Introduction: Dialysis patients tend to have a greater prevalence of cardiovascular diseases. Objectives: The aim of this study was to determine the prevalence of heart valves calcification, left ventricular hypertrophy, and left ventricular systolic and diastolic dysfunction. It also aimed to determining the relationship of the above mentioned parameters with serum calcium, phosphorus, parathormone and duration of dialysis. Patients and Methods: This cross-sectional study was conducted on 100 hemodialysis patients who were referred to Hajar hospital in Shahrekord, Iran. Using echocardiography, patients were examined for the calcification of the heart valves, left ventricular hypertrophy, and left ventricular systolic and diastolic dysfunction. Serum calcium, phosphorus, and parathormone and duration of dialysis was also determined. Results: The mean age of the patients was 58.10 ± 15.51 years. Around 24 patients suffered from calcification of the heart valves. Additionally, 85 patients suffered from left ventricular hypertrophy. The prevalence of left ventricular systolic and diastolic dysfunction was 26% and 86%, respectively. Common valvular abnormalities were mitral valve regurgitation (97%), followed by tricuspid regurgitation, aortic and pulmonary regurgitation, respectively. There was a significant relationship between serum phosphorus and calcification of cardiac valves, left ventricular hypertrophy, and left ventricular systolic dysfunction (P < 0.05). Duration of dialysis and calcium and serum parathyroid hormone levels had no significant relationship with left ventricular hypertrophy and dysfunction and calcification of cardiac valves (P > 0.05). Conclusion: Cardiovascular diseases are common among hemodialysis patients. Hyperphosphatemia is a risk factor for the prevalence of left ventricular hypertrophy, left ventricular systolic dysfunction and calcification of the heart valves.

Introduction: End-stage renal disease (ESRD) is a worldwide public health problem. ESRD reduces health-related quality of life. Quality of life is an important determinant in the mortality and morbidity of hemodialysis patients. However, several studies have suggested that high flux dialyzers increase dialysis adequacy and reduce mortality and morbidity in these patients. Objectives: This study aimed to investigate the effects of high flux and low flux dialyzers on the quality of life in hemodialysis patients. Patients and Methods: In this clinical trial, 93 patients who met the inclusion criteria were randomly assigned to two groups of high flux and low flux dialyzers. Before intervention, both groups filled demographic and quality of life questionnaires. They were undergone dialysis with two dialyzers (one group by high flux and another by low flux) three times a week for 6 weeks. Then quality of life questionnaire was filled by both groups once again. Results: The overall quality of life score was not significantly different in both groups before intervention (P=0.121). After intervention, however, high flux group attained a significantly higher mean score (54 ± 10.4) than low flux group (43.89 ± 11.64) (P<0.001). Conclusion: According to the results of this study, the use of high flux dialyzers can be a useful method to increase the quality of life in hemodialysis patients.

Introduction: The concept of diabetic nephropathy, as a metabolic disease, is now being replaced by chronic low-grade inflammatory disease. Tumor necrosis factor alpha (TNF-α) is a proinflammatory cytokine that plays an important role in the pathogenesis and clinical outcomes of diabetic nephropathy. Objectives: This study aimed to determine the relationship between plasma and urinary levels of TNF-α and chronic kidney disease (CKD) in patients with type 2 diabetes mellitus. Patients and Methods: In this descriptive-analytical study, patients with type 2 diabetes mellitus who referred to the endocrine clinic in Kashan (2016) were enrolled in the study and their clinical and laboratory data were recorded. Albumin/creatinine ratio (ACR) and glomerular filtration rate (GFR) were calculated. The patients were divided into three groups based on their GFR. Serum and urinary levels of TNF-α were determined by ELISA and were compared between the studied groups. Results: A total of 128 patients were evaluated. Of all, 35 patients (27.3%), 39 patients (30.4%), and 54 patients (42.3%), respectively, were suffering from stage 1, stage 2, and stage 3 CKD. The plasma levels of TNF-α in patients with stage 1, 2, and 3 CKD, were 66.20 ± 33.27 pg/mL, 67.47 ± 42.98 pg/mL, and 77.32 ± 47.23 pg/mL respectively, since the difference among them was not significant (P= 0.417). In addition, the urinary levels of TNF-α in patients with stage 1, 2, and 3 CKD, respectively, were 88.18 ± 26.66 pg/mL, 97.41 ± 57.76 pg/mL, and 101.18 ± 60.47 pg/mL, since no significant difference was observed between the three groups (P=0.957). Conclusion: Based on the results of this study, with changing the stage of CKD, the serum and urinary levels of the TNF-α increases too, although this increase is not significant. Moreover, the plasma and urinary levels of the TNF-α have a direct and significant relationship with each other. It is recommended to conduct further studies in this field.

Implication for health policy/practice/research/medical education:Several recently randomized clinical trials underline the substantial risk of side effects and the lack of proven efficacy with all kinds of immunosuppressive treatment including rituximab. In concordance, other studies observed a reduction of hematuria after RTX therapy. Please cite this paper as: Tamadon MR, Moghimi J, Rezaei H. Is it the time to offer rituximab as a cost-benefit treatment for immunoglobulin A nephropathy? A short-review to current concepts.