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Introduction: The emergence of a novel coronavirus (COVID-19) in late December 2019 and its rapid global spread has led World Health Organization (WHO) to introduce it as a very dangerous pandemic. People with underlying disease and a history of organ transplantation are at higher risk for COVID-19 disease compared with healthy people. Objectives: In the present study, clinical and laboratory manifestations in the patients with COVID-19 with a history of kidney transplantation has been investigated. Patients and Methods: This study conducted on 103 COVID-19-positive kidney transplant patients as a descriptive epidemiological study. Clinical and laboratory symptoms of hospitalized renal transplanted patients have been assessed. Statistical analysis of the collected data conducted using SPSS (Statistical Package for Social Sciences, version 22). Results: This study consisted of 103 COVID-19 patients with a history of kidney transplant, of which 64 males (62.1%) and 39 females (37.9%) with an average age of 48.5 ± 13.1 years. The most common clinical manifestations were headache (67%) and shortness of breath (66%). Elevated lactate dehydrogenase (LDH) levels, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) has been observed in 100%, 98.1% and 93.2% of patients, respectively. In 12.6% and 41.7% of patients, the degree of lung involvement was above 75% and 50%-75%, respectively. Moreover, 79.6% of patients has been discharged after improved, while 20.4% of patients died. Conclusion: We found, kidney transplantation may increase COVID-19-related mortality when compared to COVID-19-related mortality in the general population. [ABSTRACT FROM AUTHOR]

Introduction: Acute kidney injury (AKI) is prevalent in the coronavirus disease-2019 (COVID-19). There are little data on the relationship between renal dysfunction and COVID-19 prognosis. Objectives: The aim of this research was to investigate the effects of AKI in COVID-19 patients hospitalized to the Golestan and Razi hospitals in Ahvaz, Iran. Patients and Methods: In this retrospective cohort study, a total of 194 COVID-19 patients were included, consisting of 79 patients with AKI and 115 patients without AKI. Primary and secondary outcomes were compared between the two groups. Results: According to the findings, mortality was significantly different between the two groups, and mortality was higher in the AKI group (P < 0.001). The mean length of hospital stay was statistically significantly higher in the AKI group (P = 0.024). Moreover, there was a significant correlation between intensive care unit (ICU) admission and the study group (P < 0.001). Staging of AKI group were seen as; stage I (49.37%), stage II (36.71%), and stage III (13.92%). No significant correlation was observed between outcome and the stages of AKI (P = 0.496). Furthermore, 14 patients (17.72%) needed renal replacement therapy (RRT) in the AKI group. Conclusion: Although AKI is a common finding in COVID-19 patients, most patients were in stage I disease, which returned to normal after COVID-19 treatment. According to our research, COVID-19 rarely leads to serious and persistent kidney injury. However, the risk of death is increased in COVID-19 patients with AKI. Therefore, it is necessary to evaluate the renal function tests during the course of disease. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: There is a limited knowledge about the morphological features of IgA nephropathy (IgAN)in the middle east region. Objectives: The objective of this study was to evaluate the spectrum of histopathological findings in IgAN patients at our laboratory. Patients and Methods: At this work, an observational study reported which was conducted on IgAN patients using the Oxford-MEST classification system. Results: In this survey, of 102 patients 71.6 % were male. The mean age of the patients was 37.7 ± 13.6 years. Morphologic variables of MEST classification was as follows; M1: 90.2 %, E: 32 %, S: 67 % also,T in grads I and II were in 30% and 19% respectively, while 51% were in grade zero. A significant difference was observed in segmental glomerulosclerosis (P=0.003) and interstitial fibrosis/tubular atrophy frequency distribution (P= 0.045), between males and females . Furthermore, it was found that mesangial hypercellularity was more prevalent in yonger patients. Moreover, there was a significant correlation between serum creatinine and crescents (P<0.001). There was also significant correlation of serum creatinine with segmental glomerulosclerosis (P<0.001). Conclusions: Higher prevalence of segmental glomerulosclerosis and interstitial fibrosis/ tubular atrophy, as the two of, four variables of Oxford-MEST classification of IgAN in male patients further attests that male gender is a risk factor in this disease. In this study the significant correlation between serum creatinine and crescent was in an agreement with previous studies and suggests for the probable accomodation of extracapillary proliferation as a new variable in MEST system. [ABSTRACT FROM AUTHOR]

Introduction: The current treatment regimens for patients with idiopathic membranous nephropathy (MN) are based on cyclophosphamide-glucocorticoid or calcineurin inhibitor-glucocorticoid. Objectives: We evaluated whether mycophenolate mofetil (MMF) -glucocorticoid could be an option for first-line therapy among these patients. Patients and Methods: In a double-blinded, randomized and controlled clinical trial, we compared the effect of MMF with cyclophosphamide in inducing complete or partial remission (PR) among patients with nephrotic syndrome due to idiopathic MN. All of the patients in both groups also received steroid, renin-angiotensin blockers and statins. Diuretics were also used in the patients who had edema. The primary end point of our study was change in urinary protein/creatinine ratio. Results: A total of 30 patients completed the study. Around 17 patients received MMF (2 g/d) and 13 patients received intravenous or oral cyclophosphamide for 6 months. At the start of the study, no significant differences in demographic and biochemical parameters of patients including the urinary protein excretion rate between two groups (P = 0.432). The proportion of proteinuria was 5235 ± 1655 mg/24 in MMF group and 8781 ± 8741 mg/24 in the cyclophosphamide group at the beginning of the study. The rate of complete and PR were 5.9% and 52.9 in MMF group versus 16.7% and 100% in cyclophosphamide group which it is significantly lower in MMF group. Kidney function was stable in both groups during treatment. Conclusions: According to the result of our study, a 6-month therapy with MMF-glucocorticoid is not recommended for treatment of patients with nephrotic syndrome due to idiopathic MN. [ABSTRACT FROM AUTHOR]