ABSTRACT
in the reports presented about COVID-19, patients receiving kidney transplantation have not been specifically studied and based on national flowchart, this population is classified as highrisk group, thus it is necessary to be aware of the step-by-step treatment approach of these patients. Suspicious cases included patients with a history of dry cough, chills or sore throat accompanying by shortness of breath with or without fever, patients with upper/lower respiratory symptoms with radiological manifestations as single or double-sided multilobular infiltrations on CT scan or plain chest radiography, any one that has a history of close contact with a definite COVID-19 case within the last 14 days, any one with a history of presence in COVID-19 epidemic regions within the last 14 days and patient with pneumonia that despite of proper treatment has an inappropriate clinical response and clinical condition becomes more severe in an unusual way or unexpectedly.
Subject(s)
Coronavirus Infections/diagnosis , Coronavirus Infections/immunology , Kidney Transplantation , Pneumonia, Viral/diagnosis , Pneumonia, Viral/immunology , Transplant Recipients/statistics & numerical data , COVID-19 , Coronavirus Infections/diagnostic imaging , Coronavirus Infections/pathology , Diagnosis, Differential , Humans , Pandemics , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/pathologyABSTRACT
The administration of radiocontrast media may lead to kidney injury, known as contrast-induced nephropathy, which is reversible in most cases, but its development may be associated with adverse outcomes. This review article provides recommendations for the prevention of contrast nephropathy.
Subject(s)
Acute Kidney Injury/chemically induced , Acute Kidney Injury/prevention & control , Contrast Media/adverse effects , Acetylcysteine/therapeutic use , Biomarkers , Creatinine/blood , Humans , Randomized Controlled Trials as Topic , Sodium Chloride/therapeutic useABSTRACT
INTRODUCTION: The aim of this study was to assess the effects of pioglitazone on blood glucose control and inflammatory biomarkers in diabetic patients receiving insulin after kidney transplantation. MATERIALS AND METHODS: In a randomized placebo-controlled trial, 62 diabetic kidney transplant patients were followed for 4 months after randomly assigned to placebo and pioglitazone (30 mg/d) groups. All of the patients continued their insulin therapy irrespective of the group that they were assigned to, in order to evaluate the effects of addition of pioglitazone on blood glucose and inflammation biomarkers including serum C-reactive protein, high-sensitivity C-reactive protein, and interleukin-18 levels, as well as erythrocyte sedimentation rate. RESULTS: At baseline, there were no significant differences in laboratory studies between the two groups. After 4 months of intervention, along with significant improvement in hemoglobin A1c in the pioglitazone group, daily insulin requirements also decreased and lipid profile improved significantly. In addition, erythrocyte sedimentation rate, C-reactive protein, and high-sensitivity C-reactive protein values were significantly lower in the pioglitazone group (P = .03, P < .001, and P = .01). Interleukin-18 levels were not significantly different at the end of the study between the two groups, but it had a decreasing trend in the pioglitazone group (P = .002). CONCLUSIONS: Pioglitazone complementing insulin in diabetic kidney transplant patients not only improved glycemic control, evidenced by hemoglobin A1c, and reduced daily insulin requirement, but also decreased inflammatory markers which may have an impact on overall cardiovascular events and mortalities beyond glycemic control.
