Iranian journal of kidney diseases最新文献

{"title":"Spontaneous Tumor Lysis Syndrome as a Complication of Metastatic Breast Cancer: A Rare Case Report.","authors":"Ali Emadzadeh, Ahmad Saffari, Maryam Emadzadeh","doi":"10.61186/","DOIUrl":"10.61186/","url":null,"abstract":"<p><p>Tumor lysis syndrome (TLS) is a well-established potentially fatal condition which is considered an oncologic emergency. TLS typically develops from the rapid lysis of neoplastic cells after the commencement of cytotoxic treatment in patients with some kinds of lymphomas, especially the Burkitt variant, and acute lymphoblastic leukemia. Spontaneous TLS (STLS), a variant of TLS occurring in the absence of chemotherapy or radiation therapy, has been observed in non-Hodgkin lymphoma and acute leukemia, and rarely in solid neoplasms. In this paper, we present a 62-year-old woman with STLS, secondary to metastatic breast cancer. Unfortunately, she died because of complications of acute kidney injury, especially severe metabolic acidosis that was refractory to hemodialysis. Although it is infrequent, healthcare professionals should consider STLS as a probable consequence of breast cancer characterized by a high tumor burden and distant metastases.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"19 2","pages":"127-129"},"PeriodicalIF":0.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159006","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":"Computational Modeling of Network Topology and Molecular Dynamics for the Assessment of Therapeutic Potential of the  Astragalus Membranaceus-Salvia Miltiorrhiza Drug Pair in the Treatment of Chronic Kidney and Heart Failure.","authors":"Jiayou Liu, Jianguo Qin","doi":"10.52547/xqptv838","DOIUrl":"10.52547/xqptv838","url":null,"abstract":"<p><strong>Introduction: </strong>The bioactive components of Astragalus membranaceus and Salvia miltiorrhiza improved cardiac and renal function in chronic heart failure (CHF) and chronic kidney disease (CKD), respectively. However, the common regulating molecular mechanisms remain unclear. The aim of this study was to investigate these mechanisms using bioinformatics, network topology, and molecular dynamics simulation techniques.</p><p><strong>Methods: </strong>The active components and target sites of A. membranaceus and S. miltiorrhiza were obtained from the Traditional Chinese Medicine Systems Pharmacology database. The targets of CKD and CHF were obtained from various databases for a protein-protein interaction analysis. The Gene Ontology (GO) function and Kyotoencyclopedia of genes and genomes (KEGG) pathway enrichment of intersection targets were analyzed by using the Database for Annotation, Visualization, and Integrated Discovery (DAVID) database. Molecular docking and dynamic simulations were conducted on the core ingredients and targets. The diagnostic efficiency of the key targets was evaluated by using receiver-operating characteristic (ROC) curves.</p><p><strong>Results: </strong>A total of 70 active ingredients and 158 common targets were found. The top five core targets were AKT1, STAT3, TP53, MAPK1, and RELA. The GO enrichment analysis included apoptosis and oxidative stress. The KEGG pathway enrichment results indicated that the drug pair regulated the AGE-receptor for AGE signaling pathway, fluid shear stress and atherosclerosis, and the IL-17 signaling pathway. Molecular docking and dynamic simulations confirmed that the core ingredients had good affinity and stability with the key targets. The ROC curves confirmed the accuracy of every key target for identifying CKD and CHF and demonstrated that combining them improves diagnosis.</p><p><strong>Conclusion: </strong>The combination of A. membranaceus and S. miltiorrhiza proved effective for the treatment of CKD and CHF through various components, targets, and mechanisms. Moreover, it may predict the diagnostic value of key targets, providing a reference for clinical diagnostic applications.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"19 2","pages":"69-83"},"PeriodicalIF":0.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159031","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":"Increased Proportion of Circulating T Follicular Helper Cells and Serum Levels of IL-21 in Antibody-Mediated Rejection of Renal Allograft.","authors":"Mahboobeh Freidoon, Azam Alamdari, Fatemeh Pour-Reza-Gholi, Sara Assadiasl, Narjes Soleimanifar, Maryam Sadr, Hanieh Mojtahedi, Sedigheh Poursaleh, Mohammad Hossein Nicknam","doi":"10.61186/","DOIUrl":"10.61186/","url":null,"abstract":"<p><strong>Introduction: </strong>Antibody-mediated rejection (AMR) is one of the major obstacles to successful kidney transplantation. The T helper cell subset that plays a key role in the activation of B-lymphocytes and antibody production is T follicular helper (Tfh) cell. Therefore, we aimed to compare the percentage of Tfh cells and the serum level of interleukin 21 (IL-21), mainly secreted by this subset, in patients with AMR and stable recipients.</p><p><strong>Methods: </strong>Peripheral blood samples were taken from 30 patients diagnosed with AMR and 30 stable kidney transplant recipients as well as 10 age- and sex-matched healthy individuals. The percentage of circulating Tfh cells (TCD4+CXCR5+PD1+) and the level of IL-21 were studied by flow cytometry and ELISA techniques, respectively.  Results. The proportion of cTfh cells among circulating TCD4+ cells in AMR patients was markedly elevated compared to the other groups (P < .0001). It was also higher in stable recipients than in healthy controls (P < .0001). The serum level of IL-21 was increased in AMR patients compared to stable recipients (P = .03) and healthy participants (P = .02). In addition, there was a significant negative correlation between cTfh percentage and the estimated glomerular filtration rate (eGFR) in transplanted patients (P = .001). Moreover, the AUC of cTfh cells in AMR diagnosis was 0.83 [95% CI 0.73-0.93 (P < .0001)].</p><p><strong>Conclusion: </strong>In AMR patients, cTfh cell percentage and IL-21 levels were significantly increased. The significant association between cTfh % and eGFR, with an AUC of 0.83, indicates its potential as a diagnostic and prognostic marker in AMR.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"19 2","pages":"118-126"},"PeriodicalIF":0.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159037","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 Diagnosis of Lupus Nephritis in A Patient with Autosomal Dominant Polycystic Kidney Disease: A Rare Case Report.","authors":"Sareh Khamar-Moghadam, Soroush Mostafavi, Seyyedeh Mina Hejazian, Shahrzad Ossareh","doi":"10.52547/n8rjp713","DOIUrl":"10.52547/n8rjp713","url":null,"abstract":"<p><p>Autosomal dominant polycystic kidney disease (ADPKD), as a widespread inherited cystic kidney disease has a prevalence of ~1/1000 live births. However, there are rare reports of the association of ADPKD with nephrotic range proteinuria such as lupus nephritis (LN). In this study, we report a patient with ADPKD who manifested a sudden increase of urinary protein excretion with positive anti-double stranded DNA and antinuclear antibody tests. Finally, based on percutaneous ultrasound-guided renal biopsy LN was proved. This report advises clinicians to evaluate ADPKD patients periodically and perform complementary clinical and laboratory investigations in cases with unusual presentations such as nephrotic syndrome.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"19 2","pages":"130-133"},"PeriodicalIF":0.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159008","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":"Effect of the Combination of Hemodialysis and Hemoperfusion on Clearing Interleukin-31: A Prospective, Randomized Crossover Trial in Patients under Maintenance Hemodialysis","authors":"Xin Zhang, Lirui Wang, Jiangtao Li","doi":"10.52547/g1yt6d73","DOIUrl":"10.52547/g1yt6d73","url":null,"abstract":"<p><strong>Introduction: </strong>Uremic pruritus (UP) is a disturbing symptom in a quite large proportion of hemodialysis (HD) patients. Recent studies have indicated a potential role of interleukin-31 (IL-31) in the pathophysiology of pruritus, and it is becoming a promising therapeutic target for UP. Hemoperfusion (HP) is an extracorporeal technique that has been shown to be effective in absorbing molecules which may be responsible for inducing pruritus. In this study, we conducted this study to explore whether additional HP could enhance the removal of IL-31 in UP patients.</p><p><strong>Methods: </strong>The study was conducted in two parts. In Part A, the prevalence and intensity of UP were recorded and the basal serum IL-31 level was determined three times a week in HD patients. Patients with detectable serum IL-31 levels in part A were included in Part B. Each patient had two 4-h test sessions: conventional HD or HD plus HP (HDHP). The reduction ratio (RR) of IL-31 from HD and HDHP was compared.</p><p><strong>Results: </strong>Forty patients completed part A and 40% of them were suffering from UP. Serum IL-31 was detected at significantly higher percentages in UP patients than in non-UP patients (50% vs 4.2%). Serum levels of IL-31 in UP patients were significantly higher than that in non-UP patients (median: 8.35pg/ml vs 7.8pg/ml). Serum IL-31 levels were significantly correlated with pruritus intensity in patients with UP(r = 0.55, P < .05). Eight patients were enrolled and completed part B. The use of combined HD and HP treatment produced a better RR for IL-31 than HD alone (34.26 ± 1.43% vs 15.28 ± 2.11%, P < .01).</p><p><strong>Conclusions: </strong>IL-31 may play an important role in the pathophysiology of uremic pruritus. The addition of hemoperfusion to conventional hemodialysis provides enhanced removal of IL-31.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"19 1","pages":"1-7"},"PeriodicalIF":0.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582257","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":"Erratum:The Effect of 10 Weeks of Aerobic-resistance Exercise Training on Liver Enzymes (ALT, AST, and ALP) and Kidney Function (Creatinine, Urea, and GFR) of Kidney Transplant Patients.","authors":"","doi":"10.61186/","DOIUrl":"10.61186/","url":null,"abstract":"","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"19 1","pages":"67"},"PeriodicalIF":0.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582261","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":"Scientia et Cura: Illuminating the Dark Side of CRRT for Optimal Patient Benefits.","authors":"Amir Ahmad Nassiri, Antoine Schneider, Monir Sadat Hakemi, Tahereh Sabaghian, Azadeh Ahmadi Koomleh, Mir Mohammad Miri, Kiana Entezarmahdi, Taymaz Yousefzad, Kianoush Kashani","doi":"10.61186/","DOIUrl":"10.61186/","url":null,"abstract":"<p><strong>Introduction: </strong>Continuous Renal Replacement Therapy (CRRT) is commonly used in patients with hemodynamic instability but is associated with potential complications. Understanding these complications can improve CRRT efficiency and patient outcomes.</p><p><strong>Methods: </strong>This cross-sectional study investigated CRRT complications in patients > 18 years old who underwent CRRT at a tertiary medical center from 2017 to 2022. Data were collected from patient records and the hospital's laboratory system.</p><p><strong>Results: </strong>A total of 178 patients underwent CRRT for fluid overload (38%) and non-septic acute kidney injury (AKI) (35%). The most common CRRT modalities were hemofiltration (54%) and hemodiafiltration (31%). Among patients, 76% experienced a reduction in platelet count (mean decrease of 40% ± 24). Hemoglobin declined by ≥ 1 g/dL in 58% of patients. Phosphorus decreased in 64.6% of patients (mean reduction of 33%) and potassium decreased in 50% (mean reduction of 18%), but these reductions were not statistically significant (P-values: 0.73 and 0.88). Vasopressors were stopped in 27% of patients, and the dose was reduced in 50.4%. No significant hypothermia, allergic reactions, pneumothorax, hemothorax, or air embolism were reported. The survival rate at hospital discharge was 64% (123 out of 178).</p><p><strong>Conclusion: </strong>CRRT is a safe and efficient treatment for AKI, with notable reductions in platelet count and vasopressor dependency. However, reductions in phosphorus and potassium were not significant, indicating manageable complications.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"19 1","pages":"50-58"},"PeriodicalIF":0.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582271","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":"Evaluation of Long-term Outcomes and its Related Factors in Patients with Immune-complex Mediated Glomerulonephritis: A 20-Year Historical Cohort Study in Iran.","authors":"Shiva Shahnazari, Mitra Mehrazma, Shadi Naderyan Fe’li, Shahrzad Ossareh","doi":"10.52547/ijkd.8185","DOIUrl":"10.52547/ijkd.8185","url":null,"abstract":"<p><strong>Introduction: </strong>Immune-complex mediated glomerulonephritis (IC-GN) has a poor prognosis and commonly leads to kidney failure This study reports 20-year experience with the long-term outcomes of 222 Iranian IC-GN patients.</p><p><strong>Methods: </strong>This single-center historical cohort study was conducted on patients who underwent kidney biopsies from 1998 to 2018 in Hasheminejad Kidney Center (HKC). Initial demographic, clinical, laboratory, and pathology data were extracted from the glomerulonephritis registry of HKC. Follow-up data was obtained by reviewing hospital and outpatient files, as well as phone calls. The primary outcomes were end-stage kidney disease (ESKD) and death, and the secondary outcomes were complete remission, partial remission, and stable chronic kidney disease.</p><p><strong>Results: </strong>A total of 222 patients, (141 (63.5%) males, 81 (36.5%) females, mean age: 37.76 ± 15.71 years), were diagnosed with IC-GN. The most common causes were IgA nephropathy and lupus nephritis. Among all, 60.2% progressed to ESKD, 15.5% died, 13.1% achieved complete, and 18.5% achieved partial remission. The overall one-, three-, five-, and ten-years kidney survival rates were 52%, 42%, 38%, and 27%, respectively, with a significant difference between the IC-GN subtypes (P < .001). The highest kidney survival rate was found in lupus nephritis. Significant independent predictors of ESKD were the percentage of interstitial fibrosis and tubular atrophy (adjusted hazard ratio (aHR) = 1.022 [95% confidence interval (CI) = 1.012-1.033]), percentage of active crescents (aHR = 4.002 [95% CI = 2.066-7.752]), and initial serum creatinine level (aHR = 1.073 [95% CI = 1.035-1.112]) (P < .001 for all).</p><p><strong>Conclusion: </strong>There was a significant difference between the long-term survival of IC-GN types. Histopathologic features, and higher initial serum creatinine levels, were important predictors of poor outcome.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"19 1","pages":"30-40"},"PeriodicalIF":0.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582266","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":"Investigation of the Potential Effect of Complement 5 on Transplantation Outcome by Bioinformatics Tools","authors":"Suleyman Rustu Oguz, Demet Kivanc, Kursat Ozdilli, Sedat Karadeniz, Ekin Ece Gurer Kluge, Hayriye Senturk Ciftci","doi":"10.5254/s1q4yy85","DOIUrl":"10.5254/s1q4yy85","url":null,"abstract":"<p><strong>Introduction: </strong>Activation of the complement system following transplantation may result in allograft rejection. Our study aimed to evaluate the potential relationship between factors affecting kidney transplant success and complement 5 (C5) using bioinformatic tools.</p><p><strong>Methods: </strong>GenCards and Genemania were used to provide the genetic functional information belonging to the C5 gene, and genomic browsers of STRING, UCSC, KEGG were used to reveal interactions with other genes and various pathways. MiRDB was used to specify the miRNAs that were associated with the C5 gene. The UniProt database was used to determine the tissues that expressed the C5 gene using protein-protein interactions.</p><p><strong>Results: </strong>In the bioinformatic analyses performed, high levels of C5 gene expression were found in the naiive kidney. Twenty-five genes were found to be strongly associated with C5. Fifty-four miRNAs targeting the C5 gene were specified. The C5 gene was found to be involved in biologic processes such as complement activation (FDR = 6.46e-22), complement binding (FDR = 2.20e-06), cytolysis (FDR = 4.82e-14), regulation of complement activation (FDR = 4.08e-24), positive regulation of vascular endothelial growth factor production (FDR = 0.0430), regulation of macrophage chemotaxis (FDR = 0.0447), activation of the immune response (FDR = 1.26e-13), leukocyte-mediated immunity (FDR = 1.41e-09), innate immune response (FDR = 3.05e-09), allograft rejection (FDR = 2.40e-12), oxidative injury response (FDR = 0.00016), and trigerring of the beginning of the complement cascade (FDR = 0.0244).</p><p><strong>Conclusions: </strong>The data obtained in this study will be used to guide future experimental investigations in the field of transplantation, and these data will give physicians with insight into allograft status following transplantation.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"19 1","pages":"59-66"},"PeriodicalIF":0.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582269","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 Scent of the Muliyan River (Booye Jooye Muliyan): Report of an Educational Trip.","authors":"Zahra Pournasiri, Shokouh Shayanpour, Mahboubeh Jafari Sarouei, Ali Emadzadeh","doi":"10.61186/","DOIUrl":"10.61186/","url":null,"abstract":"<p><p>In October 2024, an Iranian educational nephrology team visited Tajikistan to participate in a continuous medical education (CME) course. This report represents the results of their trip from their perspective.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"19 1","pages":"8-11"},"PeriodicalIF":0.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582276","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}