Roham Azizi, Maryam Dehghani Mobarakeh, R. Goujani, M. Nabi-Afjadi, Soheil Mousavi Rizi, A. Maghsoudi
Introduction: Low-dose aspirin is one of the most widely used secondary prevention agents for cardiovascular disease and stroke. An unstable risk factor for chronic cardiovascular disease is a viral infection. Evidence suggests that the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could increase the risk of acute cardiovascular events by inducing systemic inflammatory responses and instability in coronary plaques. Objectives: The present study aimed to examine the impact of aspirin on clinical symptoms, laboratory indices, and clinical outcomes in patients with COVID-19. Patients and Methods: After reviewing the documents of hospitalized patients at the Dr. Shariati hospital in Isfahan, Iran, while case and control groups were selected using a cross-sectional method based on aspirin use and non-use. Following a random selection of the reference population (131 medical records of patients with COVID-19 who had aspirin use and 131 of the group of patients with COVID-19 without aspirin use). Medical records of patients with cardiovascular disease, diabetes, cardiovascular disease with diabetes, and patients without underlying disease were evaluated. After matching the two groups based on age, gender, and medical history, the examination and results were recorded in a questionnaire. Results: The results showed that during treatment, no significant difference between the case and control groups regarding clinical symptoms, laboratory results, the need for bilevel positive airway pressure (BiPAP), and mechanical ventilation ( P =0.0111 and P =0.089, respectively) were observed. Moreover, no significant difference in the outcome, including improvement and death was detected ( P =0.962). Likewise, no significant difference in hospitalization duration between the aspirin and control groups was seen ( P =0.289). Conclusion: Our study on a group of COVID-19 patients showed, aspirin is ineffective on clinical symptoms, laboratory indices, and outcomes, however our results further investigation by multi-centric investigations.
{"title":"A study on the effect of aspirin on clinical symptoms, laboratory indices, and outcomes in patients with COVID-19","authors":"Roham Azizi, Maryam Dehghani Mobarakeh, R. Goujani, M. Nabi-Afjadi, Soheil Mousavi Rizi, A. Maghsoudi","doi":"10.34172/npj.2023.10506","DOIUrl":"https://doi.org/10.34172/npj.2023.10506","url":null,"abstract":"Introduction: Low-dose aspirin is one of the most widely used secondary prevention agents for cardiovascular disease and stroke. An unstable risk factor for chronic cardiovascular disease is a viral infection. Evidence suggests that the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could increase the risk of acute cardiovascular events by inducing systemic inflammatory responses and instability in coronary plaques. Objectives: The present study aimed to examine the impact of aspirin on clinical symptoms, laboratory indices, and clinical outcomes in patients with COVID-19. Patients and Methods: After reviewing the documents of hospitalized patients at the Dr. Shariati hospital in Isfahan, Iran, while case and control groups were selected using a cross-sectional method based on aspirin use and non-use. Following a random selection of the reference population (131 medical records of patients with COVID-19 who had aspirin use and 131 of the group of patients with COVID-19 without aspirin use). Medical records of patients with cardiovascular disease, diabetes, cardiovascular disease with diabetes, and patients without underlying disease were evaluated. After matching the two groups based on age, gender, and medical history, the examination and results were recorded in a questionnaire. Results: The results showed that during treatment, no significant difference between the case and control groups regarding clinical symptoms, laboratory results, the need for bilevel positive airway pressure (BiPAP), and mechanical ventilation ( P =0.0111 and P =0.089, respectively) were observed. Moreover, no significant difference in the outcome, including improvement and death was detected ( P =0.962). Likewise, no significant difference in hospitalization duration between the aspirin and control groups was seen ( P =0.289). Conclusion: Our study on a group of COVID-19 patients showed, aspirin is ineffective on clinical symptoms, laboratory indices, and outcomes, however our results further investigation by multi-centric investigations.","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42271274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amir Aria, F. Tabesh, M. Soheilipour, Elham Tabesh, Mehrnoush Dianatkhah, M. Pourahmad, M. Momenzadeh
In this study, we considered an 83-year-old male patient admitted to the Al-Zahra hospital emergency department in Isfahan. He complained of fatigue, weakness, headache, and cough. In addition, he had hallucinations and delusions for two days; but he had no fever and chill. His physical examination showed a blood pressure of 170/100 mm Hg, heart rate of 142 beats per minute (bpm), respiratory rate of 23 pbm, oxygen saturation (in room air) of 83%, and oxygen bag reserve mask of 93%. We realized cardiac involvement during hospitalization, including sinus bradycardia, first-degree atrioventricular (AV) block, recurrent premature ventricular from tricuspid ring, atrial tachycardia (AT) rhythm with variable AV conduction block, increased heart rate with functional bundle branch block, and negative troponin. The patient was treated with medicines to control heart rate and admitted to the cardiac care unit (CCU). Next, the patient was intubated due to a worsening lung condition. Afterward, he was admitted to the intensive care unit (ICU) and died the next day. According to the literature, compromised cardiac vascular is the most common complications in hospitalized patients due to COVID-19 infection and has a higher mortality risk. Cardiac arrhythmias are additionally common clinical manifestations. These arrhythmias seem to be caused by inflammatory responses in the myocardium, electrolyte disorders, and hypoxia. Our patient showed that the COVID-19 virus might induce different types of arrhythmias.
{"title":"Arrhythmia in a COVID-19 patient: A case report","authors":"Amir Aria, F. Tabesh, M. Soheilipour, Elham Tabesh, Mehrnoush Dianatkhah, M. Pourahmad, M. Momenzadeh","doi":"10.34172/npj.2023.10510","DOIUrl":"https://doi.org/10.34172/npj.2023.10510","url":null,"abstract":"In this study, we considered an 83-year-old male patient admitted to the Al-Zahra hospital emergency department in Isfahan. He complained of fatigue, weakness, headache, and cough. In addition, he had hallucinations and delusions for two days; but he had no fever and chill. His physical examination showed a blood pressure of 170/100 mm Hg, heart rate of 142 beats per minute (bpm), respiratory rate of 23 pbm, oxygen saturation (in room air) of 83%, and oxygen bag reserve mask of 93%. We realized cardiac involvement during hospitalization, including sinus bradycardia, first-degree atrioventricular (AV) block, recurrent premature ventricular from tricuspid ring, atrial tachycardia (AT) rhythm with variable AV conduction block, increased heart rate with functional bundle branch block, and negative troponin. The patient was treated with medicines to control heart rate and admitted to the cardiac care unit (CCU). Next, the patient was intubated due to a worsening lung condition. Afterward, he was admitted to the intensive care unit (ICU) and died the next day. According to the literature, compromised cardiac vascular is the most common complications in hospitalized patients due to COVID-19 infection and has a higher mortality risk. Cardiac arrhythmias are additionally common clinical manifestations. These arrhythmias seem to be caused by inflammatory responses in the myocardium, electrolyte disorders, and hypoxia. Our patient showed that the COVID-19 virus might induce different types of arrhythmias.","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45357387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fariba Ahmadiazar, Mehrdad Rahmanian, Zahra Jalali, Akshaya Joseph, M. Foroutan
Introduction The 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMG-CoA reductase) inhibitors (i.e., statins) are recommended as a first-line of cholesterol-lowering medication for lipid control. Statins reduce low-density lipoprotein cholesterol (LDL-c), a chief contributor to atherosclerotic cardiovascular disease, which helps prevent cardiovascular disease. Recent studies demonstrate that high-dose statins augment LDL-c reduction and lead to improving cardiovascular outcomes compared to lowor moderatedose statin therapy in atherosclerotic cardiovascular disease patients (1). The benefits of high-dose statin therapy on cardiovascular risks have increased prescribing of high-dose statins. Despite beneficial effects with statin therapy, treatment with these agent is also associated with adverse events. These adverse effects range from nonthreatening asymptomatic presentations to severe organ dysfunction, especially of the kidneys and liver. Severe adverse effects associated with statin treatment include muscle damage, renal failure, liver dysfunction and polyneuropathy. Specific side effects of renal origin include rhabdomyolysis, proteinuria and acute kidney injury (AKI). Acute kidney injury Several clinical studies propose that high-dose statin treatment will increase the risk of AKI. However, cardiovascular surgery patients may respond differently to the type and dose of statin therapy. For instance, highdose statins are associated with a high risk of AKI in patients of the general population. In contrast, equivalent doses of those statins in cardiovascular surgery patients demonstrated renoprotective effects (2). Numerous studies suggest that high-dose statins will significantly increase the risk of contrast-induced AKI. A previous study has demonstrated a relationship between the high dose of atorvastatin and renal injury if administered alone or in combination with high doses of garlic; while a low-dose of atorvastatin in combination with high doses of garlic has negligible nephrotoxic effects (3). Statins should be administered cautiously in coronary artery disease patients undergoing coronary angiography (3,4). Hospitalization due to AKI was 34% higher in the cohort that received high-dose statin therapy compared to the cohort that administered low-dose statin therapy (2). High doses of atorvastatin have nephrotoxic effects, while lower doses have beneficial effects on renal function and structure (2) suggesting that, high doses of statins may be Ep id em io lo gy a nd P re ve nt io n
{"title":"Possible nephrotoxic effects of high dose statin therapy; current knowledge","authors":"Fariba Ahmadiazar, Mehrdad Rahmanian, Zahra Jalali, Akshaya Joseph, M. Foroutan","doi":"10.34172/npj.2022.10574","DOIUrl":"https://doi.org/10.34172/npj.2022.10574","url":null,"abstract":"Introduction The 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMG-CoA reductase) inhibitors (i.e., statins) are recommended as a first-line of cholesterol-lowering medication for lipid control. Statins reduce low-density lipoprotein cholesterol (LDL-c), a chief contributor to atherosclerotic cardiovascular disease, which helps prevent cardiovascular disease. Recent studies demonstrate that high-dose statins augment LDL-c reduction and lead to improving cardiovascular outcomes compared to lowor moderatedose statin therapy in atherosclerotic cardiovascular disease patients (1). The benefits of high-dose statin therapy on cardiovascular risks have increased prescribing of high-dose statins. Despite beneficial effects with statin therapy, treatment with these agent is also associated with adverse events. These adverse effects range from nonthreatening asymptomatic presentations to severe organ dysfunction, especially of the kidneys and liver. Severe adverse effects associated with statin treatment include muscle damage, renal failure, liver dysfunction and polyneuropathy. Specific side effects of renal origin include rhabdomyolysis, proteinuria and acute kidney injury (AKI). Acute kidney injury Several clinical studies propose that high-dose statin treatment will increase the risk of AKI. However, cardiovascular surgery patients may respond differently to the type and dose of statin therapy. For instance, highdose statins are associated with a high risk of AKI in patients of the general population. In contrast, equivalent doses of those statins in cardiovascular surgery patients demonstrated renoprotective effects (2). Numerous studies suggest that high-dose statins will significantly increase the risk of contrast-induced AKI. A previous study has demonstrated a relationship between the high dose of atorvastatin and renal injury if administered alone or in combination with high doses of garlic; while a low-dose of atorvastatin in combination with high doses of garlic has negligible nephrotoxic effects (3). Statins should be administered cautiously in coronary artery disease patients undergoing coronary angiography (3,4). Hospitalization due to AKI was 34% higher in the cohort that received high-dose statin therapy compared to the cohort that administered low-dose statin therapy (2). High doses of atorvastatin have nephrotoxic effects, while lower doses have beneficial effects on renal function and structure (2) suggesting that, high doses of statins may be Ep id em io lo gy a nd P re ve nt io n","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44145657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: One of the most important complications faced by cancer patients is chemotherapy-induced oral mucositis (CIOM). In addition, the role of orally used zinc sulfate in its prevention and treatment is still a controversial issue and the results in this regard have not been conclusive. Objectives: Evaluation the effect of zinc sulfate supplement on prevention of CIOM in breast cancer patients treated with adriamycin and cyclophosphamide was the aim of this study. Patients and Methods: The current double-blind randomized clinical trial was conducted on 87 patients with breast cancer. Consumption of two oral zinc sulfate tablets and two placebo tablets with food was prescribed in the case (44 patients) and control (43 patients) groups, respectively. During the 4 cycles of chemotherapy, the incidence and severity of CIOM, the onset time of mucositis from the start of chemotherapy, the severity of pain, and the severity of dry mouth were recorded. In addition, the patients’ quality of life was recorded using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Results: Findings revealed that the severity of CIOM in the first, second, and third sessions with the values of 1.22±1.01, 1.18±0.97 and 1.02±0.79, respectively, was significantly lower in the case group than the control group with the values of 1.91±0.89, 1.80±0.92, and 1.67±0.85, respectively (P<0.05). In addition, the severity of pain and dry mouth in the first and second sessions of chemotherapy was significantly lower in the case group (P<0.05). However, no significant difference was observed between the two groups in quality of life (P>0.05). Conclusion: Oral zinc sulfate had a significant role in reduction of the incidence and severity of CIOM, the severity of dry mouth, and the severity of pain in the initial sessions of chemotherapy. However, no significant difference was in postponing the incidence of CIOM and the quality of life of patients in the case group. Trial Registration: This trial protocol was approved by the Iranian Registry of Clinical Trials (identifier: IRCT20150304021338N2; https://irct.ir/trial/51105, ethical code# IR.MUI.MED. REC.1399.277).
{"title":"The effect of oral zinc sulfate on prevention of chemotherapy-induced oral mucositis in breast cancer patients treated with adriamycin and cyclophosphamide; a double-blind randomized clinical trial","authors":"M. Roayaei, Zeynab Andalib, A. Akhavan","doi":"10.34172/npj.2022.10533","DOIUrl":"https://doi.org/10.34172/npj.2022.10533","url":null,"abstract":"Introduction: One of the most important complications faced by cancer patients is chemotherapy-induced oral mucositis (CIOM). In addition, the role of orally used zinc sulfate in its prevention and treatment is still a controversial issue and the results in this regard have not been conclusive. Objectives: Evaluation the effect of zinc sulfate supplement on prevention of CIOM in breast cancer patients treated with adriamycin and cyclophosphamide was the aim of this study. Patients and Methods: The current double-blind randomized clinical trial was conducted on 87 patients with breast cancer. Consumption of two oral zinc sulfate tablets and two placebo tablets with food was prescribed in the case (44 patients) and control (43 patients) groups, respectively. During the 4 cycles of chemotherapy, the incidence and severity of CIOM, the onset time of mucositis from the start of chemotherapy, the severity of pain, and the severity of dry mouth were recorded. In addition, the patients’ quality of life was recorded using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Results: Findings revealed that the severity of CIOM in the first, second, and third sessions with the values of 1.22±1.01, 1.18±0.97 and 1.02±0.79, respectively, was significantly lower in the case group than the control group with the values of 1.91±0.89, 1.80±0.92, and 1.67±0.85, respectively (P<0.05). In addition, the severity of pain and dry mouth in the first and second sessions of chemotherapy was significantly lower in the case group (P<0.05). However, no significant difference was observed between the two groups in quality of life (P>0.05). Conclusion: Oral zinc sulfate had a significant role in reduction of the incidence and severity of CIOM, the severity of dry mouth, and the severity of pain in the initial sessions of chemotherapy. However, no significant difference was in postponing the incidence of CIOM and the quality of life of patients in the case group. Trial Registration: This trial protocol was approved by the Iranian Registry of Clinical Trials (identifier: IRCT20150304021338N2; https://irct.ir/trial/51105, ethical code# IR.MUI.MED. REC.1399.277).","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44168077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Implication for health policy/practice/research/medical education: Adriamycin is an anticancer agent with broad-spectrum efficacy against tumors. However, chemotherapy-induced renal toxicity constraints clinical efficacy of cancer treatment. The nephropathy of adriamycin is detected by podocyte damage and foot process effacement, which followed by glomerulosclerosis and inflammation in the tubulointerstitial area and fibrosis.
{"title":"Keep the corners; adriamycin nephropathy","authors":"M. Momenzadeh","doi":"10.34172/npj.2022.10567","DOIUrl":"https://doi.org/10.34172/npj.2022.10567","url":null,"abstract":"Implication for health policy/practice/research/medical education: Adriamycin is an anticancer agent with broad-spectrum efficacy against tumors. However, chemotherapy-induced renal toxicity constraints clinical efficacy of cancer treatment. The nephropathy of adriamycin is detected by podocyte damage and foot process effacement, which followed by glomerulosclerosis and inflammation in the tubulointerstitial area and fibrosis.","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41355175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Farnood, S. M. Hejazian, K. Boostani, A. Mardomi, M. Ardalan
The incidence of chronic kidney diseases (CKDs) by rare etiologies is growing along with other CKDs. This mini-review discusses the epidemiology, pathogenesis, clinical presentation, and diagnosis of rare kidney disease recurrence after kidney transplantation (KTx) including primary hyperoxaluria (PH), adenine phosphoribosyl transferase (APRT), C3 glomerulopathy (C3 GP), and fibrillary glomerulonephritis (FGN). It was shown that PH, like acute rejection, causes delayed graft function, confusing the physicians. Moreover, C3 GP is more prevalent than FGN among kidney transplant patients. Therefore, it is necessary to monitor rare diseases (RDs) before KTx in patients with any history of bilateral nephrocalcinosis or nephrolithiasis.
{"title":"Recurrence of rare disease after kidney transplant","authors":"F. Farnood, S. M. Hejazian, K. Boostani, A. Mardomi, M. Ardalan","doi":"10.34172/npj.2022.10519","DOIUrl":"https://doi.org/10.34172/npj.2022.10519","url":null,"abstract":"The incidence of chronic kidney diseases (CKDs) by rare etiologies is growing along with other CKDs. This mini-review discusses the epidemiology, pathogenesis, clinical presentation, and diagnosis of rare kidney disease recurrence after kidney transplantation (KTx) including primary hyperoxaluria (PH), adenine phosphoribosyl transferase (APRT), C3 glomerulopathy (C3 GP), and fibrillary glomerulonephritis (FGN). It was shown that PH, like acute rejection, causes delayed graft function, confusing the physicians. Moreover, C3 GP is more prevalent than FGN among kidney transplant patients. Therefore, it is necessary to monitor rare diseases (RDs) before KTx in patients with any history of bilateral nephrocalcinosis or nephrolithiasis.","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47480263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Pezeshgi, S. Jafari, Shabnam Pouladvand, N. Parsamanesh, Samad Ghodrati, H. Nasri
Introduction: Chronic kidney disease (CKD) is defined by glomerular filtration rates (GFR) of less than 60 mL/min per 1.73 m2 or albumin to creatinine ratios of greater than 30 mg/g in urine for at least three months. Patients with CKD are at risk of developing the condition, leading to end-stage renal disease (ESRD). On the other hand, hyperuricemia can result in renal failure, increased blood pressure, fibrosis, and the progression of failure. In this study, using the meta-analysis method, we are looking to investigate the effect of allopurinol on the treatment of chronic renal failure. Materials and Methods: In this meta-analysis, which was written based on PRISMA (the Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol, International databases including Cochrane, Web of Science, Scopus, PubMed, and Google Scholar search engine were searched. The data were analyzed using STATA (version 14) software, and the significance level of tests was considered P<0.05. Results: In 13 studies with a sample of 1172 people, allopurinol significantly reduced the serum level of uric acid (SMD: -1.28; 95% CI: -1.74, -0.82) more than the control group (SMD: -0.96; 95% CI: -2.09, 0.17). Additionally, allopurinol reduced the systolic blood pressure level by (SMD: -0.32; 95% CI: -0.54, -0.11) mm Hg and it was effective in reducing diastolic blood pressure level by (SMD: -0.39; 95% CI: -0.60, -0.17) mm Hg. However, the difference in scores GFR, proteinuria, cystatin C, before and after allopurinol were not statistically significant. In the control group, the difference in scores before and after the intervention was not significant in any of the above-mentioned cases. Conclusion: In CKD, allopurinol is effective in reducing blood pressure and uric acid levels. However, due to the limited number of studies and the different type of treatment in the control group of the studied studies, it is suggested to conduct more studies in this field. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO website (ID=CRD42022371439, regional ethical code #IR.IAU. NAJAFABAD.REC.1399.140).
慢性肾脏疾病(CKD)的定义是肾小球滤过率(GFR)小于60ml /min / 1.73 m2或尿白蛋白/肌酐比值大于30mg /g至少3个月。CKD患者有发展为终末期肾脏疾病(ESRD)的风险。另一方面，高尿酸血症可导致肾功能衰竭、血压升高、纤维化和衰竭的进展。在这项研究中，我们使用荟萃分析方法，研究别嘌呤醇对慢性肾功能衰竭的治疗效果。材料与方法:本meta分析基于PRISMA (the Preferred Reporting Items for Systematic Reviews and meta-analysis)协议编写，检索了Cochrane、Web of Science、Scopus、PubMed和谷歌Scholar等国际数据库。数据采用STATA (version 14)软件进行分析，认为检验的显著性水平P<0.05。结果:在13项涉及1172人的研究中，别嘌呤醇显著降低了血清尿酸水平(SMD: -1.28;95% CI: -1.74， -0.82)高于对照组(SMD: -0.96;95% ci: -2.09, 0.17)。此外，别嘌呤醇降低收缩压水平(SMD: -0.32;95% CI: -0.54， -0.11) mm Hg，有效降低舒张压水平(SMD: -0.39;95% CI: -0.60， -0.17) mm Hg。然而，别嘌呤醇治疗前后GFR、蛋白尿、胱抑素C评分差异无统计学意义。在对照组中，上述两种情况干预前后的得分差异均不显著。结论:别嘌呤醇能有效降低CKD患者的血压和尿酸水平。但由于研究数量有限，且所研究的对照组治疗方式不同，建议在该领域开展更多的研究。注册:本研究已根据PRISMA清单编制，其方案已在普洛斯彼罗网站注册(ID=CRD42022371439，区域道德代码#IR.IAU)。NAJAFABAD.REC.1399.140)。
{"title":"Effect of allopurinol on the treatment of chronic kidney disease: a systematic review and meta-analysis","authors":"A. Pezeshgi, S. Jafari, Shabnam Pouladvand, N. Parsamanesh, Samad Ghodrati, H. Nasri","doi":"10.34172/npj.2022.10566","DOIUrl":"https://doi.org/10.34172/npj.2022.10566","url":null,"abstract":"Introduction: Chronic kidney disease (CKD) is defined by glomerular filtration rates (GFR) of less than 60 mL/min per 1.73 m2 or albumin to creatinine ratios of greater than 30 mg/g in urine for at least three months. Patients with CKD are at risk of developing the condition, leading to end-stage renal disease (ESRD). On the other hand, hyperuricemia can result in renal failure, increased blood pressure, fibrosis, and the progression of failure. In this study, using the meta-analysis method, we are looking to investigate the effect of allopurinol on the treatment of chronic renal failure. Materials and Methods: In this meta-analysis, which was written based on PRISMA (the Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol, International databases including Cochrane, Web of Science, Scopus, PubMed, and Google Scholar search engine were searched. The data were analyzed using STATA (version 14) software, and the significance level of tests was considered P<0.05. Results: In 13 studies with a sample of 1172 people, allopurinol significantly reduced the serum level of uric acid (SMD: -1.28; 95% CI: -1.74, -0.82) more than the control group (SMD: -0.96; 95% CI: -2.09, 0.17). Additionally, allopurinol reduced the systolic blood pressure level by (SMD: -0.32; 95% CI: -0.54, -0.11) mm Hg and it was effective in reducing diastolic blood pressure level by (SMD: -0.39; 95% CI: -0.60, -0.17) mm Hg. However, the difference in scores GFR, proteinuria, cystatin C, before and after allopurinol were not statistically significant. In the control group, the difference in scores before and after the intervention was not significant in any of the above-mentioned cases. Conclusion: In CKD, allopurinol is effective in reducing blood pressure and uric acid levels. However, due to the limited number of studies and the different type of treatment in the control group of the studied studies, it is suggested to conduct more studies in this field. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO website (ID=CRD42022371439, regional ethical code #IR.IAU. NAJAFABAD.REC.1399.140).","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44918537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Electrolyte abnormalities are one of the most common problems in hemodialysis patients. Objectives: The present study was conducted to investigate the effect of niacin on the levels of sodium, phosphorus, calcium, intact parathormone (iPTH), alkaline phosphatase (ALP) and vitamin D in hemodialysis patients. Patients and Methods: In the present double-blinded randomized clinical trial, hemodialysis patients with phosphorus of more than 4.5 mg/dL were included in the study and were treated with niacin. The dose of niacin was increased from 50 mg to 100 mg/d in two stages on a monthly basis. Tests related to the levels of phosphorus, sodium, vitamin D, and calcium were determined before and after the intervention, and the side effects of the treatment were recorded accordingly. Data were analyzed through SPSS version 16. Results: After the intervention, the serum levels of calcium, vitamin D, and sodium increased significantly (P<0.05), while the serum levels of iPTH and phosphate decreased significantly (P<0.05). However, the serum level of ALP did not change significantly (P>0.05). There was no significant difference in the serum levels of calcium, phosphate, vitamin D, sodium, iPTH, and ALP during the intervention in the both men and women (P>0.05). Side effects were not reported in any of the patients. Conclusion: Niacin can increase vitamin D, sodium and calcium and decreased serum levels of phosphate and iPTH in hemodialysis patients. Therefore, it can be administered as an effective and safe supplement in the hemodialysis patients. Trial Registration: This trial protocol was approved by the Iranian Registry of Clinical Trials (identifier: IRCT20190702044076N2; https://en.irct.ir/trial/66567, ethical code #IR.SKUMS. REC.1400.079).
电解质异常是血液透析患者最常见的问题之一。目的:探讨烟酸对血液透析患者钠、磷、钙、完整甲状旁腺激素(iPTH)、碱性磷酸酶(ALP)和维生素D水平的影响。患者和方法:本双盲随机临床试验将磷含量大于4.5 mg/dL的血液透析患者纳入研究，并给予烟酸治疗。烟酸的剂量按月分两个阶段从50毫克/天增加到100毫克/天。在干预前后测定了与磷、钠、维生素D和钙水平相关的测试，并相应地记录了治疗的副作用。数据通过SPSS version 16进行分析。结果:干预后血清钙、维生素D、钠水平明显升高(P0.05)。干预期间，男女患者血清钙、磷酸盐、维生素D、钠、iPTH、ALP水平差异无统计学意义(P < 0.05)。没有任何患者的副作用报告。结论:烟酸可提高血液透析患者的维生素D、钠、钙水平，降低血清磷酸盐和iPTH水平。因此，它可以作为血液透析患者有效和安全的补充。试验注册:该试验方案已获得伊朗临床试验注册中心批准(标识符:IRCT20190702044076N2;https://en.irct.ir/trial/66567，道德准则#IR.SKUMS。REC.1400.079)。
{"title":"Effect of niacin on phosphorus, calcium, parathormone and vitamin D levels in hemodialysis patients; a double-blinded randomized clinical trial","authors":"Ali Mohamadi Najafabadi, A. Ahmadi, Saeed Mardani","doi":"10.34172/npj.2022.10569","DOIUrl":"https://doi.org/10.34172/npj.2022.10569","url":null,"abstract":"Introduction: Electrolyte abnormalities are one of the most common problems in hemodialysis patients. Objectives: The present study was conducted to investigate the effect of niacin on the levels of sodium, phosphorus, calcium, intact parathormone (iPTH), alkaline phosphatase (ALP) and vitamin D in hemodialysis patients. Patients and Methods: In the present double-blinded randomized clinical trial, hemodialysis patients with phosphorus of more than 4.5 mg/dL were included in the study and were treated with niacin. The dose of niacin was increased from 50 mg to 100 mg/d in two stages on a monthly basis. Tests related to the levels of phosphorus, sodium, vitamin D, and calcium were determined before and after the intervention, and the side effects of the treatment were recorded accordingly. Data were analyzed through SPSS version 16. Results: After the intervention, the serum levels of calcium, vitamin D, and sodium increased significantly (P<0.05), while the serum levels of iPTH and phosphate decreased significantly (P<0.05). However, the serum level of ALP did not change significantly (P>0.05). There was no significant difference in the serum levels of calcium, phosphate, vitamin D, sodium, iPTH, and ALP during the intervention in the both men and women (P>0.05). Side effects were not reported in any of the patients. Conclusion: Niacin can increase vitamin D, sodium and calcium and decreased serum levels of phosphate and iPTH in hemodialysis patients. Therefore, it can be administered as an effective and safe supplement in the hemodialysis patients. Trial Registration: This trial protocol was approved by the Iranian Registry of Clinical Trials (identifier: IRCT20190702044076N2; https://en.irct.ir/trial/66567, ethical code #IR.SKUMS. REC.1400.079).","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42350976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Mahmoudnia, B. Roshan, H. Jahantigh, Z. Mojtahedi, Oscar Montes, Tella Sadighpour, Mohammadreza Khosravifarsani
From March 2020, the coronavirus disease 2019 (COVID-19) pandemic challenged public health and healthcare systems worldwide. Viral infection is one of the environmental factors that has been associated with the development, relapse, or exacerbation of systemic lupus erythematosus (SLE). SLE patients are at an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) because of immune system dysfunction related to their disease as well as immunosuppression medications. So far, the most effective way to reduce SARS-CoV-2 infection-induced hospitalization and death is vaccination. On the other hand, SLE patients present distinct challenges related to the safety and effectiveness of SARS-CoV-2 vaccination. We have reviewed some reports on the onset or flare of SLE post-COVID-19 vaccination. Of note, the mRNA COVID-19 vaccines are associated with increased SLE disease activity, more frequently than the other types of COVID-19 vaccines.
{"title":"Systemic lupus erythematosus following SARS-CoV-2 vaccination; a review of literature","authors":"L. Mahmoudnia, B. Roshan, H. Jahantigh, Z. Mojtahedi, Oscar Montes, Tella Sadighpour, Mohammadreza Khosravifarsani","doi":"10.34172/npj.2022.10564","DOIUrl":"https://doi.org/10.34172/npj.2022.10564","url":null,"abstract":"From March 2020, the coronavirus disease 2019 (COVID-19) pandemic challenged public health and healthcare systems worldwide. Viral infection is one of the environmental factors that has been associated with the development, relapse, or exacerbation of systemic lupus erythematosus (SLE). SLE patients are at an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) because of immune system dysfunction related to their disease as well as immunosuppression medications. So far, the most effective way to reduce SARS-CoV-2 infection-induced hospitalization and death is vaccination. On the other hand, SLE patients present distinct challenges related to the safety and effectiveness of SARS-CoV-2 vaccination. We have reviewed some reports on the onset or flare of SLE post-COVID-19 vaccination. Of note, the mRNA COVID-19 vaccines are associated with increased SLE disease activity, more frequently than the other types of COVID-19 vaccines.","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42218925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Tolouian, Audrey Tolouian, F. Dastan, Vida Farhangi, P. Peymani, Sanam Saeifar, Oscar Felipe Borja Montes, Leila Mohmoodnia, Mohammadreza Khosravifarsani, Tella Sadighpour
Cisplatin is a first-line antitumor drug which is applied in the therapeutic field of numerous kinds of cancers. The main dose-dependent adverse effect of cisplatin is nephrotoxicity in approximately one-third of patients, who received this drug during their treatment. Oxidative stress is one of the most significant mechanisms in cisplatin nephrotoxicity. Cisplatin-induced oxidative stress stimulates apoptosis, inflammation, mitochondrial damage within cells, and endoplasmic reticulum (ER) stress. The administration of an antioxidant in this context could be a suitable approach for preventing of cisplatin nephrotoxicity. Antioxidants are categorized into four classes: dietary antioxidants, free radical scavengers, thiol-containing compounds, and iron chelators.
{"title":"Antioxidants and cisplatin nephrotoxicity; an updated review on current knowledge","authors":"R. Tolouian, Audrey Tolouian, F. Dastan, Vida Farhangi, P. Peymani, Sanam Saeifar, Oscar Felipe Borja Montes, Leila Mohmoodnia, Mohammadreza Khosravifarsani, Tella Sadighpour","doi":"10.34172/npj.2022.10556","DOIUrl":"https://doi.org/10.34172/npj.2022.10556","url":null,"abstract":"Cisplatin is a first-line antitumor drug which is applied in the therapeutic field of numerous kinds of cancers. The main dose-dependent adverse effect of cisplatin is nephrotoxicity in approximately one-third of patients, who received this drug during their treatment. Oxidative stress is one of the most significant mechanisms in cisplatin nephrotoxicity. Cisplatin-induced oxidative stress stimulates apoptosis, inflammation, mitochondrial damage within cells, and endoplasmic reticulum (ER) stress. The administration of an antioxidant in this context could be a suitable approach for preventing of cisplatin nephrotoxicity. Antioxidants are categorized into four classes: dietary antioxidants, free radical scavengers, thiol-containing compounds, and iron chelators.","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44520668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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