Hamidreza Khodabandeh, Z. Bakhshizade, Mohammad Hossein Taklif, Halime Zaeri Fakhrabadi, Soleyman Alivand, N. Alivand, Ghazaleh Rashidizadeh, Leila Jampour, Mahsa Shirani
Introduction: Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a new diabetes treatment. Considering the prescription of these medicines for kidney transplant patients, this systematic review and meta-analysis aimed to investigate the impact of SGLT2 inhibitors on kidney transplant patients. Material and Methods: This meta-analysis study was performed based on the PRISMA guideline. The necessary data were collected by searching the databases of Scopus, PubMed, Cochrane, Google Scholar search engine, and Web of Science without a time limit until March 1, 2023. The data were analyzed in STATA 14. A P value less than 0.05 was considered significant. Results: The authors assessed eight articles with a sample size of 960 patients. The SGLT2 inhibitors showed no significant impact on levels of estimated glomerular filtration rate [SMD: -0.21 (95% CI: -0.65, 0.25)], serum creatinine [SMD: -0.02 (95% CI: -0.19, 0.15)], plasma hemoglobin A1c (HbA1c) [SMD: -0.62 (95% CI: -1.43, 0.18)], systolic blood pressure [SMD: -0.64 (95% CI: -1.80, 0.52)], and diastolic blood pressure [SMD: -0.64 (95% CI: -1.41, 0.14)], and on the patient’s weight [SMD:-0.31 (95% CI: -0.80, 0.18)]. Patient age did not influence the impact of SGLT2 inhibitors on estimated glomerular filtration rate (50–59 years-old age group: [SMD: 0.13 (95% CI: -0.04, 0.30)], 60–69 years-old age group: [SMD: -0.56 (95 % CI: -1.38, 0.26]). Duration of medicine use did not affect the impact of SGLT2 inhibitors on estimated glomerular filtration rate [6 months after medicine use: SMD: -0.56 (95% CI: -1.38, 0.26)], 12 months after medicine use: [SMD: 0.10 (95% CI: -0.05, 0.26)]. Conclusion: SGLT2 inhibitors were not effective in lowering blood pressure, estimated glomerular filtration rate, serum creatinine, and hemoglobin A1c levels, or weight in kidney transplant patients. Although SGLT2 inhibitors were ineffective in improving kidney transplant patients’ renal function, there were no side effects, and the administration of this drug in kidney transplant patients can continue. Further research is required to ensure safety and determine the appropriate dosage and duration of drug use. Registration: The study was compiled according to the PRISMA checklist and its protocol was registered on the PROSPERO (ID: CRD42023407501) and Research Registry (UIN: reviewregistry1666) websites.
{"title":"Administration of sodium-glucose cotransporter-2 inhibitors in kidney transplant patients with diabetes: a systematic review and meta-analysis","authors":"Hamidreza Khodabandeh, Z. Bakhshizade, Mohammad Hossein Taklif, Halime Zaeri Fakhrabadi, Soleyman Alivand, N. Alivand, Ghazaleh Rashidizadeh, Leila Jampour, Mahsa Shirani","doi":"10.34172/jnp.2023.21477","DOIUrl":"https://doi.org/10.34172/jnp.2023.21477","url":null,"abstract":"Introduction: Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a new diabetes treatment. Considering the prescription of these medicines for kidney transplant patients, this systematic review and meta-analysis aimed to investigate the impact of SGLT2 inhibitors on kidney transplant patients. Material and Methods: This meta-analysis study was performed based on the PRISMA guideline. The necessary data were collected by searching the databases of Scopus, PubMed, Cochrane, Google Scholar search engine, and Web of Science without a time limit until March 1, 2023. The data were analyzed in STATA 14. A P value less than 0.05 was considered significant. Results: The authors assessed eight articles with a sample size of 960 patients. The SGLT2 inhibitors showed no significant impact on levels of estimated glomerular filtration rate [SMD: -0.21 (95% CI: -0.65, 0.25)], serum creatinine [SMD: -0.02 (95% CI: -0.19, 0.15)], plasma hemoglobin A1c (HbA1c) [SMD: -0.62 (95% CI: -1.43, 0.18)], systolic blood pressure [SMD: -0.64 (95% CI: -1.80, 0.52)], and diastolic blood pressure [SMD: -0.64 (95% CI: -1.41, 0.14)], and on the patient’s weight [SMD:-0.31 (95% CI: -0.80, 0.18)]. Patient age did not influence the impact of SGLT2 inhibitors on estimated glomerular filtration rate (50–59 years-old age group: [SMD: 0.13 (95% CI: -0.04, 0.30)], 60–69 years-old age group: [SMD: -0.56 (95 % CI: -1.38, 0.26]). Duration of medicine use did not affect the impact of SGLT2 inhibitors on estimated glomerular filtration rate [6 months after medicine use: SMD: -0.56 (95% CI: -1.38, 0.26)], 12 months after medicine use: [SMD: 0.10 (95% CI: -0.05, 0.26)]. Conclusion: SGLT2 inhibitors were not effective in lowering blood pressure, estimated glomerular filtration rate, serum creatinine, and hemoglobin A1c levels, or weight in kidney transplant patients. Although SGLT2 inhibitors were ineffective in improving kidney transplant patients’ renal function, there were no side effects, and the administration of this drug in kidney transplant patients can continue. Further research is required to ensure safety and determine the appropriate dosage and duration of drug use. Registration: The study was compiled according to the PRISMA checklist and its protocol was registered on the PROSPERO (ID: CRD42023407501) and Research Registry (UIN: reviewregistry1666) websites.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48548547","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}
Leila Sabetnia, Farzaneh Hematian, Hosein Jafari, R. Ganji, Ahmad Nezhadisalami
Introduction: Treatment of mild to moderate hypokalemia is a high potassium-containing diet and oral pharmaceutical potassium products. However, several medical centers in Iran use injectable dosage forms orally, which is not a confirmed method by reliable guidelines. Objectives: This study investigated the advantages and side effects of oral tablets versus injection vials of potassium chloride orally. Patients and Methods: This descriptive-analytical cross-sectional study was performed from March 2022 to June 2022. Thirty patients received tablets ("potassium chloride tablet" group), and thirty patients received injection vials ("potassium chloride vials orally" group) of potassium chloride orally. The variables, including age, gender, clinical side effects, and serum level of potassium, were regularly recorded. Results: The mean duration of serum potassium normalization was 42.00 hours for the "potassium chloride tablet" group and 84.57 hours for the "potassium chloride vials orally" group. The mean total potassium intake was 127.20 mEq/L in the "potassium chloride tablet" group and 280.03 mEq/L for the "potassium chloride vials orally" group. No significant difference was observed in gastrointestinal complications, including esophagitis, bloating, stomach ache, and nausea. None of the patients have required endoscopy due to esophagitis. Conclusion: Our result suggested that prescribing oral potassium chloride tablets has superior benefits over injection vials. However, more detailed research is needed to reveal the other aspects of this problem. Study Registration: This study was retrospectively registered in Research Registry UIN (UIN: reviewregistry1668).
{"title":"Comparison of treatment of hypokalemia with oral administration of potassium chloride vial or oral tablets","authors":"Leila Sabetnia, Farzaneh Hematian, Hosein Jafari, R. Ganji, Ahmad Nezhadisalami","doi":"10.34172/jnp.2023.21435","DOIUrl":"https://doi.org/10.34172/jnp.2023.21435","url":null,"abstract":"Introduction: Treatment of mild to moderate hypokalemia is a high potassium-containing diet and oral pharmaceutical potassium products. However, several medical centers in Iran use injectable dosage forms orally, which is not a confirmed method by reliable guidelines. Objectives: This study investigated the advantages and side effects of oral tablets versus injection vials of potassium chloride orally. Patients and Methods: This descriptive-analytical cross-sectional study was performed from March 2022 to June 2022. Thirty patients received tablets (\"potassium chloride tablet\" group), and thirty patients received injection vials (\"potassium chloride vials orally\" group) of potassium chloride orally. The variables, including age, gender, clinical side effects, and serum level of potassium, were regularly recorded. Results: The mean duration of serum potassium normalization was 42.00 hours for the \"potassium chloride tablet\" group and 84.57 hours for the \"potassium chloride vials orally\" group. The mean total potassium intake was 127.20 mEq/L in the \"potassium chloride tablet\" group and 280.03 mEq/L for the \"potassium chloride vials orally\" group. No significant difference was observed in gastrointestinal complications, including esophagitis, bloating, stomach ache, and nausea. None of the patients have required endoscopy due to esophagitis. Conclusion: Our result suggested that prescribing oral potassium chloride tablets has superior benefits over injection vials. However, more detailed research is needed to reveal the other aspects of this problem. Study Registration: This study was retrospectively registered in Research Registry UIN (UIN: reviewregistry1668).","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48039107","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}
Paniz Pourpashang, N. Esfandiar, Samaneh Panjeshahi, S. Sharafian, Seyed Hamidreza Mirbehbahani
Schimke immuno-osseous dysplasia (SIOD) is a rare disease diagnosed by skeletal malformations, steroid-resistant nephrotic syndrome (SRNs), and T-cell immunodeficiency. Proteinuria with focal segmental glomerulosclerosis (FSGS) is the most common renal pathologic finding in SIOD. In this case report, we present an 8-year-old boy with generalized edema, kyphosis, and nephrotic syndrome who was eventually diagnosed with SIOD.
{"title":"Schimke immuno-osseous dysplasia in a boy with generalized edema; a case report","authors":"Paniz Pourpashang, N. Esfandiar, Samaneh Panjeshahi, S. Sharafian, Seyed Hamidreza Mirbehbahani","doi":"10.34172/jnp.2023.21481","DOIUrl":"https://doi.org/10.34172/jnp.2023.21481","url":null,"abstract":"Schimke immuno-osseous dysplasia (SIOD) is a rare disease diagnosed by skeletal malformations, steroid-resistant nephrotic syndrome (SRNs), and T-cell immunodeficiency. Proteinuria with focal segmental glomerulosclerosis (FSGS) is the most common renal pathologic finding in SIOD. In this case report, we present an 8-year-old boy with generalized edema, kyphosis, and nephrotic syndrome who was eventually diagnosed with SIOD.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47995446","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}
Leila Alem, Mohammad Ali Esmaeil pour, Azadeh Khayyat, Parisa Kaviani, Mehrnoosh Ebadi
1Research Associate, Nickan Research Institute, Isfahan, Iran 2Resident Physician, Internal Medicine Department of UNC Health Blue Ridge, Morganton, NC, USA 3Resident Physician, Internal Medicine Department, University of New Mexico, School of Medicine, Albuquerque, NM, USA 4Resident Physician, Pathology Department of Medical College of Wisconsin, Milwaukee, WI, USA 5Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA 6Research Associate, Anatomy and Cell Biology Department, University of Iowa Healthcare, Iowa City, IA, USA
{"title":"Oncohypertension; treatment of high blood pressure in cancer patients","authors":"Leila Alem, Mohammad Ali Esmaeil pour, Azadeh Khayyat, Parisa Kaviani, Mehrnoosh Ebadi","doi":"10.34172/jnp.2023.21513","DOIUrl":"https://doi.org/10.34172/jnp.2023.21513","url":null,"abstract":"1Research Associate, Nickan Research Institute, Isfahan, Iran 2Resident Physician, Internal Medicine Department of UNC Health Blue Ridge, Morganton, NC, USA 3Resident Physician, Internal Medicine Department, University of New Mexico, School of Medicine, Albuquerque, NM, USA 4Resident Physician, Pathology Department of Medical College of Wisconsin, Milwaukee, WI, USA 5Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA 6Research Associate, Anatomy and Cell Biology Department, University of Iowa Healthcare, Iowa City, IA, USA","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136241568","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 incidence of urothelial carcinoma is increasing worldwide (including in Iran). Bladder cancer can be classified in various manners according to the standardized histomorphology set by the World Health Organization (WHO). Various genetic modifications occurring at the DNA level and the resulting variations in RNA expression give rise to different subcategories that have important implications for diagnosis, prognosis, and treatment. The molecular basis of these morphologic variances is now better understood because of recent developments in molecular biology. With updates on the genetic and clinical characteristics, we highlight the histologic traits of the divergent differentiation and subtypes recognized by the most recent WHO classification (5th Ed.). Molecular subtypes of lower and upper tract cancer can be used to characterize their clinical behaviors and determine therapeutic responses to neoadjuvant chemotherapy. In this overview article, we also present a preliminary analysis of our ongoing data collection on molecular features of urothelial carcinoma.
{"title":"Urothelial carcinoma; an overview of histology, molecular subtypes, and clinical implications based on the latest WHO classification","authors":"Fateme Khalatbari, M. Moafi-Madani, A. Amin","doi":"10.34172/jnp.2023.21482","DOIUrl":"https://doi.org/10.34172/jnp.2023.21482","url":null,"abstract":"The incidence of urothelial carcinoma is increasing worldwide (including in Iran). Bladder cancer can be classified in various manners according to the standardized histomorphology set by the World Health Organization (WHO). Various genetic modifications occurring at the DNA level and the resulting variations in RNA expression give rise to different subcategories that have important implications for diagnosis, prognosis, and treatment. The molecular basis of these morphologic variances is now better understood because of recent developments in molecular biology. With updates on the genetic and clinical characteristics, we highlight the histologic traits of the divergent differentiation and subtypes recognized by the most recent WHO classification (5th Ed.). Molecular subtypes of lower and upper tract cancer can be used to characterize their clinical behaviors and determine therapeutic responses to neoadjuvant chemotherapy. In this overview article, we also present a preliminary analysis of our ongoing data collection on molecular features of urothelial carcinoma.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46111757","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}
IgA nephropathy is a common glomerulonephritis with variable clinical outcomes. The optimal treatment for this condition remains uncertain, and corticosteroid therapy is reserved for patients unresponsive to supportive treatment. The histopathologic examination has a significant role in the diagnosis and prognosis of IgA nephropathy, but its role in the initiation of corticosteroid therapy is still under debate. Recently, targeted release formulation (TRF)-budesonide has emerged as a promising treatment due to its localized delivery to the gut and low systemic adverse effects. This brief review aims to assess recent advancements in IgA nephropathy management, focusing on applying Oxford classification in guiding corticosteroid therapy.
{"title":"Advances in IgA nephropathy management, from pathological insights to personalized treatment","authors":"Mitra Shavakhi, A. Baqir","doi":"10.34172/jnp.2023.21480","DOIUrl":"https://doi.org/10.34172/jnp.2023.21480","url":null,"abstract":"IgA nephropathy is a common glomerulonephritis with variable clinical outcomes. The optimal treatment for this condition remains uncertain, and corticosteroid therapy is reserved for patients unresponsive to supportive treatment. The histopathologic examination has a significant role in the diagnosis and prognosis of IgA nephropathy, but its role in the initiation of corticosteroid therapy is still under debate. Recently, targeted release formulation (TRF)-budesonide has emerged as a promising treatment due to its localized delivery to the gut and low systemic adverse effects. This brief review aims to assess recent advancements in IgA nephropathy management, focusing on applying Oxford classification in guiding corticosteroid therapy.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45205461","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}
Hamidreza Khodabandeh, H. Molaee, Ladan Ghashghaie, M. Farnia, Soleyman Alivand, F. Zandiyeh, Farshad Gharebakhshi, Elham Rashidi, Nahid Mir
Introduction: Sodium-glucose cotransporter-2 (SGLT2) inhibitors reduce the mortality rate, hospitalization, and cardiac morbidity in diabetic patients. However, their safety in chronic kidney disease (CKD) individuals is still debatable. Objectives: The present study aims to evaluate the effect of dapagliflozin on primary composite outcomes and mortality rate in CKD patients using a systematic review and meta-analysis approach. Materials and Methods: In this meta-analysis, Cochrane, Web of Science, Scopus, and PubMed databases, along with the Google Scholar search engine, were queried until March 2023. Data were analyzed by STATA software version 14 at a significance level of P<0.05. Results: A total of nine randomized clinical trials (RCTs) articles were reviewed, with a sample size of 16720 in the dapagliflozin group and 13 476 in the placebo group. Dapagliflozin use (10 mg/d) compared to placebo improved primary composite outcomes in CKD patients by 39% (OR=0.61, 95% CI: 0.57, 0.65) while reducing the mortality rate by 31% (OR=0.69, 95% CI: 0.63, 0.76). In an analysis by treatment length, no statistically significant change was noted in early composite outcomes (OR=0.70, 95% CI: 0.48, 1.01) and mortality rate (OR=0.75, 95% CI: 0.39, 1.45) between patients who were on dapagliflozin for less than two years and the placebo group. However, patients receiving dapagliflozin for two years and above had significantly improved primary composite outcomes (OR=0.60, 95% CI: 0.55, 0.66) and mortality rate (OR=0.69, 95% CI: 0.61, 0.79) compared to the placebo group. Conclusion: Dapagliflozin use, compared to placebo, improved the early composite outcomes and mortality rate in CKD patients. Prescribing a daily dose of 10 mg for a treatment duration of over two years seems safe in these patients. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO website (ID: CRD42023422186).
{"title":"Dapagliflozin in patients with chronic kidney disease: a systematic review and meta-analysis on randomized, double-blind, placebo-controlled multicenter trials","authors":"Hamidreza Khodabandeh, H. Molaee, Ladan Ghashghaie, M. Farnia, Soleyman Alivand, F. Zandiyeh, Farshad Gharebakhshi, Elham Rashidi, Nahid Mir","doi":"10.34172/jnp.2023.21472","DOIUrl":"https://doi.org/10.34172/jnp.2023.21472","url":null,"abstract":"Introduction: Sodium-glucose cotransporter-2 (SGLT2) inhibitors reduce the mortality rate, hospitalization, and cardiac morbidity in diabetic patients. However, their safety in chronic kidney disease (CKD) individuals is still debatable. Objectives: The present study aims to evaluate the effect of dapagliflozin on primary composite outcomes and mortality rate in CKD patients using a systematic review and meta-analysis approach. Materials and Methods: In this meta-analysis, Cochrane, Web of Science, Scopus, and PubMed databases, along with the Google Scholar search engine, were queried until March 2023. Data were analyzed by STATA software version 14 at a significance level of P<0.05. Results: A total of nine randomized clinical trials (RCTs) articles were reviewed, with a sample size of 16720 in the dapagliflozin group and 13 476 in the placebo group. Dapagliflozin use (10 mg/d) compared to placebo improved primary composite outcomes in CKD patients by 39% (OR=0.61, 95% CI: 0.57, 0.65) while reducing the mortality rate by 31% (OR=0.69, 95% CI: 0.63, 0.76). In an analysis by treatment length, no statistically significant change was noted in early composite outcomes (OR=0.70, 95% CI: 0.48, 1.01) and mortality rate (OR=0.75, 95% CI: 0.39, 1.45) between patients who were on dapagliflozin for less than two years and the placebo group. However, patients receiving dapagliflozin for two years and above had significantly improved primary composite outcomes (OR=0.60, 95% CI: 0.55, 0.66) and mortality rate (OR=0.69, 95% CI: 0.61, 0.79) compared to the placebo group. Conclusion: Dapagliflozin use, compared to placebo, improved the early composite outcomes and mortality rate in CKD patients. Prescribing a daily dose of 10 mg for a treatment duration of over two years seems safe in these patients. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO website (ID: CRD42023422186).","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42062275","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}
Paniz Pourpashang, Arefeh Zahmatkesh, F. Nili, Zahra Pournasiri, Farzaneh Khosropour
Primary hyperoxaluria (PH) is a rare genetic metabolic disease presented severely in infants with end-stage renal disease (ESRD). Promoting diagnosis with aggressive management is essential in these patients. Here we presented a rare case of primary hyperoxaluria type 1 (PH1) in a seven-month infant girl who underwent dialysis with prospective kidney transplantation in the future.
{"title":"End stage renal disease due to primary hyperoxaluria in a 7-month infant; a case report","authors":"Paniz Pourpashang, Arefeh Zahmatkesh, F. Nili, Zahra Pournasiri, Farzaneh Khosropour","doi":"10.34172/jnp.2023.21475","DOIUrl":"https://doi.org/10.34172/jnp.2023.21475","url":null,"abstract":"Primary hyperoxaluria (PH) is a rare genetic metabolic disease presented severely in infants with end-stage renal disease (ESRD). Promoting diagnosis with aggressive management is essential in these patients. Here we presented a rare case of primary hyperoxaluria type 1 (PH1) in a seven-month infant girl who underwent dialysis with prospective kidney transplantation in the future.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":"125 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69815788","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: Hyperphosphatemia is an independent risk factor for mortality in chronic kidney disease (CKD) patients. Objectives: This systematic review and meta-analysis aimed to investigate the effect of Sevelamer on serum phosphorus levels in CKD and hemodialysis patients. Materials and Methods: The data were obtained after searching the international databases of Cochrane, PubMed, Scopus, Web of Science, and the Google Scholar search engine until February 28, 2023. The heterogeneity of articles was assessed using the I2 index. The data were analyzed in STATA 14, and P values < 0.05 were considered significant. Findings: A total of 22 articles were assessed with a total sample size of 3221. Sevelamer reduced calcium levels in CKD and hemodialysis patients compared with those in the comparison group (standardized mean difference [SMD]: -0.67; 95% CI: -1.23, -0.11); however, sevelamer had no significant effect on serum parathyroid hormone (PTH) levels (SMD: 0.07; 95% CI: -0.39, 0.54) and Ca × P product (SMD: -0.20; 95% CI: -0.41, 0). A significant decrease in serum phosphorus level was observed in patients who had taken sevelamer for a maximum of 12 weeks compared with the comparison group (SMD: -0.27; 95% CI: -0.54, -0.01); however, no significant decrease in serum phosphorus level was observed in patients who had taken sevelamer for more than 12 weeks. A significant decrease in serum phosphorus level was observed in sevelamer users compared to placebo group members (SMD: -0.36; 95% CI: -0.68, -0.05). Conclusion: The administration of sevelamer reduced serum phosphorus levels in CKD and hemodialysis patients compared with those in the placebo group in the short term. Therefore, physicians are recommended to prescribe sevelamer for a maximum period of three months. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO website (ID: CRD42023406804).
引言：高磷酸盐血症是慢性肾脏病（CKD）患者死亡的独立危险因素。目的：本系统综述和荟萃分析旨在研究司维拉姆对CKD和血液透析患者血清磷水平的影响。材料和方法：数据是在搜索Cochrane、PubMed、Scopus、Web of Science和Google Scholar搜索引擎的国际数据库后获得的，直到2023年2月28日。文章的异质性使用I2指数进行评估。数据在STATA14中进行分析，P值<0.05被认为是显著的。研究结果：共评估了22篇文章，总样本量为3221。与对照组相比，司维拉姆降低了CKD和血液透析患者的钙水平（标准化平均差异[SMD]：-0.67；95%可信区间：-1.23，-0.11）；然而，司维拉姆对血清甲状旁腺激素（PTH）水平（SMD:0.07；95%CI:0.39,0.54）和Ca×P产物（SMD:-0.20；95%CI-0.41,0）没有显著影响。与对照组相比，服用司维拉姆最多12周的患者血清磷水平显著下降（SMD:-0.27；95%CI:-0.54，-0.01）；然而，在服用司维拉姆超过12周的患者中，没有观察到血清磷水平的显著下降。与安慰剂组成员相比，司维拉姆使用者的血清磷水平显著降低（SMD:-0.36；95%可信区间：-0.68，-0.05）。结论：与安慰剂组相比，短期内服用司维拉姆降低了CKD和血液透析患者的血磷水平。因此，建议医生给司维拉姆开最长三个月的处方。注册：本研究基于PRISMA检查表编制，其方案已在PROSPERO网站（ID:CRD42023406804）上注册。
{"title":"Effect of sevelamer on serum phosphorus levels in chronic kidney disease and hemodialysis patients; a systematic review and meta-analysis","authors":"Farshad Gharebakhshi, Mohammad Hossein Taklif, Arash Izadpanah Ghahremani, Mohamad Khaledi, Sara Abbasian, Seyedeh Mahsa Shariati Sough, Fatemeh Vashahi Torfi, Hamidreza Khodabandeh, Elnaz Hajian","doi":"10.34172/jnp.2023.21463","DOIUrl":"https://doi.org/10.34172/jnp.2023.21463","url":null,"abstract":"Introduction: Hyperphosphatemia is an independent risk factor for mortality in chronic kidney disease (CKD) patients. Objectives: This systematic review and meta-analysis aimed to investigate the effect of Sevelamer on serum phosphorus levels in CKD and hemodialysis patients. Materials and Methods: The data were obtained after searching the international databases of Cochrane, PubMed, Scopus, Web of Science, and the Google Scholar search engine until February 28, 2023. The heterogeneity of articles was assessed using the I2 index. The data were analyzed in STATA 14, and P values < 0.05 were considered significant. Findings: A total of 22 articles were assessed with a total sample size of 3221. Sevelamer reduced calcium levels in CKD and hemodialysis patients compared with those in the comparison group (standardized mean difference [SMD]: -0.67; 95% CI: -1.23, -0.11); however, sevelamer had no significant effect on serum parathyroid hormone (PTH) levels (SMD: 0.07; 95% CI: -0.39, 0.54) and Ca × P product (SMD: -0.20; 95% CI: -0.41, 0). A significant decrease in serum phosphorus level was observed in patients who had taken sevelamer for a maximum of 12 weeks compared with the comparison group (SMD: -0.27; 95% CI: -0.54, -0.01); however, no significant decrease in serum phosphorus level was observed in patients who had taken sevelamer for more than 12 weeks. A significant decrease in serum phosphorus level was observed in sevelamer users compared to placebo group members (SMD: -0.36; 95% CI: -0.68, -0.05). Conclusion: The administration of sevelamer reduced serum phosphorus levels in CKD and hemodialysis patients compared with those in the placebo group in the short term. Therefore, physicians are recommended to prescribe sevelamer for a maximum period of three months. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO website (ID: CRD42023406804).","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44026603","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}
N. Jose, E. Indhumathi, M. Bindra, Selvin Sundar Raj, M. Jayakumar
Anti-glomerular basement membrane (anti-GBM) disease is a rare illness with a wide spectrum of clinical manifestations. The typical presentation (90% of cases) of anti-GBM is with a rapidly progressive glomerulonephritis (RPGN) in conjunction with pulmonary disease in 25-60% of cases. In its atypical form – seen in 10% of cases, anti GBM disease takes on a chronic form, presenting with long standing renal dysfunction, proteinuria and better renal prognosis when compared to the typical form of the disease. The known associations of anti-GBM disease are with anti-neutrophil cytoplasmic antibody (ANCA)vasculitis and membranous nephropathy. In this case report, a young lady with atypical anti-GBM disease is described with a most unusual association with IgA nephropathy. This association is rare and only described in few case reports worldwide. The possible pathogenesis, clinical features, treatment and outcome of this disease are also elucidated.
{"title":"An unusual blend; IgA nephropathy and anti GBM disease","authors":"N. Jose, E. Indhumathi, M. Bindra, Selvin Sundar Raj, M. Jayakumar","doi":"10.34172/jnp.2023.17325","DOIUrl":"https://doi.org/10.34172/jnp.2023.17325","url":null,"abstract":"Anti-glomerular basement membrane (anti-GBM) disease is a rare illness with a wide spectrum of clinical manifestations. The typical presentation (90% of cases) of anti-GBM is with a rapidly progressive glomerulonephritis (RPGN) in conjunction with pulmonary disease in 25-60% of cases. In its atypical form – seen in 10% of cases, anti GBM disease takes on a chronic form, presenting with long standing renal dysfunction, proteinuria and better renal prognosis when compared to the typical form of the disease. The known associations of anti-GBM disease are with anti-neutrophil cytoplasmic antibody (ANCA)vasculitis and membranous nephropathy. In this case report, a young lady with atypical anti-GBM disease is described with a most unusual association with IgA nephropathy. This association is rare and only described in few case reports worldwide. The possible pathogenesis, clinical features, treatment and outcome of this disease are also elucidated.","PeriodicalId":16515,"journal":{"name":"Journal of Nephropathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48062170","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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