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to examine: (1) trends of IDWG among patients in relation to different variables and comorbidities e.g. age, hypertension, diabetes, CV disease...etc.; (2) associations of high IDWG with frequency of hospitalization due to systemic volume overload and the need for extra dialysis sessions, and (3) the impact of high IDWG on the frequency of intradialytic hypotension (IDH). Methods: One hundred and twenty maintenance HD patients were enrolled in this study. All patients had been receiving HD for at least 3 months, on a 4 hour, thrice weekly basis. The data collected included; age, gender, duration on HD (in months), pre-and post-HD body weights (on 3 successive sessions), pre-and post-HD blood pressure (BP) measurements (on 3 successive sessions), the type of vascular access and the average blood flow rate, dialysis efficiency (based on average Kt/V), and the presence or absence of residual kidney function.The presence of various comorbidities has been recorded including; diabetes, hypertension, coronary artery and peripheral vascular diseases, heart failure, cerebrovascular disease, and other disorders. The estimated IDWG was calculated based on the average between pre-and post-dialysis weights that were recorded on 3 consecutive dialysis sessions. The estimated IDWG was expressed in kilograms and as a percentage of the patients' dry weight. We considered an estimated average IDWG of 4% as a cutoff value between low and high IDWG. We defined IDH as the drop of systolic blood pressure of 20 mmHg or more during HD compared to the predialysis blood pressure and/or a systolic blood pressure that is less than 90 mmHg. Results: We have recorded that 50.0% of those younger than 55 years had IDWG $ 4%. On the other hand, only 31.7% of those aged 55 years or more had IDWG $ 4% (p¼0.041). There was no significant gender difference regarding IDWG. Among those who had IDWG $ 4%, 81% of these patients had at least one hospital admission due to volume overload or the need for extra HD session(s). On the other hand, only 19% of those having IDWG < 4% had been admitted or got extra HD sessions (p<0.001). Of those who were admitted (over 12 months) due to volume overload; 74.1 % had IDWG $ 4%, while 25.9% had IDWG < 4% (p< 0.001). Regarding IDH, 87% of patients having IDWG $ 4% had at least one episode of IDH/week. On the other hand, only 22.5% of those with IDWG < 4% had one episode of IDH/week (p<0.001). When analyzing those who had at least one IDH episode/ week; 72.9% of them had IDWG $ 4%, while only 27.1% had IDWG < 4% (p<0.001).Introduction: Identification of new clinical indicators for ideal dialysis is an interest. Erythrocyte glutathione transferase (e-GST) is non-dialyzable enzyme compartmentalized in the red cells. It may act as ligandins by binding and sequestering a variety of small or large toxic compounds and peptides. The aim of the study was to verify whether e-GST is able to assess hemodialysis adequacy among different treatment modalities, as a complementary to the Kt/V urea parameter. Methods: This cross secti...

Background Cardiovascular disease is the commonest cause of death in patients with end-stage renal disease (ESRD) under maintenance hemodialysis. Dyslipidemia, oxidative stress, and low-grade inflammation with increased circulating cytokines are factors that increase the cardiovascular risk in patients with chronic kidney disease, in addition to traditional risk factors, such as obesity, hypertension, and diabetes. We aimed to investigate the possible anti-inflammatory effects of atorvastatin in prevalent hemodialysis patients. Fifty-three stable adult hemodialysis patients were assigned into two groups (a drug group and a control group). Patients in the drug group received 20 mg of atorvastatin daily for 6 months. Serum levels of highly sensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6) were measured in both groups at baseline and at the end of the study period. Results Atorvastatin therapy caused a statistically significant decrease in levels of hs-CRP but no change in levels of IL-6 after 6 months of therapy. Conclusions In addition to its favorable effect on lipid profile parameters, atorvastatin therapy can be considered as an effective and safe modality to overcome the problem of chronic inflammation encountered in end-stage renal disease patients.

Introduction. Lupus nephritis (LN) affects almost two-thirds of systemic lupus erythematosus (SLE) patients. Despite initial aggressive therapy, up to 25% of patients with LN will progress to permanent renal damage. Conventional serum markers for LN lack the sensitivity of an ideal biomarker. Urinary neutrophil gelatinase-associated lipocalin (UNGAL) is an excellent biomarker for early diagnosis of acute kidney injury and predicting renal outcomes. Objective. To measure UNGAL among LN patients to correlate its levels with renal disease activity and to investigate its predictive performance in response to induction therapy. Patients and Methods. 40 SLE patients with biopsy-proven LN class III, IV, or V were randomly selected. The study was conducted in the internal medicine department and outpatient clinic in Ain Shams University Hospitals and completed after six months. UNGAL was measured at baseline, three-month follow-up, and after complete induction therapy. Results. In LN patients at baseline, the mean serum creatinine was 2.57 ± 0.96 mg/dL and the mean UNGAL was 33.50 ± 18.34 ng/dL. Mean UNGAL levels of complete response, partial response, and nonresponse groups were 14.48 ± 2.99 ng/mL, 34.49 ± 4.09 ng/mL, and 62.07 ± 14.44 ng/mL, respectively. Based on the ROC curve, we found a better performance of baseline UNGAL to discriminate the complete response group from partial and nonresponse groups to predict response to induction, outperforming conventional biomarkers. The area under the curve was 0.943, and the best cutoff level was 26.5 ng/mL (92.31% sensitivity and 88.89% specificity). Conclusion. UNGAL performed better than conventional biomarkers in predicting response to treatment of active LN.

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