Association of proteinuria with various clinical findings and morphologic variables of oxford classification in immunoglobulin a nephropathy patients

Immunoglobulin A nephropathy [IgAN] with nephrotic syndrome is an uncommon form of IgAN. Clinical and morphological characteristics of proteinuria in IgAN, especially when is in nephrotic range have not yet been fully examined. This study was aimed to correlate morphologic variables of the Oxford classification, and various clinical data with proteinuria in IgAN patients. We also aimed to demonstrate the significance of prevention of proteinuria as one of the important factors in progression of this disease. In an observational study conducted on IgAN patients, total of 114 biopsies were entered in the study. IgAN was diagnosed by light and immunofluorescence study. Of 114 patients 70.2% were male. Mean age of patients was 37.7 +/- 13.6 years. The mean of proteinuria was 1742 +/- 1324 mg/day. Also mean of serum creatinine [Cr] was 1.6 +/- 1.5 mg/dL. Of 114 patients, 11[9.6%] had nephrotic range proteinuria. In this study, there was a positive correlation between proteinuria and serum Cr, peri-glomerular fibrosis or interstitial fibrosis. There was a positive association between proteinuria and totally sclerotic glomeruli too. There was also a positive association between the amount of fibrous crescents and the level of proteinuria. Nephrotic proteinuria could just be seen in male patients. Also, nephrotic syndrome had a positive association with the number of crescents. Our findings firstly support the prognostic value of crescent due to its association with proteinuria and secondly imply the importance of treatment of proteinuria to prevent progression of IgAN

Association of neutrophil gelatinase associated lipocalin and cystatin c with kidney function in children with nephrotic syndrome

Nephrotic syndrome [NS] is a major clinical concern in human health, especially in children. Despite of the etiology, the prediction of remission in different treatment regimens based on suitable biomarkers is under development. The goal of this evaluation was the demonstration of correlation between serum level of Neutrophil gelatinase associated lipocalin [NGAL] and cystatin C with kidney function in patients with NS. During the period between September 2008 and December 2011, 52 patients admitted to St. Al Zahra University Hospital were selected for evaluation. The measured parameters consisted of NGAL, cystatin C, creatinine, albumin, blood urea nitrogen, urine protein, glomerular filtration rate. Demographic data were collected and considered in comparisons. Comparison between variables and their correlations were examined. Means of serum NGAL and cystatin C were significantly higher in case than the control group, P < 0.05. The mean of serum NGAL in patients without remission and who achieved remission were 23.09 [standard deviation [SD] +/- 10.11] and 36.26 [SD +/- 20.10] ng/ml respectively; P < 0.05. Serum NGAL levels had a correlation with the following factors: Systolic blood pressure, diastolic blood pressure [DBP], cystatin C, remission. Linear regression analysis showed a significant correlation between cystatin C and systolic and DBP. Based on the results, serum NGAL can be used as a prognostic marker for remission. In addition, NGAL and cystatin C are biomarkers of kidney injury in NS

Efficacy of co-administration of garlic extract and metformin for prevention of gentamycine-renal toxicity in wistar rats: a biochemical study

Gentamicin [GM] nephrotoxicity has been related to oxidative stress. Garlic and metformin [MF] have anti-oxadant activity and therefore, this study was aimed to evaluate the preventive and curative effects of garlic, MF and their combination on GM indeced tubular toxicity in Wistar rats. In a pre-clinical study, 70 male Wistar rats were randomly designated into 7 groups of 10 and treated as follows: Group 1: Received saline for 20 days. Group 2: Were injected 100 mg/kg/d of GM intraperitoneally [ip], for 10 days and saline for 10 more days. Group 3: Received GM for 10 days then 20 mg/kg garlic ip for the next 10 days. Group 4: Received GM for 10 days and MF [100 mg/kg] orally for the next 10 days. Group 5: Received GM for 10 days and a combination of MF and garlic for the next 10 days [100 and 20 mg/kg, respectively]. Group 6: The same as group 5but with half-doses of MF and Garlic. Group 7: Received GM for 10 days together with a combination ofMF and garlic. On 20th day of the experiment the serum blood urea nitrogen [BUN] and creatinine [Cr] were measured and compared in different groups. GM injection significantly increased the serum BUN and Cr [P < 0.05]. Administration of MF, garlic or their combination with or after injection of GM [high doses] could atenuate BUN and Cr. The results indicate that MF and garlic or their combination have curative and protective activity against GM nephrotoxicity

Evaluating the effectiveness of adding magnesium chloride to conventional protocol of citrate alkali therapy in children with urolithiasis

Potassium citrate [K-Cit] is one of the medications widely used in patients with urolithiasis. However, in some cases with calcium oxalate [CaOx] urolithiasis, the significant response to alkaline therapy with K-Cit alone does not occur. There is scarce published data on the effect of magnesium chloride [Mg-Cl2] on urolithiasis in pediatric patients. This study aimed to evaluate the effect of a combination of K-Cit - MgCl[2] as oral supplements on urinary parameters in children with CaOx urolithiasis. This study was conducted on 24 children with CaOx urolithiasis supplements included potassium citrate [K-Cit] and magnesium chloride [Mg-Cl2]. The serum and urinary electrolytes were measured before [phase 0] and after prescribing K-Cit alone [phase 1] and a combination of K-Cit and Mg-Cl[2] [phase 2]. Each phase of therapy lasted for 4 weeks. The mean age of patients was 6.46 +/- 2.7 years. Hyperoxaluria and hypercalciuria were seen in 66% and 41% of patients, respectively. Serum magnesium increased significantly during phase 2 comparing with phase 0. Urinary citrate level was significantly higher in phase 1 and 2 in comparison with phase 0, P < 0.05. In addition, urinary oxalate excretion was significantly diminished in phase 2 comparing with phase 0 and 1, P < 0.05. Soft stool was reported by 4 patients, but not severe enough to discontinue medications. These results suggested that a combination of K-Cit and Mg-Cl2 chloride is more effective on decreasing urinary oxalate excretion than K-Cit alone. The Iranian Clinical Trial registration number IRCT138707091282N1