Renal transplantation is the treatment of choice for patients with end-stage renal disease. In Iraq, renal transplantation started in 1973 and has continued until now with live donor transplantation, since deceased donor transplant program is not approved as yet. Long-term transplant data are still scarce. The aim of our study is to present data on transplantation and medical follow-up at one year and, survival analysis at one, three and five years. A total of 250 renal transplantations were performed at the Nephrology and Renal Transplantation Center, Baghdad between January 2009 and January 2014. It is a living donor, blood group compatible donor program. All patients received triple immunosuppression (calcineurine inhibitor, mycophenolate mofetil or mycophenolic acid, and steroid). The Kaplan-Meier method was used to determine the survival rate. There were 92 live related donors, 143 unrelated donors, and 15 spouse donors. The mean age was 34.07 ± 12.2 years. The one-year graft survival for related and unrelated donor transplants was 98.9% and 91.8%, respectively. Graft survival was lower (82.9%) in recipients with acute rejection episodes. The patient survival at one-year was 94%. The three-year graft and patient survival was 91% and 90%, respectively, and five-year survival for grafts and patients was 87.1% and 88%, respectively. The outcome of the renal transplantation in Iraq is improving. Long-term patient follow-up needs more meticulous attention. The development of renal transplant registry is critical for future planning. Moreover, renal transplantation practice in Iraq needs more social, religious, and governmental support.

Background: Pruritus often constitutes a major problem for patients with end stage renal disease. The pathophysiological mechanism of chronic kidney disease -associated pruritus is poorly defined.Objectives: To evaluate the prevalence of uremic pruritus in dialysis patients and their correlation with the laboratory and clinical parameters in some Iraqi patients with chronic renal disease.Patients & methods: This analytic, descriptive, cross-sectional study was performed on 103 patients on haemodialysis. Blood urea, creatinine, calcium, phosphorus, alkaline phosphatase and parathyroid hormone were determined. Complete blood count was also performed.Results: Of the 103 patients included in the study the, 79 patients (76.7%) had pruritus of whom, 27 (34.1%) had mild pruritus, 30 (38%) had moderate and 22 (27.9%) had severe pruritus. No significant association (p> 0.05) was found between pruritus and each of age and haemodialysis duration. There was no significant difference (p > 0.05) in the urea, creatinine, calcium, phosphorus, alkaline phosphatase, parathyroid hormone, hemoglobin, hematocrit, white blood cells, neutrophils, eoisinophils, basophils mean values among patients who had no pruritus, mild, moderate and severe pruritus. A significant positive correlation (p > 0.05) was found between severity of pruritus in pruritic patients and each of age, hemoglobin and hematocrit levels.Conclusion: Our study showed that age, hemoglobin and hematocrit levels had a significant positive correlation with the severity of pruritus in pruritic patients.

Aims Dietary nitrate from sources such as beetroot juice lowers blood pressure (BP) via the nitrate–nitrite–nitric oxide (NO) pathway. However, NO and nitrite are inactivated via reoxidation to nitrate, potentially limiting their activity. Cytochrome P450‐3A4 inhibition with troleandomycin prevents nitrite re‐oxidation to nitrate in rodent liver. Grapefruit juice contains the CYP3A4 inhibitor furanocoumarin. We therefore hypothesized that grapefruit juice would enhance BP‐lowering with beetroot juice by maintaining circulating [nitrite]. Methods We performed a randomized, placebo‐controlled, 7‐hour crossover study in 11 healthy volunteers, attending on 3 occasions, receiving: a 70‐mL shot of active beetroot juice (Beet‐It) and either (i) 250 mL grapefruit juice (Active Beet+GFJ), or (ii) 250 mL water (Buxton, Active Beet+H2O); or (iii) Placebo Beet+GFJ. Results The addition of grapefruit juice to active beetroot juice lowered systolic BP (SBP): Active Beet+GFJ vs Active Beet+H2O (P = .02), and pulse pressure, PP (P = .0003). Peak mean differences in SBP and PP were seen at T = 5 hours: −3.3 mmHg (95% confidence interval [CI] −6.43 to −0.15) and at T = 2.5 hours: −4.2 mmHg (95% CI −0.3 to −8.2), respectively. Contrary to the hypothesis, plasma [nitrite] was lower with Active Beet+GFJ vs Active Beet+H2O (P = .006), as was salivary nitrite production (P = .002) and saliva volume (−0.34 mL/min [95% CI −0.05 to −0.68]). The taste score of Beet+GFJ was 1.4/10 points higher than Beet+H2O (P = .03). Conclusion Grapefruit juice enhanced beetroot juice's effect on lowering SBP and PP despite decreasing plasma [nitrite]. Besides suggesting more complex mechanisms, there is potential for maximising the clinical benefit of dietary nitrate and targeting isolated systolic hypertension.

Background: Pruritus often constitutes a major problem for patients with end stage renal disease. The pathophysiological mechanism of chronic kidney disease-associated pruritus is poorly defined. Objectives: To evaluate the prevalence of uremic pruritus in dialysis patients and their correlation with the laboratory and clinical parameters in some Iraqi patients with chronic renal disease. Patients & methods: This analytic, descriptive, cross-sectional study was performed on 103 patients on haemodialysis. Blood urea, creatinine, calcium, phosphorus, alkaline phosphatase and parathyroid hormone were determined. Complete blood count was also performed. Results: Of the 103 patients included in the study the, 79 patients (76.7%) had pruritus of whom, 27 (34.1%) had mild pruritus, 30 (38%) had moderate and 22 (27.9%) had severe pruritus. No significant association (p> 0.05) was found between pruritus and each of age and haemodialysis duration. There was no significant difference (p > 0.05) in the urea, creatinine, calcium, phosphorus, alkaline phosphatase, parathyroid hormone, hemoglobin, hematocrit, white blood cells, neutrophils, eoisinophils, basophils mean values among patients who had no pruritus, mild, moderate and severe pruritus. A significant positive correlation (p > 0.05) was found between severity of pruritus in pruritic patients and each of age, hemoglobin and hematocrit levels. Conclusion: Our study showed that age, hemoglobin and hematocrit levels had a significant positive correlation with the severity of pruritus in pruritic patients.