Nephro-Urology Monthly

Review Article

26/4/2017

Erythrocyte Alterations and Increased Cardiovascular Risk in Chronic Renal Failure

Mario Bonomini, Assunta Pandolfi, Vittorio Sirolli, Arduino Arduini, Lorenzo Di Liberato, Natalia Di Pietro

Patients suffering from chronic renal failure have a higher burden of cardiovascular events, which increases in a dose-dependent fashion as renal function worsens. Increased cardiovascular risk in these patients is thought to be mediated by the simultaneous presence of both traditional and non-traditional cardiovascular risk factors, the latter being associated with renal impairment. Red blood cells are usually considered as carries of nutrients for tissues and respiratory gases, less so as compartments essential to vascular integrity. However, erythrocyte number, size, and integrity seem to severely affect cardiovascular morbidity and mortality as established in recent clinical studies with large patient cohorts. In particular, the role of red blood cells in chronic renal failure tends only to be considered exclusively in relation to a change in their number. However, these cells in the uremic milieu are prone to many alterations, which may adversely affect the cardiovascular system. In this review, we highlight the main qualitative erythrocyte alterations that may have a pathophysiologic role in the elevated cardiovascular risk of chronic renal failure.

Research Article

19/2/2017

Fate of Abstracts Presented at the First International Congress of Nephrology and Urology, Tehran, Iran, 2015

Seyed-Mostafa Hosseini-Zijoud, Farnaz Barzi, Aidin Lotfiazar, Behzad Einollahi

Methods: Data of oral and poster presentations including abstracts’ titles and authors were gathered from the proceeding of the first ICNU, Tehran, Iran, 2015. The presented abstracts were searched in Scopus, PubMed, and ISC (for Persian language published papers). All the abstracts were categorized based on presentation type (oral or poster presentation), topic, study type and design, publication status, time interval between the presentation and the publication date, and the journal publishing the full text of the abstracts. Statistical analysis was done by SPSS (version 18, SPSS Inc., Chicago, IL, USA).

Results: The total number of abstracts accepted at the first ICNU was 210 (63 as oral and 147 as poster). The results showed that 49 out of 210 abstracts were published as full-text articles in indexed journals, giving the overall publication rate of 23.3%. 6 out of 49 published papers were in Persian Language. In this survey, the rate of publication was 41.3% for oral presentations. The abstracts of prospective studies and original articles were more likely to be published in journals. The median time to publication was 5.3 months (range 1 - 12 months).

Research Article

26/3/2017

Factors Contributing to Erythropoietin Hyporesponsiveness Among Hemodialysis Patients: A Cross-Sectional Multicenter Study

Shiva Samavat, Mohsen Nafar, Alireza Khoshdel, Behrang Alipour- Abedi

Methods: In a multicenter cross-sectional study, from January 2015 to May 2015, point-prevalent hemodialysis patients from 22 dialysis centers in Tehran, Iran, were enrolled. Demographic, clinical, and laboratory data and drug history were recorded. ESA hyporesponsiveness index (EHRI) was calculated by dividing weekly ESA dose per kilogram of body weight (IU/Kg/W) by hemoglobin level (g/dL). Patients with EHRI ≥ 16.49 (4^th quartile) were compared with those with EHRI < 16.49 with respect to influential factors.

Results: A total of 1224 patients were enrolled among whom, 306 (25%) had an EHRI ≥ 16.49 with a mean hemoglobin level of 9.8 ± 1.4 g/dL. There was no age, gender, or dialysis vintage difference within the groups. Iron status, parathormone, CRP, and diabetes were also similar. Hyporesponsive patients had lower body mass index (BMI) and lower serum albumin (P < 0.05). The proportion of patients who were treated with angiotensin converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARBs) were significantly higher (P < 0.01) in hyporesponsive patients. In multivariate analysis, high doses of Venofer, high Kt/V, and high phosphate level were independently related to the presence of EHRI, and treatment with ACE/ARB was a marginally significant factor for EPO resistance.

Research Article

7/5/2017

Restless Leg Syndrome, Insomnia, and Depression in Hemodialysis Patients: Three Sides of a Triangle?

Shiva Samavat, Somayeh Fatemizadeh, Hedieh Fasihi, Marieh Farrokhy

Results: The prevalence of RLS in patients undergoing hemodialysis was 23.4%; out of which 43.6% had severe and very severe RLS. Patients with RLS had a positive family history of RLS (P value < 0.001). There was no difference between the demographic and laboratory findings of the patients. In comparison to the patients without RLS, the patients with RLS had a higher prevalence of depression (63.6% vs. 42.2%, P value = 0.005), and more severe insomnia score (mean PSQI-score = 8.2 ± 4.9 vs. 6.2 ± 4 (P value = 0.009). The PSQI score were correlated with HADS score (P value < 0.001). In multivariate analysis, the link between RLS and depression depended on insomnia.

Research Article

6/2/2017

The Prevalence of HCV Infection in Hemodialysis Population and Compared ELISA and PCR Methods for Detecting of HCV Infection

Atieh Makhlough, Mohammadreza Mahdavi, Iradj Maleki, Lotfollah Davoodi, Tahoora Mousavi, Seyed-Hosein Hasani-Mansoor, Marjan Makhlough, Mohammadreza Haghshenas

Methods: Serum samples from 162 patients undergoing chronic hemodialysis were collected in 2 hemodialysis units of Sari city (North of Iran). HCV RNAs were isolated from samples using RIBO-prep nucleic acid extraction kit (AmpliSens®, Russia). Total RNAs were extracted from samples and real-time polymerase chain reaction (PCR) was performed using HCV-FRT PCR kit (AmpliSense, Russia) according to the manufacturer’s instructions.

Research Article

26/4/2017

Treatment Failure of Botulinum Toxin A in Patients with Idiopathic Overactive Bladder: Why Do Patients Discontinue Treatment?

Tom Marcelissen, Mohammad Sajjad Rahnama’i, Beverley Brierley, Brigitte Schurch, Peter De Vries

Results: In total, 74 patients who discontinued BTX-A treatment were identified. The response rate was 62%. The most common reasons for discontinuation of treatment were insufficient effect (37%), the need for clean intermittent self-catheterization (CISC, 13%), and urinary tract infections (UTI, 9%). 17% of the patients reported that they did not want a new treatment despite good effects. After an average follow-up of 92 months, more than three quarters (76%) of the patients suffered from urgency incontinence. In most patients, incontinence had a great influence on daily life (average score of 7 on a scale of 10). During the time of this survey, 25% of the patients used drugs for their OAB symptoms, 15% were referred for sacral neuromodulation, and 1 patient underwent urinary deviation.

Research Article

7/5/2017

A Comparison of Estimated GFRs Based on Formulas of Serum Cystatin C and Serum Creatinine

Nouraddin Mousavinasab, Mojgan Jalalzadeh

Background: Serum cystatin C has been identified as a marker for the estimation of glomerular filtration rate (GFR). Although this marker is more sensitive than creatinine, it is too expensive and not available in all laboratories. In this study, we compared cystatin C-based equations with creatinine-based formulas to select the most precise creatinine-based formula for estimating GFR in patients with chronic kidney disease (CKD).

Methods: 120 patients with CKD were enrolled in this cross-sectional study. The patients were divided into groups according to BMI (< 25, 25 - 29.9, and ≥ 30) and age (≤ 40, 41 - 60, and ≥ 60). The patients’ GFRs were estimated and analyzed by using three creatinine-based equations (modification of diet in renal disease (MDRD), abbreviated MDRD, and Cockcroft and Gault (C-G)) and five cystatin C-based equations (Filler, Le Bricon, Rule, Hoek, and Larsson).

Results: The mean age of patients was 56.4 ± 16.4 years. The mean of GFRs using C-G, MDRD, and abbreviated MDRD formulas were 36.2 ± 14.3, 32.6 ± 11.4, and 32.4 ± 11.3 mL/min/1.73 m², respectively. The mean of GFRs using Filler, Le Bricon, Larsson, Rule, and Hoek equations were 54.7 ± 20.1, 53.0 ± 15.7, 43.6 ± 18.5, 45.1 ± 17.2, and 46.2 ± 16.2 mL/min/1.73 m², respectively. The closest correlation was observed between GFRs generated by Abbreviated MDRD and cystatin C-based equations (P < 0.001, r: 0.4, R²: 0.16). Differences in GFR estimation between cystatin C-based equations and C-G equation were lower at higher BMI levels (P: 0.004 - 0.01, F: 4.5 - 6.7). Differences in GFR estimation between cystatin C-based equations and C-G as well as MDRD equations were greater in older patients (P: 0.01 - 0.04, F: 3.2 - 4.1).

Research Article

26/4/2017

Feasibility of Pure Ultrasonography Guided Percutaneous Nephrolithotomy in Flank Position

Samad Zare

Results: The mean age of patients was 42.0 ± 13.4 years. Twelve patients were children under 12 years old. Mean size of the stones was 4.2 ± 1.1 cm (range from 2.5 to 5.3 cm). Mean access and operative times were 15.5 ± 2.3 and 68 ± 14.5 minutes, respectively. In 45% of patients, superior calyx was selected for access. History of previous open stone surgery was obtained in 24 cases. Early complete stone free rate (SFR) was 68%, and after auxiliary procedures (SWL and TUL), this increased to 88%. The mean hemoglobin reduction was 1.9 ± 0.9 gr/dL. Blood transfusion was needed in 6 cases (2.4%). Prolonged or delay hemorrhage did not occur in any of the patients. One patient was complicated by moderate degree of pneumothorax and managed with chest tube insertion. Solid or viscus abdominal organ injury had not happened.

Research Article

26/4/2017

Olive Leaves Extract Improved Sperm Quality and Antioxidant Status in the Testis of Rat Exposed to Rotenone

Maryam Sarbishegi, Enam Alhagh Charkhat Gorgich, Ozra Khajavi

Methods: In the current experimental study, 36 male Wistar rats were divided into 6 groups (n = 6). Control, Sham, ROT, and 3 ROTs treated with OLE (75, 150, and 300 mg/kg/day). ROT 3 mg/kg/48 hours was injected subcutaneously (s.c), and vehicle or OLE was administrated by oral gavage for 30 days. At the end of the study, animals were scarified and their testis tissue and epididymis samples were removed and their sperm parameters (viability, motility, and sperm count), total antioxidant capacity (TAC), and malondialdehyde (MDA) level were measured.

Case Report

26/3/2017

Role of Nonenhanced Spiral Computed Tomography Scan in Refractory Irritative Bladder Symptoms

Hamed Akhavizadegan

Case Presentation: We reported two elderly men with severe irritative bladder symptoms who failed to be diagnosed with routine work-ups, including urine analysis and culture, urine cytology, ultrasonography, cystoscopy and urodynamic studies. Abdomino-pelvic nonenhanced spiral CT scan was performed. Missing stones were detected by the helical CT scan without contrast, which were treated by intracorporal lithotripsy. The symptoms were relieved following stone removal.

Case Report

7/3/2017

Large Cell Neuroendocrine Carcinoma of Prostate: A Rare Interesting Case and Literature Review

Reza Mahdavi Zafarghandi, Mahmood Reza Kalantari, Alireza Akhavan Rezayat, Amir Abbas Asadpour

Nephro-Urology Monthly: May 2017, 9 (3), 11 articles.