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Chronic inflammation in dialysis patients increases the production of cytokines such as TNF-[alpha], IL-1[beta] and IFN- IFN-[gamma] and there is evidence of a significant mortality rate in dialysis patients due to inflammation. Overproduction of inflammatory cytokines can induce complications such as atherosclerosis, malnutrition and anaemia, which are mostly resistant to erythropoietin treatment. Cardiovascular disease is the leading cause of death in haemodialysis patients and about half of the mortality is attributable to cardiovascular disease. Silymarin modulates the immune system by inhibition of neutrophil immigration, mast cell immobilization, prostaglandin production and leukotriene synthesis. Furthermore, silymarin suppresses the induction of TNF-[alpha] and it was hypothesized that silymarin could decrease the serum concentration of TNF-[alpha] in peritoneal dialysis patients, and thus treat anaemia. Fifteen peritoneal dialysis patients were enrolled in this study and serum levels of soluble TNF-[alpha] were measured using an enzyme-linked immunosorbant assay (ELISA) kit. Serum TNF-[alpha] was found to be decreased in some patients and in the response group, the haemoglobin concentration after 8 weeks of silymarin administration was increased significantly (p < 0.05). Based on the results of this study, it is suggested that silymarin may be useful in the treatment of inflammation for peritoneal dialysis patients. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background/Objective: Hepatitis E virus (HEV) has caused many acute hepatitis epidemics in developing countries. Considering the high prevalence of transaminitis on early stages after renal transplantation and the uncertainty of the hepatitis E's role, we evaluated serology of hepatitis E in this high risk group. Methods: 110 patients were evaluated. After kidney transplantation, anti-HEV IgG levels were measured by ELISA. BUN and creatinine levels after renal transplantation, AST, ALT, alkaline phosphatase, and estimated glomerular filtration rate (eGFR) in the first week, and the first, third, and sixth months after renal trans- plantation were measured. Results: HEV Ab of 23 patients was higher than 1.1; they were considered seropositive for HEV. Liver and renal function tests in different periods in patients with HEV Ab higher and lower than 1.1, showed no significant difference. In this study, there was no significant correlation between the levels of creatinine, AST, ALT, and alkaline phosphatase at various periods in patients with HEV Ab higher and lower than 1.1. In patients with HEV Ab <1.1, there were significant inverse relationships between HEV Ab and GFR in the first (p=0.047, r=-0.21), third (p=0.04, r=-0.20), and sixth (p=0.04, r=-0.22) months after renal transplantation. A significant direct correlation was observed between age and HEV Ab levels (p=0.001, r=0.33). Conclusion: Our findings showed a high prevalence of seropositivity of Anti HEV IgG in patients receiving renal transplants. However, liver and renal function test results were not significantly different between seropositive and seronegative recipients within 6 months of renal transplantations. [ABSTRACT FROM AUTHOR]

Background/Objective: In this study we compared the outcome of patients who underwent one of the two surgical methods of bladder augmentation, i.e., enterocystoplasty (EC) and ureterocystoplasty (UC) before kidney transplantation, with recipients of kidney who had normal bladder function. Methods: During a 26-year period (1988-2014), 2100 renal transplantations were performed in our center by a fixed team. In 22 patients (mean age 19.5 years) enterocystoplasty (group A) and in 12 patients (mean age 12.3 years) ureterocystoplasty (group B) were performed before renal transplantation. These two groups were compared with a control group of 34 recipients with a normal bladder (group C, mean age 17.6 years) for kidney function, graft and patient survival and episodes of urinary tract infection. Results: There was normal graft function in 15,10, and 31 patients in groups A, B, and C, respectively during a mean follow-up of 92, 73, and 82 months (p<0.8). The mean±SD serum creatinine in follow-up was 1.58±0.35, 1.42±0.15, and 1.31±0.51 mg/dL in groups A, B, and C, respectively. There were no statistically significant differences among the 3 groups in terms of 1, 5, and 10-year graft and patient survivals. Episodes of febrile UTI requiring hospital admission were 23, 7, and 2 in groups A, B, and C, respectively. UTI and urosepsis were significantly more frequent in group A than group B (p=0.035) and group C (p=0.001); however, there was no significant difference between groups B and C (p=0.330). Conclusion: Although augmentation cystoplasty with segment of intestine or dilated ureter is a safe and effective procedure for reconstruction of lower urinary tract before renal transplantation, in recipients with enterocystoplasty the frequency of febrile UTI and urosepsis is high; sometime it is dangerous. In long-term, there is no significant difference in graft function among the 3 groups. As a result augmentation cystoplasty (either method) is recommended before renal transplantation for reconstruction of lower urinary tract. [ABSTRACT FROM AUTHOR]