1
|
Moradi O, Karimzadeh I, Davani-Davari D, Shafiekhani M, Sagheb MM, Raees-Jalali GA. Drug-Drug Interactions among Kidney Transplant Recipients in The Outpatient Setting. Int J Organ Transplant Med 2020; 11:185-195. [PMID: 33335699 PMCID: PMC7726842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Number of patients undergoing kidney transplantation is ever increasing. Drug-drug interactions (DDIs) can complicate transplant patient's treatment course. OBJECTIVE To investigate patterns and factors associated with potential DDIs in kidney transplant recipients under maintenance immunosuppressive regimen at a referral transplantation center in Shiraz, Iran. METHODS 390 eligible kidney transplant outpatients referred to Motahhari clinic and one of the attending nephrologist's private office during an18-month period were assessed for DDIs. Using the Lexi-Interact online drug interactions software, the prescribed drugs were assessed for the number and type of potential DDIs. Only type D and X interactions were considered eligible for inclusion. RESULTS During the study period, 344 DDIs were detected of which, 290 were type D; 54 were type XDDIs. 81% of the detected DDIs were pharmacokinetics. Interaction between cyclosporine + mycophenolic acid (32.3%) was the most frequent DDIs followed by cyclosporine + atorvastatin (11.3%). Immunosuppressant (43.44%) was the most frequently used medication responsible for DDIs. Number of co-administered medications (OR: 1.34, 95% CI: 1.12-1.51) and cyclosporine as main immunosuppressive main drug (OR: 10.43, 95% CI: 6.24-17.42) were identified as independent risk factors for DDIs. CONCLUSION Major DDIs were common in kidney transplant recipients. Considering the importance of DDIs in kidney transplant patients, more attention is warranted in this regard by health care members, especially physicians and pharmacists.
Collapse
Affiliation(s)
- O. Moradi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - I. Karimzadeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - D. Davani-Davari
- Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M. Shafiekhani
- Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M. M. Sagheb
- Nephrology-Urology Research Center and Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - G. A. Raees-Jalali
- Nephrology-Urology Research Center and Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
2
|
Khalafi-Nezhad A, Sagheb MM, Amirmoezi F, Jowkar Z, Dehghanian AR. Comparison of the Effect of Alemtuzumab versus Standard Immune Induction on Early Kidney Allograft Function in Shiraz Transplant Center. Int J Organ Transplant Med 2015; 6:150-6. [PMID: 26576260 PMCID: PMC4644567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Induction therapy regimens classified as conventional immunosuppressive agents and lower doses of conventional agents combined with antibodies against T-cell antigens have been purposed to prevent acute rejection after renal transplantation. Various induction agents with different doses and durations have been suggested based on the risk profile of patients. OBJECTIVE To assess the acute rejection rate (total rate and based on the type of induction therapy regimen) during the first year after kidney transplantation, the type of acute rejection based on Banff classification and to determine the associations between rate of acute rejection, type of the rejection and induction therapy regimen. METHODS 249 kidney transplant candidates were divided into two groups-low-risk patients (n=208) who received conventional immunosuppressive agents, and high-risk patients (n=41) who received alemtuzumab-and followed for one year to detect acute rejection first diagnosed clinically, and confirmed by percutaneous kidney biopsy based on Banff criteria. RESULTS The total incidence of acute rejection was 19.6% (20.7% of the low-risk and 14.4% of the high-risk patients). The most prevalent types of the acute rejection in patients treated with conventional immunosuppressive agents and patients received alemtuzumab as induction therapy were grade IB and grade IA, respectively. The incidence of acute rejection among recipients received a kidney from a deceased donor was 20.6% and grade IA was the most prevalent type (6.9%) whereas the most prevalent grade of acute rejection in patients who received living donor grafts was IB (8.3%). CONCLUSION Despite the expected greater risk for acute rejection among high-risk patients, no significant difference was observed between low- and high-risk patients, which may be justified by the greater efficacy of alemtuzumab compared with standard triple induction therapy in reducing the rate of acute rejection.
Collapse
Affiliation(s)
- A. Khalafi-Nezhad
- Department of Hematology, Oncology and Stem Cell Transplantation, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M. M. Sagheb
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - F. Amirmoezi
- Student Research Committee, Cell and Molecular Research Group, Shiraz University of Medical Sciences, Shiraz, Iran,Correspondence: Fatemeh Amirmoezi, Student Research Committee, Cell and Molecular Research Group, Shiraz University of Medical Sciences, Shiraz, Iran, Tel: +98-71-3647-4316, Fax: +98-71-3647-4316, E-mail:
| | - Z. Jowkar
- Department of Operative Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - A. R. Dehghanian
- Department of Pathology Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
3
|
Fallahzadeh MK, Jafari L, Roozbeh J, Singh N, Shokouh-Amiri H, Behzadi S, Rais-Jalali GA, Salehipour M, Malekhosseini SA, Sagheb MM. Comparison of health status and quality of life of related versus paid unrelated living kidney donors. Am J Transplant 2013; 13:3210-4. [PMID: 24266971 DOI: 10.1111/ajt.12488] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 07/16/2013] [Accepted: 07/21/2013] [Indexed: 01/25/2023]
Abstract
The aim of this cross-sectional study was to assess the health status and quality of life (QOL) of paid unrelated versus related living kidney donors postdonation at Shiraz Transplant Center in Iran. We invited all donors (n = 580, 347 paid unrelated, 233 related) who underwent donor nephrectomy at our center from 2004 to 2010 to participate in a health survey and physical examination. Of 580 donors, 144 consented to participate; participation of paid unrelated donors was significantly lower than related (52/347 vs. 92/233; p < 0.001). Participants underwent a complete physical examination, QOL assessment (using a 36-item short form health survey [SF-36] questionnaire) and laboratory work-up. The paid unrelated donors compared with related donors were younger (34.2 ± 7.2 vs. 40.7 ± 9.7 years, p < 0.001), had shorter time since donation (2.9 ± 1.6 vs. 3.8 ± 2 years, p = 0.004), had higher estimated GFR (72.6 ± 22 vs. 63.8 ± 15.3 mL/min/1.73 m(2), p = 0.006) and had a higher percentage of patients with microalbuminuria (35% vs. 0%, p < 0.001). Additionally, general health and social functioning scores among paid unrelated donors were significantly lower (p < 0.001 and p = 0.02, respectively) than related donors. Other SF-36 scores, although lower in paid unrelated donors, did not reach statistical significance. Iranian paid unrelated donors have lower QOL and higher incidence of microalbuminuria compared with related donors.
Collapse
Affiliation(s)
- M K Fallahzadeh
- Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; John C. McDonald Regional Transplant Center, Willis-Knighton Health System, Shreveport, LA; Division of Nephrology, Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Salehi M, Sohrabi Z, Ekramzadeh M, Fallahzadeh MK, Ayatollahi M, Geramizadeh B, Hassanzadeh J, Sagheb MM. Selenium supplementation improves the nutritional status of hemodialysis patients: a randomized, double-blind, placebo-controlled trial. Nephrol Dial Transplant 2012; 28:716-23. [DOI: 10.1093/ndt/gfs170] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
5
|
Turgutalp K, Ozhan O, Akbay E, Tiftik N, Ozcan T, Yilmaz S, Kiykim A, Wu HY, Peng YS, Huang JW, Wu KD, Tu YK, Chien KL, Kacso IM, Moldovan D, Lenghel A, Rusu CC, Gherman Caprioara M, Silva AP, Fragoso A, Pinho A, Silva C, Santos N, Tavares N, Faisca M, Camacho A, Mesquita F, Leao P, Silva AP, Silva C, Santos N, Rato F, Fragoso A, Pinho A, Faisca M, Mesquita F, Leao P, Silva AP, Silva C, Santos N, Rato F, Fragoso A, Pinho A, Faisca M, Mesquita F, Leao P, Oh DJ, Kim HR, Kim SH, Okasha K, Sweilam M, Nagy H, Hassan Rizk M, Kirkpantur A, Afsar B, Chae DW, Chin HJ, Kim S, Fallahzadeh Abarghouei MK, Dormanesh B, Roozbeh J, Kamali-Sarvestani E, Vessal G, Pakfetrat M, Sagheb MM, Imasawa T, Nishimura M, Kawaguchi T, Ishibashi R, Kitamura H, Vlad A, Petrica L, Petrica M, Jianu DC, Gluhovschi G, Ianculescu C, Negru M, Dumitrascu V, Gadalean F, Zamfir A, Popescu C, Giju S, Gluhovschi C, Velciov S, Milas O, Balgradean C, Ursoniu S, Afsar B, Silva AP, Pinho A, Fragoso A, Silva C, Santos N, Faisca M, Mesquita F, Leao P, Soltysiak J, Zachwieja J, Fichna P, Lipkowska K, Skowronska B, Stankiewicz W, Stachowiak-Lewandowska M, Kluska-Jozwiak A, Afghahi H, Prasad N, Bhadauria D, Gupta A, Sharma RK, Gupta A, Kaul A, Jain M, Loboda O, Dudar I, Korol L, Shifris I, Ito K, Ito K, Abe Y, Ogahara S, Yasuno T, Watanabe M, Sasatomi Y, Hisano S, Nakashima H, Saito T, Nogaibayeva A, Tuganbekova S, Taubaldiyeva Z, Bekishev B, Trimova R, Topchii I, Topchii I, Semenovykh P, Galchiskaya V, Efimova N, Scherban T, Yasuda F, Shimizu A, MII A, Fukui M, Postorino M, Alessi E, Dal Moro E, Postorino S, Mannino G, Giandalia A, Mannino D, Pontrelli P, Conserva F, Accetturo M, Papale M, DI Palma AM, Cordisco G, Grandaliano G, Gesualdo L, Kimoto E, Shoji T, Sonoda M, Shima H, Tsuchikura S, Mori K, Emoto M, Ishimura E, Nishizawa Y, Inaba M, Vogel C, Scholbach T, Bergner N, Lioudaki E, Lioudaki E, Stylianou K, Maragkaki E, Stratakis S, Panteri M, Choulaki C, Vardaki E, Ganotakis E, Daphnis E, Iqbal M, Ahmed Z, Mansur M, Iqbal S, Choudhury S, Nahar N, Ali S, Ahmed T, Alam A, Rahman Z, Islam M, Azad Khan A, Ogawa A, Sugiyama H, Kitagawa M, Morinaga H, Inoue T, Takiue K, Kikumoto Y, Uchida HA, Kitamura S, Maeshima Y, Tsuchiyama Y, Makino H, Nazemian F, Jafari M, Zahed NOS, Javidi Dasht Bayaz R, Papale M, DI Paolo S, Vocino G, DI Palma A, Federica C, Rocchetti MT, Grandaliano G, Gesualdo L, Prajitno CW, Ismail G, Ditoiu A, Stanciu S, Herlea V, Motoi O, Striker G, Uribarri J, Vlassara H, Gul B, Oz Gul O, Yildiz A, Eroglu A, Keni N, Ersoy C, Ersoy A, Imamoglu S, Yurtkuran M. Diabetes - Clinical. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
6
|
Usvyat LA, Raimann J, Thijssen S, van der Sande FM, Kooman J, Levin NW, Kotanko P, Von Gersdorff G, Schaller M, Bayh I, Etter M, Grassmann A, Guinsburg A, Kooman J, Lam M, Marcelli D, Marelli C, Scatizzi L, Tashman A, Thijssen S, Toffelmire T, Usvyat L, Van der Sande F, Wang Y, Levin NW, Barth C, Kotanko P, Moffitt T, Moffitt T, Hariton F, Devlin M, Garrett P, Hannon-Fletcher M, Ekramzadeh M, Sohrabi Z, Salehi M, Fallahzadeh MK, Ayatollahi M, Geramizadeh B, Hassanzadeh J, Sagheb MM, Beberashvili I, Beberashvili I, Sinuani I, Azar A, Kadoshi H, Shapiro G, Feldman L, Averbukh Z, Weissgarten J, Abe Y, Watanabe M, Ito K, Sasatomi Y, Ogahara S, Nakashima H, Saito T, Witt S, Kunze R, Guth HJ, Skarabis H, Kunze R, Vienken J, Nowak P, Wilk R, Mamelka B, Prymont-Przyminska A, Zwolinska A, Sarniak A, Wlodarczyk A, Rysz J, Nowak D, Trajceska L, Dzekova-Vidimliski P, Gelev S, Arsov S, Sikole A, Sonikian M, Dona A, Skarakis I, Metaxaki P, Chiotis C, Papoutsis I, Karaitianou A, Spiliopoulou C, Marcelli D, Tashman A, Guinsburg A, Grassmann A, Barth C, Marelli C, Van der Sande FM, Von Gersdorff G, Bayh I, Kooman J, Scatizzi L, Lam M, Schaller M, Etter M, Thijssen S, Toffelmire T, Wang Y, Usvyat LA, Kotanko P, Levin NW, Teta D, Teta D, Tappy L, Theumann N, Halabi G, Gauthier T, Mathieu C, Tremblay S, Coti P, Burnier M, Zanchi A, Martinez Vea A, Cabre C, Villa D, Munoz M, Vives JP, Arruche M, Soler J, Compte MT, Aguilera J, Romeu M, Giralt M, Barril G, Anaya S, Vozmediano C, Celayeta A, Novillo R, Bernal V, Beiret I, Huarte E, Martin J, Santana H, Torres G, Sousa F, Sanchez R, Lopez-Montes A, Tornero F, Uson J, Pousa M, Giorgi M, Rdez Cubillo B, Malhotra R, Malhotra R, Usvyat L, Abbas SR, Thjissen S, Carter M, Etter M, Tashman A, Guinsburg A, Grassmann A, Barth C, Marelli C, Van der Sande F, von Gersdorff G, Bayh I, Kooman J, Scatizzi L, Lam M, Schaller M, Toffelmire T, Wang Y, Marcelli D, Levin N, Kotanko P, Jens R, Tepel M, Katharina E, Andrea H, Simone F, Florian S, Slusanschi O, Garneata L, Moraru R, Preoteasa E, Barbulescu C, Santimbrean C, Klein C, Dragomir D, Mircescu G, Idorn T, Knop F, Holst JJ, Hornum M, Feldt-Rasmussen B, Son YK, An WS, Kim SE, Kim KH, Garneata L, Slusanschi O, Preoteasa E, Barbulescu C, Santimbrean C, Klein C, Mircescu G, Borrelli S, Minutolo R, De Nicola L, Conte G, De Simone W, Zito B, Guastaferro P, Nigro F, Bassi A, Leone L, Credendino O, Genualdo R, Capuano M, Iulianiello G, Auricchio MR, Sezer S, Bal Z, Tutal E, Erkmen Uyar M, Ozdemir Acar FN, Ribeiro S, Faria MS, Melo F, Sereno J, Freitas I, Mendonca M, Nascimento H, Fernandes J, Rocha-Pereira P, Miranda V, Mendonca D, Quintanilha A, Belo L, Costa E, Reis F, Santos-Silva A, Valtuille R, Casos ME, Fernandez EA. Nutrition, inflammation and oxidative stress - CKD 5D. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
7
|
Fallahzadeh MK, Sagheb MM, Fallahzadeh MH. In memorandum of world kidney day: chronic kidney disease: a common but often unnoticed major health problem. Iran Red Crescent Med J 2011; 13:164-6. [PMID: 22737456 PMCID: PMC3371941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Revised: 12/12/2010] [Accepted: 01/10/2011] [Indexed: 11/20/2022]
Affiliation(s)
- M K Fallahzadeh
- Shiraz Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M M Sagheb
- Department of Nephrology, Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M H Fallahzadeh
- Department of Nephrology, Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Department of Pediatric Nephrology, Shiraz University of Medical Sciences, Shiraz, Iran,Correspondence: Mohammad Hossein Fallahzadeh, MD, Shiraz Nephro-Urology Research Center, Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran, E-mail:
| |
Collapse
|
8
|
Sagheb MM, Sharifian M, Moini M, Salehi O. Acute renal failure and acute necrotizing pancreatitis after Echis carinatus sochureki bite, report of a rare complication from southern Iran. Prague Med Rep 2011; 112:67-71. [PMID: 21470501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Venomous animal bites are a significant health problem for rural populations in many parts of the world. Herein, we report an unusual presentation of Echis carinatus sochureki bite from southern Iran. A 36 year old woman was referred to Shiraz Nemaze Hospital due to anuria, headache, gastrointestinal bleeding, nausea and vomiting and severe abdominal pain after Echis carinatus sochureki bite. According to the clinical and paraclinical evaluations, the patient was admitted with impression of acute renal failure and acute pancreatitis. Acute pancreatitis is a rare complication after snake bite. This article is the first report of acute pancreatitis after Echis carinatus sochureki bite.
Collapse
Affiliation(s)
- M M Sagheb
- Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | | |
Collapse
|
9
|
Roozbeh J, Sattarinezhad A, Afshariani R, Eshraghian A, Sagheb MM, Raeesjalali G, Behzadi S, Nikeghbalian S, Salehipour M, Salahi H, Bahador A, Malek-Hosseini SA. The effect of simvastatin on lowering panel reactive antibody titer in sensitized dialysis patients: a randomized placebo controlled clinical trial. Int J Organ Transplant Med 2010; 1:85-90. [PMID: 25013570 PMCID: PMC4089224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Patients with panel reactive antibodies (PRA) have many difficulties to find a crossmatch-negative kidney for transplantation and are at a higher risk of post-transplantation rejection. OBJECTIVE To evaluate the effect of simvastatin on PRA and post-transplant outcome of these sensitized patients. METHODS 82 patients with end-stage renal disease (ESRD) with a PRA ≥25% were evaluated. In a one-year follow-up, the patients were treated with simvastatin. These patients were compared with 82 matched controls receiving placebo tablets. At the end of the second and 12(th) month, PRA was rechecked in all patients. Those patients who underwent transplantation continued to take simvastatin six months after transplantation. Serum creatinine levels were checked at monthly intervals post-operation. RESULTS The mean±SD PRA level at the end of the second month was 36.63%±31.14% and 45.34%±24.36% in cases and controls, respectively (P=0.012). Seven patients in the case group and 10 in the control group were lost to follow-up. The remaining patients continued to take simvastatin for 12 month. The mean±SD PRA level at the end of the 12(th) month was 24.02%±31.04% in cases and 43.15%±26.56% in controls (P=0.001). 25 patients underwent renal transplantation and continued to receive simvastatin 6 months after transplantation. These patients were matched with 25 controls treating with placebo. The mean±SD creatinine level 6 months after kidney transplantation was 2.05±1.14 mg/dL and 3.15±1.09 mg/dL in cases and controls consecutively (P=0.02). CONCLUSION Simvastatin can be safely used to lower PRA and improve post-transplantation outcomes.
Collapse
Affiliation(s)
- J. Roozbeh
- Organ Transplant Research Center, Nemazee Hospital, Shiraz University of Medical Science, Shiraz, Iran.,Department of Internal Medicine, Nephrology Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - A. Sattarinezhad
- Department of Internal Medicine, Nephrology Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - R. Afshariani
- Department of Health and Nutrition, School of Health, Shiraz University of Medical Sciences.
| | - A. Eshraghian
- Organ Transplant Research Center, Nemazee Hospital, Shiraz University of Medical Science, Shiraz, Iran.,Department of Internal Medicine, Nephrology Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. ,Correspondence: Ahad Eshraghian, MD, Department of Internal Medicine, Organ Transplant Research Center, Nemazee Hospital, Shiraz University of Medical Science, Shiraz, Iran
Tel: +98-711-627-6211
Fax: +98-711-627-6211
E-mail:
| | - M. M. Sagheb
- Organ Transplant Research Center, Nemazee Hospital, Shiraz University of Medical Science, Shiraz, Iran.,Department of Internal Medicine, Nephrology Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - G. Raeesjalali
- Organ Transplant Research Center, Nemazee Hospital, Shiraz University of Medical Science, Shiraz, Iran.,Department of Internal Medicine, Nephrology Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - S. Behzadi
- Organ Transplant Research Center, Nemazee Hospital, Shiraz University of Medical Science, Shiraz, Iran.,Department of Internal Medicine, Nephrology Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - S. Nikeghbalian
- Organ Transplant Research Center, Nemazee Hospital, Shiraz University of Medical Science, Shiraz, Iran.
| | - M. Salehipour
- Organ Transplant Research Center, Nemazee Hospital, Shiraz University of Medical Science, Shiraz, Iran.
| | - H. Salahi
- Organ Transplant Research Center, Nemazee Hospital, Shiraz University of Medical Science, Shiraz, Iran.
| | - A. Bahador
- Organ Transplant Research Center, Nemazee Hospital, Shiraz University of Medical Science, Shiraz, Iran.
| | - S. A. Malek-Hosseini
- Organ Transplant Research Center, Nemazee Hospital, Shiraz University of Medical Science, Shiraz, Iran.
| |
Collapse
|
10
|
Salehipour M, Jalaeian H, Salahi H, Bahador A, Davari HR, Nikeghbalian S, Sagheb MM, Raiss-Jalali GA, Roozbeh J, Behzadi S, Janghorban P, Sepas HN, Malek-Hosseini SA. Are Large Nonfunctional Kidneys Risk Factors for Posttransplantation Urinary Tract Infection in Patients With End-Stage Renal Disease Due To Autosomal Dominant Polycystic Kidney Disease? Transplant Proc 2007; 39:887-8. [PMID: 17524840 DOI: 10.1016/j.transproceed.2007.02.058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The objective of this study was to evaluate the effect of bilateral nephrectomy on posttransplantation urinary tract infection (UTI) among patients with end-stage renal disease (ESRD) due to autosomal dominant polycystic kidney disease (ADPKD). METHODS In a retrospective case-control design, 62 patients with ESRD with ADPKD were divided into 2 groups: (A) 24 patients who underwent bilateral nephrectomies, and (B) 38 patients in whom bilateral nephrectomies had not been done. Pretransplantation and posttransplantation urine cultures were evaluated for UTI. RESULTS Sixty-two patients with ESRD with ADPKD were enrolled in this study. The average age was 42 years (range, 6-60 years). Forty patients (64.5%) were male and 22 (35.5%) were female. The mean duration of hemodialysis was 24 months (range, 2-120 months), which was the same for both groups. Bilateral nephrectomies were done for 24 participants (38.7%). There were 38 patients (61.3%) in group B who did not have the operation. UTI occurred in 23 patients (37.1%): 6 patients (25%) in group A and 17 patients (44.7%) in group B. The incidence of UTI was not statistically different between the 2 groups (P>.05). Furthermore, no relationship was found between age, gender, blood group, and UTI in patients with ADPKD (P>.05). CONCLUSION According to our study, the presence of large nonfunctional kidneys is not a risk factor for posttransplantation UTI in patients with ADPKD and ESRD.
Collapse
Affiliation(s)
- M Salehipour
- Shiraz Transplant Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Serati AR, Roozbeh J, Sagheb MM. Serum LDL levels are a major prognostic factor for arteriovenous fistula thrombosis (AVFT) in hemodialysis patients. J Vasc Access 2007; 8:109-14. [PMID: 17534797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
INTRODUCTION Arteriovenous fistula thrombosis (AVFT) is still a common cause of morbidity in patients undergoing regular hemodialysis (HD). Many factors have been found to induce AVFT. Some of those factors are local and others are systemic ones. In this study, we evaluated some local and systemic factors simultaneously, to predict the most potent risk factor for AVFT in HD patients. PATIENTS AND METHODS One hundred and eighteen patients aged 20-80 yrs with end-stage renal disease (ESRD) were evaluated prospectively for a period of 14 months. First, anticardiolipin antibodies (ACLA), TG, cholesterol, low density lipoprotein (LDL) and high density lipoprotein (HDL) were analyzed by conventional methods. Other basic data were accessed from patients medical records. All fistulas were evaluated clinically as patent at the start of this study. Patients were followed-up for any evidence of AVFT within 14 months. Finally, all factors (diabetes, hypertension, presence of ACLA, ultrafiltration >or=3 L, age, gender, weight, hypotension during dialysis, fistula site, epoetin alpha usage, TG, HDL, LDL and total cholesterol) were analyzed in a stepwise regression analysis. RESULTS Eighteen episodes of AVFT documented with Doppler sonography occurred in 17 patients (15.3%). Regression analysis showed only LDL values were the AVFT predictor in our patients (p=0.002, beta-coefficient=0.3). Kaplan-Meier analysis showed a significantly lower AVF patency time in patients with LDL >130 mg/dl than those with LDL <130 mg/dl (log rank=0.0014). DISCUSSION LDL value is a major prognostic factor for AVFT in HD patients and lowering it to <130 mg/dl could improve fistula patency.
Collapse
Affiliation(s)
- A R Serati
- Division of Cardiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | | | | |
Collapse
|