[Herbs from Iranian traditional medicine for reinforcement of kidney and prevention of renal atrophy]

Background: Renal disorders including renal failure are common complications which affect the whole body system. The treatment methods in modern medicine seem to be inadequate in a large number of cases. Regarding the increasing interest of the community towards traditional and complementary medicine, the potential of Persian medicine [PM] in management of renal diseases, could be put to test in research programs in order to find possible effective treatment. Objective: The aim of this study is to introduce materia medica which are commonly used in PM for the purpose of protection and functional empowerment of the kidneys against destructive factors

Methods: This research is a literature-based study on effective material medica used in the treatment of two significant renal disorders; renal weakness and renal atrophy [Hozal]. Six pharmaceutical references of Persian medicine from different historical periods were searched by certain keywords related to renal weakness and renal atrophy

Results: Fourteen materia medica related to the prevention or treatment of renal weakness and fifteen for renal atrophy were found. Poppy [Papaver somniferum]. Amber and shellac are the most repeated medicines in the treatment of renal weakness; whereas fig [ficus carica], banana [musa sapientum] and hazelnut [corynus avelana] are mostly_repeated for either prevention or treatment of renal atrophy

Conclusion: Medicinal plants represented by Persian medicine references could be a basis for experimental and clinical researches for drug development in the field of prevention or even treatment of acute or chronic renal failure

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

Prevalence of malnutrition in dialysis patients

Introduction: Malnutrition is one of the important causes of mortality and morbidity in chronic renal failure. In this study we assessed the Prevalence of malnutrition in patients with chronic hemodialysis and CAPD

Material and Method: In this study we assessed 22 patients on hemodialysis [11 male, 11 female] and 20 patients on CAPD [11 male and 9 female] and in total 42 patients for clinical evidence of malnutrition. Four Subjective parameters including loss of body weight, Anorexia, loss of muscle mass and loss of subcutaneus fat pad were used. Every parameter was scored from 1 to 7 and then total score from 4 parameters concluded. If the total score were 7 or less than 7 the diagnosis of malnutrition was made

Results: 20% patients on CAPD and 13.2% patients on hemodialysis in Ghaem hospital of Mashhad were suffered from mild malnutrition. We did not have any cases of moderate or severe malnutrition. Prevalence of malnutrition in patients on hemodialysis or CAPD did not have any significant differences [p>0/05], and also six of patients had no effects on prevalence of malnutrition [p>0/05]. All cases of malnutrition in CAPD were seen in patients which dialysed for more than one year where as in patients with hemodialysis all cases of malnutrition were seen in the first year of dialysis [p<0/02]. Patients with recurrent peritonitis in CAPD patients had more malnutrition [p<0/005]

Conclusion: prevalence of malnutrition in our chronic dialysis patients is less than from majority of other studies but because of increasing of mortality and morbidity rate in patients with malnutrition we must sopport these patients with suitable diet. Early referral the patients with CRF to nephrologist and proper initation of dialysis will decrease prevalence of malnutrition. In other hand with prolongation of dialysis treatment in patient with CAPD and decrease of residual renal function and recurrent peritonitis the prevalence of malnutrition will increase