Pub Date : 2021-10-17DOI: 10.34172/jrip.2022.31971
Dorsa Jahangiri, Z. Mojtahedi, M. Moonesan
In COVID-19 infection, most of the renal disturbances are due to acute tubular necrosis. Renal dysfunction occurs in severe COVID-19 infection and is usually secondary to sepsis, cytokine storm, and hypotension. Other conditions, such as exacerbated inflammatory responses, dehydration, hypoxia, hypercoagulability, endothelial damage, pneumonia, septicemia, drug nephrotoxicity, and myocardial dysfunction also contribute to renal failure.
{"title":"COVID-19 and kidney failure; a mini-review to recent evidence","authors":"Dorsa Jahangiri, Z. Mojtahedi, M. Moonesan","doi":"10.34172/jrip.2022.31971","DOIUrl":"https://doi.org/10.34172/jrip.2022.31971","url":null,"abstract":"In COVID-19 infection, most of the renal disturbances are due to acute tubular necrosis. Renal dysfunction occurs in severe COVID-19 infection and is usually secondary to sepsis, cytokine storm, and hypotension. Other conditions, such as exacerbated inflammatory responses, dehydration, hypoxia, hypercoagulability, endothelial damage, pneumonia, septicemia, drug nephrotoxicity, and myocardial dysfunction also contribute to renal failure.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41457612","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 : 2021-10-15DOI: 10.34172/jrip.2022.17691
M. Abedinzadeh, H. Karami, J. Gholami, H. Maleki
Introduction: Various factors such as structure of stone, size, location of stone and metabolic diseases affect stone excretion. Objectives: The aim of this study was to investigate factors related to spontaneous ureteral stone excretion. Patients and Methods: This descriptive-analytical observational study was conducted in the university urology centers of Yazd, Iran, during a 16-month period. All patients presenting with unilateral ureteral stone whose ureteral stone was confirmed by CT scan or ultrasound were included in the study. Pregnant patients, patients with uncontrolled hypertension, patients with multiple urinary stones, patients with more than four weeks of history of urinary stones, patients with severe hydronephrosis, and patients with malformations of ureter and kidney were excluded from the study. Computed tomography and ultrasound of the patients evaluated the size of the stone, the location of the stone and the degree of hydronephrosis and also perinephric stranding. Results: In this study, 146 patients with mean age of 45.3±15.1 years (ranging from 11 to 84 years) were enrolled. CT scan and ultrasound were diagnostic in 121 (82.9%) and 25 patients (17.1%) respectively. In logistic regression model analysis, size less than 5mm, stone location and male gender and diabetes were significant predictors of spontaneous stone excretion, while size less than 5 mm was the strongest predictor. Conclusion: The strongest predictor of spontaneous excretion is the size of the stone and the next step is the location of the stone. Male gender and diabetes are also contributing factors to the spontaneous excretion of ureteral stones.
{"title":"Investigation of factors affecting spontaneous ureteral stone excretion","authors":"M. Abedinzadeh, H. Karami, J. Gholami, H. Maleki","doi":"10.34172/jrip.2022.17691","DOIUrl":"https://doi.org/10.34172/jrip.2022.17691","url":null,"abstract":"Introduction: Various factors such as structure of stone, size, location of stone and metabolic diseases affect stone excretion. Objectives: The aim of this study was to investigate factors related to spontaneous ureteral stone excretion. Patients and Methods: This descriptive-analytical observational study was conducted in the university urology centers of Yazd, Iran, during a 16-month period. All patients presenting with unilateral ureteral stone whose ureteral stone was confirmed by CT scan or ultrasound were included in the study. Pregnant patients, patients with uncontrolled hypertension, patients with multiple urinary stones, patients with more than four weeks of history of urinary stones, patients with severe hydronephrosis, and patients with malformations of ureter and kidney were excluded from the study. Computed tomography and ultrasound of the patients evaluated the size of the stone, the location of the stone and the degree of hydronephrosis and also perinephric stranding. Results: In this study, 146 patients with mean age of 45.3±15.1 years (ranging from 11 to 84 years) were enrolled. CT scan and ultrasound were diagnostic in 121 (82.9%) and 25 patients (17.1%) respectively. In logistic regression model analysis, size less than 5mm, stone location and male gender and diabetes were significant predictors of spontaneous stone excretion, while size less than 5 mm was the strongest predictor. Conclusion: The strongest predictor of spontaneous excretion is the size of the stone and the next step is the location of the stone. Male gender and diabetes are also contributing factors to the spontaneous excretion of ureteral stones.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47376386","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 : 2021-10-06DOI: 10.34172/jrip.2022.30859
S. Sadeghi, Elaheh Keivany, Z. Naderi, Samaneh Purajam, E. Nasri
Introduction: Electrolyte abnormalities are among the most common complications among the patients admitted with coronavirus disease 2019 (COVID 19) pneumonia and maybe contributed to its course of disease and severity. Objectives: The current study aims to assess the prevalence and association of electrolyte imbalance among patients with COVID 19 pneumonia. Patients and Methods: The current observational study has been conducted on 323 patients with COVID 19 pneumonia. On-admission blood samples were taken to assess electrolytes (sodium, potassium, calcium, and magnesium), complete blood count and differentiation (CBC with diff), and other biomarkers. Further measurements of electrolytes were conducted during the period of hospitalization if needed. The frequency and association of electrolyte imbalance with diverse demographic, clinical, laboratory, and in-hospital characteristics was assessed. Results: Hypo/hypernatremia, hypo/hyperkalemia, hypo/hypermagnesemia and hypo/ hypercalcemia were presented in 14.5%/9.4%, 3.8%/10.3%, 7.9%/9.3%, and 10.9%/10.8%, respectively. Time to discharge was remarkably higher among the patients with hypernatremia (P=0.031). The patients with hypermagnesemia were significantly younger than the other cases (P=0.016). The C-reactive protein (CRP) level was statistically less among the patients with hypercalcemia (P=0.025). There was no associative outcome between potassium abnormalities and patients’ characteristics. Conclusion: The present study showed that electrolyte imbalances are common laboratory abnormalities during COVID-19. However, we found no associative role, since ions balance plays a crucial prognostic role for COVID-19.
{"title":"Electrolyte imbalance in patients with COVID-19 pneumonia","authors":"S. Sadeghi, Elaheh Keivany, Z. Naderi, Samaneh Purajam, E. Nasri","doi":"10.34172/jrip.2022.30859","DOIUrl":"https://doi.org/10.34172/jrip.2022.30859","url":null,"abstract":"Introduction: Electrolyte abnormalities are among the most common complications among the patients admitted with coronavirus disease 2019 (COVID 19) pneumonia and maybe contributed to its course of disease and severity. Objectives: The current study aims to assess the prevalence and association of electrolyte imbalance among patients with COVID 19 pneumonia. Patients and Methods: The current observational study has been conducted on 323 patients with COVID 19 pneumonia. On-admission blood samples were taken to assess electrolytes (sodium, potassium, calcium, and magnesium), complete blood count and differentiation (CBC with diff), and other biomarkers. Further measurements of electrolytes were conducted during the period of hospitalization if needed. The frequency and association of electrolyte imbalance with diverse demographic, clinical, laboratory, and in-hospital characteristics was assessed. Results: Hypo/hypernatremia, hypo/hyperkalemia, hypo/hypermagnesemia and hypo/ hypercalcemia were presented in 14.5%/9.4%, 3.8%/10.3%, 7.9%/9.3%, and 10.9%/10.8%, respectively. Time to discharge was remarkably higher among the patients with hypernatremia (P=0.031). The patients with hypermagnesemia were significantly younger than the other cases (P=0.016). The C-reactive protein (CRP) level was statistically less among the patients with hypercalcemia (P=0.025). There was no associative outcome between potassium abnormalities and patients’ characteristics. Conclusion: The present study showed that electrolyte imbalances are common laboratory abnormalities during COVID-19. However, we found no associative role, since ions balance plays a crucial prognostic role for COVID-19.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43622208","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 : 2021-10-06DOI: 10.34172/jrip.2022.29849
E. Ahmadian, S. M. Hejazian, L. Vahedi, Amirhassan Khakpour, Jalal Jalalat, S. Zununi Vahed, M. Ardalan
Introduction: Glucocorticoids therapy is a selective treatment strategy for cases with nephrotic syndrome (NS). Objectives: Due to the lack of positive response of all patients to therapy and the dependency of biological effects of glucocorticoids on its receptors (GR), here, the association of the NR3C1 gene (N363S, BclI, GR-9β, and ER22/23EK) polymorphisms with the response to glucocorticoids was investigated in patients with NS. Patients and Methods: In this study, 55 patients with primary NS including 29 steroid-responder (SS) and 26 steroid-resistant (SR) and also 30 healthy individuals were recruited. The polymorphisms of NR3C1 gene were studied by PCR and sequencing of the amplified fragments and the results were compared between the groups. Results: A3669 SNP was observed in 8.7% (n=2) of patients with SRNS and 6.3% (n=2) of responders (P=0.560). In 40.7% of steroid-responsive patients (n=11) and 21.4% of patients with SRNS (n=6), BclI polymorphism was detected that was not statistically significant (P=0.098). The N363S and ER22/23EK polymorphisms were not detected in the studied groups. No significant differences were observed between the frequency of the studied polymorphisms between the different subtypes of NS; focal and segmental glomerulosclerosis (FSGS), membranous glomerulonephritis (MGN), and control group. Conclusion: The NR3C1 gene N363S, BclI, GR-9β, and ER22/23EK polymorphisms do not affect the steroid responsiveness and the pathogenesis of NS in Azari adult patients with primary NS. Other polymorphisms within NR3C1 gene need to be explored in large cohorts.
{"title":"NR3C1 gene polymorphisms in adult patients with nephrotic syndrome","authors":"E. Ahmadian, S. M. Hejazian, L. Vahedi, Amirhassan Khakpour, Jalal Jalalat, S. Zununi Vahed, M. Ardalan","doi":"10.34172/jrip.2022.29849","DOIUrl":"https://doi.org/10.34172/jrip.2022.29849","url":null,"abstract":"Introduction: Glucocorticoids therapy is a selective treatment strategy for cases with nephrotic syndrome (NS). Objectives: Due to the lack of positive response of all patients to therapy and the dependency of biological effects of glucocorticoids on its receptors (GR), here, the association of the NR3C1 gene (N363S, BclI, GR-9β, and ER22/23EK) polymorphisms with the response to glucocorticoids was investigated in patients with NS. Patients and Methods: In this study, 55 patients with primary NS including 29 steroid-responder (SS) and 26 steroid-resistant (SR) and also 30 healthy individuals were recruited. The polymorphisms of NR3C1 gene were studied by PCR and sequencing of the amplified fragments and the results were compared between the groups. Results: A3669 SNP was observed in 8.7% (n=2) of patients with SRNS and 6.3% (n=2) of responders (P=0.560). In 40.7% of steroid-responsive patients (n=11) and 21.4% of patients with SRNS (n=6), BclI polymorphism was detected that was not statistically significant (P=0.098). The N363S and ER22/23EK polymorphisms were not detected in the studied groups. No significant differences were observed between the frequency of the studied polymorphisms between the different subtypes of NS; focal and segmental glomerulosclerosis (FSGS), membranous glomerulonephritis (MGN), and control group. Conclusion: The NR3C1 gene N363S, BclI, GR-9β, and ER22/23EK polymorphisms do not affect the steroid responsiveness and the pathogenesis of NS in Azari adult patients with primary NS. Other polymorphisms within NR3C1 gene need to be explored in large cohorts.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45724391","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 : 2021-09-20DOI: 10.34172/jrip.2022.28848
Nargessadat Zahed, Marjan Pouyamehr, Adineh Taherkhani
Introduction: Cardiovascular disease is one of the major causes of death in hemodialysis patients. Lipid metabolism abnormalities and increased inflammatory factors are related factors. In recent studies, melatonin inhibits dyslipidemia and reduces inflammatory factors by inhibiting LDL-C oxidation. The purpose of this study was to evaluate the effect of melatonin supplement on hyperlipidemia and C-reactive protein (CRP) level in hemodialysis patients. Objectives: We aimed to determine the effect of melatonin on CRP and lipid profile of hemodialysis patients. Patients and Methods: Among 200 hemodialysis patients, only 28 patients fulfilled the inclusion criteria to enroll in the study. Patients were treated with melatonin supplements 3 mg/d at bedtime for 12 weeks. Serum lipid profile and CRP levels were measured after 12 weeks. Five patients were excluded, 2 patients underwent kidney transplantation, and three patients did not cooperate. The Wilcoxon signed-rank test was used to compare the two groups according to the number of participants (less than 30) and study type (pre-test and post-test). P <0.05 was considered as the level of significance. Results: A total of 23 patients completed the treatment protocol. Participants was composed of 13 male and 10 female. The participants’ mean age was 30.6± 11.6 years. After treatment mean total cholesterol levels decreased from 139.95±35.49 mg/dL to 131.13 ± 34.96 mg/dL (P=0.194) which was not statistically significant. However, the decrease in serum triglyceride level was statistically significant (P=0.004). Plasma HDL-C increased significantly after treatment (P=0.032). Serum CRP levels did not change. Conclusion: Melatonin supplement improves serum triglyceride and HDL-C levels in hemodialysis patients but has no effect on total cholesterol and CRP in hemodialysis patients. Trial Registration: This randomized controlled trial was registered by the Iranian Registry of Clinical Trials (identifier: IRCT20200308046724N1; https://en.irct.ir/trial/46407, ethical code; IR.SBMU.RETECH.REC.1397.687).
{"title":"Effect of melatonin on C-reactive protein and lipid profile of hemodialysis patients","authors":"Nargessadat Zahed, Marjan Pouyamehr, Adineh Taherkhani","doi":"10.34172/jrip.2022.28848","DOIUrl":"https://doi.org/10.34172/jrip.2022.28848","url":null,"abstract":"Introduction: Cardiovascular disease is one of the major causes of death in hemodialysis patients. Lipid metabolism abnormalities and increased inflammatory factors are related factors. In recent studies, melatonin inhibits dyslipidemia and reduces inflammatory factors by inhibiting LDL-C oxidation. The purpose of this study was to evaluate the effect of melatonin supplement on hyperlipidemia and C-reactive protein (CRP) level in hemodialysis patients. Objectives: We aimed to determine the effect of melatonin on CRP and lipid profile of hemodialysis patients. Patients and Methods: Among 200 hemodialysis patients, only 28 patients fulfilled the inclusion criteria to enroll in the study. Patients were treated with melatonin supplements 3 mg/d at bedtime for 12 weeks. Serum lipid profile and CRP levels were measured after 12 weeks. Five patients were excluded, 2 patients underwent kidney transplantation, and three patients did not cooperate. The Wilcoxon signed-rank test was used to compare the two groups according to the number of participants (less than 30) and study type (pre-test and post-test). P <0.05 was considered as the level of significance. Results: A total of 23 patients completed the treatment protocol. Participants was composed of 13 male and 10 female. The participants’ mean age was 30.6± 11.6 years. After treatment mean total cholesterol levels decreased from 139.95±35.49 mg/dL to 131.13 ± 34.96 mg/dL (P=0.194) which was not statistically significant. However, the decrease in serum triglyceride level was statistically significant (P=0.004). Plasma HDL-C increased significantly after treatment (P=0.032). Serum CRP levels did not change. Conclusion: Melatonin supplement improves serum triglyceride and HDL-C levels in hemodialysis patients but has no effect on total cholesterol and CRP in hemodialysis patients. Trial Registration: This randomized controlled trial was registered by the Iranian Registry of Clinical Trials (identifier: IRCT20200308046724N1; https://en.irct.ir/trial/46407, ethical code; IR.SBMU.RETECH.REC.1397.687).","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42862989","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 : 2021-09-19DOI: 10.34172/jrip.2022.29848
S. Zununi Vahed, Shahram Ghiyasvand, S. M. Hejazian, M. Shoja, M. Ardalan
Introduction: Steroids are considered first-line therapeutic opportunities in cases with idiopathic nephrotic syndrome (INS). The trustworthy biomarkers for steroid-resistant NS (SRNS) would permit more precise decisions in the treatment of INS. Objectives: This study aimed to evaluate the miR-15 and miR-16 levels in NS cases. Patients and Methods: Adult cases with primary NS (n=60) including 30 FSGS (Focal segmental glomerulosclerosis) and 30 membranous glomerulonephritis (MGN) patients and 24 healthy individuals were included. The evaluation of miR-15 and miR-16 expression in blood cells was performed using real-time polymerase chain reaction (qPCR). Moreover, gene ontology analysis and prediction of the miRNA targets were completed to recognize the biological procedures and signaling pathways involved in the pathophysiology of NS. Results: A significant increase was observed in miR-15a-5p expression in cases with primary MGN and FSGS compared with healthy subjects. Conversely, the miR-16-5p expression was significantly decreased in both conditions compared with healthy controls. In the clinical subdivision of FSGS group to steroid-resistant-FSGS and steroid-responsive-FSGS, significant elevated levels of miR-15a-5p and diminished levels of miR-16-5p were observed in both groups compared to normal controls. Gene annotation demonstrated that these miRNAs contribute to cell cycle, ion transport, biological adhesion, cation transport, cellular response to endogenous stimulus, and regulation of small GTPase-related signal transduction. Conclusion: Dysregulated levels of miR-15 and miR-16 may be involved in the pathogenesis and response to steroid therapy in patients with INS.
{"title":"Expression profile of miR-15 and miR-16 in peripheral blood mononuclear cells of patients with steroid-resistant nephrotic syndrome","authors":"S. Zununi Vahed, Shahram Ghiyasvand, S. M. Hejazian, M. Shoja, M. Ardalan","doi":"10.34172/jrip.2022.29848","DOIUrl":"https://doi.org/10.34172/jrip.2022.29848","url":null,"abstract":"Introduction: Steroids are considered first-line therapeutic opportunities in cases with idiopathic nephrotic syndrome (INS). The trustworthy biomarkers for steroid-resistant NS (SRNS) would permit more precise decisions in the treatment of INS. Objectives: This study aimed to evaluate the miR-15 and miR-16 levels in NS cases. Patients and Methods: Adult cases with primary NS (n=60) including 30 FSGS (Focal segmental glomerulosclerosis) and 30 membranous glomerulonephritis (MGN) patients and 24 healthy individuals were included. The evaluation of miR-15 and miR-16 expression in blood cells was performed using real-time polymerase chain reaction (qPCR). Moreover, gene ontology analysis and prediction of the miRNA targets were completed to recognize the biological procedures and signaling pathways involved in the pathophysiology of NS. Results: A significant increase was observed in miR-15a-5p expression in cases with primary MGN and FSGS compared with healthy subjects. Conversely, the miR-16-5p expression was significantly decreased in both conditions compared with healthy controls. In the clinical subdivision of FSGS group to steroid-resistant-FSGS and steroid-responsive-FSGS, significant elevated levels of miR-15a-5p and diminished levels of miR-16-5p were observed in both groups compared to normal controls. Gene annotation demonstrated that these miRNAs contribute to cell cycle, ion transport, biological adhesion, cation transport, cellular response to endogenous stimulus, and regulation of small GTPase-related signal transduction. Conclusion: Dysregulated levels of miR-15 and miR-16 may be involved in the pathogenesis and response to steroid therapy in patients with INS.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41777462","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. Mirzaei, Nader Nourimajalan, H. Morovati, M. Askarishahi, R. Hemayati
Introduction: Chronic kidney disease (CKD) is a major health problem and one of the public health threats with an increasing prevalence and burden. However, early diagnosis of this disease is challenging in Iran due to insufficient information. Objectives: In the present study, we aimed to determine the prevalence of CKD and its predisposing factors in Yazd city, Iran. Patients and Methods: We conducted this cross-sectional study using the recruitment phase data of Yazd Health Study (YaHS) collected during 2013-2014. Data of 3649 individuals, age 20-69 years were analyzed. Glomerular filtration rate (GFR) was calculated using the modification of diet in renal disease (MDRD) formula and values less than 60 mL/min/1.73 m2 were defined as CKD. Logistic regression was employed to determine the risk factors of CKD. Results: The mean age of participants was 46.0 ± 13.8 years and the overall prevalence of CKD was 6.6 percent (7.6% for women and 5.4% for men). The disease prevalence was 21.5% in the age group of 60-69 years. The prevalence of CKD had a significant relationship with older age, obesity, female gender, diabetes, high blood pressure and history of heart disease. Conclusion: CKD has a high prevalence in the population of this region of Iran. The most important modifiable risk factors for CKD included diabetes and high blood pressure. Therefore, the health system should strive for early detection of CKD in order to prevent morbidity and mortality of this disease.
{"title":"Prevalence and predisposing factors of chronic kidney disease in Yazd city; a population-based study","authors":"M. Mirzaei, Nader Nourimajalan, H. Morovati, M. Askarishahi, R. Hemayati","doi":"10.34172/jrip.2022.01","DOIUrl":"https://doi.org/10.34172/jrip.2022.01","url":null,"abstract":"\u0000 Introduction: Chronic kidney disease (CKD) is a major health problem and one of the public health threats with an increasing prevalence and burden. However, early diagnosis of this disease is challenging in Iran due to insufficient information. Objectives: In the present study, we aimed to determine the prevalence of CKD and its predisposing factors in Yazd city, Iran. Patients and Methods: We conducted this cross-sectional study using the recruitment phase data of Yazd Health Study (YaHS) collected during 2013-2014. Data of 3649 individuals, age 20-69 years were analyzed. Glomerular filtration rate (GFR) was calculated using the modification of diet in renal disease (MDRD) formula and values less than 60 mL/min/1.73 m2 were defined as CKD. Logistic regression was employed to determine the risk factors of CKD. Results: The mean age of participants was 46.0 ± 13.8 years and the overall prevalence of CKD was 6.6 percent (7.6% for women and 5.4% for men). The disease prevalence was 21.5% in the age group of 60-69 years. The prevalence of CKD had a significant relationship with older age, obesity, female gender, diabetes, high blood pressure and history of heart disease. Conclusion: CKD has a high prevalence in the population of this region of Iran. The most important modifiable risk factors for CKD included diabetes and high blood pressure. Therefore, the health system should strive for early detection of CKD in order to prevent morbidity and mortality of this disease.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42390384","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 : 2021-09-13DOI: 10.34172/jrip.2022.26822
Arash Dashtabi, Z. Mazloom, S. Ezzatzadegan Jahromi, M. Fararouei
Introduction: It has been proposed that advanced glycation end-products (AGEs) are contributory factors in diabetic nephropathy (DN) pathogenesis. Interventions regarding restriction dietary AGEs (dAGEs) intake indicate improvement in clinical outcomes. Objectives: The present study aimed to compare the effects of 10-week low AGEs diet (LAGEsd) based on recommended diabetic diet (DD) versus DD alone on glycemic status, lipid profile, serum creatinine (sCr), blood urea nitrogen (BUN), urine albumin to creatinine ratio, eGFR and urine albumin in patients with DN. Patients and Methods: This randomized, double-blind clinical trial was conducted on 62 patients with DN. Patients were assigned randomly to LAGEsd (n=31) and DD (n=31) groups for 10 weeks. All patients were prescribed calorie adjusted diet in regards to American Diabetes Association’s recommendation. In addition, patients in the LAGEsd group were instructed how to reduce dAGEs intake based on established guidelines. Demographic data were collected and dietary intakes, physical activity level, fasting blood sugar (FBS), hemoglobin A1C (HbA1c), lipid profile, sCr, blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), urine albumin to creatinine ratio (Alb/Cr), and urine albumin were measured before and after of 10-weeks intervention, and compared between the two groups. Results: The results showed that dAGEs intake decreased significantly in the LAGEsd group compared with the DD group (P<0.001). In the LAGEsd group, eGFR improved significantly compared with the DD group (18.77±20.99 mL/min/1.73 m2 versus 1.57±21.06 mL/min/1.73 m2 , P=0.002); however there were no significant difference in FBS, HbA1c, lipid profile, sCr, BUN, urine Alb/Cr, and urine albumin between the two groups (P>0.05). Conclusion: In sum, dAGEs restriction plus DD is superior to DD alone in improvement of renal function marker in patients with DD. Trial Registration: This study was registered at Iranian Registry of Clinical Trials (identifier: IRCT20191004044979N1, https://en.irct.ir/trial/42914, ethical code #IR.SUMS.REC.1398.798).
{"title":"Effects of dietary advanced glycation end-products restriction on renal function in patients with diabetic nephropathy; a randomized, double-blind clinical trial","authors":"Arash Dashtabi, Z. Mazloom, S. Ezzatzadegan Jahromi, M. Fararouei","doi":"10.34172/jrip.2022.26822","DOIUrl":"https://doi.org/10.34172/jrip.2022.26822","url":null,"abstract":"Introduction: It has been proposed that advanced glycation end-products (AGEs) are contributory factors in diabetic nephropathy (DN) pathogenesis. Interventions regarding restriction dietary AGEs (dAGEs) intake indicate improvement in clinical outcomes. Objectives: The present study aimed to compare the effects of 10-week low AGEs diet (LAGEsd) based on recommended diabetic diet (DD) versus DD alone on glycemic status, lipid profile, serum creatinine (sCr), blood urea nitrogen (BUN), urine albumin to creatinine ratio, eGFR and urine albumin in patients with DN. Patients and Methods: This randomized, double-blind clinical trial was conducted on 62 patients with DN. Patients were assigned randomly to LAGEsd (n=31) and DD (n=31) groups for 10 weeks. All patients were prescribed calorie adjusted diet in regards to American Diabetes Association’s recommendation. In addition, patients in the LAGEsd group were instructed how to reduce dAGEs intake based on established guidelines. Demographic data were collected and dietary intakes, physical activity level, fasting blood sugar (FBS), hemoglobin A1C (HbA1c), lipid profile, sCr, blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), urine albumin to creatinine ratio (Alb/Cr), and urine albumin were measured before and after of 10-weeks intervention, and compared between the two groups. Results: The results showed that dAGEs intake decreased significantly in the LAGEsd group compared with the DD group (P<0.001). In the LAGEsd group, eGFR improved significantly compared with the DD group (18.77±20.99 mL/min/1.73 m2 versus 1.57±21.06 mL/min/1.73 m2 , P=0.002); however there were no significant difference in FBS, HbA1c, lipid profile, sCr, BUN, urine Alb/Cr, and urine albumin between the two groups (P>0.05). Conclusion: In sum, dAGEs restriction plus DD is superior to DD alone in improvement of renal function marker in patients with DD. Trial Registration: This study was registered at Iranian Registry of Clinical Trials (identifier: IRCT20191004044979N1, https://en.irct.ir/trial/42914, ethical code #IR.SUMS.REC.1398.798).","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44362453","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}
Dorsa Jahangiri, Udit Narayan Padhi, H. Verma, B. Lakkakula, R. Valizadeh, H. Nasri
Introduction: Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are a new class of anti-diabetic drugs. SGLT2 inhibitors lower blood glucose levels by decreasing glucose reabsorption in the proximal renal tubule, resulting in increased urinary glucose and sodium excretion. Objective: This study was conducted to investigate the effects of SGLT2i on individual renal outcomes in diabetic patients. Methods: This study was a systematic review and meta-analysis of clinical trials. A comprehensive search of Cochrane Central Register of Controlled Trials was conducted in the Cochrane Library and PubMed, to identify relevant articles focusing on SGLT2i and chronic kidney disease (CKD) in diabetic patients. The most recent article search was conducted on July 12, 2021. Results: Seven randomized controlled trials (RCTs) were included in the meta-analysis. Two trials were comparing dapagliflozin, two comparing empagliflozin, one comparing ertugliflozin, one comparing canagliflozin, and one comparing sotagliflozin. Composite renal outcome and acute kidney injury (AKI) was found in seven and four studies, respectively. Data on end-stage kidney disease (ESKD) and albuminuria or initiation of renal replacement therapy were reported in the two studies. The pooled risk ratio (RR) 95% confidence interval (CI) for the composite renal outcome was 0.54 (0.50–0.59), with 92 % heterogeneity. The pooled RR for AKI was 0.77 (0.66–0.89), with no heterogeneity. A significant lower incidence of albuminuria (RR: 0.69; 95% CI: 0.59–0.81), initiation of renal replacement therapy (RR: 0.71; 95% CI: 0.58–0.87), was observed following the use of SGLT2 inhibitors. Conclusion: Our findings confirm that the SGLT2 inhibitors can reduce the risk of albuminuria, AKI and renal replacement therapy in ESKD patients with T2D (type 2 diabetes). These meta-analyses provide substantial evidence supporting the beneficial effect of SGLT2 inhibitors on reducing CKD events in individuals with T2D.
{"title":"Sodium-glucose co-transporter 2 inhibitors (SGLT2i); as a preventive factor of kidney failure in patients with type 2 diabetes; a meta-analysis of randomized controlled trials","authors":"Dorsa Jahangiri, Udit Narayan Padhi, H. Verma, B. Lakkakula, R. Valizadeh, H. Nasri","doi":"10.34172/jrip.2021.35","DOIUrl":"https://doi.org/10.34172/jrip.2021.35","url":null,"abstract":"\u0000 Introduction: Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are a new class of anti-diabetic drugs. SGLT2 inhibitors lower blood glucose levels by decreasing glucose reabsorption in the proximal renal tubule, resulting in increased urinary glucose and sodium excretion. Objective: This study was conducted to investigate the effects of SGLT2i on individual renal outcomes in diabetic patients. Methods: This study was a systematic review and meta-analysis of clinical trials. A comprehensive search of Cochrane Central Register of Controlled Trials was conducted in the Cochrane Library and PubMed, to identify relevant articles focusing on SGLT2i and chronic kidney disease (CKD) in diabetic patients. The most recent article search was conducted on July 12, 2021. Results: Seven randomized controlled trials (RCTs) were included in the meta-analysis. Two trials were comparing dapagliflozin, two comparing empagliflozin, one comparing ertugliflozin, one comparing canagliflozin, and one comparing sotagliflozin. Composite renal outcome and acute kidney injury (AKI) was found in seven and four studies, respectively. Data on end-stage kidney disease (ESKD) and albuminuria or initiation of renal replacement therapy were reported in the two studies. The pooled risk ratio (RR) 95% confidence interval (CI) for the composite renal outcome was 0.54 (0.50–0.59), with 92 % heterogeneity. The pooled RR for AKI was 0.77 (0.66–0.89), with no heterogeneity. A significant lower incidence of albuminuria (RR: 0.69; 95% CI: 0.59–0.81), initiation of renal replacement therapy (RR: 0.71; 95% CI: 0.58–0.87), was observed following the use of SGLT2 inhibitors. Conclusion: Our findings confirm that the SGLT2 inhibitors can reduce the risk of albuminuria, AKI and renal replacement therapy in ESKD patients with T2D (type 2 diabetes). These meta-analyses provide substantial evidence supporting the beneficial effect of SGLT2 inhibitors on reducing CKD events in individuals with T2D.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43164301","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 : 2021-09-04DOI: 10.34172/jrip.2022.31947
Dorsa Jahangiri, A. Najmaldin, Lakkakula Vks Bhaskar
The sodium–glucose cotransporter-2 inhibitors (SGLT2i) are a new class of antidiabetic agents. SGLT2i are able to inhibit SGLT2 transporter in renal tissue, increasing glycosuria and reducing blood sugar. These drugs act by inhibiting the SGLT2 in renal proximal epithelial tubular cells. SGLT2i are found to have beneficial effect on chronic renal failure caused by diabetic nephropathy.
{"title":"Ameliorative impact of sodium–glucose cotransporter-2 inhibitors in diabetic kidney disease; a mini- review to current evidence","authors":"Dorsa Jahangiri, A. Najmaldin, Lakkakula Vks Bhaskar","doi":"10.34172/jrip.2022.31947","DOIUrl":"https://doi.org/10.34172/jrip.2022.31947","url":null,"abstract":"The sodium–glucose cotransporter-2 inhibitors (SGLT2i) are a new class of antidiabetic agents. SGLT2i are able to inhibit SGLT2 transporter in renal tissue, increasing glycosuria and reducing blood sugar. These drugs act by inhibiting the SGLT2 in renal proximal epithelial tubular cells. SGLT2i are found to have beneficial effect on chronic renal failure caused by diabetic nephropathy.","PeriodicalId":16950,"journal":{"name":"Journal of Renal Injury Prevention","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47933007","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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