Iranian journal of kidney diseases最新文献

{"title":"Non-Diabetic Kidney Disease Confirmed by Biopsy in Patients with Diabetes: A Single-Center Registry Report.","authors":"Neda Najafi, Hounaz Akbari, Mitra Mehrazma, Mahsa Kohansal Vagargah, Mohsen Vahedi, Shahrzad Ossareh","doi":"10.61186/","DOIUrl":"10.61186/","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic kidney disease (DKD) is a major complication of  diabetes  mellitus  (DM),  often  leading  to  kidney  failure.  This study was designed to assess the prevalence and clinicopathological correlations  of  biopsy-confirmed  non-diabetic  kidney  disease (NDKD) in patients with diabetes.</p><p><strong>Method: </strong>A  retrospective  analysis  was  conducted  by  including 547  diabetic  patients  who  underwent  kidney  biopsies.  Data  on demographics,  laboratory  results  (including  serum  creatinine and urine protein levels), clinical symptoms, medical history, and histopathological diagnoses were collected.</p><p><strong>Result: </strong>Among the patients, 261 (47.7%) were diagnosed with DKD, while 286 (52.3%) had NDKD. The most prevalent histopathologicalfinding  in  NDKD  was  membranous  glomerulonephritis  (13.9%), followed  by  focal  and  segmental  glomerulosclerosis  (9.7%)  and IgA nephropathy (5.7%). Key predictors for DKD included longer duration  of  diabetes  mellitus  (odds  ratio  [OR]:  1.12),  elevated HbA1c  levels  (OR:  1.26),  and  the  presence  of  retinopathy  at  the time of biopsy (OR: 7.97), all with P < .05. No significant differences were  observed  in  the  frequency  of  hematuria  between  the  DKD and NDKD groups.</p><p><strong>Conclusion: </strong>Membranous glomerulonephritis was the most common diagnosis  among  NDKD  patients.  The  findings  suggest  a  strong correlation between the duration of diabetes mellitus, the presence of retinopathy, and HbA1c levels with DKD development, indicating a need for revised criteria for kidney biopsy decisions in diabetic individuals to enhance diagnostic accuracy and treatment strategies.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"19 5","pages":"279-286"},"PeriodicalIF":0.9,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Pediatric Blood Pressure Readings: The Role of Timing and Medical Personnel Presence: A cross-sectional study.","authors":"Hamidreza Badeli, Yasin Khoshhal Dahka, Mir Iman Fallahchai, Afagh Hassanzadeh Rad","doi":"10.61186/","DOIUrl":"10.61186/","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertension  is  a  major  global  health  concern, playing  a  significant  role  in  the  development  of  cardiovascular diseases  and  other  non-communicable  conditions.  Accurate blood pressure (BP) measurement is a key to its diagnosis. While guidelines recommend three BP readings with 1-2-minute intervals for adults, there is no clear consensus for children. Additionally, various factors, such as the presence of medical personnel, could impact  BP  readings.  This  study  aimed  to  evaluate  the  impact  of measurement  timing  and  the  presence  of  medical  personnel  on pediatric blood pressure readings.</p><p><strong>Methods: </strong>In this analytical cross-sectional study, 50 children aged 5-13 years were enrolled. Blood pressure was measured using an automatic device with appropriately sized cuffs. BP was recorded at five intervals: baseline, 30, 60, 90, and 120 seconds. Measurements were taken both in the presence of medical personnel (attended) and  without  their  presence  (unattended).  Data  were  analyzed using descriptive statistics and repeated measures ANOVA with IBM SPSS version 21.</p><p><strong>Results: </strong>A significant decrease in systolic BP (SBP) was observed over time (P = .000), with the initial SBP of 105.29 mmHg declining to 98.33 mmHg at 120 seconds. However, there were no significant changes in diastolic BP (DBP) or pulse pressure (PP) (P = .400 and P = .502, respectively). When comparing attended versus unattended measurements, both SBP and DBP were significantly higher whenmedical personnel were present (P = .009 for SBP, P = .010 for DBP).</p><p><strong>Conclusions: </strong>The  findings  suggest  that  shorter  intervals,  such as  30  seconds,  may  be  adequate  for  reliable  BP  measurement  in children. However, the presence of medical personnel increases BP readings, likely due to anxiety. These results highlight the need to reduce stress during pediatric BP assessments to ensure accurate hypertension diagnosis and management.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"19 5","pages":"287-293"},"PeriodicalIF":0.9,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of Hospital-Acquired Hyponatremia and its Risk Factors in Hospitalized Children: A Longitudinal Study.","authors":"Elham Bakhtiari, Farhad Heydarian, Adeleh Azarshab, Sara Saadat","doi":"10.61186/","DOIUrl":"10.61186/","url":null,"abstract":"<p><strong>Introduction: </strong>Hyponatremia in hospitalized children is associated with several clinical complications. This study aimed to evaluate the incidence and risk factors of hospital-acquired hyponatremia in pediatric patients.</p><p><strong>Method: </strong>A longitudinal study was conducted between 2016 and 2020 on hospitalized children who were admitted in Dr Sheikh Hospital, Mashhad University of Medical Sciences, Iran with normal serum sodium levels. Patients were followed for hyponatremia and its risk factors during hospitalization. Demographic data, clinical symptoms, underlying disease, type of serum, ward of hospitalization, and final diagnosis were recorded. Patients with incomplete blood samples or abnormal serum level of sodium at the time of admission were excluded.</p><p><strong>Result: </strong>A total of 456 children, including 267 males (58.6%) with a mean age of 69.40 ± 42.42 months were studied. The incidence of hyponatremia was 22.1%. The female sex (3.83 (95% confidence interval: 1.08, 13.59)) was the independent risk factors of hyponatremia. Children less than one year of age (2.68 (95% confidence interval: 0.97, 7.42) P = .057), were also borderline significant for the risk of hyponatremia.</p><p><strong>Conclusion: </strong>The incidence of hospital-acquired hyponatremia was 22.1%. The female sex was the independent risk factor of hyponatremia. Children less than one year of age may also be at risk for hyponatremia. Further studies are needed to confirm these findings.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"19 4","pages":"206-212"},"PeriodicalIF":0.9,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Sensitivity of Bioimpedance to Assess Leg Fluid Volume Changes in Children on Hemodialysis: Experimental and Model-Based Investigation.","authors":"Shahrokh Noori, Mohammad Firouzmand, Vahid Reza Nafisi, Nakysa Hooman","doi":"10.61186/","DOIUrl":"10.61186/","url":null,"abstract":"<p><strong>Introduction: </strong>Fluid management plays an essential role in pediatric hemodialysis; however, traditional assessment techniques often lack the precision required for this patient population. Bioimpedance analysis (BIA) offers a non-invasive alternative, but electrode placement significantly impacts measurement sensitivity. This study compared the efficacy of two calf-based electrode configurations - dorsal (ankle) versus plantar (sole) - in detecting fluid volume changes via bioimpedance in pediatric patients, particularly in terms of their sensitivity. Additionally, we evaluated a novel ring electrode arrangement for optimizing sensitivity distribution in lower limb tissues.</p><p><strong>Methods: </strong>This controlled before-and-after study was conducted at the dialysis unit of Ali Asghar Children's hospital in Tehran, Iran. It evaluated thirteen children (aged 3-15 years) undergoing hemodialysis using bioimpedance analysis. The primary outcome measure was the change in impedance values before and after a single dialysis session. Measurements were performed with electrodes placed in two configurations: between the plantar surface of the foot to below the knee (down), and between the ankle dorsal surface to below the knee (up). Current distribution patterns were modeled using COMSOL simulations.</p><p><strong>Results: </strong>Mean ultrafiltration volume was 1123 ± 384 mL per session. Impedance changes were observed in both dorsal and plantar electrode configurations, with no significant differences or superiority in measuring these changes. Sensitivity analysis revealed variations of 35% with dorsal placement, 24% with plantar placement, and 20% with ring electrode configuration, demonstrating superior uniformity of the ring design across tissue regions.</p><p><strong>Conclusion: </strong>Optimal electrode placement varies among patients with no universal advantage for either position. Bioimpedance sensitivity depends on location of fluid accumulation, and enhanced sensitivity is required for monitoring changes below two liters. The ring electrodes provided the most uniform sensitivity distribution. These findings support use of personalized bioimpedance monitoring approaches to improve fluid management precision in pediatric hemodialysis.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"19 4","pages":"232-242"},"PeriodicalIF":0.9,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Sacubitril/Valsartan in Treating Hemodialysis Patients with Reduced Ejection Fraction Heart Failure: A Retrospective Study.","authors":"Yan Guo, Weihua Li, Zongli Diao","doi":"10.61186/","DOIUrl":"10.61186/","url":null,"abstract":"<p><strong>Introduction: </strong>Heart failure with reduced ejection fraction (HFrEF) is a prevalent and challenging complication among patients undergoing hemodialysis. Sacubitril/Valsartan (Sac-Val), an angiotensin receptor-neprilysin inhibitor, has shown promise in improving cardiac outcomes in HFrEF patients. This study aims to evaluate the efficacy and safety of Sac-Val in treating HFrEF in patients undergoing hemodialysis.</p><p><strong>Methods: </strong>This retrospective analysis was conducted on 30 patients with HFrEF undergoing regular hemodialysis at Beijing Shijingshan Hospital between January 2019 and January 2023. The patients were divided into two groups: the Sac-Val group (14 patients) and the control group (16 patients). The Sac-Val group received an initial dose of 50 mg, titrated over four weeks to a maximum tolerated dose of 100 mg, while the control group received conventional heart failure treatment without Sac-Val. Both groups continued regular hemodialysis three times weekly. Statistical analysis included independent t-tests or Mann-Whitney U tests for continuous variables, and chi-square or Fisher's exact tests for categorical variables. Heart failure improvements, blood pressure, NT-proBNP levels, biochemical markers, and echocardiographic changes were assessed after one year.</p><p><strong>Results: </strong>The Sac-Val group showed significant improvements in systolic blood pressure (P = .027), NT-proBNP levels (P < .05), left ventricular ejection fraction (LVEF) (P < .04) compared to the control group. The Sac-Val group also had a higher total effective rate (85.71%) in alleviating heart failure symptoms compared to the control group (69%, P = .023).</p><p><strong>Conclusion: </strong>Sac-Val is a safe and effective treatment for HFrEF patients undergoing hemodialysis, potentially improving their quality of life, heart function and clinical outcomes.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"19 4","pages":"222-231"},"PeriodicalIF":0.9,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory Mediators in Kidney Disease: A Focus on IL-6in SLE-Associated CKD.","authors":"Shaymaa Abduljabbar Raoof, Paria Bayati, Mohammad Esmail Nasrabadi, Yaghoub Yazdani, Somayeh Ghorbani, Akram Gholamzadeh, Javad Enayat, Somayeh Sadani, Yasser Bagheri","doi":"10.61186/","DOIUrl":"10.61186/","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic lupus erythematosus (SLE) is an autoimmune condition that can lead to severe renal impairment, including chronic kidney disease (CKD) or end-stage kidney disease (ESKD). This study aimed to evaluate the serum levels of key pro-inflammatory cytokines which are well-known to mediate tissue injury and fibrosis in the context of kidney diseases-interleukin-1 beta (IL-1β), IL-6, tumor necrosis factor-alpha (TNF-α), and IL-12-in CKD and ESKD patients with and without SLE, as well as in healthy controls, to explore their role in disease progression.</p><p><strong>Methods: </strong>This cross-sectional study was conducted over a 15-month period in three governmental medical centers of Golestan Province, Iran (Sayyad Shirazi Hospital, 5th Azar hospital, and Al-Jalil hospital). A total of 118 individuals (age 18-65 years) were enrolled and divided into three groups:38 CKD or ESKD patients with SLE, 40 CKD or ESKD patients without SLE, and 40 healthy controls. For subgroup analyses, CKD (stages3-4) and ESKD (stage 5) patients were considered separately. Those patients meeting the American College of Rheumatology criteria for SLE, while excluding those with infections, malignancies, or other autoimmune disorders were selected. Blood samples were collected, and serum cytokine levels were measured using enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using the Kruskal-Wallis and Mann-Whitney U tests, with P ≤ .05 considered significant.</p><p><strong>Results: </strong>CKD patients with SLE showed significantly higher serum levels of IL-1β, TNF-α, and IL-12 compared to CKD patients without SLE and healthy controls (P < .05). IL-6 levels were notably higher in CKD patients compared to ESKD patients, irrespective of SLE status (P < .05). ESKD patients exhibited increased IL-1β, TNF-α, and IL-12 levels, while IL-6 levels were lower than those in CKD patients.</p><p><strong>Conclusion: </strong>IL-6 appears to play a crucial role in the pathogenesis of kidney disease, particularly in patients with SLE, and may serve as a therapeutic target. The differential regulation of cytokines in CKD and ESKD suggests that inflammatory pathways vary based on disease stage and the presence of SLE.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"19 4","pages":"187-199"},"PeriodicalIF":0.9,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Transplantation Hairy Cell Leukemia with Hemophagocytic Lymphohistiocytosis in an Adult Kidney Transplant Recipient: A Case of Rare Occurrence.","authors":"Maryam Ghazizadeh, Mohammad Moini, Matin Ghazizadeh","doi":"10.61186/","DOIUrl":"10.61186/","url":null,"abstract":"<p><p>Post-transplant lymphoproliferative disorder (PTLD) is a rare and severe complication that occurs after kidney transplantation. Most cases of PTLD are associated with reactivation of the Epstein-Barr virus (EBV), which often happens during the early phases following transplantation. Hemophagocytic lymphohistiocytosis (HLH) is an inflammatory syndrome characterized by a cytokine storm originating from activation of the reticuloendothelial system, leading to multi-organ failure (MOF). Herein, we present a case of late-onset EBV-positive hairy cell leukemia in a kidney transplant recipient who concurrently developed HLH. Diagnosing and managing HLH can be particularly challenging, as it can mimic sepsis. This is especially true for transplant recipients, where diagnosing and treating such conditions are difficult. Immunosuppressive therapy, malignancies like lymphoma, and EBV infection are recognized risk factors for developing HLH. However, very few cases have reported the simultaneous occurrence of HLH and PTLD.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"19 4","pages":"243-247"},"PeriodicalIF":0.9,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetically Confirmed Hyperoxaluria in Iranian Children- A Multicenter Survey.","authors":"Nakysa Hooman, Mahmood Maleknejad, Mitra Basiratnia, Marzieh Mojbafan, Alaleh Gheissari, Fahimeh Askarian, Rama Naghshizadian, Fatemeh Ghane Sharbaf, Arash Abbasi, Nahideh Ekhlasi, Nasrin Esfandiar, Somaye Talaeepur, Tahereh Malakoutian, Abolhassan Seyedzadeh, Rozina Abbasi Larki","doi":"10.61186/","DOIUrl":"10.61186/","url":null,"abstract":"<p><strong>Introduction: </strong>Primary hyperoxaluria (PH) is a rare autosomal recessive disorder characterized by a heterogeneous presentation that leads to kidney failure and involvement of other organs. The aim of this study was to determine the number of cases with suspected PH in Iran that have had a genetically verified diagnosis.</p><p><strong>Methods: </strong>A survey distributed among members of Iranian society of pediatric nephrology (IranSPN) to collect overall data on hyperoxaluria (HOX) in their centers, as well as those who performed whole exome sequencing (WES) or sanger sequencing genetic study. Data is presented as frequency and number blocks.</p><p><strong>Results: </strong>Nineteen out of 130 members filled out the questionnaires. About two-thirds of the responders were suspected to have HOX in the presence of recurrent multiple kidney stones. PH was genetically confirmed in 80 children above 10 years. Alanine-Glyoxylate Aminotransferase (AGXT) was the most frequent reported genetic abnormailtiy. The majority of their patients required kidney replacement therapy. Combined or sequential liver- kidney transplantation was less frequent. Conservative treatment was the only therapy applied to all children prior to end-stage kidney disease.</p><p><strong>Conclusion: </strong>This simple survey revealed that definitive diagnosis of PH occurs at older age accompanied with higher rate of kidney transplantation.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"19 4","pages":"200-205"},"PeriodicalIF":0.9,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Survival and Clinical Outcomes in Hemodialysis Patients: A 9-Year Multicenter Cohort Study.","authors":"Tayebeh Soleymanian, Atefeh Yousefi, Farnaz Tavakoli, Esmat Abdollahpour","doi":"10.61186/","DOIUrl":"10.61186/","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular and non-cardiovascular mortality rates among hemodialysis patients continue to be high despite advances in dialysis therapy.</p><p><strong>Materials and methods: </strong>This prospective cohort study enrolled 185 adult patients with end-stage kidney disease (ESKD) on maintenance hemodialysis (HD) from three hemodialysis facilities (Shariati hospital, Shohadaye Hafte-Tir hospital and Sevome-Sha'ban hospital ) in September 2012. Causes of death and HD exit were tracked over a follow-up period of 103 months (8.5 years). The Cox proportional hazards model was employed to predict mortality after adjusting for case-mix and laboratory data variables.</p><p><strong>Results: </strong>The mean age of the patients was 57 ± 15.2 years, with a mean dialysis vintage of 39 ± 45 months. The cohort comprised 52.5% males and 48% diabetic patients. In the univariate analysis, mortality rate was higher among women (81% vs. 63%), diabetics (89% vs. 55%), and those with higher body mass index, older age, and lower serum creatinine, albumin, and intact PTH levels. A total of 132 patients (71%) died, with a mortality rate of 19 per 100 patient-years. The leading causes of death were cardiovascular diseases (47%) and infections (32.5%). Kidney transplantation was performed in 25 patients (14%), including 7 women and 18 men. The median survival was 4.1 years (95% CI: 3.3-5.0). The survival rates at one, two, three, five, and nine years were 83%, 64%, 56%, 39%, and 19%, respectively.</p><p><strong>Conclusion: </strong>Older age, poor nutritional biomarkers, diabetes mellitus, and catheter vascular access are the primary factors contributing to poor long-term prognosis in hemodialysis patients.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"19 4","pages":"213-221"},"PeriodicalIF":0.9,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Tribulus Terrestris on Acute Kidney Injury: A Case Study.","authors":"Mahboobeh Freidoon, Zahra Pourvali-Souraki, Kimia Karimi Toudeshki","doi":"10.61186/","DOIUrl":"10.61186/","url":null,"abstract":"<p><p>Herbal medications, such as Tribulus terrestris, are widely used, especially by healthy individuals. Despite being easily accessible and perceived as safe, multiple reports have highlighted the potential adverse effects of these medications, although some acknowledge their benefits. In this case report, we present a 43-year-old male patient who has a significant history of self-administered herbal medicine usage. Our aim is to increase awareness about the potential toxicities linked to the use of over-the-counter herbal medicines. Initially, the patient's elevated creatinine level prompted further investigations, which led to the need for dialysis. Following management, he finally survived and recovered; currently, approximately three months later, the patient remains asymptomatic. This case serves as a cautionary example regarding the potential risks of using herbal medications without proper medical guidance.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"19 3","pages":"181-185"},"PeriodicalIF":0.9,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}