The pattern of peri-hilar and hilar arterial branching in kidney allografts of living donors

Introduction: Kidney transplantation gives us the opportunity to study kidney vascular anatomical variations and their probable effect on allograft survival. Objectives: The aim of this study was to evaluate the renal arteries’ branching patterns of the engrafted kidneys and their impact on transplant outcomes. Patients and Methods: Three hundred patients who received kidney transplantation between 2014 -2017 were included. Peri-hilar and hilar branching patterns of the engrafted kidney were studied by reviewing the archived CT angiographies of donors and then they categorized based on the existing knowledge in this field. Clinical data were also gathered from medical records and recipients’ latest clinical and laboratory evaluations. Results: Based on peri-hilar and their corresponding hilar branching patterns, our morphology findings were classified into 17 groups. From different peri-hilar branching patterns, the fork pattern was more common which is detected in 95% (242) while the ladder pattern was observed in 5% (13) of kidney grafts. In a later branching sub-categorization, among the fork pattern, 65.2% (158) were duplicated and 34.7% (84) had triplicated hilar branching patterns. There was not a statistically significant correlation between each of those patterns and allograft function (P > 0.05). Conclusion: Peri-hilar and hilar branching patterns of the kidney allografts’ renal artery were different, but they follow certain patterns. Although it may not influence the allograft survival, it provides us precise knowledge about renal vasculature patterns and outcome of probable vascular events meanwhile; it could be useful in the field of transplantation.

Determination of free L-carnitine levels in type II diabetic women with and without complications

BACKGROUND

Studies on the determination of carnitine levels and nutritional status in patients of type II diabetes.

OBJECTIVE

We designed this study to determine changes of serum-free L-carnitine in type II diabetic women.

DESIGN

A cross-sectional study (case-control study).

SETTING

Clinical of Endocrinology and Metabolism, Sina Hospital, Pharmacological Research Center, Tabriz Medical university, Iran.

PATIENTS AND METHODS

Taking into account the importance of the control of diabetes, in the present case-control study, the levels of serum-free L-carnitine, blood glucose and lipids, systolic and diastolic blood pressure, body mass index (BMI) and nutritional status assessed in the case and control groups which were selected by the simple sampling method. The control group (n=18) included patients with no complications and the case group (n=33) was grouped into three subgroups including patients with retinopathy, hyperlipidemia and neuropathy.

RESULTS

Study results indicated that the mean serum-free L-carnitine concentration in the case group was significantly lower than its mean concentration level in the control group, 39.63+/-8.99 vs 53.42+/-0.93 micromol/l, respectively (P<0.001). Serum-free L-carnitine in retinopathy, hyperlipidemia and neuropathy case subgroups were 39.03+/-9.89, 39.63+/-8.99 and 40.44+/-12.50 micromol/l, respectively (P>0.05). No significant difference was found between the serum-free carnitine levels of the case subgroups. The mean blood glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol, very low-density lipoprotein cholesterol levels and systolic and diastolic blood pressure were significantly higher in the case group than in the control group.

CONCLUSION

In this study, the mean serum-free L-carnitine levels in diabetic patients with complications was almost 25% lower than in diabetic patients with no complications. On the basis of the study results, carnitine supplementation in diabetic patients, especially in patients with diabetes complications, might be useful.