Oxford-MEST classification in IgA nephropathy patients: A report from Iran.

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

Modification of diet in renal disease and Cockraft-Gaultformula accuracy in glomerular filtration rate estimation in Iranian adults

Introduction: The aim of this study was to evaluate the accuracy of modification of diet in renal disease (MDRD) and Cockraft-Gault (C-G) formulas for estimating GFR in a sample of Iranian adult. Materials and Methods: This study was an analytic cross-sectional study on 54 patients with chronic kidney disease. Glomerular filtration rate was measured by kidney scan via TC99m-labeled diethylenetriaminepentaacetic acid, and it was estimated by MDRD and Cockraft-Gault formulas. Results: The mean of measured GFR and estimated GFR by MDRD and C-G formulas was 61.64 ± 34.26 ml/min, 51.80 ± 25.47, and 54.29 ± 24 ml/min respectively (P-value < 0.001, r = 0.818 and P-value < 0.001, r = 0.847, respectively). Pearson correlation test showed direct linear relationship between sGFR and GFR as estimated by the Cockraft-Gault and MDRD formulas. Conclusion: Based on our results, modification of diet in renal disease (MDRD) and Cockraf-Gault (C-G) formulas are accurate formulas in Iranian adults but they need a correction factor

Effect of Zinc Supplementation on Triglyceride, Cholesterol, LDL, and HDL Levels in Zinc-Deficient Hemodialysis Patients

Introduction. Zinc deficiency is known to occur in widely diverse areas of world. It has now been recognized in many disease states, such as ESRD patients on maintenance hemodialysis (HD). The purpose of this research was to study the effects of zinc supplementation on the concentration of serum zinc, total cholesterol, triglyceride, and cholesterol fractions (HDL, LDL) in HD patients. Patients and Methods. In a double blind trial, the effects of oral zinc supplementation on the serum concentration of zinc, total cholesterol, HDL and LDL cholesterol, and triglyceride in HD patients were evaluated. Results. After 42 days, the mean serum zinc concentration among participants in the zinc-supplemented group increased. There was a significant elevation in the serum total cholesterol and also in mean the serum LDL and HDL cholesterol and serum triglyceride for the subjects in the zinc-supplemented group. Discussion. A suboptimal level of the serum total cholesterol concentration is a factor associated with malnutrition and morbidity in the HD patients. Maintenance HD patients with both low serum zinc and low serum total cholesterol concentrations may benefit from zinc supplementation. Therefore, it is advisable to obtain baseline measurement of the serum zinc and total cholesterol concentrations in maintenance HD patients