Prevalence of Renal Osteodystrophy and its Related Factors among End-stage Renal Disease Patients Undergoing Hemodialysis: Report from Imam Reza Referral Hospital of Medical University of Kermanshah, Iran.

OBJECTIVES: We sought to determine the prevalence of renal osteodystrophy (ROD) and its related factors in a group consisting of end-stage renal disease (ESRD) patients undergoing maintenance hemodialysis. METHODS: A total of 128 ESRD patients (52 men and 76 women) with a mean age of 59.3 years undergoing maintenance hemodialysis at Imam Reza Referral Hospital, Iran were included in this cross-sectional study. We measured serum parathyroid hormone (PTH) levels and determined 150 to 300 pg/mL as the desirable range for the values. Values lower or higher than this range were used to determine ROD. Furthermore, this study investigated the association of ROD with clinical and laboratory variables (age at the onset of renal failure, hemodialysis sessions per week, clinical symptoms associated with ROD, and serum calcium and phosphate levels). RESULTS: ROD was diagnosed in 93 (72.7%) out of 128 patients studied. Of them, 53 (41.4%) patients had PTH levels above 300 pg/mL (high bone turnover, HTO group) and 40 patients (31.3%) had PTH levels below 150 pg/mL (low bone turnover, LTO group). No statistically significant difference was detected in terms of ROD-related clinical findings (p = 0.110), age at the time of ESRD diagnosis (p = 0.200), and the number of hemodialysis sessions per week (p = 0.200). Hyperphosphatemia was more prevalent in the ROD group (n = 52, 57.1%) compared with 11 patients (31.4%) included in the group without ROD (p = 0.004). CONCLUSIONS: The prevalence rate of ROD in this study was significant, and it was largely consistent with the rate reported in some Asian countries. Hyperphosphatemia were laboratory variables closely related to ROD.

Mycophenolate Mofetil as a Rescue Therapy in Frequently Relapsing/Steroid-Dependent Nephrotic Syndrome in Children; Ability to Maintain Remission.

INTRODUCTION: Nephrologists usually encounter therapeutic challenges and dilemmas when treating steroid-dependent nephrotic syndrome (SDNS) and frequently relapsing nephrotic syndrome (FRNS). Due to the serious side effects of long-term administration of corticosteroids, physicians administer steroid adjuvants to maintain remission and to limit the cumulative dosage of corticosteroids. Among these adjuvants, it is postulated that mycophenolate mofetil (MMF) is an impressive option owing to its fewer side effects, acceptable tolerance, and high effectiveness. METHODS: This comparative study was performed on a group of SD/FRNS patients who were on MMF therapy for an average duration of 2.75 years and on regular follow-up at the Department of Nephrology of Imam Reza Hospital, Kermanshah, Iran. RESULTS: A total of 32 patients with a male to female ratio of 1.2:1 were enrolled. The mean duration of follow-up prior to and following the initiation of MMF therapy was 2.63 and 2.75 years, respectively. The results obtained from the comparative analysis of the recurrence rate and the dose of corticosteroids used prior to and following the initiation of MMF therapy revealed that this therapy significantly lowered the recurrence rate (P < .05) and the corticosteroid dose (P < .05). Hence MMF is a well-tolerated and effective agent in decreasing the recurrence rate (64.52%) and the cumulative dosage of corticosteroid (43.88%) in complicated nephrotic syndrome patients. CONCLUSION: There were no significant differences between the patients treated with MMF as the first steroid-sparing agent and those treated with MMF as the second or third agents. DOI: 10.52547/ijkd.6376.

Maternal and fetal outcome of burn during pregnancy: 3rd report from Kermanshah, Iran.

OBJECTIVE: Burn injuries in the course of pregnancy can lead to significant complications and mortality for both mother and fetus. Mortality and morbidity depend on the severity of burn. The current article is the third report authored on burn during pregnancy from Kermanshah, Iran. METHOD: The present descriptive analytic study seeks to review the entire number of files belonging to the pregnant women with burn injury admitted in the Burn Ward of Imam Khomeini Hospital in Kermanshah during the period 2012-2020. Demographic data and fetal and maternal complications and outcome were extracted. Chi-square test was applied to analyze quantitative parameters statistically, and probit regression analysis was performed to calculate the Lethal Area 50% (LA50%) index. RESULTS: Thirty-seven patients with mean age of 32 ± 6.07 years and mean gestational age of 19.5 ± 10.47 years were enrolled. Fifteen (40.5%) patients had undergone less than 25% total burn surface area (TBSA), 5 (13.5%) 25%-50%, and 17 (45.9%) more than 50%. Maternal mortality was 16 (43.2%). Fetal complications included premature labor in 4, abortion in 14, and intrauterine fetal death in 7 cases. LA50% was calculated as 54%. CONCLUSION: Burn during pregnancy has a high rate of maternal and fetal mortality. These complications are highly related to severity of burn and TBSA. Preventive measures can play an important role in decreasing complications.