Introduction: Fibroblast growth factor-23 (FGF23) is found as a bone derived hormone which can influence the serum levels of parathormone, phosphorous and 1, 25-dihydroxyvitamin D. FGF23 may be a cardiovascular biomarker in patients with chronic kidney disease (CKD). While, FGF23 is inversely correlated with serum adiponectin level, thus it is possible that FGF23 is correlated to fat mass and related to dyslipidemia in CKD. Objectives: In this investigation, we studied the association of serum levels of FGF23 with serum lipid profile, body mass index (BMI), and various cardiovascular risk factors in patients with CKD. Patients and Methods: This is a cross-sectional study, which was conducted on 80 non-dialysis patients (glomerular filtration rate [GFR] <60 cc/min) with CKD. Laboratory results and demographic information recorded in pre-defined data sheets and their relationship with FGF23 were analyzed. Results: Eighty patients were studied. Mean ± standard deviation (SD) of serum creatinine and FGF23 were 2.18 ± 0.73 mg/dl and 15.028 ± 20.20 RU/ml respectively. The correlation between FGF23, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), ApoA, ApoB, intact parathyroid hormone (iPTH), calcium, phosphorous, alkaline phosphatase, 25-hydroxyvitamin D, BMI, waist girth, serum triglyceride and cholesterol was not significant (P > 0.05). In this study, the correlations of FGF23, with serum albumin (P = 0.036) and systolic blood pressure (P = 0.001) were significant. Conclusion: Our study showed that there are not any significant correlations among FGF23, BMI and lipid profile. There are not any significant correlations between FGF23 and age, sex, and level of calcium, phosphorous, vitamin D. However, the relationships between FGF23 and serum albumin was negatively significant. Additionally we detected a positive significant correlation of FGF23 with level of systolic blood presure.

Introduction: In the coronavirus disease 2019 (COVID-19) era, kidney transplantation recipients (KTRs) are at high risk due to using immunosuppressive drugs. Considering the lack of definitive cure for COVID-19, repurposing existing pharmaceuticals is a way to find an immediate medication. Objectives: This study aimed to evaluate the COVID-19 outcomes in KTRs, receiving combination of sofosbuvir and daclatasvir (SOF-DAC) treatment. Patients and Methods: This research was an observational study of 12 adult kidney transplant recipients with COVID-19, admitted to Shariati hospital, Tehran, Iran (October to December 2020). All the patients received a once-daily combination pill of SOF-DAC at a dose of 400/60 mg for 10 days. Results: Around October to December 2020, 12 adult KTR patients were recruited; four patients (33.3%) died and eight patients survived (66.7%). Acute kidney injury (AKI) secondary to COVID-19 was seen in 11 patients of the study population (91.7%), including four dead cases. Two of the three patients who underwent dialysis due to kidney complications, died. The laboratory results showed that the mean level of each parameter white blood cells (WBC), international normalized ratio (INR), C-reactive protein (CRP), ferritin, D-dimer on the last day of hospital stay was significantly different between two groups of survived and dead patients at a 95% confidence level (P<0.05). Conclusion: Sofosbuvir combined with DAC for treatment of KTRs with COVID-19 infection reduced the mortality rate. Further, this medication was safe. Patients tolerated it well, and no serious adverse effects were observed. Larger studies are needed to validate these results.

We report a 55-year-old man presented with anemia and weakness, history of flank pain, hematuria and nephrotic syndrome. Spiral abdominopelvic computerized tomography (CT) scan showed multiloculated cystic mass (120 ×100 ×80 mm) in lower portion of left kidney with internal enhancing solid components and coarse peripheral calcifications. Radical nephrectomy of left kidney was done and biopsy confirmed renal cell carcinoma (RCC), papillary type, sarcomatoid foci, Fuhrman grade III. We assumed that, presence of nephrotic syndrome and paraneoplastic glomerulopathy leaded to heavy proteinuria in this case. Secondary, paraneoplastic glomerulopathy such as immunoglobulin A nephropathy and focal segmental glomerulosclerosis as a paraneoplastic syndrome of RCC have been reported previously. RCC can present with a wide range of signs and symptoms. Atypical presentations of papillary RCC such as proteinuria should be considered for patients presenting with nephrotic syndrome.

Introduction: Disorders of minerals metabolism are common metabolic problems in patients undergoing peritoneal dialysis (PD) which causes increase in mortality and morbidity in these patients. Objectives: In this study, the relationship between bone metabolic indices and mortality rate in patients on PD was assessed. Patients and Methods: Data were collected from Iranian peritoneal dialysis registry database, covering the period 2009–2015 and comprised 2000 adult patients. Patients with less than three months follow-up and incomplete data were excluded. Demographic and some laboratory data (including age, gender, body mass index, serum albumin, dialysis vintage and comorbidities) of patients recorded. Additionally, the unadjusted and adjusted, hazard ratios (HRs) of serum phosphorus (P), calcium (Ca) and parathyroid hormone (PTH) levels, to find their association with mortality were calculated, using the Cox proportional-hazards model. Results: In total, 1197 out of 2000 patients had the inclusion criteria and were included in the study. We found that serum iPTH (intact parathyroid hormone) over 600 pg/mL significantly increased the mortality rate by 2.7 times compared to iPTH levels between 200 to 600 pg/ mL (HR: 2.7, P=0.002). Additionally, the serum phosphorus level less than 4 mg/dL was significantly (P=0.0001) related to higher mortality rate (HR: 1.6). There was no significant association of serum calcium and alkaline phosphatase (ALP) levels with mortality (P > 0.05). Conclusion: Although high serum iPTH and low-serum phosphorus levels could determine the mortality risk in PD patients, Ca and ALP levels were not risk factors for mortality.