Introduction: Catheter-related infection in the patients with end-stage renal disease (ESRD) is one of the leading causes of death. Identifying risk factors for infection, including patients’ iron profile, plays an important role in preventing this complication. Objectives: In this study, we aimed to determine the risk factors of catheter-related infections among the ESRD patients in Qazvin, Iran. Patients and Methods: In this observational study, 41 patients with hemodialysis venous catheter-related infection (case group) and 42 patients without catheter-related infection ( control group) in Qazvin educational and medical centers were studied. The definition of functional iron deficiency anemia included ferritin <500 ng/mL and serum iron/total iron-binding capacity (TIBC) <30%. The laboratory evaluation method was based on enzyme-linked immunosorbent assay method. Definition of catheter-related infection in this study consisted of two positive results of the three cultures from blue and red catheter lines and blood at the same time with the same microorganism. Results: In studying iron parameters, a significant difference between serum iron levels and transferrin saturation in the two groups was detected (P values of 0.0016 and 0.003, respectively). Both parameters were higher in the control group. The most common microorganism causing the infection was Staphylococcus aureus (43.9%) and most of the catheters used were of temporary internal jugular vein types. The most important risk factors in the incidence of catheter infection were diabetes mellitus (OR = 5.059) and high serum iron levels (OR = 1.053). Decreased transferrin saturation levels reduced the risk of infection (OR = 0.825). Conclusion: There was a relationship between iron profile and diabetes mellitus and the increased risk of catheter-related infections. To prevent infection, patients with ESRD undergoing hemodialysis with venous catheters, blood sugar and serum iron levels need to be monitored carefully and iron overdose should be prevented in these patients.
{"title":"Evaluating risk factors for catheter-related infections in hemodialysis patients","authors":"S. Hajian, M. Seifzade","doi":"10.34172/npj.2022.10489","DOIUrl":"https://doi.org/10.34172/npj.2022.10489","url":null,"abstract":"Introduction: Catheter-related infection in the patients with end-stage renal disease (ESRD) is one of the leading causes of death. Identifying risk factors for infection, including patients’ iron profile, plays an important role in preventing this complication. Objectives: In this study, we aimed to determine the risk factors of catheter-related infections among the ESRD patients in Qazvin, Iran. Patients and Methods: In this observational study, 41 patients with hemodialysis venous catheter-related infection (case group) and 42 patients without catheter-related infection ( control group) in Qazvin educational and medical centers were studied. The definition of functional iron deficiency anemia included ferritin <500 ng/mL and serum iron/total iron-binding capacity (TIBC) <30%. The laboratory evaluation method was based on enzyme-linked immunosorbent assay method. Definition of catheter-related infection in this study consisted of two positive results of the three cultures from blue and red catheter lines and blood at the same time with the same microorganism. Results: In studying iron parameters, a significant difference between serum iron levels and transferrin saturation in the two groups was detected (P values of 0.0016 and 0.003, respectively). Both parameters were higher in the control group. The most common microorganism causing the infection was Staphylococcus aureus (43.9%) and most of the catheters used were of temporary internal jugular vein types. The most important risk factors in the incidence of catheter infection were diabetes mellitus (OR = 5.059) and high serum iron levels (OR = 1.053). Decreased transferrin saturation levels reduced the risk of infection (OR = 0.825). Conclusion: There was a relationship between iron profile and diabetes mellitus and the increased risk of catheter-related infections. To prevent infection, patients with ESRD undergoing hemodialysis with venous catheters, blood sugar and serum iron levels need to be monitored carefully and iron overdose should be prevented in these patients.","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46714082","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}
M. Bhojaraja, R. Prabhu, S. Nagaraju, I. Rao, S. Shenoy, Dhrshan Rangasamy, V. Krishna, M. Nayak
Aim and objectives: In hemodialysis patients, catheter-related bloodstream infections (CRBSI) cause significant morbidity and mortality. We analyzed CRBSI incidence, associated factors, and the causative organisms’ spectrum. Methodology: Patients aged ≥18 years either on maintenance hemodialysis or with acute kidney injury having CRBSI (NKF-KDOQI criteria) were included in this prospective observational study and patients with other infections were excluded. Blood, catheter tip culture and antibiogram were analyzed. All patients were initially treated with antibiotics covering both gram-positive and gram-negative pathogens. Results: Of 921 catheters (882 patients) analyzed, 212 (23%) had CRBSI, of which 69(32.5%) and 143(67.5%) had possible CRBSI and probable CRBSI respectively. 131 (61.8%) were <60 years, 133 (62.7%) were males, 177 (83.5%) had diabetes, 141(66.5%) had leukocytosis and 172(81.1%) had positive procalcitonin. 193 (91%) had uncuffed catheters and 162 (76.4%) had jugular catheters. Our study showed that CRBSI incidence was 13.39/1000 catheter days, median catheter days, and median time to CRBSI was 40 and 17.2 days. Gram-positive coagulase-negative staphylococcus aureus (n=31; 44.9%) followed by extended-spectrum beta-lactamase (ESBL) enteric gram-negative organisms (n=30; 43.4%) were common isolates and remaining had fungal etiology (n=8; 11.7%). Conclusion: The incidence of CRBSI was high in our population. In culture-positive cases, gram-positive organisms contributed marginally higher than gram-negative organisms. Coagulase Negative Staphylococcus aureus (CONS) and ESBL enteric gram-negative organisms are the commonest isolates. More than two-thirds of patients with CRBSI had diabetes mellitus and leukocytosis at presentation.
{"title":"Hemodialysis catheter-related bloodstream infections: A single-centre experience","authors":"M. Bhojaraja, R. Prabhu, S. Nagaraju, I. Rao, S. Shenoy, Dhrshan Rangasamy, V. Krishna, M. Nayak","doi":"10.34172/npj.2022.10475","DOIUrl":"https://doi.org/10.34172/npj.2022.10475","url":null,"abstract":"Aim and objectives: In hemodialysis patients, catheter-related bloodstream infections (CRBSI) cause significant morbidity and mortality. We analyzed CRBSI incidence, associated factors, and the causative organisms’ spectrum. Methodology: Patients aged ≥18 years either on maintenance hemodialysis or with acute kidney injury having CRBSI (NKF-KDOQI criteria) were included in this prospective observational study and patients with other infections were excluded. Blood, catheter tip culture and antibiogram were analyzed. All patients were initially treated with antibiotics covering both gram-positive and gram-negative pathogens. Results: Of 921 catheters (882 patients) analyzed, 212 (23%) had CRBSI, of which 69(32.5%) and 143(67.5%) had possible CRBSI and probable CRBSI respectively. 131 (61.8%) were <60 years, 133 (62.7%) were males, 177 (83.5%) had diabetes, 141(66.5%) had leukocytosis and 172(81.1%) had positive procalcitonin. 193 (91%) had uncuffed catheters and 162 (76.4%) had jugular catheters. Our study showed that CRBSI incidence was 13.39/1000 catheter days, median catheter days, and median time to CRBSI was 40 and 17.2 days. Gram-positive coagulase-negative staphylococcus aureus (n=31; 44.9%) followed by extended-spectrum beta-lactamase (ESBL) enteric gram-negative organisms (n=30; 43.4%) were common isolates and remaining had fungal etiology (n=8; 11.7%). Conclusion: The incidence of CRBSI was high in our population. In culture-positive cases, gram-positive organisms contributed marginally higher than gram-negative organisms. Coagulase Negative Staphylococcus aureus (CONS) and ESBL enteric gram-negative organisms are the commonest isolates. More than two-thirds of patients with CRBSI had diabetes mellitus and leukocytosis at presentation.","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43611999","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}
The use of herbal remedies has grown in recent years, largely due to their increased production and the media advertisements which target their use for the cure of almost all symptoms. Herbal remedies have also become popular in multi-plant forms and have recently become available in both industrial and condensed formulations, with higher doses being administered. We report a 68-year-old woman presenting with symptoms of flank pain, nausea, vomiting, anuria, and hematuria. She has history diabetes mellitus, hypertension and use of herbal including Achillea millefolium and Thymus migricus, Nasturtium for the last four months. Kidney biopsy was performed and was diagnosed with oxalate nephropathy. After the use of herbals was stopped, creatinine levels returned toward normal value in the following months with no complications. Herbal remedies would cause severe organ failures if administered in high-doses and should be considered as a possible cause in patients presenting with AKI.
{"title":"Acute oxalate nephropathy associated with herbal remedies","authors":"B. Bashardoust, M. Asgari","doi":"10.34172/npj.2022.10482","DOIUrl":"https://doi.org/10.34172/npj.2022.10482","url":null,"abstract":"The use of herbal remedies has grown in recent years, largely due to their increased production and the media advertisements which target their use for the cure of almost all symptoms. Herbal remedies have also become popular in multi-plant forms and have recently become available in both industrial and condensed formulations, with higher doses being administered. We report a 68-year-old woman presenting with symptoms of flank pain, nausea, vomiting, anuria, and hematuria. She has history diabetes mellitus, hypertension and use of herbal including Achillea millefolium and Thymus migricus, Nasturtium for the last four months. Kidney biopsy was performed and was diagnosed with oxalate nephropathy. After the use of herbals was stopped, creatinine levels returned toward normal value in the following months with no complications. Herbal remedies would cause severe organ failures if administered in high-doses and should be considered as a possible cause in patients presenting with AKI.","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44513965","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}
S. Nagaraju, Kosuru Srinivas, M. Bhojaraja, S. Shenoy, I. Rao, R. Prabhu, D. Rangaswamy, V. Guddattu, V. Krishna, M. Nayak
Aim: In transplantation, accurate donor glomerular filtration rate (GFR) estimation is crucial. While various creatinine based equations are in use, none are validated in Indians, thus this study was conducted to judge accuracy of creatinine based GFR estimation equations and urinary creatinine clearance. Methods: A single-centre, observational and retrospective study at a tertiary care hospital. Adult voluntary donors GFR measured (mGFR) by Tc‑99m DTPA were included. Primary outcome was performance of estimated GFR (eGFR) by Cockcroft-Gault's formula corrected for body surface area (CG-BSA), Modification of diet in renal disease (MDRD) 4/6 and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI); Secondary outcome was performance of 24 hour urinary creatinine clearance (Cr Cl). Results: 102 kidney donors were analysed with mean age of 45.89 ± 9.98 years and 85.3% females. Mean ± SD mGFR by Tc‑99m DTPA was 82.11 ± 14.32 ml/min/1.73m2. Mean ± SD eGFR (ml/min/1.73m2) by CG-BSA was 99.68 ± 23.71, by MDRD-4 was 98.25 ± 28.61, by MDRD-6 was 93.66 ± 19.44 and by CKD-EPI was 111.14 ± 31.61. Lowest bias (2.3), highest precision (16.23) and accuracy (97.1%) was with MDRD-6; 24-hour urinary Cr Cl highly overestimated GFR (158.27 ml/min/1.73 m2) with highest bias, lowest precision and accuracy. Conclusion: Among the equations, MDRD-6 was the most precise and accurate with 24 hour urinary creatinine clearance being the least reliable. This study highlights the need for a correction factor or a new GFR estimation equation and not to consider urinary Cr Cl to assess donor GFR.
{"title":"\"Comparison of creatinine based glomerular filtration rate estimation equations in voluntary Indian kidney donors: A single centre study\"","authors":"S. Nagaraju, Kosuru Srinivas, M. Bhojaraja, S. Shenoy, I. Rao, R. Prabhu, D. Rangaswamy, V. Guddattu, V. Krishna, M. Nayak","doi":"10.34172/npj.2022.10443","DOIUrl":"https://doi.org/10.34172/npj.2022.10443","url":null,"abstract":"Aim: In transplantation, accurate donor glomerular filtration rate (GFR) estimation is crucial. While various creatinine based equations are in use, none are validated in Indians, thus this study was conducted to judge accuracy of creatinine based GFR estimation equations and urinary creatinine clearance. Methods: A single-centre, observational and retrospective study at a tertiary care hospital. Adult voluntary donors GFR measured (mGFR) by Tc‑99m DTPA were included. Primary outcome was performance of estimated GFR (eGFR) by Cockcroft-Gault's formula corrected for body surface area (CG-BSA), Modification of diet in renal disease (MDRD) 4/6 and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI); Secondary outcome was performance of 24 hour urinary creatinine clearance (Cr Cl). Results: 102 kidney donors were analysed with mean age of 45.89 ± 9.98 years and 85.3% females. Mean ± SD mGFR by Tc‑99m DTPA was 82.11 ± 14.32 ml/min/1.73m2. Mean ± SD eGFR (ml/min/1.73m2) by CG-BSA was 99.68 ± 23.71, by MDRD-4 was 98.25 ± 28.61, by MDRD-6 was 93.66 ± 19.44 and by CKD-EPI was 111.14 ± 31.61. Lowest bias (2.3), highest precision (16.23) and accuracy (97.1%) was with MDRD-6; 24-hour urinary Cr Cl highly overestimated GFR (158.27 ml/min/1.73 m2) with highest bias, lowest precision and accuracy. Conclusion: Among the equations, MDRD-6 was the most precise and accurate with 24 hour urinary creatinine clearance being the least reliable. This study highlights the need for a correction factor or a new GFR estimation equation and not to consider urinary Cr Cl to assess donor GFR.","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49302803","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}
Akiko Syawalidhany Tahir, H. Rasyid, S. Bakri, H. Kasim, Tutik Harjianti, M. L. Parewangi, Harun Iskandar, A. Seweng, Resha Dermawansyah Rusman
Introduction: One of the chronic kidney disease (CKD) manifestations is mineral disorder, such as phosphate and calcium. Phosphatonin levels are regulated by the hormone phosphatonin, which the most commonly associated with CKD is fibroblast growth factor-23 (FGF-23), mainly synthesized by bone cells. The increase in FGF-23 in CKD subjects is a physiological response to stabilize phosphate levels. Several conditions can increase FGF-23 levels including age, body mass index (BMI), diabetes mellitus (DM), and hypertension. Objectives: This study aims to test the correlation between FGF-23 levels at various stages of glomerular filtration rate (GFR) in CKD. Patients and Methods: This study is observational with a cross-sectional approach conducted at Wahidin Sudirohusodo and Unhas hospitals of Makassar. Subjects are CKD patients which meet inclusion criteria. Intact serum FGF-23 levels were measured using an ELISA (enzyme-linked immunosorbent assay) kit (Immutopics). Statistical analysis was conducted using ANOVA test, Mann-Whitney U, and Spearman’s correlation tests. Statistical results are considered significant if P<0.05. Results: The research was conducted on 78 subjects with CKD stages 3, 4 and 5, which consisted of 40 men and 38 women. The correlation test showed that the lower the GFR, the higher the FGF-23 level (P<0.05). No significant correlation between age, body mass index, diabetes mellitus, and hypertension with FGF-23 were detected (P>0.05). Conclusion: We found that every increase in the CKD stages and decrease of GFR, would be associated with an increase in the plasma levels of FGF-23. However, FGF-23 plasma concentration had no significant correlation with age, BMI, DM, and hypertension.
{"title":"Correlation of glomerular filtration rate and fibroblast growth factor-23 levels in chronic kidney disease; sub analysis chronic kidney disease–mineral and bone disorder study","authors":"Akiko Syawalidhany Tahir, H. Rasyid, S. Bakri, H. Kasim, Tutik Harjianti, M. L. Parewangi, Harun Iskandar, A. Seweng, Resha Dermawansyah Rusman","doi":"10.34172/npj.2022.10446","DOIUrl":"https://doi.org/10.34172/npj.2022.10446","url":null,"abstract":"Introduction: One of the chronic kidney disease (CKD) manifestations is mineral disorder, such as phosphate and calcium. Phosphatonin levels are regulated by the hormone phosphatonin, which the most commonly associated with CKD is fibroblast growth factor-23 (FGF-23), mainly synthesized by bone cells. The increase in FGF-23 in CKD subjects is a physiological response to stabilize phosphate levels. Several conditions can increase FGF-23 levels including age, body mass index (BMI), diabetes mellitus (DM), and hypertension. Objectives: This study aims to test the correlation between FGF-23 levels at various stages of glomerular filtration rate (GFR) in CKD. Patients and Methods: This study is observational with a cross-sectional approach conducted at Wahidin Sudirohusodo and Unhas hospitals of Makassar. Subjects are CKD patients which meet inclusion criteria. Intact serum FGF-23 levels were measured using an ELISA (enzyme-linked immunosorbent assay) kit (Immutopics). Statistical analysis was conducted using ANOVA test, Mann-Whitney U, and Spearman’s correlation tests. Statistical results are considered significant if P<0.05. Results: The research was conducted on 78 subjects with CKD stages 3, 4 and 5, which consisted of 40 men and 38 women. The correlation test showed that the lower the GFR, the higher the FGF-23 level (P<0.05). No significant correlation between age, body mass index, diabetes mellitus, and hypertension with FGF-23 were detected (P>0.05). Conclusion: We found that every increase in the CKD stages and decrease of GFR, would be associated with an increase in the plasma levels of FGF-23. However, FGF-23 plasma concentration had no significant correlation with age, BMI, DM, and hypertension.","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44080830","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}
{"title":"Recurrent urinary tract infections in a patient with neurogenic bladder","authors":"Elham Emami, A. Alikhani, Atrin Oroojeni","doi":"10.34172/npj.2022.10466","DOIUrl":"https://doi.org/10.34172/npj.2022.10466","url":null,"abstract":"<jats:p> </jats:p>","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49134927","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}
Sakineh Moghaddam Zeabadi, M. Ranjbaran, F. Rashvand, Akram Rostampourromdasht, S. Hosseinigolafshani
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.
{"title":"Predictors of hope in Iranian patients undergoing hemodialysis","authors":"Sakineh Moghaddam Zeabadi, M. Ranjbaran, F. Rashvand, Akram Rostampourromdasht, S. Hosseinigolafshani","doi":"10.34172/npj.2022.10415","DOIUrl":"https://doi.org/10.34172/npj.2022.10415","url":null,"abstract":"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.","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41394963","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. Rezazadeh, S. Mohammadi Kebar, K. Isazadehfar, S. Hoseininia, Mohammadbagher Didar-Shetaban, M. Bahadoram
Introduction: Central catheters that are inserted for dialysis, often fail due to clots in the lumen or veins with a 63% prevalence. Recent studies have shown that aspirin not only acts as an antiplatelet, but also causes diminishing oxidative stress and inflammation. Objectives: The purpose of the study was to investigate the effectiveness of aspirin in preventing thrombosis in tunneled dialysis catheters in the internal jugular vein and increasing catheter survival in dialysis patients. Patients and Methods: This randomized clinical trial was conducted on 114 dialysis patients who were divided randomly into two matched groups in terms of age and gender. One group was treated with 80 mg daily aspirin regimen while other group was treated with placebo. Additionally necessary information such as age, gender, cause of renal failure, concomitant diseases like diabetes and hypertension, history of cardiovascular disease and stroke, peripheral vascular diseases, history of statin use and history of anti-thrombotic drugs were obtained of patients by checklists. Results: The incidence of venous thrombosis in the aspirin group was 3.5% and in the control group was 14%. The difference was statistically significant (P=0.001). Conclusion: Results showed that administration of aspirin can be effective in increasing catheter survival in dialysis patients and preventing thrombosis of catheters especially in diabetics and male patients. Trial Registration: The trial was approved by the Iranian registry of clinical trials (identifier: IRCT20181128041785N1; https://www.irct.ir/trial/35610, ethical code; IR.ARUMS.REC.1397.190).
{"title":"Effect of aspirin in preventing thrombosis of tunneled dialysis catheters and increasing catheter survival in dialysis patients; controlled clinical trial study","authors":"A. Rezazadeh, S. Mohammadi Kebar, K. Isazadehfar, S. Hoseininia, Mohammadbagher Didar-Shetaban, M. Bahadoram","doi":"10.34172/npj.2022.10464","DOIUrl":"https://doi.org/10.34172/npj.2022.10464","url":null,"abstract":"Introduction: Central catheters that are inserted for dialysis, often fail due to clots in the lumen or veins with a 63% prevalence. Recent studies have shown that aspirin not only acts as an antiplatelet, but also causes diminishing oxidative stress and inflammation. Objectives: The purpose of the study was to investigate the effectiveness of aspirin in preventing thrombosis in tunneled dialysis catheters in the internal jugular vein and increasing catheter survival in dialysis patients. Patients and Methods: This randomized clinical trial was conducted on 114 dialysis patients who were divided randomly into two matched groups in terms of age and gender. One group was treated with 80 mg daily aspirin regimen while other group was treated with placebo. Additionally necessary information such as age, gender, cause of renal failure, concomitant diseases like diabetes and hypertension, history of cardiovascular disease and stroke, peripheral vascular diseases, history of statin use and history of anti-thrombotic drugs were obtained of patients by checklists. Results: The incidence of venous thrombosis in the aspirin group was 3.5% and in the control group was 14%. The difference was statistically significant (P=0.001). Conclusion: Results showed that administration of aspirin can be effective in increasing catheter survival in dialysis patients and preventing thrombosis of catheters especially in diabetics and male patients. Trial Registration: The trial was approved by the Iranian registry of clinical trials (identifier: IRCT20181128041785N1; https://www.irct.ir/trial/35610, ethical code; IR.ARUMS.REC.1397.190).","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43778948","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}
Samad Ghodrati, Yeganeh Ragati Haghi, J. Baharani, Akshaya Joseph, Niloufar Alimohammadi, Farzad Koosha, Leila Mostafavi, A. Pezeshgi
Renal fibrosis is the hallmark of advanced chronic kidney disease (CKD), which is characterized by excessive accumulation of extracellular matrix (ECM) proteins and plays a central role in the pathogenesis and progression of CKD to end-stage renal disease (ESRD). The molecular and cellular substances of kidney fibrosis include growth factors, such as fibroblast growth factor (FGF), transforming growth factor beta (TGF-β) and platelet-derived growth factor (PDGF), alongside cytokines (like interleukin-1b) and metalloproteinases. Therefore, these factors can be evaluated as possible targets for anti-fibrotic agents. Among the mediators of fibrosis, TGF-β is the dominant facilitator of renal fibrosis that induces ECM construction and accumulation. Numerous studies have focused on the inhibition of TGF-β and its downstream targets for the treatment of renal disease. Abolition of TGF-β mRNA expression was found to be the mechanism of anti-fibrotic drug, pirfenidone, in the heart and kidneys of diabetic rats. Various investigations have shown the impact of pirfenidone in diminishing kidney fibrosis, with studies containing patients diagnosed with subtotal nephrectomy, diabetic kidney disease and unilateral ureteral obstruction (UUO), administered drugs such as cyclosporine, tacrolimus, doxorubicin and vanadate. Several therapeutic drugs for fibrosis reduce only one of the oxidative, inflammatory or profibrogenic markers, while pirfenidone targets all three of these markers and therefore, seems to be a particularly valuable drug.
{"title":"Ameliorative effects of pirfenidone in chronic kidney disease","authors":"Samad Ghodrati, Yeganeh Ragati Haghi, J. Baharani, Akshaya Joseph, Niloufar Alimohammadi, Farzad Koosha, Leila Mostafavi, A. Pezeshgi","doi":"10.34172/npj.2022.10458","DOIUrl":"https://doi.org/10.34172/npj.2022.10458","url":null,"abstract":"Renal fibrosis is the hallmark of advanced chronic kidney disease (CKD), which is characterized by excessive accumulation of extracellular matrix (ECM) proteins and plays a central role in the pathogenesis and progression of CKD to end-stage renal disease (ESRD). The molecular and cellular substances of kidney fibrosis include growth factors, such as fibroblast growth factor (FGF), transforming growth factor beta (TGF-β) and platelet-derived growth factor (PDGF), alongside cytokines (like interleukin-1b) and metalloproteinases. Therefore, these factors can be evaluated as possible targets for anti-fibrotic agents. Among the mediators of fibrosis, TGF-β is the dominant facilitator of renal fibrosis that induces ECM construction and accumulation. Numerous studies have focused on the inhibition of TGF-β and its downstream targets for the treatment of renal disease. Abolition of TGF-β mRNA expression was found to be the mechanism of anti-fibrotic drug, pirfenidone, in the heart and kidneys of diabetic rats. Various investigations have shown the impact of pirfenidone in diminishing kidney fibrosis, with studies containing patients diagnosed with subtotal nephrectomy, diabetic kidney disease and unilateral ureteral obstruction (UUO), administered drugs such as cyclosporine, tacrolimus, doxorubicin and vanadate. Several therapeutic drugs for fibrosis reduce only one of the oxidative, inflammatory or profibrogenic markers, while pirfenidone targets all three of these markers and therefore, seems to be a particularly valuable drug.","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48946571","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. Hajigholami, Hourieh Ansari, S. Ansari, S. Hassanzadeh
Acquired hemophilia (AH) is a potentially life-threatening hemorrhagic disorder. We report the second confirmed case of COVID-19-associated AH in a 45-year-old female which, unfortunately, expired as her treatment failed. She presented to the emergency department with abnormal bleeding and spontaneous hemoptysis about ten days after a removal surgery of her epiglottis tumor. Aggregation tests, such as partial thromboplastin time (PTT), are recommended in patients with COVID-19 infection that have bleeding episodes.
{"title":"Acquired hemophilia in a patient with SARS-CoV-2 infection; a case report","authors":"A. Hajigholami, Hourieh Ansari, S. Ansari, S. Hassanzadeh","doi":"10.34172/npj.2022.10453","DOIUrl":"https://doi.org/10.34172/npj.2022.10453","url":null,"abstract":"Acquired hemophilia (AH) is a potentially life-threatening hemorrhagic disorder. We report the second confirmed case of COVID-19-associated AH in a 45-year-old female which, unfortunately, expired as her treatment failed. She presented to the emergency department with abnormal bleeding and spontaneous hemoptysis about ten days after a removal surgery of her epiglottis tumor. Aggregation tests, such as partial thromboplastin time (PTT), are recommended in patients with COVID-19 infection that have bleeding episodes.","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48130871","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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