Publications by authors named "Seyed Seifollah Beladi-Mousavi"

32 Publications

Changes in body mass index after pediatric renal transplantation.

Saudi J Kidney Dis Transpl 2020 Mar-Apr;31(2):448-453

Department of Epidemiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Significant weight gain following renal transplantation is common in adult and pediatric recipients and mostly depends on receiving higher doses of steroids, changes in mood and feelings, as well as their level of physical activities. This study was performed to evaluate body weight and body mass index (BMI) before and after kidney transplantation in children and adolescents. In this cross-sectional study, 71 pediatric renal transplant recipients (42 boys and 29 girls) were included. World Health Organization criteria were used for comparing Z-score BMI for age in our cases. Overweight was defined as Z-score BMI >+1 SD (standard deviation) and obesity as >+2 SD. At the time of transplantation, the mean age was 10.8 ± 3 years (5-16 years) and based on BMIZ-score, the patients were found to be thin (BMIZs <-2 SD) in 16.9%, normal (BMIZs = -2 to +1 SD) in 67.6%, overweight (>+1 SD to +2 SD) in 9.9%, and obese (BMIZs >+2 SD) in 5.6%.The mean follow-up duration after transplantation was 3.57 ± 1.68 years (1-7 years) and at the time of reevaluation after transplant, their mean age was 14.4 years (6-18 years). The mean BMI was 22 ± 5.3 kg/m, and for BMI grouping, the patients were thin in 7%, normal in 54.9%, overweight in 21.1%, and obese in 17%. Pretransplant thinness (BMIZs <-2 SD) was found in 12 patients (16.9%), equally in boys and girls, and in most of them (83.3%), BMIZs changed to normal or even >+1 SD after transplant. Chronic continuous decrease of glomerular filtration rate (CCD/GFR) was found in 27 cases (38%); 74.1% were male (P = 0.045), hypertriglyceridemia was found in 74.1% (P = 0.023%), hypercholesterolemia in 63% (P = 0.032),and obesity in 18.5% (p = 0.5). The incidence of obesity has tripled after kidney transplantation. It was not a risk factor for graft or patient survival in our experience, whereas pretransplant obesity had some effects on long-term graft outcome.
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http://dx.doi.org/10.4103/1319-2442.284020DOI Listing
May 2020

Diabetes mellitus and end-stage renal disease.

Saudi J Kidney Dis Transpl 2018 Jul-Aug;29(4):1005-1006

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.4103/1319-2442.239662DOI Listing
July 2019

Pulmonary hypertension among patients undergoing hemodialysis.

J Renal Inj Prev 2017 4;6(2):122-126. Epub 2016 Dec 4.

Chronic Renal Failure Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

The epidemiology of pulmonary hypertension (PHT) among long-term hemodialysis patients has been described in relatively small studies in Iran. The purpose of this study was to evaluate the prevalence of PHT and its relationship among end-stage renal disease (ESRD) patients undergoing long-term hemodialysis (HD). In a cross-sectional study, patients with ESRD treated with HD for at least 3 months in the Imam hospital enrolled for the study. PHT was defined as an estimated systolic pulmonary artery pressure (PAP) equal to or higher than 25 mm Hg using echocardiograms performed by cardiologist. A total of 69 HD patients were included in the investigation. The mean of age of our patients was 52.6±15.3 years. The mean duration of HD was 39±36 months. The mean ejection fraction was 45±7%. The prevalence of PHT was 62.3%. These patients were more likely to have lower ejection fraction. The PHT was more common among female HD patients. We did not find any association between PHT and cause of ESRD, duration of HD, anemia and serum calcium, phosphor and parathyroid hormone levels. Our findings show that PHT is a common problem among ESRD patients undergoing maintenance HD and it is strongly associated with heart failure. It is necessary to screen this disorder among these patients.
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http://dx.doi.org/10.15171/jrip.2017.24DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423279PMC
December 2016

Prevalence and predictors of atherosclerotic renal artery stenosis in hypertensive patients undergoing simultaneous coronary and renal artery angiography; a cross-sectional study.

J Renal Inj Prev 2016 18;5(1):34-8. Epub 2016 Feb 18.

Chronic Renal Failure Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Introduction: According to the non-specific presentation of atherosclerotic renal artery stenosis (ARAS), this disease is usually an under-diagnosed in clinical conditions.

Objectives: The aim of the presence study was to evaluate the prevalence of renal artery stenosis (RAS) and its related risk factors in hypertensive patients undergoing coronary angiography.

Patients And Methods: In a cross-sectional study, between March 2009 and October 2010, all of hypertensive patients candidate for diagnostic cardiac catheterization, underwent nonselective renal angiography before completion of their coronary angiography procedure. A standardized questionnaire was used to collect demographics, cardiac history, indications for cardiac catheterization and angiographic data. The degree of ARAS was estimated visually by skilled cardiologist. Narrowing greater than 50% of the arterial lumen considered as arterial stenosis. Data was analyzed by SPSS version 19, and by chi-square test and logistic regression model.

Results: In overall 274 patients with mean age of 60.75 ± 10.92 years 108 (39.4%) were male and 166 (60.61%) were female. The prevalence of ARAS calculated 18.2%. According to the present study, heart failure and smoking were predictors of ARAS. However, old age, gender, diabetes mellitus, hyperlipidemia and family history of cardiovascular disease were not clinical predictors of significant ARAS in hypertensive patients, candidate for coronary angiography.

Conclusion: According to present data, we suggest to consider renal artery angiography in combination with coronary artery angiography especially in hypertensive patients who are smoker or individuals who have heart failure.
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http://dx.doi.org/10.15171/jrip.2016.08DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4827384PMC
April 2016

Contrast induced nephropathy among patients with normal renal function undergoing coronary angiography.

J Renal Inj Prev 2016 26;5(1):21-4. Epub 2016 Feb 26.

Chronic Renal Failure Research Center, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Introduction: Although contrast induced nephropathy (CIN) is a well-known complication of radiocontrast media administration among patients with underlying renal insufficiency, however the data about CIN among patients with normal renal function are few and it seems that CIN often remained under-diagnosed among these patients.

Objectives: The aim of present study was evaluation of CIN in diabetic and nondiabetic patients with normal renal function undergoing coronary angiography.

Patients And Methods: This cross-sectional and prospective study has conducted on patients with normal renal function candidate for diagnostic coronary angiography at Imam hospital, Ahvaz, Iran from October 2010 to February 2011. CIN defined as an increase in serum creatinine (sCr) >0.5 mg/dL after two days of contrast administration. A standardized questionnaire was used to collect demographics, clinical and laboratory data.

Results: A total of 254 patients (140 males and 114 Females with mean age of 56.6 ± 11.9 years) were included in the study. Of them, 60 patients (23.6%) had congestive heart failure (CHF) and 57 patients (22.4%) had diabetes mellitus (DM). The mean sCr levels before contrast administration in men and women were 1.05 ± 0.22 and 0.93 ± 0.17 mg/dL respectively. In overall CIN occurred in 27 patients (10.6%) with no difference between males and females (P = 0.386) and in patients with or without CHF (P = 0.766). There was a significant association between CIN and DM (P = 0.001) and mean volume of contrast administration (P = 0.001).

Conclusion: Although CIN is a common problem in patients with diabetic nephropathy undergoing coronary angiography, diabetic patients without diabetic nephropathy and also patients without DM who had normal renal function are also at risk of contrast nephropathy.
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http://dx.doi.org/10.15171/jrip.2016.05DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4827381PMC
April 2016

Restless Legs Syndrome: Associated Risk Factors in Hemodialysis Patients.

Nephrourol Mon 2015 Nov 29;7(6):e31967. Epub 2015 Nov 29.

Department of Pharmacology and Toxicology, Herbal Research Center, Pharmacy School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran.

Background: Restless legs syndrome (RLS) may be associated with increased morbidity and mortality among end-stage renal disease (ESRD) patients; however, it is a disorder that is neglected in dialysis centers.

Objectives: The goal of this study was to investigate the clinical factors associated with RLS among ESRD patients.

Patients And Methods: This cross-sectional study was conducted on ESRD patients undergoing maintenance hemodialysis (HD) in three HD centers in Ahvaz city in Southwest Iran. Blood samples were obtained prior to a dialysis session to check the routine laboratory test results and assess the adequacy of dialysis. The presence of RLS was assessed by using the international RLS study group (IRLSSG) diagnostic criteria. The IRLSSG rating scale was also used to evaluate the severity of the RLS symptoms.

Results: Of the 139 HD patients enrolled in this study, 60 were female (43.2%) and 79 were male (56.8%), with a mean age of 51.82 ± 13.31 years. The prevalence of RLS was 15.8% (22 patients), with 50% of them (11 patients) having severe or very severe symptoms. There was a significant relationship between RLS and longer durations of dialysis (P < 0.001). The mean level of serum ferritin was lower in patients without RLS, but it was not significant (P = 0.065). No significant differences were found according to age, gender, dialysis shifts, and hemoglobin (Hb) level among patients with and without RLS.

Conclusions: We conclude that a significant percentage of ESRD patients undergoing maintenance HD have severe or very severe RLS symptoms. The presence of RLS is associated to longer durations of dialysis.
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http://dx.doi.org/10.5812/numonthly.31967DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4744637PMC
November 2015

The effect of gabapentin on muscle cramps during hemodialysis: A double-blind clinical trial.

Saudi J Kidney Dis Transpl 2015 Nov;26(6):1142-8

Department of Nephrology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

Hemodialysis-associated muscle cramps (HAMC) are a common complication during hemodialysis (HD) sessions. A number of pharmacologic agents have been evaluated to prevent and or diminish HAMC; however, none of them has an established role. To the best of our knowledge, this is the first study to evaluate the possible effect of gabapentin on HAMC. In a double-blinded clinical trial, we compared the possible effect of gabapentin with a placebo in prevention and or diminishing episodes of HAMC in HD patients who had experienced frequent intradialytic muscle cramps. At first, placebo was given before each dialysis session for four weeks and then, after a two-week washout period, 300 mg of gabapentin was given before each dialysis session for four weeks to verify the effect of gabapentin on HAMC. Overall, 15 patients (seven men and eight women; mean age, 52.02 years) with frequent intradialytic muscle cramps were enrolled in the study. The incidence of symptomatic muscle cramp decreased in the gabapentin group compared with the placebo group, with a significant difference between them (P = 0.001). The intensity of muscle cramps also decreased in the gabapentin group (P = 0.001). There was no significant association between HAMC in male and female patients (P = 0. 397), mean age of HD patients (P = 0.226) and cause of end-stage renal disease (P = 0.551). According to the results of our study, gabapentin prescription before each HD session significantly reduced the frequency and the intensity of muscle cramps during HD without any major side-effects.
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http://dx.doi.org/10.4103/1319-2442.168588DOI Listing
November 2015

Effect of sour tea (Lipicom) pill versus captopril on the treatment of hypertension.

J Renal Inj Prev 2015 1;4(3):73-9. Epub 2015 Sep 1.

Department of Internal Medicine, Semnan University of Medical Sciences, Semnan, Iran.

Introduction: Herbal medicines are traditionally prescribed to manage blood pressure.

Objectives: We aimed to evaluate effect of sour tea pill containing the herb's extract versus captopril on the treatment of hypertension.

Patients And Methods: In our crossover clinical trial 20 patients were enrolled in the study and advised for life style modification then the participants were randomly divided into 2 groups. Sour tea pills was prescribed at a dose of 500 mg and captopril at a dose of 12.5 mg twice daily. In order to improve precision and final measurement, ambulatory blood pressure monitoring (ABPM) was performed both prior and after measuring the hypertension in 2 successive visits. After 6 weeks of therapy, the methods changed and 6 weeks later ABPM was performed three times (baseline, at end of the 6th and 12th week). The 2 groups were merged together before data analysis.

Results: Of the 20 patients, 13 (65%) were male and 7 (35%) were female. No significant difference of sex, age, and job was detected between 2 groups (P ≥ 0.05). Mean decreasing in systolic blood pressure was 7.75 ± 8.3 and 13.3 ± 16.1 mm Hg in the captopril and sour tea groups, respectively. Also, mean decline in diastolic blood pressure decreases was 2.15 ± 4.14 and 5.8 ± 7.8 mm Hg for captopril and sour tea groups, respectively. No side effect was observed in the sour tea pill group in the study.

Conclusion: According to the effect of sour tea pill on decreasing blood pressure, without giving priority over captopril, sour tea pill containing the herb's extract can be prescribed as an adjuvant therapy for lowering the prescribed dosage of captopril.
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http://dx.doi.org/10.12861/jrip.2015.15DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4594217PMC
October 2015

Prevention of cisplatin nephrotoxicity.

J Nephropharmacol 2016 22;5(1):57-60. Epub 2015 Aug 22.

Chronic Renal Failure Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Cisplatin has a well-established role in the treatment of broad spectrum of malignancies; however its use is limited because of cisplatin-induced nephrotoxicity (CIN) which can be progressive in more than 50% of cases. The most important risk factors for CIN include higher doses of cisplatin, previous cisplatin chemotherapy, underlying kidney damage and concurrent treatment with other potential nephrotoxin agents, such as aminoglycosides, nonsteroidal anti-inflammatory agents, or iodinated contrast media. Different strategies have been offered to diminish or prevent nephrotoxicity of cisplatin. The standard approach for prevention of CIN is the administration of lower doses of cisplatin in combination with full intravenous hydration prior and after cisplatin administration. Cisplatin-induced oxidative stress in the kidney may be prevented by natural antioxidant compounds. The results of this review show that many strategies for prevention of CIN exist, however, attention to the administration of these agent for CIN is necessary.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5297508PMC
August 2015

Diabetes and end-stage renal disease; a review article on new concepts.

J Renal Inj Prev 2015 1;4(2):28-33. Epub 2015 Jun 1.

Chronic Renal Failure Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

It is well established that diabetic nephropathy is the most common cause or in combination with hypertensive nephropathy are the most common causes of end-stage renal disease (ESRD) in developed and developing countries. For this review, we used a variety of sources by searching through PubMed, Embase, Scopus, Current Content and Iran Medex from January 1990 up to December 2014. Manuscripts published in English and Persian languages, as full-text articles, and or as abstract were included in the study. Patient survival in diabetics on maintenance renal replacement therapy including hemodialysis (HD), peritoneal dialysis (PD) and kidney transplantation is significantly lower than that seen in nondiabetics with ESRD. The poor prognosis of diabetic patients with ESRD is partly due to presence of significant cardiovascular disease, problems with vascular access, more susceptible to infections, foot ulcer, and hemodynamic instability during HD. Although, many complications related to kidney transplantation may occur in diabetic ESRD patients, multiple studies have found that the kidney transplantation is the preferred renal replacement therapy for diabetic patients with ESRD and it is associated with a much better survival and quality of life than dialysis among these patients.
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http://dx.doi.org/10.12861/jrip.2015.07DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4459725PMC
June 2015

Stability of renal function in spite of low glomerular filtration rate: a case report.

Iran Red Crescent Med J 2015 Feb 25;17(2):e21604. Epub 2015 Jan 25.

Chronic Renal Failure Research Center, Jundishapur University of Medical Sciences, Ahvaz, IR Iran.

Introduction: Chronic renal dysfunction is a progressive and irreversible process in kidney function, which often resulted in chronic kidney disease (CKD) or chronic renal failure (CRF). Range of CKD is varying from proteinuria and renal failure to CRF.

Case Presentation: A 78-year-old man presented with stage 4 CKD for 7 years; the glomerular filtration rate (GFR) and creatinine levels remained constant despite no change in his weight.

Conclusions: Although our patient had CKD stage 4, but his condition has not deteriorated and remained constant and stable for several years only by control of blood pressure and usual treatment which prescribed for patients at this stage.
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http://dx.doi.org/10.5812/ircmj.21604DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4379326PMC
February 2015

Vasopressin and prevention of hypotension during hemodialysis.

Iran Red Crescent Med J 2014 Nov 5;16(11):e20219. Epub 2014 Nov 5.

Department of Internal Medicine, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, IR Iran.

Context: The occurrence of intradialytic hypotension (IDH) during hemodialysis (HD) continues to be a main problem in patients with ESRD (end-stage kidney disease). It also negatively affects health-related quality of life. We aimed to determine vasopressin effect in decreasing IDH.

Evidence Acquisition: We reviewed clinical and experimental literature in a variety of sources, including PubMed, Current Content, Scopus, Embase, and Iranmedex regarding the possible effect of vasopressin administration in prevention of hypotension during HD to clarify its mechanism, efficacy, and safety.

Results: Although arginine vasopressin is widely recognized for its anti-diuretic properties, it is also a well-recognized vasoconstrictor. It has been shown that the vasopressin release (as it would normally be expected) does not increase in the majority of HD patients with recurrent dialysis hypotension. In addition, it has also been reported that vasopressin secretion (due to the osmotic stimulation) is the most important mechanism in blood pressure control in ESRD patients receiving hypertonic solution for IDH. Therefore, it is suggested that vasopressin administration may improve hemodynamic stability among ESRD patients during HD. There are few clinical trials about this issue, suggesting that administration of exogenous vasopressin may be significantly associated with a decreased incidence of IDH as well as cardiovascular stability in ESRD patients in need of volume removal during HD.

Conclusions: Vasopressin insufficiency may have an important role in the pathogenesis of hemodynamic instability during HD and administration of exogenous vasopressin is significantly associated with a lower incidence of IDH.
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http://dx.doi.org/10.5812/ircmj.20219DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4329956PMC
November 2014

Comparison of survival in patients with end-stage renal disease receiving hemodialysis versus peritoneal dialysis.

Saudi J Kidney Dis Transpl 2015 Mar;26(2):392-7

Department of Pediatric, Jundishapour University of Medical Sciences, Ahvaz, Iran.

Although the life expectancy of patients with end-stage renal disease (ESRD) has improved in recent years, it is still far below that of the general population. In this retrospective study, we compared the survival of patients with ESRD receiving hemodialysis (HD) versus those on peritoneal dialysis (PD). The study was conducted on patients referred to the HD and PD centers of the Emam Khomini Hospital and the Aboozar Children's Hospital from January 2007 to May 2012 in Ahvaz, Iran. All ESRD patients on maintenance HD or PD for more than two months were included in the study. The survival was estimated by the Kaplan-Meier method and the differences between HD and PD patients were tested by the log-rank test. Overall, 239 patients, 148 patients on HD (61.92%) and 91 patients on continuous ambulatory PD (CAPD) (38.55%) with mean age of 54.1 ± 17 years were enrolled in the study. Regardless of the causes of ESRD and type of renal replacement therapy (RRT), one-, two- and three-year survival of patients was 65%, 51% and 35%, respectively. There was no significant difference between type of RRT in one- (P-value = 0.737), two- (P-value = 0.534) and three- (P-value = 0.867) year survival. There was also no significant difference between diabetic and non-diabetic patients under HD and CAPD in the one-, two- and three-year survival. Although the three-year survival of diabetic patients under CAPD was lower than that of non-diabetic patients (13% vs. 34%), it was not statistically significant (P-value = 0.50). According to the results of the current study, there is no survival advantage of PD during the first years of initiation of dialysis, and the one-, two- and three-year survival of HD and PD patients is also similar.
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http://dx.doi.org/10.4103/1319-2442.152559DOI Listing
March 2015

The role of diabetes mellitus and hypertension in chronic kidney disease.

J Renal Inj Prev 2014 1;3(4):109-10. Epub 2014 Dec 1.

Chronic Renal Failure Research Center, Department of Internal Medicine, Ahvaz University of Medical Sciences, Ahvaz, Iran.

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http://dx.doi.org/10.12861/jrip.2014.31DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4301389PMC
January 2015

Administration of antioxidants in chronic kidney disease.

J Nephropharmacol 2015 1;4(1):9-11. Epub 2015 Jan 1.

Chronic Renal Failure Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5297480PMC
January 2015

Epidemiology of hepatitis e virus infection in patients on chronic hemodialysis.

Jundishapur J Microbiol 2014 May 1;7(5):e6993. Epub 2014 May 1.

Department of Chemistry, Islamic Azad University of Omidiyeh Branch, Omidiyeh, IR Iran.

Background: Many studies have been done on the epidemiology of Hepatitis E on general population, but the data among patients with end stage renal disease (ESRD) are few and give conflicting results.

Objectives: The aim of this study was to investigate the prevalence of hepatitis E virus (HEV) infection and its relationship in ESRD patients undergoing maintenance hemodialysis (HD).

Patients And Methods: This cross-sectional study was carried out on ESRD patients treated with HD in Imam Khomeini Hospital, Ahvaz city, Southwest of Iran. Blood sampling of patients was collected immediately before the dialysis session and the serum were evaluated for anti-HEV IgG titers by enzyme-linked immunosorbent assays. The statistical package for social sciences (SPSS) version 15 software was used for data analysis.

Results: Out of 47 ESRD patients, 27 were male (57.4%) and 20 were female (42.6%), with mean age of 55.27 ± 8.1 years. The prevalence of anti-HEV antibody was 10.6 % (five patients, four male and one female). The mean age of HEV positive and negative patients were 58 ± 5.52 and 53.82 ± 15.55 years, respectively without any significant difference (P = 0.058). There also was no significant association between HEV and gender (P = 0.28). The mean time of HD in HEV positive and negative patients were 1224.2 and 1168.5 days, respectively with no significant association (P = 0.88). In addition, there also was no association between HEV and HCV (P = 0.61).

Conclusions: According to the present study, the prevalence of anti-HEV IgG antibody was 10.63 % among chronic HD patients and there was no association between HEV, age, gender, duration of HD and HCV antibody titer.
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http://dx.doi.org/10.5812/jjm.6993DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4138630PMC
May 2014

The theme of the world diabetes day 2014; healthy living and diabetes; a nephrology viewpoint.

J Nephropharmacol 2014 1;3(2):43-45. Epub 2014 Jul 1.

Department of Physical Education and Sport Science, Khorasgan University, Isfahan, Iran.

Annually, on November 14, the world diabetes day (WDD) is celebrated. WDD is a campaign led by the International Diabetes Federation (IDF) and its member associations throughout the world. It was created in 1991 by IDF and World Health Organization (WHO) in response to increasing concerns about the intensifying threat of diabetes worldwide. The WDD 2014 organization marks the first of a three-year (2014-16) emphasis on "healthy living and diabetes". Replacement of whole grain and cereal-based foods with refined grains in diet planning could be an operative and practical strategy in type II diabetic patients. This strategy beyond the development of glycemic control, leads to more benefits for management of other features of diabetes, diminution of diabetes-induced metabolic disorders, and prevents long-term complications especially diabetic kidney disease and cardiovascular disease.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5297527PMC
July 2014

Epidemiology of end-stage renal disease in Iran: a review article.

Saudi J Kidney Dis Transpl 2014 May;25(3):697-702

Department of Internal Medicine, Kashan University of Medical Sciences, Kashan, Iran.

The prevalence and incidence of end-stage renal disease (ESRD) are increasing in developed and developing countries, and this will place an enormous financial burden for health-care systems. The exact reasons of the rising prevalence of ESRD patients are unknown, but it can be attributed to an increase in the prevalence of diabetes mellitus and hypertension as the most common causes of ESRD. However, in contrast to the developed countries, the etiology of ESRD in the significant percent of patients with ESRD in Iran is unknown. In our country, the patients with chronic kidney diseases present themselves to the hospital only when they have severe symptoms of uremia, and, at this time, determining the primary cause of ESRD is often not possible. In addition, although the prevalence and incidence of ESRD are also significantly increasing in Iran in recent years, they are still lower compared with developed countries, which may also be due to poor referral resulting in the under diagnosis of ESRD. The aim of this review is to evaluate the epidemiologic aspects of ESRD in Iran, including demographic data, cause of ESRD, kind of renal replacement therapies implemented and their survival.
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http://dx.doi.org/10.4103/1319-2442.132242DOI Listing
May 2014

The protective effect of theophyline in cisplatin nephrotoxicity.

Saudi J Kidney Dis Transpl 2014 Mar;25(2):333-7

Islamic Azad University, Omidiyeh, Khuzestan, Iran.

Cisplatin is a potent and a major anti-neoplastic drug in the treatment of a broad spectrum of malignancies. However, its clinical use is limited by renal tubular dysfunction that occurs in a significant percent of patients. The aim of the present study was to evaluate the possible protective effect of theophyline in the prevention of cisplatin-induced nephrotoxicity. The trial design was prospective, randomized, double-blinded and placebo controlled. Chemotherapeutic patients who received cisplatin at a dosage of at least 50 mg/m 2 alone or in combination with other chemotherapy agent(s) were included in the study. There were a total of 76 patients who were randomly divided into two groups. In group 1 (n = 38), placebo was advised; in group 2 (n = 38), patients received 4 mg/kg aminophyline as an intravenous loading dose, followed by theophyline in a dose of 200 mg three times daily orally for four consecutive days. The placebo group had 22 males and 16 females and the theophyline group had 26 males and 12 females. The mean age was 51 ± 17.6 years and the mean dose of cisplatin was 86.71 ± 43.18 mg. The prevalence of cisplatin nephrotoxicity in groups 1 and 2 was 7.9 and 5.3%, respectively, and the difference was not significant (P = 1). In addition, there was no significant association of cisplatin nephrotoxicity with age (P = 0.1), gender (P = 0.64) and mean dose of cisplatin (P = 0.8). These results indicate that prophy-lactic application of aminophyline and theophyline does not have a protective effect against cisplatin nephrotoxicity.
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http://dx.doi.org/10.4103/1319-2442.128528DOI Listing
March 2014

Dose kidney transplant nephrectomy stop disease progression in plasma exchange resistant post transplant hemolytic uremic syndrome? A case report.

J Nephropathol 2013 Jan 1;2(1):85-9. Epub 2013 Jan 1.

Department of Chemistry, Behbahan Branch, Islamic Azad University, Behbahan, Iran.

Background: Two different case reports, which have been published previously, suggested that bilateral nephrectomy can improve sever and refractory hemolytic uremic syndrome (HUS) in adults without a history of transplantation. At this study, kidney transplant nephrectomy in a patient with sever post transplant HUS was investigated.

Case: Patient was a 55 years old man with a single small size kidney and end-stage renal disease (ESRD). He had received a kidney from an unrelated donor three months before admission. The patient was admitted with fever and acute renal failure. Clinical and laboratory evaluation wereconsistent with sever De novo hemolytic uremic syndrome (HUS). Different therapeutic regimens administered in this patient including intensive plasma exchange, plasma infusion, empirical antibiotics, and high doses of corticosteroid. Although Cyclosporine was changed to Tacrolimus. After 45 days of treatment, patient's condition did not improve and sever thrombocytopenia (10000-15000/µL) developed. Patient was also suffered from severe hypersensitivity reaction (fever, chills, and itching) following each plasma exchange. Kidney transplant nephrectomy was done. However, sever post operativebleedingoccurred.HUS and thrombocytopenia did not improve and patient died two days after operation.

Conclusions: According to this experience, Kidney transplant nephrectomy may not be an effective treatment and is not recommended in the treatment of severe and refractory post transplant HUS.
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http://dx.doi.org/10.5812/nephropathol.8944DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3886173PMC
January 2013

Renal bone disease among patients with ESRD.

Nephrourol Mon 2013 Jul 5;5(3):849-50. Epub 2013 Jun 5.

Department of Internal Medicine, Faculty of Medicine, Jundishapour University of Medical Sciences, Ahvaz, IR Iran.

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http://dx.doi.org/10.5812/numonthly.9556DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3830916PMC
July 2013

A review article: access recirculation among end stage renal disease patients undergoing maintenance hemodialysis.

Nephrourol Mon 2013 30;5(2):728-32. Epub 2013 Mar 30.

Department of Nephrology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran.

Background: The presence of arterio-venous (A-V) fistula recirculation among hemodialysis (HD) patients markedly decrease adequacy of dialysis.

Objectives: The present article summarize some of observations about clinical significance, causes, the most common techniques for measurement, and main source of pitfall in calculation of access recirculation.

Materials And Methods: A variety of literature sources such as PubMed, Current Content, Scopus, Embase, and Iranmedex; with key words such as inadequate dialysis and arterio-venous fistula access recirculation were used to collect current data. Manuscripts published in English language as full-text articles or as abstract form were included in our review study.

Results: Any access recirculation among HD patients should be considered abnormal and if it presents prompt investigation should be performed for its causes. There are two most common techniques for accurate assessment of access recirculation: Urea (or chemical) and nonurea-based method by ultrasound dilution technique. The most common causes of access recirculation are the presence of high-grade venous stenosis, inadequate arterial blood flow rate, close proximity, or misdirection of arterial and venous needles placement by HD staff especially in new vascular accesses due to a lack of familiarity with the access anatomy.

Conclusions: The presence of access recirculation among HD patients can lead to significant inadequate dialysis thereby resulting in reducing the survival of these patients. Therefore, periodic assessment of access recirculation should be performed in HD wards.
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http://dx.doi.org/10.5812/numonthly.6689DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3703129PMC
July 2013

Erythropoietin; a review on current knowledge and new concepts.

J Renal Inj Prev 2013 10;2(4):119-21. Epub 2013 Oct 10.

Department of Internal Medicine, Ahvaz Jundishapour University of Medical Sciences, Ahvaz, Iran.

Chronic kidney disease (CKD) is a worldwide health problem. However, despite to new routes of dialysis, mortality and morbidity is high. One of the most common symptom of CKD is anemia, especially is more obvious in stages 3 and 4. In this review, we compared the effects of erythropoietin and anemia correction on kidney function (GFR) by investigating in various studies. Despite extensive studies in this category, still we do not sure about the effects of erythropoietin and anemia correction on the glomerular filtration rate.
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http://dx.doi.org/10.12861/jrip.2013.38DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4206029PMC
October 2014

Long-term survival of patients with end-stage renal disease on maintenance hemodialysis: a multicenter study in Iran.

Iran J Kidney Dis 2012 Nov;6(6):452-6

Department of Nephrology, Jundishapur University of Medical Sciences, Ahvaz, Iran.

Introduction: Although maintenance dialysis in patients with end-stage renal disease prevents death from uremia, patient survival remains an important issue. This study is the first in Iran to evaluate long-term survival of patients with ESRD.

Materials And Methods: This retrospective study was conducted on 1861 patients with ESRD referred to 12 hemodialysis centers in Khuzestan province, Iran. The period of study was 21 years, which was between 1989 to may 2010. The median follow-up duration was 46.0 months. Patients who died within 90 days of commencing dialysis were excluded. The patient's death as outcome measure was recorded and the survival was estimated by the Kaplan-Meier method.

Results: The mean age of 1861 patients at initiation of hemodialysis was 51.2 ± 17.2 years, and 1120 were men (60.2%). Diabetes mellitus (32.9%) and hypertension (24.1%) were the most common known causes of ESRD in our patients. Regardless of the cause of ESRD, 1-, 5-, 10-, and 15-year survival of hemodialysis patients was 83%, 25.2%, 3.8%, and 1.0% respectively. Survival of diabetic patients was significantly lower than nondiabetic patients (P <.001) and no one of diabetic patients survived up to 10 years.

Conclusions: Based on our findings, the survival of ESRD patients undergoing hemodialysis in Iran is relatively poor, especially among diabetics. This can be explained by socioeconomic differences and the fact that dialysis patients who are otherwise healthy and are more likely to survival for a longer time have higher chances of receiving a kidney transplant in Iran.
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November 2012

Hyperuricemia; a new look at an old problem.

J Nephropharmacol 2012 1;1(2):13-14. Epub 2012 Jul 1.

Department of Internal Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5297576PMC
July 2012

Efficacy of topical cromolyn sodium 4% on pruritus in uremic nephrogenic patients: a randomized double-blind study in 60 patients.

Int J Clin Pharmacol Ther 2012 Jul;50(7):510-3

AJA University of Medical Sciences, Tehran, Iran.

Background: Chronic kidney disease (CKD)-associated pruritus is a significant clinical symptom affecting more than 50% of patients on hemodialysis. The availability of effective therapeutic options for management of CKD-associated pruritus remains a treatment challenge.

Objective: The aim of this study was to compare cromolyn sodium cream 4% with placebo for the treatment of renal pruritus.

Methods: A randomized, double-blind, prospective, 4-week study was designed. 60 patients with ESRD in our dialysis ward were randomly allocated to cromolyn sodium cream 4% or placebo. All of them completed the study period and their pruritus levels were evaluated 5 times (before the start of the study and at the end of each week for 4 weeks) using a Visual Analogue Scale (VAS).

Results: The average pruritus score before administration of the drug in cromolyn sodium 4% and placebo group had been 2.5 ± 1.1 and 2.7 ± 1.3, respectively. In the cromolyn sodium 4% group the average score of pruritus gradually reduced to 0.3 ± 1.3 and in the placebo group it gradually decreased to 1.3 ± 1.4 at the end of Week 4. Method of t-test repeat analytical measurement indicated that there is no significant difference between reduction of pruritus in cromolyn 4% and placebo groups in the first and second week of the study, but in third and fourth week there were significant differences in reducing pruritus in favor of cromolyn sodium 4% (p < 0.04).

Conclusion: According to our study cromolyn sodium cream 4% was more effective than placebo in reducing pruritus in uremic patients. We suggest to our colleagues to consider this treatment when facing a patient suffering from this symptom.
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http://dx.doi.org/10.5414/cp201629DOI Listing
July 2012

Metformin improves diabetic kidney disease.

J Nephropharmacol 2012 1;1(1):1-2. Epub 2012 Jan 1.

Department of Internal Medicine, Semnan University of Medical Sciences, Semnan, Iran.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5297539PMC
January 2012

Tuberous sclerosis, deep vein thrombosis and lack of C and S proteins: A case report.

J Renal Inj Prev 2012 1;1(1):33-6. Epub 2012 Jan 1.

Department of Chemistry, Behbahan Branch, Islamic Azad University, Behbahan, Iran.

Introduction: Tuberous sclerosis, an autosomal dominant disorder, is characterized by hamartomas in different organs of body. Kidney involvement is quite common in this disorder and sometimes it is accompanied by adult polycystic kidney disease.

Case: A 46-year-old woman who was being treated for adult polycystic kidney disease and systemic hypertension was admitted to this hospital because of acute lower limb edema. Color Doppler sonography study showed deep vein thrombosis of lower limbs and also left iliac vein. Despite the initiation of hourly heparin infusion, the patient involved by pulmonary emboli on the 2(nd)day of admission. Lab tests revealed protein C and S deficiency. The patient had already experienced episodes of pneumothorax too. Cutaneous lesions due to sebaceous adenoma were seen on her cheeks, nose and neck. She had also periungual fibroma suggestive of tuberous sclerosis.

Conclusion: Although, according to our patient with both tuberous sclerosis and protein C and S deficiency, a significant relation between these two diseases, cannot confirmed, however, evaluation of other patients who have tuberous sclerosis can help to confirm or rule out this relation.
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http://dx.doi.org/10.12861/jrip.2012.12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4205983PMC
October 2014

Comparison of alendronate and pamidronate on bone loss in kidney transplant patients for the first 6 months of transplantation.

Iran J Kidney Dis 2011 Nov;5(6):420-4

Department of Nephrology, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Introduction: Osteoporosis develops and progresses in a considerable number of kidney transplant patients. Bisphosphonates, which are used for prevention and treatment of osteoporosis, may accentuate gasterointestinal complications and lead to more nonadherence to treatment. This randomized clinical trial was conducted to compare the effect of pamidronate versus alendronate on early bone mineral density changes in kidney transplant patients.

Materials And Methods: Forty patients (27 men and 13 women), aged from 20 to 58 years, with low bone mineral density (T score < -2) in the spine, total hip, or femur neck were enrolled. Participants were randomly allocated into 2 groups to receive pamidronate or alendronate. The pamidronate group received intravenous pamidronate, 90 mg, starting from the 3rd week of transplantation for 3 months. The alendronate group started to receive oral alendronate, 70 mg per week for the same period. At baseline and 6 months, bone mineral density was measured by dual-energy x-ray absorptiometry. Gastrointestinal side effects were monitored every month.

Results: No significant difference was found in bone density changes of the lumber area between the two groups; however, significantly less reduction in bone mineral density of the femur neck and femur occurred in the pamidronate group. Kidney function and parathyroid hormone levels were similar in the two groups before and after the study. Gastrointestinal side effects were seen in 3 patients of the alendronate group only.

Conclusions: Pamidronate was comparable to alendronate in prevention of early bone loss after kidney transplantation.
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November 2011

Outcome of patients on haemodialysis in Khuzestan, Iran.

NDT Plus 2011 Apr;4(2):143-4

Department of Statistics, Jundishapur University of Medical Sciences, Ahvaz, Iran.

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http://dx.doi.org/10.1093/ndtplus/sfq207DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4421574PMC
April 2011