Introduction: Anemia is one of the most common complications in dialysis patients. Deficiency of erythropoietin is the most common cause of anemia in dialysis patients. Chronic kidney disease (CKD) patients have a negative iron balance. Hepcidin is an antibacterial peptide that its synthesis is controlled by the iron surface and inflammatory markers and plays an important role in iron hemostasis in hemodialysis patients. In the presence of anemia, the level of hepcidin in normal individuals is reduced. Therefore, the normal level of hepcidin in CKD individuals is considered high due to their anemia level, while, the level of hepcidin is reduced after dialysis. Objectives: We aimed to study the level of hepcidin-25 in hemodialysis patients and its relationship with anemia and serum iron indices. Patients and Methods: In a cross-sectional study, 70 patients who fulfilled inclusion criteria enrolled in the study. Serum hepcidin 25 was measured by ELISA method. At the same time, blood samples were taken to measure other indices including iron, ferritin, C-reactive protein (CRP), total iron binding capacity (TIBC) and albumin. Hepcidin-25 levels compared with other mentioned parameters. Statistical analysis was done in SPSS 18.0 software. Results: No significant relationship between inflammatory cytokines, TIBC and CRP and erythrocyte sedimentation rate (ESR) with hepcidin levels was detected. Additionally, relationship between serum iron, ferritin and hepcidin levels was not significant (P > 0.05). Conclusion: Assessment of hepcidin 25 level for inflammation and iron status does not seem to be helpful for anemia management in hemodialysis patients.
Introduction: Oxalate nephropathy after RYGB, albeit rare, has a poor prognosis with a rapid progression to kidney failure. Oxalate nephropathy has many etiologies and is one of the rare causes of renal failure. Case Presentation: A 39-year-old diabetic woman came to our nephrology clinic because of a progressive increase in serum creatinine from 1 to 4.2. She had a history of Roux-en-Y gastric bypass (RYGB) surgery six months earlier. In view of the unexplained progressive increase in creatinine, a kidney biopsy was done. The histological diagnosis of oxalate nephropathy with diabetic nephropathy class 2b was made. Conclusions: Oxalate nephropathy is a rare and most severe renal complication after bariatric surgery that is reported in some patients after jejunoileal bypass and RYGB surgery. Oxalate nephropathy is progressive in nature and has a poor prognosis. In our case, oxalate nephropathy and kidney failure occurred six months after RYGB surgery. Since the histological finding in our patient revealed oxalate nephropathy with diabetic nephropathy class 2b, it seems diabetic nephropathy can probably facilitate calcium oxalate crystals formation. This important point should be considered that oxalate nephropathy could rapidly progress to renal failure; so, patients who undergo Roux-en-Y gastric bypass surgery should have regular follow-ups.
: Parvovirus is one of the uncommon causes of anemia in a kidney transplant patient. We reported a kidney transplant patient with parvovirus infection who developed severe anemia three weeks after kidney transplantation. Suspicion of infections increased due to the decrease in erythrocyte level. The patient's anemia became normal with a decrease in the amount of immunosuppressant and treatment with intravenous immunoglobulin (IVIG). Parvovirus B19 infection should be considered in all patients with persistent anemia with or without graft failure after renal transplant.
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