Evaluation of Predictor Factors of Non-Diabetic Nephropathy in Diabetic Patient’s Biopsy Specimen in Labbafinejad Hospital

Background and Aim: Nephropathy is one of the major complications in diabetic patients that causes high mortality worldwide. In diabetic patients, differentiating non-diabetic nephropathy from diabetic nephropathy is clinically essential in treating patients. The present study aimed to examine clinical, laboratory, demographic variables and their relationship with the type of non-diabetic nephropathy in diabetic patients. Methods: Clinical, demographic and laboratory data of 104 diabetic patients who underwent renal biopsy in Labbafinejad Hospital in Tehran in 2009-2010 were assessed. Patients were categorized into two groups based on the type of nephropathy (whether diabetic or non-diabetic). The recorded data were statistically compared between the two groups at the time of kidney biopsy and six months later. Results: In this study, 104 patients were studied. The mean age of patients was 57.2 ± 13.4 years, and 50% of patients were male. Shorter duration of diabetes, no insulin use, renal failure, higher mean arterial pressure, smaller kidneys, lack of diabetic retinopathy, lower GFR and higher serum creatinine in patients with diabetic nephropathy were identical with non-diabetic nephropathy group (in all cases) (P < 0.05). Conclusion: The need for kidney biopsy in diabetic patients can be determined with acceptable accuracy using the mentioned demographic, clinical, imaging and laboratory data. This study showed that the six-month GFR index could be used as a prognostic marker in patients

Exploring Biomarkers Beyond Exercise Testing: The Impact of Smoking on Cardiovascular and Pulmonary Health among CKD Patients

Background: Chronic Kidney Disease (CKD) patients often face complex health challenges, including cardiovascular and pulmonary issues. Smoking is a recognized risk factor for these conditions, but its specific impact on CKD patients remains less understood. Materials and Methods: In this cross-sectional study, we investigated the relationship between smoking habits and cardiopulmonary health among CKD patients. We examined baseline characteristics, including demographics, medical history, and biochemical markers, in a cohort of CKD patients. Cardiopulmonary parameters were assessed during exercise testing, including oxygen consumption, ventilation rates, ventilation-perfusion matching markers, and oxygen saturation levels. Results: Our findings revealed no statistically significant differences in cardiopulmonary parameters between smokers and non-smokers within the CKD patient population. This suggests that the relationship between smoking and exercise capacity in CKD patients is complex and influenced by multiple factors. Our analysis of demographics, comorbidities, and medication history provided critical context for interpreting these results. Conclusion: This study contributes to our understanding of the intricate relationship between smoking habits and cardiopulmonary health in CKD patients. While smoking is recognized as a risk factor, its specific impact on exercise capacity within this population may be influenced by individual variables. Further research is needed to explore these relationships in larger and more diverse cohorts. These findings underscore the importance of considering multiple variables when assessing the impact of smoking on the health of CKD patients

Evaluation of correlation of serum vitamin B12 with proteinuria in type 2 Diabetes Mellitus patients

Background and aims: Diabetic nephropathy is one of the leading causes of end stage renal disease (ESRD)  in the world. This study was conducted to investigate the correlation of  B12 deficiency with presence of proteinuria in patients with Diabetes Mellitus. Materials and Methods: This study was performed on patients with type 2 Diabetes Mellitus. The inclusion criteria were: HbA1C ≤8%, absence of hypertension or controlled blood pressure (BP<140/90) in hypertensive patients, no smoking, absence of any recent stressful illness such as MI, CVA and causes of proteinuria other than diabetic nephropathy. The serum level of B12 and the amount of urine protein–to-creatinine ratio (UPCR) were measured, and correlation between b12 deficiency and presence of proteinuria was assessed using Spearman correlation test. Results:  In this study 78 patients (44.87% women and 55.13% men) were examined. There was an inverse and weak correlation between the serum B12 deficiency and presence of proteinuria (r = -0 / 104), which was not statistically significant (p = 0.254). Due to the statistically significant difference between two groups with and without proteinuria in antiproteinuric drugs, as well as Metformin use and chronic kidney disease (CKD) stage, a subgroup analysis was performed in each of these subgroups. There was no correlation between the B12 deficiency and presence of proteinuria. Conclusion: The findings  revealed no statistically significant correlation between the serum B12 deficiency and presence of proteinuria

The Novel Diagnostic Biomarkers for Focal Segmental Glomerulosclerosis

Background. Focal segmental glomerulosclerosis (FSGS) is a glomerular injury with various pathogenic mechanisms. Urine proteome panel might help in noninvasive diagnosis and better understanding of pathogenesis of FSGS. Method. We have analyzed the urine sample of 11 biopsy-proven FSGS subjects, 8 healthy controls, and 6 patients with biopsy-proven IgA nephropathy (disease controls) by means of liquid chromatography tandem mass spectrometry (nLC-MS/MS). Multivariate analysis of quantified proteins was performed by principal component analysis (PCA) and partial least squares (PLS). Results. Of the total number of 389 proteins, after multivariate analysis and additional filter criterion and comparing FSGS versus IgA nephropathy and healthy subjects, 77 proteins were considered as putative biomarkers of FSGS. CD59, CD44, IBP7, Robo4, and DPEP1 were the most significant differentially expressed proteins. These proteins are involved in pathogenic pathways: complement pathway, sclerosis, cell proliferation, actin cytoskeleton remodeling, and activity of TRPC6.There was complete absence of DPEP1 in urine proteome of FSGS subjects compared with healthy and disease controls. DPEP1 acts via leukotrienes on TRPC6 and results in increased podocyte motility and proteinuria. Conclusion. The results suggest a panel of candidate biomarkers for noninvasive diagnosis of FSGS, while complete absence of DPEP1 might represent a novel marker of FSGS