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Bazazzadeh S, Sharbafchi MR, Naeini MK, Hosseini SM, Atapour A, Mortazavi M. Evaluation of factors related to depression in peritoneal dialysis patients: a multicenter cross-sectional study. Ren Replace Ther 2023. [DOI: 10.1186/s41100-023-00468-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
Abstract
Background
End-stage renal disease (ESRD) is serious global public health challenge in many developing countries. Treatment of ESRD is carried out through renal replacement therapy like peritoneal dialysis (PD). Depression is the most common mood disorder which has a strong impact on the quality of life in patients with ESRD. Little is known about the prevalence and risk factors of depression in peritoneal dialysis patients.
Method and materials
A multicenter cross-sectional study was conducted on 164 adult ESRD patients undergoing peritoneal dialysis for at least three months who referred to the peritoneal dialysis centers of Al-Zahra, Noor & Ali Asghar hospitals, Isfahan, Iran from May to August 2019. Beck Depression Inventory Second Edition questionnaire was used to measure the symptoms of depression and its severity.
Results
43.5% of patients had some levels of depression. Assessing the association of depression with demographic and PD-related factors showed that there was no significant difference regarding age, BMI, dialysis adequacy and residual kidney function, dialysis frequency, type of dialysis solution used, disease duration, and age at the start of dialysis. Ordinal logistics regression analysis showed significant association between depression severity categories and gender (OR = 0.397, CI: 0.160–0.985, p = 0.046), marital status (OR = 2.983, CI: 1.180–7.541, p = 0.021), having a separate room for dialysis (OR = 2.511, CI: 1.108–5.692, p = 0.027).
Conclusion
As our findings have revealed 43.5% of our participants suffered from mild-to-severe depression, we suggest careful attention and routine evaluation for depression in PD patients, especially women and single patients and those who have low socioeconomic status.
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Atapour A, Sattari M, Mortazavi M. Identifying the Factors Affecting the Survival Rate of Kidney Transplant Patients in Isfahan Using Classification Techniques. fbt 2022. [DOI: 10.18502/fbt.v10i1.11506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Purpose: 10% of the world's population suffers from chronic kidney disease and millions of deaths occur annually due to lack of access to appropriate treatment in the world. Kidney transplantation is associated with several problems. These problems, including kidney rejection, the consequences of surgery, drug poisoning, and infectious diseases can reduce the chances of survival of these patients. The science of classification has been proposed in recent years to reduce medical errors due to inexperience, reduce the workload of physicians and provide a suitable model for making better decisions.
Materials and Methods: The data set includes information about patients for whom kidney transplantation was performed in Isfahan. The data set includes 2554 patients and 38 attributes. The techniques used in this study will include random forest, Principal Component Analysis (PCA), and Support Vector Machine (SVM).
Results: Among the studied techniques, PCA technique in three classes out of four classes had better performance than other techniques. The syndrome has the highest recurrence among traits. Five attributes include syndrome, blood type, dialysis time, weight, and age.
Conclusion: The results showed that the PCA method in the case of non-numerical data has a good performance in identifying attributes. Also, five attributes that affect the survival rate of kidney transplant patients were identified.
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Shahidi S, Vahdat S, Atapour A, Reisizadeh S, Soltaninejad F, Maghami-Mehr A. The clinical course and risk factors in COVID-19 patients with acute kidney injury. J Family Med Prim Care 2022; 11:6183-6189. [PMID: 36618164 PMCID: PMC9810939 DOI: 10.4103/jfmpc.jfmpc_231_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/28/2022] [Accepted: 05/17/2022] [Indexed: 11/11/2022] Open
Abstract
Background Acute kidney injury (AKI) has the most prevalent complications in COVID-19 patients. A variety of factors is involved in the disease progression and its associated outcomes. The present study aimed at both examining the correlated clinical features of COVID-19 disease and AKI and evaluating its clinical outcomes. Materials and Methods In the present retrospective study, 102 COVID-19 patients that encountered AKI were enrolled and categorized into three AKI stages. Basic and clinical characteristics, clinical signs and symptoms, laboratory and imaging findings, and treatment approaches were examined. Then, clinical outcomes as well as the factors associated with the mortality of patients were evaluated. Results Diabetes was the only significant clinical characteristic among the patients (P = 0.004). An increasing trend was observed for neutrophil-to-lymphocyte ratio (P = 0.027) and potassium (K) (P = 0.006), and a decreasing trend was seen for hemoglobin (P < 0.001), albumin (P = 0.005), and calcium (P < 0.001) factors at higher stages of AKI. Secondary infection (P = 0.019) and hypoproteinemia (P = 0.018) were the most significant clinical outcomes. Chronic obstructive lung disease (OR = 1.362, P = 0.007), renal replacement therapy (OR = 2.067, P = 0.005), lung consolidation (OR = 0.722, P = 0.032), and bilateral pulmonary infiltration (OR = 4.793, P = 0.002) were the factors associated with mortality rate of COVID-19 patients with AKI. Conclusion AKI, as an important complication of COVID-19, that can predict the higher mortality rate as well as the laboratory and clinical characteristics should receive more due consideration in order to employ proper preventive or supportive treatment approaches that are the pivotal key to reduce the mortality rate in target patients.
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Affiliation(s)
- Shahrzad Shahidi
- Department of Nephrology, Isfahan Kidney Diseases Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sahar Vahdat
- Department of Nephrology, Isfahan Kidney Diseases Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Dr. Sahar Vahdat, Assistant Professor of Nephrology, Isfahan Kidney Diseases Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:
| | - Abdolamir Atapour
- Department of Nephrology, Isfahan Kidney Diseases Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shadi Reisizadeh
- Department of Internal Medicine, Isfahan Kidney Diseases Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Forogh Soltaninejad
- Associate Professor of Pulmonary Diseases, Isfahan Kidney Diseases Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
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Azmandian J, Shafii Z, Ezzatzadegan Jahromi S, Nourimajalan N, Seyrafian S, Atapour A, Atabak S, Mazloomzadeh S, Norouzi Z, Najafi I. The Epidemiological Characteristics and Outcome of COVID-19 in Patients Undergoing Peritoneal Dialysis: A Multi-center Study in Iran. Iran J Kidney Dis 2022; 16:280-283. [PMID: 36178861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/21/2022] [Indexed: 06/16/2023]
Abstract
The pandemic of COVID-19 emerged in December 2019. Although numerous features of the illness have been investigated, the impact of disease on those patients with underlying diseases, is still a major problem. The aim of this multicenter, cohort study, was to determine the clinical manifestations of COVID-19 in peritoneal dialysis (PD) patients. Five hundred and five patients, receiving PD, were enrolled in this study, out of which 3.7% had coronavirus infection. Fever was the most common symptom (63.2%). The hospitalization rate was 10.5, 21.1% required admission to intensive care units (ICU) and the mortality rate was 21%. The most common cause of infection included close contact with the infected individuals and lower rates of protective equipment use. Although the incidence of COVID-19 among PD patients is low, the severity of the disease and the mortality rate are quite high. Vaccination and adherence to preventive measures are strongly recommended in PD patients. DOI: 10.52547/ijkd.7147.
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Affiliation(s)
| | - Zahra Shafii
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
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Shahidi S, Dolatkhah S, Mortazavi M, Atapour A, Aghaaliakbari F, Meamar R, Badri M, Taheri D. An Epidemiological Survey on Kidney Stones and Related Risk Factors in the Iranian Community. ACTA 2022. [DOI: 10.18502/acta.v60i5.9558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Increasing number of patients with kidney stones is a major worldwide concern that needs more attention for recognizing the disease in order to set up suitable prevention systems. In this study, we aimed to assess the prevalence and related risk factors of kidney stones in our local area (Isfahan, Iran). In 2011, we celebrated World Kidney Day (WKD) with several training programs for informing people about kidney diseases. A questionnaire containing demographic data, past medical history, and familial and self-history of kidney disease was fulfilled by each individual who participated in WKD. Blood pressure and body mass index (BMI) were also measured using standard methods. Statistical analysis with SPSS-20 software was done. 556 participants with a mean age of 44.69±15.32 were included in the study, of which 107 cases (19.2%) with a mean age of 50.24±12.33 had a kidney stone, and 449 cases (80.8%) with a mean age of 44.69±15.32 had no history of kidney stone. There were no significant differences between those with and without kidney stones regarding sex (P=0.176), type of daily work (P=0.91), diabetes mellitus (P=0.64), and place of living (urban versus rural) (P=0.92) and BMI (P=0.26). However, there were differences between groups regarding age (P˂0.001), Hypertension (HTN) (P=001), Cardiovascular disease (CVD) (P=0.02), and familial history of kidney stone (P˂0.001). Out of 107 patients with kidney stones, the mean number of urinary excretion of stones was 2.56±2.98. We found a greater prevalence of kidney stones in our local area compared with data from other research studies. Despite some previous studies, comparison of people with and without kidney stones did not reveal differences in the prevalence of DM, type of daily work (low activity versus high activity), and obesity but differences in the field of HTN and CVD were seen.
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Atapour A, Vahdat S, Hosseini M, Mohamadian H. Effect of Selenium on Triglyceride and Total Cholesterol, Weight Gain, and Physical Activity on Hemodialysis Patients: A Randomized Double-Blinded Controlled Trial. Int J Prev Med 2022; 13:63. [PMID: 35706870 PMCID: PMC9188886 DOI: 10.4103/ijpvm.ijpvm_378_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/28/2020] [Indexed: 11/16/2022] Open
Abstract
Background: End-stage renal disease is one of the most important chronic diseases. Selenium is one of the so-called rare elements which are essential for our body functions. Here, we aimed to investigate and the effects of selenium supplement therapy on weight gain, physical activity, and triglyceride (TG) and total cholesterol in patients under hemodialysis. Methods: The current study is a double-blinded clinical trial performed on patients with ESRD under hemodialysis in 2019. In the beginning, serum selenium levels were assessed. All patients were randomly divided into two groups. The first group was under treatments with tablets of selenium 400 μg. Patients received selenium tablets three times after each hemodialysis session (3 times a week) and the other group received placebo tablets. 3 months after the beginning of the study, blood selenium levels, TG and total cholesterol, and weight and physical activities of patients were evaluated again and compared with the beginning. Results: A total of 78 patients were included. Serum selenium levels at the beginning of our study were 40.06 ± 8.50 in the intervention group and 45.00 ± 8.16 in control groups. Selenium levels and physical activities of patients were increased significantly in intervention group compared to baseline (P < 0.001 for both). Weight, physical activity, total cholesterol, and TG in both intervention and control groups did not change significantly after interventions (P > 0.05). Conclusions: We showed that selenium supplement therapies have beneficial effects in patients under hemodialysis. Furthermore, we showed that selenium supplement therapies have positive effects on serum selenium levels but no effects on total cholesterol and TG.
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Affiliation(s)
- Abdolamir Atapour
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran
| | - Sahar Vahdat
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran
| | - Mohsen Hosseini
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran
| | - Hamed Mohamadian
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran
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Halaji M, Shahidi S, Ataei B, Atapour A, Feizi A, Havaei SA. Molecular epidemiology of bla CTX-M gene-producing uropathogenic Escherichia coli among Iranian kidney transplant patients: clonal dissemination of CC131 and CC10. Ann Clin Microbiol Antimicrob 2021; 20:65. [PMID: 34496873 PMCID: PMC8424993 DOI: 10.1186/s12941-021-00470-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 08/31/2021] [Indexed: 11/25/2022] Open
Abstract
Background This study aimed to investigate the phylogenetic characterization and virulence traits of uropathogenic Escherichia coli (UPEC) isolated from kidney transplant patients (KTPs) as well as non-KTPs and analyze the clonal distribution of Extended spectrum β-lactamases (ESBLs)-producing UPEC containing blaCTX-M gene. Methods To this end, we determined virulence marker and the phylogenetic characterization of UPEC in non-KTPs (n = 65) and KTPs (n = 46). The non-KTPs were considered the control group of the study. Also, according to the Achtman scheme, we performed multilocus sequence typing to assess the relationship between twenty-nine of ESBL-producing isolates containing blaCTX-M gene. Results According to the results of PCR assay, the prevalence of virulence factor genes ranged from 0% (cnf and papG III) to 93.7% (fimH). Also, KTP isolates significantly differed from non-KTP isolates only in terms of the prevalence of pap GI elements. Moreover, the most frequent UPEC isolates were in phylogenetic group B2, followed by group D (18.9%), and group A (13.5%). Furthermore, except for phylogenetic group C, there was no significant correlation between phylogenetic distribution in KTPs and non-KTPs. Additionally, MLST analysis of blaCTX-M carrying isolates identified 18 unique sequence types (ST) the most common of which was ST131 (24.1%), followed by ST1193 (10.3%), while fourteen STs were detected only once. Conclusions The results further revealed significant differences between the UPEC isolates from KTPs and non-KTPs regarding the phylogroups C and PAI gene. Based on MLST analysis, we also observed a relatively high diversity in UPEC isolates obtained from KTPs and non-KTPs. Moreover, clonal complex (CC) 131 and ST131 were found to be the most prevalent clones and ST types, respectively. Besides, for the first time, ST8503 were reported in KTPs. These results suggested regular studies on characterization of UPEC isolates among KTPs. Supplementary Information The online version contains supplementary material available at 10.1186/s12941-021-00470-7.
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Affiliation(s)
- Mehrdad Halaji
- Infectious Diseases and Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Shahrzad Shahidi
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behrooz Ataei
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdolamir Atapour
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Asghar Havaei
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
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Abbasi S, Naderi Z, Amra B, Atapour A, Dadkhahi SA, Eslami MJ, Hajian MR, Hashemi M, Hashemi ST, Iraj B, Khorvash F, Madadi S, Pour HM, Mansourian M, Rezvani M, Sami R, Soltaninejad F, Shahidi S, Vahdat S, Zamani Z, Moeinzadeh F. Hemoperfusion in patients with severe COVID-19 respiratory failure, lifesaving or not? J Res Med Sci 2021; 26:34. [PMID: 34345245 PMCID: PMC8305775 DOI: 10.4103/jrms.jrms_1122_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 10/28/2020] [Accepted: 01/18/2021] [Indexed: 01/10/2023]
Abstract
Background: The new coronavirus outbreak quickly filled hospital beds and stunned the world. Intensive care is required for 5% of patients, and the mortality rate for critically ill patients is 49%. The “cytokine storm” is considered as the main cause of pathogenesis for coronavirus disease-19 (COVID-19)-related respiratory failure, hemoperfusion may be a modality for treatment of disease. Materials and Methods: Thirty-seven an patients with positive real-time polymerase chain reaction for SARStions2 in an upper respiratory tract sample or typical chest computed tomography lesion were eligible for this case–control study. Patients meeting the criteria for hemoperfusion including clinical and laboratory indices, were evaluated for outcomes such as hospitalization length and mortality. Patients were divided into three groups, i.e., patients who received hemoperfusion without a need for mechanical ventilation (MV), patients who received hemoperfusion before MV, and patients who received hemoperfusion after MV. Results: Among 37 patients with COVID-19 respiratory failure, 32% were female with a mean age of 55.54 (standard deviation 14.1) years. There was no statistically significant difference between the three groups in terms of length of hospital stay and intensive care unit (ICU) stay (P-tayns: 0.593 and 0.243, respectively, confidence interval [CI]: 95%). Heart rate, respiratory rate, PaO2/FIO2, high-sensitivity C-reactive protein, and ferritin significantly improved after the application of hemoperfusion in all groups (P < 0.05, CI: 95%). Conclusion: It seems that applying hemoperfusion in the inflammatory phase of the disease, especially before the intubation, reduce the need for MV. However, hemoperfusion does not have any impacts on the duration of hospital and ICU stay.
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Affiliation(s)
- Saeed Abbasi
- Anesthesiology and Critical Care Research Center, Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zohre Naderi
- Department of Pulmonology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Babak Amra
- Bamdad Respiratory Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdolamir Atapour
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Amir Dadkhahi
- Department of Pulmonology, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | | - Marzieh Hashemi
- Department of Pulmonology, Amin Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Taghi Hashemi
- Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bijan Iraj
- Department of Internal Medicine, Endocrine and Metabolism Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzin Khorvash
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Samane Madadi
- Khatamolanbia Natanz Regional Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Mahjoubi Pour
- Department of Anesthesiology and Critical Care Medicine, Critical care Research Center, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Mansourian
- Department of Epidemiology and Biostatics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Rezvani
- Department of Neurosurgery, Neuroscience Research Center, School of Medicine, Al Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ramin Sami
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Forough Soltaninejad
- Respiratory Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahrzad Shahidi
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sahar Vahdat
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Zamani
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firouzeh Moeinzadeh
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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VAHDAT S, Shahidi S, Atapour A, Reisizadeh S, Soltaninejad F, Maghami-Mehr A. POS-214 The outcome of COVID-19 patients with acute kidney injury and the factors affecting mortality. Kidney Int Rep 2021. [PMCID: PMC8049709 DOI: 10.1016/j.ekir.2021.03.227] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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Azarnoush H, Mortazavi M, Rouhani MH, Seirafian S, Atapour A, Hosseini M, Toghyani A. Dietary nutrients' intake and sleep quality in peritoneal dialysis patients. Sleep Sci 2021; 14:174-178. [PMID: 35082988 PMCID: PMC8764949 DOI: 10.5935/1984-0063.20200102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/05/2021] [Indexed: 11/20/2022] Open
Abstract
Sleep disturbances are common in dialysis patients. However, there is a lack of information on nutritional determinants of sleep disorders in dialysis patients. The objective of the current study was to investigate the association between nutrients’ intake and sleep quality in peritoneal dialysis patients. The cross-sectional study was done on 114 peritoneal dialysis patients referred to Alzahra and Khorshid hospitals, Isfahan, Iran. Information on sleep quality and dietary intakes were collected using Pittsburgh sleep quality index and 168-item food frequency questionnaire respectively. Anthropometric measurements were done by a trained dietitian based on standard protocols. Socio-demographic and clinical data were obtained through a structured questionnaire. The binary logistic regression model was used to detect the association between nutrients’ intake and sleep quality. Our results indicated that there was not any significant difference in basic (socio-demographic and clinical) characteristics between peritoneal dialysis patients with good and poor sleep quality (p>0.05). The results of logistic regression indicated a positive significant association between dietary intake of carbohydrate (OR:3;95% CI:1.32-6.81; p<0.05), fat (OR:3;95% CI:1.32-6.81; p<0.05), and fiber (OR:2.53;95% CI: 1.12-5.67; p<0.05) with poor sleep quality in crude and adjusted models (p<0.05). However, there was not any significant association between dietary intake of protein and poor sleep quality (p>0.05). The results of the present study indicated that dietary intake of nutrients affect sleep quality in dialysis patients. These results help healthcare professionals in making nutritional interventions to improve sleep quality in dialysis patients.
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Affiliation(s)
- Hamed Azarnoush
- Isfahan University of Medical Sciences, Internal Medicine Department, Medical School - Isfahan - Iran (the Islamic Republic of) - Iran
| | - Mojgan Mortazavi
- Isfahan University of Medical Sciences, Internal Medicine Department, Medical School - Isfahan - Iran (the Islamic Republic of) - Iran.,Isfahan University of Medical Sciences, Isfahan Kidney Diseases Research Center, Alzahra Hospital - Isfahan - Iran (the Islamic Republic of) - Iran
| | - Mohammad Hossein Rouhani
- Isfahan University of Medical Sciences, Food Security Center and Department of Community Nutrition - Isfahan - Iran (the Islamic Republic of) - Iran
| | - Shiva Seirafian
- Isfahan University of Medical Sciences, Internal Medicine Department, Medical School - Isfahan - Iran (the Islamic Republic of) - Iran.,Isfahan University of Medical Sciences, Isfahan Kidney Diseases Research Center, Alzahra Hospital - Isfahan - Iran (the Islamic Republic of) - Iran
| | - Abdolamir Atapour
- Isfahan University of Medical Sciences, Internal Medicine Department, Medical School - Isfahan - Iran (the Islamic Republic of) - Iran.,Isfahan University of Medical Sciences, Isfahan Kidney Diseases Research Center, Khorshid Hospital - Isfahan - Iran (the Islamic Republic of) - Iran
| | - Mohsen Hosseini
- Isfahan University of Medical Sciences, Department of Biostatistics and Epidemiology, School of Public Health - Isfahan - Iran (the Islamic Republic of) - Iran
| | - Arash Toghyani
- Isfahan University of Medical Sciences, Internal Medicine Department, Medical School - Isfahan - Iran (the Islamic Republic of) - Iran
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Halaji M, Shahidi S, Atapour A, Ataei B, Feizi A, Havaei SA. Characterization of Extended-Spectrum β-Lactamase-Producing Uropathogenic Escherichia coli Among Iranian Kidney Transplant Patients. Infect Drug Resist 2020; 13:1429-1437. [PMID: 32523361 PMCID: PMC7237106 DOI: 10.2147/idr.s248572] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 05/05/2020] [Indexed: 12/21/2022] Open
Abstract
Introduction The aim of this study was to investigate the antimicrobial susceptibility pattern and the presence of ESBLs among the uropathogenic Escherichia coli (UPEC) isolated from kidney transplant patients (KTP) and community-acquired urinary tract infections (UTIs) using phenotypic and molecular methods. Materials and Methods A total of 111 pure cultures of UPEC isolates were collected from 65 and 46 of non-KTP and KTPs with UTIs. The pattern and ESBL production of the strains were evaluated. PCR reaction to detect the presence of bla SHV, bla TEM, and bla CTX-M genes was performed. Results The results revealed that most of UPEC isolates obtained from KTPs and control group were resistant to trimethoprim/sulfamethoxazole (84.8% vs 46.2%), while carbapenems (100% sensitivity) were the most effective against UPEC isolates. ESBL-producing strains were significantly more frequent in KTPs compared with control group (43.5% vs 23.1%, P = 0.021). The molecular results revealed that 53.2% (59/111), 45% (50/111), and 5.4% (6/111) of isolates harbored bla CTX-M, bla TEM, and bla SHV genes, respectively. Of the genes investigated, bla CTX-M and bla TEM genes were significantly higher among KTP than the control group. Conclusion Our results showed a high proportion of multidrug-resistant and ESBL-producing isolates, which most of them harbor blaCTX-M. A significant high co-resistance to different classes of antibiotics was reported from ESBL-producing UPEC from KTPs, which remains a serious clinical challenge.
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Affiliation(s)
- Mehrdad Halaji
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahrzad Shahidi
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdolamir Atapour
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behrooz Ataei
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Asghar Havaei
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Mirzaeian S, Saraf-Bank S, Entezari MH, Hekmatdoost A, Feizi A, Atapour A. Effects of synbiotic supplementation on microbiota-derived protein-bound uremic toxins, systemic inflammation, and biochemical parameters in patients on hemodialysis: A double-blind, placebo-controlled, randomized clinical trial. Nutrition 2020; 73:110713. [DOI: 10.1016/j.nut.2019.110713] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 12/15/2019] [Accepted: 12/18/2019] [Indexed: 10/25/2022]
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13
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Halaji M, Shahidi S, Atapour A, Ataei B, Feizi A, Havaei SA. <p>Characterization of Extended-Spectrum β-Lactamase-Producing Uropathogenic <em>Escherichia coli</em> Among Iranian Kidney Transplant Patients</p>. Infect Drug Resist 2020. [DOI: 10.2147/idr.s248572 and 21=21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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14
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Taheri D, Dolatkhah S, Aghaaliakbari F, Beinabadi Y, Atapour A, Shahidi S. P213 The association between mononuclear inflammatory cells infiltration and histopathologic changes of acute renal allograft rejection; a local experience and review of literatures. Hum Immunol 2019. [DOI: 10.1016/j.humimm.2019.07.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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15
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Fathi F, Atapour A, Eskandari N, Keyhanmehr N, Hafezi H, Mohammadi S, Motedayyen H. Regulatory T-cells and their impacts on cytokine profile of end-stage renal disease patients suffering from systemic lupus erythematosus. Int J Immunopathol Pharmacol 2019; 33:2058738419863238. [PMID: 31280608 PMCID: PMC6614948 DOI: 10.1177/2058738419863238] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/12/2019] [Indexed: 11/15/2022] Open
Abstract
Autoimmunity is an identified factor for development of end-stage renal disease (ESRD). Regulatory T-cells (Tregs) play a fundamental role in preventing autoimmunity. This study aimed to determine Treg frequency and its effects on cytokine profile of ESRD patients with and without systemic lupus erythematosus (SLE). Moreover, this study also determines how Treg number is affected by blood transfusion and gender. Peripheral blood mononuclear cells were isolated from 26 ESRD and 10 healthy subjects and stained with anti-CD4, anti-CD25, and anti-FoxP3 antibodies. Treg frequencies in ESRD patients with and without blood transfusion were determined by flow cytometry. Antibodies against human leukocyte antigens (HLAs) were investigated by panel-reactive antibodies screening. Tumor growth factor (TGF)-β1, interleukin (IL)-4, IL-10, TNF-α, IL-17A, and interferon (IFN)-γ serum levels in participants were measured by enzyme-linked immunoasorbent assay (ELISA). ESRD patients with SLE, unlike the patients without SLE, showed a significant reduction in Treg percentage compared to healthy subjects (P < 0.01). All women had a reduced number of Tregs compared to men. Treg number was significantly decreased in ESRD patients with HLA antibodies (P < 0.05). Blood transfusion enhanced Treg development in ESRD patients without SLE, unlike the patients with SLE (P < 0.05). ESRD patients with low Treg showed a reduction in TGF-β1 and IL-4 and an increase in TNF-α and IL-17A levels compared to control groups (P < 0.05-0.0001). However, no change was observed in IL-10 and IFN-γ levels. Treg frequency was negatively associated with the age of patients (P < 0.01), while this association was not observed in healthy subjects. Based on these findings, it can be observed that reduction in Treg number may contribute to ESRD development in patients with SLE.
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Affiliation(s)
- Farshid Fathi
- Department of Immunology, School of
Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdolamir Atapour
- Isfahan Kidney Diseases Research Center,
Isfahan University of Medical Sciences, Isfahan, Iran
- Internal Medicine Department, Isfahan
University of Medical Sciences, Isfahan, Iran
- Khorshid Hospital, Isfahan University of
Medical Sciences, Isfahan, Iran
| | - Nahid Eskandari
- Department of Immunology, School of
Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Niloufar Keyhanmehr
- Department of Immunology, Faculty of
Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Hafezi
- Department of Dermatology, Isfahan
University of Medical Sciences, Isfahan, Iran
| | - Shohreh Mohammadi
- Isfahan Kidney Diseases Research Center,
Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Motedayyen
- Autoimmune Diseases Research Center,
Shahid Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran
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Mazdak H, Ghavami M, Dolatkhah S, Daneshpajouhnejad P, Fesharakizadeh M, Fesharakizadeh S, Atapour A, Mahzouni P, Hashemi M, Salajegheh R, Taheri D. Pathological assessment of allograft nephrectomy: An Iranian experience. J Res Med Sci 2018; 23:55. [PMID: 30057639 PMCID: PMC6040153 DOI: 10.4103/jrms.jrms_440_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 09/20/2017] [Accepted: 04/16/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND The aim of this study was to determine the pathologic causes of renal allograft failure in transplant nephrectomy specimens. MATERIALS AND METHODS In this cross-sectional study performed in the referral transplant center of Isfahan, Iran, medical files of all patients who underwent nephrectomy in 2008-2013 were studied. Age at transplantation, sex, donor's characteristics, causes of primary renal failure, duration of allograft function, and pathologic reasons of nephrectomy were extracted. Slides of nephrectomy biopsies were evaluated. Data were analyzed using SPSS. RESULTS Medical files of 39 individuals (male: 56.4%; mean age: 35.1 ± 16.0 years) were evaluated. The main disease of patients was hypertension (17.9%), and most cases (64.1%) were nephrectomized < 6 months posttransplantation. Renal vein thrombosis (RVT) (51.3%) and T-cell-mediated rejection (TCMR) (41.0%) were the most prevalent causes of transplanted nephrectomy. Cause of primary renal failure was correlated to nephrectomy result (P = 0.04). TCMR was the only pathologic finding in all of patients nephrectomized >2 years posttransplantation. There were 14 cases in which biopsy results showed a relationship between primary disease of patients and pathologic assessment of allograft (P = 0.04). A significant relationship between transplantation-nephrectomy interval and both the nephrectomy result and histopathologic result existed (P < 0.0001). A relationship between primary allograft biopsy appearance and further assessment of nephrectomized specimen (P < 0.001) existed as well. CONCLUSION The most pathologic diagnoses of nephrectomy in a period of less than and more than 6 months posttransplantation were RVT and TCMR, respectively. Early obtained allograft protocol biopsy is suggested, which leads to better diagnosis of allograft failure.
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Affiliation(s)
- Hamid Mazdak
- Department of Urology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojgan Ghavami
- Department of Pathology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahaboddin Dolatkhah
- Department of Pathology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parnaz Daneshpajouhnejad
- Isfahan Medical Students’ Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Pathology, Isfahan Kidney Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Fesharakizadeh
- Department of Surgery, Najaf Abad Branch of Islamic Azad University, Isfahan, Iran
| | | | - Abdolamir Atapour
- Department of Nephrology, Isfahan University of Medical Sciences, Isfahan, Iran
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvin Mahzouni
- Department of Pathology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mozaffar Hashemi
- Department of Thoracic Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roxana Salajegheh
- Department of Pathology, Faculty of Medicine, Yazd University of Medical Sciences, Yazd, Iran
| | - Diana Taheri
- Department of Pathology, Isfahan University of Medical Sciences, Isfahan, Iran
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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17
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Naini MA, Mokarram P, Kavousipour S, Zare N, Atapour A, Zarin1 MH, Mehrabani G, Borji M. Sensitive and Noninvasive Detection of Aberrant SFRP2 and MGMT-B Methylation in Iranian Patients with Colon Polyps. Asian Pac J Cancer Prev 2017; 17:2185-93. [PMID: 27221916 DOI: 10.7314/apjcp.2016.17.4.2185] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The pathogenesis of sporadic colorectal cancer (CRC) is influenced by the patient genetic background and environmental factors. Based on prior understanding, these are classified in two major pathways of genetic instability. Microsatellite instability (MSI) and CPG island methylator phenotype (CIMP) are categorized as features of the hypermethylated prototype, and chromosomal instability (CIN) is known to be indicative of the non-hypermethylated category. Secreted frizzled related protein 2 (SFRP2), APC1A in WNT signaling pathway and the DNA repair gene, O6-methylguanine-DNA methyltransferase (MGMT), are frequently hypermethylated in colorectal cancer. Detection of methylated DNA as a biomarker by easy and inexpensive methods might improve the quality of life of patients with CRC via early detection of cancer or a precancerous condition. AIM To evaluate the rate of SFRP2 and MGMT hypermethylation in both polyp tissue and serum of patients in south Iran as compared with matched control normal population corresponding samples. MATERIALS AND METHODS Methylation-specific PCR was used to detect hypermethylation in DNA extracted from 48 polypoid tissue samples and 25 healthy individuals. RESULTS Of total polyp samples, 89.5% had at least one promoter gene hypermethylation. The most frequent methylated locus was SFRP2 followed by MGMT-B (81.2 and 66.6 percent respectively). Serologic detection of hypermethylation was 95% sensitive as compared with polyp tissue. No hypermethylation was detected in normal tissue and serum and its detection in patients with polyps, especially of serrated type, was specific. CONCLUSIONS Serologic investigation for detection of MGMT-B, SFRP2 hypermethylation could facilitate prioritization of high risk patients for colonoscopic polyp detection and excision.
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Affiliation(s)
- M Alizade Naini
- Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran E-mail :
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18
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Atapour A, Nasr S, Boroujeni AM, Taheri D, Dolatkhah S. A comparison of the quality of life of the patients undergoing hemodialysis versus peritoneal dialysis and its correlation to the quality of dialysis. Saudi J Kidney Dis Transpl 2016; 27:270-80. [PMID: 26997380 DOI: 10.4103/1319-2442.178259] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Over the years, there has been a steady increase in the number of patients requiring dialysis. However, no consensus exists between choosing either hemodialysis (HD) or peritoneal dialysis (PD) as the preferred method of dialysis for patients. In this study, we have compared the quality of life of the patients undergoing either HD or PD. This cross-sectional study was performed in the dialysis center of the Noor and Saint Ali Asghar University Hospital in Isfahan, Iran in 2012. Forty-six patients who underwent PD (28 males and 18 females) and 46 similar patients undergoing HD (26 males and 20 females) were compared. A standardized Persian version of the short form-36 (SF-36) tool was used to assess the quality of life and to assess the quality of dialysis weekly Kt/V in patients undergoing PD and single random Kt/V sampling in HD patients were assessed. Patients undergoing PD reported higher scores in physical functioning. The lowest scores in both groups were reported in mental health section. In physical functioning section, physical role functioning section and overall score of the SF-36 tool, PD patients reported significantly higher scores compared to the HD patients (P <0.05). There was no significant difference between the qualities of the dialysis in the two patient groups. Aspects of quality of life such as physical functioning, physical role functioning, bodily pain, general health perceptions, and overall score were significantly different between the two groups. If these results are substantiated by subsequent longitudinal studies, then the choice of dialysis could be better guided in patients by the quality of life issues.
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Affiliation(s)
- Abdolamir Atapour
- Department of Nephrology, Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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19
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Abstract
There is an increasing need for renal replacement therapy due to the growing number of cases with chronic kidney disease leading to end-stage renal disease. Two modalities of dialysis available are hemodialysis (HD) and peritoneal dialysis (PD). In this study, we aimed to compare the financial aspects of HD with PD. A total of 53 patients on HD and 43 patients on PD were included in the study and were assessed for several financial aspects of dialysis. The data collected were analyzed using SPSS-18. A statistically significant difference was noted between the HD and PD groups in the need for diagnostic tests, drugs, hospitalization, etc, with PD being less expensive. We strongly suggest physicians in our area to use PD on a larger number of patients for better financial outcome.
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Affiliation(s)
- Abdolamir Atapour
- Department of Nephrology, Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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20
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Taheri D, Sarmadi T, Shahidi S, Taheri S, Mortazavi M, Atapour A, Dolatkhah S, Moayednia R. Oxalate nephropathy after Jejuno-Ileal bypass surgery. Saudi J Kidney Dis Transpl 2015; 26:1026-7. [PMID: 26354586 DOI: 10.4103/1319-2442.164599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Diana Taheri
- Department of Pathology, Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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21
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Shahidi S, Ashrafi F, Mohammadi M, Moeinzadeh F, Atapour A. Low-dose pamidronate for treatment of early bone loss following kidney transplantation: a randomized controlled trial. Iran J Kidney Dis 2015; 9:50-55. [PMID: 25599737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 07/27/2014] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Kidney transplantation is associated with rapid loss of bone mineral density (BMD) in the first months after transplantation. The effect of pamidronate on bone loss after transplantation was evaluated in a randomized controlled trial. MATERIALS AND METHODS Forty patients were enrolled in this study (16 in the pamidronate group and 24 in the control group). Pamidrinate was administered as 30-mg intravenous infusion within 2 days after transplantation and 3 months later. All of the patients received calcium and vitamin D supplementation. Laboratory parameters and BMD (lumbar spine and femoral neck) were measured at baseline and 6 months after kidney transplantation. RESULTS Bone mineral density at the initiation of study had no significant differences between the two groups. In each group, BMD of femoral neck and lumbar spine had no significant differences 6 months after transplantation in comparison to pretransplantation values. There was no significant difference in BMD changes after intervention between two groups. Parathyroid hormone level normalized in both of the pamidronate and control groups 6 months after kidney transplantation. Glomerular filtration rate at the end of study was not significantly different between the two groups. CONCLUSIONS Our study suggests that administration of calcium and vitamin D following transplantation may be beneficial to counterbalance the substantial bone loss occurring within 6 months after transplantation, and addition of pamidronate has no beneficial effect in BMD in this short interval after kidney transplantation.
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Affiliation(s)
| | - Farzaneh Ashrafi
- Isfahan Kidney Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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22
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Pourfarzam M, Nia KM, Atapour A, Sadeghi HMM. The influence of BsmI and TaqI vitamin D receptor gene polymorphisms on the intensity of hyperparathyroidism in Iranian hemodialysis patients. Adv Biomed Res 2014; 3:213. [PMID: 25371870 PMCID: PMC4219211 DOI: 10.4103/2277-9175.143260] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 09/24/2013] [Indexed: 11/22/2022] Open
Abstract
Background: The influence of vitamin D receptor (VDR) gene polymorphisms on the regulation of the parathyroid hormone is important in end-stage renal disease (ESRD) patients. We analyzed rs1544410 (BsmI) and rs731236 (TaqI) polymorphisms of VDR gene in hemodialysis patients to determine their relationship with serum intact parathyroid hormone (iPTH). Materials and Methods: Ninety hemodialysis patients were included in this study. Patients were classified into four groups according to their serum iPTH level. Polymorphisms of VDR gene were surveyed using polymerase chain reaction-restriction fragment length polymorphism method with BsmI and TaqI enzymes in all the patients. Results: Patients age ranged between 30 and 60 years (mean ± SD: 36.0 ± 11.4) and period undergoing hemodialysis 80 ± 71 months. Patients were divided into four groups based on the serum concentration of iPTH. The distribution of VDR gene allelic variation for BsmI and TaqI polymorphisms was different between the four groups of uremic patients. Analysis of data revealed a significant correlation between the TaqI variants and serum iPTH level. There was also a correlation between the BsmI variants and serum iPTH level in that patients with the BB genotype were more likely to have a higher serum iPTH level. However, the latter was not statistically significant. Conclusions: Genotype of the TaqI and BsmI VDR gene polymorphisms is reported in Iranian patients with ESRD. Those with tt or BB genotypes may develop more severe secondary hyperparathyroidism.
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Affiliation(s)
- Morteza Pourfarzam
- Isfahan Pharmaceutical Sciences Research Center, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Khadijeh Mahboob Nia
- Isfahan Pharmaceutical Sciences Research Center, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdolamir Atapour
- Department of Nephrology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Mir Mohammad Sadeghi
- Department of Clinical Biochemistry and Biotechnology, Isfahan University of Medical Sciences, Isfahan, Iran
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Hami M, Shahidi S, Nouri-Majalan N, Atapour A, Fogazzi GB. A workshop on urinalysis and a survey on urine microscopy among kidney centers of Iran. Iran J Kidney Dis 2013; 7:432-438. [PMID: 24241087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 09/04/2013] [Indexed: 06/02/2023]
Abstract
Urinalysis is a mandatory diagnostic tool for the evaluation of patients with kidney diseases. A workshop on urinalysis was held for nephrologists in Isfahan, Iran, on October 11-12, 2012. After the presentation of the results of a survey of the nephrology centers of Iran on urine microscopy, the most important aspects of urinalysis were presented and discussed. These included the following: (1) urinalysis by dipstick, which provides results in a few seconds, is simple to use, has a low cost, and is used worldwide for screening purposes, in spite of some limitations; (2) measurement of proteinuria by 24-hour urine collection, which still represents the reference method in spite of limitations due to frequent over or under collection errors; (3) protein-creatinine ratio in a random urine sample, which is recommended by international guidelines as an alternative to the measurement of 24-hour protein excretion; (4) microalbuminuria, which is seen as a marker of systemic endothelial damage; and (5) the urinary sediment, which is underused even among nephrologists in spite of the relevant diagnostic information it can supply in a wide spectrum of kidney diseases.
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Affiliation(s)
- Maryam Hami
- Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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24
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Atapour A, Elham K, Shahidi S, Najafabadi MM, Hedayati P. Modification of diet in renal disease and Cockraft-Gaultformula accuracy in glomerular filtration rate estimation in Iranian adults. Adv Biomed Res 2013; 2:32. [PMID: 23977660 PMCID: PMC3748638 DOI: 10.4103/2277-9175.108771] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Accepted: 03/10/2012] [Indexed: 11/15/2022] Open
Abstract
Introduction: The aim of this study was to evaluate the accuracy of modification of diet in renal disease (MDRD) and Cockraft-Gault (C-G) formulas for estimating GFR in a sample of Iranian adult. Materials and Methods: This study was an analytic cross-sectional study on 54 patients with chronic kidney disease. Glomerular filtration rate was measured by kidney scan via TC99m-labeled diethylenetriaminepentaacetic acid, and it was estimated by MDRD and Cockraft-Gault formulas. Results: The mean of measured GFR and estimated GFR by MDRD and C-G formulas was 61.64 ± 34.26 ml/min, 51.80 ± 25.47, and 54.29 ± 24 ml/min respectively (P-value < 0.001, r = 0.818 and P-value < 0.001, r = 0.847, respectively). Pearson correlation test showed direct linear relationship between sGFR and GFR as estimated by the Cockraft-Gault and MDRD formulas. Conclusion: Based on our results, modification of diet in renal disease (MDRD) and Cockraf-Gault (C-G) formulas are accurate formulas in Iranian adults but they need a correction factor.
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Affiliation(s)
- Abdolamir Atapour
- Isfahan Kidney Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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25
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Abstract
Pulmonary arterial hypertension (PAH) is a serious cardiac complication among patients with end-stage renal disease (ESRD). We investigated pulmonary hypertension and its associated factors among patients who were on chronic dialysis and kidney transplant recipients. One hundred-eighty patients in three groups of hemodialysis (HD), peritoneal dialysis (PD), and kidney transplant were studied. Demographic and clinical characteristics and echocardiographic findings were evaluated. A multivariable linear regression model was used to find factors associated with pulmonary artery pressure. The mean age of participants was 50.3 ± 15.5 years and 63.9% were male. We found pulmonary hypertension (mean pulmonary artery pressure >25 mmHg) in 31.6%, 8.3%, and 5% of the patients on HD, PD, and transplant recipients, respectively (p < 0.001). In multivariate analyses, being on HD (B = 5.276, confidence interval [CI] 95%: 1.211-9.341), age (B = -0.319, CI 95%: -0.501 to -0.138), smoking (B = 11.631, CI 95%: 1.847-21.416), systolic cardiac dysfunction (B = 6.313, CI 95%: 3.073-9.554), and diastolic cardiac dysfunction (B = 5.227, CI 95%: 1.176-9.277) were associated with systolic pulmonary artery pressure. These results showed that pulmonary hypertension is a frequent cardiac complication among patients with ESRD, and the type of renal replacement therapy (HD), systolic and diastolic cardiac dysfunction, and smoking are associated with increased pulmonary artery pressure. Further studies with larger sample sizes and also prospective studies are recommended in this regard.
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Affiliation(s)
- Mokhtar Abedini
- Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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26
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Shahidi S, Pakzad B, Mortazavi M, Akbari M, Seirafian S, Atapour A, Al Saeidi S, Shayegannejad A. Reduction of proteinuria by pioglitazone in patients with non-diabetic renal disease. J Res Med Sci 2011; 16:1459-65. [PMID: 22973348 PMCID: PMC3430064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Accepted: 10/16/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND Increased proteinuria would lead to a larger risk for renal failure in the long term. Therefore, proteinuria requires immediate and thorough evaluation. This study was designed to evaluate the effects of pioglitazone on proteinuria in patients with non-diabetic renal disease. METHODS In this self-controlled clinical trial study, forty four non-diabetic patients aged 18 and more, who had renal disease and a stable proteinuria of over 0.5 g in 24 hour, were studied. All patients received 15 mg of daily pioglitazone for 4 months. Urine protein excretion was measured as a main end point prior to the study, at the end of the 2nd and 4th months of treatment, and 2 and 4 months after the cessation of the active drug. Other evaluated variables included systolic blood pressure, serum creatinine, urea, alanine aminotransferase (ALT), aspartate aminotransferase (AST), fasting blood sugar (FBS), blood urea nitrogen (BUN) and glomerular filtration rate (GFR) levels. RESULTS Proteinuria (mean ± SEM) prior to the study, at the 2nd and 4th months of the treatment, and 2 and 4 months after the cessation of pioglitazone were 1088.6 ± 131.1, 699.9 ± 118.3, 433.9 ± 68.7, 416.1 ± 54.9 and 646.9 ± 89.1, respectively (p < 0.001). In addition, the reduction of 24-hour urine protein was statistically significant for both male and female patients (p < 0.001 for both). CONCLUSIONS A reduction of proteinuria in patients with non-diabetic renal disease was observed during the 4-month treatment with pioglitazone which continued for 2 months after the cessation of the treatment. However, 4 months after the cessation of the treatment, a little increase was detected in the level of proteinuria.
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Affiliation(s)
- Shahrzad Shahidi
- Associate Professor, Isfahan Kidney Diseases Research Center, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahram Pakzad
- Internist, Isfahan Kidney Diseases Research Center, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,
Corresponding author: Bahram Pakzad E-mail:
| | - Mojgan Mortazavi
- Assistant Professor, Isfahan Kidney Diseases Research Center, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojtaba Akbari
- Epidemiologist, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shiva Seirafian
- Associate Professor, Isfahan Kidney Diseases Research Center, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdolamir Atapour
- Assistant Professor, Isfahan Kidney Diseases Research Center, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Samira Al Saeidi
- Internist, Department of Internal Medicine, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Khorasan Razavi, Iran
| | - Alireza Shayegannejad
- Internist, Isfahan Kidney Diseases Research Center, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Taheri S, Kafilzadeh F, Shafa M, Yaran M, Mortazavi M, Seirafian S, Shahidi S, Atapour A. Comparison of polyomavirus (BK virus and JC viruses) viruria in renal transplant recipients with and without kidney dysfunction. J Res Med Sci 2011; 16:916-22. [PMID: 22279460 PMCID: PMC3263105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2011] [Accepted: 07/03/2011] [Indexed: 11/14/2022]
Abstract
BACKGROUND Post-transplant infection with polyoma viruses (BK and JC viruses) is an important cause of graft loss and nephropathy. The objective of this study was to compare the frequency of BK and JC viruria in renal transplant recipients with and without graft dysfunction. METHODS In a case-control study, we selected 60 kidney transplant patients with and without graft dysfunction in the first two years after transplantation. Each group consisted of 30 patients evaluated for basic demographic and laboratory characteristics. First morning urine samples were sent for BK and JC virus detection with QIAamp DNA Mini Kit and real-time polymerase PCR. Chi-square test with Yates' correction, Student t-test and Mann-Whitney U test were used as indicated. P value of less than 0.05 was regarded as statistically significant. RESULTS Both groups were similar in age, gender, and time after transplant and pretransplant dialysis. In both groups, seven patients (23.3%) were JC virus positive whereas in case group 14 patients (46.7%) and in control group 9 patients (30%) were BK virus positive. There were no statistical significant difference between case and control groups for both JC and BK virus infection rate. CONCLUSIONS We concluded that JC and BK virus infection is very prevalent in the first 2 years after transplant and might be monitored appropriately.
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Affiliation(s)
- Shahram Taheri
- Associate Professor, Isfahan Kidney Diseases Research Center, Internal Medicine Department, Isfahan University of Medical Sciences, Isfahan, Iran.,
Corresponding Author: Shahram Taheri, E-mail:
| | - Farshid Kafilzadeh
- Associated Professor, Department of Biology, Jahrom branch, Islamic Azad University, Jahrom, Iran
| | - Maryam Shafa
- Master of Science, Department of Biology, Jahrom branch, Islamic Azad University, Jahrom, Iran
| | - Majid Yaran
- Medical Laboratory Doctor, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Science, Isfahan, Iran
| | - Mojgan Mortazavi
- Assistant Professor, Isfahan Kidney Diseases Research Center, Internal Medicine Department, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shiva Seirafian
- Associate Professor, Isfahan Kidney Diseases Research Center, Internal Medicine Department, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahrzad Shahidi
- Associate Professor, Isfahan Kidney Diseases Research Center, Internal Medicine Department, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdolamir Atapour
- Assistant Professor, Isfahan Kidney Diseases Research Center, Internal Medicine Department, Isfahan University of Medical Sciences, Isfahan, Iran
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Ferrieres J, Berkenboom G, Coufal Z, James S, Mohacsi A, Pavlides G, Norrbacka K, Sartral M, Paget MA, Tomlin M, Zeymer U, Hoffmann P, Keller F, Blicher TM, Hommel K, Abildstrom SZ, Madsen M, Kamper AL, Rogacev K, Pinsdorf T, Weingartner O, Gerhart M, Welzel E, van Bentum K, Menzner A, Fliser D, Lutjohann D, Heine G, Di Benedetto A, Marcelli D, Giordana G, Cerino F, Gatti E, Otero A, Dominguez-Sardina M, Castineira MC, Crespo JJ, Ferreras A, Mojon A, Ayala DE, Fernandez JR, Hermida RC, Investigadores Proyecto Hygia, Doi Y, Yoshihara F, Iwashima Y, Takata H, Fujii T, Horio T, Nakamura S, Kawano Y, Onofriescu M, Cepoi V, Segall L, Covic A, Kurnatowska I, Grzelak P, Kaczmarska M, Masajtis-Zagajewska A, Rutkowska-Majewska E, Stefanczyk L, Nowicki M, Gozhenko A, Susla O, Shved M, Mysula I, Susla H, Cordeiro Silva Junior AC, Smanio P, Amparo FC, Oliveira MAC, Gonzaga CC, Sousa MG, Passarelli Jr O, Borelli F, Lotaif LD, Sousa AGMR, Amodeo C, Inaguma D, Ando R, Ikeda M, Joki N, Koiwa F, Komatsu Y, Sakaguchi T, Shinoda T, Yamaka T, Shigematsu T, Pizzarelli F, Rossi C, Dattolo P, Tripepi G, Mieth M, Bandinelli S, Zoccali C, Mass R, Ferrucci L, Gifford F, Methven S, Boag DE, Spalding EM, MacGregor MS, Kirsch M, Dorhofer L, Bruning J, Banas B, Kramer BK, Schubert M, Boger CA, Dorhofer L, Kirsch M, Bruning J, Banas B, Kramer BK, Schubert M, Boger CA, Atapour A, Kalantari E, Shahidi S, Mortazavi M, Marron B, Quiros P, Vega N, Garcia-Canton C, Moreno F, Prieto M, Ahijado F, Salgueira M, Paez C, Castellano I, Lerma JL, De Arriba G, Martinez-Ocana JC, Morales A, Ramirez de Orellana M, Ramos A, Duarte V, Ruiz C, Gallego S, Ortiz A, Furuhashi T, Moroi M, Joki N, Hase H, Masai H, Kunimasa T, Nakazato R, Fukuda H, Sugi K, Valluri A, Severn A, Chakraverty S, Palma R, Polo A, Espigares MJ, Manjon M, Cerezo S, Garcia-Agudo R, Aoufi S, Ruiz-Carrillo F, Gonzalez-Carro P, Perez-Roldan F, Tenias JM, Santiago da Silva P, Cunha C, Coelho L, Viana A, Moreira R, Wagner S, Friedman R, Veloso V, Suassuna J, Grinsztejn B, Iimuro S, Imai E, Matsuo S, Watanabe T, Nitta K, Akizawa T, Makino H, Ohashi Y, Hishida A, Fujimoto S, Yano Y, Sato Y, Konta T, Iseki K, Moriyama T, Yamagata K, Tsuruya K, Yoshida H, Asahi K, Watanabe T, Bellasi A, Mandreoli M, Baldrati L, Rigotti A, Corradini M, Russo G, David S, Malmusi G, Di Nicolo P, Orsi C, Poisetti P, Zanbianchi L, Caruso F, Fabbri A, Santoro A, Moranne O, Couchoud C, Pradier C, Esnault V, Vigneau C, Skapinakis P, Ikonomou M, Kyroglou E, Chondrogiannis P, Sygelakis M, Varvara C, Kyriklidou P, Balafa O, Mavreas V, Tsakiris D, Goumenos D, Siamopoulos K, Ikonomou M, Skapinakis P, Eleftheroudi M, Chardalias A, Kyroglou E, Banioti A, Vakianos I, Sygelakis M, Kalaitzidis R, Asimakopoulos K, Tsakiris D, Goumenos D, Siamopoulos K, Methven S, Jardine A, MacGregor M, van der Tol A, Van Biesen W, De Groote G, Verbeke P, Eeckhaut K, Vanholder R, Ivkovic V, Karanovic S, Vukovic Lela I, Juric D, Fistrek M, Kos J, Kovac-Peic A, Pecin I, Premuzic V, Miletic-Medved M, Cvitkovic A, Fodor L, Jelakovic B. General & clinical epidemiology CKD 1-5 (1). Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Atapour A, Asadabadi HR, Karimi S, Eslami A, Beigi AA. Comparing the outcomes of open surgical procedure and percutaneously peritoneal dialysis catheter (PDC) insertion using laparoscopic needle: A two month follow-up study. J Res Med Sci 2011; 16:463-8. [PMID: 22091260 PMCID: PMC3214349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Accepted: 03/05/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND This study was performed to compare the outcomes of open surgical procedure and percutaneously peritoneal dialysis catheter (PDC) insertion using laparoscopic needle. METHODS This randomized clinical trial study was conducted in the Nephrology Department in Noor Hospital, Isfahan, Iran between 2009 and 2010. 64 uremic patients were randomized into two study groups using random allocation software. Thirty four catheters were inserted percutaneously (P group) and 30 catheters were placed surgically (S group). Collected information included demographic data, body mass index, and cause of renal disease, duration of operation and length of hospitalization. Outcomes were considered as mechanical and infectious complications. RESULTS There were no significant differences in age, gender, the mean of body mass index, having history of hemodialysis, diabetes mellitus, hypertension, ischemic heart disease, and length of hospitalization. Hemopenitoneom was more frequent in S group than P group (13.3% versus 3.2%; p < 0.0001). There was no significant difference between two groups in early peritonitis, early leakage, hernia, hollow viscous perforation, catheter obstruction, and malpositioning and the time of peritoneal dialysis onset. Outflow failure and the exit site infection were more frequent in S group than P group (p < 0.0001). Mean of the operative time was longer in S group than P group (27.70 ± 2.79 minutes versus 10.48 ± 1.91 minutes, p < 0.001). CONCLUSIONS Percutaneous catheter insertion has fewer rate of complications and is less time consuming in comparison with surgical method.
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Affiliation(s)
- Abdolamir Atapour
- Assistant Professor of Nephrology, Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hojatollah Raji Asadabadi
- Resident of General Surgery, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shirin Karimi
- Nurse of CAPD Ward, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Akram Eslami
- Nurse of CAPD Ward, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Akbar Beigi
- Associate Professor of Vascular Surgery, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran., Corresponding Author E-mail:
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Mortazavi M, Alsaeidi S, Sobhani R, Salimi F, Atapour A, Sharif N, Akbari M, Pakzad B, Jazi AHD. Successful prevention of tunneled, central catheter infection by antibiotic lock therapy using cefotaxime. J Res Med Sci 2011; 16:303-9. [PMID: 22091249 PMCID: PMC3214338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Accepted: 03/14/2011] [Indexed: 10/26/2022]
Abstract
BACKGROUND Chronic hemodialysis patients frequently require vascular access through central venous catheters (CVCs). The most significant complication of these catheters is infection. This risk can be lowered by the use of an antibiotic-Heparin lock. This study focuses on hemodialysis patients using Tunneled-cuffed catheters (TCC), to assess the rate of catheter-related infections (CRI) in catheter-restricted filling with Cefotaxime and Heparin in end stage renal disease patients. METHODS A double-blind randomized study was conducted to compare 5000 U/ml Heparin plus10 mg/ml cefotaxime (CE/HS) as catheter-lock solutions, with Heparin (5000 U/ml) alone. A total of 30 patients with end-stage renal disease and different etiologies, were enrolled for chronic hemodialysis with permanent catheters from December 2009 to March 2010. These patients were randomly assigned to two groups of 15 members. Blood samples were collected for culture, sensitivity, and colony count, from the catheter lumen and the peripheral vein. CRI was considered as the end point. RESULTS The rate of CRI was significantly lower in the cefotaxime group versus control group (p < 0.001). No exit site infection was occurred in both groups. Infection-free survival rates at 180 days were 100% for the CE/HS group, and 56% for the HS group. CONCLUSIONS Antibiotic lock therapy using cefotaxime reduces the risk of CRI in hemodialysis patients.
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Affiliation(s)
- Mojgan Mortazavi
- Isfahan Kidney Diseases Research Center, Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Samira Alsaeidi
- Isfahan Kidney Diseases Research Center, Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran., Corresponding Author E-mail:
| | | | - Fereshte Salimi
- Department of Vascular Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdolamir Atapour
- Isfahan Kidney Diseases Research Center, Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Mojtaba Akbari
- Isfahan Kidney Diseases Research Center, Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahram Pakzad
- Isfahan Kidney Diseases Research Center, Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Gheissari A, Salehi M, Dastjerdi SB, Jahangiri M, Hooman N, Otookesh H, Merikhipour A, Ajir A, Foroughmand A, Khatami S, Shahidi S, Atapour A, Seirafian S, Naeini AE. Angiotensin-converting enzyme gene polymorphism and the progression rate of focal segmental glomerulosclerosis in Iranian children. Nephrology (Carlton) 2008; 13:708-11. [PMID: 19076285 DOI: 10.1111/j.1440-1797.2008.00990.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM Focal segmental glomerulosclerosis (FSGS) is one of the most common forms of glomerulonephritis leading to end-stage renal disease (ESRD). A few clinical and paraclinical factors are considered as contributing factors in progression rate. However, there are controversial reports on the relationship between ACE gene polymorphism and rapidity of progression of FSGS to ESRD in different populations. To elucidate this issue, we investigated the relationship between the insertion (I) and deletion (D) ACE gene polymorphism and rapidity of progression of FSGS to ESRD in Iranian children. METHODS Forty-one children aged 1-18 years admitted to St AlZahra Hospital, Isfahan, and St Ali Asghar Hospital, Tehran, Iran, with idiopathic FSGS were enrolled. Renal death was defined as a glomerular filtration rate (GFR) of less than 50 mL/min per 1.73 m(2) or a decreased GFR to less than 50% compare to baseline. Reaching renal death in less or more than 2 years were labelled as rapid progressors (RP) or slow progressors (SP), respectively. Intron 16 of the ACE gene was amplified by the polymerase chain reaction technique. RESULTS Twenty-eight patients were male and 13 were female. In 15 RP patients, the genotype distribution was 26.6% DD, 6.7% II and 66.7% ID. In 26 SP patients, the genotype was similar (38.6% DD, 7.6% II and 53.8% ID, P > 0.05). There were no statistically significant differences for ACE I/D gene polymorphism between the two groups of patients (P > 0.05). CONCLUSION Our study revealed no correlation between ACE I/D gene polymorphism and rapidity of progression of FSGS to ESRD in Iranian children.
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Affiliation(s)
- Alaleh Gheissari
- Departments of Paediatric Nephrology, Isfahan University of Medical Sciences, Tehran, Iran.
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Atapour A, Mosakazemi M, Mortazavi M, Beigi A, Shahidi S. Access recirculation in jugular venous catheter in regular and reversed lines. Iran J Kidney Dis 2008; 2:91-94. [PMID: 19377215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
INTRODUCTION The aim of this study was to determine access recirculation in functioning catheters in the regular and reversed positions. MATERIALS AND METHODS Access recirculation was measured in 2 sequential hemodialysis sessions in patients with functioning internal jugular catheters inserted not earlier than 2 weeks before the study. The arterial and venous lines were in their regular position during the first session and they were reversed during the second measurement. Changes in access recirculation were assessed. Also, type of the catheter and number of catheter insertions were evaluated in relation to access recirculation. RESULTS Twenty-five of the patients had a permanent catheter and 5 had a temporary catheter. During the first session, the mean of access recirculation was 6.9 +/- 6.7% in the patients with a permanent catheter and 7.8 +/- 8.4% in those with a temporary catheter (P = .45). The mean access recirculation was 7.1 +/- 6.9% (range, 0 to 20%) in the 30 patients on hemodialysis with the arterial and venous lines in their regular positions. When the lines were reversed, access recirculation increased significantly (P = .01) to a mean of 20.5 +/- 20.5% (range, 2.3% to 75%). There was no significant correlation between the type of catheter or the number of catheter insertions and access recirculation. CONCLUSIONS After reversing the arterial and venous lines, access recirculation in both temporary and permanent functioning catheters may increase; therefore, dialysis adequacy might be impaired by reversed lines. Replacing malfunctioning catheters with new ones seems to be better than reversing the lines.
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Affiliation(s)
- Abdolamir Atapour
- Division of Nephrology, Department of Internal Medicine, Noor Hospital, Isfahan University of Medical Sciences, Esfahan, Iran.
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