Publications by authors named "Mohammadkazem Lebadi"

7 Publications

  • Page 1 of 1

Incidence and Risk Factors of Post-renal Transplantation Malignancies in North of Iran, A 20-year Experience.

Iran J Kidney Dis 2020 12;14(6):439-447

Urology Research Center, School of Medicine, Razi hospital, Guilan University of Medical Sciences, Rasht, Iran.

Introduction: The main causes of death in kidney transplant recipients are cardiovascular diseases and malignancy. This study aimed to determine the types of post-transplant malignancy, incidence, and related factors in renal transplant recipients referred to Razi Hospital in Rasht, Iran.

Methods: This retrospective cross-sectional study was conducted on 549 kidney transplant recipients between 1998 and 2018. Patient-, transplant-, and medication-related factors and pathology reports were recorded in the check list. Chi-square, T-test and Logistic Regression were used to investigate the effect of variables. Malignancy-person-year incidence rate was calculated using survival tables and Kaplan-Mayer analysis.

Results: 43 (7.8%) recipients had malignancies. The most common site of malignancy was the skin (53.5%). Non-Melanoma Skin Cancer (NMSC) was the most common cancer (32.6%) followed by Kaposi sarcoma (20.9%). The standardized incidence ratio (SIR) of post-transplant malignancies in renal transplant recipients was 26.9 times the malignancies in Guilan province and 21.7 times the malignancies in Iran. Cox proportional hazard models identified older age at the time of transplantation and history of azathioprine consumption seems to be associated with risk for post-transplant malignancy.

Conclusion: The most common malignancies in these people were non-melanoma skin cancer, Kaposi sarcoma and then GI malignancies. According to the information obtained in this study, regular periodic examinations of kidney transplant recipients for early detection of malignancy is important.
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December 2020

Analysis of risk factors influencing the BK polyomavirus replication in patients with ESRD waiting for kidney transplantation.

Microb Pathog 2020 Dec 10;149:104558. Epub 2020 Oct 10.

Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Background: Since the pre-transplant status affects the renal transplantation success and ultimately the survival rate, identifying the probable risk factors that increase the chance of BK virus replication in end-stage renal disease patients can be included in proposing proper surveillance guidelines during pre and post-transplantation.

Methods: A descriptive cross-sectional study was performed by collecting plasma samples from 192 ESRD patients undergoing hemodialysis for at least 3 months. Quantitative Real-time PCR assay was used to detect and measure the BK viral load. Demographic and clinical characteristics of the patients who had BK viremia were documented.

Results: 14 (7.3%) out of our 192 participants had BK virus viremia (95%CI 4.2%-11.6%). Demographic characteristics including etiology of ESRD and underlying diseases, mean duration and frequency of dialysis, co-infection with HBV and HCV did not affect the virus replication, since the difference between patients with BK virus viremia and BK virus negative individuals was not statistically significant. However, the statistical significance of the mean age of men with BKV and without BK virus viremia was found (OR: 3.42, P = 0.02 95%CI 0.86-13.61). Also, multiple regression analyses of some other parameters revealed that old age, high body mass index and male gender can be predictive factors of BK virus viremia in ESRD patients.

Conclusion: Based on our findings, elderly male had higher chance of being exposed to BK virus viremia. Some other demographic characteristics such as a high BMI, old age and gender (male) can increase the risk of BK viremia in patients with ESRD prior to kidney transplantation.
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December 2020

The authors' reply.

Transplantation 2014 Dec;98(11):e89-90

1 Urology Research Center School of Medicine Guilan University of Medical Sciences Rasht, Iran 2 School of Medicine Guilan University of Medical Sciences Rasht, Iran.

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December 2014

Hyperhomocysteinemia and assessment of its associated factors in renal transplant recipients: a single-center study in northern Iran.

Transplantation 2014 Jul;98(1):66-71

1 Urology Research Center, School of Medical, Guilan University of Medical Sciences, Rasht, Iran. 2 School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. 3 Address correspondence to: Seyyede Zeinab Azimi, M.D., Urology Research Center, School of Medical, Guilan University of Medical Sciences, Department of Nephrology, Razi Hospital, Rasht, Iran.

Introduction: Hyperhomocysteinemia (hyperHcy) is an important risk factor for atherosclerosis, which is currently a major cause of death in renal transplant patients (RTRs). The aim of this study was to determine the associated factors of hyperHcy in RTRs in northern Iran.

Methods: In 148 stable RTRs, total serum homocysteine (tHcy) level, folate, serum albumin and creatinine, creatinine clearance, lipid status, body mass index (BMI), and blood cyclosporine levels (C0 and C2) were determined. The mean doses of cyclosporine A (mg/kg/day) were recorded.

Results: In this analytic cross-sectional study the prevalence of hyperHcy was 70.3%. Hyperhomocysteinemia was defined as total serum homocysteine of 12 μmol/L or greater. The comparison of the group of 44 patients with tHcy level less than 12 and the group of 104 patients with tHcy level of 12 μmol/L or greater revealed that those subjects with hyperHcy were mostly younger, male, with lower BMI, history of glomerulonephritis, higher serum level of uric acid, and blood cyclosporine trough level (C0) and used higher doses of cyclosporine A. Significant correlation was found between tHcy level and recipients age, serum creatinine, BUN, folate concentrations, and creatinine clearance. However, multivariate analysis indicated that serum folate (P=0.01), vitamin B12 (P=0.05), creatinine (P=0.03), and BUN (P=0.05), and blood cyclosporine trough level (C0, P=0.005) were independently associated with tHcy levels.

Conclusion: HyperHcy persists after successful kidney transplantation in the majority of RTRs. Serum creatinine, BUN, folate and vitamin B12, and blood cyclosporine trough level (C0) are independently associated with tHcy levels.
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July 2014

Association of left ventricular hypertrophy with high-sensitive C-reactive protein in hemodialysis patients.

Int Urol Nephrol 2013 Dec 11;45(6):1679-86. Epub 2013 Jan 11.

Urology Research Center, Guilan University of Medical Sciences, Rasht, Iran,

Background: Micro inflammation and cardiovascular disease such as left ventricular hypertrophy (LVH) are common in hemodialysis (HD) patients. Hence, we have evaluated the relationship between high-sensitive C-reactive protein (hs-CRP), as an inflammation marker, and left ventricular mass index (LVMi) and left ventricular mass (LVM) in HD patients.

Methods: An analytical cross-sectional study was performed in 104 HD patients. Serum hs-CRP, LVMi, LVM, and blood pressure were evaluated; demographic data and duration of HD were also recorded. Finally, results were analyzed by using Student's t test, Pearson's correlation coefficient, one-way ANOVA and multiple regression to determine the relationship between LVMi and other variables.

Results: A total of 66 male patients (63.46 %) and 38 female patients, with a mean age of 51.75 ± 15.98 years-old, participated in this study. Hypertension was the most common underlying disease (65.4 %). The mean LVMi was 366.98 ± 120.89 g/m(2) and the mean hs-CRP was 8.55 mg/l. Eighty-nine percent of patients had LVH. The hs-CRP level was significantly associated with age and with LVM (P = 0.0001, P = 0.039, respectively). On multivariate analysis, hs-CRP and systolic blood pressure were found to be independent predictors of LVM and LVMi.

Conclusions: This study shows that hs-CRP and systolic BP are independent predictors of LVH in HD patients.
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December 2013

Distribution of renal histopathology in Guilan: a single-center report.

Iran J Kidney Dis 2012 May;6(3):173-7

Department of Internal Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Introduction: Glomerulonephritis is the third most common cause of end-stage renal disease. Epidemiological data of kidney disease is population-based and has great geographic variability. The aim of this study was to assess the results of all kidney biopsies in a 5-year period in the Guilan province.

Materials And Methods: In a retrospective study of 336 kidney biopsies recorded in the Department of Nephrology in Razi Hospital of Rasht, capital city of Guilan province, from August 2001 to September 2006, data consisting of age, gender, indication of kidney biopsy, and histopathological diagnosis were collected and analyzed.

Results: A total of 336 kidney biopsies were reviewed (73.8% males; mean age, 40.12 ± 16.78 years). Nephritic syndrome (42.5%) and nephrotic syndrome (38.7%) were the most frequent indications of biopsy. Overall, pathologic examinations were indicative of glomerulonephritis in 272 (81.0%) biopsies and nonglomerular diseases in 64 (19.0%). The most common cause of secondary glomerulonephritis was lupus nephritis (82.6%). Focal and segmental glomerusclerosis (20.5%) was the most common pathologic diagnosis, followed by membranous glomerulonephritis (14.9%), minimal change disease (11.6%), tubulointerstitial nephritis (8.9%), and IgA nephropathy (3.6%). The most common pathologic finding among glomerular diseases was focal segmental glomerusclerosis (25.4%), while tubulointerstitial nephritis (46.9%) was the most common among nonglomerular diseases, followed by diffuse glomerulosclerosis, interstitial fibrosis, and tubular atrophy indicative of end-stage renal disease (23.4%).

Conclusions: In our study, FSGS was the most common pathologic finding in kidney biopsies, and the frequency of IgA nephropathy was much lower than that in other studies.
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May 2012

QT intervals in patients receiving a renal transplant.

Exp Clin Transplant 2012 Apr;10(2):105-9

Urology Research Center, Guilan University of Medical Sciences, Urology Research Center, Razi Hospital, Sardar Jangal Street, Rasht, Iran.

Objectives: Cardiovascular disease is the most-common cause of mortality in patients with end-stage renal disease and renal transplant. Prolongation of QTc(max) and QTc dispersion are risk factors of cardiac arrhythmias and mortality. This study compares the changes of QT parameters before hemodialysis, after hemodialysis, and after renal transplant.

Materials And Methods: Patient candidates for renal transplant were selected. Mean serum electrolyte and 12-lead electrocardiogram were recorded (1) immediately, (2) before and, (3) after the last dialysis session before renal transplant, (4) and 2 weeks after a kidney transplant in 34 patients with normal graft function (plasma Cr ≤ 176.8 μmol/L). Each QT interval was corrected for the patient's heart rate using Bazett's formula. The QT parameters (QTd, QTcd, QTc(max)) were compared between prehemodialysis, posthemodialysis, and 2 weeks after renal transplant using a paired t test and a general liner model repeated measure. The correlation between QT parameter changes and serum electrolyte and acidbase alternation was analyzed.

Results: The corrected maximal QT interval (QTc(max)) decreased significantly after successful renal transplant compared to prehemodialysis (P = .002) and posthemodialysis (P = .003) with a paired t test and a General Liner Model Repeated Measure (P < .001) between the 3 groups. Also, the mean of QTc(max) decreased significantly after renal transplant (P = .001) compared to what it was before hemodialysis and after hemodialysis. There was a significant correlation (r= -0.37) between reduction of QTc(max) and serum Ca level (P = .01) in postrenal transplant period.

Conclusions: Renal transplant with normal graft function decrease QTc(max) compared to prehemodialysis and posthemodialysis that may correlate with normalization of electrolytes from the uremic state of the normal kidney function.
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April 2012