Background: Patients with chronic kidney disease have multiple alterations of thyroid hormone metabolism in the absence of concurrent thyroid disease. These may include elevated basal TSH values, which may transiently increase to greater than 10 mU/liter, blunted TSH response to TRH, diminished or absent TSH diurnal rhythm, altered TSH glycosylation, and impaired TSH and TRH clearance rates. In addition, serum total and free T3 and T4 values may be reduced, free rT3 levels are elevated while total values are normal, serum binding protein concentrations may be altered, and disease-specific inhibitors reduce serum T4 binding .
Objective:. To assess the prevalence of hypothyroidism and u/s abnormalities of thyroid gland in patients with chronic kidney disease at different levels of estimated glomerular filtration rate (eGFR) and their association with age , sex and duration of chronic renal failure . cross sectional study.
Patients and Method: a cross sectional study total of 50 patients who seek medical advice in Baghdad teaching hospital (29 male , 21 female) , the mean of their age was 60, with established chronic kidney disease were categorized into five groups according to the stages of chronic kidney disease . Full clinical, biochemical ( includes blood urea , serum creatinine , total T3, total T4 , TSH ) , thyroid ultrasonography studies were performed to all patients in this study. Risk factors such as hypertension, diabetes mellitus, smoking and family history of CKD were also recorded. Type of treatment of CKD whether conservative or renal replacement therapy (in form of peritoneal or hemodialysis) were also.
Results:- From a total of 50 patients with chronic kidney disease (CKD ), eight patients had hypothyroidism (16 %) , three patients from stage 4 CKD and five patients from stage 5 CKD . Twelve patients from study sample had abnormalities in thyroid ultrasonography (24%) , one patient from stage 2 CKD , three patients from stage 3 CKD ,three patients from stage 4 CKD and five patients from stage 5 CKD . Thyroid ultrasound abnormalities includes six patients with simple goiter and six patients with multinodular goiter .From those eight patients with hypothyroidism , six patients were males (75%) and two patients were females (25%) .Regarding 12 patients with thyroid u/s abnormalities , five patients were male (41.6%) and seven patients were female (58.4%).Statistical analysis showed a significant association between drop in GFR and drop in thyroid function, from 13 patients in stage 4 CKD , three patients (23.07%) had hypothyroidism , and from 23 patients in stage 5 CKD , five patients (21.739%) had hypothyroidism .
Conclusion:- reduced glomerular filtration rate was associated with an increased prevalence of hypothyroidism, with many subclinical cases. Future studies are needed to determine the potential adverse effects of subclinical and clinical hypothyroidism in persons with chronic kidney disease.
Background: Chronic obstructive pulmonary disease (COPD) is a preventable disease with some significant extra pulmonary effects that may contribute to the severity in individual patients.. The systemic manifestations of COPD include a number of endocrine disorders , such as those involving the pituitary, the thyroid , the gonads, the adrenals and the pancreas. The mechanisms by which COPD alters endocrine function are incompletely understood but likely involve hypoxemia , hypercapnia , systemic inflammation and glucocorticoid administration.
Objective: To evaluate the relationship bet
... Show MoreThis study designed to examine association between-174G/C polymorphism of interleukin-6 gene and phosphate, calcium, vitamin D3, and parathyroid hormone levels in Iraqi patient with chronic kidney disease on maintenance hemodialysis. Seventy chronic renal failure patients (patients group) and 20 healthy subjects (control group) were genotyped for interleukin-6 polymorphism and genotyping was performed by conventional polymerase chain reaction-restriction fragment length polymorphism. No significant differences in phosphate levels were observed in patients and control with different interleukin-6 genotypes. Control had non-significant differences in calcium levels, while patients with GG and CG genotypes displayed significant e
... Show MoreBackground: Fibromyalgia has been associated with physical and emotional trauma including invasive medical procedures. Both Fibromyalgia and ischemic heart disease have been linked with depression. The aim of the study is to assess the prevalence of fibromyalgia syndrome in patients with ischemic heart disease.Patients and Methods: A cross-sectional comparative study was done in the Iraqi Center for Heart Disease. One hundred patients, angiographically proved to have ischemic heart disease, were subjected to rheumatologic examination by another physician, and compared to hundred healthy individuals as a control group. Diagnosis of fibromyalgia was based on 1990 American College of Rheumatology Classification criteria for the diagnosis of
... Show MoreChronic Kidney Disease (CKD) is a public health problem and many studies support the link between kidney dysfunction and cardiovascular events. Aldosterone has been shown for decades that a plasma aldosterone concentration is elevated in CKD. Whilst, Osteoprotegerin (OPG), after its capacity to protect bone, also osteoprotegerin is elevated in patients with chronic kidney disease (CKD), where it could predict the deterioration of kidney function, cardiovascular, vascular events and all-cause mortality. On the other hand, fibroblast growth factors (FGFs), in patients with CKD, its levels seem to increase progressively as kidney function worsens. The aim of the present study is to assess the correlations between serum osteoprotegerin
... Show MoreBackground: The etiology of ischemic heart disease (IHD) is believed to have an immunological component. Association with human leukocyte antigens (HLAs) has been previously reported, particularly with DR6.
Patients and methods: 75 cardiac patients were admitted to the coronary care unit, Baghdad Teaching Hospital over the period October 2008-May 2009 with the clinical diagnosis of acute
coronary syndrome and STEMI myocardial infarction their ages range was (25-82) years the number of male was (55) (73.3%) and female was (20) (26.7%). All cases have routine ECG, cardiac marker’s measurements, routine haematological, Biochemical test and 2mls of blood reserved for HLA study.
Results: It was found that H
Background: Heart failure is a complex clinical syndrome caused by any functional or structural cardiac disease that reduces the ventricle's ability to fill or pump blood. Anemia is frequent in patient with heart failure and is associated with deterioration through the activation of neuro-hormonal pathways. Dapagliflozin is a selective and reversible inhibitor of Sodium-glucose co-transporter-2 (SGLT2). Dapagliflozin increases hemoglobin level through different mechanisms such increasing plasma concentration by diuresis or increasing Erythropoietin synthesis.
Objective: To evaluate the effect of additional dapagliflozin into conventional therapy on hemoglobin in heart failure patients with chronic
... Show MoreFifty celiac disease (CD) patients (21 males and 29 females) with an age range of 2-35 years and 25 apparently healthy controls were investigated for 10 autoantibodies (anti-tissue transglutaminase IgA antibody; ATA, anti-tissue transglutaminase IgG antibody; ATG, anti-gliadine IgA antibody; AGA, anti-gliadine IgG antibody; AGG, anti-nuclear antibody; ANA, anti-double strand DNA antibody; AdsDNA, anti-thyroid peroxidase antibody; ATP, anti-phospholipid antibody; APP, anti-myeloperoxidase antibody; AMP and anti-proteinase 3 antibody; AP3) in their sera. Six autoantibodies (ATA, ATG, AGA, AGG, AMP and AP3) showed significant variations between CD patients and controls. The first four antibodies were not detected in sera of controls, while
... Show MoreThis study was done to find the potential renal protective effects of sildenafil and its underlying mechanisms in mice with adenine-induced CKD. For the experiment, 40 male mice were split into four groups. The control group (A) received the same food without medication until the research ends, while the other three collections (B, C, and D) were given adenine (0.25% w/w in feed daily for 8 weeks), groups (C and D) were given sildenafil (0.5 and 2.5 mg/kg) respectively orally every day for 30 days, and then blood samples were taken to assess the function of the kidneys (Urea, total protein, and creatinine), total antioxidant capacity (TAC), superoxide dismutase (SOD), and catalase (CAT) in addition to kidney histopathology, as w
... Show MoreBackground: Patients requiring renal biopsies have various glomerular diseases according to their demographic characteristics.
Objective: To study types of glomerular disease among adult Iraqi patients in a single center in Baghdad/Iraq
Material and Methods: A total of 120 native kidney biopsies were studied. All biopsies were adequate and were processed for Light Microscopy.
The age range of the study patients was 17-67 years, with a mean of 38.5 years. The mean follow up period was 28 weeks (4-52 weeks)
Indication for biopsy included: Nephrotic syndrome (N=72; 60%), Asymptomatic proteinuria (N=21; 17.5%), acute nephritic presentation (N=17; 14.16%), asymptomatic haematuria (N=10; 8.33%).
Results: Primary glomerulonephrit
Background: Although the issue of anemia after renal transplantation (RT) has received increasing attention lately, the data on the exact prevalence of post-transplantation anemia (PTA) in the Iraqi patients are limited.
Objective: In this study we sought to determine the prevalence of PTA among Iraqi patients and to correlate the renal allograft function measurements and the use of immunosuppressant with the prevalence of anemia.
Patients and Methods: One hundred and twelve (74 male, 38 female) kidney transplant recipients (KTR) attending the kidney transplant center at surgical specialties hospital were studied. All patients were on maintenance, combined immunosuppressive therapy. The renal function