The triggering receptor expressed on myeloid cells-1 (TREM-1) is a member of the immunoglobulin superfamily. TREM-1 has been implicated as an amplifier of inflammation. Soluble TREM-1 (sTREM-1) was investigated in different clinical conditions, but not in hemodialysis (HD) patients. We aimed to investigate sTREM-1 as a marker of inflammation in HD patients. We investigated 40 CKD patients undergoing chronic HD treatment and 15 controls. Routine laboratory investigations in addition to CRP measured by immunoturbidimetry, TNF- α, and sTREM-1 measured by ELISA were assayed in post-hemodialysis patients' blood samples and in controls' blood samples. CRP, TNF-α, and sTREM-1 levels were significantly higher in HD patients than in controls (p < 0.001 for all). sTREM-1 was positively correlated with CRP and TNF-α (r = +0.50, p < 0.001 and r = +0.53, p < 0.001 respectively). It was negatively correlated with hemoglobin concentration (r = -0.69, p < 0.001). Hemoglobin concentration was the significant predictor of sTREM-1 level (p < 0.001). In conclusion, sTREM-1 level is significantly increased in HD patients as are other pro-inflammatory markers.

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Hemodialysis (HD) patients are at risk for developing serious infections. Methicillin- resistant Staphylococcus aureus (MRSA) is one of the most prevalent pathogens in healthcare facilities with a major threat to the medical community. We aimed to determine the prevalence of MRSA colonization among patients and medical staff members in a HD Unit and determine efficacy of mupirocin as a decolonizing agent. This cross-sectional study enrolled 250 patients and 35 health care providers of a HD unit. Nasal and hand swabs were collected to assess the prevalence of MRSA carriage. Those exhibiting MRSA phenotype were subjected to conventional Polymerase chain reaction (PCR) assay for detection of mecA gene. Colonized patients and medical personnel with MRSA were prescribed mupirocin ointment (2%) for decolonization. The screening approach identified 54/285 (18.9%) nasal MRSA carriers (41/250 of HD patients and 13/35 of the medical staff members). Concomitant extranasal MRSA colonization of the hands was observed in 10 (18.5%) of these 54 MRSA carriers. In relation to PCR results the sensitivity, specificity, and diagnostic accuracy of cefoxitin disk test were 98.2%, 75%, and 93.9% respectively and for MRSA Select II agar screening method, the sensitivity, specificity, and diagnostic accuracy were 92.6%, 66.7%, and 87.9% respectively. Decolonization approach using mupirocin ointment revealed an overall success rate up to 77.8% (42/54) and failure rate of 16.7% (9/54), while 5.6% (3/54) of decolonized carriers showed recolonization. There is still high prevalence of MRSA colonization in HD vicinity. Implementation of strict infection control measures is essential in dialysis units to avoid MRSA cross-transmission and invasive infections.

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Background and Aim: Diabetic nephropathy (DN) is a major determinant of end-stage renal disease (ESRD). Altered microRNA levels lead to serious chronic diseases, such as diabetes. We aimed to measure the expression levels of two microRNAs, microRNA126 and 192 in DN and investigate their connection with albuminuria levels. Methods: This study included 229 subjects (134 DN patients and 95 controls). Serum lipid profiles, glucose levels, glycated haemoglobin (HbA1c) levels, and renal functions were assayed. The microRNA126 and microRNA192 expression levels were determined by real-time PCR. Results: Patients with DN had higher weights, BMI values, glucose levels (p<0.001), HbA1c levels (p<0.001), urinary albumin-creatinine ratio (ACR) values (p<0.001), urea levels (P=0.002), and creatinine levels (P=0.004) and lower expression levels of both microRNA192 (p<0.001) and microRNA126 (p<0.001) than controls. MicroRNA126 expression was positively correlated with age, estimated glomerular filtration rate (eGFR) and microRNA192 expression but negatively correlated with blood sugar, HbA1c, urea, creatinine and ACR. MicroRNA192 had higher sensitivity (91%), specificity (94%), and area under the curve (AUC) (0.967) values than microRNA126 (sensitivity, 90%; specificity, 68%; AUC, 0.897) and thus can precisely diagnose DN. Conclusion: Both MicroRNA126 and microRNA192 expression were obviously associated with DN and might determine the progression of the disease owing to prominent relation with macroalbuminuria.

End-stage renal disease is associated with the inflammatory state characterized by infiltrating macrophages/lymphocytes, a major source of chemokines. The aim of this study was to determine the association of CCR2 G190A polymorphism in patients with chronic renal failure (CRF) requiring hemodialysis. Seventy CRF patients and thirty healthy controls were enrolled in the current study; PCR-RFLP technique was used to assess the gene frequencies of CCR2 G190A. The results of the present study showed that there was a significant difference in the genotype and allele frequency distribution of CCR2 G190A in CRF patients and control subjects. A significant association was found between CCR2 G190A and CRF risk, especially, the AA genotype (OR= 2.5, 95% CI=0.26-23.66) and A allele (OR=2.9, 95% CI=1.14-7.3). The polymorphism was significantly associated with the presence of diabetes mellitus. From this study, it could be concluded that, a significant association was found between the AA genotype of CCR2 G190A polymorphism and CRF. Other chemokine polymorphisms in renal pathologies have to be further investigated with larger population based studies.

There is a high prevalence of hepatitis C virus (HCV) infection in hemodialysis (HD) patients in Menoufia Governorate, Egypt. The aim of this cross-sectional study was to assess current HCV status and its seroconversion in HD patients after implementing preventative measures to limit transmission of HCV. All data were compared with our previous data collected in 2011 before implementation of isolation policy. There was a significant decrease in HCV infection in HD patients from 49.6% in year 2011 to 41.9% in year 2016 (P = 0.001). The seroconversion rate was significantly reduced from 14.5% in year 2011 to 4.9% in year 2016 (P = 0.001). Age, gender, body mass index, hemoglobin, and calcium did not show any significant difference whereas blood transfusion, serum phosphate, and urea reduction ratio showed a significant difference with much improvement in year 2016. When comparing seroconversion group with HCV-negative patients, blood transfusion did not show significant difference whereas seroconverted group showed significantly longer duration of dialysis (94.94 ± 82.87 months vs. 38.21 ± 31.55 months). Same result was obtained in year 2011; however, when all data analyzed the duration of dialysis and blood transfusion were higher significantly in seroconverted group. Binary logistic regression analysis for all data demonstrated that isolation reduced the likelihood of seroconversion while longer duration of dialysis increased the risk for seroconversion. HCV infection and its seroconversion in HD patients were significantly reduced in year 2016 compared to year 2011. Isolation policy is recommended for HD patients with HCV in dialysis units with high HCV prevalence in developing countries.

Background Chronic kidney disease (CKD) is a worldwide public health problem due to its increasing prevalence worldwide. Endoplasmic reticulum (ER) stress has been shown to play a role in the pathogenesis of various renal diseases in humans. It leads to the activation of the unfolded protein response (UPR) which triggers three known trans membrane sensors in the ER: activating transcription factor 6 (ATF6), inositol-requiring enzyme I (IRE1), and PKR (double-stranded RNA-dependent protein kinase)-like ER protein kinase (PERK). The activation of these signal transduction pathways can result in cell death, inflammation, and fibrosis in the context of CKD. Objectives The aim of this study was to detect the level of gene expression of activating transcription factor 6 (ATF6), inositol-requiring enzyme I (IRE1), and PKR (double-stranded RNA-dependent protein kinase)-like ER protein kinase (PERK) in chronic kidney disease patients. Subjects and methods This study was carried out on eighty subjects, 50 patients with CKD (25 with hypertension and 25 without hypertension) and 30 healthy subjects served as controls. All studied subjects underwent laboratory investigations, including CBC, Serum Lipid profile: Total cholesterol, Triglycerides, HDL-cholesterol and LDL-cholesterol, liver and kidney functions, fasting and 2 h postprandial blood glucose and HbA1C, serum level of IL6 and gene expression of ATF6, IRE1 and PERK using real time PCR technique. Results There was a significant increase in relative quantitation (RQ) of gene expression of IRE1, ATF6 and PERK in chronic kidney patient groups with hypertension and without hypertension compared to control group. Also, there was a significant positive correlation of PERK and ATF6 gene expressions and a significant negative correlation of PERK gene expressions and GFR in groups I&II. Conclusion Endoplasmic reticulum (ER) stress occurs in CKD with activation of gene expression of three trans -membrane sensors in the ER: activating transcription factor 6 (ATF6), inositol-requiring enzyme I (IRE1), and PKR (double-stranded RNA-dependent protein kinase)-like ER protein kinase (PERK).