INTRODUCTION: Herbal medicines are traditionally prescribed to manage blood pressure. OBJECTIVES: We aimed to evaluate effect of sour tea pill containing the herb's extract versus captopril on the treatment of hypertension. PATIENTS AND METHODS: In our crossover clinical trial 20 patients were enrolled in the study and advised for life style modification then the participants were randomly divided into 2 groups. Sour tea pills was prescribed at a dose of 500 mg and captopril at a dose of 12.5 mg twice daily. In order to improve precision and final measurement, ambulatory blood pressure monitoring (ABPM) was performed both prior and after measuring the hypertension in 2 successive visits. After 6 weeks of therapy, the methods changed and 6 weeks later ABPM was performed three times (baseline, at end of the 6th and 12th week). The 2 groups were merged together before data analysis. RESULTS: Of the 20 patients, 13 (65%) were male and 7 (35%) were female. No significant difference of sex, age, and job was detected between 2 groups (P ≥ 0.05). Mean decreasing in systolic blood pressure was 7.75 ± 8.3 and 13.3 ± 16.1 mm Hg in the captopril and sour tea groups, respectively. Also, mean decline in diastolic blood pressure decreases was 2.15 ± 4.14 and 5.8 ± 7.8 mm Hg for captopril and sour tea groups, respectively. No side effect was observed in the sour tea pill group in the study. CONCLUSION: According to the effect of sour tea pill on decreasing blood pressure, without giving priority over captopril, sour tea pill containing the herb's extract can be prescribed as an adjuvant therapy for lowering the prescribed dosage of captopril.
CONTEXT: The occurrence of intradialytic hypotension (IDH) during hemodialysis (HD) continues to be a main problem in patients with ESRD (end-stage kidney disease). It also negatively affects health-related quality of life. We aimed to determine vasopressin effect in decreasing IDH. EVIDENCE ACQUISITION: We reviewed clinical and experimental literature in a variety of sources, including PubMed, Current Content, Scopus, Embase, and Iranmedex regarding the possible effect of vasopressin administration in prevention of hypotension during HD to clarify its mechanism, efficacy, and safety. RESULTS: Although arginine vasopressin is widely recognized for its anti-diuretic properties, it is also a well-recognized vasoconstrictor. It has been shown that the vasopressin release (as it would normally be expected) does not increase in the majority of HD patients with recurrent dialysis hypotension. In addition, it has also been reported that vasopressin secretion (due to the osmotic stimulation) is the most important mechanism in blood pressure control in ESRD patients receiving hypertonic solution for IDH. Therefore, it is suggested that vasopressin administration may improve hemodynamic stability among ESRD patients during HD. There are few clinical trials about this issue, suggesting that administration of exogenous vasopressin may be significantly associated with a decreased incidence of IDH as well as cardiovascular stability in ESRD patients in need of volume removal during HD. CONCLUSIONS: Vasopressin insufficiency may have an important role in the pathogenesis of hemodynamic instability during HD and administration of exogenous vasopressin is significantly associated with a lower incidence of IDH.
BACKGROUND: Hemodialysis is the most common method of renal replacement therapy for treatment of acute and chronic kidney failure. Helicobacter pylori (H. pylori) plays a major role in development of peptic ulcer, gastric neoplasms, and lymphoma as well as increased risk of cardiovascular disorders in hemodialysis patients. OBJECTIVES: In this study the diagnostic values of noninvasive tests [i.e. urea breath test (UBT), helicobacter pylori stool antigen test (HPSA) and serology] in diagnosis of H. pylori infection in hemodialysis patients have been studied. PATIENTS AND METHODS: All patients undergoing hemodialysis in Fatemieh Hospital, Semnan, Iran, were enrolled in the study, and their H. pylori status were assessed by using non-invasive tests including UBT, HPSA and serology. Patients with at least two out of 3 positive tests were considered infected with H. pylori. RESULTS: The sensitivity, specificity, and positive and negative predictive values of the tests used in diagnosing H. pylori infection were 62.5%, 65.4%, 62.5% and 65.4% for UBT, 100%, 72.2%, 58.3% and 100% for serology, and 100%, 75%, 60.9% and 100% for fecal antigen test, respectively. CONCLUSIONS: This study showed that H. pylori serology and stool antigen tests have higher diagnostic values than UBT, and they are more reliable than UBT in diagnosis of H. pylori infection in hemodialysis patients.
Chronic kidney disease (CKD) is a worldwide health problem. However, despite to new routes of dialysis, mortality and morbidity is high. One of the most common symptom of CKD is anemia, especially is more obvious in stages 3 and 4. In this review, we compared the effects of erythropoietin and anemia correction on kidney function (GFR) by investigating in various studies. Despite extensive studies in this category, still we do not sure about the effects of erythropoietin and anemia correction on the glomerular filtration rate.
BACKGROUND: There is a limited knowledge about the morphological features of IgA nephropathy (IgAN)in the middle east region. OBJECTIVES: The objective of this study was to evaluate the spectrum of histopathological findings in IgAN patients at our laboratory. PATIENTS AND METHODS: At this work, an observational study reported which was conducted on IgAN patients using the Oxford-MEST classification system. RESULTS: In this survey, of 102 patients 71.6 % were male. The mean age of the patients was 37.7 ± 13.6 years. Morphologic variables of MEST classification was as follows; M1: 90.2 %, E: 32 %, S: 67 % also,T in grads I and II were in 30% and 19% respectively, while 51% were in grade zero. A significant difference was observed in segmental glomerulosclerosis (P=0.003) and interstitial fibrosis/tubular atrophy frequency distribution (P= 0.045), between males and females . Furthermore, it was found that mesangial hypercellularity was more prevalent in yonger patients. Moreover, there was a significant correlation between serum creatinine and crescents (P<0.001). There was also significant correlation of serum creatinine with segmental glomerulosclerosis (P<0.001). CONCLUSIONS: Higher prevalence of segmental glomerulosclerosis and interstitial fibrosis/ tubular atrophy, as the two of, four variables of Oxford-MEST classification of IgAN in male patients further attests that male gender is a risk factor in this disease.In this study the significant correlation between serum creatinine and crescent was in an agreement with previous studies and suggests for the probable accomodation of extracapillary proliferation as a new variable in MEST system.
INTRODUCTION: Hyperhomocysteinemia is common in patients with end-stage renal disease. It is one of the risk factors for cardiovascular disease. We evaluated the effect of different doses of folic acid on serum homocysteine level in patients on hemodialysis. MATERIALS AND METHODS: Patients on maintenance hemodialysis were randomized into 4 groups to receive oral folic acid at doses of 2, 5, 10, and 15 mg/d, each for a period of 4 weeks. Serum homocysteine level was measured in all of the patients before and at the end of each week of therapy. Folic acid supplementation was discontinued during a washout period of 1 week between each of the four phases of the trial. RESULTS: Thirty-one hemodialysis patients completed the four phases of treatment with each dose of folic acid (17 women and 14 men). The mean age of patients was 57.6 ± 14.6 years. Serum homocysteine level was reduced significantly compared to its basal level after treatment with folic acid at different doses (P < .001). Different doses of folic acid were not significantly different in lowering serum homocysteine levels. CONCLUSIONS: Our study failed to show any difference between high-dose and low-dose folic acid therapy regarding their effect on serum homocysteine level. It seems folic acid, 2 mg/d, is an adequate dose, and there is no need to administer a higher dose of it.
Folic Acid/administration & dosage , Homocysteine/blood , Kidney Failure, Chronic/therapy , Aged , Aged, 80 and over , Cross-Over Studies , Female , Folic Acid/therapeutic use , Humans , Hyperhomocysteinemia/prevention & control , Kidney Failure, Chronic/blood , Male , Middle Aged , Renal Dialysis
