Pub Date : 2022-03-04DOI: 10.34172/jrip.2022.31972
Elham Emami, Samane Safari, Pedram Javanmard
High incidence of thromboembolic diseases in patients with coronavirus disease 2019 (COVID-19) have been reported that can affect several organs ranging from cutaneous thrombosis to pulmonary embolism, stroke, coronary thrombosis or kidney infarction. There are two proposed mechanisms for these phenomena, disseminated intravascular coagulation (DIC) and endotheliopathy. We report a case of 11-year-old girl presented to the emergency department with generalized tonic colonic seizure with upward gaze which was repeated in emergency room. Respiratory distress and loss of consciousness happened which led to her intubation. Due to increased serum creatinine levels and impaired consciousness which was associated with thrombocytopenia and hemolysis, she underwent plasmapheresis three times by the diagnosis of hemolytic uremic syndrome. Additionally, antihypertensive therapy was conducted. The patient’s condition improved and was discharged with good circumstances. Two weeks later the patient returned with thromboembolism that happened in the distal part of her left hand which underwent fasciotomy and thrombectomy.
{"title":"Hemolytic uremic syndrome following COVID-19; a case report","authors":"Elham Emami, Samane Safari, Pedram Javanmard","doi":"10.34172/jrip.2022.31972","DOIUrl":"https://doi.org/10.34172/jrip.2022.31972","url":null,"abstract":"High incidence of thromboembolic diseases in patients with coronavirus disease 2019 (COVID-19) have been reported that can affect several organs ranging from cutaneous thrombosis to pulmonary embolism, stroke, coronary thrombosis or kidney infarction. There are two proposed mechanisms for these phenomena, disseminated intravascular coagulation (DIC) and endotheliopathy. We report a case of 11-year-old girl presented to the emergency department with generalized tonic colonic seizure with upward gaze which was repeated in emergency room. Respiratory distress and loss of consciousness happened which led to her intubation. Due to increased serum creatinine levels and impaired consciousness which was associated with thrombocytopenia and hemolysis, she underwent plasmapheresis three times by the diagnosis of hemolytic uremic syndrome. Additionally, antihypertensive therapy was conducted. The patient’s condition improved and was discharged with good circumstances. Two weeks later the patient returned with thromboembolism that happened in the distal part of her left hand which underwent fasciotomy and thrombectomy.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42259743","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}
Pub Date : 2022-03-04DOI: 10.34172/jrip.2022.31946
A. Dalili, E. Ramezanzadeh, Fahime Soleimani Farsani, Elahe Saffari, Azin Vakilpour, Eshagh Mohammadyari, S. Samiee, Masumeh Namdar
Introduction: Since December 2019, an outbreak of pneumonia caused by a new coronavirus has emerged. The standard diagnostic method for COVID-19 infection is the real-time reverse transcriptase-polymerase chain reaction (RT-PCR). High-resolution computed tomography (HRCT) has been proven as a sensitive, feasible and accessible test in Iran. In addition to respiratory system, other organs could also be involved in this disease. The exact mechanism of renal involvement is unknown; however, acute kidney injury (AKI) occurs in almost 5-15% of cases. Different HRCT patterns might be associated with AKI presence and severity of the disease. Objectives: To investigate patterns and prevalence of different HRCT findings in COVID-19 patients with concurrent AKI. Patients and Methods: In this retrospective study, we reviewed all hospitalized patients with COVID-19 infection, from February to April 2020 in Razi hospital, Rasht. Twenty-two cases who had AKI were enrolled. The HRCT findings of the patients were reviewed independently by two radiologists. Percentage and prevalence of HRCT findings were analyzed in SPSS 21 software. Results: All 22 cases had multifocal distribution on HRCT. Around 95.5% had peripheral involvement, 86.4% had central zones opacity while 72.2% of cases had peribronchovascular pattern. Bilateral lung involvement was found in 90.9%, but only 9.1% had unilateral involvement. There was 59.1% of lower lobe predominance for COVID-19 involvement since sub-pleural regions were spared in 18.2% of individuals. All the patients’ HRCTs showed ground glass opacity. Reticular pattern (81.8%), consolidation (77.3%), vascular enlargement in involved zones (68.2%) and airway changes (68.2%) were the next more prevalent findings. Half of the subjects showed crazy paving, 45.5% had pleural effusion and 13.6% had also lymphadenopathy. We found 40.9% of the patients had arcade-like sign. Less frequent findings were nodular opacities (13.6%), halo sign (9.1%) and reverse-halo sign (9.1%), respectively. Conclusion: This study demonstrated that atypical patterns are likely to be more common in COVID-19 patients with kidney injury.
{"title":"Pattern and prevalence of different findings in high resolution computed tomography images in patients with coronavirus disease and kidney injury; a pilot study","authors":"A. Dalili, E. Ramezanzadeh, Fahime Soleimani Farsani, Elahe Saffari, Azin Vakilpour, Eshagh Mohammadyari, S. Samiee, Masumeh Namdar","doi":"10.34172/jrip.2022.31946","DOIUrl":"https://doi.org/10.34172/jrip.2022.31946","url":null,"abstract":"Introduction: Since December 2019, an outbreak of pneumonia caused by a new coronavirus has emerged. The standard diagnostic method for COVID-19 infection is the real-time reverse transcriptase-polymerase chain reaction (RT-PCR). High-resolution computed tomography (HRCT) has been proven as a sensitive, feasible and accessible test in Iran. In addition to respiratory system, other organs could also be involved in this disease. The exact mechanism of renal involvement is unknown; however, acute kidney injury (AKI) occurs in almost 5-15% of cases. Different HRCT patterns might be associated with AKI presence and severity of the disease. Objectives: To investigate patterns and prevalence of different HRCT findings in COVID-19 patients with concurrent AKI. Patients and Methods: In this retrospective study, we reviewed all hospitalized patients with COVID-19 infection, from February to April 2020 in Razi hospital, Rasht. Twenty-two cases who had AKI were enrolled. The HRCT findings of the patients were reviewed independently by two radiologists. Percentage and prevalence of HRCT findings were analyzed in SPSS 21 software. Results: All 22 cases had multifocal distribution on HRCT. Around 95.5% had peripheral involvement, 86.4% had central zones opacity while 72.2% of cases had peribronchovascular pattern. Bilateral lung involvement was found in 90.9%, but only 9.1% had unilateral involvement. There was 59.1% of lower lobe predominance for COVID-19 involvement since sub-pleural regions were spared in 18.2% of individuals. All the patients’ HRCTs showed ground glass opacity. Reticular pattern (81.8%), consolidation (77.3%), vascular enlargement in involved zones (68.2%) and airway changes (68.2%) were the next more prevalent findings. Half of the subjects showed crazy paving, 45.5% had pleural effusion and 13.6% had also lymphadenopathy. We found 40.9% of the patients had arcade-like sign. Less frequent findings were nodular opacities (13.6%), halo sign (9.1%) and reverse-halo sign (9.1%), respectively. Conclusion: This study demonstrated that atypical patterns are likely to be more common in COVID-19 patients with kidney injury.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46978588","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}
Pub Date : 2022-03-04DOI: 10.34172/jrip.2022.31977
T. Jahed Bozorgan, Pegah Azadi, Zahra Dehghani
Introduction: One of the probable mechanisms of hypertension that may occur in women with preeclampsia after delivery is returning of interstitial and extravascular fluid into the bloodstream. Objectives: The present study aimed to investigate the effect of furosemide to control postpartum hypertension in women with preeclampsia. Patients and Methods: This randomized clinical trial was conducted on 116 patients with preeclampsia with a blood pressure (BP) of more than 150/100 mm Hg in the first 24 hours after delivery. Patients were randomly divided into two groups of nifedipine (taking 10 mg tablets every 8 hours) and nifedipine plus furosemide (nifedipine plus 20 mg furosemide tablet once daily). Patients were monitored until the fifth day after delivery. After the first 48 hours, patients with a BP lower than 150/100 mm Hg were discharged from the hospital and the treatment continued at home. Results: Systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP) were significantly reduced in all patients and in each group on the first to fifth days after delivery. On the second day, DBP in the nifedipine group was significantly lower (P=0.005). On the third to fifth days, SBP in the nifedipine plus furosemide group was significantly lower (P<0.05), while DBP did not change (P>0.05). On the third and fourth days, MAP was significantly lower in the nifedipine plus furosemide group (P<0.05), however it was not significantly different on the fifth day (P=0.383). The need for additional medication to control BP was higher in the nifedipine group than in the nifedipine plus furosemide group. BP became normal (less than 120/80 mmHg) in 74 patients (68%) within five days after delivery; which was more popular in the nifedipine plus furosemide group (P<0.001). Conclusion: The findings of the present study showed that inclusion of furosemide in nifedipine regimen was associated with a further reduction in SBP and MAP. Furosemide also reduced the need for additional medication to control BP and increased the frequency and speed of reaching toward normal BP. Trial Registration: The trial protocol was approved by the Iranian Registry of Clinical Trials (identifier: IRCT20191031045289N2; https://irct.ir/trial/49806, ethical code; IR.SBMU.MSP. REC.1399.067).
导言:分娩后子痫前期妇女高血压的可能机制之一是间质和血管外液体回流到血液中。目的:本研究旨在探讨速尿对子痫前期妇女产后高血压的控制作用。患者和方法:本随机临床试验对116例分娩后24小时血压(BP)大于150/100 mm Hg的先兆子痫患者进行了研究。患者随机分为硝苯地平组(每8小时服用10 mg片)和硝苯地平加呋塞米组(硝苯地平加呋塞米片20 mg，每日1次)。监测患者至分娩后第5天。48小时后，血压低于150/100 mm Hg的患者出院，并在家中继续治疗。结果:所有患者及各组在分娩后第1 ~ 5天收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)均显著降低。第2天，硝苯地平组DBP显著降低(P=0.005)。第3 ~ 5天，硝苯地平加呋塞米组收缩压明显降低(P0.05)。硝苯地平加呋塞米组在第3、4天MAP显著降低(P<0.05)，第5天差异无统计学意义(P=0.383)。硝苯地平组需要额外的药物来控制血压高于硝苯地平加呋塞米组。74例患者(68%)在分娩后5天内血压恢复正常(低于120/80 mmHg);硝苯地平加呋塞米组更常见(P<0.001)。结论:本研究结果表明，在硝苯地平方案中纳入呋塞米与收缩压和MAP的进一步降低有关。速尿也减少了额外的药物控制血压的需要，并增加了达到正常血压的频率和速度。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:IRCT20191031045289N2;https://irct.ir/trial/49806，道德准则;IR.SBMU.MSP。REC.1399.067)。
{"title":"Assessment of the effect of adding furosemide to antihypertensive treatment on postpartum hypertension in women with preeclampsia; a randomized clinical trial","authors":"T. Jahed Bozorgan, Pegah Azadi, Zahra Dehghani","doi":"10.34172/jrip.2022.31977","DOIUrl":"https://doi.org/10.34172/jrip.2022.31977","url":null,"abstract":"Introduction: One of the probable mechanisms of hypertension that may occur in women with preeclampsia after delivery is returning of interstitial and extravascular fluid into the bloodstream. Objectives: The present study aimed to investigate the effect of furosemide to control postpartum hypertension in women with preeclampsia. Patients and Methods: This randomized clinical trial was conducted on 116 patients with preeclampsia with a blood pressure (BP) of more than 150/100 mm Hg in the first 24 hours after delivery. Patients were randomly divided into two groups of nifedipine (taking 10 mg tablets every 8 hours) and nifedipine plus furosemide (nifedipine plus 20 mg furosemide tablet once daily). Patients were monitored until the fifth day after delivery. After the first 48 hours, patients with a BP lower than 150/100 mm Hg were discharged from the hospital and the treatment continued at home. Results: Systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP) were significantly reduced in all patients and in each group on the first to fifth days after delivery. On the second day, DBP in the nifedipine group was significantly lower (P=0.005). On the third to fifth days, SBP in the nifedipine plus furosemide group was significantly lower (P<0.05), while DBP did not change (P>0.05). On the third and fourth days, MAP was significantly lower in the nifedipine plus furosemide group (P<0.05), however it was not significantly different on the fifth day (P=0.383). The need for additional medication to control BP was higher in the nifedipine group than in the nifedipine plus furosemide group. BP became normal (less than 120/80 mmHg) in 74 patients (68%) within five days after delivery; which was more popular in the nifedipine plus furosemide group (P<0.001). Conclusion: The findings of the present study showed that inclusion of furosemide in nifedipine regimen was associated with a further reduction in SBP and MAP. Furosemide also reduced the need for additional medication to control BP and increased the frequency and speed of reaching toward normal BP. Trial Registration: The trial protocol was approved by the Iranian Registry of Clinical Trials (identifier: IRCT20191031045289N2; https://irct.ir/trial/49806, ethical code; IR.SBMU.MSP. REC.1399.067).","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43493827","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}
Pub Date : 2022-03-04DOI: 10.34172/jrip.2022.31949
N. Aghakhani, Z. G. Metin, M. Akbari
{"title":"It is time to consider complementary and integrative health approaches to improve hope in patients undergoing hemodialysis","authors":"N. Aghakhani, Z. G. Metin, M. Akbari","doi":"10.34172/jrip.2022.31949","DOIUrl":"https://doi.org/10.34172/jrip.2022.31949","url":null,"abstract":"<jats:p>\u0000 </jats:p>","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49448088","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: Acute kidney injury (AKI) is one of the most frequent complications in patients with severe cardiopulmonary dysfunction on extracorporeal membrane oxygenation (ECMO) therapy. Although renal replacement therapy (RRT) is the standard of care for AKI, the timing of initiation of RRT remains controversial. Objectives: This study aimed to determine the optimal timing of RRT initiation among patients receiving ECMO therapy. Patients and Methods: We conducted a retrospective cohort study of 40 patients in a tertiary hospital centre from March 2014 until December 2019. The patients were divided into two groups according to the timing of RRT initiation, i.e. early RRT (within 72 hours) or late RRT after ECMO treatment. The primary outcome was 60-day mortality. The secondary outcomes were survival predictors of these patients. Results: The 60-day mortality was not significantly different between the two groups (76.9% in the early RRT initiation and 88.9% in the late group; P=0.321). The predictors of survival were RRT start within 72 hours of ECMO initiation (HR: 0.067, 95%, CI: 0.010-0.457), age ≥ 60 years (HR: 6.334, 95% CI: 1.268-31.625), fluid balance on day seven of ECMO (HR: 1.093, 95% CI: 1.007-1.187), and eGFR-EPI ≥ 60 mL/min/1.73 m2 (HR: 0.970, 95% CI: 0.946-0.996). Conclusion: Among patients with ECMO and RRT, early RRT within 72 hours of ECMO initiation was significantly associated with a decreased risk of death. Our findings suggest the survival benefit of early RRT in critically ill patients treated with ECMO.
{"title":"Identifying the optimal timing of renal replacement therapy initiation among critically ill patients on extracorporeal membrane oxygenation therapy","authors":"Ussanee Boonsrirat, Chokethawee Ouejiaraphant, Atthaphong Phongphithakchai","doi":"10.34172/jrip.2022.31974","DOIUrl":"https://doi.org/10.34172/jrip.2022.31974","url":null,"abstract":"Introduction: Acute kidney injury (AKI) is one of the most frequent complications in patients with severe cardiopulmonary dysfunction on extracorporeal membrane oxygenation (ECMO) therapy. Although renal replacement therapy (RRT) is the standard of care for AKI, the timing of initiation of RRT remains controversial. Objectives: This study aimed to determine the optimal timing of RRT initiation among patients receiving ECMO therapy. Patients and Methods: We conducted a retrospective cohort study of 40 patients in a tertiary hospital centre from March 2014 until December 2019. The patients were divided into two groups according to the timing of RRT initiation, i.e. early RRT (within 72 hours) or late RRT after ECMO treatment. The primary outcome was 60-day mortality. The secondary outcomes were survival predictors of these patients. Results: The 60-day mortality was not significantly different between the two groups (76.9% in the early RRT initiation and 88.9% in the late group; P=0.321). The predictors of survival were RRT start within 72 hours of ECMO initiation (HR: 0.067, 95%, CI: 0.010-0.457), age ≥ 60 years (HR: 6.334, 95% CI: 1.268-31.625), fluid balance on day seven of ECMO (HR: 1.093, 95% CI: 1.007-1.187), and eGFR-EPI ≥ 60 mL/min/1.73 m2 (HR: 0.970, 95% CI: 0.946-0.996). Conclusion: Among patients with ECMO and RRT, early RRT within 72 hours of ECMO initiation was significantly associated with a decreased risk of death. Our findings suggest the survival benefit of early RRT in critically ill patients treated with ECMO.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43400006","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}
Pub Date : 2022-02-07DOI: 10.34172/jrip.2022.31957
S. Sadeghi, Peiman Nasri, M. Nasirian, M. Mirenayat, A. Toghyani, Mohammadsaeid Khaksar, E. Nasri, A. Safaei, H. Fakhim, Elham Raofi, Koorosh Nemati, H. Hashemi, Elaheh Keivany
Introduction: The unrelenting storm of coronavirus disease (COVID-19) since late 2019 has turned into a crucial health matter of the globe. There is increasing evidence in terms of a hypercoagulable state by this infection. Objectives: The current study aims to clarify the association between thromboembolic events in COVID-19 and the patient, the infection and in-hospital related characteristics. Patients and Methods: The current case-control study has been conducted on 243 COVID-19 pneumonia patients including 83 cases with thrombotic events and 160 controls without thrombosis. The thrombotic events included deep venous thrombosis (DVT) (n=9), pulmonary thromboembolism (PTE) (n=48), acute myocardial infarction (AMI) (n=17), cerebrovascular accidents (CVA) (n=4) and arterial thrombosis (n=5). On admission, hemodynamic parameters, on admission laboratory assessments, mobility during hospitalization, type of oxygenation, intensive care unit (ICU) admission requirement and duration of ICU and also hospital stay were recorded in the checklist. Results: According to logistic regression assessment, on admission O2 saturation (OR: 0.97, 95% CI: 0.94-0.99), hemoglobin level (OR: 0.87, 95% CI: 0.77-0.97) and albumin level (OR: 0.53, 95% CI: 0.3-0.86) were independently correlated with thrombosis due to COVID-19. Other factors, including demographic, infection severity, laboratory and in-hospital characteristics, were not significantly associated with thrombotic events. Conclusion: Based on this study’s findings, hemoglobin and albumin levels were the independent factors associated with the thrombotic events in COVID-19 patients.
{"title":"On admission hemoglobin and albumin, as the two novel factors associated with thrombosis in COVID-19 pneumonia","authors":"S. Sadeghi, Peiman Nasri, M. Nasirian, M. Mirenayat, A. Toghyani, Mohammadsaeid Khaksar, E. Nasri, A. Safaei, H. Fakhim, Elham Raofi, Koorosh Nemati, H. Hashemi, Elaheh Keivany","doi":"10.34172/jrip.2022.31957","DOIUrl":"https://doi.org/10.34172/jrip.2022.31957","url":null,"abstract":"\u0000 Introduction: The unrelenting storm of coronavirus disease (COVID-19) since late 2019 has turned into a crucial health matter of the globe. There is increasing evidence in terms of a hypercoagulable state by this infection. Objectives: The current study aims to clarify the association between thromboembolic events in COVID-19 and the patient, the infection and in-hospital related characteristics. Patients and Methods: The current case-control study has been conducted on 243 COVID-19 pneumonia patients including 83 cases with thrombotic events and 160 controls without thrombosis. The thrombotic events included deep venous thrombosis (DVT) (n=9), pulmonary thromboembolism (PTE) (n=48), acute myocardial infarction (AMI) (n=17), cerebrovascular accidents (CVA) (n=4) and arterial thrombosis (n=5). On admission, hemodynamic parameters, on admission laboratory assessments, mobility during hospitalization, type of oxygenation, intensive care unit (ICU) admission requirement and duration of ICU and also hospital stay were recorded in the checklist. Results: According to logistic regression assessment, on admission O2 saturation (OR: 0.97, 95% CI: 0.94-0.99), hemoglobin level (OR: 0.87, 95% CI: 0.77-0.97) and albumin level (OR: 0.53, 95% CI: 0.3-0.86) were independently correlated with thrombosis due to COVID-19. Other factors, including demographic, infection severity, laboratory and in-hospital characteristics, were not significantly associated with thrombotic events. Conclusion: Based on this study’s findings, hemoglobin and albumin levels were the independent factors associated with the thrombotic events in COVID-19 patients.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48064879","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}
Pub Date : 2022-02-03DOI: 10.34172/jrip.2022.31951
Rahimpour Amiri, R. Raeisi, J. Amiri, Fateme Sheida, Ziba Mohammad Alizadeh, G. Solgi, H. Bazmamoun, J. Faradmal, A. Hasanpour Dehkordi
Introduction: Vesicoureteral reflux (VUR) is considered as the most common urogenital abnormality occurring in children. There is no reliable and routine clinical test that is non-invasive and rapid for recognizing the renal scars from VUR. Objectives: Urine neutrophil gelatinase-associated lipocalin (uNGAL) can be the best indicator for early diagnosis of scar formation in children with VUR. Patients and Methods: Children with primary VUR admitted to Hamadan’s Besat hospital from March to December 2020 were included in this cross-sectional study. A dimercaptosuccinic acid (DMSA) scan was employed to assess all subjects in order to diagnose scar formation at least 180 days after the last episode of urinary tract infection (UTI). Additionally, uNGAL and its ratio to urine creatinine (uCr) levels were measured. Results: During the study, all 63 cases (male/female, 13.50) with VUR were included for further evaluation. The mean age of the patients was 59.1 ± 34.7 months (range 2 to 132 months). Twelve subjects suffered from unilateral VUR, while bilateral VUR inflicted 51. According to the disease severity, nine patients had mild, 35 had moderate, and 19 had a severe form of VUR. No significant difference was observed between patients with (n = 31) and without (n = 32) renal scars regarding mean levels of the uNGAL and uNGAL/uCR ratios (P>0.05). Conclusion: We found no significant difference between the groups with and without the renal scar in terms of biomarker levels.
{"title":"Urinary neutrophil gelatinase-associated lipocalin might be an associated marker for anticipating scar formation in children with vesicoureteral reflux","authors":"Rahimpour Amiri, R. Raeisi, J. Amiri, Fateme Sheida, Ziba Mohammad Alizadeh, G. Solgi, H. Bazmamoun, J. Faradmal, A. Hasanpour Dehkordi","doi":"10.34172/jrip.2022.31951","DOIUrl":"https://doi.org/10.34172/jrip.2022.31951","url":null,"abstract":"Introduction: Vesicoureteral reflux (VUR) is considered as the most common urogenital abnormality occurring in children. There is no reliable and routine clinical test that is non-invasive and rapid for recognizing the renal scars from VUR. Objectives: Urine neutrophil gelatinase-associated lipocalin (uNGAL) can be the best indicator for early diagnosis of scar formation in children with VUR. Patients and Methods: Children with primary VUR admitted to Hamadan’s Besat hospital from March to December 2020 were included in this cross-sectional study. A dimercaptosuccinic acid (DMSA) scan was employed to assess all subjects in order to diagnose scar formation at least 180 days after the last episode of urinary tract infection (UTI). Additionally, uNGAL and its ratio to urine creatinine (uCr) levels were measured. Results: During the study, all 63 cases (male/female, 13.50) with VUR were included for further evaluation. The mean age of the patients was 59.1 ± 34.7 months (range 2 to 132 months). Twelve subjects suffered from unilateral VUR, while bilateral VUR inflicted 51. According to the disease severity, nine patients had mild, 35 had moderate, and 19 had a severe form of VUR. No significant difference was observed between patients with (n = 31) and without (n = 32) renal scars regarding mean levels of the uNGAL and uNGAL/uCR ratios (P>0.05). Conclusion: We found no significant difference between the groups with and without the renal scar in terms of biomarker levels.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43485859","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}
Pub Date : 2022-02-03DOI: 10.34172/jrip.2022.28846
M. Ghorbani, Maryam Kia, Maedeh Razzaghi
Introduction: Chronic inflammation is a major factor in the pathogenesis of atherosclerosis in hemodialysis patients compared to healthy individuals. Chronic inflammation is part of the malnutrition, atherosclerosis, and inflammation syndrome in advanced renal failure. Objectives: In this study, the relationships of platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) with the inflammatory factors were investigated. Patients and Methods: This cross-sectional study was conducted on 108 hemodialysis patients who were on dialysis for more than three months. For patients, serum levels of urea, creatinine (Cr), sodium, potassium, calcium, phosphate, parathyroid hormone, total cholesterol, triglyceride, ferritin, 25-hydroxy vitamin D, albumin, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and complete blood cell count were assessed before dialysis since serum urea was examined again after dialysis too. Results: The mean age of the patients (58 male and 50 female) was 63.43±14.65 years. The median values for NLR and PLR were 2.25 and 114.7, respectively. ESR was significantly higher in hemodialysis patients with NLR >2.25 (46.7±29.7 versus 36±22.7) and in those with PLR >114.7 (47.09±27.8 versus 35.6±24.8). Plasma hemoglobin and serum 25-hydroxy vitamin D levels were observed to be lower (10.37±1.6 versus 11.7±1.8 and 33.1±2.5 versus 37.9±15.2) in patients with PLR >114.7. Bivariate correlation showed that PLR and NLR had positive significant correlation with ESR while PLR had a significant negative correlation with values of blood 25-hydroxy vitamin D hemoglobin and Cr. Conclusion: Due to availability and affordability of PLR and NLR, they could be used for early assessment of inflammation in end-stage renal disease (ESRD) patients. PLR may be better predictor than NLR (to detect inflammation.
{"title":"The association between platelet to lymphocyte ratio and neutrophil to lymphocyte ratio with inflammatory factors in hemodialysis patients","authors":"M. Ghorbani, Maryam Kia, Maedeh Razzaghi","doi":"10.34172/jrip.2022.28846","DOIUrl":"https://doi.org/10.34172/jrip.2022.28846","url":null,"abstract":"Introduction: Chronic inflammation is a major factor in the pathogenesis of atherosclerosis in hemodialysis patients compared to healthy individuals. Chronic inflammation is part of the malnutrition, atherosclerosis, and inflammation syndrome in advanced renal failure. Objectives: In this study, the relationships of platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) with the inflammatory factors were investigated. Patients and Methods: This cross-sectional study was conducted on 108 hemodialysis patients who were on dialysis for more than three months. For patients, serum levels of urea, creatinine (Cr), sodium, potassium, calcium, phosphate, parathyroid hormone, total cholesterol, triglyceride, ferritin, 25-hydroxy vitamin D, albumin, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and complete blood cell count were assessed before dialysis since serum urea was examined again after dialysis too. Results: The mean age of the patients (58 male and 50 female) was 63.43±14.65 years. The median values for NLR and PLR were 2.25 and 114.7, respectively. ESR was significantly higher in hemodialysis patients with NLR >2.25 (46.7±29.7 versus 36±22.7) and in those with PLR >114.7 (47.09±27.8 versus 35.6±24.8). Plasma hemoglobin and serum 25-hydroxy vitamin D levels were observed to be lower (10.37±1.6 versus 11.7±1.8 and 33.1±2.5 versus 37.9±15.2) in patients with PLR >114.7. Bivariate correlation showed that PLR and NLR had positive significant correlation with ESR while PLR had a significant negative correlation with values of blood 25-hydroxy vitamin D hemoglobin and Cr. Conclusion: Due to availability and affordability of PLR and NLR, they could be used for early assessment of inflammation in end-stage renal disease (ESRD) patients. PLR may be better predictor than NLR (to detect inflammation.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":"1 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41375462","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}
Pub Date : 2022-02-01DOI: 10.34172/jrip.2022.32005
G. Yilmaz, O. Timur
Introduction: The mortality rate in COVID-19 patients is about 2%, however advanced age, male gender, comorbid diseases increase the risk of mortality. Patients with end-stage renal disease (ESRD) and hemodialysis (HD) treatment are more susceptible to infection due to both existing comorbid diseases and immune suppression caused by uremia. Objectives: This study aims to show the potential of easily obtainable, inexpensive and reproducible markers in predicting mortality in HD patients at the time of diagnosis. Patients and Methods: In this study, we examined the relationship between; neutrophil to lymphocyte ratio (NLR), mean platelet volume (MPV) and C-reactive protein (CRP)/albumin values at the time of hospital admission with mortality in 75 HD patients diagnosed with COVID-19. All analyses were conducted using IBM SPSS Statistics 21.0 and MS-Excel 2010 software. Results: A total of 75 HD patients diagnosed with COVID-19 were included in the study. Out of these, at least 19 (25.3%) patients received hydroxychloroquine, 68 (90.6%) patients favipiravir, two (2.6%) patients tocilizumab and two patients (2.6%) immune plasma therapy. Among these patients, sixteen patients (21.3%) needed invasive mechanic ventilation, eight patients (10.6%) needed high flow oxygen and seven patients (9.3%) needed non-invasive mechanic ventilation and 17 of 75 patients (23%) died. A total of 14 of the 17 non-survivors were intubated. In comparison between survivors and non-survivors in our study; NLR, MPV, CRP, CRP/albumin and phosphorus values were significantly higher in the non-survivors group. Conclusion: According to this study, NLR, MPV and CRP/albumin values are associated with mortality in HD patients affected with COVID-19.
{"title":"Factors related to mortality in hemodialysis patients with COVID-19","authors":"G. Yilmaz, O. Timur","doi":"10.34172/jrip.2022.32005","DOIUrl":"https://doi.org/10.34172/jrip.2022.32005","url":null,"abstract":"Introduction: The mortality rate in COVID-19 patients is about 2%, however advanced age, male gender, comorbid diseases increase the risk of mortality. Patients with end-stage renal disease (ESRD) and hemodialysis (HD) treatment are more susceptible to infection due to both existing comorbid diseases and immune suppression caused by uremia. Objectives: This study aims to show the potential of easily obtainable, inexpensive and reproducible markers in predicting mortality in HD patients at the time of diagnosis. Patients and Methods: In this study, we examined the relationship between; neutrophil to lymphocyte ratio (NLR), mean platelet volume (MPV) and C-reactive protein (CRP)/albumin values at the time of hospital admission with mortality in 75 HD patients diagnosed with COVID-19. All analyses were conducted using IBM SPSS Statistics 21.0 and MS-Excel 2010 software. Results: A total of 75 HD patients diagnosed with COVID-19 were included in the study. Out of these, at least 19 (25.3%) patients received hydroxychloroquine, 68 (90.6%) patients favipiravir, two (2.6%) patients tocilizumab and two patients (2.6%) immune plasma therapy. Among these patients, sixteen patients (21.3%) needed invasive mechanic ventilation, eight patients (10.6%) needed high flow oxygen and seven patients (9.3%) needed non-invasive mechanic ventilation and 17 of 75 patients (23%) died. A total of 14 of the 17 non-survivors were intubated. In comparison between survivors and non-survivors in our study; NLR, MPV, CRP, CRP/albumin and phosphorus values were significantly higher in the non-survivors group. Conclusion: According to this study, NLR, MPV and CRP/albumin values are associated with mortality in HD patients affected with COVID-19.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44741717","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}
Shamsedin Namjoo, M. Mirzaei, M. Foroughan, Gholamreza Ghaedamini Harouni, Omid Aboubakri
Introduction: Mental disorders (depression, anxiety and stress) cause disability and aggravate various diseases, including diabetes mellitus and its common complication such as diabetic nephropathy. Objectives: The current study aimed to investigate the prevalence of mental health disorders (depression, anxiety and stress) and their associated factors among the Iranian older people with type 2 diabetes mellitus (T2DM). Patients and Methods: In this cross-sectional study, 501 subjects with T2DM and 551 subjects without T2DM were selected by a multistage stratified sampling method from Yazd Greater Area, Iran. Delphi method and experts panel were used for selection of priorities of effective factors. The obtained data were analyzed using the chi-square test and Stata software version 14. A P value of ≤0.05 was considered statistically significant. Results: The prevalence of moderate to severe depression and anxiety was 51.9% and 61.9%, among diabetic, 22% and 33.4% among non-diabetic groups, respectively. According to multiple logistic regression analysis results in diabetics group specified female gender (OR=1.97, 95% CI=1.03-3.75), poor sleep quality (OR=1.08, 95% CI=1.02-1.15), decreased social support (OR=0.89, 95% CI=0.54-1.68), and body mass index (BMI) ≥30 kg/m² (OR=1.6, 95% CI=1.2-5.63) for depression, as well as female gender (OR=2.97, 95% CI=1.5- 5.87), BMI ≥30 kg/m² (OR=2.69, 95% CI=1.22-5.96), and decreased social support (OR=0.87, 95% CI=0.78-0.98) for anxiety as the predicting characteristics. Conclusion: The present research findings revealed a significantly higher prevalence of depression and anxiety in older people with T2DM rather than older people without T2DM. Therefore, appropriate interventions such as screenings and psychiatric evaluations are necessary to diagnose and treat depression and anxiety in this population, especially the females to avoid diabetic complications like diabetic kidney disease.
{"title":"Prevalence and determinants of depression, anxiety and stress among the Iranian older people with type 2 diabetes","authors":"Shamsedin Namjoo, M. Mirzaei, M. Foroughan, Gholamreza Ghaedamini Harouni, Omid Aboubakri","doi":"10.34172/jrip.2022.10","DOIUrl":"https://doi.org/10.34172/jrip.2022.10","url":null,"abstract":"Introduction: Mental disorders (depression, anxiety and stress) cause disability and aggravate various diseases, including diabetes mellitus and its common complication such as diabetic nephropathy. Objectives: The current study aimed to investigate the prevalence of mental health disorders (depression, anxiety and stress) and their associated factors among the Iranian older people with type 2 diabetes mellitus (T2DM). Patients and Methods: In this cross-sectional study, 501 subjects with T2DM and 551 subjects without T2DM were selected by a multistage stratified sampling method from Yazd Greater Area, Iran. Delphi method and experts panel were used for selection of priorities of effective factors. The obtained data were analyzed using the chi-square test and Stata software version 14. A P value of ≤0.05 was considered statistically significant. Results: The prevalence of moderate to severe depression and anxiety was 51.9% and 61.9%, among diabetic, 22% and 33.4% among non-diabetic groups, respectively. According to multiple logistic regression analysis results in diabetics group specified female gender (OR=1.97, 95% CI=1.03-3.75), poor sleep quality (OR=1.08, 95% CI=1.02-1.15), decreased social support (OR=0.89, 95% CI=0.54-1.68), and body mass index (BMI) ≥30 kg/m² (OR=1.6, 95% CI=1.2-5.63) for depression, as well as female gender (OR=2.97, 95% CI=1.5- 5.87), BMI ≥30 kg/m² (OR=2.69, 95% CI=1.22-5.96), and decreased social support (OR=0.87, 95% CI=0.78-0.98) for anxiety as the predicting characteristics. Conclusion: The present research findings revealed a significantly higher prevalence of depression and anxiety in older people with T2DM rather than older people without T2DM. Therefore, appropriate interventions such as screenings and psychiatric evaluations are necessary to diagnose and treat depression and anxiety in this population, especially the females to avoid diabetic complications like diabetic kidney disease.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44178062","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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