Inadequate dietary intakes are a major determinant of malnutrition in hemodialysis (HD) patients. Considering the lack of information available on dietary intakes of HD patients in Iran, the present study was designed to assess the dietary intakes of HD patients in Tehran, Iran. For this cross-sectional study, from among adult HD patients of 50 Tehran hemodialysis centers, 291 patients were randomly selected. Dietary intakes of these patients were assessed using a 4-day dietary recall. In addition, 4 mL of blood was obtained from each patient before dialysis to measure serum urea, creatinine, albumin, phosphorus, calcium, potassium, and high sensitive C-reactive protein levels. Dietary intakes of energy, protein and fiber were lower than recommended intakes in 88%, 84.5%, and 99% of HD patients, respectively. There were significant associations between dietary energy intake with the patient's age (p < 0.05), and HD vintage (P < 0.001). In addition, a significant association was found between dietary protein intake and sex (P < 0.05). Intakes of vitamins B1, B2, B3, B6, B12, C, E, folic acid, and of the minerals calcium and zinc (from both the diet and supplements) were lower than recommended intakes in 13.5%, 41.5%, 19%, 66%, 61%, 78%, 77%, 24%, 34%, and 98.5% of HD patients, respectively. Inadequate intakes of energy and various nutrients are prevalent in HD patients in Tehran, Iran, which may contribute to increased morbidity and mortality in these patients. Therefore, nutrition counseling and the administration of vitamin and mineral supplements are necessary in Iranian HD patients.

BackgroundWhen using brain dead donors for organ donation, assessment of kidney function before the procedure is essential.ObjectivesIt would be ideal to find an early marker of viability of donor kidneys that is more accurate than creatinine.Patients and MethodsThe present study was conducted from March of 2011 to March of 2012, included 52 deceased donors. Serum and urinary Neutrophil Gelatinase Associated Lipocalin (NGAL) and creatinine were measured at 0, 2, 4, 8, 12 and 18 hours after their admission to the ICU of our organ procurement unit (OPU). Other routine laboratory tests of hemglobin, blood glucose and lipid profile were performed as well.ResultsThere were 31 males and 21 females with the mean age of 29.7 ± 14.3 (6-58) years. Thirty one patients became brain dead due to car accidents. The mean time of admission time before harvest was 12.6 ± 5.8 (3-30) hours. We did not discover any correlation of serum creatinine with serum or urinary NGAL at any time before the organ harvesting. However, serum NGAL level measurement 2 hours after admission correlated significantly with other hours' measurements (4, 6, 8 hours, r > 0.9; P < 0.001).ConclusionsThe serum NGAL level, especially at 2 hours after admission to the ICU, should be evaluated with kidney function after transplantation to get the accurate predictive value.

Background: This study was designed to determine the prevalence of protein-energy wasting (PEW) and its various types in hemodialysis (HD) patients in Tehran, Iran. Methods: For this cross-sectional study, 291 HD patients were randomly selected. The nutritional status of the patients was determined by subjective global assessment (SGA) and their dietary intakes were assessed using a 4-day dietary recall. In addition, serum high-sensitive C-reactive protein (hs-CRP) was measured. Results: The prevalence of mild-to-moderate and severe PEW based on SGA was 60.5% and 1% in Tehran HD patients, respectively. The prevalence of various types of PEW in HD patients was 20.5% type I (inadequate energy or protein intake without inflammation), 65.5% type IIa (inadequate energy or protein intake with inflammation), and 14% type IIb (adequate energy and protein intake with inflammation). Of the total HD patients with no PEW based on SGA, about 3.5% had type 0 normal nutritional status (adequate energy and protein intake without inflammation), 34% had type I normal nutritional status (inadequate energy or protein intake without inflammation), 55.5% had type IIa normal nutritional status (inadequate energy or protein intake with inflammation), and 7% had type IIb normal nutritional status (adequate energy and protein intake with inflammation). Conclusion: PEW in Tehran HD patients is considerably prevalent and PEW type IIa is the most common type. In addition, HD patients with no PEW based on SGA should also be paid attention because they may be in the early stages of inadequate intake of energy and/or protein and inflammation.

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