[Correlation between histological findings, activity and choronicity indices and laboratory data in patients with lupus nephritis]

Renal involvement in systemic lupus erythematosus [SLE] is one of the most serious complications. Numerous reports have documented the unpredictable course of lupus nephritis and the role of renal biopsy in evaluation of individual patients. It is impossible to predict the types, severity and activity of renal lesions based only on combination of clinical and laboratory findings. The aim of this study was to evaluate the histological findings, activity and chronicity scores, and also assessing the correlation between histology and other laboratory findings in patients with lupus nephritis. This cross-sectional study was carried out on 40 patients with diagnosis of lupus nephritis at Ghaem Hospital in Mashhad during 2003 to 2006. Renal biopsy was performed for all patients and correlation between laboratory and serologic parameters and the histological findings were investigated. Data were analyzed using t-test, Chi square test, and Fischer exact test. Activity score was 9.02 in 34 patients with proteinuria and 6.33 in 6 patients without proteinuria [p=0.018]. There was a significant correlation between the activity score and serum C4 levels [p=0.031]. Also, a significant correlation was shown between fibrous crescent [one of the chronicity criteria on biopsy] and nephrotic syndrome [p=0.047]. No significant correlation between activity and chronicity scores and other laboratory and serologic findings was found. Based on our data, no exact correlation between histological findings and laboratory data in lupus nephritis was demonstrated; therefore, emphasis on important role of renal biopsy in evaluation of these patients is suggested

comparative study on using coiled versus straight Swan-Neck Tenckhoff catheters in patients undergoing peritoneal dialysis

The key to successful long-term peritoneal dialysis [PD] is permanent and safe access to peritoneal cavity. The two most commonly used Tenckoff catheters for PD are the straight and coiled catheters. The present study was undertaken to assess the catheter survival, catheter associated infections, and all cause mortality and to compare the straight with coiled catheters in PD. During April 1997-August 2006, 96 patients undergoing peritoneal dialysis in Ghaem Hospital, Mashhad, Iran were enrolled in this study. In 53 patients straight catheter and in 43 patients coiled catheter were used. The catheter survival, and catheter associated infections including peritonitis and exit site infection rate were compared between the two groups. The catheter survival in the two groups was in favor of coiled ones. Catheter associated peritonitis and exit site infection were more prevalent in patients with straight catheters [P=0.027 and P=0.006 respectively]. Overall patient survival rate was not different between the two groups [P=0.919]. There was no difference regarding tunnel infection between the two groups [P=0.673]. Straight PD catheters were not associated with more overall patient morality rate but less catheter survival was noted in this group. In comparison with coiled PD catheters, peritonitis and exit site infection were seen more frequently in patients dialyzed using straight catheters. We found no difference regarding leakage episodes [P =0.562] or re-operation due to catheter malposition resulting in catheter salvage [P =0.26]. Overall re-operation rate was not different between the two groups [P =0.732]. Straight PD catheters were not associated with more patients' morality rate but had less catheter survival than coiled PD catheters. Peritonitis and exit site infection were found more frequently in patients dialyzed with straight catheters