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Article
A Study of Some Immunological Markers in Patients with Chronic Kidney Disease in Kerbala

Authors: Ali Mansoor Al-Ameri --- Hasanain salah jaafar2 --- Reyadh Hneawa2 --- Weaam Awad Al-Muhana*
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2014 Volume: 7 Issue: 2 Pages: 1878-1884
Publisher: Kerbala University جامعة كربلاء

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background: Chronic kidney disease (CKD) is a progressive loss in renal functionover a period of months or years.Immune status of patients with CKD represents a fruitful area of research world-wide. Many hypotheses were mounted in this regards and most of them based on levels of certain immunological markers.Aim: To evaluate the serum levels of some immunologic markers in patients with CKD and to predict their correlation with the disease severity.Study design and objective: This is a cross sectional survey study. It was performed during December, 2013 through April, 2014at Al-Hussein Medical City, Holly Kerbala.Method: A total of 60 doctor-diagnosed patients with chronic kidney diseases for different causes and in variable stages of the disease. Their gender distribution and age range were (39 women; 30-62 years and 21 men; 33-70 years). Other 20 healthy persons were chosen as control group. An informed consent was taken from all the participants submitted to the study. Age, gender and presence of diabetes or hypertension were recorded. Then, 3-ml venous blood sample was taken from each participant and sera were isolated via centrifuge. The serum levels of the following markers were determined using ELISA; haptoglobin, alpha1 anti-trypsin, immunoglobulin-A (IgA), IgG, IgM, alpha-2-macroglobulin (A2M) and the complement proteins C3 and C4.Results: Serum levels of all studied immunologic markers were significantly lower in patients with CKD than those in the control subjects, p value < 0.05. An exclusion is the non significant rise in serum level of haptoglobin and alpha-2-macroglobulinnoticed in CKD stages other than ESRD.In addition, serum levels ofhaptoglobin, A2M, IgA and IgM are significantly lower in ESRD than other stages of CKD (p value < 0.05), while levels of C3 and C4 are significantly lower in moderate CKD than other stages of renal impairment included in this study (p value < 0.05).Discussion: It is well known that the CKD patients suffer significant immune compromization. Our data revealed down regulation of certain immunological parameters in their sera such as alpha1 anti-trypsin, immunoglobulin-A (IgA), IgG, IgM, and the complement proteins C3 and C4.This could explain the susceptibility to infection and abnormally delayed wound healing accompanying CKD.Conclusion: It was concluded that serum levels of all studied immunologic markers, excepthaptoglobin and alpha-2-macroglobulin,were significantly lower in patients with CKD than those in the healthysubjects. Furthermore, this is not associated with the presence or absence of diabetes and/or hypertension. This finding could, in part, prove that the immune deficiency status in these patients is purely due to their impaired renal functions. Key words: immunologic markers, chronic kidney disease.


Article
5.RISK FACTORS OF CHRONIC KIDNEY DISEASE AMONG PATIENTS ATTENDING IBN SINA TEACHING HOSPITAL IN MOSUL CITY

Authors: Fanar F. Khaleel فنار فاضل خليل --- Shaima S. Hussain شيماء سالم حسين --- Azzam H. Hmood عزام حسين حمود
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2019 Volume: 17 Issue: 1 Pages: 24-31
Publisher: Al-Nahrain University جامعة النهرين

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Background:Chronic kidney disease (CKD) is a long-term health condition that in many cases is preventable. Many people do not know they have kidney disease, because up to 90% of kidney function can be lost before symptoms are evident. Fortunately, simple tests performed by a general practitioner can identify most cases of CKD when the disease is in its early stages, enabling treatment to prevent or slow progress.Objective:To evaluate the risk factors for the development of CKD.Methods:A case-control study conducted to 300 persons (150 cases and 150 controls) selected from Medical Wards, Dialysis Kidney Unit and in Outpatient Clinic at Ibn Sina Teaching Hospital in Mosul City.Results:Diabetes mellitus (DM) had 12.9 folds risk for developing of CKD and both type 1 and type 2 D.M. had significant role for developing CKD. Diabetic patients for (> 15 years) had 29.8 times risk for development of CKD. Hypertension (HT) had 3.5 folds risk for CKD and those having HT more than 15 years had 12.9 times risk for CKD. Cardiovascular disease (CVD) had 13.6 folds risk for CKD and having more than one type of CVD had 37 times risk for CKD than heart failure, ischemic heart disease. Family history of renal diseases had 7.1 times risk for CKD and there was statistically significant role of having family history of CKD that had more than 22 times risk for CKD. Statistically significant role of having proteinuria with 383 times risk for CKD.Conclusion:There are many risk factors significantly contributing to the development of CKD in Mosul especially DM, HT, CVD, family history of renal disease, family history of chronic diseases, and from this study it has been concluded that proteinuria plays a major role for the development and progress of CKD.Keywords:Chronic kidney disease, risk factorsCitation:Khaleel FF, Hussain SS, Hmood AH. Risk factors of chronic kidney disease among patients attending Ibn Sina Teaching Hospital in Mosul City. Iraqi JMS. 2019; 17(1): 24-31. doi: 10.22578/IJMS.17.1.5


Article
Sensorineural Deafness Among Patients with Chronic Renal Failure in Al-kindi Teaching Hospital

Author: Raad Aboud Aloubaide رعد عبود العبيدي
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2011 Volume: 7 Issue: 2 Pages: 137-141
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Patients with chronic kidney disease have different grades of sensorineural deafness . Objective: To study the incidence of sensorineural hearing loss and possible contributing factors in patients with chronic kidney disease. Methods: A total of 100 patients with chronic kidney disease were studied. All of them were males. 92 of them were on regular haemodialysis programme. Only 8 patients were on conservative management the age range of the study patients was 18-40 year patients were divided into three groups according to age. All patients were assessed clinically and were evaluated by audiometry , and analysis was made on bone conduction threshold .The mean follow up period was 28 weeks . Results: 36 patients (36 %) showed sensorineural hearing loss .The incidence of sensorineural deafness was found to increase with the advancing age and duration of chronic kidney disease but not directly proportional to the number of haemodialysis sessions .The number of haemodialysis sessions did not show increase in the degree of sensorineural deafness . Conclusion: Patients with chronic kidney disease have sensorineural deafness of some degree which should be assessed and evaluated to halt its progression.


Article
Insulin Resistance and Risk of Chronic Renal Impairment in Non and Diabetic Iraqi Adults

Authors: Rana Ali Hamdi --- Manal kamal Rasheed --- Mohammed Kamal Rasheed
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2013 Volume: 6 Issue: 1 Pages: 1514-1524
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Patients with chronic renal impairment (CRI) present a high prevalenceof insulin resistance (IR). Chronic Renal Failure (CRF) is a syndrome of persistentrenal impairment involving loss of glomeruli, tubular and nephron function. Dialysismay be used as a lineal treated to patients who have suddenly but temporarily, lost theirkidney function (acute renal failure) or as a regular region for quite stable patients who havepermanently lost their kidney function.Central obesity, particularly visceral adiposity is considered to play a major role in causinginsulin resistance and type 2 diabetes mellitus. Insulin resistance is characterized by adecrease in the insulin effect on glucose transport in muscle, adipose tissue and liver.Aim of the study: The purpose of this study is to investigate the relationship between thelevel of serum Insulin and Homeostasis model Assessment (HOMA)-Insulin resistance levelsto risk of chronic renal impairment (CRI)Materials and methods:This study include 50 patients (32 males and 18 females) who have chronic renalimpairment disease with and without T2DM aged between (30-70) years, the mean age as(mean± SD) is (56.4± 10.7),(52.8±18.5) years who attended the hemodialysis (HD) at theartificial kidney in AL- Karama Hospital and 30 normal volunteers aged mach with (30-70years)act as control. The mean age is (57±6) years .This study examined the relationshipbetween fasting serum glucose ,insulin ,Homeostasis Model Assessment (HOMA) –Insulinresistance in CRI patients . Insulin was measured by (enzyme immunosorbant assay) .Results: Mean systolic BP and body max index BMI values were significantly higher amongpersons with diabetes compared with their counters without diabetes and control. Diabeticparticipants had higher mean levels of serum glucose, serum insulin, HbA1c and HOMAinsulinresistance compared with non diabetic participants and control. Diabetic participantsalso had a higher prevalence of elevated serum creatinine, urea and cholesterol level withCRI compared with their counterparts without diabetes and control .Conclusion: This study documents the presence of a strong, positive correlation betweeninsulin resistance and chronic renal impairment among non diabetic patients .These datademonstrate that patients with chronic renal impairment have a high prevalence of IR, insulinlevels .


Article
Lipid Profile in Children with Chronic Renal Failure Undergoing Hemodialysis

Author: Qahtan M. Ali, Nariman F. Ahmed Azat
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2015 Volume: 14 Issue: 2 Pages: 222-228
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT: BACKGROUND: Dyslipidemia is common in Patients with chronic renal failure undergoing intermittent haemodialysis and is considered a risk factor of cardiovascular disease in these patients. OBJECTIVE: To highlight the lipid profile abnormalities in children with end stage renal disease undergoing maintenance hemodialysis and know whether the hemodialysis duration and frequency of sessions per week has any impact on lipid profile in these patients. PATIENTS AND METHOD: A case-control study which was collected in the dialysis unit of (Al Karama Teaching Hospital, Child's Central Teaching Hospital , Al Kadhumia Teaching Hospital and Ibn Al Balady Hospital) for six months started on 1st June 2013 till the 1st of December 2013. Blood samples were obtained from 40 patients with end stage renal disease undergoing maintenance haemodialysis (2-3 sessions per week) and 40 matched healthy controls and analyzed for serum total cholesterol, low density lipoproteins, high density lipoprotein and serum triglyceride. RESULTS: A statistically significant decrease was found in serum high density lipoprotein level (Mean= 46.40mg/dl ,p < 0.025) in Hemodialysis patients when compared with healthy controls. A significant increase in serum triglyceride content of patients (p < 0.000) was also observed. It was found that improvements in lipid profile results were achieved with the use of more frequent (more than 2sessions of haemodialysis per week). There is no any impact of the duration being on HD on the lipid profile in the study.CONCLUSION: This study found that normal lipid profile is better maintained in patients undergoing adequate haemodialysis, and the frequency of haemodialysis sessions can affect the atherogenic states of the lipid profile which is probably the responsible for high incidence of atherosclerotic heart diseases among these patients.


Article
Clinical Course of Children and Adolescents with Primary Focal Segmental Glomerulosclerosis and the Predictors of Their Outcome

Author: Faleeha Obaid Hasan
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2008 Volume: 7 Issue: 4 Pages: 351-357
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:The aim of this retrospective study is to report the clinical course of children and adolescents with primary focal segmental glomerulosclerosis (FSGS), and to study their outcome and to identify the predictors of progression to end stage renal disease (ESRD).PATIENTS AND METHODS:This is a retrospective study of 50 patients with biopsy-proven primary FSGS who were admitted from April 1995 - January 2007, during the study period from May 2005 - June 2007. Clinical, Laboratory and histopathological data were recorded. The median follow-up time of 4.5 year.RESULTS:The commonest age and sex group is male between 1 - 5 year. At presentation all patients had nephrotic-range proteinuria, hypertension was noted in 22 (44%) of patients, microscopic haematuria was detected in 20 (40%) of patients, five patients had evidence of abnormal renal function. The distribution of patients according to steroid responsiveness show that the steroid sensitive patients were 21 (42%), 8 (38.09%) of them were frequent relapsers and 11 (52.38%) of them were steroid dependant and 2 (9.52%) of them developed secondary steroid resistance. But those who had steroid resistance from the start of treatment were 29 (58%) patients. During follow-up 30 (62%) patients had complete remission, 15 patients (30%) developed chronic kidney disease (9 of them stage 5).At the end of follow-up, 24 (80%) of 30 patients with normal renal function had short stature. The univariate analysis identified the presence of hypertension (P=0.0027), heamaturia (P=0.0107) and presence of abnormal renal function (P=0.0001) at presentation, also presence of initial steroid resistance (P=0.0383), resistance to cytotoxic therapy (P=0.0032), capsular adhesions in renal biopsy (P=0.0066), tubular atrophy (P=0.0027), interstitial fibrosis (P=0.0010), all expect to be significant predictors of progression to ESRD.CONCLUSION:Considering the clinical and histological characteristics of studied patients, apparently our results are comparable to other published series. The progression to chronic kidney disease (CKD) occurs in 30% of patients after 5 years follow-up, must of them with ESRD, this is relatively good out come compared to other studies.


Article
Chronic Kidny Disease and Risk of coronary Artery Disease,Aprospective study

Author: Ali Abdul Majid Allawi , FICMS(Int.Med.),FICM (NEPH
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2013 Volume: 9 Issue: 1 Pages: 1-8
Publisher: Baghdad University جامعة بغداد

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AbstractBackground:Reduced glomeular filtration rate isassociated with increasedmorbidity in patientswith coronary arterydisease.Objectives :To analyze the declining eGFR andmortality risks in a patients with Chronic KidneyDisease and have had Coronary Artery Diseaseincluding risk factors .Patientsand Methods:The study included (160)patientsbetween the ages of 16 and 87years.Glomerular filtration rate was estimated (eGFR)using the Modification of Diet in Renal Diseaseequationand was categorized in the ranges<60 mL· min−1 per 1.73 m2and≥ 60 ml/min/1.73 m2.Baseline risk factors were analyzed by category ofeGFR,.The studied patients in emergencydepartment, were investigatedusing Coxproportional hazard models adjusting for traditionalrisk factors.Results:The study included (106) male (54)and female (52) between the ages of 16 and87Years mean age (54.9±15.2).The eGFR dataare calculated for all randomized studiedPatientseGFR <60ml/min/1.73 m287 (82%),and group of patients with eGFR ≥60ml/min/1.73 m219(18%). Overall there was(44) death 42% mortality risk. Patients witheGFR≥60 ml/min/1.73m219(18%), positivehistory of (CAD) is 3 (15.8%) and negativehistory of (CAD) is16 (84.2%, P=0.0001).group with reduced eGFR <60 ml/min/1.73 m2and positive history of (CAD) 42(48.2%), andwith negative history is 45(51.8%). In eGFR≥60ml/min/1.73 m2group and positive historyof (CAD), the mortality rate is2 (10.5%) and innegative history (CAD) group is 17 (89.5%)Conclusion:This study concluded that impaired GFR,in an adult population, is independentlyassociated with significant levels of increasedrisk of mortality of fatal and nonfatal coronaryevents ,e GFR change over time addsprognostic information to traditional mortalityrisk predictors among patients withchronic


Article
Serum Gamma GlutamylTransferase, Amylase and Alkaline Phosphatase activities in kidney diseases

Author: Mayssoon M. Najeeb M. Saleem ميسون نجيب
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 2 Pages: 209-213
Publisher: Baghdad University جامعة بغداد

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Background: The study enrolled a total of 78 patients with acute and chronic kidney diseases for evaluation of the activity of enzymes, gamma-glutamyltransferase (GGT), alkaline phosphatase (ALP) and amylase and compared with 42 normal healthy groups with normal albumin, creatinine and other kidney functions test and the samples were obtained from different hospitals in Baghdad. Patients and methods: Three groups of patients were included. The first group consists of 15 patients with acute kidney diseases that occurs over days to weeks in which measurement of GGT, ALP and amylase were performed. Second group consists of 38 patients suffering from acute kidney diseases for 2-3 months in which serum GGT was evaluated .Third group consist of 25 patients with chronic kidney diseases used for estimation of GGT, ALP and amylase and other biochemical parameters, total cholesterol, urea, creatinine, uric acid and total protein. Results: There was statistically highly significant difference in the activity of enzymes GGT, ALP and amylase P< 0.001 for three groups of patients with acute kidney diseases, and there was a remarkable difference in GGT activity with chronic kidney diseases (P < 0.001). Conclusion: Acute and chronic kidney diseases in human was diagnosed by measurement of enzyme GGT, ALP, and amylase activitiesKeyword: Chronic kidney disease, acute kidney disease, GGT, ALP, Amylase.


Article
Effects of Chronic Kidney Disease on Some Liver Enzymes Activity Before and After Dialysis

Author: Riyadh Hussein Wally
Journal: journal of the college of basic education مجلة كلية التربية الاساسية ISSN: 18157467(print) 27068536(online) Year: 2016 Volume: 22 Issue: 96/ علمي Pages: 89-94
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Effects of Chronic Kidney Disease on Some Liver Enzymes Activity Before and After DialysisRiyadh Hussein Wally kut-Technical InstituteAbstractThe aim of the study is to compare the activity level of some liver enzymes such as aspartate transaminase (AST), alanine transaminase (ALT) and alkaline phosphatase (ALP) of chronic kidney disease (CKD) patient before and after dialysis. 50 blood samples of male and female with chronic kidney disease compared with (55) healthy persons samples as control group ,both group aged between 20-65 years and have no history of liver diseases. The results of study showed a decrease (P<0.001) in activity level of (AST) and (ALT) ,while the study showed elevated (P<0.001) in activity level of (ALP) in serum of CKD patients before and after dialysis in compared with control group for male and female.Keywords: Aminotransferase, Alkaline phosphatase , Chronic kidney disease, dialysis

تأثير مرض عجز الكلى المزمن على فعالية بعض الانزيمات الكبدية قبل وبعد عملية غسيل الكلىرياض حسين والي - مدرس / المعهد التقني- كوتالدراسة تضمنت مقارنة فعالية انزيمات الكبد (الاسبارتيت الناقل للامين , الالانين الناقل للامين والفوسفاتيز القاعدي ) في مصل المرضى المصابين بمرض عجز الكلى المزمن قبل وبعد عملية الغسيل حيث تمت مقارنة نشاط الانزيمات ل 50 عينة دم لاشخاص مصابين بمرض عجز الكلى المزمن من كلا الجنسين مع 55 عينة دم لاشخاص اصحاء كمجموعة سيطرة , كلا المجموعتين تتراوح اعمارهم بين 20 الى 65 عام وغير مصابين بامراض الكبد مسبقا أظهرت النتائج انخفاض في نشاط (الاسبارتيت الناقل للامين و الالانين الناقل للامين ) بينما اظهرت الدراسة زيادة ملحوظة في نشاط (الفوسفاتيز القاعدي) لمرضى العجز الكلوي قبل وبعد عملية غسيل الكلى بالمقارنة مع المجموعة القياسية ولكلا الجنسين


Article
Effects of Thyroid Dysfunction in Chronic Kidney Disease Patients

Authors: Maleeha Massud --- Manal Azat Aziz --- Hadeel Munem Jassim
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2017 Volume: 14 Issue: 4 Pages: 663 -669
Publisher: Babylon University جامعة بابل

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The interactions between thyroid and kidney functions are well determined thyroid hormones affect renal development and physiology and kidney is required in the regulation of thyroid hormones metabolism.The goal of the current study was to evaluate the prevalence of thyroid dysfunction in patients with chronic kidney diseases (CKD). The study included (50) hemodialysis patients. All subjects were investigated with laboratory tests to estimate thyroid function, including: serum free tri iodothyronine (FT3), free thyroxine ( FT4) and thyroid-stimulating hormone (TSH). Results were compared with the same measurements in (50) control groups. The incidence of CKD detected among those both with subclinical hypothyroidism (40.0%) and overt subclinical hyperthyroidism (34.0%) and low FT3 in H.D patients (5.6976±1.85334) in comparison with control groups. In conclusion. We observed high of thyroid function disorders in CKD patients. Low FT3 syndrome and high subclinical hypothyroidism are the frequently thyroid function disorders in CKD patients.

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