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Background: Cardiovascular diseases are the most important causes of mortality in Iran. Hypercholesterolemia is one of the major risk factors for cardiovascular diseases. Dietary modification such as cereal bran consumption is an approach to reduce this risk factor. The purpose of this present study was to compare the effects of rice bran and wheat bran on serum lipids in hypercholesterolemic women. Methods: This study was a randomized clinical trial in which 19 women aged 35-65 years with fasting serum total cholesterol 240-300 mg/dl randomly allocated in two groups of wheat bran and rice bran. All subjects recieved 40 g/day bran in addition to their usual diet for 4 weeks. Anthropometric measurements, dietary assessments by using a 24-hr dietary recall questionnaire and determination of serum lipids were done at the beginning and the end of the study. Data were statistically analyzed by t-test and paired t-test. Results: There were no significant differences between groups for mean body weight, BMI and dietary confounding factors. During 4 weeks, wheat bran significantly reduced serum total cholesterol and LDL-C by 11% and 21% respectively (P

Background and objectives: Scrophularia atropatana (S. atropatana) is endemic to western and central regions of Iran. It belongs to the genus of Scrophularia (family: Scrophulariaceae). These species have been found to possess antibacterial, antitumor and anti-inflammatory properties. Most of these effects were proven to be attributed to the non-volatile components, which were known as secondary metabolites. Iridoids, phenylpropanoids, phenolic acids and flavonoids have been identified as their main secondary metabolites. This investigation was performed to analyze the composition of the essential oil (EO) of S. atropatana and evaluation of its anti-oxidant and total toxicity properties. Methods: About 150 g powder of the air dried parts of S. atropatana was submitted to hydro-distillation and also was successively extracted (with n-hexane, dichloromethane (DCM) and methanol (MeOH)), by using Clevenger and Soxhlet apparatus, respectively. In addition, Essential Oil (EO) was analyzed by GC-MS and GC-FID. Furthermore, the anti-oxidant activity of the extracts, fractions and EO as well as general toxicity were investigated by DPPH and brine shrimp larva assay, respectively. Results: Totally, sixty eight volatile compounds were identified, which constituted 91.78% of the total oil composition. Among the compounds, major constituents were identified as non-terpenoides (59.59%). Moreover, among the extracts and EO, methanol extract demonstrated high free radical scavenging and general toxic activities with RC50 equal 0.143±0.13 mg/mL and LD50 0.271 mcg/mL respectively. Conclusion: Overall, the main constituents of S. atropatana were hydrocarbons. In comparison to other genesis of Scrophularia, antioxidant activity of the essential oil of S. atropatana was less noticeable.

It has been found that people undergoing dialysis have a lower quality of life than the rest of the population. The aim of dialysis is to improve physical health, but also well-being. We were interested in the perception of the quality of life of patients undergoing Peritoneal Dialysis. We used the narrative interview method to collect their feelings, their daily experience, and their impressions about their care. We conducted four in-depth interviews, following the principle of theoretical data saturation, with adults treated at the Hospital of Nice. These interviews indicated that Peritoneal Dialysis rapidly improves physical and emotional health. Patients are satisfied with the technique, which allows them to return to a social, familial, and professional life. However, they regret that it does not relieve them of dietary restrictions, especially on salt. Patients appreciate the temporary support of a private nurse, which is systematically offered by our center at the beginning of treatment. They wish the involvement of peers to benefit from their experience, explanations and practical demonstrations. Quality of life is important to assess when choosing a renal replacement technique. Caregivers have to understand patients’ expectations and wishes in order to guide them towards the dialysis modality that suits their lifestyle and preferences best. This will improve treatment outcomes.

Aims: The present study was conducted to examine the association between dietary acid load (DAL) and markers of inflammation, oxidative stress, and malnutrition in a group of Iranian hemodialysis (HD) patients., Methods: This cross-sectional study was performed on individuals aged ≥18 years who were on HD at least 6 months before their enrollment in the study. A 4-day dietary recall was used for the evaluation of dietary intake. DAL was calculated using two methods including potential renal acid load (PRAL) and net endogenous acid production (NEAP). For assessing the malnutrition status, we used the subjective global assessment (SGA), dialysis malnutrition score (DMS), and malnutrition inflammation score (MIS). Fasting blood samples were collected from each participant to assess serum levels of high-sensitivity C-reactive protein (hs-CRP), soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular adhesion molecule-1 (sVCAM-1), sE-selectin, malondialdehyde (MDA), nitric oxide (NO), and endothelin-1., Results: In total, 291 patients with a mean age of 57.73 ± 0.88 years and HD vintage of 4.27 ± 0.25 months were enrolled in the current study. Significant positive associations were observed between PRAL and hs-CRP ( β = 1.77, 95% CI: 0.88, 2.65), sICAM-1 ( β = 83.21, 95% CI: 10.39, 156.04), sVCAM-1 ( β = 194.63, 95% CI: 74.68, 314.58), and sE-selectin ( β = 6.66, 95% CI: 1.81, 11.50) among participants with the highest PRAL scores, compared to those with the lowest PRAL scores. NEAP was positively correlated with hs-CRP ( β = 1.34, 95% CI: 0.46, 2.22), sICAM-1 ( β = 88.83, 95% CI: 16.99, 160.67), and MDA ( β = 0.35, 95% CI: 0.005, 0.71). Additionally, marginally significant higher odds of SGA (OR = 1.98, 95% CI: 0.95, 4.11) and DMS (OR = 1.94, 95% CI: 0.92, 4.05) were observed in individuals in the third tertile of PRAL vs. the first tertile of PRAL. NEAP had also a marginally significant positive correlation with DMS (OR = 2.01, 95% CI: 0.93, 4.31)., Conclusion: This study illustrates that higher consumption of acidic foods is correlated with markers of inflammation, oxidative stress, and malnutrition in HD patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Balali, Nehls, Tabibi, As’habi and Arab.)

Objectives: The current survey aimed to investigate the link between energy-adjusted dietary inflammatory index (E-DII) and risk factors for CVD including markers of endothelial and systemic inflammation in Iranian hemodialysis patients., Methods: Patients on hemodialysis for at least 6 months prior to enrollment were considered eligible in this cross-sectional study. The usual dietary intakes of the hemodialysis individuals were examined through 4 non-consecutive days including 2 dialysis days and 2 non-dialysis days using a 24-h recall approach to calculate E-DII. Multiple linear regression analysis was utilized to investigate the link between E-DII and selected biomarkers of inflammation and oxidative stress including high-sensitive C reactive protein (hs-CRP), serum intercellular adhesion molecule (sICAM), serum vascular cell adhesion molecule (sVCAM), malondialdehyde, and nitric oxide (NO), sE-selectin, and endothelin-1, and beta (β) and 95% confidence interval (CI) was reported. Value of p < 0.05 was considered statistically significant., Results: Overall, 291 hemodialysis patients make up our study population. In the crude model, the E-DII score was positively associated with a higher sVCAM-1 (β = 177.39; 95% CI: 60.51, 294.26; p trend = 0.003). Further adjustment for potential confounders attenuated the findings in a way that an increase of 128.72 in the sVCAM-1 was observed when the E-DII score increased from -2.68 to -1.14 (95% CI: 13.50, 243.94). After controlling for potential confounders, E-DII was associated with sE-selectin in hemodialysis patients in the highest category of E-DII as compared to the lowest category (β = 4.11; 95% CI: 0.22, 8.00; p trend = 0.039)., Conclusion: The present findings suggest that adherence to a pro-inflammatory diet among hemodialysis patients is associated with a higher inflammatory status as evidenced by sVCAM-1 and sE-selectin; however, bidirectionality may exist and the role of residual confounders should be taken into account. Therefore, more longitudinal investigations are needed to elucidate the role of diet on the inflammatory status of hemodialysis patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Arab, Karimi, Nazari, Tabibi and As’habi.)

Trace minerals are essential for the normal functioning of all living organisms. In addition, the positive effects of several medicinal plants have been demonstrated in aquaculture. In the present study, we aimed to investigate the effects of a mixture of medicinal plants and test the synergistic effects of medicinal plants and chelated minerals on fish growth and immunity. Thus, in the present experiment we evaluated the combined effects of a commercial chelated mineral source (BonzaFish®) and a mixture of 4 medicinal plants including caraway (Carum carvi), green cumin (Cuminum cyminum), dill (Anethum graveolens), and anise (Pimpinella anisum). Rainbow trout (Oncorhynchus mykiss) fingerlings (n = 225) were fed with five formulated diets, including a control diet (basal diet), Bonza (basal diet + 1 g/kg BonzaFish®), Z-5 (basal diet + 1 g/kg BonzaFish® + 5 g/kg mixture of plant seeds), Z-10 (basal diet + 1 g/kg BonzaFish®+10 g/kg mixture of plant seeds), Z-20 (basal diet+1 g/kg BonzaFish®+20 g/kg mixture of plant seeds) for 6 weeks. In diets including BonzaFish®, 50% of the inorganic mineral premix was replaced by BonzaFish®. Results revealed that fish receiving the Z-20 diet showed the best performance in terms of growth parameters, followed by the Bonza treatment (P < 0.05). The highest protease activity was found in Z-5 and Z-10. RBCs were highest in Z-5, while the highest WBCs and hemoglobin were found in the Bonza treatment followed by Z-20. Stress biomarkers were lowest in the Z-20 treatment. Results showed that Z-20 could elicit the most robust immunological responses of lysozyme activity, ACH50, total Ig, C3, and C4. In conclusion, chelated minerals could be successfully used to replace 50% of mineral premix with no negative impacts on fish growth and together with four medicinal plants, could enhance rainbow trout overall growth performance and immunity., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Purpose: Hyperlipoproteinemia (a) is a prevalent complication in dialysis patients, with no valid treatment strategy. The aim of this narrative review was to investigate the clinical significance of hyperlipoproteinemia (a) and phytoestrogen therapy in dialysis patients., Methods: A comprehensive literature search of the published data was performed regarding the effects of phytoestrogen therapy on hyperlipoproteinemia (a) in dialysis patients., Findings: Hyperlipoproteinemia (a) occurs in dialysis patients due to decreased catabolism and increased synthesis of lipoprotein (a) [Lp(a)]. A few clinical trials have studied the effects of phytoestrogens on serum Lp(a). All studies of dialysis patients or nonuremic individuals with hyperlipoproteinemia (a), except one, showed that phytoestrogens could significantly reduce serum Lp(a) levels. However, all investigations of phytoestrogen therapy in individuals with normal serum Lp(a) levels showed that it had no effect on serum Lp(a). Phytoestrogens seem to have effects similar to those of estrogen in lowering Lp(a) concentrations., Implications: Considering the high prevalence of hyperlipoproteinemia (a) in dialysis patients, phytoestrogen therapy is a reasonable approach for reducing serum Lp(a) levels and its complications in these patients., Competing Interests: Declaration of Competing Interest None declared., (Copyright © 2023 Elsevier Inc. All rights reserved.)

In this study, we aimed to examine the relationship between energy-adjusted dietary inflammatory index (E-DII) and a comprehensive profile of malnutrition in Iranian haemodialysis (HD) patients. In this cross-sectional study, 291 participants on HD for at least 6 months before enrollment were included. The current dietary intakes of participants were assessed using a 4-d diet diary-assisted recall, including 2 non-dialysis days and 2 dialysis days to calculate E-DII. To determine the malnutrition status of HD patients, BMI, subjective global assessment (SGA), dialysis malnutrition score (DMS) and malnutrition inflammation score (MIS) were used. Overall, 291 HD patients comprised our study population. After controlling for potential confounders, E-DII was associated with a higher risk of malnutrition, as evidenced by SGA (OR = 2·23; 95 % CI: 1·11, 4·49), DMS (OR = 2·31; 95 % CI: 1·16, 4·60) and MIS (OR = 2·50; 95 % CI: 1·28, 4·88). No significant association was detected between E-DII and BMI either before (OR = 1·78; 95 % CI: 0·83, 3·81) or after adjustment for possible confounders (OR = 1·43; 95 % CI: 0·58, 3·54). This study showed that E-DII was significantly associated with reliable malnutrition markers including SGA, DMS and MIS in HD patients. However, further longitudinal studies are warranted to infer a cause-and-effect relationship between DII and malnutrition.

Limited data are available linking dietary factors to glioma. The current study was conducted to investigate the association between Dietary Acid Load (DAL) and odds of glioma in Iranian adults. This case-control study was done on 128 newly diagnosed patients with glioma and 256 healthy controls in Tehran, Iran. A validated detailed food frequency questionnaire (FFQ) was used to assess dietary intakes of participants. DAL was estimated using the protein to potassium ratio (Pro: K). Glioma was diagnosed based on pathological tests. A detailed questionnaire including several non-dietary confounders was also completed. Participants in the highest tertile of DAL score had a non-significant higher odds of glioma as compared to those in the lowest tertile (OR: 1.50; 95% CI: 0.88-2.57), which remained after controlling for some potential confounders (OR: 1.66; 0.70-3.91). After further adjustment for dietary intakes of meats and processed meats, legumes and nuts, fruits, salt tea, and coffee, those in the top tertile of DAL score were significantly more likely to have glioma than those in the bottom tertile (OR: 3.09; 95% CI: 1.06, 8.99; P  = 0.03). This association was also reached following further adjustment for BMI (OR: 3.05; 95% CI: 1.04, 8.91; P  = 0.03). We found a significant positive association between dietary acid load, as estimated by Prot:K ratio, and odds of glioma among adults. Further studies, in particular prospective cohorts with long-term follow up, are required to confirm these findings.

Measuring the volume of urine in the bladder is a significant issue in patients who suffer from the lack of bladder fullness sensation or have problems with timeliness getting to the restroom, such as spinal cord injury patients and some of the elderlies. Real-time monitoring of the bladder, therefore, can be highly helpful for urinary incontinence. Bladder volume monitoring technologies can be divided into two distinct categories of invasive and non-invasive. In invasive techniques, a catheter is directly inserted into the urethra to measure the amount of urine accurately. However, it is painful, limits the user's ordinary movements, and may hurt the urinary tract. Current non-invasive techniques measure the volume of the bladder from the skin using different stationary or portable apparatus at health centers. Both techniques have difficulties and are not cost-effective to use for a long period. Recently, both invasive and non-invasive methods have been attempted to be produced in the form of wearable devices utilizing different sensing and communication technologies. Wearable bladder monitoring devices can be easily used by patients with no or few clinical steps, making them much more affordable than non-wearable devices. While wearable devices seem to be a highly convenient and effective solution, they suffer from few drawbacks, such as relatively low precision. Hence, a great number of studies have been conducted to address these issues. In this article, we review and discuss non-invasive and minimally invasive methods for monitoring the bladder volume. We focus on the most practical and state-of-the-art methods employed in wearable devices, classify them by engineering and medical characteristics, and investigate their specifications, architectures, and measurement algorithms. This study aims to introduce the latest advances in this field to practitioners while comparing the advantages and disadvantages of existing approaches. Our study concludes with open problems and future trends in the area of bladder monitoring and measurement systems. Graphical abstract Wearable bladder monitoring system., (© 2021. International Federation for Medical and Biological Engineering.)

Introduction: High serum concentrations of glucose, advanced glycation end products (AGEs), and hypertension are some of the major risk factors for cardiovascular disease and peritoneal membrane fibrosis in peritoneal dialysis (PD) patients. Some investigations in nonuremic individuals have indicated that isoflavones can reduce serum glucose, blood pressure, and increase insulin sensitivity. However, such study in this field in PD patients is still lacking. Therefore, we aimed to determine the effects of isoflavones on serum glucose, fructosamine, AGEs, and blood pressure in PD patients., Methods: This study was a randomized, double blind, placebocontrolled trial. Thirty-eight PD patients were randomly assigned to either the isoflavone group or the placebo. The patients in the isoflavone group received 100 mg/d soy isoflavone for 8 weeks, while the control group received corresponding placebo. At baseline and the end of the 8th week, 7 mL of blood was collected from each patient and serum glucose, fructosamine, carboxymethyl lysine, pentosidine, accompanied by systolic and diastolic blood pressures were measured., Results: Serum glucose and pentosidine reduced significantly in the isoflavone group at the end of 8th week compared with baseline (P < .05), whereas no statistically significant changes were observed in the placebo group. Serum carboxymethyl lysine, fructosamine, and systolic and diastolic blood pressures did not significantly change within each group during the study., Conclusion: This study indicates that soy isoflavones could decrease serum glucose and pentosidine in PD patients.

Cardiovascular disease (CVD) is common in peritoneal dialysis (PD) patients. This study was designed to investigate the effects of isoflavones on systemic and vascular inflammation markers and oxidative stress in PD patients. In this randomized clinical trial, 40 PD patients were randomly assigned to either the isoflavone or the placebo group. The isoflavone group received 100 mg soy isoflavones daily for 8 weeks, whereas the placebo group received corresponding placebos. At baseline and the end of eighth week, serum high sensitive C-reactive protein (hs-CRP), intercellular adhesion molecule type 1 (ICAM-1), vascular cell adhesion molecule type 1 (VCAM-1), E-selectin, and malondialdehyde were measured. Serum VCAM-1 decreased significantly in the isoflavone group at the end of Week 8 compared to baseline (p = .01), whereas no significant change was observed in the placebo group. Serum ICAM-1 decreased significantly in the isoflavone (p = .01) and placebo (p = .01) group compared to baseline. However, the reduction of ICAM-1 was significantly higher in the isoflavone group than in the placebo group (p = .02). There were no significant differences between the two groups in mean changes of serum E-selectin, malondialdehyde, and hs-CRP. This study indicates that isoflavones reduce serum VCAM-1 and ICAM-1, which are two CVD risk factors, in PD patients., (© 2020 John Wiley & Sons, Ltd.)

Background and Aim: Lipid abnormalities are common in peritoneal dialysis (PD) patients and no effective treatment to decrease serum lipoprotein (a) [Lp(a)] in dialysis patients is known so far. Therefore, this research was designed to investigate the effects of soy isoflavone supplement on serum lipids and Lp(a) in PD patients., Methods & Results: In this randomized, double-blind, placebo-controlled trial, 40 PD patients were randomly assigned to either the isoflavone or the placebo group. The patients in the isoflavone group received 100 mg soy isoflavone daily for 8 weeks, whereas the placebo group received corresponding placebos. At baseline and the end of the 8th week, 7 mL of blood was obtained from each patient and serum triglycerides, total cholesterol, low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), and Lp(a) were measured. Serum Lp(a) reduced significantly up to 10% in the isoflavone group at the end of week 8 compared to baseline (P < 0.05), and the reduction was significant in comparison with the placebo group (P < 0.05). Serum HDL-C increased significantly up to 11.5% in the isoflavone group at the end of week 8 compared to baseline (P = 0.05), and the increment was significant in comparison with the placebo group (P < 0.05). There were no significant differences between the two groups in mean changes of serum triglycerides, total cholesterol, and LDL-C., Conclusions: This study indicates that daily administration of 100 mg soy isoflavones reduces serum Lp(a) and increases HDL-C concentration which are two determinants of cardiovascular disease in PD patients. CLINICALTRIALS.GOV: NCT03773029., Registration Number and Date: NCT03773029 - 2018., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflicts of interest., (Copyright © 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Purpose: The aim of this study was to investigate the effects of soy isoflavones on serum markers of bone formation and resorption in peritoneal dialysis (PD) patients., Methods: In this randomized, double-blind, placebo-controlled trial, 40 PD patients were randomly assigned to either the soy isoflavone or the placebo group. The patients in the soy isoflavone group received 100 mg soy isoflavones daily for 8 weeks, whereas the placebo group received corresponding placebos. At baseline and the end of the 8th week, 7 ml of blood was obtained from each patient after a 12- to 14-h fast and serum concentrations of bone formation markers (osteocalcin and bone alkaline phosphatase), bone resorption markers [N-telopeptide and receptor activator of nuclear factor kappa B ligand (RANKL)], and osteoprotegerin as an inhibitor of bone resorption were measured., Results: Serum N-telopeptide concentration decreased significantly up to 27% in the soy isoflavone group at the end of week 8 compared to baseline (P = 0.003). Also, serum RANKL concentration reduced significantly up to 17% in the soy isoflavone group at the end of week 8 compared to baseline (P = 0.03). These bone resorption markers did not significantly change in the placebo group during the study. There were no significant differences between the two groups in mean changes of serum osteocalcin, bone alkaline phosphatase, and osteoprotegerin., Conclusion: This study indicates that daily administration of 100 mg soy isoflavone supplement to PD patients reduces serum N-telopeptide and RANKL which are two bone resorption markers. CLINICALTRIALS.GOV: NCT03773029, 2018.

Introduction: Loss of skeletal muscle mass and muscle strength is common in dialysis patients. Therefore, this investigation was designed to determine the association between body composition, muscle function, and physical activity with mortality in peritoneal dialysis (PD) patients., Methods: This was a multicenter cohort study on all eligible PD patients (n = 79) in Tehran PD centers. At baseline, skeletal muscle mass and muscle strength were determined using bioelectrical impedance analysis and handgrip strength, respectively. Physical performance was assessed by a 4-meter walk gait speed test. Physical activity level was estimated by using the long-form International Physical Activity Questionnaire at baseline. The mortality of PD patients was evaluated two years after the start of this study., Results: The total dialysis adequacy was significantly lower in dead patients in comparison with live patients (P < .05). In contrast, serum hs-CRP (P < .05), and the total amount of glucose absorbed daily from PD solutions (P < .05) were significantly higher in dead patients in comparison with live patients. There were no significant associations between body fat mass, skeletal muscle mass, skeletal muscle mass index, muscle strength and physical performance with mortality in PD patients. However, in PD patients with physical activity ≤ median, odds of mortality was 7.4 times higher than those with physical activity > median (OR = 7.4, 95% CI: 1.3 to 43.3; P < .05)., Conclusion: This study indicates that low physical activity; low dialysis adequacy, high serum hs-CRP, and high amount of glucose absorbed from PD solutions are related with high mortality in PD patients.

Introduction: Poor nutritional status is prevalent in peritonealdialysis (PD) patients and is related to morbidity and mortality.Therefore, the aim of the present study was to assess the dietaryintake and its related factors in PD patients in Tehran, Iran., Methods: All eligible PD patients in Tehran peritoneal dialysiscenters were included in this cross-sectional study. Dietary intakeof PD patients was determined using a 3-day dietary recall. Also,a 4 mL blood sample was obtained from each patient to measureserum biochemical parameters., Results: Intake of energy, protein, and fiber were lower thanrecommended values in 81%, 92%, and 100% of PD patients;respectively. The prevalence of inadequate energy intake in PDpatients with dialysis vintage ≤ 5 years was significantly higheras compared to those with dialysis vintage > 5 years (P < .05). Asignificant association was observed between inadequate energyintake and inadequate vitamin B3 intake (P < .05). There was amarginally (not) significant association between inadequate energyintake and inadequate vitamin B1 intake (P = 0.06). Intake of thevitamins B1, B2, B3, B6, folic acid, B12, E, C, and of the minerals,calcium, and zinc from both the diet and supplements were lowerthan recommended values in 15%, 38%, 23%, 39%, 52%, 32%, 47%,29%, 54%, and 50.5% of PD patients, respectively., Conclusion: Insufficient intake of energy and various nutrients arecommon in PD patients in Tehran, Iran; which may contribute tomorbidity and mortality in these patients.

Background & Aims: Nutrient pattern analysis is an easy way to compare nutrient intakes across different nations due to the universality of nutrients nature. The current study aimed to investigate the relation between patterns of nutrients intake and glioma in a case-control study in Iranian adults., Methods: In this hospital-based case-control study, we enrolled 128 pathologically confirmed new cases of glioma and 256 age and sex-matched controls. Dietary intakes of study participants were assessed using the validated Block-format 123-item semi-quantitative FFQ. Data on potential confounders were also collected through the use of pre-tested questionnaire., Results: Four nutrient patterns were identified through the use of factor analysis. Participants were categorized based on tertiles of nutrient patterns' scores. Adherence to the first nutrient pattern was not significantly associated with the odds of glioma (0.93; 0.40-2.15). Participants with greater adherence to the second nutrient pattern were less likely to have glioma in crude model (0.48; 0.28-0.83). The inverse association remained significant after controlling for age, sex and energy intake (0.42; 0.24-0.78). Further controlling for other potential confounders, including BMI, resulted in the disappearance of the association (0.52; 0.25-1.10). Greater adherence to the third nutrient pattern was directly associated with the odds of glioma (1.92; 1.10-3.35). Even after controlling for sex, age and energy intake, the association was statistically significant (2.83; 1.28-4.21). However, when other confounders were taken into account, the association became non-significant (2.28; 0.89-5.82). The fourth nutrient pattern was not associated with the odds of glioma (0.71; 0.35-1.42)., Conclusion: We failed to find any significant independent association between nutrient patterns and odds of glioma. Further studies needed to confirm these findings., (Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Scrophularia atropatana ( S. atropatana ) , an Iranian plant belonging to the family of Scrophulariaceae, was assigned for its chemical compositions and biological activities of essential oil (EO) and extracts of the aerial parts of the plant during the flowering stage. Combination of GC-MS and GC-FID was assessed for analyzing the chemical compositions of the EO from the aerial parts of S. atropatana . Furthermore, Brine shrimp lethality test and DPPH assay were performed to evaluate general toxicity and free-radical-scavenging properties, respectively. Furthermore, anti-proliferative and antimicrobial activities were assessed by MTT assay and disc diffusion methods correspondingly. Additionally, all the potent samples (extracts) and its fractions in the MTT assay were further studied for the presence of various compounds by GC-MS apparatus . MeOH extract and 40% sep-pak fraction indicated high amounts of total phenolic (TPC), total flavonoid content (TFC), and antioxidant properties. In the case of general toxicity, among the extracts, dichloromethane (DCM) extract showed noticeable effect. Furthermore, DCM extract was indicated potent ability to eliminate breast tumor cells and minimum efficacy on normal cells. Anti-microbial activity of all samples was ignorable. The potent extracts and fractions which had more anti-proliferative activity were further elucidated by GC-MS and showed high amounts of Alkanes and fatty acids. In the case of EO constituents, non-terpenoids were the major compounds. To sum up, it seems BSLT could be a good preliminary approach for evaluating the cytotoxicity in MCF-7 cell line. Additionally, antioxidant activity, TPC, and TFC contents of all samples were in consistent with each other.

Purpose: Data on the link between tea and coffee consumption and risk of glioma are controversial. We aimed to examine the association between tea and coffee consumption and glioma in Iranian adults., Methods: In this hospital-based case-control study, we enrolled 128 pathologically confirmed new cases of glioma and 256 age- and sex-matched controls. Dietary intakes of study participants including tea and coffee consumption was assessed using the validated Block-format 123-item semi-quantitative FFQ. Participants were categorized based on tertiles of tea and coffee consumption. Data on potential confounders were also collected through the use of pre-tested questionnaire., Results: Individuals with the greatest tea consumption were less likely to have glioma compared with those with the lowest consumption (0.36; 0.20-0.68). This inverse association was not changed after controlling for energy intake. The association remained statistically significant even after taking other potential confounders, including dietary intakes of red and processed meats, legumes and nuts, fruits, salt and mutual effects of tea and coffee consumption, into account (0.33; 0.13-0.86). Additional adjustments for BMI did not alter the association. After controlling for potential confounders, including dietary intakes and BMI, coffee consumption was inversely associated with odds of glioma; such that individuals in the top category of coffee consumption were 91% less likely to have glioma compared with those in the bottom category (0.09; 0.03-0.24). Considering coffee and tea intake combined, those in the highest tertile were 65% less likely to have glioma compared with those in the lowest tertile (0.35; 0.15-0.83)., Conclusion: We found an inverse association between tea and coffee consumption and odds of glioma, even after controlling for a wide range of confounders.

Introduction: Protein-energy wasting (PEW) is prevalent in dialysis patients, and cardiovascular disease (CVD) is the leading cause of mortality in these patients. This study aimed to determine the prevalence of PEW and its relationship with CVD risk factors in peritoneal dialysis (PD) patients in Tehran, Iran., Materials and Methods: All eligible PD patients in Tehran peritoneal dialysis centers were included in this cross-sectional study. The diagnosis of PEW was done based on the criteria of the International Society of Renal Nutrition and Metabolism. Serum high-sensitivity C-reactive protein, soluble intercellular adhesion molecule type 1, malondialdehyde, and lipid profile were measured., Results: The prevalence of PEW was 29% in the PD patients. Significant associations were found between the prevalence of PEW in PD patients and sex (P = .01), age (P = .03), type of PD dialysis solution (P = .04), and microinflammation (P = .03). Serum C-reactive protein (P = .02), soluble intercellular adhesion molecule type 1 (P = .001), and triglyceride (P = .03) were significantly higher in the PD patients without PEW as compared to those with PEW, whereas high-density lipoprotein cholesterol level was significantly lower in the PD patients without PEW as compared to those with PEW (P = .003)., Conclusions: Our study shows that PEW is prevalent in Iranian PD patients. In addition, serum concentrations of CVD risk factors are dependent on the amount of glucose absorbed from PD solutions and are more impaired in PD patients without PEW as compared to those with PEW.

Background: Dynapenic obesity and sarcopenic obesity increase cardiovascular disease (CVD) and mortality in nonuremic patients. The present study was designed to determine the prevalence of dynapenic obesity and sarcopenic obesity and their associations with CVD risk factors in peritoneal dialysis (PD) patients., Methods: All eligible PD patients in Tehran peritoneal dialysis centers were included in this cross-sectional study. Skeletal muscle mass and fat mass were assessed using bioelectrical impedance analysis. Muscle strength and physical performance were determined using hand grip strength and a 4-meter walk gait speed test, respectively. In addition, a 5-mL blood sample was obtained from each patient., Results: The prevalence of dynapenic obesity and sarcopenic obesity were 11.4% and 3.8% in PD patients, respectively. Serum high-sensitive C-reactive protein (hs-CRP), soluble intercellular adhesion molecule type 1, triglyceride, total cholesterol, and low-density lipoprotein cholesterol were significantly higher in PD patients with dynapenic obesity than in dynapenic nonobese and nondynapenic nonobese patients. Similarly, serum concentrations of CVD risk factors in PD patients with sarcopenic obesity were higher than in nonsarcopenic nonobese patients, but these differences were statistically significant only for serum hs-CRP and triglyceride. In addition, muscle strength and skeletal muscle mass percentage were negatively associated with markers of inflammation and dyslipidemia, whereas body fat percentage was positively associated with these CVD risk factors., Conclusion: This study indicates that although the prevalence of dynapenic obesity and sarcopenic obesity are relatively low in PD patients, these disorders may be associated with CVD risk factors., Competing Interests: Conflicts of interest All authors have no conflicts of interest to declare.

Introduction: Chronic kidney disease-mineral and bone disorder is a common complication in hemodialysis patients. The present study was designed to investigate the effects of flaxseed oil, a rich source of plant omega-3 fatty acid alpha-linolenic acid, on serum markers of bone formation and resorption in hemodialysis patients., Materials and Methods: In this randomized controlled trial, 34 hemodialysis patients were randomly assigned to either the flaxseed oil or the control group. The patients in the flaxseed oil group received 6 g/d of flaxseed oil for 8 weeks, whereas the control group received 6 g/d of medium chain triglycerides oil. At baseline and the end of the 8th week, 7 mL of blood was obtained from each patient after a 12- to 14-hour fast and serum concentrations of osteocalcin, osteoprotegerin, N-telopeptide, and receptor activator of nuclear factor kappa B ligand were measured., Results: Serum N-telopeptide concentration decreased significantly up to 17% in the flaxseed oil group at the end of week 8, as compared to baseline (P < .01), and the reduction was significant in comparison with the control group. There were no significant differences between the two groups in the mean changes of serum osteocalcin, osteoprotegerin, or receptor activator of nuclear factor kappa B ligand., Conclusions: This study indicates that daily consumption of 6 g/d of flaxseed oil may reduce bone resorption in hemodialysis patients.

Introduction: Uremic sarcopenia and dynapenia are prevalent in chronic kidney disease patients, including dialysis patients. The present study was designed to determine the prevalence of sarcopenia and dynapenia and their determinants in peritoneal dialysis (PD) patients in Tehran, Iran., Materials and Methods: All eligible PD patients at the peritoneal dialysis centers of Tehran were included in this cross-sectional study. Skeletal muscle mass and muscle strength were assessed using bioelectrical impedance analysis and hand grip strength, respectively. Physical performance was determined by a 4-m walk gait speed test., Results: The prevalence rates of dynapenia and sarcopenia were 43.0% and 11.5% in the PD patients, respectively. There were significant associations between the prevalence of dynapenia and the age of patients (P = .03), physical activity level (P = .04), and the presence of diabetes mellitus (P = .005). In addition, a significant association was found between the prevalence of sarcopenia and sex (P = .009)., Conclusions: This study indicates that uremic sarcopenia and dynapenia are prevalent in PD patients in Tehran, Iran. These conditions may contribute to physical disability, decreased the quality of life, increased morbidity, and a high mortality rate. Therefore, prevention and treatment of uremic sarcopenia and dynapenia are necessary for Iranian PD patients.

Aspartame is one of the most popular artificial sweeteners over the world. Although its consumption is considered to be safe in acceptable daily intake ranges which were set by the United States Food and Drugs Administration and other regulatory agencies, there are lots of controversies regarding its safety nowadays. Some of the recent experimental and epidemiological studies showed that consumption of aspartame may causes some adverse health effects including obesity, metabolic syndrome, and alteration in gut microbiota. Moreover, studies on the nephrotoxic effect of aspartame have increased. A search of several literature databases for publications on adverse effects of aspartame on the kidney function from 1980 to 2016 showed that long-term consumption of aspartame led to a dose-dependent increased production of free radicals in renal tissues as well as kidney injury, based on several studies on animals However, given the lack of clinical data in this area, it is difficult to make a definitive conclusion regarding nephrotoxic effect of aspartame. Overall, consumers should be aware of the potential side effects of aspartame and other artificial sweeteners. At present it may be recommended that only a minimal amount of them would be consumed.

Introduction: In hemodialysis (HD) patients, one of the common complications is renal anemia. Therefore, the present study was designed to investigate the effects of flaxseed oil consumption on blood hepcidin and hematologic factors in HD patients., Methods: In this randomized, double-blind, clinical trial, 38 HD patients were randomly assigned to either the flaxseed oil or the control group. The patients in the flaxseed oil group received 6 g/d flaxseed oil for 8 wk, whereas the control group received 6 g/d medium chain triglycerides (MCT) oil. At baseline and the end of week 8, serum hepcidin, and blood hemoglobin, hematocrit, red blood cells (RBCs), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) were measured after a 12- to 14-h fast., Findings: Flaxseed oil consumption significantly reduced serum hepcidin concentration up to 25% during 8 weeks, and the reduction was significant in comparison with the MCT oil group. In addition, the number of RBCs, blood hemoglobin, hematocrit, MCH and MCHC increased significantly in the flaxseed oil group up to 6%, 10%, 6%, 5%, and 2%, respectively, and these elevations were significant in comparison with the MCT oil group. There was no significant difference between the two groups in mean changes of MCV., Discussion: This study indicates that daily consumption of 6 g flaxseed oil reduces serum hepcidin and improves hematologic factors in HD patients., (© 2016 International Society for Hemodialysis.)

Introduction: One of the major risk factors for cardiovascular disease is lipid abnormalities among hemodialysis patients. The present study was designed to investigate the effects of flaxseed oil consumption on serum lipids and lipoproteins in hemodialysis patients., Materials and Methods: In a randomized double-blinded controlled trial, 34 hemodialysis patients were assigned to either the flaxseed oil or the control group. The patients in the flaxseed oil group received 6 g/d of flaxseed oil for 8 weeks, whereas the control group received 6 g/d of medium chain triglycerides oil. At baseline and the end of week 8, blood samples were obtained after a 12- to 14-hour fast and serum concentrations of triglyceride, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and lipoprotein(a) were measured., Results: Serum triglyceride concentration decreased significantly up to 23% in the flaxseed oil group at the end of week 8 compared to baseline, and the reduction was significant in comparison with the medium chain triglycerides oil group (P < .01). There were no significant differences between the two groups in the mean changes of serum total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and lipoprotein(a)., Conclusions: This study indicates that daily consumption of 6 g of flaxseed oil reduces serum triglyceride concentration, which is a risk factor for cardiovascular disease in hemodialysis patients, whereas it has no effects on other lipid parameters, especially lipoprotein(a).

Purpose: The aim of this study was to investigate the effects of flaxseed oil consumption on serum systemic and vascular inflammation markers, and oxidative stress in hemodialysis (HD) patients., Methods: In this randomized, double-blind, clinical trial, 34 HD patients were randomly assigned to either the flaxseed oil or the control group. The patients in the flaxseed oil group received 6 g/day flaxseed oil for 8 week, whereas the control group received 6 g/day medium-chain triglycerides (MCT) oil. At baseline and the end of week 8, serum concentrations of high-sensitive C-reactive protein (hs-CRP), soluble intercellular adhesion molecule type 1 (sICAM-1), soluble vascular cell adhesion molecule type 1 (sVCAM-1), sE-selectin, and malondialdehyde (MDA) were measured after a 12- to 14-h fast., Results: Serum hs-CRP, a systemic inflammation marker, and sVCAM-1, a vascular inflammation marker, reduced significantly in the flaxseed oil group at the end of week 8 compared to baseline (P < 0.05), and the reductions were significant in comparison with the MCT oil group (P < 0.05). There were no significant differences between the two groups in mean changes in serum sICAM-1, sE-selectin, and MDA., Conclusion: This study indicates that daily consumption of 6 g flaxseed oil reduces serum hs-CRP and sVCAM-1, which are two risk factors for CVD. Therefore, the inclusion of flaxseed oil in the usual diet of HD patients can be considered as a strategy for reducing CVD risk factors.

Data on the association of adherence to the Dietary Approaches to Stop Hypertension (DASH)-style and glioma are scarce. We aimed to examine the association between adherence to the DASH-style diet and glioma in Iranian adults. In this study, 128 pathologically confirmed cases of glioma were recruited from hospitals and 256 age- and sex-matched controls were enrolled from other wards of the hospital. Dietary intakes were assessed using a 126-item validated FFQ. Adherence to the DASH-style diet was followed considering the healthy and non-healthy foods emphasised in the DASH dietary pattern. After controlling for potential confounders, individuals with the greatest adherence to the DASH diet were 72 % less likely to have glioma compared with those with the lowest adherence (OR 0·28; 95 % CI 0·13, 0·57). Individuals with the highest consumption of fruits had lower odds for having glioma compared with those with the lowest intake (OR 0·31; 95 % CI 0·14, 0·68). A protective association was also observed between consumption of legumes and nuts and risk of glioma (OR 0·23; 95 % CI 0·10, 0·53). We found a significant positive association between red and processed meat (OR 2·60; 95 % CI 1·16, 5·81) and salt intakes (OR 2·87; 95 % CI 1·30, 6·34) and risk of glioma, after taking all potential confounders into account. Adherence to the DASH-style dietary pattern was inversely associated with glioma. In addition, some components of the DASH diet, including red meats and salt intakes, were positively associated with glioma. Consumption of nuts and legumes as well as fruits was inversely associated with glioma. Prospective cohort studies are required to confirm our findings.

Unlabelled: ♦, Background: In peritoneal dialysis (PD) patients, one of the major risk factors for cardiovascular disease is lipid abnormalities. This study was designed to investigate the effects of ginger supplementation on serum lipids and lipoproteins in PD patients. ♦, Methods: In this randomized, double-blind, placebo-controlled trial, 36 PD patients were randomly assigned to either the ginger or the placebo group. The patients in the ginger group received 1,000 mg ginger daily for 10 weeks, while the placebo group received corresponding placebos. At baseline and at the end of week 10, 7 mL of blood were obtained from each patient after a 12- to 14-hour fast, and serum concentrations of triglyceride, total cholesterol, low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), and lipoprotein (a) [Lp (a)] were measured. ♦, Results: Serum triglyceride concentration decreased significantly up to 15% in the ginger group at the end of week 10 compared with baseline (p < 0.01), and the reduction was significant in comparison with the placebo group (p < 0.05). There were no significant differences between the 2 groups in mean changes of serum total cholesterol, LDL-C, HDL-C, and Lp (a). ♦, Conclusion: This study indicates that daily administration of 1,000 mg ginger reduces serum triglyceride concentration, which is a risk factor for cardiovascular disease, in PD patients., (Copyright © 2016 International Society for Peritoneal Dialysis.)

Introduction: Diabetes mellitus characterized by hyperglycemia could increase oxidative stress and formation of advanced glycated end-products (AGEs), which contribute to diabetic complications. The purpose of this study was to assess the effect of pomegranate juice (PJ) containing natural antioxidant on lipid peroxidation and plasma AGEs in patients with type 2 diabetes (T2D)., Materials and Methods: In a randomized, double-blind, placebo-controlled trial, 44 patients (age range 56±6.8 years), T2D were randomly assigned to one of two groups: group A (PJ, n=22) and group B (Placebo, n=22). At the baseline and the end of 12-week intervention, biochemical markers including fasting plasma glucose, insulin, oxidative stress, and AGE markers including carboxy methyl lysine (CML) and pentosidine were assayed., Results: At baseline, there were no significant differences in plasma total antioxidant capacity (TAC) levels between the two groups, but malondialdehyde (MDA) decreased levels were significantly different (P<0.001). After 12 weeks of intervention, TAC increased (P<0.05) and MDA decreased (P<0.01) in the PJ group when compared with the placebo group. However, no significant differences were observed in plasma concentration of CML and pentosidine between the two groups., Conclusions: The study showed that PJ decreases lipid peroxidation. Therefore, PJ consumption may delay onset of T2D complications related to oxidative stress.

Inflammation is a common complication in hemodialysis (HD) patients with no valid treatment strategy. In addition, carnitine deficiency occurs frequently in HD patients because of intradialytic loss of carnitine, impaired de novo carnitine renal synthesis, and reduced dietary intake. It appears that carnitine deficiency is related to inflammation in HD patients. A few clinical trials have investigated the effect of L-carnitine supplement on inflammatory markers in HD patients. All studies in this field, except one, showed that L-carnitine could significantly reduce C-reactive protein and serum amyloid A, as two systemic inflammation markers, in HD patients. Therefore, considering high prevalence of inflammation and carnitine deficiency in HD patients, L-carnitine therapy is a reasonable approach for reducing systemic inflammation and its complications in these patients.

Objective: The aim of this study was to investigate the effects of ginger supplementation on serum glucose, advanced glycation end products, oxidative stress, and systemic and vascular inflammatory markers in patients on peritoneal dialysis (PD)., Methods: In this randomized, double-blind, placebo-controlled trial, 36 patients on PD were randomly assigned to either the ginger or the placebo group. The patients in the ginger group received 1000 mg/d ginger for 10 wk, whereas the placebo group received corresponding placebos. At baseline and the end of week 10, serum concentrations of glucose, carboxymethyl lysine, pentosidine, malondialdehyde (MDA), high-sensitivity C-reactive protein (hs-CRP), soluble intercellular adhesion molecule type 1 (sICAM-1), soluble vascular cell adhesion molecule type 1 (sVCAM-1), and sE-selectin were measured after a 12- to 14-h fast., Results: Serum fasting glucose decreased significantly up to 20% in the ginger group at the end of week 10 compared with baseline (P < 0.05), and the reduction was significant in comparison with the placebo group (P < 0.05). There were no significant differences between the two groups in mean changes of serum carboxymethyl lysine, pentosidine, MDA, hs-CRP, sICAM-1, sVCAM-1, and sE-selectin., Conclusion: This study indicated that daily administration of 1000 mg ginger reduces serum fasting glucose, which is a risk factor for hyperinsulinemia, dyslipidemia, peritoneal membrane fibrosis, and cardiovascular disease, in patients on PD., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: This study was designed to investigate the associations between malnutrition-inflammation score (MIS), dialysis-malnutrition score (DMS) and serum albumin with novel risk factors for cardiovascular diseases (CVD) in hemodialysis (HD) patients., Methods: In this cross-sectional study, 291 HD patients were randomly selected from among 2302 adult HD patients in Tehran HD centers. The MIS and DMS were determined during one of the dialysis sessions in these patients. In addition, 4 mL blood was obtained before dialysis and analyzed for serum albumin and novel risk factors for CVD, including C-reactive protein (CRP), soluble intercellular adhesion molecule type 1 (sICAM-1), soluble vascular cell adhesion molecule type 1 (sVCAM-1), sE-selectin, malondialdehyde (MDA), nitric oxide (NO), endothelin-1 and lipoprotein (a) [Lp (a)]., Results: MIS and DMS were significantly positively correlated with serum CRP (p < 0.01) and sICAM-1 (p < 0.01), whereas serum albumin concentration was significantly negatively correlated with serum CRP (p < 0.01) and sICAM-1 (p < 0.01). There were no significant correlations between MIS, DMS and serum albumin with serum concentrations of sVCAM-1, sE-selectin, MDA, NO, endothelin-1 and Lp (a)., Conclusion: This study indicates that protein-energy wasting indicators in HD patients are associated with serum CRP and sICAM-1, as two CVD risk factors.

Purpose: The present study was designed to compare novel risk factors for cardiovascular diseases (CVD) between hemodialysis (HD) patients with or without protein-energy wasting (PEW) for determining novel risk factors for CVD in HD patients with PEW., Methods: In this cross-sectional study, 291 HD patients were randomly selected from among 2,302 adult HD patients in Tehran hemodialysis centers. The presence of PEW in HD patients was determined by subjective global assessment. In addition, 4 mL blood was obtained before dialysis and analyzed for serum concentrations of novel risk factors for CVD, including C-reactive protein (CRP), soluble intercellular adhesion molecule type 1 (sICAM-1), soluble vascular cell adhesion molecule type 1 (sVCAM-1), sE-selectin, malondialdehyde (MDA), nitric oxide (NO), endothelin-1 and lipoprotein (a) [Lp (a)]., Results: Serum CRP and sICAM-1 were significantly higher in HD patients with PEW as compared to those without PEW (P < 0.01), whereas there were no significant differences in serum sVCAM-1, sE-selectin, MDA, NO, endothelin-1 and Lp (a) between the two groups. Serum CRP and sICAM-1 were significantly higher in HD patients with PEW type IIa and IIb than in those with PEW type I (P < 0.01)., Conclusion: The present study indicates that serum CRP and sICAM-1, as two CVD risk factors, increase in HD patients with PEW as compared to those without PEW and these increases occur in HD patients with PEW type IIa and IIb who have inflammation.

Purpose: The present study was designed to determine the cutoff points for the diagnosis of mild-to-moderate and severe protein-energy wasting (PEW) based on dialysis malnutrition score (DMS) and malnutrition inflammation score (MIS), and the sensitivity, specificity, accuracy, area under receiver operating characteristic (ROC) curve, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR(+)) and negative likelihood ratio (LR(-)) of DMS and MIS in comparison with subjective global assessment (SGA) in hemodialysis (HD) patients., Methods: In this study, 291 HD patients were randomly selected from among 2,302 adult HD patients in Tehran hemodialysis centers. The PEW in these patients was determined by SGA, DMS and MIS., Results: According to the cutoff points derived from the area under ROC curves, scores of 7-13 for DMS represented normal status or without PEW; 14-23, mild-to-moderate PEW; and 24-35, severe PEW. For MIS, scores of 0-7 represented normal status or without PEW; 8-18, mild-to-moderate PEW; and 19-30, severe PEW. In comparison with SGA, the sensitivity, specificity, accuracy, area under ROC curve, PPV, NPV, LR(+) and LR(-) of DMS were 94 %, 88 %, 92 %, 97 %, 93 %, 92 %, 7.8 and 0.07, respectively. Those of MIS were 87 %, 96 %, 91 %, 97 %, 97 %, 83 %, 22.0 and 0.13 in comparison with SGA, respectively., Conclusion: The results of the present study indicate that the DMS and MIS are almost similar to SGA for identifying PEW in HD patients, but it seems that the DMS is a more appropriate alternative tool for SGA in hospital routine assessments.

Introduction: The aim of this study was to compare the effect of continuous care model with routine care on the quality of life among patients who receive a kidney transplant., Materials and Methods: In a randomized clinical trial, 90 kidney transplant patients were selected from 4 hospitals in Tehran, Iran, and were randomly assigned to 2 group. In the experimental group, continuous care model was applied for 3 months and the control group received routine care. The scale scores of the Kidney Transplant Questionnaire concerning quality of life were monthly compared between the two groups., Results: Of 90 patients, 4 in the experimental and 8 in the control group were excluded from the study. Final analysis was performed on 41 in the experimental and 37 in the control groups. No significant difference was found between the two groups in terms of demographic variables. Although the quality of life scores increased in both groups, the mean scores of the experimental group were significantly higher than those in the control group at 1, 2, and 3 months., Conclusions: Continuous care model may improve the kidney transplant patients' quality of life.

Inflammation and lipid abnormalities are two important risk factors for cardiovascular disease in hemodialysis (HD) patients. The present study was designed to investigate the effects of flaxseed consumption on systemic inflammation and serum lipid profile in HD patients with lipid abnormalities. This was an unblinded, randomized clinical trial. Thirty HD patients with dyslipidemia (triglyceride >200 mg/dL and/or high-density lipoprotein-cholesterol (HDL-C) <40 mg/dL) were randomly assigned to either a flaxseed or control group. Patients in the flaxseed group received 40 g/day ground flaxseed for 8 weeks, whereas patients in the control group received their usual diet, without any flaxseed. At baseline and at the end of week 8, 7 mL of blood was collected after a 12- to 14-hour fast and serum concentrations of triglyceride, total cholesterol, low-density lipoprotein-cholesterol (LDL-C), HDL-C, and C-reactive protein (CRP) were measured. Serum concentrations of triglyceride (P < 0.01), total cholesterol (P < 0.01), LDL-C (P < 0.01), and CRP (P < 0.05) decreased significantly in the flaxseed group at the end of week 8 compared with baseline, whereas serum HDL-C showed a significant increase (P < 0.01). These changes in the flaxseed group were significant in comparison with the control group. The study indicates that flaxseed consumption improves lipid abnormalities and reduces systemic inflammation in HD patients with lipid abnormalities., (© 2012 The Authors. Hemodialysis International © 2012 International Society for Hemodialysis.)

This study was designed to investigate the effects of combined administration of lipoic acid and pyridoxine on albuminuria, oxidative stress, blood pressure, serum advanced glycation end-products, nitric oxide (NO), and endothelin-1 in patients with diabetic nephropathy. Thirty-four patients were randomly assigned to either a supplement group or a placebo group. The patients in the supplement group received 800 mg lipoic acid and 80 mg pyridoxine daily for 12 weeks, whereas the placebo group received corresponding placebos. Urinary albumin, serum malondialdehyde (MDA), and systolic blood pressure decreased significantly in the supplement group compared to the placebo group (p < 0.05). Serum NO increased in the supplement group compared to the placebo group (p < 0.05). Serum pentosidine and carboxymethyl lysine decreased significantly in the supplement group at the end of week 12 compared to baseline (p < 0.05). No statistically significant differences were observed between the two groups in mean changes of serum endothelin-1, glucose, and diastolic blood pressure. The present study indicates that combined administration of lipoic acid and pyridoxine improves albuminuria in patients with diabetic nephropathy by reducing oxidative stress, advanced glycation end-products, and systolic blood pressure. The reduction in microalbuminuria may be of benefit in retarding the progression of diabetic nephropathy.

Background: This study was designed to determine the prevalence of protein-energy wasting (PEW) and its various types in hemodialysis (HD) patients in Tehran, Iran., Methods: For this cross-sectional study, 291 HD patients were randomly selected. The nutritional status of the patients was determined by subjective global assessment (SGA) and their dietary intakes were assessed using a 4-day dietary recall. In addition, serum high-sensitive C-reactive protein (hs-CRP) was measured., Results: The prevalence of mild-to-moderate and severe PEW based on SGA was 60.5% and 1% in Tehran HD patients, respectively. The prevalence of various types of PEW in HD patients was 20.5% type I (inadequate energy or protein intake without inflammation), 65.5% type IIa (inadequate energy or protein intake with inflammation), and 14% type IIb (adequate energy and protein intake with inflammation). Of the total HD patients with no PEW based on SGA, about 3.5% had type 0 normal nutritional status (adequate energy and protein intake without inflammation), 34% had type I normal nutritional status (inadequate energy or protein intake without inflammation), 55.5% had type IIa normal nutritional status (inadequate energy or protein intake with inflammation), and 7% had type IIb normal nutritional status (adequate energy and protein intake with inflammation)., Conclusion: PEW in Tehran HD patients is considerably prevalent and PEW type IIa is the most common type. In addition, HD patients with no PEW based on SGA should also be paid attention because they may be in the early stages of inadequate intake of energy and/or protein and inflammation.

Objective: We studied the effects of l-carnitine supplement on serum amyloid A (SAA), a systemic inflammation marker, and vascular inflammation markers in hemodialysis patients., Design: This was a randomized, double-blind, placebo-controlled trial., Setting: The study was performed in Soodeh Hemodialysis Center in Islamshahr, Iran., Patients: We included 36 hemodialysis patients (15 men and 21 women)., Intervention: The patients on hemodialysis were randomly assigned to either a carnitine or a placebo group. Patients in the carnitine group received 1,000 mg/day oral l-carnitine for 12 weeks, whereas patients in the placebo group received a corresponding placebo during the study., Main Outcome Measures: Serum free carnitine, SAA, soluble intercellular adhesion molecule type 1, soluble intercellular adhesion molecule type 2, soluble vascular cell adhesion molecule type 1, sE-selectin, sP-selectin, and oxidized low-density lipoprotein were measured at baseline and at the end of week 12 of the study., Results: Mean serum free carnitine concentration increased significantly to 150% of baseline in the carnitine group at the end of week 12 (P < .001), whereas serum SAA showed a significant 32% decrease (P < .001). No significant changes were observed in the serum concentrations of free carnitine and SAA in the placebo group during the study. There were no significant differences between the two groups in mean changes in serum soluble intercellular adhesion molecule type 1, soluble intercellular adhesion molecule type 2, soluble vascular cell adhesion molecule type 1, sE-selectin, sP-selectin, and oxidized low-density lipoprotein concentrations., Conclusion: The study indicates that l-carnitine supplement reduces serum SAA, which is a risk factor for cardiovascular diseases in hemodialysis patients, but has no effect on vascular inflammation markers., (Copyright © 2011 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)

Inadequate dietary intakes are a major determinant of malnutrition in hemodialysis (HD) patients. Considering the lack of information available on dietary intakes of HD patients in Iran, the present study was designed to assess the dietary intakes of HD patients in Tehran, Iran. For this cross-sectional study, from among adult HD patients of 50 Tehran hemodialysis centers, 291 patients were randomly selected. Dietary intakes of these patients were assessed using a 4-day dietary recall. In addition, 4 mL of blood was obtained from each patient before dialysis to measure serum urea, creatinine, albumin, phosphorus, calcium, potassium, and high sensitive C-reactive protein levels. Dietary intakes of energy, protein and fiber were lower than recommended intakes in 88%, 84.5%, and 99% of HD patients, respectively. There were significant associations between dietary energy intake with the patient's age (p < 0.05), and HD vintage (P < 0.001). In addition, a significant association was found between dietary protein intake and sex (P < 0.05). Intakes of vitamins B1, B2, B3, B6, B12, C, E, folic acid, and of the minerals calcium and zinc (from both the diet and supplements) were lower than recommended intakes in 13.5%, 41.5%, 19%, 66%, 61%, 78%, 77%, 24%, 34%, and 98.5% of HD patients, respectively. Inadequate intakes of energy and various nutrients are prevalent in HD patients in Tehran, Iran, which may contribute to increased morbidity and mortality in these patients. Therefore, nutrition counseling and the administration of vitamin and mineral supplements are necessary in Iranian HD patients., (© 2011 The Authors; Hemodialysis International © 2011 International Society for Hemodialysis.)

Background and Aims: High concentrations of serum inflammation markers, especially vascular inflammation markers, are an important risk factor for cardiovascular diseases in hemodialysis patients. The present study was designed to investigate the effects of marine omega-3 fatty acids on serum systemic and vascular inflammation markers and oxidative stress in hemodialysis patients., Methods: Thirty-four hemodialysis patients were randomly assigned to either the marine omega-3 fatty acid or the placebo group. Patients in the omega-3 fatty acid group received 2,080 mg marine omega-3 fatty acids daily for 10 weeks, whereas the placebo group received a corresponding placebo.At baseline and the end of week 10, 5 ml blood was collected after a 12- to 14-hour fast., Results: Mean serum soluble intercellular adhesion molecule type 1 (sICAM-1) decreased significantly in the omega-3 fatty acid group at the end of week 10 compared to baseline (p < 0.05) and this reduction was significant in comparison with the placebo group (p < 0.05). No significant differences were observed between the two groups in mean changes in serum soluble vascular cell adhesion molecule type 1, sE-selectin, sP-selectin, C-reactive protein, interleukin-6, tumor necrosis factor-α, malondialdehyde and total antioxidant capacity., Conclusion: The results of the present study indicate that marine omega-3 fatty acids can reduce serum sICAM-1, a risk factor for cardiovascular diseases, but it has no effect on serum systemic inflammation markers and oxidative stress in hemodialysis patients., (Copyright © 2011 S. Karger AG, Basel.)

Background: Lipid abnormalities, especially high serum lipoprotein (a) [Lp (a)] concentration, and anemia are two major causes of cardiovascular diseases (CVDs) in hemodialysis patients. Therefore, this study was designed to investigate the effects of marine omega-3 fatty acids on serum lipids, Lp (a), and hematologic factors in hemodialysis patients., Methods: Thirty-four hemodialysis patients were randomly assigned to either omega-3 fatty acid supplement or placebo group. Patients in the omega-3 fatty acids group received 2080 mg marine omega-3 fatty acids, daily for 10 weeks, whereas the placebo group received a corresponding placebo. At baseline and the end of week 10, 7 mL blood was collected after a 12- to 14-h fast and serum triglyceride, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), Lp (a), blood hemoglobin, hematocrit, red blood cells (RBCs), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) were measured., Results: Serum triglyceride decreased significantly in the omega-3 fatty acids group at the end of week 10 compared with baseline (p < 0.05) and this reduction was significant in comparison with the placebo group (p < 0.01). No significant differences were observed between the two groups in mean changes of serum total cholesterol, LDL-C, HDL-C, Lp (a), blood hemoglobin, hematocrit, RBC, MCV, MCH, and MCHC., Conclusion: The results of our study indicate that marine omega-3 fatty acids can reduce serum triglyceride, as a risk factor for CVD, but it does not affect other serum lipids, Lp (a), and hematologic factors in hemodialysis patients.

Background: Lipid abnormalities, particularly high serum concentration of lipoprotein(a) [Lp(a)], are one of the major risk factors for cardiovascular disease (CVD) in peritoneal dialysis (PD) patients. The present study was designed to investigate the effects of soy consumption on serum lipids and apoproteins, especially Lp(a), in PD patients. ♢, Methods: This study was a randomized clinical trial in which 40 PD patients (20 males, 20 females) were randomly assigned to either the soy or the control group. Patients in the soy group received 28 g/day textured soy flour (containing 14 g of soy protein) for 8 weeks, whereas patients in the control group received their usual diet, without any soy. At baseline and the end of week 8 of the study, 5 mL of blood was collected from each patient after a 12- to 14-hour fast and serum triglyceride, total cholesterol, low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), apoprotein B100 (apo B100), apoprotein AI (apo AI), and Lp(a) were measured. ♢, Results: In the present study, serum Lp(a) concentrations were above the normal range in 86% of the PD patients. Mean serum Lp(a) concentration was reduced significantly, by 41%, in the soy group at the end of week 8 compared to baseline (p < 0.01); the reduction was also significant compared to the control group (p < 0.05). During the study, mean serum Lp(a) concentration did not change significantly in the control group. There were no significant differences between the two groups in mean changes in serum triglyceride, total cholesterol, HDL-C, LDL-C, apo B100, or apoAI. ♢, Conclusion: The results of our study indicate that soy consumption reduces serum Lp(a) concentration, which is a risk factor for cardiovascular disease in peritoneal dialysis patients.

Inflammation, oxidative stress, and high concentration of serum lipoprotein (a) [Lp (a)] are common complications in hemodialysis patients. The present study was designed to investigate the effects of L-carnitine supplement on serum inflammatory cytokines, C-reactive protein (CRP), Lp (a), and oxidative stress in hemodialysis patients with Lp (a) hyperlipoproteinemia [hyper Lp (a)]. This was an unblinded, randomized clinical trial. Thirty-six hyper Lp (a) hemodialysis patients (23 men and 13 women) were randomly assigned to either a carnitine or control group. Patients in the carnitine group received 1000 mg/d oral L-carnitine for 12 weeks, whereas patients in the control group did not receive any L-carnitine supplement. At baseline and the end of week 12, 5 mL of blood were collected after a 12- to 14-hours fast and serum free carnitine, CRP, interleukin-1β, interleukin-6 (IL-6), tumor necrosis factor-α, Lp (a), and oxidized low-density lipoprotein were measured. Serum free carnitine concentration increased significantly by 86% in the carnitine group at the end of week 12 compared with baseline (P<0.001), while serum CRP and IL-6 showed a significant decrease of 29% (P<0.05) and 61% (P<0.001), respectively. No significant changes were observed in serum free carnitine, CRP, and IL-6 in the control group. There were no significant differences between the two groups in mean changes of serum interleukin-1β, tumor necrosis factor-α, Lp (a), and oxidized low-density lipoprotein concentrations. L-carnitine supplement reduces inflammation in hemodialysis patients, but has no effect on hyper Lp (a) and oxidative stress., (© 2010 The Authors. Hemodialysis International © 2010 International Society for Hemodialysis.)

Background: Hypercoagulability is an important risk factor for thrombosis and its complications in hemodialysis patients. This study was designed to investigate the effects of l-carnitine supplement on plasma coagulation and anticoagulation factors in hemodialysis patients., Methods: Thirty-six hemodialysis patients were randomly assigned to either a carnitine or a placebo group. Patients in the carnitine group received 1000 mg/day oral l-carnitine for 12 weeks, whereas patients in the placebo group received a corresponding placebo. At baseline and the end of week 12, 5 mL blood was collected after a 12- to 14-hour fast and plasma fibrinogen concentration, activity of plasma protein C, coagulation factors V, VII, IX, and serum concentrations of tissue plasminogen activator (tPA), plasminogen activator inhibitor type-1 (PAI-1), free carnitine, and C-reactive protein (CRP) were measured., Results: In the carnitine group, mean serum free carnitine concentration increased significantly to 150% of baseline (p < 0.001), whereas plasma fibrinogen and serum CRP had 98 mg/dL (p < 0.01) and 41% (p < 0.01) significant decreases, respectively, at the end of week 12 compared with baseline. The reductions were significant compared with the placebo group (p < 0.05). No significant differences were observed between the two groups with regard to mean changes of the activity of plasma protein C, coagulation factors V, VII, IX, and serum PAI-1 to tPA ratio., Conclusion: l-Carnitine supplement reduces serum CRP, a marker of systemic inflammation, and plasma fibrinogen, an inflammation-related coagulation factor, in hemodialysis patients. Therefore, l-carnitine may play an effective role in preventing cardiovascular diseases in these patients.

Objective: We studied the effects of soy consumption on oxidative stress, blood homocysteine, coagulation factors, and phosphorus in peritoneal dialysis patients., Design: This was an unblinded, randomized clinical trial., Setting: This study involved peritoneal dialysis centers in Tehran, Iran., Patients: We included 40 peritoneal dialysis patients (20 males and 20 females)., Intervention: Peritoneal dialysis patients were randomly assigned to either a soy or control group. Patients in the soy group received 28 g/day textured soy flour (containing 14 g of soy protein) for 8 weeks, whereas patients in the control group received their usual diet, without any soy., Main Outcome Measures: Blood oxidized low-density lipoprotein (ox-LDL), homocysteine, phosphorus, fibrinogen concentrations, and the activities of coagulation factors VII, IX, and X were measured at baseline and at the end of week 8 of the study., Results: The percentage of plasma coagulation factor IX activity decreased significantly by 17% in the soy group at the end of week 8 compared with baseline (P < .01), and the reduction was significant compared with the control group (P < .05). There were no significant differences between the two groups in mean changes of blood ox-LDL, homocysteine, phosphorus, fibrinogen concentrations, and the activities of coagulation factors VII and X., Conclusion: Soy consumption reduces plasma coagulation factor IX activity, which is a risk factor for thrombosis in peritoneal dialysis patients.