Introduction: Hyperlipidemia is considered a prominent risk factor for coronary heart disease. Coronary heart disease is the most common cause of mortality and morbidity in chronic kidney disease (CKD) patients. Objectives: The aim of this study was to evaluate the effects of artichoke leaf extract (ALE) supplementation on the lipid profile of CKD patients. Patients and Methods: A randomized, double-blind, placebo-controlled clinical trial was conducted in 38 CKD subjects (GFR<60 and >15 mL/min/1.73 m2 ) with hypercholesterolemia (total cholesterol ≥ 200 mg/dL or low-density lipoprotein cholesterol [LDL-C] ≥ 110 mg/dL). The intervention group received an artichoke capsule (320 mg) and an indistinguishable placebo was given to the control group twice daily for 6 weeks. Lipid profile and appetite were assessed at week 8 and the results were compared with the baseline data. Results: ALE supplementation was correlated with a statistically significant decrease in mean total cholesterol (P=0.028) and LDL-C (P=0.005) compared to the control group. The two groups did not show a significant difference in high-density lipoprotein-cholesterol (P=0.071) and triglyceride levels (P=0.22). There was a statistically significant difference in appetite between the two groups (P=0.016). Conclusion: This randomized controlled trial demonstrated that consumption of ALE supplement may improve appetite and lipid profile in CKD patients.

There has been little attention to sexual dysfunction (SD) in women undergoing hemodialysis (HD), therefore few studies are found in this field. The aim of this study was to determine the incidence of SD, assess its association with biochemical factors, employment and educational status, economic situation, depression, anxiety, and medication. End stage renal disease (ESRD) married women aged 18 to 60 years presenting to Tehran University of Medical Sciences (TUMS) hospitals’ (Imam Khomeini, Sina, and Baharloo) from April to September 2017 were included in the study. Female Sexual Function Index (FSFI) questionnaire was used to evaluate SD. Patients were divided into two groups with SD (scores≤28) and without SD (scores˃28). Hospital Anxiety and Depression Scale (HADS) questionnaire was used to investigate anxiety and depression; patients with scores equal to or more than 11 were implied as depressed or anxious. Demographic data, duration of dialysis, ESRD causes and biochemical tests were also collected. Thirty patients (81.1%) out of 37 showed SD who were older, had lower educational and economic status, had higher hemoglobin levels and used erythropoietin products and Venofer® (iron sucrose injection) less; most of these patients were housewives. The incidence of SD among patients was high. Erythropoietin and Venofer use was less frequent in patients with SD compared to the other group. This suggests that these two products have a role in treatment of SD rather than the treatment of anemia. © 2019 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2019;57(4):244-252.

Background:In the past few decades, Chronic Kidney Disease (CKD) - a disease with progressive decline in renal function - has become an important problem of global public health, not only in developed countries, but also in developing countries with less economic power.Objectives:In this study, CKD progression to death or End Stage Renal Disease (ESRD) in elderly Iranian patients was compared with younger counterparts.Patients and Methods:This retrospective cohort study was conducted on CKD patients with estimated Glomerular Filtration Rate (eGFR) < 60 mL/min, in a nephrology clinic in Tehran from December of 2006 until December of 2012. eGFR trend, death and need to renal replacement therapy (RRT) were evaluated as outcomes and compared between patients younger and older than 60 years. Data were analyzed using SPSS version 13.Results:Five-hundred and two patients were enrolled and followed up for an average of 37.6 months. Two thirds of the patients were older than 60 years. The incidence density of ESRD in patients younger and older than 60 years were 6.3 and 3.6 for 100 persons per year, respectively. Younger ones showed more rapid decline in their eGFR, while older patients had more stable renal function.Conclusions:It seems necessary to conduct more researches in order to redefine CKD and identify its prognostic markers in elderly population.

Background Urinary tract infection (UTI) accounts for about half of all post- kidney transplant infections. There is conflicting data regarding vitamin C and UTI prevention. So far, its efficacy has not been studied in renal transplant patients. Methods Kidney transplant candidates were randomized between vitamin C and placebo arms. In the treatment group, patients received vitamin C infusion at a single dose of 70 mg/kg. In another study arm, only the diluent solution was administered. Data regarding bacteriuria during the first hospitalization after transplantation were recorded. Results A total of 19 patients were randomized to the placebo (n = 10) and vitamin C (n = 9) group. The rate of bacteriuria during the first hospitalization after transplantation was significantly lower in the vitamin C group than in the placebo group, 11.1% versus 60%, respectively. (P = 0.02). Conclusion Vitamin C as a safe treatment is a potential prophylactic agent in post kidney transplantation UTI.

Background: Serum magnesium (Mg) status in kidney transplant recipients has been a center of attention in the past few years. Current evidence suggests an association between pre-transplant hypomagnesemia and post-transplant hyperglycemia. Objective: The purpose of this study was to assess the associations of pre-transplant magnesemia with blood glucose disturbances within 6 months post-kidney transplantation. Methods: In this retrospective cohort, 89 first-time kidney transplant recipients with 6 months of follow-up were included. None of the participants had a positive history of rejection, pre-transplant history of diabetes mellitus or fasting plasma glucose ≥ 100 mg/dL. Results: Post-transplant diabetes mellitus (PTDM) and impaired fasting glucose (IFG) 6 months post-transplant was found in 7.9% and 41.6% of the study group, respectively. The mean pre-transplant serum Mg level was 1.92 ± 0.30 mg/dL in the study population (n = 89), and it was significantly lower in IFG (n = 37) and IFG/PTDM (n = 44) groups compared to normoglycemic (n = 45) recipients (1.83 ± 0.31 mg/dL vs. 2.00 ± 0.27 mg/dL, P = 0.008, and 1.84 ± 0.31 mg/dL vs. 2.00 ± 0.27 mg/dL, P = 0.012, respectively). Patients with serum Mg less than 1.9 mg/dL were nearly 2.6 times more likely to develop IFG or IFG/PTDM within 6 months post-transplant (P = 0.044 and P = 0.040, respectively). Conclusions: Pre-transplant hypomagnesemia may be considered a risk factor for developing post-transplant glycemic disturbances, and patients with lower pre-transplant Mg concentration could be at a higher risk for developing IFG.