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Article
Frequency of HLA-A and B Antigens in Iraqi Patients with End-Stage Renal Disease Preparing for Transplantation

Authors: Lazem H. Al-Taie --- Batool H. Al-Ghurabi --- Ahmed A .Al-Hassan --- Abid J. Dage
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: supplement Pages: 642-648
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:The likelihood of developing end-stage renal disease in an individual is determined by interactions between genetic and environmental factors. Human leukocyte antigen is the most polymorphic genetic system in man. Genes of this region influence susceptibility to certain diseases.OBJECTIVE:The purpose of the present study is to investigate the association of HLA class I (HLA-A and HLA-B) with the end-stage renal disease in Iraqi patients (Arab and Kurd).SUBJECTS AND METHODS:HLA-typing was assessed in 200 patients with end-stage renal disease and 110 healthy controls by microlymphocytotxicity assay.RESULTS:A survey of the distribution of HLA-A and HLA-B antigens frequencies yielded a significant variation between patients and healthy control group. Arab patients have significant increase in frequency of HLA-A2 as compared with healthy control (P=0.005). Whereas Kurdish patients revealed significant increase in frequency of HLA-B35 when compared with healthy control (P=0.033).CONCLUSION:The current study suggests that high frequency of HLA-A2 in Arab patients and HLA-B35 in Kurdish patients might be associated with susceptibility to risk of end-stage renal disease


Article
Effect of Dialysis Duration on the Immunochemical Changes
تأثير فترة الديلزة على المتغيرات الكيمومناعية

Author: Shatha MJ. AL-Khateeb د. شذى محمد جواد الخطيب
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2012 Volume: 25 Issue: 1 Pages: 66-72
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Objective: To study the effect of dialysis on the immunochemical changes of some interleukins and other biochemical parameters.Design setting: A total of 25 patients with end stage renal disease (mal and female) underwent dialysis with different duration were included in this study. Their age ranged from (22-75).The patients were divided according to the duration, the first group who received dialysis less than one year and the second group who received dialysis more than one year Healthy control group were sex, ethnic, matched and semimatched in age with patients group were selected. Results: Using ELISA technique, serum IL-1α and IL-8 were estimated for dialyzed patients when divided in to two groups (less than one year and more than one year). Also Serum FT3 and albumin were also measured for the above two groups compared with healthy controls. All the above parameters showed different pattern. Conclusion: Hemodialysis duration was influenced serum levels of interleukins and other biochemical parameters.Key words: End stage renal disease, Dialysis, Interleukins.

الغــــــرض: دراسة تأثير الديلزه على المتغيرات الكيمومناعيه والكيميائيه الحياتيه وبعض الانترلوكينات.التصميـــــــــــم: تضمنت الدراسة (25) عينه ذكور وإناث تراوحت أعمارهم بين ( 22-75) سنه من مرضى في الحالات المتأخرة من إمراض الكلى الخاضعين للديلزه في أوقات مختلفة.تم تقسيم المرضى اعتمادا على فترة الديلزه حيث تضمنت المجموعة الأولى الديلزه لأقل من سنه بينما كانت المجموعة الثانية لأكثر من سنه والتي قورنت مع الأصحاء.النتائـــــــــــج: باستخدام تقنية ELISA)) تم قياس الانترلوكين IL-8) و α IL-1) في مصل الدم لكلا المجموعتين أعلاه , تضمنت الدراسة كذلك دراسة هرمون الغدة الدرقية الحر والالبومين وكانت كل المتغيرات قد أظهرت منحى متغير مقارنة بالأصحاء.الخلاصـــــــــة: إن فترة الديلزه قد أظهرت تأثيرا على الانترلوكينات والمتغيرات الكيميائية الحياتية.


Article
Prevalence of Xerostomia in Patients with Chronic Hemodialysis in Babil City

Author: Ali Mihsen Hussein Al-yassiri
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2014 Volume: 7 Issue: 1 Pages: 1822-1828
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Xerostomia is as a subjective complaint of dry mouth that may result from deficient production of saliva. It may be caused by reduced salivary flow secondary to atrophy and fibrosis of the salivary glands, use of medications, restriction of fluid intake and old age. In patients undergoing hemodialysis, xerostomia is associated with difficulties in chewing, swallowing, tasting and speaking; increased risk of oral diseases. Aim of the study: The aim of this study was to find the prevalence of xerostomia in chronic hemodialysis patients in Babil- Hilla, and compare it with healthy controls. Materials and Methods: Forty three subjects were incorporated in this study, with end stage renal disease and undergoing hemodialysis , they were already diagnosed by a nephrologist specialists, all these patients are without any other systemic diseases. Healthy control group, forty control subjects with no signs and symptoms of any systemic disease. They were sex and age matched to hemodialysis patients.Results and Discussion: A total of 43 patients were registered in Merjan teaching hospital in Babil- Hilla. These patients on hemodialysis programs at the beginning of the study, from February to April, 2013. They were (20) males and (23) females and the age range (24- 69) years. Xerostomia was recorded in 69.767% (n=30) of all patients with hemodialysis. Our data involved mostly xerostomia was recorded in patients with hemodialysis, in these patients due to presence of xerostomia increased the poor oral hygiene. Dysgeusia and uremic fetor, bad odor and taste are caused not only by xerostomia but also by the presence of urease-splitting oral organisms, which metabolize urea (present in high levels in these patients) and thus elaborate ammonia. Patients with xerostomia are at increased risk of lesions to the mucosa, gingival, and tongue, as well as candidiasis, dental caries, periodontal disease and other bacterial and fungal infections. Many of these conditions either cause inflammation, or worsen the chronic inflammation that is frequently present in patients on hemodialysis, and consequently contribute to the risk of developing cardiovascular diseases.Conclusions: Xerostomia remains a frustrating symptom for patients on hemodialysis, and further efforts should be made to identify effective treatments, restoration of the salivary function.


Article
Acute cardiovascular complications of hemodialysis in patient with end-stage renal disease - a single center experience

Author: Safaa ali khudhair
Journal: Muthanna Medical Journal مجلة المثنى الطبية ISSN: 2226146x Year: 2019 Volume: 6 Issue: 2 Pages: 1-28
Publisher: Al-Muthanna University جامعة المثنى

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Abstract

Hemodialysis (HD) is an important modality of renal replacement therapy and during HD, patients are at greater risk of cardiovascular complication compared with the general population, with estimated risk is as high as (8 to 20) fold. Most important cardiovascular complications during hemodialysis include; hypotension, arrhythmias, myocardial ischemia and heart failure. The aim of study is to evaluate patient on hemodialysis for occurrence of cardiovascular complication. One hundred patients on hemodialysis were enrolled in this study. Patients were evaluated for cardiovascular complication when they were undergoing hemodialysis through physical examination, electrocardiogram and echocardiography during their admission in hemodialysis unit. The age of the patients enrolled ranged from 30 to 75 years. The mean BMI was ranging from 19 to 29 kg/m2. In this study cardiovascular complications encountered are hypotension (the most frequent complication reported), followed by ventricular ectopic, angina, AF, SVT, LV dysfunction, peripheral vascular disease, AMI and stroke. Hypotension was significantly more in patients with UF >500 ml. Angina and PVD were significantly associated with graft type of venous access. Inconclusion: Hypotension was the most commonly reported cardiovascular complication of hemodialysis in patients who has had a high ultrafiltration rate; presence of other common comorbidity like diabetic mellitus, hypertension, and smoking increase the risk of angina, arrhythmia and infarction.


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
Basilic Vein Mobilization for Brachio-Basilic Arterio-Venous Fistula in Dialysis

Author: Dr. Sabah Noori Jabir*, Dr. Muthanna D.R.Al-Assal**, Dr. Hazim J. Shini ***, Dr. Saif S. ALmudaffar
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2015 Volume: 11 Issue: 2 Pages: 7-9
Publisher: Baghdad University جامعة بغداد

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Background: The first and second choice for vascular access in patients with end stage renal disease (ESRD) is radio cephalic and brachio cephalic arteriovenous fistula (AVF).In patients with failed previous AVF e or poorly visualized or impalpable cephalic veins, the basilic vein can be mobilized and superficialized to create an AVF with the brachial artery.Objective: The aim of this study is to report our experience at the Vascular Surgery Department/ Surgical Specialty Hospital in brachio-basilic (BB) vascular access for hemodialysis.Methods: From January 2006 to December 2009, 31 patients with ESRD whose cephalic veins were thrombosed or impalpable or had previous unsuccessful vascular access procedures were referred to the Vascular Surgery Department/Surgical Specialty Hospital for creation of vascular access. Brachio - basilic mobilization AVF was offered to them. There were 20 females and 11 males. Their ages ranged from 12 to 70 years with a mean of 40. following a careful clinical assessment of the patients, particularly their upper limb superficial veins, Doppler study of both subclavian veins was done to all patients; those with a vein stenosis exceeding 40% were excluded from the study. All patients had mobilization of basilic vein under general anesthesia via a hooky racket incision on medial aspect of upper arm extending from the axilla to the antecubital fossa. The vein is tunneled subcutaneously and anastomosed end to side to brachial artery. The postoperative condition was monitored looking for any complication. The follow up period lasted for 6 months.Results: nineteen patients (61.3%) had left-sided operations. All fistulae except one functioned well primarily (a success rate of 96.8%). One patient had primary thrombosis of the fistula while another patient developed an aneurysm of the AVF 4 months after the operation. The remainder had a smooth non-complicated postoperative course. All fistulae matured and were ready for cannulation in 6 weeks and remained functioning during the 6 months of follow up.Conclusion:: Brachio-basilic AV fistula with anterior basilica vein mobilization is an acceptable option for dialysis with good success rate and fewer complications.


Article
Prevalence of Latent Tuberculosis in End Stage Renal Disease Patients at Baghdad Teaching Hospital

Author: Kassim .M. Sultan*, Muhammed .W.AL.Obaidy *, Amer Musa Hasan **
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 3 Pages: 321-327
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND: Tuberculosis (TB) is one of the oldest diseases known to affect humans, it caused by infection with Mycobacterium Tuberculosis (MTB). MTB is most commonly transmitted from a patient with infectious pulmonary TB to other person by droplet nuclei. End Stage Renal Disease (ESRD) patients are exposed to a variety of infections, including TB. The standard test for detecting Latent TB infection (LTBI) is tuberculin skin test (TST).OBJECTIVE: Determination the prevalence of latent tuberculosis among end stage renal disease patients in hemodialysis unit in Baghdad teaching hospital, and assessing its correlations with various conditions.METHODS: A stratified random sampling technique was used to select a sample of 71 patients of ESRD in hemodiaylsis unit in Baghdad teaching hospital. The selected patients were interviewed using a structured pretested questionnaire.Two units of PPD (0.1mL) had been injected intradermally to the volar surface of forearm to be seen within 48-72 hours. The test was considered positive if (>=10mm induration) developed.RESULTS: The study showed the rate of tuberculin reactivity among End Stage Renal Disease (ESRD) patients is 28.57%. About 57.14% of patients were male; mean age of patient was 54.34 ± 15.25 years. The major cause of renal impairment were diabetes mellitus (DM) 52.86%, followed by hypertension 15.71%, duration of dialysis more than 6 months was 46.67% . History of contact with active tuberculosis patient was 62.5%.CONCLUSION: Significant relationship between history of contact with active TB patients, duration of dialysis, and age of patients with TST positivity..


Article
Level of Reproductive Hormones in Men and Women after Successful Kidney Transplantation

Author: Makarim Q. Al-Lami
Journal: Al-Nahrain Journal of Science مجلة النهرين للعلوم ISSN: (print)26635453,(online)26635461 Year: 2012 Volume: 15 Issue: 3 Pages: 143-150
Publisher: Al-Nahrain University جامعة النهرين

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This study was designed to shed a light on the reproductive function in men and women after successful kidney transplantation (KT). Forty five adult patients (25 men and 20 women) were included; these patients met the inclusion criteria (serum creatinine ≤ 1.4 mg/dl; glomerular filtration rate (GFR) ≥ 60 ml/min at least 3 months after KT). Twenty two healthy individuals (12 men and 10 women) were included as control group. Assessment of the renal function tests [blood urea, serum creatinine, and GFR] and determination of the level of the reproductive hormones [luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin (PRL) in men and women; and testosterone and 17-β-estradiol (E2) in the men and the women, respectively] had been carried out. The correlation between level of these hormones and the renal function tests was also studied in the patients. The results of the renal function tests showed that patients had higher blood urea and serum creatinine than the controls, while GFR was lower in the patients as compared to controls. Regarding to the reproductive hormones, it was found there were no significant differences in levels of LH, FSH and testosterone between men patients and men controls, while PRL was significantly (P<0.05) higher in the male patients as compared to the male controls. The results revealed that no significant differences in levels of LH, FSH and E2 between women patients and women controls, while PRL was significantly (P<0.01) higher in the female patients than the female control. When the correlation between the level of the reproductive hormones and the renal function tests was studied in men and women kidney transplanted patients, the findings showed that a significant negative correlation (r=-0.48, P<0.05) and a highly significant negative correlation (r=-0.74, p<0.01) were found between levels of FSH and serum creatinine in men and women patients, respectively. While a significant positive correlation was found between levels of PRL and blood urea in each of men (r=0.48, P<0.05) and women (r=0.49, P<0.05) patients

صممت الدراسة الحالية لالقاء الضوء على الوظيفة التكاثرية في الرجال والنساء بعد عملية زرع الكلية الناجحة. تضمنت الدراسة 45 مريضاً بالغاً ( 25 رجلاً و 20 امرأة) ممن تتوفر فيهم المعايير المتضمنة (تركيز كرياتينين المصل ≤1.4غم/100 مل، قيمة معدل الترشيح الكبيبي ≥60 مل/ دقيقة، المدة الزمنية بعد عملية زرع الكلية على الاقل 3 أشهر). كذلك تضمنت الدراسة 12 رجلاً و10 نساء من الاصحاء كمجموعة سيطرة. تم تقييم اختبارات الوظيفة الكلوية (يوريا الدم، كرياتينين المصل، ومعدل الترشيح الكبيبي) وتحديد مستوى الهرمونات التكاثرية (الهرمون اللوتيني، الهرمون المحفز للجريب، والبرولاكتين) في الرجال والنساء، والتيستوستيرون والاسترادايول في الرجال والنساء على التوالي. كذلك تمت دراسة علاقة الترابط بين مستوى هذه الهرمونات واختبارات الوظيفة الكلوية في المرضى. اظهرت نتائج اختبارات الوظيفة الكلوية ارتفاعاً معنوياً في تراكيز يوريا الدم وكرياتينين المصل وانخفاضاً معنوياً عالياً في قيمة معدل الترشيح الكبيبي عند المرضى مقارنة بمجموعة السيطرة. فيما يتعلق بمستوى الهرمونات التكاثرية، لم تكن هناك اختلافات معنوية في مستويات الهرمون اللوتيني، الهرمون المحفز للجريب، والتيستوستيرون في المرضى الذكور والسيطرة الذكور، بينما كان مستوى البرولاكتين اعلى بصورة معنوية في المرضى الذكور مقارنة مع السيطرة الذكور. كذلك لم تكن هناك اختلافات معنوية في مستويات الهرمون اللوتيني، الهرمون المحفز للجريب، والاسترادايول في المرضى الاناث والسيطرة الاناث، بينما كان مستوى البرولاكتين اعلى بصورة معنوية عالية في المرضى الاناث مقارنة مع السيطرة الاناث. عند دراسة علاقة الترابط بين مستوى الهرمونات التكاثرية واختبارات الوظيفة الكلوية في المرضى، اظهرت النتائج وجود علاقة سالبة معنوية وعلاقة سالبة معنوية عالية بين مستوى الهرمون المحفز للجريب و تركيز كرياتينين المصل فى المرضى الرجال والنساء على التوالي. بينما وجدت علاقة موجبة معنوية بين مستوى البرولاكتين ويوريا الدم في جميع المرضى رجالاً ونساءً.


Article
Estimation of total serum fucose in patients with end-stage renal disease
تقدير مجموع فوكوسي المصل في المرضى الذين يعانون من مرض الكلى في نهاية المرحلة

Authors: Hussein Adnan Mohammed حسين عدنان --- Fawzi hassan zayr فوزي حسن --- Sabah Fadhil AL-Qurashy صباح فاضل القريشي
Journal: Al-Kufa University Journal for Biology مجلة جامعة الكوفة لعلوم الحياة ISSN: 20738854 23116544 Year: 2015 Volume: 7 Issue: 1 Pages: 283-292
Publisher: University of Kufa جامعة الكوفة

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Abstract

The objective of the study: is to compare between concentration of total serum fucose in normal healthy controls and patient with end-stage renal disease.Design: cross-sectional study of patients with end-stage renal disease Setting: Al- Kut hospital Department of renal dialysis in Al- Kut city. Patients and Method:-This cross-sectional study incorporated patients with end-stage renal disease (October 2011 to September 2012) in Al- Kut hospital Department of renal dialysis. Results: The patients were arranged into two groups, group 1 (normal healthy controls) and group 2(patients with end-stage renal disease). Regarding group 1 (which were 29 individual). Regarding group 2 which represents the patients with end-stage renal disease (there were 25patients).the concentration of total serum fucose was increased in patients with end-stage renal disease and also we found that there is positive relationship between the level of the total serum fucose and the serum creatinine and blood urea . Conclusions: the level of total serum fucose increase in patients with end-stage renal disease and this level have positive relationship with level of serum creatinine and blood urea.

الهدف من الدراسة: هو مقارنة بين تركيز من إجمالي فوكوسي المصل في ضوابط صحية طبيعية والمريض مع مرض الكلى في نهاية المرحلة.تصميم: دراسة مستعرضة من المرضى الذين يعانون من نهاية مرحلة المرض الكلوي إعداد: آل الكوت إدارة المستشفى لغسيل الكلى في مدينة آل الكوت. المرضى والطريقة: تتوافر هذه دراسة مستعرضة دمج المرضى الذين يعانون من مرض في نهاية المرحلة الكلوي (أكتوبر 2011 إلى سبتمبر 2012) في آل الكوت إدارة المستشفى لغسيل الكلى.النتائج: تم ترتيب المرضى إلى مجموعتين، المجموعة 1 (ضوابط صحية طبيعية) والمجموعة 2 (المرضى الذين يعانون من مرض الكلى في نهاية المرحلة). وفيما يتعلق المجموعة 1 (التي كانت 29 فرد). وفيما يتعلق تم رفع مجموعة (2) الذي يمثل المرضى الذين يعانون من مرض الكلى في نهاية المرحلة (هناك 25patients). وتركيز من إجمالي فوكوسي المصل في المرضى الذين يعانون من مرض الكلى في نهاية المرحلة، وأيضا وجدنا أن هناك علاقة إيجابية بين مستوى مجموع فوكوسي في الدم والكرياتينين واليوريا في الدم.الاستنتاجات: مستوى مجمل الزيادة فوكوسي المصل في المرضى الذين يعانون من مرض الكلى في نهاية المرحلة، وهذا مستوى لها علاقة إيجابية مع مستوى الكرياتينين واليوريا في الدم.

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