affects allograft survival. Oxidative stress (OS) is implicated in AMR pathogenesis by triggering inflammation, apoptosis and fibrosis in the graft tissue. However, the status of OS and antioxidant defense in AMR patients remains unclear. We aimed to evaluate the levels of OS markers and antioxidant enzymes in AMR patients. Methods. We conducted a case-control study involving 22 biopsy-proven AMR patients (test group) and 14 kidney recipients with stable graft function (control group). Serum total oxidant status (TOS), total antioxidant capacity (TAC), total thiol groups, nitric oxide (NO), 8-isoprostane (8-IP) were determined and activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) were measured by spectrophotometric methods.</p><p><strong>Results: </strong>Data analysis showed significant increases in TOS, TAC and 8-IP levels together with marked reductions in NO and total thiol groups in AMR patients. CAT and GPx activities did not differ between groups, however SOD activity was significantly lower in AMR patients.</p><p><strong>Conclusion: </strong>Our study showed increased OS and impaired antioxidant defense in AMR patients. NO level may serve as a potential biomarker of OS severity and immune response in AMR. Further studies are required to elucidate the mechanisms and consequences of OS in AMR and to explore the therapeutic potential of antioxidants.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"18 4","pages":"227-235"},"PeriodicalIF":0.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Despite the significant decline in the incidence of pregnancy-related acute kidney injury (AKI) in recent decades due to advancements in medicine and increased awareness of this disease, it remains an important risk factor for maternal morbidity and mortality. However, as fertilization techniques allow women of advanced age to become pregnant, the incidence of pregnancy-related AKI has increased. Consequently, early identification of and intervention for pregnancy-related AKI are particularly important.
Methods: This was a retrospective clinical analysis. Data were collected from pregnant patients who were treated in the ICU of Shengjing Hospital of China Medical University from January 2014 to June 2020; The patients were divided into two groups based on their kidney function status: AKI and non-AKI. Additionally, they were further categorized into recovered and non-recovered groups based on their prognosis. The Wilcoxon rank sum test and the chi-square test were used for multigroup comparisons, while logistic regression analysis was used for the analysis of risk factors. P < .05 was considered to indicate a statistically significant difference in all correlation analyses.
Results: Among 874 pregnant women in this study, 136 had AKI (15.56%), while 36 developed chronic renal insufficiency (26.47%). Statistically significant associations were shown for shock (P = .002), sepsis (P < .001), coagulopathies (P = .001), liver insufficiency (P < .001), postpartum hemorrhage (P = .016), intrauterine fetal death (P = .042) and mechanical ventilation (P = .006) between the AKI-group and the non-AKI group. The development of AKI based on an elevated baseline creatinine level was significantly related to the outcome of renal function (P < .001), while a significant difference was shown in the use of continuous renal replacement therapy (CRRT) between the recovery group and the non-recovery group (P = .023).
Conclusion: We identified the relevant risk factors leading to pregnancy-related AKI and affecting the patients' prognosis. Shock, sepsis, coagulation disorders, liver insufficiency, postpartum hemorrhage, intrauterine fetal death and mechanical ventilation are independent risk factors for pregnancy-related AKI, while an elevated baseline creatine level is a key factor for poor prognosis. Meanwhile, early CRRT can effectively reverse renal outcomes.
导言:尽管近几十年来,由于医学的进步和人们对这种疾病认识的提高,妊娠相关急性肾损伤(AKI)的发病率大幅下降,但它仍然是孕产妇发病和死亡的一个重要风险因素。然而,由于受精技术允许高龄产妇怀孕,妊娠相关急性肾损伤的发病率也随之增加。因此,早期识别和干预妊娠相关性 AKI 尤为重要:这是一项回顾性临床分析。数据来源于2014年1月至2020年6月在中国医科大学附属盛京医院ICU接受治疗的妊娠期患者:根据肾功能状态将患者分为两组:AKI 组和非 AKI 组。此外,根据预后将患者进一步分为康复组和未康复组。多组比较采用 Wilcoxon 秩和检验和卡方检验,风险因素分析采用逻辑回归分析。在所有相关分析中,P < .05 被认为表明差异具有统计学意义:结果:在这项研究的 874 名孕妇中,136 人(15.56%)发生了 AKI,36 人(26.47%)出现了慢性肾功能不全。在休克(P = .002)、败血症(P < .001)、凝血功能障碍(P = .001)、肝功能不全(P < .001)、产后出血(P = .016)、胎儿宫内死亡(P = .042)和机械通气(P = .006)方面,AKI 组和非 AKI 组之间存在统计学意义上的关联。基线肌酐水平升高导致的AKI与肾功能结果有显著相关性(P < .001),而恢复组和非恢复组在使用持续肾脏替代疗法(CRRT)方面存在显著差异(P = .023):我们确定了导致妊娠相关性 AKI 并影响患者预后的相关风险因素。休克、脓毒症、凝血功能障碍、肝功能不全、产后出血、胎儿宫内死亡和机械通气是妊娠相关性 AKI 的独立危险因素,而基线肌酸水平升高是预后不良的关键因素。同时,早期的 CRRT 可以有效地逆转肾脏预后。
{"title":"Acute Kidney Injury in Critically Ill Pregnant Women:A Retrospective Study on Risk Factors and Outcomes.","authors":"Qifeng Song, Jia Jia, Chen Chen, Guofu Li","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the significant decline in the incidence of pregnancy-related acute kidney injury (AKI) in recent decades due to advancements in medicine and increased awareness of this disease, it remains an important risk factor for maternal morbidity and mortality. However, as fertilization techniques allow women of advanced age to become pregnant, the incidence of pregnancy-related AKI has increased. Consequently, early identification of and intervention for pregnancy-related AKI are particularly important.</p><p><strong>Methods: </strong>This was a retrospective clinical analysis. Data were collected from pregnant patients who were treated in the ICU of Shengjing Hospital of China Medical University from January 2014 to June 2020; The patients were divided into two groups based on their kidney function status: AKI and non-AKI. Additionally, they were further categorized into recovered and non-recovered groups based on their prognosis. The Wilcoxon rank sum test and the chi-square test were used for multigroup comparisons, while logistic regression analysis was used for the analysis of risk factors. P < .05 was considered to indicate a statistically significant difference in all correlation analyses.</p><p><strong>Results: </strong>Among 874 pregnant women in this study, 136 had AKI (15.56%), while 36 developed chronic renal insufficiency (26.47%). Statistically significant associations were shown for shock (P = .002), sepsis (P < .001), coagulopathies (P = .001), liver insufficiency (P < .001), postpartum hemorrhage (P = .016), intrauterine fetal death (P = .042) and mechanical ventilation (P = .006) between the AKI-group and the non-AKI group. The development of AKI based on an elevated baseline creatinine level was significantly related to the outcome of renal function (P < .001), while a significant difference was shown in the use of continuous renal replacement therapy (CRRT) between the recovery group and the non-recovery group (P = .023).</p><p><strong>Conclusion: </strong>We identified the relevant risk factors leading to pregnancy-related AKI and affecting the patients' prognosis. Shock, sepsis, coagulation disorders, liver insufficiency, postpartum hemorrhage, intrauterine fetal death and mechanical ventilation are independent risk factors for pregnancy-related AKI, while an elevated baseline creatine level is a key factor for poor prognosis. Meanwhile, early CRRT can effectively reverse renal outcomes.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"18 4","pages":"195-203"},"PeriodicalIF":0.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: In recent years, the incidence of pediatric nephrotic syndrome (NS) has been increasing, and timely and effective treatment is critical to protect the health of children with NS. This study is an attempt to compare the therapeutic effects of prednisone (Pred) plus dipyridamole (DIP) versus Pred plus valsartan (VAL)on pediatric NS.
Methods: Two hundred pediatric cases of NS were selected as the research participants, including 109 cases (group A) receiving Pred + DIP and 91 cases (group B) receiving Pred + VAL. The clinical efficacy, adverse reactions, and renal, coagulation functions and blood lipid levels, as well as the pre- and post-treatment levels of inflammatory factors (IFs) and immunoglobulins (Igs) were comparatively analyzed.
Results: No statistically significant differences were found between groups in terms of clinical efficacy, incidence of adverse reactions and renal function (P > .05). After receiving the corresponding treatment, group A showed better coagulation and immune functions than group B, but higher levels of IFs and poorer blood lipid function (P < .05).
Conclusion: Both Pred + DIP and Pred + VAL combination therapies can be used for the treatment of pediatric NS, with the former contributing to more obviously enhanced coagulation and immune functions, and the latter leading to more significantly inhibited inflammation and better regulated blood lipid function.
导言:近年来,小儿肾病综合征(NS)的发病率不断上升,及时有效的治疗对于保护NS患儿的健康至关重要。本研究试图比较泼尼松(Prednisone,Pred)加双嘧达莫(DIP)与泼尼松加缬沙坦(VAL)对小儿肾病综合征的治疗效果:选取200例小儿NS患者作为研究对象,其中109例(A组)接受强的松+双嘧达莫治疗,91例(B组)接受强的松+缬沙坦治疗。对比分析两组的临床疗效、不良反应、肾功能、凝血功能、血脂水平以及治疗前后炎症因子(IFs)和免疫球蛋白(Igs)水平:结果:各组在临床疗效、不良反应发生率和肾功能方面差异无统计学意义(P>0.05)。接受相应治疗后,A 组的凝血功能和免疫功能优于 B 组,但 IFs 水平较高,血脂功能较差(P < .05):结论:Pred + DIP 和 Pred + VAL 联合疗法均可用于治疗小儿 NS,前者能更明显地增强凝血和免疫功能,后者能更显著地抑制炎症和更好地调节血脂功能。
{"title":"Comparison of the Safety of Prednisone Plus Dipyridamole Versus Prednisone Plus Valsartan in the Treatment of Children with Primary Nephrotic Syndrome.","authors":"Guoqiang Chen, Wenliang Li","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>In recent years, the incidence of pediatric nephrotic syndrome (NS) has been increasing, and timely and effective treatment is critical to protect the health of children with NS. This study is an attempt to compare the therapeutic effects of prednisone (Pred) plus dipyridamole (DIP) versus Pred plus valsartan (VAL)on pediatric NS.</p><p><strong>Methods: </strong>Two hundred pediatric cases of NS were selected as the research participants, including 109 cases (group A) receiving Pred + DIP and 91 cases (group B) receiving Pred + VAL. The clinical efficacy, adverse reactions, and renal, coagulation functions and blood lipid levels, as well as the pre- and post-treatment levels of inflammatory factors (IFs) and immunoglobulins (Igs) were comparatively analyzed.</p><p><strong>Results: </strong>No statistically significant differences were found between groups in terms of clinical efficacy, incidence of adverse reactions and renal function (P > .05). After receiving the corresponding treatment, group A showed better coagulation and immune functions than group B, but higher levels of IFs and poorer blood lipid function (P < .05).</p><p><strong>Conclusion: </strong>Both Pred + DIP and Pred + VAL combination therapies can be used for the treatment of pediatric NS, with the former contributing to more obviously enhanced coagulation and immune functions, and the latter leading to more significantly inhibited inflammation and better regulated blood lipid function.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"18 4","pages":"204-211"},"PeriodicalIF":0.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Taghi Najafi, Mohammad Reza Abbasi, Seyed Mansour Gatmiri, Mohammad Reza Khatami, Atefeh Mokhtardokht, Mohammad Hossein Shojamoradi
Introduction: Ambulatory blood pressure monitoring (ABPM) is a valuable tool for detecting abnormalities in nighttime blood pressure (BP), including non-dipping and nighttime hypertension. These abnormalities are independent predictors of a poor prognosis in patients with chronic kidney disease (CKD). The aim of our study was to analyze ABPM data and evaluate nighttime BP abnormalities in an Iranian CKD population.
Methods: This cross-sectional study was conducted on sixty two patients at stages III and IV of CKD who were referred to a nephrology clinic in Tehran, Iran. The patients were classified as either dippers (19.4%) or non-dippers (80.6%), as well as nighttime normotensives (38.7%) or hypertensives (61.3%), based on ABPM data and in accordance with 2023 ESC/ESH guidelines. We compared demographic data, estimated glomerular filtration rate (eGFR), and daytime BP levels among these groups.
Results: The mean age of patients was 56.34 years, with 61.1% of them being male. Daytime pulse pressure was significantly greater in non-dippers compared to dippers (52.67 vs. 44 mmHg, P = .02). We found a significant correlation between the extent of BP dipping and eGFR (R = 0.281, P = .02). Systolic and diastolic daytime BP levels were significantly higher in individuals with nighttime hypertension. Diabetic patients were more likely to be non-dippers and have nighttime hypertension. After adjusting for age, diabetes mellitus, and daytime pulse pressure in a multivariable model, we determined that eGFR independently predicted the extent of BP dipping.
Conclusion: Our results showed that both non-dipping and nighttime hypertension are highly prevalent in CKD patients, but they have distinct contributing factors. The eGFR was identified as an independent predictor of BP dipping, whereas nighttime BP levels were primarily determined by daytime BP levels. DOI: 10.52547/ijkd.7559.
{"title":"Nighttime Blood Pressure Abnormalities in Iranian CKD Patients: Necessity to Perform Ambulatory Blood Pressure Monitoring.","authors":"Mohammad Taghi Najafi, Mohammad Reza Abbasi, Seyed Mansour Gatmiri, Mohammad Reza Khatami, Atefeh Mokhtardokht, Mohammad Hossein Shojamoradi","doi":"10.52547/q4b5rx79","DOIUrl":"10.52547/q4b5rx79","url":null,"abstract":"<p><strong>Introduction: </strong>Ambulatory blood pressure monitoring (ABPM) is a valuable tool for detecting abnormalities in nighttime blood pressure (BP), including non-dipping and nighttime hypertension. These abnormalities are independent predictors of a poor prognosis in patients with chronic kidney disease (CKD). The aim of our study was to analyze ABPM data and evaluate nighttime BP abnormalities in an Iranian CKD population.</p><p><strong>Methods: </strong>This cross-sectional study was conducted on sixty two patients at stages III and IV of CKD who were referred to a nephrology clinic in Tehran, Iran. The patients were classified as either dippers (19.4%) or non-dippers (80.6%), as well as nighttime normotensives (38.7%) or hypertensives (61.3%), based on ABPM data and in accordance with 2023 ESC/ESH guidelines. We compared demographic data, estimated glomerular filtration rate (eGFR), and daytime BP levels among these groups.</p><p><strong>Results: </strong>The mean age of patients was 56.34 years, with 61.1% of them being male. Daytime pulse pressure was significantly greater in non-dippers compared to dippers (52.67 vs. 44 mmHg, P = .02). We found a significant correlation between the extent of BP dipping and eGFR (R = 0.281, P = .02). Systolic and diastolic daytime BP levels were significantly higher in individuals with nighttime hypertension. Diabetic patients were more likely to be non-dippers and have nighttime hypertension. After adjusting for age, diabetes mellitus, and daytime pulse pressure in a multivariable model, we determined that eGFR independently predicted the extent of BP dipping.</p><p><strong>Conclusion: </strong>Our results showed that both non-dipping and nighttime hypertension are highly prevalent in CKD patients, but they have distinct contributing factors. The eGFR was identified as an independent predictor of BP dipping, whereas nighttime BP levels were primarily determined by daytime BP levels. DOI: 10.52547/ijkd.7559.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"18 3","pages":"150-158"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yingying Wang, Shasha Dai, Jing Yang, Jun Ma, Peng Wang, Xiaowei Zhao, Jua Liu, Ao Xiao, Yahui Song, Lipin Gao
Introduction: Diabetic nephropathy (DN) belongs to the major cause of end-stage kidney disease. We probed the functions of a microRNA miR-33a in inducing podocytes injury during childhood DN (CDN).
Methods: Kidney samples were collected from 20 children with DN. Matrix deposition and glomerular basement membranes thickness were examined by periodic acid-Schiff staining. Immunofluorescence staining was performed to assess kidney function-related proteins. MicroRNA (MiR)-33a mimic together with miR-33a inhibitor was transfected into podocytes for determining the roles of miR-33a. Glomerular podocyte apoptosis was determined by terminal deoxynucleotidyl transferase (TdT) dUTP Nick-End Labeling (TUNEL) staining along with flow cytometry.
Results: Down-regulation of Nephrin and Podocin and increased podocyte apoptosis rate were observed in the glomerulus of CDN as well as podocytes treated with high glucose. MiR-33a was up regulated in the glomeruli and glucose-treated podocytes. Injury in podocytes was aggravated with miR-33a elevation but alleviated with miR-33a inhibition. Moreover, the expression of Sirtuin 6 (Sirt6) was decreased while the levels of notch receptor 1 (Notch1) and notch receptor 4 (Notch4) were elevated in the glomerulus and glucose-treated podocytes. Decreased level of Sirt6 upon glucose treatment was abrogated by miR-33a inhibition, and the podocytes injury induced by glucose exposure was relieved by Sirt6 via Notch signaling.
Conclusion: These findings indicated that miR-33a promoted podocyte injury via targeting Sirt6-dependent Notch signaling in CDN, which might provide a novel sight for CDN treatment. DOI: 10.52547/ijkd.7904.
{"title":"MiR-33a Overexpression Exacerbates Diabetic Nephropathy Through Sirt6-dependent Notch Signaling.","authors":"Yingying Wang, Shasha Dai, Jing Yang, Jun Ma, Peng Wang, Xiaowei Zhao, Jua Liu, Ao Xiao, Yahui Song, Lipin Gao","doi":"10.52547/g7kbp983","DOIUrl":"10.52547/g7kbp983","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic nephropathy (DN) belongs to the major cause of end-stage kidney disease. We probed the functions of a microRNA miR-33a in inducing podocytes injury during childhood DN (CDN).</p><p><strong>Methods: </strong>Kidney samples were collected from 20 children with DN. Matrix deposition and glomerular basement membranes thickness were examined by periodic acid-Schiff staining. Immunofluorescence staining was performed to assess kidney function-related proteins. MicroRNA (MiR)-33a mimic together with miR-33a inhibitor was transfected into podocytes for determining the roles of miR-33a. Glomerular podocyte apoptosis was determined by terminal deoxynucleotidyl transferase (TdT) dUTP Nick-End Labeling (TUNEL) staining along with flow cytometry.</p><p><strong>Results: </strong>Down-regulation of Nephrin and Podocin and increased podocyte apoptosis rate were observed in the glomerulus of CDN as well as podocytes treated with high glucose. MiR-33a was up regulated in the glomeruli and glucose-treated podocytes. Injury in podocytes was aggravated with miR-33a elevation but alleviated with miR-33a inhibition. Moreover, the expression of Sirtuin 6 (Sirt6) was decreased while the levels of notch receptor 1 (Notch1) and notch receptor 4 (Notch4) were elevated in the glomerulus and glucose-treated podocytes. Decreased level of Sirt6 upon glucose treatment was abrogated by miR-33a inhibition, and the podocytes injury induced by glucose exposure was relieved by Sirt6 via Notch signaling.</p><p><strong>Conclusion: </strong>These findings indicated that miR-33a promoted podocyte injury via targeting Sirt6-dependent Notch signaling in CDN, which might provide a novel sight for CDN treatment. DOI: 10.52547/ijkd.7904.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"18 3","pages":"168-178"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohsen Nafar, Sara Keshtkari, Shadi Ziaie, Ahmad Firouzan, Nasrin Borumandnia, Nooshin Dalili, Fatemeh Poorrezagholi, Fariba Samadian, Shiva Samavat
Introduction: Tacrolimus is the mainstem of immunosuppressive therapy in kidney transplant patients. It has high intrapatient variability (Tac-IPV), which has been reported to affect graft function by predisposing patients to rejection or nephrotoxicity. We conducted this study with the aim of assessing the influence of Tac-IPV on 2-year graft function, biopsy-proven rejection, and infections in compliant renal recipients.
Methods: In this single-center retrospective analytic cross-sectional study, 250 patients who underwent transplantation from March 21, 2018, to March 20, 2020 and had at least three outpatient tacrolimus trough levels on the same daily dose 6 to 12 months after transplantation were recruited. Tac-IPV was defined as a coefficient variation of > 15%. Graft function, biopsy-proven rejection, cytomegalovirus (CMV) and BK virus viremia, and calcineurin inhibitor (CNI) toxicity were evaluated.
Results: Of 202 transplant recipients, 128 were included with a mean age of 45.48 ± 13.14 years. The median Tac-IPV was 13.28% with 43.75% of patients with Tac-IPV > 15%. There were no significant differences in graft function, rejection, CNI toxicity, and CMV viremia among the groups during the 24-month study (P > .05). However, BK viremia was significantly higher among patients with Tac-IPV > 15% (13 vs. 2.9%, P = .042). The risk of antibody mediated rejection alone (22.7 vs. 2.9%) or any kind of rejection (22.7 vs. 11.8%) was significantly higher in patients with higher Tac-IPV, and in those who had mean trough levels below 7 ng/mL (P = .015, .032; respectively).
Conclusion: Tac-IPV is low in adherent patients (with the median of 13.28%) and maintaining tacrolimus trough level above 7 ng/mL can overcome the adverse graft outcome of Tac-IPV in compliant kidney transplant recipients. DOI: 10.52547/ijkd.7815.
{"title":"Tacrolimus Intrapatient Variability on Graft Outcomes in Adherent Renal Transplantation Patients: A Cross-Sectional Study.","authors":"Mohsen Nafar, Sara Keshtkari, Shadi Ziaie, Ahmad Firouzan, Nasrin Borumandnia, Nooshin Dalili, Fatemeh Poorrezagholi, Fariba Samadian, Shiva Samavat","doi":"10.52547/54drw293","DOIUrl":"https://doi.org/10.52547/54drw293","url":null,"abstract":"<p><strong>Introduction: </strong>Tacrolimus is the mainstem of immunosuppressive therapy in kidney transplant patients. It has high intrapatient variability (Tac-IPV), which has been reported to affect graft function by predisposing patients to rejection or nephrotoxicity. We conducted this study with the aim of assessing the influence of Tac-IPV on 2-year graft function, biopsy-proven rejection, and infections in compliant renal recipients.</p><p><strong>Methods: </strong>In this single-center retrospective analytic cross-sectional study, 250 patients who underwent transplantation from March 21, 2018, to March 20, 2020 and had at least three outpatient tacrolimus trough levels on the same daily dose 6 to 12 months after transplantation were recruited. Tac-IPV was defined as a coefficient variation of > 15%. Graft function, biopsy-proven rejection, cytomegalovirus (CMV) and BK virus viremia, and calcineurin inhibitor (CNI) toxicity were evaluated.</p><p><strong>Results: </strong>Of 202 transplant recipients, 128 were included with a mean age of 45.48 ± 13.14 years. The median Tac-IPV was 13.28% with 43.75% of patients with Tac-IPV > 15%. There were no significant differences in graft function, rejection, CNI toxicity, and CMV viremia among the groups during the 24-month study (P > .05). However, BK viremia was significantly higher among patients with Tac-IPV > 15% (13 vs. 2.9%, P = .042). The risk of antibody mediated rejection alone (22.7 vs. 2.9%) or any kind of rejection (22.7 vs. 11.8%) was significantly higher in patients with higher Tac-IPV, and in those who had mean trough levels below 7 ng/mL (P = .015, .032; respectively).</p><p><strong>Conclusion: </strong>Tac-IPV is low in adherent patients (with the median of 13.28%) and maintaining tacrolimus trough level above 7 ng/mL can overcome the adverse graft outcome of Tac-IPV in compliant kidney transplant recipients. DOI: 10.52547/ijkd.7815.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"18 3","pages":"187-194"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acute kidney injury (AKI) is a significant global health concern that was first recognized in 2004 and has subsequently affected more than thirteen million individuals each year, resulting in 1.7 million deaths. The present study explored the evolving of the research on AKI worldwide, specifically addressing the analysis of the trends between the years 2000 and 2022 using the Web of Science Core Collection (WOSCC). CiteSpace software was employed to analyze 19,741 literature sources, which revealed shifts in keyword dynamics from foundational disease research to treatment prognosis and humanistic care. The keyword outbreaks occurred in the years 2004, 2010, and 2019 (i.e., significant occurrences or peaks related to the specified keyword were observed in the years 2004, 2010, and 2019). The present study highlighted the transition of AKI studies from the initial concerns regarding definitions to further comprehensive inquiries regarding biomarkers, etiology, inductors, prediction, and prognosis. The future research focus could include the Corona Virus Disease 2019 (COVID-19), machine learning, and continuous renal replacement treatment within the AKI realm. DOI: 10.52547/ijkd.8018.
{"title":"Trends in Research on Acute Kidney Injury: A Bibliometric Analysis of Academic Journals Published Between the Years 2000 and 2022.","authors":"Yunxi Tao, Shenglong Xu, Xuhua Ge","doi":"10.52547/tvy8jz17","DOIUrl":"https://doi.org/10.52547/tvy8jz17","url":null,"abstract":"<p><p>Acute kidney injury (AKI) is a significant global health concern that was first recognized in 2004 and has subsequently affected more than thirteen million individuals each year, resulting in 1.7 million deaths. The present study explored the evolving of the research on AKI worldwide, specifically addressing the analysis of the trends between the years 2000 and 2022 using the Web of Science Core Collection (WOSCC). CiteSpace software was employed to analyze 19,741 literature sources, which revealed shifts in keyword dynamics from foundational disease research to treatment prognosis and humanistic care. The keyword outbreaks occurred in the years 2004, 2010, and 2019 (i.e., significant occurrences or peaks related to the specified keyword were observed in the years 2004, 2010, and 2019). The present study highlighted the transition of AKI studies from the initial concerns regarding definitions to further comprehensive inquiries regarding biomarkers, etiology, inductors, prediction, and prognosis. The future research focus could include the Corona Virus Disease 2019 (COVID-19), machine learning, and continuous renal replacement treatment within the AKI realm. DOI: 10.52547/ijkd.8018.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"18 3","pages":"137-149"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asma Rezaei Arnesa, Sepideh Hajian, Saeede Salemi Bazargani, Iman Salahshourifar, Sahar Moghbelinejad, Zohreh Abdolvahabi, Hayedeh Yaghoobzadeh, Mojtaba Fathi, Hossein Piri
Introduction: Diabetic nephropathy is one of the most common severe symptoms of diabetes mellitus. Hyperglycemia can lead to tissue damage and inflammation due to mediators such as receptor for advanced glycation end-products (RAGE). Therefore, in this study, we aimed to investigate the association between the G82S polymorphism of the RAGE gene and diabetic nephropathy in diabetic patients.
Methods: In this case-control study, 356 participants (158 men and 198 women) of Asian race, aged 45 to 65 years, who were diagnosed with type 2 diabetes mellitus based on their fasting plasma glucose levels were enrolled. DNA was isolated from the participants' blood samples and genotyped using TETRA -Primer ARMS-PCR. Serum protein concentration of soluble RAGE (sRAGE) was also determined by enzyme-linked immunosorbent assay (ELISA).
Results: Although we found differences in genotyping of participants between homozygous AA and GG and heterozygous GA in the studied groups, the differences were not significant (P = .568). In addition, we found no significant correlation between the G82S polymorphism of RAGE and the development of diabetic nephropathy. Serum levels of sRAGE were only slightly decreased in patients with diabetic nephropathy compared with diabetic patients (P > .05).
Conclusion: The results of this study indicate no significant association between the G82S polymorphism in the gene RAGE and the development of diabetic nephropathy. Serum levels of sRAGE were only slightly decreased in patients with diabetic nephropathy compared to diabetic patients without nephropathy. Therefore, the study suggests that there is probably no association between the G82S polymorphism in the gene RAGE and the development of diabetic nephropathy. DOI: 10.52547/ijkd.7872.
{"title":"Association Between the G82S Polymorphism of the Receptor Gene for Advanced Glycation End-products and Soluble Serum Levels RAGE with Diabetic Nephropathy in the White (Asian) Race.","authors":"Asma Rezaei Arnesa, Sepideh Hajian, Saeede Salemi Bazargani, Iman Salahshourifar, Sahar Moghbelinejad, Zohreh Abdolvahabi, Hayedeh Yaghoobzadeh, Mojtaba Fathi, Hossein Piri","doi":"10.52547/wngvvr19","DOIUrl":"10.52547/wngvvr19","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic nephropathy is one of the most common severe symptoms of diabetes mellitus. Hyperglycemia can lead to tissue damage and inflammation due to mediators such as receptor for advanced glycation end-products (RAGE). Therefore, in this study, we aimed to investigate the association between the G82S polymorphism of the RAGE gene and diabetic nephropathy in diabetic patients.</p><p><strong>Methods: </strong>In this case-control study, 356 participants (158 men and 198 women) of Asian race, aged 45 to 65 years, who were diagnosed with type 2 diabetes mellitus based on their fasting plasma glucose levels were enrolled. DNA was isolated from the participants' blood samples and genotyped using TETRA -Primer ARMS-PCR. Serum protein concentration of soluble RAGE (sRAGE) was also determined by enzyme-linked immunosorbent assay (ELISA).</p><p><strong>Results: </strong>Although we found differences in genotyping of participants between homozygous AA and GG and heterozygous GA in the studied groups, the differences were not significant (P = .568). In addition, we found no significant correlation between the G82S polymorphism of RAGE and the development of diabetic nephropathy. Serum levels of sRAGE were only slightly decreased in patients with diabetic nephropathy compared with diabetic patients (P > .05).</p><p><strong>Conclusion: </strong>The results of this study indicate no significant association between the G82S polymorphism in the gene RAGE and the development of diabetic nephropathy. Serum levels of sRAGE were only slightly decreased in patients with diabetic nephropathy compared to diabetic patients without nephropathy. Therefore, the study suggests that there is probably no association between the G82S polymorphism in the gene RAGE and the development of diabetic nephropathy. DOI: 10.52547/ijkd.7872.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"18 3","pages":"179-186"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}