Uremic pruritus and serum phosphorus level

Pruritus is a common and bothersome problem among uremic patients which negatively affects life quality and prognosis of the patient. Various factors are known to be involved in the development of pruritus. The aim of this study was to assess the frequency and the factors which may have relationship with uremic pruritus, especially bone mineral metabolism indicators. Current cross-sectional study was done on 99 hemodialysis patients. Having pruritus, its duration, severity and correlation with patient's laboratory data was evaluated. For each patient a questionnaire was filled. The mean age of patients was 55.9 +/- 15.4 [23-87] years and 35.7% were female. They were on hemodialysis for 74.79 +/- 75.04 months. Frequency of pruritus was 58.6% [58 patients]. Considering the severity, 16.2% suffered from severe pruritus, measured by visual analogue scale [VAS]. Pruritus was more common in those on dialysis for more than 2 years [0.014]. 82.8% of those with VAS of less than 3, in comparison with 37.5% of those with VAS of greater than 7, had no complaint of awakening due to pruritus. The frequency of pruritus and its severity was more in patients with higher serum phosphorus level [P=0.048]. It seems that phosphate control which is not mainly attributed to dialysis adequacy and efficiency, needs more attention not only by medical team but also by patient. Decreasing the phosphate content of regimen may be cheap and helpful modality in pruritus management

Effect of antibiotic therapy on asymptomatic bacteriuria in kidney transplant recipients

Asymptomatic bacteriuria is a very common complication after kidney transplantation and the need for antibiotic therapy is controversial. The aim of this study was to evaluate the effect of antibiotic therapy on the clinical course of asymptomatic bacteriuria in renal transplant recipients. In the present study, 88 kidney transplant recipients with asymptomatic bacteriuria were divided into two groups of cases and controls. The patients had been selected from among those with at least 1 year follow-up. In the case group, asymptomatic bacteriuric episodes were treated with antibiotics, and in control group, they were followed without antibiotic therapy. The follow-up period was 9 to 12 months. Bacteriuric episodes, symptomatic urinary tract infection [UTI] episodes, and changes in plasma creatinine level were recorded and compared between the two groups. The rate of bacteriuric episodes and symptomatic UTIs were not significantly different between the two groups [P >0.05]. In addition, level of plasma creatinine did not increase significantly in neither of the groups during the study [P >0.05]. It seems that treatment of asymptomatic bacteriuria in kidney recipients does not decrease the rate of UTI episodes afterwards. Asymptomatic bacteriuria does not affect renal function in short term. Thus, we can abandon antibiotic therapy, subject to careful follow-up