Renal involvement in patients with hepatitis c virus infection

Hepatitis C virus [HCV] infection is a hepatotropic virus causing a variety of extrahepatic immunological manifestations and is a risk factor of a variety of extrahepatic diseases, such as mixed cryoglobulinemia and membranoproliferative glomerulonephritis [MPGN], which is the most common glomerulonephritis. The aim of this study was to evaluate renal involvement in HCV-infected patients. A total of 300 randomly-selected HCV antibody-positive outpatients at the HCV clinic of Shariati hospital were enrolled. Serum creatinine was measured and glomerular filtration rate was estimated accordingly. Urine proteinuria was measured in 24-hour urine samples. The patients were 249 men [83.2%] and 51 women [16.8%] with a mean age of 37.8 +/- 11.7 years [range, 18 to 70 years]. Proteinuria was found in 12 HCV antibody-positive adults [4%], 1 of whom underwent biopsy. He was a 55-year-old man with a 4-month history of facial and lower extremities edema and 3-g proteinuria with a normal kidney function [glomerular filtration rate, 85 mL/min] and normocomplementemia. Kidney biopsy specimens showed MPGN. The frequency of low glomerular filtration rate was 0.7% [2 patients] in the HCV antibody-positive adults. There was no significant relationship between HCV seropositivity and low glomerular filtration rate. Our observations showed renal involvement in HCV antibody-positive patients. Among immune complex glomerular kidney diseases, MPGN without cryoglobulins is thought to be the most common in these patients

Frequency, risk factors, and outcome of acute kidney injury following bone marrow transplantation at dr shariati hospital in Tehran

Bone marrow transplantation [BMT] is a major modality for malignant and hematologic disorders. This procedure is associated with a high morbidity and mortality such as acute kidney injury [AKI]. Many factors, such as therapeutic agents, irradiation, and graft versus host disease [GVHD] can cause AKI. Bone marrow transplantation conditioning therapy in Iran is based on drugs such as busulfan and cyclophosphamide and without irradiation therapy. The aim of this study was to evaluate the frequency, risk factors, and mortality of AKI among patients who underwent BMT. Acute kidney injury was defined as doubling serum creatinine from baseline at any time during the first 180 days posttransplant. The risk of AKI in relation to non-total-body-irradiation-based conditioning regimen, type of graft [allograft and autograft], comorbidities, GVHD, drug toxicity, and veno-occlusive disease were examined in 375 patients with BMT. One hundred and forty-two patients [37.6%] developed AKI at a median of 18 days after transplant. A higher frequency of AKI was observed in patients who received cyclosporine A [40%], patients with allograft BMT [42.1%], and those who developed gastrointestinal GVHD [47.3%] .The remainder AKI cases were associated with amphotericin B, veno-occlusive disease, and hemolytic-uremic syndrome. The frequency of AKI in our patients with BMT remained high. Cyclosporine A and amphotericin B and the presence of GVHD and veno-occlusive disease increased the risk of AKI within the first 180 days after BMT