Introduction: Thymoglobulin is a lymphocyte-depleting polyclonal antibody, administered for induction therapy at the time of kidney transplantation to reduce the risk of acute allograft rejection. The appropriate dosage and duration of therapy is controversial. The higher dosages are associated with infection and malignancy. Objectives: In this study efficacy and safety of lower dosage (in comparison with previous studies) of thymoglobulin in kidney transplant recipients was evaluated. Patients and Methods: In this clinical trial, 106 adult kidney transplant recipients, were randomized before transplantation in two groups (case and control). The case group (53 patients) were received induction therapy with thymoglobulin (1.5 mg/kg/d for 3 days) and the control group (53 patients) were received non-induction regiment. Delayed graft function (DGF), glomerular filtration rate (GFR), acute allograft rejection and thymoglobulin complications were evaluated during the first post-transplantation year. Results: Around 106 kidney transplant recipients were enrolled (71 or 66.98% deceased donor) to the study. No significant statistical differences were found in GFR at the time of discharge from hospital (P=0.399) and at 1 year (P=0.851) and acute allograft rejection (P= 0.304) between two groups. Graft survival (73.5% in case group versus 81.1% in control group, P=0.392) at month 12th was similar among groups. Additionally, no significant differences of acute allograft rejection in recipient from deceased or living donor between two groups were detected. There was a higher incidence of DGF in the control group (26.4%) than the thymoglobulin group (5.8%) and the difference was statistically significant (P= 0.004). Thrombocytopenia (17% versus 49.1%, P<0.001) and leukopenia (11.3% versus 50.9%, P<0.001) were also significantly higher in the case group. Conclusion: While the incidence of DGF was reduced in thymoglobulin group, the short-term acute allograft rejection rate was not reduced compared to the control group. However, our results require further consideration with larger samples
Introduction: The patients undergoing maintenance hemodialysis (MHD) who are affected with COVID-19 may be at a higher risk for severe disease and complications. Considering the current COVID-19 pandemic, there is a need for studies investigating the various aspects of COVID-19 in patients with MHD. Objectives: The present study aimed to identify the risk factors associated with higher COVID-19- related mortality in patients under MHD. Patients and Methods: The present retrospective study included 90 patients under MHD who were hospitalized with COVID-19 and diagnosed using the reverse transcription polymerase chain reaction (RT-PCR) from March 20, 2020, to December 20, 2020. Results: The participants’ mean age was 57.5±18.61 years, and 49 patients (54.4%) were men. Moreover, 35 patients (38.9%) were expired due to COVID-19. The most common underlying diseases included diabetes mellitus, hypertension and cardiovascular diseases. The patients expired due to COVID-19 had a significantly higher chance of needing oxygen therapy, mechanical ventilation, and intensive care unit admission compared to survived patients. Moreover, a significant negative relationship between mineral-multivitamin supplementation and COVID-19-related mortality was detected. The prevalence of dyspnea was significantly higher in the expired patients compared to survived patients. Conclusion: The COVID-19 patients under MHD are high-risk for severe disease and mortality. Therefore, hemodialysis centers should establish strict preventive measures.
Background: Depression is a prevalent psychological disorder among hemodialysis patients and is associated with a variety of adverse outcomes. Dialysis adequacy also affects hemodialysis patients' survival rates. Objectives: This study aimed to investigate the prevalence of depression in hemodialysis patients and its association with dialysis adequacy. Methods: In this cross-sectional study, 205 individuals undergoing hemodialysis at Ahvaz teaching hospitals in 2019 were included. The depression level was determined using the Beck Depression Inventory (BDI-II) for the participants aged below 65 years and Geriatric Depression Scale (GDS) for the patients aged above 65 years. Dialysis adequacy measures, including the Kt/V and urea reduction rate (URR), were calculated using standard formulas. Results: IN this study, 60.5% of the participants suffered from depression, and the overall prevalence of depression was 54.6% in individuals aged below 65 and 67% in those aged above 65 years. Among the patients with age below 65 years, 19 persons (17.6%) were suffering from mild depression, 22 individuals (20.4%) were suffering from moderate depression, and 18 individuals (16.7%) had severe depression. Among the patients aged above 65 years, moderate depression was found to affect 45 persons (46.4%), and 20 individuals (20.6%) had severe depression. The mean values of Kt/V and URR were not significantly correlated with depression scores (P > 0.05). Conclusions: Depression is a common disorder among hemodialysis patients in Iran; however, it is not significantly associated with dialysis adequacy. However, the results of studies on the relationship between depression and dialysis adequacy cannot be analyzed simply.
In an approach to a patient with anuria after pelvic operations, urinary tract obstruction must be reminded. Early diagnosing and resolving obstruction may lead to completely return of renal function. However, if neglected, it can lead to non-compensative complications.
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