Effects of L-carnitine supplementation on serum lipids and apoproteins in hemodialysis patients with LP[a] hyperlipoproteinemia

Lipid abnormalities, especially high serum Lp[a] concentrations, are one of the major causes of cardiovascular diseases in hemodialysis patients. The present study was designed to investigate the effects of L-carnitine supplementation on serum lipids and apoproteins in hemodialysis patients with Lp[a] hyperlipoproteinemia. The study was a randomized clinical trial in which 36 hyper Lp[a] hemodialysis patients [23 males and 13 females] with serum Lp[a] more than 30 mg/dl were randomly assigned to receive either a daily oral carnitine supplement of 1000mg [carnitine group] or no supplement [control group] for 12 weeks. At the baseline and the end of the period 5ml blood were collected after a 12 to 14-hour fast from each patient before dialysis and serum free carnitine, triglyceride, total cholesterol, HDL-C, LDL-C, apoAI, apoB100, Lp[a], IL-6 and albumin were measured. As compared to the initial values, the mean serum free carnitine concentration increased significantly in the carnitine group at the end of the period [P<0.001], while serum triglyceride [P<0.05], total cholesterol [P<0.001] and IL-6 [P<0.001] decreased significantly. No significant changes were observed in the serum concentrations of free carnitine, triglyceride, total cholesterol and IL-6 in the control group. In addition, there were no significant differences between the 2groups as regards mean changes of the serum HDL-C, LDL-C, apoAI, apoB100, Lp[a], and albumin levels. The results of the present study indicate that an L-carnitine supplement has no effect on serum Lp[a] concentration in hemodialysis patients with Lp[a] hyperlipoproteinemia, but it may be effective in preventing cardiovascular diseases by reducing serum triglyceride and total cholesterol concentrations in these patients

relative frequency, clinical and laboratory findings of adult glomerulonephritidies in Tehran

Renal diseases information is population-based and has great geographic variability. Due to the lack of national renal data registry system, there is no information on the prevalence rate, and clinical and laboratory features of various glomerulonephritidies [GNs] in Iran. In a retrospective cross sectional study, we analyzed 462 adult renal biopsies in Hashemi Nejad hospital, Tehran, Iran. We determined the prevalence rate and the frequency of different clinical and laboratory findings in patients with different GNs. We also compared our results with the reports from other countries. There were 267[57.8%] males and 195[42.2%] females. The mean age [ +/- SD] was 33.6 +/- 15.7 [range, 13-75] years old. After exclusion of 55 biopsies with pathologies other than GNs and in the remaining 407 biopsies, membranous glomerulopathy [MGN] was the most common GN [23.6%], followed by IgAN [13.5%], membranoproliferative GN [11.5%], systemic lupus nephritis [10.6%], focal segmental glomerulosclerosis [10.3%], and minimal change disease [9.8%]. These 6 GNs comprised the majority [79.4%] of all GNs. MGN is the most common form of GN, followed by IgAN, MPGN, SLE-GN, FSGS and MCD in adult patients in our study. The multi-center studies with a larger sample size are needed for more comprehensive data in Iranian population

Comparison of dobutamine stress echocardiography and ECG for screening of coronary artery disease in high- risk hemodialysis patients

To compare the results of dobutamine stress echocardiography [DSE] as a sensitive and specific, non-invasive test for screening of coronary artery disease [CAD] in end-stage renal disease hemodialysis patients with the results of ECG. Thirty nine patients at high-risk for CAD by definition were studied. Coronary artery risk factors including age, sex, hypertension, hyperlipidemia and hyperglycemia were reviewed. ECG, chest x-ray [CXR], Echocardiography [Echo] and DSE were done in all. The results showed that 10 out of 11 patients with a normal ECG had negative DSE [npv = 91%] and 9 out of 26 patients with any abnormal ECG had positive DSE [ppv = 35%]. On the other hand 19 out of 26 patients without symptoms of CAD had negative DSE [npv = 73%] and 3 out of 11 patients with symptoms of CAD had positive DSE [ppv = 27%]. Even in high-risk HD patients a normal ECG can reliably predict a normal DSE. Also any abnormal ECG would emphasize on the need for further CAD screening by DSE