Epidemiology of invasive fungal infections in kidney transplant patients

Behzad EinollahiNephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IranI recently read with great interest the review article "Epidemiology and treatment approaches in management of invasive fungal infections" by Kriengkauykiat et al1 that was published in your journal. This review drew attention to the steadily growing number of invasive fungal infections (IFIs) that are due to the increasing number of severely immunocompromised patients. Despite advances in antifungal regimens in terms of prophylaxis and treatment, IFIs may lead to high mortality rates in solid organ recipients.&nbsp

Delayed Graft Function

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Importance of Socioeconomic, Clinical, and Psychological Factors on Health-related Quality of Life in Adolescents After Kidney Transplant

Objectives: Health-related quality of life after kidney transplant in adolescents is a major concern; nevertheless, there is a paucity of data on the variables that have an effect on it. This study evaluated the extent to which socioeconomic, clinical, and psychological characteristics explain the variance in the health-related quality of life of adolescent Iranian kidney transplant recipients. Materials and Methods: Into a hierarchical regression analysis, the cross-sectional socioeconomic, clinical, and psychological characteristics were entered among 55 adolescent Iranian kidney transplant recipients. Results: The relative predictive power of socioeconomic, clinical, and psychological variables with respect to health-related quality of life was 21.8% (P = .088), 21.2% (P = .014), and 27.6% (P = .001). Conclusions: Psychological factors had a greater relative predictive power in postrenal transplant health-related quality of life of adolescents than did the socioeconomic and clinical characteristics. Further research should target to improve the health-related quality of life in adolescent kidney recipients by psychological intervention

Protective effects of curcumin on diabetic nephropathy via attenuation of kidney injury molecule 1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) expression and alleviation of oxidative stress in rats with type 1 diabetes

Objective(s): One of the serious complications of Type1 diabetes (T1D) is diabetic nephropathy, which is accompanied with overexpression of kidney injury molecule 1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) and enhanced oxidative stress. The present study was conducted to examine the protective effect of curcumin on the expression of KIM-1, NGAL genes and oxidative damage in the kidney of T1D rats. Materials and Methods: Thirty-six adult male rats were divided into 6 groups (n=6). The control and T1D groups received treatment with curcumin or without it (80 and 130 mg/kg, respectively). After 60 days of treatment, using spectrophotometric methods, biochemical factors and oxidative stress markers were measured. Gene expression of KIM-1 and NGAL was evaluated using quantitative PCR.  Also, plasma and urine levels of these two proteins were assayed by the ELISA kit. Results: Diabetes caused a significant increase in the levels of creatinine, FBS, uric acid, urea, and creatinine in the serum, which were attenuated after the administration of curcumin. There was a significant reduction in the values of creatinine, uric acid, and urea in urine in the diabetic group whereas in the rats treated with curcumin, these values were normalized to the normal level (especially in 130 mg/kg). Curcumin administration had a significant role in modulation of serum lipid profile, and it was shown to decrease the kidney and urinary expression levels of KIM-1 and NGAL genes and improve oxidative toxic stress in the kidney tissues.Conclusion: Curcumin can play a protective role in reducing the unpleasant consequences of diabetic nephropathy

A Prospective Study on Risk Factors for Acute Kidney Injury and All-Cause Mortality in Hospitalized COVID-19 Patients From Tehran (Iran)

BackgroundSeveral reports suggested that acute kidney injury (AKI) is a relatively common occurrence in hospitalized COVID-19 patients, but its prevalence is inconsistently reported across different populations. Moreover, it is unknown whether AKI results from a direct infection of the kidney by SARS-CoV-2 or it is a consequence of the physiologic disturbances and therapies used to treat COVID-19. We aimed to estimate the prevalence of AKI since it varies by geographical settings, time periods, and populations studied and to investigate whether clinical information and laboratory findings collected at hospital admission might influence AKI incidence (and mortality) in a particular point in time during hospitalization for COVID-19.MethodsHerein we conducted a prospective longitudinal study investigating the prevalence of AKI and associated factors in 997 COVID-19 patients admitted to the Baqiyatallah general hospital of Tehran (Iran), collecting both clinical information and several dates (of: birth; hospital admission; AKI onset; ICU admission; hospital discharge; death). In order to examine how the clinical factors influenced AKI incidence and all-cause mortality during hospitalization, survival analysis using the Cox proportional-hazard models was adopted. Two separate multiple Cox regression models were fitted for each outcome (AKI and death).ResultsIn this group of hospitalized COVID-19 patients, the prevalence of AKI was 28.5% and the mortality rate was 19.3%. AKI incidence was significantly enhanced by diabetes, hyperkalemia, higher levels of WBC count, and blood urea nitrogen (BUN). COVID-19 patients more likely to die over the course of their hospitalization were those presenting a joint association between ICU admission with either severe COVID-19 or even mild/moderate COVID-19, hypokalemia, and higher levels of BUN, WBC, and LDH measured at hospital admission. Diabetes and comorbidities did not increase the mortality risk among these hospitalized COVID-19 patients.ConclusionsSince the majority of patients developed AKI after ICU referral and 40% of them were admitted to ICU within 2 days since hospital admission, these patients may have been already in critical clinical conditions at admission, despite being affected by a mild/moderate form of COVID-19, suggesting the need of early monitoring of these patients for the onset of eventual systemic complications

Effect of Cytomegalovirus Exposure on the Atherosclerotic Events Among Kidney-Transplanted Patients, A Systematic Review and Meta-Analysis

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