Response to hepatitis B virus vaccination in haemodialysis patients with and without hepatitis C infection.

The aim of this study was to determine the efficacy of hepatitis B virus (HBV) vaccination and the response to vaccine in individuals on haemodialysis with and without HCV infection. From April 2000 to September 2003 all haemodialysis patients referred to the haemodialysis department in a Babol hospital received 4 microg vaccine intramuscularly at 0, 1, and 6 months. All were negative for HBV infection markers (HBcAb, HBsAg and HBsAb). Of 62 patients, 53 (85.5%) responded to vaccination and 26 (49.1%) were high responders. All individuals with HCV infection responded to vaccination. Duration of haemodialysis had no effect on response to vaccination.

Response to hepatitis B virus vaccination in haemodialysis patients with and without hepatitis C infection

The aim of this study was to determine the efficacy of hepatitis B virus [HBV] vaccination and the response to vaccine in individuals on haemodialysis with and without HCV infection. From April 2000 to September 2003 all haemodialysis patients referred to the haemodialysis department in a Babol hospital received 4 microg vaccine intramuscularly at 0, 1, and 6 months. All were negative for HBV infection markers [HBcAb, HBsAg and HBsAb]. Of 62 patients, 53 [85.5%] responded to vaccination and 26 [49.1%] were high responders. All individuals with HCV infection responded to vaccination. Duration of haemodialysis had no effect on response to vaccination

Evaluation of insulin like growth factor-1 (IGF-1) in children with different stages of chronic renal failure.

Growth retardation in children with chronic kidney disease (CKD) is multifactorial that include inadequate protein and calorie intake, persistent metabolic acidosis, calcitriol deficiency, renal osteodystrophy, drug toxicity, uremic toxins and growth factor abnormalities such as insulin-like growth factor (IGF) and IGF binding proteins. In this study, we compare the IGF-1 levels in normal and growth retarded CKD children. Serum IGF-1 levels were determined in 22 children with end-stage renal disease, 26 children with CKD at different stages, 23 children with normal height and weight for age and 23 children with constitutionally short stature. Mean serum levels of IGF-1 were 209 +/- 141 ng/ml in the ESRD group (group 1), 159 +/- 163 ng/ml in the CKD group (group 2), 420 +/- 182 ng/ml in normal children (group 3) and 360 +/- 183 ng/ml in children with constitutional short stature (group 4). The differences in the levels of IGF-1 in groups 1 and 2 were statistically significant when compared to groups 3 and 4 (p< 0.0001 and p< 0.02, respectively), while the levels of IGF-1 were not statistically different between groups 1 and 2. No correlation was found between IGF-1 levels and glomerular filtration rate, height or weight in groups 1 and 2. In conclusion, serum levels of IGF-1 in children with CKD are significantly lower than healthy children.

Risk factors for long-term outcome of ifosfamide-induced nephrotoxicity in children.

Ifosfamide is widely used in the treatment of pediatric solid tumors. Its main adverse effects are various forms of renal tubular and glomerular damage. The authors sought to determine factors that predict the risk for the development and severity of ifosfamide-induced nephrotoxicity in children and to examine the long-term outcome of this complication. A total of 174 children who had received ifosfamide for various cancers were studied. Nephrotoxicity was assessed by laboratory markers of glomerular and tubular function and a grading score (none, mild, moderate, severe). Patients were assessed 4 to 12 weeks after each ifosfamide course, 3 months after completion of chemotherapy, and 5 years later. Of 174 children, 72 (41.4%) developed tubular dysfunction, whereas only 11 (6.3%) demonstrated glomerular dysfunction; 40 (23.0%) demonstrated mild toxicity, 16 (9.2%) demonstrated moderate toxicity, and 16 (9.2%) developed severe nephrotoxicity. The four severity subgroups (none, mild, moderate, severe) received comparable doses/m2/cycle of ifosfamide and mesna. Children exhibiting severe toxicity were significantly younger compared to those with moderate, mild, or no nephrotoxicity (median age: 2.2, 7.0, 8.2, and 10.5 years, respectively; p < 0.001) and received significantly higher cumulative doses of ifosfamide (49.6 +/- 12.3, 46.0 +/- 13.1, 36.2 +/- 9.7, and 33.8 +/- 7.6 g/m2, respectively; p < 0.001). Cumulative doses of cisplatin were higher among children with severe nephrotoxicity compared to those with moderate, mild, or no toxicity, although this difference did not reach statistical significance. Of all risk factors analyzed by multiple regression analysis, age was the most significant predictor for the grade of nephrotoxicity (p < 0.001), followed by the cumulative dose of ifosfamide (p = 0.005). Seven out of 16 children (44.0%) with severe nephrotoxicity and 4 out of 16 children (25.0%) with moderate nephrotoxicity demonstrated severe chronic tubular toxicity over a follow-up period of 5 years. Since severe ifosfamide-induced renal toxicity tends to be chronic in a substantial number of treated children, it should be balanced carefully against efficacy. Cumulative ifosfamide doses of 45 g/m2 and above should be carefully considered, especially in children younger than age 3.

Infantile cortical hyperostosis Caffey's disease.

A 2 1/2-month-old girl with cortical hyperostosis (Caffey's disease) is described with a brief review of the literature. This is the first case reported from Iran.