Association of elevated frequency of micronuclei in peripheral blood lymphocytes of type 2 diabetes patients with nephropathy complications.

The increasing incidence of type 2 diabetes mellitus globally has increased the incidence of diabetes-associated complications such as nephropathy. DNA damage induced by oxidative stress might be one of the important mechanisms in the pathogenesis of diabetic complications. Two hundred Iranian individuals with the conditions of type 2 diabetes, diabetic nephropathy and nephropathy patients with no sign of diabetes and normal unaffected sex- and age-matched controls (50 in each group) were enrolled in the study. The background and the net levels of micronucleus (MN) formation as well as other cellular damages induced after in vitro treatment with 25 µg/ml of bleomycin (BLM) were evaluated using cytokinesis block MNs cytome assay (CBMN cyt) in peripheral blood lymphocytes. The background and net BLM-induced levels of MNs were significantly higher in all patient groups compared with the control (P < 0.01, P < 0.001, respectively). The frequency of MNs was significantly higher in those patients with prior incidence of nephropathy than those without. A positive association was observed between basal and net MN frequency among study groups and also between net genetic damages and serum creatinine value and duration of diabetes. The rate of basal and net apoptosis was significantly higher in patients with hyperglycemia. Our results indicate that increased genomic instability expressed as MNs is associated with nephropathy in all pathological stages. Therefore, implementation of MN assay in clinical level may potentially enhance the quality of management of patients with diabetes and its complications such as nephropathy.

Dietary and fluid compliance: an educational intervention for patients having haemodialysis.

AIM: This paper is a report of a study conducted to determine the effect of an educational intervention on dietary and fluid compliance in patients having haemodialysis. BACKGROUND: Many of the clinical problems experienced by patients having haemodialysis are related to their failure to eat appropriate foods and restrict their fluid intake. Educational intervention in patients having haemodialysis to improve their compliance with dietary and fluid restrictions appears to be effective. METHODS: Sixty-three patients having haemodialysis in three general hospitals in Tehran, Iran, were allocated into two groups at random for oral and/or video education. They were asked to give demographic and medical data. Bimonthly average values of serum potassium, sodium, calcium, phosphate, albumin, creatinine, uric acid, and blood urea nitrogen and interdialytic weight gain were measured before and after the teaching programmes. The data were collected in 2007. FINDINGS: Compliance in terms of biochemical parameters and interdialytic weight gain was observed in 63.5% and 76.2% of patients in the oral and video teaching groups respectively. Statistically significant correlations were observed between demographic variables (age, educational level and occupation) and dietary and fluid compliances (P < 0.001). There was no difference between the effectiveness of two educational interventions. CONCLUSION: Nurses should emphasize sodium compliance in patients having haemodialysis and explain its adverse effects, such as excessive weight gain, hypertension, and peripheral oedema.