Background and Aims: Homocysteine is a sulphur amino acid derived from methionine. Epidemiological studies show an association between hyperhomocysteinemia and an increased cardiovascular risk, a fact that has also been confirmed in patients with chronic renal failure. This study, conducted in stage 5 chronic kidney disease patients, seeks to define the prevalence of hyperhomocysteinemia, evaluate the clearance of homocysteine with dialysis, and describe the frequency of the mutation in the mutilen-tetrahydrofolate reductase enzyme and its relationship with plasma levels of homocysteine.Methods: The reduced percentage of homocysteine and clearance of urea were analysed every six months for seven years in patients on dialysis. Urea and total homocysteine in plasma were measured in each of these studies and the type of dialyser - low or high permeability - used and the dialysis duration was determined.A molecular study of the gene coding for mutilen-tetrahydrofolate reductase enzyme was carried out in a group of patients and any C-T point mutation at position 677 of this gene was investigated. Mutation was described as not present, heterozygous for this mutation or homozygous for lactation.Results: Neither the average levels of homocysteine before and after dialysis or the reduction percentage of homocysteine varied with gender, although purification of urea was higher in women. Comparisons of homocysteine levels and percentage reduction in this ratio according to the ultra filtration of the dialyser used showed significant results. The molecular study of the gene in mutilen-tetrahydrofolate reductase enzyme showed that mutation was present in 54.8%: 45.2% with heterozygous polymorphism and 9.7% with homozygous.Conclusions: Patients undergoing HEMODIALYSIS were found to have higher levels of urea and its clearance was greater with the higher the ratio of ultra filtration dialyser. Mutation of the gene in mutilen-tetrahydrofolate reductase enzyme was similar in our patients compared to the general population and had no impact on plasma levels of homocysteine.

Background & Objectives: Depression is the most common psychological problem in patients with End-Stage Renal Disease (ESRD). The present study was conducted to determine the rate of depression in chronic HEMODIALYSIS (HO) patients.Methods: It was a descriptive cross-sectional study. 120 chronic HO patients who referred to dialysis ward of Shahid Beheshti Medical University (SBMU) hospitals were selected through an available (non-random) sampling and after exclusion of 20 patients due to study's exclusion criteria, all were assessed for depression, using Beck's Depression Inventory (BDI). Statistical analyses were preformed by SPSS (rel 11.5) using analysis of variance (ANOVA), independent t-test, Chi- Square and coefficient of correlation.Results: Totally, considering the intensity of depression, 69% of patients were in depression spectrum (BDI>9), but the rate of depression was 45% (BDI >15) among chomic HEMODIALYSIS patients. There was no significant difference between the intensity of depression and various parameters, but unemployment associated with higher rate of depression (p=0.018).Conclusion: It seems the screening of HD Patients with BDI followed by referring the depressed patients to a psychiatrist for more evaluation is necessary so that at least some of the suffering, morbidity and mortality of the patients will be diminished.  

Introduction: Uremic pruritus is one of the most common and debilitating complications of HEMODIALYSIS patients which affects 50 to 90 percent of them. Pruritus can lead to skin infections, scaling, anxiety, sleep disorders, social dysfunction and so on in patient. The aim of study was to evaluate the effect of HEMODIALYSIS with cold dialysis fluid on reducing the level of uremic pruritus in HEMODIALYSIS patients.Methods: This study was a pre and post-test double-blind clinical trial performed in summer 2012 in HEMODIALYSIS department of Fatemieh hospital, Semnan. Of all patients in the HEMODIALYSIS department, 35 people were eligible. To collect data, demographic questionnaire, medical records and itching scale were used. Patients were hemodialized three times per week and each session was four hours, for one month with standard HEMODIALYSIS(37oc) and then in the second month with cold HEMODIALYSIS(35oc). Data were analyzed by Paired t-test and Wilcoxon tests at a significant level of 5%.Results: The results showed that the mean and standard deviation of pruritus in standard and cool HEMODIALYSIS stage were 23.0±10.3 and 8.8±1.3, respectively. The data indicate that the patients' pruritus in the cold stage of HEMODIALYSIS was significantly reduced (P<0.001).Conclusion: Cold HEMODIALYSIS can relieve uremic pruritus among HEMODIALYSIS patients.

Introdution: Chronic kidney failure has a serious effect on the patients' quality of life. Nowadays, humans are not only inclined to live longer, but also they are demanding improvements in quality of life. it may be possible to improve the quality of life of those patients by low cost, easy and A little bit of a complication methods such as dialysis fluid cooling. Methods: This study was a clinical trial that randomized, crossover and double-blind. 42 HEMODIALYSIS patients were divided into two groups: 20 and 22 patients. Then, the first group received standard HEMODIALYSIS (37° c) for four weeks and simultaneously the second group received cold HEMODIALYSIS (35° c). In the second four weeks, the type of HEMODIALYSIS was changed. During this time, quality of life was assessed three times, before the study, after the completion of the first four weeks and second four weeks with using a short questionnaire of 36 quality of life questions (SF-36). For statistical analysis SPSS22 and Mann-Whitney and Friedman statistical tests were used at the significant level of P <0. 05. Results: The results showed that 45. 2% of the samples were male and 54. 8% were female. . After the first four weeks, the average quality of life in the cold and standard stage was 73. 45 and 44. 30, and after the second four weeks was 79. 83 and 48. 51, respectively. This means that cold HEMODIALYSIS significantly has improved quality of life based on health (P <0. 001). Conclusion: Cold HEMODIALYSIS can improve the quality of life based on health in HEMODIALYSIS patients.

Introduction: HEMODIALYSIS is the most common replacement therapy for patients with ESRD in Iran. By effective and adequate HEMODIALYSIS can improve life quality and reduced complications of renal failure, inadequate dialysis may lead to some irreversible consequences of uremia. Urea reducation ratio and Kt/v are methods for assessing of dialysis adequacy. Regular assessing of dialysis adequacy is necessary in a HEMODIALYSIS center is necessary but this procedure is not performed regularly in some centers.Objective: evaluation of HEMODIALYSIS adequacy on patients undergoing HEMODIALYSIS in Rasht.Materials and Methods: This is a cross sectional descriptive study. The number of cases was 139, who were selected base on their age, sex, time of dialysis onset, duration of each session and frequency of dialysis in week. They were tested twice, first; before starting the dialysis for BUN, Cr, Alb, Ca, P and Hb, then after ending, for BUN, Cr. The Kt/v was calculated by Daugirdas II formula. Data were analyzed with SPPS Ver10 statistical software and statistical test including c2, t-test and logistic regression. Results: In this study, the mean age of patients was 54.9±14.7 and 58.3% of patients were male. 69.8% of cases were being dialyzed 3 times a weak and mean duration of each session was 3.78±0.35.hr.73.9% of patients had Kt/v ratio greater than 1.2 and also 72.7% had URR greater than 65%.Dialysis in adequacy had significant relation- ship to hypoalbuminemia (p<0.001).Conclusion: Dialysis adequacy was lower in comparison with US studies but it is better than published papers in Iran, for example Kashan and Hamedan, next studies is necessary to improve dialysis adequacy and have better achievement.

Background: Blood-borne viral infection is a public health problem, especially in high-risk patients, including those with renal failure.Objectives: The aim of this study was to investigate the prevalence of humanimmunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections in patients undergoing HEMODIALYSIS.Methods: In this study, 94 patients were recruited and examined for HBV surface antigen (HBsAg), HCV antibodies (HCVAb), and HIV using ELISA assay. HCV positivity was confirmed via real-time polymerase chain reaction (RT-PCR). The patients were followed-up by testing their blood samples for HBsAg, HCVAb, and HIV on a monthly basis.Results: At the beginning of the study, 3 out of 94 (3.2%) patients were HBsAg positive. In addition, 4 out of 94 (4.3%) patients were HCVAb positive; HCV-positive patients were confirmed via RT-PCR. In addition, three new samples (2 males and 1 female) became HCVAb positive during the follow up. New cases of infection might be associated with exposure to inadequately sterilized dialysis.All the recruited patients were negative for HIV throughout the study.Conclusions: The prevalence of HBsAg and HCV positivity in subjects undergoing HEMODIALYSIS was comparable to most neighboring countries. Strict infection control measures should be taken to prevent infection transmission.