Ali Ghorbani | Ahvaz Jundishapur University of Medical Sciences (original) (raw)

Papers by Ali Ghorbani

Research paper thumbnail of Seroprevalence of Cytomegalovirus Antibody in Renal Transplant Recipients and Donors in Khuzestan Province, Iran

Objective: Cytomegalovirus (CMV) has been recognized as one of the most important opportunistic p... more Objective: Cytomegalovirus (CMV) has been recognized as one of the most important opportunistic pathogens in kidney transplant patients. The aim of this study was to determine the prevalence of CMV antibody in donors and recipients before transplantation. Material and Methods: In a cross sectional study from March 2008 to August 2009 we prospectively studied donors and recipients who referred to our kidney transplant center. All of routine pretransplante laboratory studies including liver function tests and CMV IgG and IgM antibody were performed for them. Results: A total of 148 patients (79 donors and 69 recipients) were included in the study. Mean age of donors and recipients were 30 ± 8 years and 40 ± 18 years respectively. Liver Function tests (SGOT and SGPT) were at normal range and marker of HBV infection was negative in both groups but HCV antibody was positive in 2.89 percent of recipients (n=2) and negative in all of donors. CMV IgG antibody was positive in 100 percent of ...

Research paper thumbnail of Relationship of bone density with serum parathyroid hormone in hemodialysis patients; a single center study

Journal of Parathyroid Disease

Introduction: The existence of a relationship between the level of serum parathyroid hormone (PTH... more Introduction: The existence of a relationship between the level of serum parathyroid hormone (PTH) and bone density can be a warning sign in hemodialysis patients. Objectives: In the studies conducted so far, the relationship between these two factors has not been specifically investigated. Hence, this study was aimed to exclusively evaluate the levels of serum PTH hormone and bone density. Patients and Methods: In this cross sectional study, 85 eligible chronic hemodialysis patients aged over 18 years old who underwent hemodialysis a minimum of two times a week for at least 6 months were enrolled in the study. Serum intact PTH, 25 OH-vitamin D3, CBC, calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), albumin (Alb), and VBG were measured. Additionally, lumbar radiographic profile and densitometry tests were conducted for patients. Results: The mean age of patients was 52.9 years (20 to 86 years old). Of them, 43 patients were male (50.58%). There was a significant correlation between age and the decrease in bone density (P = 0.004). There was a significant relationship between different groups of bone density and serum vitamin D3 level (P < 0.05). Based on the results of Z standard, a significant difference between the mean levels of intact PTH in different groups of bone density was seen (P = 0.037). Conclusion: The prevalence of osteopenia and osteoporosis in hemodialysis patients is high. In addition, the decrease in bone density is associated with high levels of PTH. While this association is mainly associated with Z score, it is necessary to investigate the secondary causes of this condition.

Research paper thumbnail of Urinary level of interleukin-1alpha and interleukin-6 in patients underwent extracorporeal shock wave lithotripsy

Journal of Renal Injury Prevention

Findings of the current study highlighted the underlying inflammatory process following extracorp... more Findings of the current study highlighted the underlying inflammatory process following extracorporeal shock wave lithotripsy (ESWL) procedure and can be a good sample for further investigations.

Research paper thumbnail of The Relationship between Serum Level of Vitamin D3 and the Severity of New Onset Rheumatoid Arthritis Activity

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2017

Rheumatoid Arthritis (RA) is a systemic inflammatory disease which typically involves wrists, ank... more Rheumatoid Arthritis (RA) is a systemic inflammatory disease which typically involves wrists, ankles, and finally every joint. Some of studies have reported a reverse relationship between the level of vitamin D and RA severity. The present study was carried out in order to check the potential relationship between the level of vitamin D and RA severity. Ninety-three patients with RA with onset in recent three months (new onset RA), and 31 patients without RA were chosen as the control group. The patients all aged under 75 years and were diagnosed by a rheumatologist. The serum level of vitamin D was measured through blood test by chemiluminescence method by taking a blood sample of 5 cc. The relationship between the average level of vitamin D and disease severity was analyzed based on scoring scale of DAS28 in different groups with RA. The significant level of the above mentioned tests was set at p&amp;amp;lt;0.05. Data analysis was carried out using SPSS 20.0. The results of the present study indicated that there was no significant relationship between the two groups in terms of the serum level of vitamin D. Since the subgroups of the patients are not homogenous in terms of age and based on disease severity, ANOVA and chi-square were used to modify this heterogeneity and compare vitamin D levels in patients based on disease severity. The results indicated that there was a significant difference between the three groups of patients in terms of disease severity, such that disease severity rose with a decrease in the serum level of vitamin D, (p-value &amp;amp;lt;0.001). There was a significant reverse relationship between the serum level of vitamin D and RA severity based on Das Score 28. Therefore, it is recommended that if there is a lack of or insufficient amounts of this vitamin in the body, vitamin D supply needs to be optimized along with other standard medications in order to reduce the RA severity.

Research paper thumbnail of Effect of Atorvastatin on the Disease Activity and Severity of Rheumatoid Arthritis: Double-Blind Randomized Controlled Trial

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2016

HMG-CoA (3-hydroxy-3- methylglutary lcoenzyme A) reductase inhibitors (statins) have anti-inflamm... more HMG-CoA (3-hydroxy-3- methylglutary lcoenzyme A) reductase inhibitors (statins) have anti-inflammatory properties which may be particularly useful in rheumatoid arthritis to suppress disease activity and inflammatory factors. The purpose of this clinical trial was to determine anti-inflammatory properties of statins in rheumatoid arthritis. Eighty Iranian patients with rheumatoid arthritis, aged between 19 to 75 years were recruited to take part in this randomized, double-blind placebo-controlled trial. Subjects were randomly allocated to two groups to take atorvastatin or placebo 40 mg daily as an adjunct to current disease-modifying anti-rheumatic drugs (DMARDs) treatment. Disease Activity Score-28 (DAS28), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), swollen joint count (SJC) &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; tender joint count (TJC) were assessed before and after three months intervention. Analysis was based on intention to treat. DAS28 significantly declined in the atorvastatin group in comparison with placebo (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). SJC, TJC, CRP and ESR also were significantly dropped in the atorvastatin group in comparison with placebo. It can be concluded that atorvastatin can suppress RA activity and inflmmatory factors in RA patients for high to moderate grade of inflmmation.

Research paper thumbnail of Half-Saline versus Combined Normal Saline and 1/3-2/3 Intravenous Fluid Therapy in Kidney Transplantation

International journal of organ transplantation medicine, 2011

Sufficient intravascular volume should be established for optimal graft function after renal tran... more Sufficient intravascular volume should be established for optimal graft function after renal transplantation. However, there is no recommendation for the type of fluid therapy post-operatively. We compared half-saline vs. normal saline and 1/3-2/3 intravenous fluid replacement after renal transplantation. We enrolled all patients who underwent kidney transplantation between June 2008 and March 2010 in Golestan Hospital, Ahwaz, southwestern Iran. Patients were randomly divided into two groups using a blinded allocation technique. Group A patients (Case) received half saline, and group B patients (Control) received normal saline and 1/3-2/3 intravenous fluid. According to our protocol, we replaced as much as 100% of hourly urine output in the first day, followed by 90% and 70% of every 2-hour urine output in the 2nd and 3rd days, respectively. Blood pressure and pulse rate were recorded hourly. Serum sodium, potassium, creatinine and pH were assessed twice a day. There were 34 and 36 ...

Research paper thumbnail of Survival at 1, 3, and 5 years in diabetic and nondiabetic patients on hemodialysis

Iranian journal of kidney diseases, 2010

We analyzed survival of 185 adult patients on maintenance hemodialysis (9 h/wk to 12 h/wk) at Ema... more We analyzed survival of 185 adult patients on maintenance hemodialysis (9 h/wk to 12 h/wk) at Emam Khomini Hospital in Ahvaz, Iran. Patient survival at 1, 3, and 5 years was 89.2%, 69.2%, and 46.8%, respectively. There was no significant difference between diabetic and nondiabetic patients in 1-year survival (87.1% versus 89.7%, P = .66). But, 3- and 5-year survival rates of diabetic patients were significantly lower than those of nondiabetic patients (52.2% versus 73.8%, P = .04; zero versus 56.9%, P < .001; respectively). Based on our findings, the survival of diabetic patients undergoing hemodialysis was much worse than survival of nondiabetic patients. Thus, prevention of diabetic nephropathy should be more emphasized; and if end-stage renal disease is present, other renal replacement therapies such as kidney transplantation must be considered as soon as possible.

Research paper thumbnail of Alteration of panel-reactive antibodies following treatment with either atorvastatin or low-dose mycophenolate mofetil in sensitized hemodialysis patients

Iranian journal of kidney diseases, 2011

Both atorvastatin and mycophenolate mofetil (MMF) have been used for panel reactive antibodies (P... more Both atorvastatin and mycophenolate mofetil (MMF) have been used for panel reactive antibodies (PRA) reduction in transplant candidates. The purpose of this study was to compare the effect of low-dose MMF and atorvastatin on PRA in sensitized hemodialysis patients waiting for kidney transplantation. A total of 40 adult patients with end-stage renal disease who were highly sensitized to human leukocyte antigens (PRA > 40%) were enrolled and randomly assigned into atorvastatin or low-dose MMF groups. All of the patients received the treatments for 2 months. The PRA status was determined at the end of the 1st and 2nd month. Forty percent of the patients in the atorvastatin group compared with 5% in the low-dose MMF group showed complete response, defined as a minimum 50% reduction in PRA (P = .02). Reduction of PRA in the atorvastatin group was significantly higher than that in the low-dose MMF group (P = .01). No major infectious or other complications occurred in our patients. Ato...

Research paper thumbnail of Comparison of alendronate and pamidronate on bone loss in kidney transplant patients for the first 6 months of transplantation

Iranian journal of kidney diseases, 2011

Osteoporosis develops and progresses in a considerable number of kidney transplant patients. Bisp... more Osteoporosis develops and progresses in a considerable number of kidney transplant patients. Bisphosphonates, which are used for prevention and treatment of osteoporosis, may accentuate gasterointestinal complications and lead to more nonadherence to treatment. This randomized clinical trial was conducted to compare the effect of pamidronate versus alendronate on early bone mineral density changes in kidney transplant patients. Forty patients (27 men and 13 women), aged from 20 to 58 years, with low bone mineral density (T score < -2) in the spine, total hip, or femur neck were enrolled. Participants were randomly allocated into 2 groups to receive pamidronate or alendronate. The pamidronate group received intravenous pamidronate, 90 mg, starting from the 3rd week of transplantation for 3 months. The alendronate group started to receive oral alendronate, 70 mg per week for the same period. At baseline and 6 months, bone mineral density was measured by dual-energy x-ray absorptiom...

Research paper thumbnail of Renal protective effect of selenium on cisplatin-induced nephrotoxicity

Journal of renal injury prevention, 2012

Selenium supplementation reduces the products of oxidative stress in kidney failure patients and ... more Selenium supplementation reduces the products of oxidative stress in kidney failure patients and can be protective against cisplatin nephrotoxicity.

Research paper thumbnail of The effect of pentoxifylline on reduction of proteinuria among patients with type 2 diabetes under blockade of angiotensin system: a double blind and randomized clinical trial

Nefrología : publicación oficial de la Sociedad Española Nefrologia, 2012

Although blockade of renin-angiotensin system have been cited as the first line of therapy for th... more Although blockade of renin-angiotensin system have been cited as the first line of therapy for the management of diabetic nephropathy (DN), however in a substantial number of patients, progression of renal disease are not completely halted by these agents. We have conducted a double blinded clinical trial to assess the additive effect of pentoxifylline on reduction of proteinuria among patients with type 2 DM under blockade of angiotensin system. The dosage of PTX used in our trial was at a low dosage of 400mg daily and to our knowledge, we did not found article which evaluated the antiproteinuric effect of pentoxifylline in this dosage. One hundred patients with DN and persistent proteinuria despite treatment with losartan and enalapril in at least 3 months before inclusion in the study were randomly assigned to two groups. Control group (n=50, 26 males and 24 females) received losartan and enalapril, while treatment group (PTX Group) (n=50, 28 males and 22 females) was given losar...

Research paper thumbnail of Does erythropoietin slow progression of chronic kidney disease?

Journal of renal injury prevention, 2013

The initiation of erythropoietin therapy for the purpose of renoprotection may need to be sooner ... more The initiation of erythropoietin therapy for the purpose of renoprotection may need to be sooner than that for erythropoiesis, because erythropoietin may attenuate renal fibrosis through macrophage adjustment and endothelial cell protection by other uncertain mechanisms. Although, agents re-establishing the initial function of renal erythropoietin-producing cells could defer kidney fibrosis, however more studies should be carried out to determine the cellular target of erythropoietin in kidney and developinga new erythropoietin derivative for renal care.

Research paper thumbnail of Ticlopidine to prevent primary arteriovenous fistula failure in hemodialysis patients; a randomized controlled trial

Journal of renal injury prevention, 2013

arteriovenous fistula failure in hemodialysis patients; a randomized controlled trial.

Research paper thumbnail of Lipoprotein (a): More than a bystander in the etiology of hypertension? A study on essential hypertensive patients not yet on treatment

Journal of nephropathology, 2013

Hypertension (HTN) is a very common disorder with a substantial impact on public health because o... more Hypertension (HTN) is a very common disorder with a substantial impact on public health because of its complications. To study the association of serum lipoprotein(a) [Lp(a)] elevation with essential hypertension (eHTN). This study was conducted on a group of essential hypertensive patients. Laboratory exams consisting of serum creatinine and Lp(a) were measured. Ninety five essential hypertensive patients were enrolled to the study. Serum LP (a) in patients was 46.5±20. In patients an inverse correlation between serum Lp(a) andcreatinine clearance was seen (r = -0.175 p<0.05). There was a significant correlation between serum Lp(a) and age (r =0.191 p<0.05) or duration of HTN (known duration of hypertension period) (r =0.362 p<0.05). Our data suggest that Lp(a) may be involved as a cofactor in essential hypertension, with a mechanism that remains to be elucidated.

Research paper thumbnail of Protective effect of selenium on cisplatin induced nephrotoxicity: A double-blind controlled randomized clinical trial

Journal of nephropathology, 2013

Renal injury is common following cisplatin infusion. Some agents have been used to attenuate cisp... more Renal injury is common following cisplatin infusion. Some agents have been used to attenuate cisplatin nephrotoxicity. However, except hydration, none of them has been proved to be effective. In this study selenium as an antioxidant supplement was tested on cisplatin induced renal injury. 122 cancerous patients (85 male and 37 female; age range of 14 to 82 years old) were enrolled to receive chemotherapy regimens consisting cisplatin. They were allocated into two groups using a random number list . Investigators, patients and analyzers all, were blinded in allocation by using sealed opaque envelopes. Intervention group received a single 400 mcg selenium tablet and patients in control group took a placebo tablet which was similar with selenium preparation in color, weight, shape and taste. Primary end points were an increase in plasma creatinine above 1.5 mg/dl in men and 1.4mg/dl in women, or increase of plasma creatinine more than 50% from baseline or urine flow rate less than 0.5 ...

Research paper thumbnail of Comment on: The effects of Vitamin E and Selenium on cisplatin-induced nephrotoxicity in cancer patients treated with cisplatin-based chemotherapy: A randomized, placebo-controlled study

Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 2013

much attention has been made toward kidney protective efficiency of selenium. The results of the ... more much attention has been made toward kidney protective efficiency of selenium. The results of the study conducted by Randjelovic et al., showed selenium supplementation attenuates oxidative-stress-associated renal injury by reducing oxygen free radicals and lipid peroxidation in gentamicin-treated rats, [4] while gentamicin-renal damage in Wistar rats is a model of acute kidney injury indicated that gentamicin-induced tissue injury was mediated through oxidative reactions. [5-11] Selenium is a trace element that participates as a cofactor in several enzymes, one of them is participant in the regulation of enzymatic antioxidant defenses. [12] It was found that selenium supplementation in renal patients reduce the products of oxidative stress. [12-14] In a study by Taskin et al., on adriamycin-induced renal damage in rats showed selenium is effective in vivo against adriamycin-induced kidney injury via the restoration of total antioxidant and oxidant status, which prevented mitochondrial damage. [15] Recent findings have shown that plasma selenium level have been found to be reduced in patients with acute kidney injury. [16-18] indeed, low serum selenium levels are a frequent finding in patients with chronic renal failure too. [19-21] However, to date, few investigations have studied the association of hyposelenemia and morbidity and mortality in renal failure patients. Thus, these available data lend further evidence for the attribution of selenium in its kidney protective property. In this regard, to understand the selenium kidney protective properties better, more experimental rat models or clinical studies are suggested.

Research paper thumbnail of The protective effect of theophyline in cisplatin nephrotoxicity

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2014

Cisplatin is a potent and a major anti-neoplastic drug in the treatment of a broad spectrum of ma... more Cisplatin is a potent and a major anti-neoplastic drug in the treatment of a broad spectrum of malignancies. However, its clinical use is limited by renal tubular dysfunction that occurs in a significant percent of patients. The aim of the present study was to evaluate the possible protective effect of theophyline in the prevention of cisplatin-induced nephrotoxicity. The trial design was prospective, randomized, double-blinded and placebo controlled. Chemotherapeutic patients who received cisplatin at a dosage of at least 50 mg/m 2 alone or in combination with other chemotherapy agent(s) were included in the study. There were a total of 76 patients who were randomly divided into two groups. In group 1 (n = 38), placebo was advised; in group 2 (n = 38), patients received 4 mg/kg aminophyline as an intravenous loading dose, followed by theophyline in a dose of 200 mg three times daily orally for four consecutive days. The placebo group had 22 males and 16 females and the theophyline ...

Research paper thumbnail of The comparison of general health status between hemodialysis and kidney transplant patients in university hospitals of Ahvaz, Iran

Journal of renal injury prevention, 2014

Patients undergoing chronic hemodialysis and kidney transplant patients will be afflicted with va... more Patients undergoing chronic hemodialysis and kidney transplant patients will be afflicted with various mental and physical problems, which may affect their general health. Previous studies have shown that, general health level in these patients is lower than general population. However, definitive studies comparing the general health between the two groups of patients undergoing hemodialysis and kidney transplant recipients have not been done, yet. In this study, we aimed to compare the general health between the two groups of chronic hemodialysis patients and kidney transplant recipients. This investigation was a cross-sectional descriptive-analytic study that has been conducted on 31 hemodialysis and 33 kidney transplant patients in two university hospitals of Ahvaz, Iran. Data were collected through a general health questionnaire (GHQ-28) and they were analyzed with SPSS software. The mean score of general health was 28.8 and 27.57 in hemodialysis and kidney transplant patients, ...

Research paper thumbnail of Bacterial urinary tract infection in renal transplant recipients and their antibiotic resistance pattern: A four-year study

Iranian journal of microbiology, 2014

Urinary tract infections (UTIs) are the most common infections in renal transplant recipients and... more Urinary tract infections (UTIs) are the most common infections in renal transplant recipients and are considered a potential cause of bacteremia, sepsis, and affects graft outcomes. The aim of the present study was to determine the incidence of UTI among renal transplant recipients and investigation of antimicrobial susceptibility pattern of causative agents. In total, 1165 patients from March 2009 to December 2012, in transplant center of Golestan Hospital, Ahvaz, Iran, were investigated. Qualitative urine cultures were performed for all cases, causative microorganisms were identified and colony count was performed according to the standard protocol. Antibiotic susceptibility testing was then performed to determine the susceptibility pattern of recovered bacteria from confirmed UTIs. UTI was diagnosed in 391 patients(33.56%). Gram-negative bacteria were the most prevalent isolated microorganisms with E. coli (43.53%), followed by Enterobacter spp. (35.37%) as the major organisms. A...

Research paper thumbnail of اپیدمیولوژی بیماری مزمن کلیه در جهان و ایران‎

Research paper thumbnail of Seroprevalence of Cytomegalovirus Antibody in Renal Transplant Recipients and Donors in Khuzestan Province, Iran

Objective: Cytomegalovirus (CMV) has been recognized as one of the most important opportunistic p... more Objective: Cytomegalovirus (CMV) has been recognized as one of the most important opportunistic pathogens in kidney transplant patients. The aim of this study was to determine the prevalence of CMV antibody in donors and recipients before transplantation. Material and Methods: In a cross sectional study from March 2008 to August 2009 we prospectively studied donors and recipients who referred to our kidney transplant center. All of routine pretransplante laboratory studies including liver function tests and CMV IgG and IgM antibody were performed for them. Results: A total of 148 patients (79 donors and 69 recipients) were included in the study. Mean age of donors and recipients were 30 ± 8 years and 40 ± 18 years respectively. Liver Function tests (SGOT and SGPT) were at normal range and marker of HBV infection was negative in both groups but HCV antibody was positive in 2.89 percent of recipients (n=2) and negative in all of donors. CMV IgG antibody was positive in 100 percent of ...

Research paper thumbnail of Relationship of bone density with serum parathyroid hormone in hemodialysis patients; a single center study

Journal of Parathyroid Disease

Introduction: The existence of a relationship between the level of serum parathyroid hormone (PTH... more Introduction: The existence of a relationship between the level of serum parathyroid hormone (PTH) and bone density can be a warning sign in hemodialysis patients. Objectives: In the studies conducted so far, the relationship between these two factors has not been specifically investigated. Hence, this study was aimed to exclusively evaluate the levels of serum PTH hormone and bone density. Patients and Methods: In this cross sectional study, 85 eligible chronic hemodialysis patients aged over 18 years old who underwent hemodialysis a minimum of two times a week for at least 6 months were enrolled in the study. Serum intact PTH, 25 OH-vitamin D3, CBC, calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), albumin (Alb), and VBG were measured. Additionally, lumbar radiographic profile and densitometry tests were conducted for patients. Results: The mean age of patients was 52.9 years (20 to 86 years old). Of them, 43 patients were male (50.58%). There was a significant correlation between age and the decrease in bone density (P = 0.004). There was a significant relationship between different groups of bone density and serum vitamin D3 level (P < 0.05). Based on the results of Z standard, a significant difference between the mean levels of intact PTH in different groups of bone density was seen (P = 0.037). Conclusion: The prevalence of osteopenia and osteoporosis in hemodialysis patients is high. In addition, the decrease in bone density is associated with high levels of PTH. While this association is mainly associated with Z score, it is necessary to investigate the secondary causes of this condition.

Research paper thumbnail of Urinary level of interleukin-1alpha and interleukin-6 in patients underwent extracorporeal shock wave lithotripsy

Journal of Renal Injury Prevention

Findings of the current study highlighted the underlying inflammatory process following extracorp... more Findings of the current study highlighted the underlying inflammatory process following extracorporeal shock wave lithotripsy (ESWL) procedure and can be a good sample for further investigations.

Research paper thumbnail of The Relationship between Serum Level of Vitamin D3 and the Severity of New Onset Rheumatoid Arthritis Activity

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2017

Rheumatoid Arthritis (RA) is a systemic inflammatory disease which typically involves wrists, ank... more Rheumatoid Arthritis (RA) is a systemic inflammatory disease which typically involves wrists, ankles, and finally every joint. Some of studies have reported a reverse relationship between the level of vitamin D and RA severity. The present study was carried out in order to check the potential relationship between the level of vitamin D and RA severity. Ninety-three patients with RA with onset in recent three months (new onset RA), and 31 patients without RA were chosen as the control group. The patients all aged under 75 years and were diagnosed by a rheumatologist. The serum level of vitamin D was measured through blood test by chemiluminescence method by taking a blood sample of 5 cc. The relationship between the average level of vitamin D and disease severity was analyzed based on scoring scale of DAS28 in different groups with RA. The significant level of the above mentioned tests was set at p&amp;amp;lt;0.05. Data analysis was carried out using SPSS 20.0. The results of the present study indicated that there was no significant relationship between the two groups in terms of the serum level of vitamin D. Since the subgroups of the patients are not homogenous in terms of age and based on disease severity, ANOVA and chi-square were used to modify this heterogeneity and compare vitamin D levels in patients based on disease severity. The results indicated that there was a significant difference between the three groups of patients in terms of disease severity, such that disease severity rose with a decrease in the serum level of vitamin D, (p-value &amp;amp;lt;0.001). There was a significant reverse relationship between the serum level of vitamin D and RA severity based on Das Score 28. Therefore, it is recommended that if there is a lack of or insufficient amounts of this vitamin in the body, vitamin D supply needs to be optimized along with other standard medications in order to reduce the RA severity.

Research paper thumbnail of Effect of Atorvastatin on the Disease Activity and Severity of Rheumatoid Arthritis: Double-Blind Randomized Controlled Trial

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2016

HMG-CoA (3-hydroxy-3- methylglutary lcoenzyme A) reductase inhibitors (statins) have anti-inflamm... more HMG-CoA (3-hydroxy-3- methylglutary lcoenzyme A) reductase inhibitors (statins) have anti-inflammatory properties which may be particularly useful in rheumatoid arthritis to suppress disease activity and inflammatory factors. The purpose of this clinical trial was to determine anti-inflammatory properties of statins in rheumatoid arthritis. Eighty Iranian patients with rheumatoid arthritis, aged between 19 to 75 years were recruited to take part in this randomized, double-blind placebo-controlled trial. Subjects were randomly allocated to two groups to take atorvastatin or placebo 40 mg daily as an adjunct to current disease-modifying anti-rheumatic drugs (DMARDs) treatment. Disease Activity Score-28 (DAS28), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), swollen joint count (SJC) &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; tender joint count (TJC) were assessed before and after three months intervention. Analysis was based on intention to treat. DAS28 significantly declined in the atorvastatin group in comparison with placebo (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). SJC, TJC, CRP and ESR also were significantly dropped in the atorvastatin group in comparison with placebo. It can be concluded that atorvastatin can suppress RA activity and inflmmatory factors in RA patients for high to moderate grade of inflmmation.

Research paper thumbnail of Half-Saline versus Combined Normal Saline and 1/3-2/3 Intravenous Fluid Therapy in Kidney Transplantation

International journal of organ transplantation medicine, 2011

Sufficient intravascular volume should be established for optimal graft function after renal tran... more Sufficient intravascular volume should be established for optimal graft function after renal transplantation. However, there is no recommendation for the type of fluid therapy post-operatively. We compared half-saline vs. normal saline and 1/3-2/3 intravenous fluid replacement after renal transplantation. We enrolled all patients who underwent kidney transplantation between June 2008 and March 2010 in Golestan Hospital, Ahwaz, southwestern Iran. Patients were randomly divided into two groups using a blinded allocation technique. Group A patients (Case) received half saline, and group B patients (Control) received normal saline and 1/3-2/3 intravenous fluid. According to our protocol, we replaced as much as 100% of hourly urine output in the first day, followed by 90% and 70% of every 2-hour urine output in the 2nd and 3rd days, respectively. Blood pressure and pulse rate were recorded hourly. Serum sodium, potassium, creatinine and pH were assessed twice a day. There were 34 and 36 ...

Research paper thumbnail of Survival at 1, 3, and 5 years in diabetic and nondiabetic patients on hemodialysis

Iranian journal of kidney diseases, 2010

We analyzed survival of 185 adult patients on maintenance hemodialysis (9 h/wk to 12 h/wk) at Ema... more We analyzed survival of 185 adult patients on maintenance hemodialysis (9 h/wk to 12 h/wk) at Emam Khomini Hospital in Ahvaz, Iran. Patient survival at 1, 3, and 5 years was 89.2%, 69.2%, and 46.8%, respectively. There was no significant difference between diabetic and nondiabetic patients in 1-year survival (87.1% versus 89.7%, P = .66). But, 3- and 5-year survival rates of diabetic patients were significantly lower than those of nondiabetic patients (52.2% versus 73.8%, P = .04; zero versus 56.9%, P < .001; respectively). Based on our findings, the survival of diabetic patients undergoing hemodialysis was much worse than survival of nondiabetic patients. Thus, prevention of diabetic nephropathy should be more emphasized; and if end-stage renal disease is present, other renal replacement therapies such as kidney transplantation must be considered as soon as possible.

Research paper thumbnail of Alteration of panel-reactive antibodies following treatment with either atorvastatin or low-dose mycophenolate mofetil in sensitized hemodialysis patients

Iranian journal of kidney diseases, 2011

Both atorvastatin and mycophenolate mofetil (MMF) have been used for panel reactive antibodies (P... more Both atorvastatin and mycophenolate mofetil (MMF) have been used for panel reactive antibodies (PRA) reduction in transplant candidates. The purpose of this study was to compare the effect of low-dose MMF and atorvastatin on PRA in sensitized hemodialysis patients waiting for kidney transplantation. A total of 40 adult patients with end-stage renal disease who were highly sensitized to human leukocyte antigens (PRA > 40%) were enrolled and randomly assigned into atorvastatin or low-dose MMF groups. All of the patients received the treatments for 2 months. The PRA status was determined at the end of the 1st and 2nd month. Forty percent of the patients in the atorvastatin group compared with 5% in the low-dose MMF group showed complete response, defined as a minimum 50% reduction in PRA (P = .02). Reduction of PRA in the atorvastatin group was significantly higher than that in the low-dose MMF group (P = .01). No major infectious or other complications occurred in our patients. Ato...

Research paper thumbnail of Comparison of alendronate and pamidronate on bone loss in kidney transplant patients for the first 6 months of transplantation

Iranian journal of kidney diseases, 2011

Osteoporosis develops and progresses in a considerable number of kidney transplant patients. Bisp... more Osteoporosis develops and progresses in a considerable number of kidney transplant patients. Bisphosphonates, which are used for prevention and treatment of osteoporosis, may accentuate gasterointestinal complications and lead to more nonadherence to treatment. This randomized clinical trial was conducted to compare the effect of pamidronate versus alendronate on early bone mineral density changes in kidney transplant patients. Forty patients (27 men and 13 women), aged from 20 to 58 years, with low bone mineral density (T score < -2) in the spine, total hip, or femur neck were enrolled. Participants were randomly allocated into 2 groups to receive pamidronate or alendronate. The pamidronate group received intravenous pamidronate, 90 mg, starting from the 3rd week of transplantation for 3 months. The alendronate group started to receive oral alendronate, 70 mg per week for the same period. At baseline and 6 months, bone mineral density was measured by dual-energy x-ray absorptiom...

Research paper thumbnail of Renal protective effect of selenium on cisplatin-induced nephrotoxicity

Journal of renal injury prevention, 2012

Selenium supplementation reduces the products of oxidative stress in kidney failure patients and ... more Selenium supplementation reduces the products of oxidative stress in kidney failure patients and can be protective against cisplatin nephrotoxicity.

Research paper thumbnail of The effect of pentoxifylline on reduction of proteinuria among patients with type 2 diabetes under blockade of angiotensin system: a double blind and randomized clinical trial

Nefrología : publicación oficial de la Sociedad Española Nefrologia, 2012

Although blockade of renin-angiotensin system have been cited as the first line of therapy for th... more Although blockade of renin-angiotensin system have been cited as the first line of therapy for the management of diabetic nephropathy (DN), however in a substantial number of patients, progression of renal disease are not completely halted by these agents. We have conducted a double blinded clinical trial to assess the additive effect of pentoxifylline on reduction of proteinuria among patients with type 2 DM under blockade of angiotensin system. The dosage of PTX used in our trial was at a low dosage of 400mg daily and to our knowledge, we did not found article which evaluated the antiproteinuric effect of pentoxifylline in this dosage. One hundred patients with DN and persistent proteinuria despite treatment with losartan and enalapril in at least 3 months before inclusion in the study were randomly assigned to two groups. Control group (n=50, 26 males and 24 females) received losartan and enalapril, while treatment group (PTX Group) (n=50, 28 males and 22 females) was given losar...

Research paper thumbnail of Does erythropoietin slow progression of chronic kidney disease?

Journal of renal injury prevention, 2013

The initiation of erythropoietin therapy for the purpose of renoprotection may need to be sooner ... more The initiation of erythropoietin therapy for the purpose of renoprotection may need to be sooner than that for erythropoiesis, because erythropoietin may attenuate renal fibrosis through macrophage adjustment and endothelial cell protection by other uncertain mechanisms. Although, agents re-establishing the initial function of renal erythropoietin-producing cells could defer kidney fibrosis, however more studies should be carried out to determine the cellular target of erythropoietin in kidney and developinga new erythropoietin derivative for renal care.

Research paper thumbnail of Ticlopidine to prevent primary arteriovenous fistula failure in hemodialysis patients; a randomized controlled trial

Journal of renal injury prevention, 2013

arteriovenous fistula failure in hemodialysis patients; a randomized controlled trial.

Research paper thumbnail of Lipoprotein (a): More than a bystander in the etiology of hypertension? A study on essential hypertensive patients not yet on treatment

Journal of nephropathology, 2013

Hypertension (HTN) is a very common disorder with a substantial impact on public health because o... more Hypertension (HTN) is a very common disorder with a substantial impact on public health because of its complications. To study the association of serum lipoprotein(a) [Lp(a)] elevation with essential hypertension (eHTN). This study was conducted on a group of essential hypertensive patients. Laboratory exams consisting of serum creatinine and Lp(a) were measured. Ninety five essential hypertensive patients were enrolled to the study. Serum LP (a) in patients was 46.5±20. In patients an inverse correlation between serum Lp(a) andcreatinine clearance was seen (r = -0.175 p<0.05). There was a significant correlation between serum Lp(a) and age (r =0.191 p<0.05) or duration of HTN (known duration of hypertension period) (r =0.362 p<0.05). Our data suggest that Lp(a) may be involved as a cofactor in essential hypertension, with a mechanism that remains to be elucidated.

Research paper thumbnail of Protective effect of selenium on cisplatin induced nephrotoxicity: A double-blind controlled randomized clinical trial

Journal of nephropathology, 2013

Renal injury is common following cisplatin infusion. Some agents have been used to attenuate cisp... more Renal injury is common following cisplatin infusion. Some agents have been used to attenuate cisplatin nephrotoxicity. However, except hydration, none of them has been proved to be effective. In this study selenium as an antioxidant supplement was tested on cisplatin induced renal injury. 122 cancerous patients (85 male and 37 female; age range of 14 to 82 years old) were enrolled to receive chemotherapy regimens consisting cisplatin. They were allocated into two groups using a random number list . Investigators, patients and analyzers all, were blinded in allocation by using sealed opaque envelopes. Intervention group received a single 400 mcg selenium tablet and patients in control group took a placebo tablet which was similar with selenium preparation in color, weight, shape and taste. Primary end points were an increase in plasma creatinine above 1.5 mg/dl in men and 1.4mg/dl in women, or increase of plasma creatinine more than 50% from baseline or urine flow rate less than 0.5 ...

Research paper thumbnail of Comment on: The effects of Vitamin E and Selenium on cisplatin-induced nephrotoxicity in cancer patients treated with cisplatin-based chemotherapy: A randomized, placebo-controlled study

Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 2013

much attention has been made toward kidney protective efficiency of selenium. The results of the ... more much attention has been made toward kidney protective efficiency of selenium. The results of the study conducted by Randjelovic et al., showed selenium supplementation attenuates oxidative-stress-associated renal injury by reducing oxygen free radicals and lipid peroxidation in gentamicin-treated rats, [4] while gentamicin-renal damage in Wistar rats is a model of acute kidney injury indicated that gentamicin-induced tissue injury was mediated through oxidative reactions. [5-11] Selenium is a trace element that participates as a cofactor in several enzymes, one of them is participant in the regulation of enzymatic antioxidant defenses. [12] It was found that selenium supplementation in renal patients reduce the products of oxidative stress. [12-14] In a study by Taskin et al., on adriamycin-induced renal damage in rats showed selenium is effective in vivo against adriamycin-induced kidney injury via the restoration of total antioxidant and oxidant status, which prevented mitochondrial damage. [15] Recent findings have shown that plasma selenium level have been found to be reduced in patients with acute kidney injury. [16-18] indeed, low serum selenium levels are a frequent finding in patients with chronic renal failure too. [19-21] However, to date, few investigations have studied the association of hyposelenemia and morbidity and mortality in renal failure patients. Thus, these available data lend further evidence for the attribution of selenium in its kidney protective property. In this regard, to understand the selenium kidney protective properties better, more experimental rat models or clinical studies are suggested.

Research paper thumbnail of The protective effect of theophyline in cisplatin nephrotoxicity

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2014

Cisplatin is a potent and a major anti-neoplastic drug in the treatment of a broad spectrum of ma... more Cisplatin is a potent and a major anti-neoplastic drug in the treatment of a broad spectrum of malignancies. However, its clinical use is limited by renal tubular dysfunction that occurs in a significant percent of patients. The aim of the present study was to evaluate the possible protective effect of theophyline in the prevention of cisplatin-induced nephrotoxicity. The trial design was prospective, randomized, double-blinded and placebo controlled. Chemotherapeutic patients who received cisplatin at a dosage of at least 50 mg/m 2 alone or in combination with other chemotherapy agent(s) were included in the study. There were a total of 76 patients who were randomly divided into two groups. In group 1 (n = 38), placebo was advised; in group 2 (n = 38), patients received 4 mg/kg aminophyline as an intravenous loading dose, followed by theophyline in a dose of 200 mg three times daily orally for four consecutive days. The placebo group had 22 males and 16 females and the theophyline ...

Research paper thumbnail of The comparison of general health status between hemodialysis and kidney transplant patients in university hospitals of Ahvaz, Iran

Journal of renal injury prevention, 2014

Patients undergoing chronic hemodialysis and kidney transplant patients will be afflicted with va... more Patients undergoing chronic hemodialysis and kidney transplant patients will be afflicted with various mental and physical problems, which may affect their general health. Previous studies have shown that, general health level in these patients is lower than general population. However, definitive studies comparing the general health between the two groups of patients undergoing hemodialysis and kidney transplant recipients have not been done, yet. In this study, we aimed to compare the general health between the two groups of chronic hemodialysis patients and kidney transplant recipients. This investigation was a cross-sectional descriptive-analytic study that has been conducted on 31 hemodialysis and 33 kidney transplant patients in two university hospitals of Ahvaz, Iran. Data were collected through a general health questionnaire (GHQ-28) and they were analyzed with SPSS software. The mean score of general health was 28.8 and 27.57 in hemodialysis and kidney transplant patients, ...

Research paper thumbnail of Bacterial urinary tract infection in renal transplant recipients and their antibiotic resistance pattern: A four-year study

Iranian journal of microbiology, 2014

Urinary tract infections (UTIs) are the most common infections in renal transplant recipients and... more Urinary tract infections (UTIs) are the most common infections in renal transplant recipients and are considered a potential cause of bacteremia, sepsis, and affects graft outcomes. The aim of the present study was to determine the incidence of UTI among renal transplant recipients and investigation of antimicrobial susceptibility pattern of causative agents. In total, 1165 patients from March 2009 to December 2012, in transplant center of Golestan Hospital, Ahvaz, Iran, were investigated. Qualitative urine cultures were performed for all cases, causative microorganisms were identified and colony count was performed according to the standard protocol. Antibiotic susceptibility testing was then performed to determine the susceptibility pattern of recovered bacteria from confirmed UTIs. UTI was diagnosed in 391 patients(33.56%). Gram-negative bacteria were the most prevalent isolated microorganisms with E. coli (43.53%), followed by Enterobacter spp. (35.37%) as the major organisms. A...

Research paper thumbnail of اپیدمیولوژی بیماری مزمن کلیه در جهان و ایران‎