Effect of renal transplantation on serum hepatocyte growth factor levels in hemodialysis patients with HCV infection

Hepatocyte growth factor [HGF] acts as an activator of mitogenesis, motogenesis, and morphogenesis, and as a potent survival factor. It is one of the cytokines that has proven to be involved in the regeneration of renal tubule cells following injury. The purpose of this study was to evaluate the effect of renal transplantation on serum hepatocyte growth factor levels in hemodialysis patients with HCV infection.74 subjects with HCV infection were enrolled in the study, they were further subdivided into three groups: Control group [n=10]; hemodialysis group [HD] [n= 30] and renal transplant recipient group [n=34]. Serum hepatocyte growth factor [HGF] determination was performed using quantitative sandwich enzyme immunoassay. Our study revealed that serum levels of HGF, in HD patients showed a significant increase as compared to control [p<0.001] and renal transplant groups [p<0.001]. In HD patients serum HGF levels showed a positive correlation with both serum creatinine levels [r =0.874, p< 0.001] and urea levels [T= 0.559, p< 0.001] but did not correlate with ALT levels or duration of HD. Serum HGF values in renal transplant recipients showed no statistically significant changes as compared to controls and did not correlate with either creatinine, urea, ALT and cyclosporine blood levels. We concluded that serum HGF was elevated in HD patients, which may be attributed to the increased production of HGF in response to the chronic renal injury, the effect of heparin, or reduced removal of serum HGF in CRF patients. Serum levels of HGF in renal transplant recipients showed no statistically significant changes as compared to controls and no correlation with cyclosporine blood levels as patients had good allograft function and cyclosporine blood levels were properly monitored. Although serum HGF values in HD patients are elevated, levels return back to normal in renal transplant recipients with good allograft function

Occult gastrointestinal bleeding in-patients on acetylsalicylic acid for prevention of coronary artery diseases

In a trial to study the effect of the high versus the low dose acetyl-salicylic acid [ASA] schedules on the gastrointestinal tract of patients with coronary artery disease, one hundred patients with a previous acute myocardial infarction and fifty age-matched controls were studied. The patients were divided into 2 groups: group A [50 patients] received 300 mg ASA and group B [50 patients] received 75 mg ASA. The control group C [50 subjects] were not given ASA. After 3 months of ASA ingestion, occult blood in stools was done and gastroduodenoscopy was done for occult blood positive patients. Among the control group C; one subject had positive occult blood in stools and proved by gastroscopy to be due to gastric carcinoma. Group A patients showed 12 while group B patients showed 3 with occult blood in stools. On gastroscopy these patients had scattered mucosal gastroduodenal erosions including one with a benign gastric ulcer in group A and one with erosive hemorrhagic gastritis in group B. We concluded that low dose ASA schedules appear to be safer in the primary and secondary prevention of future cardiovascular events. A test for occult blood in stools would be advised every three months