In conclusion, circulating ANCA at transplant was associated with the development of vascular lesions in the graft but was not significantly correlated with graft survival. Most grafts were lost due to patient death, which was more likely if transplantation occurred <12 months following induction of remission of ANCA-positive vasculitis.

Background:The risk for diabetic nephropathy in type 2 diabetes is about 30-40%, and it is considered the leading cause of end-stage renal disease. Small dense low-density lipoprotein (sdLDL) particles are believed to be atherogenic, and its predominance has been accepted as an emerging cardiovascular risk factor. This study aimed to assess small dense LDL as a potential risk factor and a possible predictor for diabetic nephropathy in type 2 diabetic patients.Patients and Methods:According to microalbuminuria test, 40 diabetic patients were categorized into two groups: Diabetic patients without nephropathy (microalbuminuria negative group) and diabetic patients with nephropathy (microalbuminuria positive group), each group consists of 20 patients and all were non-obese and normotensive. The patients were re-classified into three sub-groups depending on the glomerular filtration rate (GFR).Results:The mean of small dense LDL level in the microalbuminuria positive group was higher than that in the microalbuminuria negative group, but without statistical significance. It was significantly higher in patients with either mild or moderate decrease in estimated GFR than in patients with normal estimated GFR. There was statistically significant correlation between small dense LDL and albuminuria and significant inverse correlation between small dense LDL and estimated GFR in all patients in the study. Based on microalbuminuria, the sensitivity and specificity of small dense LDL in the diagnosis of diabetic nephropathy was 40% and 80%, respectively, with cutoff values of small dense LDL >55.14 mg/dl. On the other hand, based on GFR, the sensitivity and specificity were 88.24% and 73.91% respectively, with cutoff values of small dense LDL >41.89 mg/dl.Conclusion:Small dense LDL is correlated with the incidence and severity of diabetic nephropathy in type 2 diabetic patients. It should be considered as a potential risk factor and as a diagnostic biomarker to be used in conjunction with other biochemical markers for early diagnosis, assessment, and follow-up of diabetic nephropathy.

Background: Several studies documented the non-hematologic clinical therapeutic uses of recombinant human erythropoietin (EPO). On the other hand, hypertension, thromboembolism, and increased oxidative stress were toxic effects related to the increased hematocrit (Hct) with recombinant human EPO treatment. Accordingly, alternate strategies to reduce erythropoietic activity and other potential side effects of EPO will greatly improve its non-hematopoietic clinical applicability. Aims and Objectives: Our objective was to demonstrate whether curcumin treatment could attenuate the effect of recombinant human EPO on erythropoiesis in EPO-induced polycythemia, and if so, whether this effect is mediated by changing concentrations of iron and its key regulator hormone hepcidin in rats. Materials and Methods: Totally 24 male albino Sprague-Dawley rats were included in this study. Rats were equally divided into four groups: Control group, curcumin-treated group, EPO-induced polycythemia group, and curcumin + EPO-induced polycythemia group. Blood indices and serum concentrations of iron, ferritin, and hepcidin were measured. Results: EPO treatment caused significant increase in hemoglobin (Hb), red blood cells, and Hct versus other study groups (P < 0.05). Curcumin treatment significantly decreased Hct in curcumin-treated group versus control and EPO-induced polycythemia groups (P = 0.021 and 0.008, respectively). Serum iron concentrations were significantly decreased in curcumin + EPO-induced polycythemia group versus control group. Serum ferritin concentrations were significantly decreased in all treated groups versus the control group. Serum hepcidin concentrations were significantly decreased in EPO-induced polycythemia group and curcumin + EPO-induced polycythemia group versus control group. Conclusion: The presented data suggest a potentially attenuating effect of curcumin administration on recombinant human EPO-induced polycythemia. This effect may be mediated by promoting iron deficiency. However, further studies are required to address the safety of this combination treatment and interspecies differences in iron metabolism between rats and human in addition to have better understanding of the role of the hepcidin.

Background: Etiology of uremic pruritus as a common complication in patients with end stage renal disease (ESRD) is not fully understood. Aim: Our aim was to highlight beta 2 microglobulin (β2M) as a risk factor for uremic pruritus and to assess the diagnostic performance of β2M for predicting pruritus in patients with ESRD. We assessed the serum level of β2M in hemodialysis patients with pruritus compared to those without pruritus. Subjects and Methods: This study included 17 ESRD patients on hemodialysis with pruritus and 17 ESRD patients on hemodialysis without pruritus. Patients included in this study were subjected to detailed history taking, assessment of pruritus severity using visual analog scale (VAS) in pruritic group, kidney function test and estimation of serum β2M levels. Results: The pre-dialysis serum level of β2M was significantly higher in pruritic group than in nonpruritic group (2.79±1.20 and 1.52±0.66, respectively, p=0.002). The post-dialysis serum level of β2M was also significantly higher in pruritic group than in nonpruritic group (3.44±1.31 and 1.89±0.62 respectively, p=0.001). The diagnostic performance of β2M for predicting pruritus in patients with ESRD was good as evidenced by area under the curve (AUC: 81.7, p=0.0001). Best cut off point for predicting pruritus in ESRD was >2.05 in predialysis and >2.66 in post-dialysis. Conclusion: Our results showed high serum level of β2M in ESRD patients with pruritus that may highlight the role of β2M in the pathogenesis of this important problem. β2M has good diagnostic performance of for predicting pruritus in patients with ESRD.

Anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitides are rare autoimmune diseases that can often be life threatening. They particularly affect the kidneys and lungs but can also affect many other organs. Various hypotheses have been proposed to explain the loss of tolerance against ANCA antigens (present in granules of neutrophils and monocytes); however, clear mechanisms remain elusive. Clinical observation, in vitro studies and newly developed animal models implicate ANCAs in disease pathogenesis and relevant mechanisms are now being characterized. Abnormalities in patient's T-cell populations exist and the increasingly recognized role of B cells in ANCA-associated vasculitis is also discussed.