Mahdavi Mazdeh M, Moradiance V, Lesan Pezeshki M, Jahan Zad I,
Volume 61, Issue 3 (14 2003)
Abstract
LP(a) level in uremic patients is high. It has recently considered that the effect of androgens on lipids vary widely. The aim of this study was to determine the effect of nandrolone decanoate on lipid profile in chronic hemodialysis patients.
Materials and Methods: thirty six stable male patients over 40 years who were under maintenance hemodialysis were randomized to receive nandrolone decanoate , 100 mg weekly for six month, by intramuscular injection on nondialysis day (Group A, N=18) or B complex (Group B, N=18). Between September 2001 and 2002, male hemodialysis patients more than 40 years old without history of high prostatic specific antigen (PAS) or sensitization to drug were started on treatment with androgen therapy. The evolution in the liquid profile was prospectively assessed immediately before the first dose of nandrolone decanoate (basal values) and at 2, 4 and 6 month of therapy. The evolution of lipids after withdrawal of androgens at 2 month after the last dose was also studied. The patients underwent hemodialysis 3 to 4 hours three times a week. The dialysis schedule was not modified during the period of study.
Results: Mean decrease of LP(a) level in group A was significantly lower then group B in second month (p<0.05). Surprisingly HP level decreased also in second month. Other lipid parameters did not show significant changes.
Conclusion: In this study we observed that nandrolone decanoate affects on LP(a) leveK but the changes of it did not correlate with those of hemoglobin or other lipid parameters< suggesting that the underlying mechanisms are unrelated. Our finding might be affected by low dose of the drug. Further studies with higher doses will be requied to clarify the beneficial or adverse effects of this type of therapy.
Seifi S, Soleimani A, Lesan Pezeshki M, Einollahi B, Khatami Mr, Mazdeh M.m, Ahmadi F.l, Maziyar S,
Volume 64, Issue 8 (13 2006)
Abstract
Background: Autosomal-dominant polycystic kidney disease (ADPKD), a common hereditary disease, is characterized by the progressive development and enlargement of multiple cysts in both kidneys, and typically resulting in end stage renal disease (ESRD) by the fifth decade of life. Post-transplant diabetes mellitus (PTDM), a common complication after transplantation with an incidence rate of 2.5-20%, is associated with poor graft and patient survival. In few studies, PTDM has been more frequent in ADPKD transplanted patients. In the present study, we investigated whether there is any association between PTDM and ADPKD in our patients.
Methods: In this prospective study, 140 non-diabetic and nonsmoker successfully transplanted patients (27 ADPKD and 113 non ADPKD patients) were enrolled during three years. Both groups were matched for age, sex, body mass index (BMI), duration of renal replacement therapy before transplantation and also immunosuppressive protocols after transplant. Post-transplant diabetes mellitus was defined as Clinical Practice Guidelines advocated by Canadian Diabetes Association. All patients were followed for 12 months.
Results: PTDM occurred in 11.1% of ADPKD patients and in 13.1% of control group which was statistically insignificant (P > 0.05). The development of PTDM in ADPKD group was not related to sex, age, and hypertension, duration of renal replacement therapy before transplantation, BMI and serum creatinine levels (P > 0.05).
Conclusion: Post-transplant diabetes mellitus appears not to be associated with autosomal-dominant polycystic kidney disease as an etiology of end stage renal disease.
Ahmadi F, Alimadadi A, Lesan Pezeshki M,
Volume 65, Issue 10 (2 2008)
Abstract
Background: While excellent organ quality and ideal transplant conditions eliminate many of the known factors that compromise initial graft function (IGF), slow graft function (SGF), still occurs after living donor kidney transplantation (LDKT). The aim of our current study is determination SGF frequency and its risk factors in LDKT
Methods: In this prospective study, between April 2004 and March 2006, data were collected on 340 LDKT, in Baghiyattallah Hospital, Tehran. Recipients were analyzed in two groups based on initial graft function (IGF): Creatinine <3 mg/dl 5 day after transplantation, SGF: Creatinine ≥ 3 mg/dl 5 day after transplantation with out dialysis in the first week. Donors' and recipients' characteristics and recipient lab. data were compared in two groups by chi-square, Mann-whitney & independent samples T-test.
Results: The incidence of SGF was 22 (6.2%) and IGF 318 (89.8%), Recipients' BMI in IGF were 22.1±3.9 and in SGF were 25.3±3.8 (P=0.001 95% Cl 1.097-1.401 OR= 1.24). SGF relative frequency in female donors is more than male donors. A multivariate analysis model confirms this significant difference. (P=0.044 95% Cl 1.028-7.971 OR= 2.862). SGF relative frequency in PRA (Panel Reactive Antibody) positive recipients are more than negative ones. A multivariate analysis model confirms this significant difference. (P=0.007 95%Cl 1.755-35.280 OR= 7.849). Recipients' age and donors' BMI are significant in univariate analysis (P=0.002 & P=0.029 respectively) but multivariate analysis model dose not confirm those significance. Serum ca & P & PTH levels don't have significant difference between IGF & SGF. Using calcium channels blockers have not a protective effect.
Conclusions: We conclude that negative PRA and lower recipient BMI have protective effects on SGF. Recipients with female donors have higher chance to develop SGF. We recommend recipients reduce their BMI before transplantation. The male donors are preferred to female ones.