Background and Aims Heme oxygenase 1 is an essential enzyme in heme catabolism induced by oxidative stress.It induced in avariety of kidney substructres in response to injury, including proximal tubules, glomeruli and renal interstitium.We aimed to assess the possible role of heme Oxygenase-1 as a potential marker in early diagnosis of diabetic nephropathy. Method This case control study was conducted in Ain Shams university hospital, Cairo, Egypt. It included 80 type 2 diabetic patients diagnosed according to the American Diabetes Association (ADA) criteria, with and without DN ,and 20 healthy control subjects matched in age and sex .Patients were divided into two groups according to the value of the urinary albumin-to-creatinine ratio (ACR) : Group I: 40 normoalbuminuric patients(16 M and 24 F) with ACR<30 mg/g, and Group II: 40 microalbuminuric patients (18M and 22 F) with ACR 30-300mg/g. We excluded patients with history of diabetic ketoacidosis or hypoglycemic coma in the past 3 months preceding the study. Patients with glomerulonephritis, nephrolithiasis, tumors or any other renal diseases were excluded as well. For all studied groups,full history taking and clinical examination were done. We assessed glycosylated hemoglobin (HbA1C),blood urea, serum creatinine, urine creatinine, urinary albumin-to creatinine ratio (ACR mg/g) ,and urinary hemeoxygenase 1(UHO-1) by ELISA . Glomerular filtration rate (eGFR) was estimated by modification of diet in renal disease formula(MDRD)and uHO-1/cr was calculated. Results Group I patients were diabetic for 6.18±0.75 years, while group II patients for 6.05±0.81 years(p = 0.477). Normoalbuminuric patients had significantly higher levels of uHO-1 compared to control (3.01ng/ml vs 0.3 ng/ml,p<0.001).UHO-1 reached highest value among the microalbuminuric group (5.02 ng/ml) with P<0.001.UHO-1/cr ratio was significantly positively correlated with urinary ACR (r = 0.61,p<0.001) and significantly negatively correlated with eGFR(r = -0.71,p <0.001). There was highly significant correlation between uHO-1and eGFR by linear regression. ROC curves showed that AUC of uHO-1is comparable to uHO-1/ Cr ratio (0.957 vs 0.954) respectively with equivocal sensitivity 100 % and specificity 95% and cut off value of uHO-1 >0.46 ng/mland > 0.7 for uHO-1/ Cr ratio. Conclusion UHO-1 is increased in normoalbuminuric patients before the presence of any proteinuria and level increased with the progression of proteinuria and falling of eGFR as well as with the uncontrol of diabetes. UHO-1 is more sensitive than albumin for the detection of early diabetic nephropathy.

Soluble haemojuvelin levels seem to be associated with iron overload parameters and hepcidin levels in HCV positive HD patients.

Background: Malnutrition and inflammation have significant roles in chronic kidney disease (CKD), which causes cardiovascular mortality and morbidity. Objective: To evaluate the value of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as an inflammatory marker among CKD patients and their association with the nutritional status of the patients. Patients and Methods: A case-control study included 60 adult patients' non-dialysis CKD stage G3-5, from Ain Shams University Hospitals, and 30 healthy volunteers as a control group. Anthropometric measurements include body mass index, mid-arm circumference, triceps skin fold thickness, mid-arm muscle circumference (MAMC), and modified subjective global assessment (m-SGA). Laboratory parameters include complete blood count, NLR and PLR, hs-CRP, routine blood chemistry, and urinary albumin/creatinine ratio. Results: The mean of NLR in patients' group was significantly higher compared to healthy subjects. The mean of PLR in patients' group was higher than the control group, but with no statistically significant difference. Both ratios PLR and NLR were positively correlated to high hs-CRP in patients' group. The mean of hs-CRP among CKD patients was significantly higher than that in the control group. There was a significant correlation of NLR with MAMC in patients' group. But there was no statistically significant correlation between m-SGA score and NLR, PLR, or hs-CRP among patients' group. Conclusions: Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio can be used as inflammatory markers in chronic kidney disease patients with malnutrition.

No abstract

Background: Nephritis is a challenging domain of systemic lupus erythematosus (SLE). There is a growing need for identification of a non-invasive marker for diagnosing and monitoring nephritis. Objective: To explore the relevance of using anti-ficolin-2 antibody (Anti-FCN2) as a biomarker for detecting lupus nephritis (LN), and its relation to renal biopsy histopathology and disease activity. Patients and Methods: Sixty SLE patients were compared to 30 apparently healthy individuals. Thirty of the patients were LN patients (documented by a recent renal biopsy). Full history, examination and laboratory investigations were done. Activity was assessed by SLE disease activity index (SLEDAI) score, and Anti-FCN2 titer was measured by enzyme-linked immunosorbent assay technique (ELISA). Results: Forty-four of our SLE patients were in disease activity by SLEDAI score. Anti-FCN2 titer was significantly higher among SLE patients compared to control group (p value <0.001). It was also higher among patients with high disease activity compared to those with low disease activity and cutoff value was at 37 ng/ml (p value is <0.001). Anti-FCN2 titer was significantly higher among patients with LN compared to those without LN (p value is <0.001) with best cutoff value at 72.50 ng/ml. Regarding LN patients, it was significantly higher among patients with proliferative changes than LN patients with non-proliferative changes (p value is 0.05) with best cutoff value at 155 ng/ml. Conclusion: Anti-FCN2 shows promising results as a biomarker for lupus disease activity, especially regarding LN and proliferative changes. Further longitudinal studies on larger samples are needed to confirm.