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Background and Aims Patients suffering from end stage renal disease usually cope with many problems due to their lengthy illness and its complications. Renal transplantation is the most effective therapeutic strategy in these patients. One of the post transplantation complications is gastrointestinal bleeding due to peptic ulcers and other upper gastrointestinal diseases which can affect the morbidity and mortality of these patients. The present research aims to shed lights on prevalence of gastrointestinal lesions and Helicobacter pylori infection using upper endoscopy in asymptomatic candidates for renal transplantation. Method The present cross-sectional research was performed on renal transplant candidates suffering chronic renal failure referred to Montaserie organ transplantation center in the time period of January 2016, to January 2018. Eighty five ESRD patients, 45 male and 40 female, mean age 39.09 ± 11.09 years, enrolled in the study. Hypertension and diabetes were the most common causes of kidney failure in the patients. In the present research about 90.6% of patients had been on chronic dialysis,. Mean duration of vintage time on dialysis was 20.46 ±16.12 months, and hemodialysis (87%) was the most common dialysis method. Including criteria were patients candidature for renal transplant and consent for involvement in the research. Excluding criteria were patients with apparent dyspeptic symptoms, patients with known upper gastrointestinal diseases, and patients who have been using PPIs (proton pump inhibitors), NSAIDs(non-steroid anti-inflammatory drug), H2 blockers or antibiotics over the past two weeks preceding the enrollment in study . Patients who met criteria underwent endoscopy and were classified according to endoscopic findings, Helicobacter pylori infection and pathologic findings. Chi-square statistics was used for evaluating the correlation between categorical endoscopic or pathologic findings with categorical demographic and dialysis characteristics parameters. The Statistical Package for the Social Sciences software (SPSS version 20.0, SPSS Inc., Chicago, IL, USA) was used for data analyses. A P <0.05 was considered significant. Results Sixty two patients (72%) had significant endoscopic findings; erosive gastroduodenitis (32.5%) was the most common findings. There was not a significant correlation between endoscopic findings and: age (p = 0.5), cause of renal failure (p-value = 0.9), dialysis type (p-value = 0.08), gender (p-value = 0.9), infection with H. Pylori (p-value = 0.2) and mean duration of vintage dialysis time (p = 0.4).All the patients with significant endoscopic findings, had also significant abnormal pathologic findings on endoscopic obtained biopsied samples. Helicobacter pylori infection was seen in, 36 patient(42%)s. Significant association between H. Pylori infection and abnormal pathology was found (p=0.04) . Conclusion Asymptomatic gastrointestinal lesions and Helicobacter pylori infection are prevalent in renal transplant candidates, so routine upper endoscopy in these patients is strongly recommended.

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Introduction: patients who undergo on-pump cardiac surgery are at risk of acute kidney injury following the operation. This is mainly due to some ischemic events and also pre- and postoperative stress responses which can result in postoperative organ dysfunction. Selenium as an antioxidant may help to reduce the inflammation and subsequent related complications. In this study we tested that if administration of oral Se compliment before and following the on-pump cardiac surgery can reduce the incidence or severity of kidney injury following the operation. Methods: In a randomized double-blind trial we divided the randomly selected patients who were candidate for on-pupm cardiac surgery into two groups of those who received selenium and control group. In selenium group we administrated 500 µg of selenium orally 14 and 2 hours before surgery and every 12 hours postoperatively for 2 days (overall 3000 µg) while the control group received only the routine and standard care. Subsequently patients were closely observed for serum creatinine rise and incidence of post-operative AKI during their hospitalization period in both groups using both Rifle and AKIN criteria separately. Besides, some additional data including: ICU-stay, duration of the operation and need for Blood products during the operation were recorded. At the end, the statistical analysis was carried out using SPSS 11.5 software in order to determine any significant difference in case and control group. Results: The study population included 120 patients divided in two equal groups of 60, consisting of 46 (38.3%) males and 74 (61.7%) females with the mean age of 52.8±16.7 years. Both groups were similar regarding the demographics and comorbidities. Also statistics showed no significant difference regarding Cardiac Operative Risk Evaluation (EuroSCORE) in both groups. Considering the RIFLR criteria, AKI occurred in 11 (17.9%) patients in selenium group and 13 (21.4%) patients in control group while based on AKIN criteria figures were 17 (28.6%) and 21 (35.7%) in selenium and the control group , respectively. The most frequent stage of AKI among patients was the first stage in both group and the highest rate of AKI occurred in 3-4 days after surgery in both groups. Conclusion: According to our research Administrating oral Selenium was not beneficial in order to prevent AKI after on-pump cardiac surgery.

Introduction: Systemic bacterial infections are a common cause of mortality and morbidity in hemodialysis patients. Zinc has a critical role in several immune system functions. Patients who have enough amounts of zinc are able to better face infections caused by various pathogens in comparison to those with zinc insufficiency Objective We sought to assess the role of zinc deficiency in dialysis-associated bacterial infections. Patients and Methods: Eighty-Three adult patients with end-stage renal disease (ESRD) on hemodialysis including 43 patients with bacterial infectious complications and 40 non-infected patients as well as 41 healthy individuals were enrolled. Clinical data, laboratory values including serum zinc level and imaging findings were collected. SPSS was utilized to analyze the data with a significance cutoff set at P < 0.05. Results: Out of 124 participants, 80 (64.51%) were males and 44 (35.49%) were females. The mean age of infected hemodialysis group, non-infected hemodialysis group, and healthy controls were 50.8 ± 16.25, 49.1 ± 18.1, and 56.3 ± 18.2 years, respectively. Catheter site infection (37.3%) and urinary tract infection (30.2%) were the most common infections. The mean serum zinc concentration was significantly lower in the infected patients, compared to non-infected patients and healthy individuals (P < 0.001). Conclusion: The ESRD patients on hemodialysis have lower serum zinc levels which are associated with increased risk of bacterial infection. The role of screening for zinc deficiency and use of supplemental zinc in these patients need to be studied.