Microwave-assisted solvent-free synthesis of 14-aryl/alkyl-14H-dibenzo[a,j]xanthenes and tetrahydrobenzo[a]xanthen-11-ones catalyzed by nano silica phosphoric acid

Nano silica phosphoric acid (nano SPA) was applied as a catalyst for synthesis of 14-aryl/alkyl-14H-dibenzo[a,j]xanthenes and tetrahydrobenzo[a]xanthen-11-ones in microwave oven under solvent free conditions. High efficiency, easy availability and reusability are some advantages of this catalyst

The relationship between serology of hepatitis E virus with liver and kidney function in kidney transplant patients

Although hepatitis E virus (HEV) is well known to cause acute hepatitis, there are reports showing that HEV may also be responsible for progression of acute to chronic hepatitis and liver cirrhosis in patients receiving organ transplantation. In this study, we aimed to evaluate the prevalence of HEV in patients with kidney transplantation. In this study, 110 patients with kidney transplantation were recruited, and anti-HEV IgG, creatinine, alanine transaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and estimated glomerular filtration rate (eGFR) in the first, third and sixth months after renal transplantation were measured. The mean serum anti-HEV IgG titers in the study participants was 1.36 (range 0.23 to 6.3). Twenty-three patients were found to be seropositive for HEV Ab defined as anti-HEV IgG titer > 1.1. The difference in liver and renal function tests (creatinine, eGFR, AST, ALT and ALP) at different intervals was not significant between patients with HEV Ab titers higher and lower than 1.1 (p > 0.05). However, an inverse correlation was observed between HEV Ab and eGFR values in the first (p = 0.047, r = -0.21), third (p = 0.04, r = -0.20) and sixth (p = 0.04, r = -0.22) months after renal transplantation in patients with HEV Ab 1.1. Also, a significant correlation between age and HEV Ab levels was found in the entire study population (p =0.001, r = 0.33). Our findings showed a high prevalence of seropositivity for anti-HEV IgG in patients receiving renal transplants. However, liver and renal functions were not found to be significantly different seropositive and seronegative patients by up to 6 months post-transplantation

Gender Disparity in Kidney Transplantation

Gender discrimination in benefiting from medical treatment is a worldwide pro-blem. Kidney transplantation, as the ideal treatment for patients with end-stage renal disease (ESRD), is not an exception. Considering the unique kidney donation patterns and different family styles in the Middle East, studying this problem in Iran seemed justifiable and necessary. In addition to comparing the numbers of female and male recipients, which has been done in other similar studies, considering the critical effect of waiting time on the outcome, we assessed and compared the waiting times also. The data of age, gender, nationality, donor type and waiting time before transplantation of 1426 (61.85% male, 38.14% female) recipients who underwent transplantation in Imam Reza Hospital in the northeast of Iran from 1990 to 2003, was analyzed. Recipients were categorised into three groups based on donation patterns: those receiving kidney from live unrelated, live related and cadaver donors. The number of patients in each group was 1057 (61.96% male, 38.03% female), 232 (67.24% male, 32.75% female) and 137 (51.82% male, 48.17% female) respectively. The mean overall waiting time was 708 days. Comparing waiting time of male and female recipients in each of these groups did not show significant difference. In all categories of donors, females were less likely than males to be recipients. Furthermore, waiting time for females was longer than males when receiving kidney from sisters and children. For spousal donations, males were recipients more frequently than females although female recipients in this group waited less than their male counterparts to receive the kidney. Generally, our results are in accordance with results of similar researches. In all three mentioned groups, males com-prised the majority while the waiting time does not show significant difference between genders. We suggest some reasons for this phenomenon, of which the two main ones are: fewer females are suffering from ESRD and/or females have less chance to find a potential donor in the family, which can be attributed to their lower socio-economic status

Comparison of Phosphate Lowering Properties of Calcium Acetate and Calcium Carbonate in Hemodialysis Patients

Hyperphosphatemia has an important role in the development of secondary hyperparathyroidism and bone disease in patients with end-stage renal disease (ESRD). The most effective method of phosphate elimination lies with phosphate binders, the agent that more commonly used, calcium carbonate, is not an ideal binding agent. In this regard, calcium acetate has been reported to have more or at least a similar phosphate binding efficacy and less pronounced hypercalcemic effect. However, this subject is still a matter of controversy. This study was designed to compare the efficiency of these salts. Preparation of calcium acetate and comparison of the phosphate binding power and hypercalcemic effect of calcium acetate with that of calcium carbonate in hemodialysis patients. Thirty stable ESRD patients undergoing regular hemodialysis for mean 4.23 years (SD 3.63) were studied. Half of the patients were started on calcium acetate for a month. Then, after two weeks wash out period, they received calcium carbonate for a month. The others followed an inverse protocol. 24 patients completed the study. A significant decrease in plasma phosphate levels was only observed after treatment with calcium acetate [6.65 mg/dL (SD 1.38) vs. 5.83 mg/dL (SD 1.55) p < 0.05]. Calcium acetate may be a better choice in handling of hyperphophatemia in ESRD patients and when calcium acetate is used, control of hyperphophatemia can be better achieved with a lower risk of hypercalcemia

Prognosis of HTLV-1 positive renal transplant recipients in Iran

The human T lymphocyte virus-1 (HTLV-1) is the responsible pathogen for diseases such as HTLV-1 associated myelopathy (HAM) and adult T-cell leukemia (ATL). Mashhad, in northeast Iran, with high instances of this infection, has a noticeable number of infected renal failure patients. Since immunosuppressive drugs might decrease the latency period of HTLV-1 or increase its complications, the question arises whether HTLV-1 positive renal failure patients are suitable candidates for kidney transplants. To answer this, HTLV-1 positive recipients were evaluated in our study. Patients were divided into two groups. First group consisted of patients at the Imam Reza Hospital dialysis center. Second group had 20 kidney transplantation recipients consisting of ten infected and ten uninfected recipients as control from Imam Reza. Medical history of these patients was recorded and evaluated. The follow-up periods were between one and six years. Among them, 3.8% of patients undergoing dialysis were infected. The most important fact resulting from this study is that none of the infected recipients suffered from HAM or ATL during the follow-up period. In addition, it did not show any significant difference in the incidence of post-transplant complications between the infected and non-infected groups. Our study indicates that HTLV-1 positive patients may undergo kidney transplant without fear of increased incidence of side effects than those found in uninfected recipients. Because of short-term follow-up, probable long latency period of the virus, and the limited number of infected recipients, further work on this issue would be prudent

Risk of obstructive sleep apnea and hemodialysis efficacy

Background: Obstructive sleep apnea (OSA) occurs frequently in hemodialysis (HD) patients with important consequences and increased mortality. However the role of adequacy of HD on the prevalence of OSA is less studied. Objectives: Our aim was to screen OSA and evaluate the effect of HD adequacy on the risk of OSA. Patients and Methods: This is a cross-sectional study on adult HD patients. Clinical and laboratory parameters were collected. The risk of OSA was assessed by STOP-BANG and Berlin questionnaire (BQ). Excessive daytime sleepiness (EDS) was evaluated with Epworth Sleepiness Scale (ESS). Kt/V index was applied for determining HD adequacy. Mortality followed after 2 years. Results: Sixty-five patients (63% men, with a mean age of 53±16.5 years) were included in the study. Most of the subjects were categorized as high risk by Berlin (68.3%) and STOPBANG (84.6%) questionnaires and 25.8% had EDS. Participants who were categorized as high risk of OSA showed lower Kt/V (P=0.018 based on BQ, P=0.002 based on STOPBANG). OSA risk was significantly correlated with Kt/V (OR: 0.007; CI: 0-0.36; p: 0.01). Two-year mortality was not significantly correlated with OSA. Conclusion: OSA was prevalent in our HD patients and correlated with less adequacy of HD. Screening for this common disease by nephrologists using simple questionnaires is recommended