Mohammad Fathi; Nilofar Massoudi; Amirhesam Alirezaei; Mahmood Bakhtiyari
Volume 20, Issue 10 , 2018, Pages 1-8
Abstract
Background: Metabolic acidosis following kidney transplantation can lead to several undesirable effects such as disturbing the protein balance resulting in a negative nitrogen equilibrium, increased protein degradation, and essential amino acid oxidation. Objectives: The current study aimed tocompare ...
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Background: Metabolic acidosis following kidney transplantation can lead to several undesirable effects such as disturbing the protein balance resulting in a negative nitrogen equilibrium, increased protein degradation, and essential amino acid oxidation. Objectives: The current study aimed tocompare the effect of normal saline as a common crystalloid in kidney transplant surgery to reduce the risk of hyperkalemia and sodium bicarbonate on the metabolic acidosis rate after renal transplantation. Methods: A total of 40 patients with end-stage renal disease (ESRD) and candidates receiving renal transplant from a living donor referring to the kidney transplantation department of a University affiliated hospital, Tehran, Iran, that meeting the inclusion cri- teria of this study, were randomly assigned to the intervention group, who were treated with sodium bicarbonate, and the control group, who were treated with normal saline. The primary outcomes measured in this study were acidosis biomarkers including BE, HCO3, PaCO2, and PH and the secondary outcomes included some inflammatory biomarkers and some renal function biomarkers.Results: The mean ± standard deviation of age in the intervention and control groups was 44.4 ± 12.4 and 40.0 ± 13.0, respectively (P = 0.01). A total of 29 of the participants were male (14 in the intervention group and 15 in the control group), and 11 of them (six in the intervention group and five in the control group) were female. The mean ± standard deviation of change in the concentration of PH, BE, HCO3, and PaCO2 in the intervention and control groups was 0.01 ± 0.1 and -0.08 ± 0.1 (P < 0.001); 0.61 ± 4.2 and -3.8 ± 2.6 (P < 0.001); 0.36 ± 2.9 and -2.67 ± 2.1 (P: 0.001); and 0.8 ± 5.4 and 1.4 ± 5.3 (P: 0.799), respectively. Conclusions: The present study revealed that the patients who received sodium bicarbonate had a better status than the normal saline recipients in terms of the maintenance of acid-base homeostasis, inflammatory indexes, and renal function.
Nasser Malekpour Alamdari; Nilofar Massoudi; Hamed Asgarpour
Volume 19, Issue 6 , June 2017, , Pages 1-4
Abstract
Introduction: Splenic artery aneurysms are the most common visceral arterial aneurysm formations, as well as the 3rd frequent abdominal aneurysm. Most of them are asymptomatic until rupture and are ascertained unintentionally, usually after an imaging study. Open surgery is the elective therapy for ...
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Introduction: Splenic artery aneurysms are the most common visceral arterial aneurysm formations, as well as the 3rd frequent abdominal aneurysm. Most of them are asymptomatic until rupture and are ascertained unintentionally, usually after an imaging study. Open surgery is the elective therapy for splenic artery aneurysm, but has the disadvantages of severe surgical injuries including high rates of mortality and high risk complications.Case Presentation: In this case report, we present a 44-year-old woman with right upper quadrant abdominal pain diagnosed as Splenic artery aneurysms. This pain was first vague and gradually caused more discomfort and, occasionally, caused a sharp pain with radiation to the back that had no relation with food or position aneurysms.Conclusions: Selection of a suitable super-stiff guide wire during the procedure to provide sufficient support and decrease the difficulties related to stent graft delivery and release seems to be necessary. Nowadays endovascular modality for the treatment of splenic artery aneurysm is recognized and in selected patients can be done with fewer complications and good results.
Majid Aliasgari; Amir Hesam Alirezaei; Nilofar Massoudi; Farid Dadkhah; Syd Ahmad Tara; Mohammad Fathi
Volume 19, Issue 3 , March 2017, , Pages 1-4
Abstract
Heart failure is common in patients with chronic renal disease, either as a complication of renal failure or from shared risk factors, or is the major cause of death in patients on dialysis. At present, end stage renal disease (ESRD) patients who have systolic heart failure are considered high-risk for ...
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Heart failure is common in patients with chronic renal disease, either as a complication of renal failure or from shared risk factors, or is the major cause of death in patients on dialysis. At present, end stage renal disease (ESRD) patients who have systolic heart failure are considered high-risk for surgery; and nephrologists and cardiologists are reluctant to refer these patients for kidney transplant evaluation. It is unclear whether such patients should be accepted and waitlisted for transplantation. seven cases with end stage renal disease (ESRD) and severe heart failure with ejection fraction (EF) of less than 20% and newyork class 3 - 4, despite being on optimal treatment, who underwent renal transplant from nonrelative living donor at Shahid Moddaress hospital in Tehran, Iran during the July 2013 to December 2015, were retrospectively collected and analysed. The mean ± SD of patient’s age was 32.7 ± 16 years, and about 72% of them were female. The left ventricle ejection fraction increased by 35% on an average after the renal transplantation. Renal transplantation significantly improved the LV systolic function and ejection fraction status and subsequently decreased the need for medical treatment and heart transplantation.
