Introduction:Chronic kidney disease (CKD) has lots of complication like calcium and phosphate metabolism disorders, hyperparathyroidism, vitamin D deficiency and metabolic acidosis. Objectives: The aim of this study was to determine and compare the effect of calcitriol and cinacalcet on hyperparathyroidism in hemodialysis patients due to end-stage renal disease (ESRD). Patients and Methods: This study was a double-blinded randomized clinical trial, which was conducted on 60 hemodialysis patients in 2017-2018. The patients were randomly assigned to two groups of 30 patients, which one group was treated with cinacalcet and the other group was treated with calcitriol. During this study, phosphorus, calcium and iPTH were measured. Results: The results showed that in the group treated with cinacalcet, the amount of calcium [t(22)=0.294, P>0.05] and the amount of phosphorus [t(22)=1.87, P>0.05] did not change significantly while iPTH values before and after the study had statistically significant difference [t(22)=4.37, P<0.05]. In group treated with calcitriol, the calcium, phosphorus and iPTH values did not change significantly (P>0.05). Calcium changes in the cinacalcet group compared to the calcitriol group [t (47) =-1.14, P>0.05] and also, the amount of phosphorus changes [t (47) =-1.022, P>0.05] was not statistically significant. The iPTH changes were not statistically significant between the two groups however iPTH in the calcitriol group was higher than the cinacalcet group [t (47) =-1.13, P>0.05]. Conclusion: In contrast to calcitriol, cinacalcet significantly reduced iPTH and did not significantly change calcium and phosphorus levels. Trial Registration: The trial was registered by Iranian Registry of Clinical Trials (IRCT) (identifier: IRCT20190702044076N1; https://en.irct.ir/trial/40547, Ethical code# IR.SKUMS.REC.1397.026).
{"title":"A comparative study on the effect of calcitriol and cinacalcet on hyperparathyroidism in hemodialysis patients; a double-blinded randomized clinical trial","authors":"Saeed Mardani, Faranak Sadat Filsouf","doi":"10.34172/npj.2022.12","DOIUrl":"https://doi.org/10.34172/npj.2022.12","url":null,"abstract":"\u0000 Introduction:Chronic kidney disease (CKD) has lots of complication like calcium and phosphate metabolism disorders, hyperparathyroidism, vitamin D deficiency and metabolic acidosis. Objectives: The aim of this study was to determine and compare the effect of calcitriol and cinacalcet on hyperparathyroidism in hemodialysis patients due to end-stage renal disease (ESRD). Patients and Methods: This study was a double-blinded randomized clinical trial, which was conducted on 60 hemodialysis patients in 2017-2018. The patients were randomly assigned to two groups of 30 patients, which one group was treated with cinacalcet and the other group was treated with calcitriol. During this study, phosphorus, calcium and iPTH were measured. Results: The results showed that in the group treated with cinacalcet, the amount of calcium [t(22)=0.294, P>0.05] and the amount of phosphorus [t(22)=1.87, P>0.05] did not change significantly while iPTH values before and after the study had statistically significant difference [t(22)=4.37, P<0.05]. In group treated with calcitriol, the calcium, phosphorus and iPTH values did not change significantly (P>0.05). Calcium changes in the cinacalcet group compared to the calcitriol group [t (47) =-1.14, P>0.05] and also, the amount of phosphorus changes [t (47) =-1.022, P>0.05] was not statistically significant. The iPTH changes were not statistically significant between the two groups however iPTH in the calcitriol group was higher than the cinacalcet group [t (47) =-1.13, P>0.05]. Conclusion: In contrast to calcitriol, cinacalcet significantly reduced iPTH and did not significantly change calcium and phosphorus levels. Trial Registration: The trial was registered by Iranian Registry of Clinical Trials (IRCT) (identifier: IRCT20190702044076N1; https://en.irct.ir/trial/40547, Ethical code# IR.SKUMS.REC.1397.026).","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42007349","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}
E. Valavi, A. Nickavar, Kamran Shehni Nejadpour, Elmira Esmizadeh
Introduction: Nephrolithiasis has been increasingly recognized in recent years. Urine metabolic abnormality is the main cause of renal stone in children. Therefore, identification and medical treatment of metabolic abnormalities have been suggested as an alternative approach to surgical treatments. Objectives: This study was performed to evaluate the therapeutic effect of urine alkalinization and metabolic management in children with renal stone. Patients and Methods: A total of 300 children (from 408 renal clinics) with nephrolithiasis were enrolled in this study. All of them were treated by supportive managements, including urine alkalinization and specific medical treatment of underlying metabolic abnormality. Improvement was defined as stone resolution, stone passage or decrease of stone dimension. Results: Mean age at diagnosis was 28.7 ± 2.6 months (1-150 months). About 78.8% of patients had metabolic abnormality, of which, hypercalciuria (51.7%) and hypocitraturia (33.4%) were the most common causes, respectively. Resolution of renal stone occurred in 89.7% of patients after one year follow up, more in children less than 5 years (P=0.003), and stones smaller than 5 mm (P<0.001). However, 87.5% of large stones (5-12 mm) improved by medical treatment. Conclusion: Pharmacologic treatment is recommended in young children with small nephrolithiasis. Pharmacologic treatment also suggested as a primary intervention in children with uncomplicated large renal stones, and prior to invasive surgical management.
{"title":"Evaluation of medical treatment in Iranian children with nephrolithiasis","authors":"E. Valavi, A. Nickavar, Kamran Shehni Nejadpour, Elmira Esmizadeh","doi":"10.34172/npj.2022.09","DOIUrl":"https://doi.org/10.34172/npj.2022.09","url":null,"abstract":"\u0000 Introduction: Nephrolithiasis has been increasingly recognized in recent years. Urine metabolic abnormality is the main cause of renal stone in children. Therefore, identification and medical treatment of metabolic abnormalities have been suggested as an alternative approach to surgical treatments. Objectives: This study was performed to evaluate the therapeutic effect of urine alkalinization and metabolic management in children with renal stone. Patients and Methods: A total of 300 children (from 408 renal clinics) with nephrolithiasis were enrolled in this study. All of them were treated by supportive managements, including urine alkalinization and specific medical treatment of underlying metabolic abnormality. Improvement was defined as stone resolution, stone passage or decrease of stone dimension. Results: Mean age at diagnosis was 28.7 ± 2.6 months (1-150 months). About 78.8% of patients had metabolic abnormality, of which, hypercalciuria (51.7%) and hypocitraturia (33.4%) were the most common causes, respectively. Resolution of renal stone occurred in 89.7% of patients after one year follow up, more in children less than 5 years (P=0.003), and stones smaller than 5 mm (P<0.001). However, 87.5% of large stones (5-12 mm) improved by medical treatment. Conclusion: Pharmacologic treatment is recommended in young children with small nephrolithiasis. Pharmacologic treatment also suggested as a primary intervention in children with uncomplicated large renal stones, and prior to invasive surgical management.","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46179462","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. Moein, S. Moein, F. Farmani, Sahere Rozbehan, Z. Sabahi
Introduction: In most ancient cultures, honey has been used for both nutritional and medical purposes. Objectives: In this research, phenolic extracts of four Iranian honeys were evaluated to determine the antioxidant potentials using DPPH (2,2-diphenyl-1-picrylhydrazyl) radical scavenging, nitric oxide (NO) radical scavenging and reducing power by ferric reducing activity of plasma (FRAP) method. Additionally, anti-diabetic properties of honey and phenolic extracts were evaluated by determination of α-amylase and α-glucosidase inhibition. Patients and Methods: Besides, reducing potential was evaluated by ferric-reducing antioxidant power method. Moreover, determination of phenolic and flavonoid contents was performed. Moreover, inhibition of α-amylase and α-glucosidase of honey and phenolic extracts were evaluated. Results: With considering to antioxidant potentials, Gavan (Astragalus) sample showed the greatest phenolic (3817±1.52 mg GAE/100 g), flavonoid contents (3.1±0.005 mg QE/100 g), and DPPH radical scavenging (IC50 = 2±0.003 mg/mL). Bahareh honey had the highest NO radical scavenging (IC50=0.0403±0.0009 mg/mL) and Meymand honey possessed the highest reducing potential by FRAP method (IC50=0.0018±0.000003 mg/mL). The maximum inhibition of α-glucosidase was shown in Meymand honey extract (46±0.1%). After sugar isolation, Zataria honey had the highest inhibition of α-glucosidase (54±0.6%) and the mode of α-amylase inhibition was noncompetitive by this honey. Whole extract (23±0.1%) and phenolic extract of Gavan honey presented the maximum inhibition of α-amylase (31.2±0.1%). Conclusion: Honey samples showed antioxidant potentials and anti-diabetic properties by retardation of α-amylase and α-glucosidase.
{"title":"Examination the antioxidant potentials and antidiabetic properties of phenolic extracts of some Iranian honeys","authors":"M. Moein, S. Moein, F. Farmani, Sahere Rozbehan, Z. Sabahi","doi":"10.34172/npj.2022.06","DOIUrl":"https://doi.org/10.34172/npj.2022.06","url":null,"abstract":"\u0000 Introduction: In most ancient cultures, honey has been used for both nutritional and medical purposes. Objectives: In this research, phenolic extracts of four Iranian honeys were evaluated to determine the antioxidant potentials using DPPH (2,2-diphenyl-1-picrylhydrazyl) radical scavenging, nitric oxide (NO) radical scavenging and reducing power by ferric reducing activity of plasma (FRAP) method. Additionally, anti-diabetic properties of honey and phenolic extracts were evaluated by determination of α-amylase and α-glucosidase inhibition. Patients and Methods: Besides, reducing potential was evaluated by ferric-reducing antioxidant power method. Moreover, determination of phenolic and flavonoid contents was performed. Moreover, inhibition of α-amylase and α-glucosidase of honey and phenolic extracts were evaluated. Results: With considering to antioxidant potentials, Gavan (Astragalus) sample showed the greatest phenolic (3817±1.52 mg GAE/100 g), flavonoid contents (3.1±0.005 mg QE/100 g), and DPPH radical scavenging (IC50 = 2±0.003 mg/mL). Bahareh honey had the highest NO radical scavenging (IC50=0.0403±0.0009 mg/mL) and Meymand honey possessed the highest reducing potential by FRAP method (IC50=0.0018±0.000003 mg/mL). The maximum inhibition of α-glucosidase was shown in Meymand honey extract (46±0.1%). After sugar isolation, Zataria honey had the highest inhibition of α-glucosidase (54±0.6%) and the mode of α-amylase inhibition was noncompetitive by this honey. Whole extract (23±0.1%) and phenolic extract of Gavan honey presented the maximum inhibition of α-amylase (31.2±0.1%). Conclusion: Honey samples showed antioxidant potentials and anti-diabetic properties by retardation of α-amylase and α-glucosidase.","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45790511","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. Behairy, R. Elsharabasy, Abdel Bassit El Shaarawy, W. Anwar, Zeinab Ahmed Mahmoud, L. Khedr
Introduction: Low 25-hydroxyvitamin D (25(OH)D) level in hemodialysis (HD) patients is associated with high bone turnover, secondary hyperparathyroidism, and decreased bone mineral density (BMD). Objective: To investigate the efficacy of equivalent doses of pulse oral cholecalciferol versus intramuscular (IM) cholecalciferol in correcting serum 25(OH)D levels in HD patients with vitamin D deficiency. Patients and Methods: In a prospective randomized open-label clinical trial, 80 HD patients with 25(OH)D level <20 ng/mL and serum intact parathyroid hormone (iPTH) level >100 pg/mL were enrolled in the study. Patients were divided into two groups. Group I: 40 HD patients received oral cholecalciferol 25 000 IU weekly for 12 weeks. Group II: 40 HD patients received a single dose of IM cholecalciferol 300 000 IU. Patients were maintained on their regular medications as alfacalcidol or phosphate binders. Serum calcium, phosphorus, 25(OH)D, alkaline phosphatase and iPTH were monitored at 0, 6th, and 12th week of intervention. Results: Significant increase in serum 25(OH)D level in group II patients who received IM (intramuscular) cholecalciferol, with delta mean a change of vitamin D level was 2.92 ±7.29 ng/mL over three months in comparison to the insignificant change in oral cholecalciferol group. Additionally there was a significant increase in the mean of serum calcium in comparison to oral cholecalciferol group, while we found a statistically significant decrease in alkaline phosphatase level in both groups too (P<0.05). The mean of iPTH levels was reduced significantly with IM cholecalciferol dose (1064.00 ± 787.60 to 609.9 ± 551.41 pg/mL; P<0.05). Conclusion: Intramuscular cholecalciferol dose is more effective at increasing 25(OH) D levels in dialysis patients than oral supplementation, achieves more increase in serum calcium and reduce iPTH levels. However, the longer duration of treatment is required to achieve recommended levels of vitamin D and suppress high iPTH levels.
{"title":"Oral versus intramuscular cholecalciferol replacement in hemodialysis patients with vitamin D deficiency","authors":"M. Behairy, R. Elsharabasy, Abdel Bassit El Shaarawy, W. Anwar, Zeinab Ahmed Mahmoud, L. Khedr","doi":"10.34172/npj.2022.07","DOIUrl":"https://doi.org/10.34172/npj.2022.07","url":null,"abstract":"\u0000 Introduction: Low 25-hydroxyvitamin D (25(OH)D) level in hemodialysis (HD) patients is associated with high bone turnover, secondary hyperparathyroidism, and decreased bone mineral density (BMD). Objective: To investigate the efficacy of equivalent doses of pulse oral cholecalciferol versus intramuscular (IM) cholecalciferol in correcting serum 25(OH)D levels in HD patients with vitamin D deficiency. Patients and Methods: In a prospective randomized open-label clinical trial, 80 HD patients with 25(OH)D level <20 ng/mL and serum intact parathyroid hormone (iPTH) level >100 pg/mL were enrolled in the study. Patients were divided into two groups. Group I: 40 HD patients received oral cholecalciferol 25 000 IU weekly for 12 weeks. Group II: 40 HD patients received a single dose of IM cholecalciferol 300 000 IU. Patients were maintained on their regular medications as alfacalcidol or phosphate binders. Serum calcium, phosphorus, 25(OH)D, alkaline phosphatase and iPTH were monitored at 0, 6th, and 12th week of intervention. Results: Significant increase in serum 25(OH)D level in group II patients who received IM (intramuscular) cholecalciferol, with delta mean a change of vitamin D level was 2.92 ±7.29 ng/mL over three months in comparison to the insignificant change in oral cholecalciferol group. Additionally there was a significant increase in the mean of serum calcium in comparison to oral cholecalciferol group, while we found a statistically significant decrease in alkaline phosphatase level in both groups too (P<0.05). The mean of iPTH levels was reduced significantly with IM cholecalciferol dose (1064.00 ± 787.60 to 609.9 ± 551.41 pg/mL; P<0.05). Conclusion: Intramuscular cholecalciferol dose is more effective at increasing 25(OH) D levels in dialysis patients than oral supplementation, achieves more increase in serum calcium and reduce iPTH levels. However, the longer duration of treatment is required to achieve recommended levels of vitamin D and suppress high iPTH levels.","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47358019","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: Urinary stones are the third most common urinary tract disease after urinary tract infections and prostate diseases. Objectives: The aim of this study was to compare efficacy of Nigella sativa seeds and tamsulosin on expulsion and pain relief of ureteral and renal stones smaller than 10 mm. Patients and Methods: In this randomized clinical trial study conducted from March 2018-2019, 80 patients over 18 years old with kidney and ureteral stones sized between 4 to 10 mm were assigned to two groups by the simple random sampling method. In group one, after performing ultrasonography and confirming the presence of 4 to 10 mm stones, one 0.4 mg capsule of tamsulosin was prescribed each night for two weeks. In group 2, one gram of Nigellasativa prescribed every 12 hours after each meal with a glass of water for two weeks. After 2 weeks, patients were visited while a urinary tract sonography was conducted and the modification in size of stones and the existence of residual stones were measured and noted. The pain severity was measured through the visual analog scale (VSA). Data was gathered and analyzed throughout treatment and at the end of the study by the SPSS version 21 software, chi-square and independent t tests. Results: Mean sizes of stones before treatment with Nigella versus tamsulosin groups were 10.3±1.81 and 9.41 ± 1.68 mm respectively (P=0.06). Mean size of stones after treatment with Nigella versus tamsulosin groups were 4.97±4.33 and 5.21 ± 3.63 mm respectively (P=0.39). There was no significant difference between two groups regarding average of the pain score after treatment (P=0.05), but after intervention this score significantly declined in both groups, indicating more substantial in Nigella sativa group (P=0.001). Efficacy of treatment in Nigella and tamsulosin groups was 78.5 and 61.6, respectively (P=0.005). Conclusion: The present study indicated that both Nigella sativa seed and tamsulosin reduce urinary stone size and numbers without significant difference, however stone passage and pain control was more in the group of Nigella sativa. Trial Registration: The trial protocol was approved by the Iranian Registry of Clinical Trial (identifier: IRCT20081011001323N23; https://irct.ir/user/trial/35993/, ethical code; IR.YUMS.REC.1397.155).
导读:尿路结石是继尿路感染和前列腺疾病之后的第三大常见泌尿道疾病。目的:本研究的目的是比较黑草种子和坦索罗辛对小于10毫米输尿管结石和肾结石的排出和疼痛缓解的疗效。患者和方法:本研究于2018年3月至2019年3月进行随机临床试验，采用简单随机抽样法将80例18岁以上肾脏和输尿管结石患者分为两组，结石大小在4 ~ 10 mm之间。第一组在超声检查确认结石大小为4 ~ 10 mm后，每晚给予坦索罗辛0.4 mg胶囊1粒，连续2周。第二组，每餐后12小时服用1克奈甲草，并加一杯水，持续两周。2周后，对患者进行尿路超声检查，测量并记录结石大小的改变和残留结石的存在。通过视觉模拟量表(VSA)测量疼痛严重程度。在整个治疗过程和研究结束时，通过SPSS version 21软件、卡方检验和独立t检验收集和分析数据。结果:尼黑菌组与坦索罗辛组治疗前结石的平均大小分别为10.3±1.81 mm和9.41±1.68 mm (P=0.06)。奈皮菌组与坦索罗辛组结石平均大小分别为4.97±4.33 mm和5.21±3.63 mm (P=0.39)。治疗后两组患者疼痛评分平均值比较差异无统计学意义(P=0.05)，干预后两组患者疼痛评分均显著下降，干预组疼痛评分更明显(P=0.001)。尼格拉组和坦索罗辛组的总有效率分别为78.5分和61.6分(P=0.005)。结论:本研究表明，黑皮籽和坦索罗辛均能减少尿结石的大小和数量，差异无统计学意义，但黑皮籽组结石的排出和疼痛的控制更明显。试验注册:试验方案已获得伊朗临床试验注册中心批准(标识符:IRCT20081011001323N23;https://irct.ir/user/trial/35993/，道德准则;IR.YUMS.REC.1397.155)。
{"title":"Comparison efficacy of oral Nigella sativa seeds and tamsulosin on pain relief and passage of 4 to 10 mm stones of kidney and ureter; a randomized clinical trial","authors":"N. Shakeri, S. Mehrabi, A. Paymard","doi":"10.34172/npj.2022.08","DOIUrl":"https://doi.org/10.34172/npj.2022.08","url":null,"abstract":"\u0000 Introduction: Urinary stones are the third most common urinary tract disease after urinary tract infections and prostate diseases. Objectives: The aim of this study was to compare efficacy of Nigella sativa seeds and tamsulosin on expulsion and pain relief of ureteral and renal stones smaller than 10 mm. Patients and Methods: In this randomized clinical trial study conducted from March 2018-2019, 80 patients over 18 years old with kidney and ureteral stones sized between 4 to 10 mm were assigned to two groups by the simple random sampling method. In group one, after performing ultrasonography and confirming the presence of 4 to 10 mm stones, one 0.4 mg capsule of tamsulosin was prescribed each night for two weeks. In group 2, one gram of Nigellasativa prescribed every 12 hours after each meal with a glass of water for two weeks. After 2 weeks, patients were visited while a urinary tract sonography was conducted and the modification in size of stones and the existence of residual stones were measured and noted. The pain severity was measured through the visual analog scale (VSA). Data was gathered and analyzed throughout treatment and at the end of the study by the SPSS version 21 software, chi-square and independent t tests. Results: Mean sizes of stones before treatment with Nigella versus tamsulosin groups were 10.3±1.81 and 9.41 ± 1.68 mm respectively (P=0.06). Mean size of stones after treatment with Nigella versus tamsulosin groups were 4.97±4.33 and 5.21 ± 3.63 mm respectively (P=0.39). There was no significant difference between two groups regarding average of the pain score after treatment (P=0.05), but after intervention this score significantly declined in both groups, indicating more substantial in Nigella sativa group (P=0.001). Efficacy of treatment in Nigella and tamsulosin groups was 78.5 and 61.6, respectively (P=0.005). Conclusion: The present study indicated that both Nigella sativa seed and tamsulosin reduce urinary stone size and numbers without significant difference, however stone passage and pain control was more in the group of Nigella sativa. Trial Registration: The trial protocol was approved by the Iranian Registry of Clinical Trial (identifier: IRCT20081011001323N23; https://irct.ir/user/trial/35993/, ethical code; IR.YUMS.REC.1397.155).","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47291380","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}
Tella Sadighpour, C. Cagnazzo, S. Alimohammadi, Anahita Emami, Azadeh Khayyat, Mohammad Ali Esmaeilpour
Chemotherapy-associated renal injury is considered one of the major concerns among nephrological and oncological practice. The use of novel anti-neoplastic therapies that target carcinomas has helped in the detection of this form of renal injury. Immune checkpoint inhibitors (ICPIs) are a group of monoclonal antibodies targeting inhibitory receptors that exist on tumor cells and T cells. ICPIs are able to suppress tumors that might have escaped from the immune surveillance. Meanwhile, although ICPIs have shown promising efficacy in cancer treatment, their immune-related side effects limit their widespread use in cancer therapy schedules. One of the major side effects limiting ICPIs’ usage is nephrotoxicity. Glomerular disease, acute interstitial nephritis (AIN), and acute tubular necrosis (ATN) are considered different infusion-related adverse events. Infiltration of eosinophils, T lymphocytes, and plasma cells, as well as interstitial inflammation and edema, leading to acute tubulointerstitial nephritis (ATIN). It is conceivable that the rupture of self-tolerance by ICPIs induces an autoimmune reaction against some specific self-antigens in the organs including kidneys. The exact nature of the antigen is unclear; however, it is possible that it is found in the renal tubular cells, as indicated by a greater frequency of ATIN in kidney biopsies. The current review paper discusses the relationship between ICPIs therapy and kidney disorders or more specifically, their possible role in renal damage along with renal toxicity profile in the setting of ICPIs treatment.
{"title":"Immune-related adverse kidney events by immune checkpoint inhibitors; a narrative review on current studies","authors":"Tella Sadighpour, C. Cagnazzo, S. Alimohammadi, Anahita Emami, Azadeh Khayyat, Mohammad Ali Esmaeilpour","doi":"10.34172/NPJ.2021.22","DOIUrl":"https://doi.org/10.34172/NPJ.2021.22","url":null,"abstract":"Chemotherapy-associated renal injury is considered one of the major concerns among nephrological and oncological practice. The use of novel anti-neoplastic therapies that target carcinomas has helped in the detection of this form of renal injury. Immune checkpoint inhibitors (ICPIs) are a group of monoclonal antibodies targeting inhibitory receptors that exist on tumor cells and T cells. ICPIs are able to suppress tumors that might have escaped from the immune surveillance. Meanwhile, although ICPIs have shown promising efficacy in cancer treatment, their immune-related side effects limit their widespread use in cancer therapy schedules. One of the major side effects limiting ICPIs’ usage is nephrotoxicity. Glomerular disease, acute interstitial nephritis (AIN), and acute tubular necrosis (ATN) are considered different infusion-related adverse events. Infiltration of eosinophils, T lymphocytes, and plasma cells, as well as interstitial inflammation and edema, leading to acute tubulointerstitial nephritis (ATIN). It is conceivable that the rupture of self-tolerance by ICPIs induces an autoimmune reaction against some specific self-antigens in the organs including kidneys. The exact nature of the antigen is unclear; however, it is possible that it is found in the renal tubular cells, as indicated by a greater frequency of ATIN in kidney biopsies. The current review paper discusses the relationship between ICPIs therapy and kidney disorders or more specifically, their possible role in renal damage along with renal toxicity profile in the setting of ICPIs treatment.","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45838243","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}
Taraneh Esmaili, Zahra Aghaalitafreshi, M. Gharib, M. Montazeri
Introduction: Atherosclerosis progression in the patients suffering from end-stage renal disease (ESRD) is more than normal population. Magnesium levels are also associated with an increase in atherosclerosis in the common carotid artery. Intima-media carotid calcification is either directly or indirectly related to cardiovascular disease and a higher rate of death among patients with chronic renal failure. Objectives: The purpose of the present study was to evaluate the protective role of serum magnesium levels in vascular calcification and the improvement of the carotid intima-media thickness (CIMT). Patients and Methods: In this cross-sectional research, the participants were selected from all patients with ESRD in Five Azar Medical Center of Gorgan, Iran. Blood samples collected from research units were tested for serum magnesium level in three times. Patients were referred to a radiologist to measure CIMT. Data collected in all patients were evaluated based on Spearman’s correlation test. Results: The correlation between serum magnesium level and CIMT was not statistically significant (P = 0.66 r= 0.04), however a positive correlation between CIMT and the dialysis adequacy (KT/V) was detected (r = 0.306, P = 0.006). Conclusion: This study demonstrated no correlation between the serum magnesium level and the CIMT in hemodialysis patients.
{"title":"A study on the correlation of serum magnesium with intima-media thickness of carotid in hemodialysis patients","authors":"Taraneh Esmaili, Zahra Aghaalitafreshi, M. Gharib, M. Montazeri","doi":"10.34172/NPJ.2021.21","DOIUrl":"https://doi.org/10.34172/NPJ.2021.21","url":null,"abstract":"\u0000 Introduction: Atherosclerosis progression in the patients suffering from end-stage renal disease (ESRD) is more than normal population. Magnesium levels are also associated with an increase in atherosclerosis in the common carotid artery. Intima-media carotid calcification is either directly or indirectly related to cardiovascular disease and a higher rate of death among patients with chronic renal failure. Objectives: The purpose of the present study was to evaluate the protective role of serum magnesium levels in vascular calcification and the improvement of the carotid intima-media thickness (CIMT). Patients and Methods: In this cross-sectional research, the participants were selected from all patients with ESRD in Five Azar Medical Center of Gorgan, Iran. Blood samples collected from research units were tested for serum magnesium level in three times. Patients were referred to a radiologist to measure CIMT. Data collected in all patients were evaluated based on Spearman’s correlation test. Results: The correlation between serum magnesium level and CIMT was not statistically significant (P = 0.66 r= 0.04), however a positive correlation between CIMT and the dialysis adequacy (KT/V) was detected (r = 0.306, P = 0.006). Conclusion: This study demonstrated no correlation between the serum magnesium level and the CIMT in hemodialysis patients.","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47008227","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. Maghsoudi, Maryam Dehghani Mobarakeh, A. Momeni, Alireza Nematollahi, Shahin Asgari, Laa'ya Rasooli
Introduction: Hypertension is one of the most leading causes of death worldwide. It is an important risk factor for ischemic heart disease (IHD), chronic kidney disease (CKD) and cerebrovascular diseases. Objectives: The aim of the study was evaluation of the status of blood pressure control and trends in prescribed antihypertensive medication usage among hypertensive patients in Shahrekord, Iran. Patients and Methods: In a cross-sectional descriptive study 250 hypertensive patients were enrolled. The patients were evaluated based on the status of blood pressure (BP) control and the prescription trends and efficacy of antihypertensive drugs. The data were also evaluated in subgroups of diabetics or non-diabetics, smokers or non-smokers, patients with or without CKD, patients with or without IHD. Results: A total of 250 patients (149 women and 101 men) were enrolled in this study. The mean age of participants was 66.22±13.58 years. Mean systolic and diastolic BP were 143.4±29.4 mm Hg and 85.8±12.5 mm Hg respectively. Poor controlled BP was seen in 106 patients. The more common prescribed antihypertensive drugs were angiotensin receptor blockers (46%), diuretics (33.6%) and beta-blockers (32.8%). Conclusion: The study showed that most of the patients had poor controlled BP and physicians increasingly prescribe angiotensin receptor blockers.
{"title":"Antihypertensive drug prescription trends in Shahrekord, Iran","authors":"A. Maghsoudi, Maryam Dehghani Mobarakeh, A. Momeni, Alireza Nematollahi, Shahin Asgari, Laa'ya Rasooli","doi":"10.34172/npj.2022.13","DOIUrl":"https://doi.org/10.34172/npj.2022.13","url":null,"abstract":"\u0000 Introduction: Hypertension is one of the most leading causes of death worldwide. It is an important risk factor for ischemic heart disease (IHD), chronic kidney disease (CKD) and cerebrovascular diseases. Objectives: The aim of the study was evaluation of the status of blood pressure control and trends in prescribed antihypertensive medication usage among hypertensive patients in Shahrekord, Iran. Patients and Methods: In a cross-sectional descriptive study 250 hypertensive patients were enrolled. The patients were evaluated based on the status of blood pressure (BP) control and the prescription trends and efficacy of antihypertensive drugs. The data were also evaluated in subgroups of diabetics or non-diabetics, smokers or non-smokers, patients with or without CKD, patients with or without IHD. Results: A total of 250 patients (149 women and 101 men) were enrolled in this study. The mean age of participants was 66.22±13.58 years. Mean systolic and diastolic BP were 143.4±29.4 mm Hg and 85.8±12.5 mm Hg respectively. Poor controlled BP was seen in 106 patients. The more common prescribed antihypertensive drugs were angiotensin receptor blockers (46%), diuretics (33.6%) and beta-blockers (32.8%). Conclusion: The study showed that most of the patients had poor controlled BP and physicians increasingly prescribe angiotensin receptor blockers.","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48060993","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}
Elnaz Golestaneh, A. Hasanpour Dehkordi, Banafsheh Yalameha, P. Noorshargh, Parto Nasri, H. Nasri
Introduction: Diabetes mellitus (DM) is distinguished as a serious health problem worldwide. The universal outbreak of DM because of urban life and alteration of lifestyle, day to day is increasing. Objectives: The present investigation was designed to evaluate the nephroprotective effects of resveratrol (RSV) and silymarin (SM) on morphologic injury to renal tubular cells in adult male diabetic rats. Materials and Methods: Twenty-five male Wistar rats randomly were designated into five groups (n = 5) including group I (control); rats received normal saline by gavage for 14 days. Group II; rats received a single injection of STZ at a dose of 60 mg/kg intraperitoneally and were also given isotonic saline orally for 14 days. Group III; Rats, after STZ injection, received 100 mg/kg of SM by gavage for 14 days. Group IV; Rats, after STZ injection, received 100 ml/kg of RSV by gavage for 14 days. Group V; rats, after STZ injection, received the combination of SM and RSV at a dose of 100 mg/kg by gavage for 14 days. The kidneys were removed immediately after sacrificing and prepared for morphological examination. Kidney sections were examined for the intensity of kidney damage (vacuolization, flattening, degeneration and necrosis). Results: Significant differences were observed in types of morphologic injury to renal tubular cells (vacuolization, flattening, degeneration and necrosis) between groups (P < 0.05). Significantly, both the SM and RSV reduced the injury of renal tubular cells in diabetic rats (P < 0.05). Conclusion: The findings of the present study indicated that although the protective effect of SM and RSV was more significant on necrosis and flattening, respectively, SM and RSV produced a nephroprotective impact on the injury of renal tubular cells in diabetic rats than their combination influences.
{"title":"Comparative study of nephroprotective effects of resveratrol and silymarin in diabetic rats; an experimental histopathologic study","authors":"Elnaz Golestaneh, A. Hasanpour Dehkordi, Banafsheh Yalameha, P. Noorshargh, Parto Nasri, H. Nasri","doi":"10.34172/npj.2022.10381","DOIUrl":"https://doi.org/10.34172/npj.2022.10381","url":null,"abstract":"Introduction: Diabetes mellitus (DM) is distinguished as a serious health problem worldwide. The universal outbreak of DM because of urban life and alteration of lifestyle, day to day is increasing. Objectives: The present investigation was designed to evaluate the nephroprotective effects of resveratrol (RSV) and silymarin (SM) on morphologic injury to renal tubular cells in adult male diabetic rats. Materials and Methods: Twenty-five male Wistar rats randomly were designated into five groups (n = 5) including group I (control); rats received normal saline by gavage for 14 days. Group II; rats received a single injection of STZ at a dose of 60 mg/kg intraperitoneally and were also given isotonic saline orally for 14 days. Group III; Rats, after STZ injection, received 100 mg/kg of SM by gavage for 14 days. Group IV; Rats, after STZ injection, received 100 ml/kg of RSV by gavage for 14 days. Group V; rats, after STZ injection, received the combination of SM and RSV at a dose of 100 mg/kg by gavage for 14 days. The kidneys were removed immediately after sacrificing and prepared for morphological examination. Kidney sections were examined for the intensity of kidney damage (vacuolization, flattening, degeneration and necrosis). Results: Significant differences were observed in types of morphologic injury to renal tubular cells (vacuolization, flattening, degeneration and necrosis) between groups (P < 0.05). Significantly, both the SM and RSV reduced the injury of renal tubular cells in diabetic rats (P < 0.05). Conclusion: The findings of the present study indicated that although the protective effect of SM and RSV was more significant on necrosis and flattening, respectively, SM and RSV produced a nephroprotective impact on the injury of renal tubular cells in diabetic rats than their combination influences.","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45727838","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}
G. Cancarini, Vincenzo Terlizzi, Anna Garatti, Letizia Zeni, Mattia Tonoli, Elena Pezzini, F. Boni, S. Possenti, B. F. Viola, M. Gaggiotti
Introduction: Cast nephropathy is a prevalent cause of acute kidney injury (AKI) in patients with myeloma. Objectives: The aim of this study is to define the outcome of a standardized supportive therapy for cast nephropathy. Patients and Methods: Retrospective analysis of the outcome of cast nephropathy in a University hospital for a period of five years. Data analysed; serum creatinine, estimated glomerular filtration rate (eGFR; mL/min/1.73 m2 BSA) and need for dialysis. Standardized therapy with the aim of preventing/removing tubular casts; fluid administration and mannitol to increase urine flow, sodium bicarbonate to alkalize the urine and low dose steroid to reduce peritubular inflammation. Statistical analysis: Student’s t-test or the Mann-Whitney test according to data distribution. A two-tailed P value <0.05 was considered statistically significant. Survival curve was drawn according to Kaplan and Meier. Results: Twenty-seven cases were reviewed. Upon admission, mean serum creatinine was 7.1±4.9 mg/dL and mean eGFR 6±4 mL/min/1.73 m2 BSA; 30% of patients had oligo-anuria. Diagnosis of cast nephropathy was presumptive in 23 patients, and renal biopsy proven in four. Hemodialysis was required by 10 (37%) patients, two of whom continued dialysis after discharge. At discharge, serum creatinine was 3.7±2.5 mg/dL and eGFR 20±13 mL/min/1.73 m2 BSA (P=0.002), and after a median of 3.4 months, the values were 2.9±2.1 mg/dL and 35±32 mL/min/1.73 m2 BSA, respectively. Patient survival was 60% after 24 months. Conclusion: Administration of fluid, mannitol, sodium bicarbonate and low-dose steroid may improve the outcome of cast nephropathy. Despite the fact that the study has many limitations, its findings could be the base for prospective controlled trials on cast nephropathy and could be useful in those countries where the expensive extracorporeal treatments are not available.
{"title":"Supportive treatment for cast nephropathy in patients with multiple myeloma; a pilot study","authors":"G. Cancarini, Vincenzo Terlizzi, Anna Garatti, Letizia Zeni, Mattia Tonoli, Elena Pezzini, F. Boni, S. Possenti, B. F. Viola, M. Gaggiotti","doi":"10.34172/NPJ.2021.20","DOIUrl":"https://doi.org/10.34172/NPJ.2021.20","url":null,"abstract":"\u0000 Introduction: Cast nephropathy is a prevalent cause of acute kidney injury (AKI) in patients with myeloma. Objectives: The aim of this study is to define the outcome of a standardized supportive therapy for cast nephropathy. Patients and Methods: Retrospective analysis of the outcome of cast nephropathy in a University hospital for a period of five years. Data analysed; serum creatinine, estimated glomerular filtration rate (eGFR; mL/min/1.73 m2 BSA) and need for dialysis. Standardized therapy with the aim of preventing/removing tubular casts; fluid administration and mannitol to increase urine flow, sodium bicarbonate to alkalize the urine and low dose steroid to reduce peritubular inflammation. Statistical analysis: Student’s t-test or the Mann-Whitney test according to data distribution. A two-tailed P value <0.05 was considered statistically significant. Survival curve was drawn according to Kaplan and Meier. Results: Twenty-seven cases were reviewed. Upon admission, mean serum creatinine was 7.1±4.9 mg/dL and mean eGFR 6±4 mL/min/1.73 m2 BSA; 30% of patients had oligo-anuria. Diagnosis of cast nephropathy was presumptive in 23 patients, and renal biopsy proven in four. Hemodialysis was required by 10 (37%) patients, two of whom continued dialysis after discharge. At discharge, serum creatinine was 3.7±2.5 mg/dL and eGFR 20±13 mL/min/1.73 m2 BSA (P=0.002), and after a median of 3.4 months, the values were 2.9±2.1 mg/dL and 35±32 mL/min/1.73 m2 BSA, respectively. Patient survival was 60% after 24 months. Conclusion: Administration of fluid, mannitol, sodium bicarbonate and low-dose steroid may improve the outcome of cast nephropathy. Despite the fact that the study has many limitations, its findings could be the base for prospective controlled trials on cast nephropathy and could be useful in those countries where the expensive extracorporeal treatments are not available.","PeriodicalId":16388,"journal":{"name":"Journal of Nephropharmacology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47913414","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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