Masoud Khosravi

Chronic kidney disease (CKD) is closely associated with systemic inflammation. This randomized controlled trial aimed to evaluate the effects of omega‐3 fatty acids supplementation on inflammatory markers in patients with CKD undergoing hemodialysis. Eligible participants with CKD receiving hemodialysis were randomly assigned to either an intervention group or a control group. The intervention group received three capsules of omega‐3 fatty acids (3 g/day) for two months, while the control group received placebo capsules containing medium‐chain triglyceride (MCT) oil. Inflammatory markers, including C‐reactive protein (CRP) and interleukin‐6 (IL‐6), were measured both before and after the interventions. The results showed that CRP levels increased from 9.86 ± 12.64 to 11.46 ± 22.23 mg/L in the intervention group and from 5.24 ± 9.01 to 5.61 ± 7.93 mg/L in the control group ( p = 0.11). Similarly, IL‐6 levels increased from 17.84 ± 14.08 to 81.82 ± 66.22 pg/mL in the intervention group and from 14.96 ± 18.41 to 56.73 ± 115.45 pg/mL in the control group ( p = 0.53). No statistically significant group differences were observed after adjusting for confounders such as age, sex, body mass index (BMI), smoking, dietary intake, and pre‐existing diseases. The study findings showed that a two‐month intake of omega‐3 fatty acids supplements did not have a significant impact on reducing the levels of inflammatory markers in CKD patients undergoing hemodialysis. Larger trials with longer durations are warranted. Study Highlights: What is the Current Knowledge on the Topic? Omega‐3 fatty acids have anti‐inflammatory properties and are reported to be potentially beneficial in reducing inflammation associated with CKD, but the evidence regarding the effectiveness of omega‐3 supplements in reducing inflammatory markers in this population remains inconsistent. What Question did this Study Address? What is the effect of omega‐3 fatty acids supplementation for 2 months on CRP and IL‐6 levels in patients with CKD undergoing hemodialysis? What Does This Study Add to Our Knowledge? Contrary to previous studies, this study found that omega‐3 fatty acids supplementation did not significantly reduce CRP or IL‐6 levels compared with placebo over 2 months and that short‐term supplementation is not sufficient to reduce systemic inflammation in hemodialysis patients. How Might this Change Clinical Pharmacology or Translational Science? These findings suggest that short‐term omega‐3 fatty acids supplementation may not be sufficient in reducing inflammatory markers in CKD patients undergoing hemodialysis and highlight the need for larger‐scale clinical trials with different doses and longer durations to investigate nutritional or pharmacological strategies.

Background: Recent studies reported that omega-3 fatty acids may improve renal function in patients with chronic kidney disease (CKD). The aim of the present study was to assess the effect of omega-3 supplements on renal function indices in patients with CKD undergoing hemodialysis. Methods: This randomized controlled clinical trial was carried out on 120 CKD patients who were undergoing hemodialysis treatment in Rasht, Iran. The intervention group (n = 60) received 3 capsules of 1000 mg omega-3 fatty acid supplement capsules daily for 2 months. The control group (n = 60) received 3 placebo capsules containing 1000 mg of MCT. Renal function indicators included blood urea nitrogen (BUN), creatinine (Cr), sodium (Na), potassium (K), calcium (Ca), and phosphorus (P) were measured at baseline and after the intervention. Results: Omega-3 supplementation significantly improved BUN (68.26 ± 2.97 to 56.59 ± 2.14, P = .03) and Cr levels (8.94 ± 0.29 to 7.58 ± 0.41, P < .01) after adjustment for age, gender, body mass index (BMI), smoking, diet, and underlying diseases including diabetes and hypertension. However, no significant effect was found on serum levels of Na, K, Ca, and P. Conclusion: According to the present study, giving omega-3 supplementation to patients with CKD undergoing HD may enhanced their renal function. Additional research is required to verify these results.

Simultaneous electrochemical early detection of miRNAs for kidney transplant graft nephropathy.

Chronic kidney disease (CKD), characterized by progressive kidney failure, significantly increases mortality and comorbidity risks such as anemia. This study contrasts the impacts of omega-3 and medium-chain triglycerides (MCT) oil on levels of iron, ferritin, total iron-binding capacity (TIBC), hemoglobin (Hb), and transferrin saturation in patients with CKD undergoing dialysis. This interventional trial was conducted on 120 patients with CKD undergoing dialysis in Rasht, Iran. For 8 weeks, the omega-3 group was orally administered three 1000-mg capsules of omega-3 fatty acid supplement, and the MCT group was administered three 1000-mg capsules containing MCT oil daily. Serum concentrations of ferritin, iron, TIBC, Hb, and transferrin saturation were assessed pre-intervention and after the intervention. There was a significant increase in serum iron levels in the MCT group compared to the omega-3 group (103.72 ± 57.8 vs. 77.48±40.13; P = 0.031). No effect was found regarding other iron-related factors such as TIBC, Hb, transferrin saturation, and ferritin levels. The results of our study indicated that taking MCT oil increased serum iron levels compared to omega-3 supplementation in patients with CKD undergoing dialysis. Further research is needed to better understand the potential benefits of MCT oils in patients with CKD.

Background: Patients undergoing hemodialysis (HD) frequently experience the chronic kidney disease-associated pruritus (CKD-aP).Objective: The aim of this study was to investigate the effectiveness of omega-3 supplementation in the management of CKD-aP in patients undergoing hemodialysis.Methods: In this triple blind, randomized clinical trial, the effect of the omega-3 supplement on uremic CKD-aP was assessed in 112 chronic hemodialysis patients at Caspian Hemodialysis Center in Rasht, Iran. Patients were randomly divided into the intervention group receiving omega-3 supplements (3 g/day) and the control group receiving placebo containing MCT oil for 2 months.Results: Omega-3 supplementation had no effect on CKD-aP. The results did not change after adjusting for age and sex, additional adjustments for weight, height, physical activity, smoking, and alcohol use, additional adjustments for underlying diseases and weight, height, physical activity, smoking, and drinking alcohol, and further adjustments for underlying diseases and biochemical indices.Discussion: Omega-3 supplementation for 2 months had no effect on CKD-aP in patients with CKD. Further studies with longer duration are warranted.Clinical Trial Registration: https://www.irct.ir/trial/66638, IRCT20151226025699N6

Introduction: There are possible adverse effects and pathological disorders that can occur after kidney transplantation. The prevalence of these outcomes in kidney transplant patients is different worldwide. Objectives: In this study, we decided to take a general look at the prevalence of pathological disorders in kidney transplant patients undergoing biopsy. Patients and Methods: This cross-sectional study was conducted on 206 kidney transplant recipients who underwent biopsy of transplanted kidney at Razi medical education center in Rasht city between 2008 and 2019. Information was collected from medical records and interviewing patients. The data were analyzed using SPSS software version 26. They were summarized as the mean (SD) or as median (IQR). The frequency distribution (percentage) was conducted to describe the qualitative variables. Results: Out of 206 patients, 143 (69.4%) were male and the mean age at transplantation was 46.7±13.6 years. About 42.72% were non-relative donors, 47.57% were brain dead donors and 9.71% were family donors. The most common pathological disorder was nephrotoxic caused by calcineurin inhibitors (CNIs) (41.75%) and the most common type of graft rejection was antibody-dependent graft rejection (46.12%). In terms of transplant outcome, 35.92% of the patients suffered transplant rejection and 23.3% of them died. The results of this study did not show a significant relationship between the administration of immunosuppressive drugs and the pathological disorders. Conclusion: The present study showed that the most common pathological disorder in kidney transplant patients was CNIs nephrotoxicity, and the most common type of transplant rejection was antibody-dependent transplant rejection.

Introduction: Coronavirus disease 2019 (COVID-19), a novel disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to millions of deaths worldwide. Kidney transplant recipients (KTRs) are a fragile population due to their immunosuppressed status. However, there are limited studies available comparing this population with the general population regarding clinical symptoms, and laboratory and imaging features as well as disease severity and clinical outcomes. Methods: A total of 24 KTRs and 40 patients from the general population (control group) were enrolled after applying exclusion criteria. Clinical symptoms, laboratory values, and lung involvement patterns in high-resolution computed tomography (HRCT) were compared between KTRs with COVID-19 and their counterparts from the general population. Moreover, the category of disease severity and adverse outcomes such as intensive care unit (ICU) admission, mechanical ventilation (MV), and mortality rate were also compared between these two groups. Results: Hypertension was significantly higher among KTRs. Dyspnea was significantly more among the control group (P = 0.045). There was no significant difference in the rest of clinical symptoms (P > 0.05). There was no significant difference in CT features as well, except pleural effusion, which was more prevalent in the control group. A lower absolute lymphocytic count (ALC) and platelet count were observed in KTRs. Renal transplant recipients (RTRs) had a higher elevation in creatinine level than their counterparts. The ICU admission, MV, duration of hospital stay, and mortality as adverse outcomes were not significantly different between the KTR and control groups. Conclusion: In conclusion, there was no significant difference in the severity and risk of adverse outcomes, including MV, ICU admission, and mortality between KTRs under chronic immunosuppression and the control group.

Introduction. Fibroblast growth factor-23 (FGF23) is responsible for regulating the metabolism of phosphorus and vitamin D by affecting the kidneys and parathyroid gland. Phosphate is present in the 2, 3-diphosphoglycerate (2,3DPG) ester composition, which can shift the O2-Hb dissociation curve to the right. Therefore, we hypothesized that maybe there is an association between red cell distribution width (RDW) and FGF23 level. The aim of this study was to investigate the relationship between iFGF23 and RDW in patients with end-stage renal disease undergoing hemodialysis. Methods. This cross-sectional study was performed on 254 end stage renal diseases (ESRD) patients undergoing hemodialysis who were admitted to Rasht Razi Hospital Hemodialysis Center, in 2017. We used Shapiro-Wilk, Spearman correlation coefficient, Mann- Whitney U-test, and Multiple Linear Regression Analysis. All statistical analyses were performed by SPSS software. Results. The median age of patients was 60 years (IQR: 49 to 69). The mean and median iFGF23 concentration in patients were 59.5 +/- 14.6 and 62 (IQR: 49 to 69) pg/mL, respectively. According to spearman test, iFGF23 had a statistically significant association with age (r = 0.856, P < 0.001), MCV (r = 0.202, P < .001), phosphorus (r =-0.176, P < .05), weight difference before and after dialysis (r =-0.264, P < .05), and Vitamin D (r =-0.201, P < .05). Also in multiple linear regression analysis, the variables of RDW, IDWG, iPTH, MCH, DM, HTN, Age, and CRP were considered as predictors of iFGF23 . Conclusion. RDW was identified as one of the predictors of iFGF23 changes. Perhaps in the future, more value will be given to the role of RDW in dialysis patients.