Iranian Journal of Kidney Diseases
type: channel
description: The Iranian Journal of Kidney Diseases (IJKD), a peer-reviewed journal in English, is the official publication of the Iranian Society of Nephrology. The aim of the IJKD is the worldwide reflection of the knowledge produced by the scientists and clinicians in nephrology. It has been published quarterly since 2007 and every 2 months since January 2011. The IJKD provides a new platform for the advancement of the field. The journal’s objective is to serve as a focal point for debates and exchange of knowledge and experience among researchers in a global context. Original papers, case reports, and invited reviews on all aspects of kidney diseases, hypertension, dialysis, and transplantation will be covered by the IJKD. Research on the basic science, clinical practice, and socio-economics of renal health are all welcomed by the journal editors. Indexing/Abstracting. SCI Expanded, MEDLINE, EMBASE, Scopus, Cinahl, CAB International, Index Copernicus, Index Medicus for the WHO Eastern Mediterranean Region (IMEMR), Scientific Information Database (SID), and Google Scholar
publisher: Iranian Society of Nephrology
language: en
publication name: Iranian Journal of Kidney Diseases
issn: 1735-8582
items: Evaluation of the Performance of Biomarkers in Predicting Hemodialysis Patients Survival Using Time-Dependent ROC Curve
items: Machine Learning-Based Prediction of 30-Day Hospital Readmission in Patients with Chronic Kidney Disease: A Retrospective Cohort Study
items: Predictors of Kidney and Patient Survival in Monoclonal Gammopathy–Associated Kidney Disease: A Single-Center Cohort from Colombia
items: Years of Potential Life Lost (YPLL), the Key Metric in Strategic Planning for Chronic Kidney Disease Care
items: Muscle Mass Deficit Indexed to Body Surface Area Predicts Poor Physical Health and Quality of Life in Hemodialysis Patients
items: Genetic Associations Between Gastrointestinal Diseases and Chronic Kidney Disease: An Integrated Mendelian Randomization and Bioinformatics Analysis
items: Efficacy and Safety of Oral Antidiabetic Drugs in People with Diabetes and Chronic Kidney Disease: A Systematic Review
items: A Study on the Correlation between Metabolic Syndrome and Proteinuria in Chronic Kidney Disease
items: Bibliometric Analysis of Uremia Research: 2021–2025
items: Association Between Occult Kidney Disease and COVID-19 Mortality: Evidence from a Retrospective Study
items: Comparative Analysis of Quality of Life and Surgical Outcomes Following Laparoscopic Versus Open Living Donor Nephrectomy: A Randomized Clinical Trial
items: Non-Diabetic Kidney Disease Confirmed by Biopsy in Patients with Diabetes: A Single-Center Registry Report
items: The Association Between Serum Sodium Variation During Pediatric Intensive Care Unit Admission and the Risk of Clinical Outcomes in Critically Ill Children: A Retrospective Cohort Study
items: The Trend of Mortality Rate and Years of Life Lost Due to Kidney Failure in Fars Province, Iran, During the Years 2004-2019
items: Inflammatory Mediators in Kidney Disease: A Focus on IL-6in SLE-Associated CKD
items: Stepwise Interpretation of Albumin Fraction Abnormalities on Serum Protein Capillary Electrophoresis in Nephrotic Syndrome: A Case Series
items: The Sensitivity of Bioimpedance to Assess Leg Fluid Volume Changes in Children on Hemodialysis: Experimental and Model-Based Investigation
items: Genetically Confirmed Hyperoxaluria in Iranian Children- A Multicenter Survey
items: Predictors of Survival and Clinical Outcomes in Hemodialysis Patients: A 9-Year Multicenter Cohort Study
items: Post-Transplantation Hairy Cell Leukemia with Hemophagocytic Lymphohistiocytosis in an Adult Kidney Transplant Recipient: A Case of Rare Occurrence
items: A Rare Cause of Retroperitoneal Fibrosis in Adults: H Syndrome Presenting After 35 Years- A Case Report
items: Optimizing Pediatric Blood Pressure Readings: The Role of Timing and Medical Personnel Presence: A cross-sectional study
items: Examining the Association between Oxidative Stress Markers and the Severity of Symptoms in Individuals with COVID-19 and Healthy Individuals
items: Calf Bioimpedance Analysis: A Novel Approach for Evaluating Hydration Status in Pediatric Dialysis Patients Under High Dialysate Sodium
items: Protective Effect of Garlic on Diazinon Induced Kidney Toxicity in Rat: A Biochemical and Histopathological Evaluation
items: Incidence of Hospital-Acquired Hyponatremia and its Risk Factors in Hospitalized Children: A Longitudinal Study
items: Retrospective Analysis of Acute Kidney Injury in Hospitalizations with Covid-19
items: Efficacy of Sacubitril/Valsartan in Treating Hemodialysis Patients with Reduced Ejection Fraction Heart Failure: A Retrospective Study
items: Correlation of Left Atrial Volume Index with Estimated Glomerular Filtration Rate in Chronic Kidney Disease: A Cross-Sectional Echocardiographic Study
items: Psychological Burden of Chronic Kidney Disease Caregivers

Evaluation of the Performance of Biomarkers in Predicting Hemodialysis Patients Survival Using Time-Dependent ROC Curve
type: item
description: Introduction. End-stage kidney disease (ESKD) is a growing global public health problem, and patients undergoing hemodialysis (HD) experience a high mortality rate despite advances in medical care. Identifying reliable prognostic biomarkers is therefore essential. Regression-based survival models are widely used in HD studies; however, while they estimate associations, they do not directly quantify the predictive accuracy of biomarkers. This study aimed to evaluate the predictive performance of selected baseline biomarkers for survival in HD patients using the time-dependent receiver operating characteristic (ROC) curve. Methods. This retrospective cohort study included 2,192 ESKD patients undergoing maintenance HD in Fars province, Iran, between 2011 and 2020. Time-dependent area under the ROC curve (AUC) values were calculated to assess the prognostic performance of baseline biomarkers at 3, 12, 24, and 36 months after initiation of dialysis. Results. Age, serum albumin, creatinine, and calcium showed relatively better predictive performance for survival. For age, the AUCs at 3, 12, 24, and 36 months were 64.2, 57.1, 57.1, and 58.8, respectively, while corresponding values for serum albumin were 67.5, 62.3, 61.4, and 59.8. Serum albumin and calcium demonstrated higher discrimination for early survival, whereas serum creatinine showed more stable predictive performance over the follow-up period. The combined risk score outperformed individual biomarkers, with AUCs of 71.2, 63.9, 63.5, and 64.1 at 3, 12, 24, and 36 months, respectively. Conclusion. Time-dependent ROC analysis revealed time-varying prognostic performance of baseline biomarkers in HD patients and demonstrated improved discrimination when biomarkers were combined into a composite risk score.
subject: ORIGINAL | Dialysis
  topic: section
subject: Time-dependent ROC curve
  topic: keywords
subject: Survival
  topic: keywords
subject: Hemodialysis
  topic: keywords
subject: This study is conducted to evaluate the predictive performance of some baseline biomarkers in predicting the survival of HD patients using the time-dependent ROC curve.
  topic: subjects
subject:
  topic: disciplines
  value: In this retrospective cohort study, data of all patients undergoing maintenance HD who survived the initial 3 months on maintenance HD in centers affiliated with Shiraz University of Medical Sciences (SUMS), Fars Province, Iran, were used.
creator: Zahra Shayan
creator: Shahrokh Ezzatzadegan Jahromi
creator: Somayeh Abbasi
creator: Kamran Mehrabani-Zeinabad
creator: Farnaz Niroomand
rights: Copyright (c) 2026 Iranian Journal of Kidney Diseases
date: 2026-04-19
publication date: 2026-04-19
starting page: 97
ending page: 104
doi: 10.61882/ijkd.20.02.9299

Machine Learning-Based Prediction of 30-Day Hospital Readmission in Patients with Chronic Kidney Disease: A Retrospective Cohort Study
type: item
description: Introduction. Chronic Kidney Disease (CKD) is associated with high 30-day hospital readmission rates due to progressive renal dysfunction, multiple comorbidities, and complications related to dialysis and catheter use. Artificial Intelligence (AI) and Machine Learning (ML) offer promising tools for early identification of high-risk patients. To develop and evaluate ML models for predicting 30-day hospital readmission among CKD patients and identify key clinical and laboratory predictors related to readmission risk. Methods. This retrospective study analyzed 277 hospitalized patients with CKD at Hasheminejad Kidney Center (2019–2022). Forty-four demographic, clinical, and laboratory features were included. Preprocessing included handling missing data, normalization, outlier removal, categorical encoding, and oversampling. Six ML models, including eXtreme Gradient Boosting (XGBoost), Random Forest, Decision Tree, AdaBoost, Multilayer Perceptron (MLP), and Logistic Regression, were trained using a 70/30 train-test split with cross-validation. Feature selection employed SHAP values, mutual information, F-values, SVM, and chi-squared tests. Results. XGBoost outperformed other models (accuracy > 90%). The strongest predictors were estimated Glomerular Filtration Rate (eGFR), Blood Urea Nitrogen (BUN) and creatinine levels, age, presence of diabetes mellitus and hypertension, catheter-related infection, and triglycerides, intact Parathyroid hormone (iPTH), and albumin levels. Catheter infection emerged as a modifiable, high-impact predictor. The SHAP values analysis confirmed strong contributions of kidney function markers, inflammatory indicators, and metabolic variables to re-admission risk. Conclusion. ML-based prediction models, particularly XGBoost, demonstrated high accuracy in identifying CKD patients at risk of 30-day readmission. Integration of these models into clinical workflows may improve early intervention, reduce hospital readmissions, and support evidence-b…
subject: ORIGINAL | Kidney Diseases
  topic: section
subject: hronic kidney disease
  topic: keywords
subject: Hospital readmission
  topic: keywords
subject: Machine learning
  topic: keywords
subject: XGBoost
  topic: keywords
subject: Predictive modeling
  topic: keywords
subject: Nephrology
  topic: keywords
subject: Catheter infection
  topic: keywords
subject: eGFR
  topic: keywords
subject: chronic kidney disease
  topic: subjects
subject: machine learning
  topic: subjects
subject: hospital readmission
  topic: subjects
subject: Medical science
  topic: disciplines
subject: Advanced Technologies in Medicine
  topic: disciplines
creator: Houshang Sanadgol
creator: Sedigheh Barati
creator: Nasibeh Rady Raz
rights: Copyright (c) 2026 Iranian Journal of Kidney Diseases
date: 2026-04-19
publication date: 2026-04-19
starting page: 69
ending page: 76
doi: 10.61882/ijkd.20.02.9522

Predictors of Kidney and Patient Survival in Monoclonal Gammopathy–Associated Kidney Disease: A Single-Center Cohort from Colombia
type: item
description: Introduction. Monoclonal gammopathies can induce various kidney disorders through the deposition of monoclonal immunoglobulin. Precise recognition and classification are essential for predicting outcomes and customizing treatment. However, data on prognostic factors in Hispanic and Latin American populations remain scarce. This study aimed to determine the predictors of kidney and patient survival in adults with biopsy-proven monoclonal gammopathy-associated kidney disease. Methods. We conducted a retrospective cohort involving 98 individuals with biopsy-confirmed disease evaluated between 2011 and 2022. Kidney and patient survival were estimated using Kaplan-Meier analysis, and differences across histopathologic subtypes were assessed with the log-rank test. Predictors of end-stage kidney disease (ESKD) and mortality were identified using univariate and multivariable Cox regression after verification of the proportional hazards’ assumption. Results. Approximately one third of patients required kidney replacement therapy (KRT) at presentation. The need for KRT (hazard ratio [HR] 4.86, 95% confidence interval [CI] 2.01-11.79) and an estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m² (HR 4.02, 95% CI 1.38-11.71) independently predicted progression to ESKD. Amyloidosis (HR 2.38, 95% CI 1.22-4.86) and age > 60 years (HR 1.96, 95% CI 1.06-3.61) were associated with higher mortality. The median follow-up was 41 months (interquartile range 24-68); 31% progressed to ESKD and 46% died. Conclusions. Severe kidney dysfunction and the need for replacement therapy at diagnosis are strong predictors of poor renal outcomes. Amyloidosis and older age significantly affect overall survival. Early recognition of high-risk patients and access to effective, clone-directed therapy are essential to improve prognosis in resource-limited settings.
subject: ORIGINAL | Kidney Diseases
  topic: section
subject: amyloidosis
  topic: keywords
subject: multiple mieloma
  topic: keywords
subject: kidney biopsy
  topic: keywords
subject: End stage kidney disease
  topic: keywords
subject: kidney survival
  topic: keywords
subject: Paraproteinemias, Monoclonal gammopathy of undetermined significance, Kidney biopsy, AL amyloidosis, Monoclonal gammopathy of renal significance, Multiple myeloma.
  topic: subjects
subject: Prognostic factors for ESKD in monoclonal gammapathies.
  topic: subjects
subject: Nephrology, Pathology, Clinical Medicine, Hematology
  topic: disciplines
creator: Sebastian Gomez Jimenez
creator: Simon Cano Rodas
creator: Jose Nelson Carvajal Quiroz
creator: Luis Fernando Arias Restrepo
creator: Joaquín Roberto Rodelo-Ceballos
rights: Copyright (c) 2026 Iranian Journal of Kidney Diseases
date: 2026-01-03
publication date: 2026-01-03
starting page: 341
ending page: 350
doi: 10.61882/ijkd.20.01.8912

Years of Potential Life Lost (YPLL), the Key Metric in Strategic Planning for Chronic Kidney Disease Care
type: item
subject: EDITORIAL
  topic: section
creator: Shahrzad Ossareh
rights: Copyright (c) 2026 Iranian Journal of Kidney Diseases
date: 2026-01-03
publication date: 2026-01-03
starting page: 309
ending page: 310
doi: 10.61882/ijkd.19.06.9371

Muscle Mass Deficit Indexed to Body Surface Area Predicts Poor Physical Health and Quality of Life in Hemodialysis Patients
type: item
description: Introduction. Hemodialysis patients experience significantly lower quality of life compared to the healthy individuals, largely due to symptoms such as bone pain, fatigue, pruritus, anorexia, inflammation, malnutrition, and anemia. This study aimed to investigate the effects of sarcopenia and low muscle mass on quality of life, with a particular focus on physical health indices. Methods. The study included 62 patients on maintenance hemodialysis. Sarcopenia was diagnosed using the fat-free mass index (FFMI), defined as skeletal muscle mass divided by height squared (kg/m²). Additionally, skeletal muscle mass was normalized to body surface area (BSA); values below the sample mean of 46.12 kg/m² were classified as low muscle mass. Quality of life was assessed with the Kidney Disease Quality of Life (KDQOL) Version 1.3 questionnaire and scored using the KDQOL-SF™ Version 1.3 Scoring Program. Results. Sarcopenia was present in 18 patients (29%) according to FFMI. Patients scored lowest in general health (35.6), energy/fatigue (40.9), and both SF-12 physical (37.5) and mental health (37.2) domains. Sarcopenic patients reported significantly higher pain scores (60.97 ± 29.54 vs. 46.19 ± 27.37; P = .046), but other domains did not differ. Patients with low muscle mass/BSA (kg/m2) had lower sleep (51.5 ± 11.7 vs. 59.6 ± 13.0; P = .01), energy/fatigue (35.6 ± 20.1 vs. 52.8 ± 20.7; P = .005), and SF-12 physical health scores (35.7 ± 9.0 vs. 40.6 ± 8.3; P = .03). Muscle mass indexed to BSA was an independent predictor of the SF-12 physical health composite score. Conclusion. Low muscle mass, particularly when indexed to BSA, is associated with reduced physical health in hemodialysis patients and poorer quality of life across multiple domains. BSA-indexed muscle mass showed stronger and more consistent associations than FFMI-based definitions.
subject: ORIGINAL | Dialysis
  topic: section
subject: Body surface area
  topic: keywords
subject: Hemodialysis
  topic: keywords
subject: Low Muscle Mass
  topic: keywords
subject: Physical Health
  topic: keywords
subject: Quality of life
  topic: keywords
subject: Sarcopenia
  topic: keywords
subject: Body surface area, Hemodialysis, Low Muscle Mass, Physical Health, Quality of life, Sarcopenia
  topic: subjects
subject: Nephrology
  topic: disciplines
subject: Endocrinology
  topic: disciplines
creator: Turkan Yagmur Ozel
creator: Feyza Nur Sarısık
creator: Murat Sahin
creator: Esra Tasgetiren
creator: Ertugrul Erken
creator: Ozkan Gungor
creator: Orcun Altunoren
rights: Copyright (c) 2026 Iranian Journal of Kidney Diseases
date: 2026-04-19
publication date: 2026-04-19
starting page: 105
ending page: 115
doi: 10.61882/ijkd.20.02.9451

Genetic Associations Between Gastrointestinal Diseases and Chronic Kidney Disease: An Integrated Mendelian Randomization and Bioinformatics Analysis
type: item
description: Introduction. Chronic kidney disease (CKD) is a progressive condition with complex genetic and environmental influences. This study aims to investigate the genetic causal relationships between gastrointestinal diseases and CKD using the Mendelian Randomization (MR) approach and bioinformatics analysis. Methods. We analyzed genetic associations between nineteen gastrointestinal diseases including celiac disease (CeD), inflammatory bowel disease (IBD), intestinal malabsorption, and CKD. A two- sample MR analysis was performed using publicly available Genome-Wide Association Studies (GWAS) data with SingleNucleotide Polymorphisms (SNPs) as instrumental variables (IVs). The primary analysis employed the inverse variance weighted (IVW) method, with MR-Egger and weighted median as supplements. To explore potential biological mechanisms, Functional Mapping and Annotation (FUMA) analysis was used to map genes corresponding to IVs, followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Results. Significant genetic causal effects were observed for CeD (OR = 1.021, 95% CI = 1.002–1.041, P = .032), IBD (OR = 1.051, 95% CI = 1.014–1.089, P = .006), and intestinal malabsorption (OR = 1.031, 95% CI = 1.006–1.056, P = .013) on the risk of developing CKD. Other gastrointestinal diseases did not demonstrate significant causal effects on CKD. Reverse MR analyses did not reveal significant causal effects of CKD on CeD, IBD, or intestinal malabsorption, respectively. FUMA analysis identified 93 genes associated with CeD, 143 genes with IBD, and 26 genes with intestinal malabsorption. GO and KEGG enrichment analyses highlighted key pathways, including T-cell receptor signaling, cytokine-cytokine receptor interaction, chromatin regulation, and immune-related pathways. Conclusions. This study provides genetic and bioinformatics evidence linking CeD, IBD, and intestinal malabsorption to an increased risk of CKD, highlighting the systemic impac…
subject: ORIGINAL | Kidney Diseases
  topic: section
subject: Mendelian Randomization
  topic: keywords
subject: Gastrointestinal diseases
  topic: keywords
subject: Celiac disease
  topic: keywords
subject: Inflammatory bowel disease
  topic: keywords
subject: Chronic Kidney Disease
  topic: keywords
creator: Xinming Li
creator: Bo Yang
creator: Huihui Hou
creator: Xin Hong
creator: Ming Yang
creator: Juan Chen
creator: Kai Hu
creator: Mengjin Li
creator: Chenchen Zhou
creator: Liming Zhang
creator: Cheng Xue
creator: Zhiguo Mao
rights: Copyright (c) 2026 Iranian Journal of Kidney Diseases
date: 2026-02-25
publication date: 2026-02-25
starting page: 25
ending page: 45
doi: 10.61882/ijkd.20.01.9227

Efficacy and Safety of Oral Antidiabetic Drugs in People with Diabetes and Chronic Kidney Disease: A Systematic Review
type: item
description: This study is a systematic review assessing the efficacy and safety of oral antidiabetic drugs in managing type 2 diabetes mellitus in people with chronic kidney disease (CKD), focusing on their dosing and effects on renal function and glycemic control. A systematic search of online databases was conducted for published from January 2023 to September 2024. Studies that focused on oral antidiabetic drugs for individuals with diabetes and CKD, and reported outcomes such as glycemic control, renal function, and adverse events were included. A risk-of-bias assessment was performed to evaluate study quality. A total of 21 studies that met the criteria were included. The evidences indicate that SGLT2 (Sodium-Glucose Cotransporter-2) inhibitors and GLP-1 (Glucagon-like peptide-1) receptor agonists provide renal protective benefits. SGLT2 inhibitors are more effective especially in early-stages of CKD. DPP-4 (Dipeptidyl peptidase 4) inhibitors are safe across various CKD stages and require minimal dose adjustments. Metformin remains a popular drug for glycemic control but should be monitored and even discontinued in advanced stages of CKD because of the risk of lactic acidosis. Sulfonylureas were related to hypoglycemia risk. Oral antidiabetic drugs, especially SGLT2 inhibitors and GLP-1 receptor agonists, are suggested in managing blood glucose in CKD patients owing to their renal and cardiovascular benefits. Individualized therapy is an important factor as drug safety and efficacy are influenced by CKD stage, comorbid conditions, and hypoglycemia risk. Individualized therapy helps maximize renal and cardiovascular protection while minimizing adverse outcomes. Regular monitoring of HbA1c (hemoglobin A1c), GFR (glomerular filtration rate), and albuminuria is recommended.
subject: REVIEW | Kidney Diseases
  topic: section
subject: Chronic kidney disease
  topic: keywords
subject: Diabetes mellitus
  topic: keywords
subject: Hypoglycemic agent
  topic: keywords
subject: Oral drug administrations
  topic: keywords
subject: SGLT-2 Inhibitors
  topic: keywords
creator: Hoda Borooghani
creator: Mohsen Arabi
creator: Mitra Kazemi Jahromi
rights: Copyright (c) 2025 Iranian Journal of Kidney Diseases
date: 2025-11-15
publication date: 2025-11-15
starting page: 249
ending page: 259
doi: 10.61882/zwq4sh57

A Study on the Correlation between Metabolic Syndrome and Proteinuria in Chronic Kidney Disease
type: item
description: Introduction. To assess the frequency of metabolic syndrome (MS) and its association with proteinuria in patients with chronickidney disease (CKD). Methods. A cross-sectional study was conducted among 386 CKD patients from June 2022 to June 2023. Prevalence of MS was calculated, clinical characteristics of CKD patients with and without MS were compared, and multivariable logistic regression was performed to estimate associations between the components of MS with the categories of proteinuria. Results. The prevalence of MS was 24.9% among the 386 CKD patients. Patients with MS had greater 24-h urinary protein excretion and lower estimated glomerular filtration rate (eGFR) compared to patients without MS (P < .05). The proportion of patients withMS increased across proteinuria strata: mild (< 1.0 g/day) 14.4%, moderate (1.0 to 3.5 g/day) 35.2%, and severe (≥ 3.5 g/day) 49.0% (P < .05). In adjusted models, increased postprandial blood glucose (PBG), hypertension, and the ratio of triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) were independent associations with increased burden of proteinuria. Conclusion. Metabolic syndrome was independently associated with increased proteinuria burden in CKD. Early recognition and treatment of metabolic risk factors, especially dysglycemia, hypertension, and dyslipidemia, may help to promote renal protection and improve overall patient health.
subject: ORIGINAL | Kidney Diseases
  topic: section
subject: Microalbuminuria
  topic: keywords
subject: Metabolic syndrome
  topic: keywords
subject: Chronic kidney disease
  topic: keywords
creator: Li Guo
creator: Lei Ran
creator: Jing Li
creator: Jiandong Li
creator: Youlan Gong
rights: Copyright (c) 2026 Iranian Journal of Kidney Diseases
date: 2026-02-25
publication date: 2026-02-25
starting page: 16
ending page: 24
doi: 10.61882/ijkd.20.01.8999

Bibliometric Analysis of Uremia Research: 2021–2025
type: item
description: Introduction. This study aimed to perform a bibliometric analysis of academic research on uremia, identifying research hotspots, development trends, and international collaboration networks in this field. Methods. Relevant publications related to uremia were retrieved from Web of Science database. Bibliometric analysis was conducted using R software. Co-occurrence analysis of keywords, co-citation network analysis, and author/country collaboration analysis were performed to explore research focuses and academic influence. Results. From 2021 to 2022, research on uremia mainly concentrated on traditional areas such as chronic kidney disease, hemodialysis, and patient management. Since 2023, the focus has gradually shifted toward emerging topics including plasma biomarkers, inflammation mechanisms, and precision patient care. Co-citation network analysis revealed that studies related to chronic kidney disease and hemodialysis had the strongest academic influence, while research on inflammation and uremia also occupied central positions in the network. International collaboration was most active in China, the United States, and Europe, reflecting a trend toward cross-border and interdisciplinary research. Meanwhile, keywords such as gut microbiota, metabolomics, and precision medicine are increasingly frequent, highlighting new research frontiers. Conclusion. This study demonstrates that uremia research is shifting from traditional areas such as chronic kidney disease and hemodialysis toward emerging themes including inflammation, biomarkers, and patient management. These findings provide objective evidence of research hotspots and trends in uremia and underscore the importance of enhancing international and interdisciplinary collaboration.
subject: REVIEW | Kidney Diseases
  topic: section
subject: Uremia; Bibliometrics; Chronic Kidney Disease; Inflammation; Dialysis
  topic: keywords
subject: Uremia; Bibliometrics; Chronic Kidney Disease; Inflammation; Dialysis
  topic: subjects
subject: Department of Nephrology
  topic: disciplines
creator: Jie Wei
creator: Pan Gao
creator: Zhi Wang
creator: Lei Fan
creator: Jin Zhao
rights: Copyright (c) 2026 Iranian Journal of Kidney Diseases
date: 2026-01-03
publication date: 2026-01-03
starting page: 311
ending page: 321
doi: 10.61882/pjm29b56

Association Between Occult Kidney Disease and COVID-19 Mortality: Evidence from a Retrospective Study
type: item
description: Introduction. Occult kidney disease (OKD), a term that describes the initial phase of renal failure, is usually overlooked in routine clinical evaluations. Therefore, the goal of this study was to determine whether OKD is associated with the disease severity and mortality in COVID-19 patients. Methods. A retrospective study was conducted in patients with COVID-19. COVID-19 was considered based on a positive reverse transcriptase-polymerase chain reaction test for SARS-CoV-2. OKD was defined with an estimated glomerular filtration rate < 60 ml/min/1.73 m2 and creatinine concentrations ≤1.3 mg/dl. Results. A total of 809 patients with COVID-19 were selected for the study. The frequency of OKD, acute kidney injury, and chronic kidney disease was 7.7%, 15.0%, and 12.4%, respectively. The logistic regression analysis adjusted showed that OKD (OR = 1.86; CI 95%: 1.05-3.32), acute kidney injury (OR = 2.03; CI 95%: 1.42-2.89), and chronic kidney disease (OR = 3.07; CI 95%: 1.90-4.97) were associated with mortality by COVID-19. Conclusion. Our results indicate that OKD is associated with increased mortality in patients with COVID-19.
subject: BRIEF COMMUNICATION | Kidney diseases
  topic: section
subject: Occult kidney disease (OKD)
  topic: keywords
subject: cute kidney injury (AKI)
  topic: keywords
subject: COVID-19
  topic: keywords
subject: Kidney diseases
  topic: keywords
subject: Mortality
  topic: keywords
subject: COVID-19
  topic: subjects
subject: Kidney injury
  topic: subjects
subject: Occult kidney disease
  topic: subjects
subject: Nephrology
  topic: disciplines
creator: Fernando Guerrero-Romero
creator: Gerardo Martínez-Aguilar
creator: Mayela Ríos-Mier
creator: Julia B. Garay-Sierra
creator: Abraham S. Mercado-Sosa
creator: Paulina Flores-Galindo
creator: Luis E. Simental-Mendía
rights: Copyright (c) 2026 Iranian Journal of Kidney Diseases
date: 2026-04-19
publication date: 2026-04-19
starting page: 116
ending page: 121
doi: 10.61882/ijkd.20.02.9439

Comparative Analysis of Quality of Life and Surgical Outcomes Following Laparoscopic Versus Open Living Donor Nephrectomy: A Randomized Clinical Trial
type: item
description: Introduction. This study aimed to evaluate and compare quality of life and surgical outcomes following laparoscopic donor nephrectomy (LDN) versus the standard open donor nephrectomy (ODN) technique. Methods. This open-label randomized clinical trial was conductedat Imam Khomeini Hospital, Urmia, Iran, from 2022 to 2023). Ninety-one kidney donors were randomly assigned to the ODN (n = 46) or LDN (n = 45) group. Outcomes included hemoglobin changes, renal function, hospitalization length, operation time, time to return to normal activities, complications, and one-year quality of life (SF-36). Data were analyzed using t-tests and Chi-square tests (P < .05). Results. The mean duration of surgery was significantly longer in the LDN group compared to the ODN group (3.13 ± 0.37 vs. 2.30 ± 0.37 hours; P < .001). However, the ODN group experienced a significantly greater reduction in hemoglobin (-1.59 ± 0.78 vs. -1.04 ± 0.94; P = .004) and longer hospitalization (4.06 ± 0.38 vs. 3.31 ± 0.55 days; P < .001). Furthermore, a significantly higher proportion of LDN patients returned to normal activities within one month of surgery (84.1% vs. 54.5%; P = .004). There were no significant differences regarding urinary output, complications,or long-term quality of life (P > .05). Conclusion. Although laparoscopic donor nephrectomy requires a longer operative time, it offers superior clinical benefits, including reduced blood loss, shorter hospital stays, and faster functional recovery. These findings support the adoption of the laparoscopic approach as the preferred standard of care for living kidney donors to optimize postoperative recovery.
subject: ORIGINAL | Kidney Diseases
  topic: section
subject: Donor nephrectomy
  topic: keywords
subject: Laparoscopy
  topic: keywords
subject: Open surgery
  topic: keywords
subject: Clinical outcomes
  topic: keywords
subject: Quality of life
  topic: keywords
creator: Saman Farshid
creator: Ali Taghizadeh Afshari
creator: Hamed Bayat
rights: Copyright (c) 2026 Iranian Journal of Kidney Diseases
date: 2026-02-25
publication date: 2026-02-25
starting page: 1
ending page: 9
doi: 10.61882/ijkd.20.01.9208

Non-Diabetic Kidney Disease Confirmed by Biopsy in Patients with Diabetes: A Single-Center Registry Report
type: item
description: Introduction. Diabetic kidney disease (DKD) is a major complication of diabetes mellitus (DM), often leading to kidney failure. This study was designed to assess the prevalence and clinicopathological correlations of biopsy-confirmed non-diabetic kidney disease (NDKD) in patients with diabetes. Method. A retrospective analysis was conducted by including 547 diabetic patients who underwent kidney biopsies. Data on demographics, laboratory results (including serum creatinine and urine protein levels), clinical symptoms, medical history, and histopathological diagnoses were collected. Result. Among the patients, 261 (47.7%) were diagnosed with DKD, while 286 (52.3%) had NDKD. The most prevalent histopathologicalfinding in NDKD was membranous glomerulonephritis (13.9%), followed by focal and segmental glomerulosclerosis (9.7%) and IgA nephropathy (5.7%). Key predictors for DKD included longer duration of diabetes mellitus (odds ratio [OR]: 1.12), elevated HbA1c levels (OR: 1.26), and the presence of retinopathy at the time of biopsy (OR: 7.97), all with P < .05. No significant differences were observed in the frequency of hematuria between the DKD and NDKD groups. Conclusion. Membranous glomerulonephritis was the most common diagnosis among NDKD patients. The findings suggest a strong correlation between the duration of diabetes mellitus, the presence of retinopathy, and HbA1c levels with DKD development, indicating a need for revised criteria for kidney biopsy decisions in diabetic individuals to enhance diagnostic accuracy and treatment strategies.
subject: ORIGINAL | Kidney Diseases
  topic: section
subject: Diabetes mellitus
  topic: keywords
subject: Diabetic kidney disease
  topic: keywords
subject: Kidney biopsies
  topic: keywords
subject: Histopathology
  topic: keywords
creator: Neda Najafi
creator: Hounaz Akbari
creator: Mitra Mehrazma
creator: Mahsa Kohansal Vagargah
creator: Mohsen Vahedi
creator: Shahrzad Ossareh
rights: Copyright (c) 2025 Iranian Journal of Kidney Diseases
date: 2025-11-15
publication date: 2025-11-15
starting page: 279
ending page: 286
doi: 10.61186/

The Association Between Serum Sodium Variation During Pediatric Intensive Care Unit Admission and the Risk of Clinical Outcomes in Critically Ill Children: A Retrospective Cohort Study
type: item
description: Introduction. Dysnatremia at Pediatric Intensive Care Unit (PICU) has been associated with adverse outcomes; however, the impact of sodium variation during PICU stay remains underexplored. We aimed to assess the association between dysnatremia and sodium fluctuations during PICU admission and the probability of prolonged PICU stay (≥7days) and mortality. Methods. This retrospective cohort study included 966 critically ill children (2019–2022) with at least two serum sodium measurements during PICU admission. Patients were classified as normonatremic, hyponatremic, hypernatremic, or mixed dysnatremic based on all sodium values. Sodium fluctuation was defined as the difference between the highest and lowest sodium levels during admission and categorized into quartiles. Associations of dysnatremia categories and sodium fluctuation with prolonged PICU stay and PICU mortality were evaluated using multivariable logistic regression. Results. During the PICU admission, 542 patients developed dysnatremia. The PICU-acquired dysnatremia was independently associated with higher odds of prolonged PICU stay after adjusting for major confounders. The PICU-acquired hypernatremia (OR:5.23;95%CI:1.72-15.92) and mixed dysnatremia (OR:2.89;95%CI:1.14-7.29) had significantly higher odds for PICU mortality. Even mild sodium fluctuations (4-8mmoL/L) during PICU admission were significantly associated with higher odds of prolonged PICU stay. The highest (≥15mmol/L) fluctuations in serum sodium levels during PICU admission were also significantly associated with higher odds of PICU mortality (OR:2.74;95%CI:1.11-6.79). Conclusion. Our findings underscore the importance of careful monitoring of serum sodium levels during PICU admission to improve clinical outcomes. These results should be interpreted in light of the retrospective design and the unavailability of standardized illness-severity scores (e.g., PRISM or PIM) in the dataset.
subject: ORIGINAL | Kidney Diseases
  topic: section
subject: Pediatric Intensive Care Unit
  topic: keywords
subject: sodium fluctuations
  topic: keywords
subject: dysnatremia
  topic: keywords
subject: prolonged PICU stay
  topic: keywords
subject: mortality
  topic: keywords
subject: serum sodium variation during Pediatric Intensive Care Unit admission and the risk of clinical outcomes in critically ill children
  topic: subjects
subject: Medicine
  topic: disciplines
creator: Zahra Pournasiri
creator: Ali Nikparast
creator: Mahsa Bakhtiary
creator: Masumeh Hashemi
creator: Seyyedeh Narjes Ahmadizadeh
creator: Azita Behzad
creator: Golaleh Asghari
rights: Copyright (c) 2026 Iranian Journal of Kidney Diseases
date: 2026-01-03
publication date: 2026-01-03
starting page: 331
ending page: 340
doi: 10.61882/ijkd.19.06.8917

The Trend of Mortality Rate and Years of Life Lost Due to Kidney Failure in Fars Province, Iran, During the Years 2004-2019
type: item
description: Introduction. Chronic kidney disease is a general term for heterogeneous disorders that affect the structure and function of the kidney. This study was conducted to determine the mortality rate and years of life lost due to kidney failure in southern Iran. Method. In this retrospective, population-based descriptive trend study, all deaths due to kidney failure in Fars province were extracted from the electronic population-based death registration system (EDRS). The crude mortality rate, age-standardized mortality rate, years of life lost (YLL) and YLL rate data were calculated. The Joinpoint Regression method was used to examine the trend. Results. During the 16-year study period, 2853 deaths due to kidney failure occurred in Fars province. Of this number, 57.2% (1633 cases) were men. The crude mortality rate had a stable trend in men and an increasing trend in women. However, the age-standardized mortality rate had a stable trend in both sexes. The total years of life lost due to kidney failure were 19366 in men and 15769 in women. According to the Joinpoint regression analysis, the trend of YLL rate due to premature mortality was stable and the annual percent change (APC) were -2.6% (95% CI -5.6 to 0.4, P = .088) and 1.8% (95% CI -1.9 to 5.6, P = .318) for males and females respectively. Conclusions. The trend of crude mortality rate had a stable trend in men and an increasing trend in women. Also, the trend of YLL was stable for both sexes. The increasing trend in mortality among women may be due to increases in life expectancy and the increasing prevalence of non-communicable diseases such as hypertension and diabetes mellitus.
subject: ORIGINAL | Kidney Diseases
  topic: section
creator: Habibollah Azarbakhsh
creator: Najibullah Baeradeh
creator: Seyed parsa Dehghani
creator: Iman Shakibkhah
creator: Jafar Hassanzadeh
creator: Alireza Mirahmadizadeh
rights: Copyright (c) 2026 Iranian Journal of Kidney Diseases
date: 2026-01-03
publication date: 2026-01-03
starting page: 322
ending page: 330
doi: 10.61882/k4badb64

Inflammatory Mediators in Kidney Disease: A Focus on IL-6in SLE-Associated CKD
type: item
description: Introduction. Systemic lupus erythematosus (SLE) is an autoimmune condition that can lead to severe renal impairment, including chronic kidney disease (CKD) or end-stage kidney disease (ESKD). This study aimed to evaluate the serum levels of key pro-inflammatory cytokines which are well-known to mediate tissue injury and fibrosis in the context of kidney diseases—interleukin-1 beta (IL-1β), IL-6, tumor necrosis factor-alpha (TNF-α), and IL-12—in CKD and ESKD patients with and without SLE, as well as in healthy controls, to explore their role in disease progression. Methods. This cross-sectional study was conducted over a 15-month period in three governmental medical centers of Golestan Province, Iran (Sayyad Shirazi Hospital, 5th Azar hospital, and Al-Jalil hospital). A total of 118 individuals (age 18-65 years) were enrolled and divided into three groups:38 CKD or ESKD patients with SLE, 40 CKD or ESKD patients without SLE, and 40 healthy controls. For subgroup analyses, CKD (stages3-4) and ESKD (stage 5) patients were considered separately. Those patients meeting the American College of Rheumatology criteria for SLE, while excluding those with infections, malignancies, or other autoimmune disorders were selected. Blood samples were collected, and serum cytokine levels were measured using enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using the Kruskal-Wallis and Mann-Whitney U tests, with P ≤ .05 considered significant. Results. CKD patients with SLE showed significantly higher serum levels of IL-1β, TNF-α, and IL-12 compared to CKD patients without SLE and healthy controls (P < .05). IL-6 levels were notably higher in CKD patients compared to ESKD patients, irrespective of SLE status (P < .05). ESKD patients exhibited increased IL-1β, TNF-α, and IL-12 levels, while IL-6 levels were lower than those in CKD patients. Conclusion. IL-6 appears to play a crucial role in the pathogenesis of kidney disease, particularly in patients with SL…
subject: ORIGINAL | Kidney Diseases
  topic: section
subject: Chronic kidney disease
  topic: keywords
subject: Lupus erythematosus
  topic: keywords
subject: Systemic
  topic: keywords
subject: Lupus nephritis
  topic: keywords
subject: Interleukin-6
  topic: keywords
subject: Tumor necrosis factor-alpha
  topic: keywords
subject: chronic kidney disease
  topic: subjects
subject: systemic lupus erythematosus
  topic: subjects
subject: Interleukin
  topic: subjects
subject: Tumor Necrosis Factor-alpha
  topic: subjects
subject: IL-6
  topic: subjects
subject: Immunology
  topic: disciplines
subject: Laboratory Sciences
  topic: disciplines
subject: Chronic kidney disease
  topic: disciplines
creator: Shaymaa Abduljabbar Raoof
creator: Paria Bayati
creator: Mohammad Esmail Nasrabadi
creator: Yaghoub Yazdani
creator: Somayeh Ghorbani
creator: Akram Gholamzadeh
creator: Javad Enayat
creator: Somayeh Sadani
creator: Yasser Bagheri
rights: Copyright (c) 2025 Iranian Journal of Kidney Diseases
date: 2025-09-27
publication date: 2025-09-27
starting page: 187
ending page: 199
doi: 10.61882/ijkd.19.04.8861

Stepwise Interpretation of Albumin Fraction Abnormalities on Serum Protein Capillary Electrophoresis in Nephrotic Syndrome: A Case Series
type: item
description: Serum protein electrophoresis (SPEP) is commonly used in the diagnostic evaluation of nephrotic syndrome (NS) to rule out monoclonal gammopathies. However, NS itself and various other factors may cause transient bisalbuminemia, resulting in albumin fraction irregularities in capillary SPEP and complicating interpretation. This study proposes a stepwise approach for interpreting albumin fraction irregularities, illustrated through three representative cases of NS. Case 1: a 44-year-old woman with isolated proteinuria, Case 2: a 36-year-old woman with diabetic foot infection, and Case 3: a 58-year-old man with ankylosing spondylitis, all presenting with nephrotic-range proteinuria. On initial SPEP case 1 exhibited a distinct sharp peak, while cases 2 and 3 showed irregular bands between the albumin and α1 regions. A stepwise interpretative approach was applied: First, technical errors were excluded by repeat analysis using alternative capillaries on the same analyzer. Second, potential biochemical interferences were evaluated. Third, SPEP was repeated using freshly collected samples. Fourth, persistent albumin fraction irregularities prompted consideration of biochemical albumin modifications, such as glycosylated or carbamylated forms. Fifth, other causes including drugs, heavy metal toxicity, liver disease, and systemic inflammation were excluded. Finally, additional tests such as immunofixation electrophoresis were performed to rule out monoclonal proteins. In the absence of monoclonal proteins, the condition was interpreted as bisalbuminemia related to NS. Using this approach, transient bisalbuminemia was considered the most likely cause in Cases 1 and 2, whereas the disappearance of the irregular band in Case 3 suggested a preanalytical artifact. Systematic interpretation of albumin fraction irregularities can help distinguish true pathology from benign or artifactual patterns in patients with NS.
subject: CASE REPORT | Kidney Diseases
  topic: section
subject: Albumin
  topic: keywords
subject: Capillary electrophoresis
  topic: keywords
subject: Multiple myeloma
  topic: keywords
subject: Nephrotic syndrome
  topic: keywords
subject: Serum proteins
  topic: keywords
subject: Nephrotic Syndrome
  topic: subjects
subject: Hypoalbuminemia
  topic: subjects
subject: Multiple Myeloma
  topic: subjects
subject: Paraproteinemias, Monoclonal gammopathy of undetermined significance, Kidney biopsy, AL amyloidosis, Monoclonal gammopathy of renal significance, Multiple myeloma.
  topic: subjects
subject: Clinical biochemistry
  topic: disciplines
creator: Emine Feyza Yurt
creator: Medine Alpdemir
creator: Mehmet ŞENEŞ
rights: Copyright (c) 2026 Iranian Journal of Kidney Diseases
date: 2026-04-19
publication date: 2026-04-19
starting page: 122
ending page: 129
doi: 10.61882/ijkd.20.02.9386

The Sensitivity of Bioimpedance to Assess Leg Fluid Volume Changes in Children on Hemodialysis: Experimental and Model-Based Investigation
type: item
description: Introduction. Fluid management plays an essential role in pediatric hemodialysis; however, traditional assessment techniques often lack the precision required for this patient population. Bioimpedance analysis (BIA) offers a non-invasive alternative, but electrode placement significantly impacts measurement sensitivity. This study compared the efficacy of two calf-based electrode configurations — dorsal (ankle) versus plantar (sole) — in detecting fluid volume changes via bioimpedance in pediatric patients, particularly in terms of their sensitivity. Additionally, we evaluated a novel ring electrode arrangement for optimizing sensitivity distribution in lower limb tissues. Methods. This controlled before-and-after study was conducted at the dialysis unit of Ali Asghar Children’s hospital in Tehran, Iran. It evaluated thirteen children (aged 3-15 years) undergoing hemodialysis using bioimpedance analysis. The primary outcome measure was the change in impedance values before and after a single dialysis session. Measurements were performed with electrodes placed in two configurations: between the plantar surface of the foot to below the knee (down), and between the ankle dorsal surface to below the knee (up). Current distribution patterns were modeled using COMSOL simulations. Results. Mean ultrafiltration volume was 1123 ± 384 mL per session. Impedance changes were observed in both dorsal and plantar electrode configurations, with no significant differences or superiority in measuring these changes. Sensitivity analysis revealed variations of 35% with dorsal placement, 24% with plantar placement, and 20% with ring electrode configuration, demonstrating superior uniformity of the ring design across tissue regions. Conclusion. Optimal electrode placement varies among patients with no universal advantage for either position. Bioimpedance sensitivity depends on location of fluid accumulation, and enhanced sensitivity is required for monitoring changes below two liters. Th…
subject: ORIGINAL | Dialysis
  topic: section
subject: Bioimpedance
  topic: keywords
subject: Hemodialysis
  topic: keywords
subject: Pediatric
  topic: keywords
subject: Electrode Placement
  topic: keywords
subject: Fluid Assessment
  topic: keywords
subject: Diagnostic Techniques and Procedures; Blood Volume Determination; Electrodes; Dialysis, Bioelectrical impedance analysis; Pediatrics
  topic: subjects
subject: smart dialysis
  topic: disciplines
creator: Shahrokh Noori
creator: Mohammad Firouzmand
creator: Vahid Reza Nafisi
creator: Nakysa Hooman
rights: Copyright (c) 2025 Iranian Journal of Kidney Diseases
date: 2025-09-27
publication date: 2025-09-27
starting page: 232
ending page: 242
doi: 10.61882/ijkd.19.04.8556

Genetically Confirmed Hyperoxaluria in Iranian Children- A Multicenter Survey
type: item
description: Introduction. Primary hyperoxaluria (PH) is a rare autosomal recessive disorder characterized by a heterogeneous presentation that leads to kidney failure and involvement of other organs. The aim of this study was to determine the number of cases with suspected PH in Iran that have had a genetically verified diagnosis. Methods. A survey distributed among members of Iranian society of pediatric nephrology (IranSPN) to collect overall data on hyperoxaluria (HOX) in their centers, as well as those who performed whole exome sequencing (WES) or sanger sequencing genetic study. Data is presented as frequency and number blocks. Results. Nineteen out of 130 members filled out the questionnaires. About two-thirds of the responders were suspected to have HOX in the presence of recurrent multiple kidney stones. PH was genetically confirmed in 80 children above 10 years. Alanine-Glyoxylate Aminotransferase (AGXT) was the most frequent reported genetic abnormailtiy. The majority of their patients required kidney replacement therapy. Combined or sequential liver- kidney transplantation was less frequent. Conservative treatment was the only therapy applied to all children prior to end-stage kidney disease. Conclusion. This simple survey revealed that definitive diagnosis of PH occurs at older age accompanied with higher rate of kidney transplantation.
subject: ORIGINAL | Kidney Diseases
  topic: section
subject: Primary hyperoxaluria
  topic: keywords
subject: Kidney replacement therapy
  topic: keywords
subject: Genetic testing
  topic: keywords
subject: Combined or sequential liver and kidney transplantation
  topic: keywords
subject: Hyperoxaluria , genetic
  topic: subjects
subject: Original article
  topic: disciplines
creator: Nakysa Hooman
creator: Mahmood Maleknejad
creator: Mitra Basiratnia
creator: Marzieh Mojbafan
creator: Alaleh Gheissari
creator: Fahimeh Askarian
creator: Rama Naghshizadian
creator: Fatemeh Ghane Sharbaf
creator: Arash Abbasi
creator: Nahideh Ekhlasi
creator: Nasrin Esfandiar
creator: Somaye Talaeepur
creator: Tahereh Malakoutian
creator: Abolhassan Seyedzadeh
creator: Rozina Abbasi Larki
rights: Copyright (c) 2025 Iranian Journal of Kidney Diseases
date: 2025-09-27
publication date: 2025-09-27
starting page: 200
ending page: 205
doi: 10.61882/ijkd.19.04.8546

Predictors of Survival and Clinical Outcomes in Hemodialysis Patients: A 9-Year Multicenter Cohort Study
type: item
description: Introduction. Cardiovascular and non-cardiovascular mortality rates among hemodialysis patients continue to be high despite advances in dialysis therapy. Materials and Methods. This prospective cohort study enrolled 185 adult patients with end-stage kidney disease (ESKD) on maintenance hemodialysis (HD) from three hemodialysis facilities (Shariati hospital, Shohadaye Hafte-Tir hospital and Sevome-Sha’ban hospital ) in September 2012. Causes of death and HD exit were tracked over a follow-up period of 103 months (8.5 years). The Cox proportional hazards model was employed to predict mortality after adjusting for case-mix and laboratory data variables. Results. The mean age of the patients was 57 ± 15.2 years, with a mean dialysis vintage of 39 ± 45 months. The cohort comprised 52.5% males and 48% diabetic patients. In the univariate analysis, mortality rate was higher among women (81% vs. 63%), diabetics (89% vs. 55%), and those with higher body mass index, older age, and lower serum creatinine, albumin, and intact PTH levels. A total of 132 patients (71%) died, with a mortality rate of 19 per 100 patient-years. The leading causes of death were cardiovascular diseases (47%) and infections (32.5%). Kidney transplantation was performed in 25 patients (14%), including 7 women and 18 men. The median survival was 4.1 years (95% CI: 3.3-5.0). The survival rates at one, two, three, five, and nine years were 83%, 64%, 56%, 39%, and 19%, respectively. Conclusion. Older age, poor nutritional biomarkers, diabetes mellitus, and catheter vascular access are the primary factors contributing to poor long-term prognosis in hemodialysis patients.
subject: ORIGINAL | Dialysis
  topic: section
subject: Hemodialysis patients
  topic: keywords
subject: Survival
  topic: keywords
subject: Clinical outcome
  topic: keywords
creator: Tayebeh Soleymanian
creator: Atefeh Yousefi
creator: Farnaz Tavakoli
creator: Esmat Abdollahpour
rights: Copyright (c) 2025 Iranian Journal of Kidney Diseases
date: 2025-09-27
publication date: 2025-09-27
starting page: 213
ending page: 221
doi: 10.61882/ijkd.19.04.8737

Post-Transplantation Hairy Cell Leukemia with Hemophagocytic Lymphohistiocytosis in an Adult Kidney Transplant Recipient: A Case of Rare Occurrence
type: item
description: Post-transplant lymphoproliferative disorder (PTLD) is a rare and severe complication that occurs after kidney transplantation. Most cases of PTLD are associated with reactivation of the Epstein-Barr virus (EBV), which often happens during the early phases following transplantation. Hemophagocytic lymphohistiocytosis (HLH) is an inflammatory syndrome characterized by a cytokine storm originating from activation of the reticuloendothelial system, leading to multi-organ failure (MOF). Herein, we present a case of late-onset EBV-positive hairy cell leukemia in a kidney transplant recipient who concurrently developed HLH. Diagnosing and managing HLH can be particularly challenging, as it can mimic sepsis. This is especially true for transplant recipients, where diagnosing and treating such conditions are difficult. Immunosuppressive therapy, malignancies like lymphoma, and EBV infection are recognized risk factors for developing HLH. However, very few cases have reported the simultaneous occurrence of HLH and PTLD.
subject: CASE REPORT | Transplantation
  topic: section
subject: Epstein-Barr virus infections
  topic: keywords
subject: Hemophagocytic lymphohistiocytosis
  topic: keywords
subject: Kidney transplantation
  topic: keywords
subject: Hairy cell Leukemia
  topic: keywords
subject: Transplant recipients
  topic: keywords
subject: Lymphoproliferative disorders
  topic: keywords
subject: Neoplasms
  topic: keywords
subject: Immunosuppressive therapy
  topic: keywords
subject: Hairy Cell Leukemia
  topic: subjects
subject: Rare Hematologic Malignancies
  topic: subjects
subject: Epstein-Barr Virus (EBV)
  topic: subjects
subject: Kidney Transplant Complications
  topic: subjects
subject: Hemophagocytic Lymphohistiocytosis (HLH)
  topic: subjects
subject: Post-Transplant Lymphoproliferative Disorder (PTLD)
  topic: subjects
subject: Medicine
  topic: disciplines
subject: Hematology
  topic: disciplines
subject: Transplantation Medicine
  topic: disciplines
subject: Oncology
  topic: disciplines
subject: Immunology
  topic: disciplines
creator: Maryam Ghazizadeh
creator: Mohammad Moini
creator: Matin Ghazizadeh
rights: Copyright (c) 2025 Iranian Journal of Kidney Diseases
date: 2025-09-27
publication date: 2025-09-27
starting page: 243
ending page: 247
doi: 10.61882/ijkd.19.04.8943

A Rare Cause of Retroperitoneal Fibrosis in Adults: H Syndrome Presenting After 35 Years- A Case Report
type: item
description: Introduction. Retroperitoneal fibrosis (RPF) is a rare fibro- inflammatory disorder that may cause urinary tract obstruction and renal failure. Although most RPF cases are IgG4-related, rare genetic conditions can also contribute to the disease. H syndrome, an autosomal recessive disorder caused by biallelic SLC29A3 mutations, usually presents in childhood with cutaneous, endocrine, and systemic manifestations; adult onset is exceptionally rare. Case presentation. A 36-year-old woman was admitted to hospital with the complaint of nausea, vomiting, and oliguria. Laboratory tests showed urea 116 mg/dL, creatinine 5,8 mg/dL,. Non-contrast computed tomography imaging revealed bilateral hydronephrosis and a 2,5 cm retroperitoneal fibrotic mass encasing the abdominal aorta and iliac arteries. Extensive evaluation—including positron emission tomography, lymph-node histology, and autoimmune/ IgG4 serology—found no evidence of malignancy, infection, or IgG4- related disease. Family history disclosed parental consanguinity and a brother with H syndrome. Next-generation sequencingidentified a homozygous SLC29A3 (NM_018344.5):c.1339G > A (p.Glu447Lys) mutation, confirming H syndrome. Bilateral ureteral stenting and corticosteroid therapy led to full renal recovery (creatinine 0.7 mg/dL). Conclusion. This case expands the clinical spectrum of H syndrome by documenting late-onset RPF without typical dermatologic or auditory signs. Recognition of familial risk and timely genetic testing were decisive for diagnosis. Early decompression and immunosuppression preserved renal function. Reporting suchatypical presentations increases awareness of H syndrome as a rare genetic cause of RPF and supports comprehensive genetic evaluation in adults with unexplained retroperitoneal fibrosis.
subject: CASE REPORT | Kidney Diseases
  topic: section
subject: Retroperitoneal fibrosis
  topic: keywords
subject: H syndrome
  topic: keywords
subject: SLC29A3gene mutation
  topic: keywords
subject: Adult onset H syndrome
  topic: keywords
subject: Renal failure
  topic: keywords
creator: Türker Emre
creator: Nazife Nur Özer Şensoy
rights: Copyright (c) 2025 Iranian Journal of Kidney Diseases
date: 2025-11-15
publication date: 2025-11-15
starting page: 304
ending page: 309
doi: 10.61882/npz6gc25

Optimizing Pediatric Blood Pressure Readings: The Role of Timing and Medical Personnel Presence: A cross-sectional study
type: item
description: Introduction. Hypertension is a major global health concern, playing a significant role in the development of cardiovascular diseases and other non-communicable conditions. Accurate blood pressure (BP) measurement is a key to its diagnosis. While guidelines recommend three BP readings with 1–2-minute intervals for adults, there is no clear consensus for children. Additionally, various factors, such as the presence of medical personnel, could impact BP readings. This study aimed to evaluate the impact of measurement timing and the presence of medical personnel on pediatric blood pressure readings. Methods. In this analytical cross-sectional study, 50 children aged 5-13 years were enrolled. Blood pressure was measured using an automatic device with appropriately sized cuffs. BP was recorded at five intervals: baseline, 30, 60, 90, and 120 seconds. Measurements were taken both in the presence of medical personnel (attended) and without their presence (unattended). Data were analyzed using descriptive statistics and repeated measures ANOVA with IBM SPSS version 21. Results. A significant decrease in systolic BP (SBP) was observed over time (P = .000), with the initial SBP of 105.29 mmHg declining to 98.33 mmHg at 120 seconds. However, there were no significant changes in diastolic BP (DBP) or pulse pressure (PP) (P = .400 and P = .502, respectively). When comparing attended versus unattended measurements, both SBP and DBP were significantly higher whenmedical personnel were present (P = .009 for SBP, P = .010 for DBP). Conclusions. The findings suggest that shorter intervals, such as 30 seconds, may be adequate for reliable BP measurement in children. However, the presence of medical personnel increases BP readings, likely due to anxiety. These results highlight the need to reduce stress during pediatric BP assessments to ensure accurate hypertension diagnosis and management.
subject: ORIGINAL | Kidney Diseases
  topic: section
subject: Hypertension
  topic: keywords
subject: Child
  topic: keywords
subject: Blood pressure
  topic: keywords
subject: White coat hypertension
  topic: keywords
creator: Hamidreza Badeli
creator: Yasin Khoshhal Dahka
creator: Mir Iman Fallahchai
creator: Afagh Hassanzadeh Rad
rights: Copyright (c) 2025 Iranian Journal of Kidney Diseases
date: 2025-11-15
publication date: 2025-11-15
starting page: 287
ending page: 293
doi: 10.61186/

Examining the Association between Oxidative Stress Markers and the Severity of Symptoms in Individuals with COVID-19 and Healthy Individuals
type: item
description: Introduction. The association between inflammation and oxidative stress in COVID-19 patients is well documented. The primary objective of the present study was to evaluate the levels of oxidative stress markers in COVID-19 patients compared to the healthy individuals. Methods. In this case-control study, a comprehensive evaluation was conducted on 45 individuals, comprising 30 patients diagnosed with COVID-19 and 15 in a healthy control. COVID-19 patients were divided into two groups: mild and severe, based on clinical severity. In addition to standard laboratory tests like ESR, serum levels of oxidative stress markers were measured, including total protein, total antioxidant capacity, total oxidant status, carbonylated protein content, glutathione reductase enzyme, and catalase activity.Results. ESR levels were significantly elevated in the severe group compared to the mild group. However, no significant differences were observed in the levels of oxidative stress markers between mild and severe COVID-19 patients. Compared to healthy controls, COVID-19 patients exhibited a significant decrease in total protein levels (P < .0001), and significant increases were observed in serum total antioxidant capacity (TAC) (P < .0001) and total oxidant status(TOS) (P = .002). Conclusion. Oxidative stress markers exhibit a substantial rise in patients with COVID-19, suggesting a potential role in the progression of the disease. Implementing strategies to prevent oxidative stress may offer clinical advantageous in managing COVID-19 patients.
subject: ORIGINAL | Kidney Diseases
  topic: section
subject: Oxidative stress
  topic: keywords
subject: COVID-19
  topic: keywords
subject: Total antioxidant capacity
  topic: keywords
subject: Total oxidant status
  topic: keywords
subject: Catalase activity
  topic: keywords
creator: Fatemeh Pourrezagholi
creator: Masoumeh Ebrahimi
creator: Yadollah Shakiba
creator: Hossein Amini
creator: Mohammad Rahmanian
creator: Tayebe Zomorrodi Jangaee
creator: Zahra Golkar
creator: Shideh Anvari
creator: Nooshin Dalili
rights: Copyright (c) 2025 Iranian Journal of Kidney Diseases
date: 2025-11-15
publication date: 2025-11-15
starting page: 272
ending page: 278
doi: 10.61186/

Calf Bioimpedance Analysis: A Novel Approach for Evaluating Hydration Status in Pediatric Dialysis Patients Under High Dialysate Sodium
type: item
description: Introduction. Assessment of hydration status in pediatric hemodialysis is complicated by dynamic fluid shifts and sodium variability. Conventional methods such as clinical evaluation and whole-body bioimpedance analysis (BIA) lack precision for individual-level monitoring. This study introduces a calf impedance ratio (ΔZ₁₅ₖₕ / ΔZ₁₅₀ₖₕ) to classify fluid responses and evaluate the impact of high dialysate sodium (143 mEq/L) on fluid dynamics and blood pressure. Methods. A cross-sectional study was conducted involving 14 children aged 5–12 years undergoing maintenance hemodialysis. Impedance was measured pre- and post-dialysis at two frequencies using a custom-built device. The raw impedance changes were analyzed without conversion to fluid volumes, allowing for classification into three physiological response groups based on the impedance ratio.Results. Three distinct physiological profiles emerged. Group1 (ΔZΔZ150kh15kh > 1) showed effective extracellular fluid removal with stable hemodynamics. Group 2 (ratio between 0 and 1) reflected minimal Extracellular Water (ECW) ECW changes, potentially due to sodium-driven redistribution, with additional influence from sodium-enhanced tissue conductivity. Group 3 (ΔZ₁₅ₖₕ < 0) exhibited paradoxical impedance decreases despite fluid removal,along with sodium increase and blood pressure elevation. ΔZ₁₅ₖₕpositively correlated with ΔBP-sys (r = 0.650, P = .012). Conclusion. The impedance ratio (ΔZΔZ150kh15kh ) provides a sensitive index for classifying fluid responses and identifying sodium-related effects in pediatric hemodialysis. It may support individualized dialysis prescriptions by guiding adjustments in ultrafiltration and dialysate sodium to improve hemodynamic stability and fluid balance.
subject: ORIGINAL | Dialysis
  topic: section
subject: Calf bioimpedance
  topic: keywords
subject: Hydration status
  topic: keywords
subject: Hemodialysis
  topic: keywords
subject: Pediatric nephrology
  topic: keywords
subject: Sodium balance
  topic: keywords
subject: Fluid monitoring
  topic: keywords
subject: Ultrafiltration
  topic: keywords
creator: Mohammad Firouzmand
creator: Shahrokh Noori
creator: Vahid Reza Nafisi
creator: Nakysa hooman
rights: Copyright (c) 2025 Iranian Journal of Kidney Diseases
date: 2025-11-15
publication date: 2025-11-15
starting page: 294
ending page: 303
doi: 10.61186/

Protective Effect of Garlic on Diazinon Induced Kidney Toxicity in Rat: A Biochemical and Histopathological Evaluation
type: item
description: Introduction. Diazinon (DZN) is a widely used pesticide applied in agriculture to eliminate pests, but it can cause adverse effects on various organs. This study investigated the nephrotoxic changes and oxidative stress induced by diazinon, as well as the potential protective role of garlic in ameliorating kidney toxicity in male Wistar rats. Methods. The animals were treated with diazinon (DZN; 70 mg/ kg/day, orally) with or without garlic extract (500 mg/kg, orally) for four consecutive weeks. Biomarkers including malondialdehyde (MDA), total antioxidant capacity (TAC), catalase (CAT), superoxide dismutase (SOD), and total thiol molecules were measured to evaluate oxidative stress. In addition, kidney histopathology was examined using the hematoxylin and eosin (H&E) staining. Results and conclusion. As expected, DZN significantly increased MDA levels while decreased the levels of CAT, SOD, TAC, and total thiol molecules in kidney tissue. Co-treatment with garlic reversed the oxidative stress status. Moreover, garlic ameliorated the kidney histopathological injuries induced by DZN. Our findings suggest that garlic can be considered a safe and effective agent for mitigating DZN-induced nephrotoxicity.
subject: ORIGINAL | Kidney Diseases
  topic: section
subject: Diazinon
  topic: keywords
subject: Nephrotoxicity
  topic: keywords
subject: Garlic
  topic: keywords
subject: Kidney
  topic: keywords
subject: Oxidative stress
  topic: keywords
creator: Saeed Afzali
creator: Behnaz Alafchi
creator: Elham Shiri
creator: Fereshteh Mehri
rights: Copyright (c) 2026 Iranian Journal of Kidney Diseases
date: 2026-02-25
publication date: 2026-02-25
starting page: 46
ending page: 53
doi: 10.61882/ijkd.20.01.8158

Incidence of Hospital-Acquired Hyponatremia and its Risk Factors in Hospitalized Children: A Longitudinal Study
type: item
description: Introduction. Hyponatremia in hospitalized children is associated with several clinical complications. This study aimed to evaluate the incidence and risk factors of hospital-acquired hyponatremia in pediatric patients. Method. A longitudinal study was conducted between 2016 and 2020 on hospitalized children who were admitted in Dr Sheikh Hospital, Mashhad University of Medical Sciences, Iran with normal serum sodium levels. Patients were followed for hyponatremia and its risk factors during hospitalization. Demographic data, clinical symptoms, underlying disease, type of serum, ward of hospitalization, and final diagnosis were recorded. Patients with incomplete blood samples or abnormal serum level of sodium at the time of admission were excluded. Result. A total of 456 children, including 267 males (58.6%) with a mean age of 69.40 ± 42.42 months were studied. The incidence of hyponatremia was 22.1%. The female sex (3.83 (95% confidence interval: 1.08, 13.59)) was the independent risk factors of hyponatremia. Children less than one year of age (2.68 (95% confidence interval: 0.97, 7.42) P = .057), were also borderline significant for the risk of hyponatremia. Conclusion. The incidence of hospital-acquired hyponatremia was 22.1%. The female sex was the independent risk factor of hyponatremia. Children less than one year of age may also be at risk for hyponatremia. Further studies are needed to confirm these findings.
subject: ORIGINAL | Kidney Diseases
  topic: section
subject: Hyponatremia
  topic: keywords
subject: Pediatric
  topic: keywords
subject: Hospital-acquired
  topic: keywords
subject: Sodium
  topic: keywords
subject: hyponatremia, child, hospital, sodium
  topic: subjects
subject: fluid and electrolytes
  topic: disciplines
creator: Elham Bakhtiari
creator: Farhad Heydarian
creator: Adeleh Azarshab
creator: Sara Saadat
rights: Copyright (c) 2025 Iranian Journal of Kidney Diseases
date: 2025-09-27
publication date: 2025-09-27
starting page: 206
ending page: 212
doi: 10.61882/ijkd.19.04.8541

Retrospective Analysis of Acute Kidney Injury in Hospitalizations with Covid-19
type: item
description: Introduction. Coronavirus Disease 2019 (COVID-19) affected the entire world. While the effects on the lungs are more pronounced, the kidneys are also susceptible, and there is a potential risk of acute kidney injury (AKI) among COVID-19 patients. This study aimed to evaluate the incidence, clinical characteristics, and outcomes of AKI in patients hospitalized with COVID-19. Methods. This study analyzed the incidence, characteristics, and outcomes of AKI in hospitalized patients with COVID-19. Medical records of 755 COVID-19 patients with AKI and 4647 patients without kidney injury admitted between March 2020 and July 2022 were analyzed at Karabuk Training and Research Hospital. We recorded patients’ demographic information, length of stay, laboratory results, and the necessity for renal replacement therapy. AKI staging was based on initial and peak values of renal parameters such as serum. Results. The results indicated a high incidence of AKI in COVID-19patients, particularly in those requiring intensive care units (ICU), where mortality rates were significantly high. The findings revealed that patients with AKI, especially those requiring hemodialysis (n = 110, 49.32%), had lower rates of recovery and discharge (n = 633, 83.84%), and significantly higher mortality rates compared to those without AKI (P = .032). The mortality rate in patients requiring hemodialysis was 33.64%, underscoring the severity of AKI and the high mortality risk associated with cases necessitating hemodialysis. Conclusion. The development of AKI in COVID-19 patients is associated with a significant increase in mortality risk, indicating the need for further detailed investigations to better understand this condition.
subject: ORIGINAL | Kidney Diseases
  topic: section
subject: Acute kidney injury
  topic: keywords
subject: COVID-19
  topic: keywords
subject: Mortality
  topic: keywords
subject: Hemodialysis
  topic: keywords
subject: Acute kidney injury
  topic: subjects
subject: COVID-19
  topic: subjects
subject: Mortality
  topic: subjects
subject: Hemodialysis
  topic: subjects
subject: Orginal Article
  topic: disciplines
creator: Öznur Sarı
creator: Mehmet Polat
rights: Copyright (c) 2026 Iranian Journal of Kidney Diseases
date: 2026-02-25
publication date: 2026-02-25
starting page: 10
ending page: 15
doi: 10.61882/ijkd.20.01.8878

Efficacy of Sacubitril/Valsartan in Treating Hemodialysis Patients with Reduced Ejection Fraction Heart Failure: A Retrospective Study
type: item
description: Introduction. Heart failure with reduced ejection fraction (HFrEF) is a prevalent and challenging complication among patients undergoing hemodialysis. Sacubitril/Valsartan (Sac-Val), an angiotensin receptor-neprilysin inhibitor, has shown promise in improving cardiac outcomes in HFrEF patients. This study aims to evaluate the efficacy and safety of Sac-Val in treating HFrEF in patients undergoing hemodialysis. Methods. This retrospective analysis was conducted on 30 patients with HFrEF undergoing regular hemodialysis at Beijing Shijingshan Hospital between January 2019 and January 2023. The patients were divided into two groups: the Sac-Val group (14 patients) and the control group (16 patients). The Sac-Val group received an initial dose of 50 mg, titrated over four weeks to a maximum tolerated dose of 100 mg, while the control group received conventional heart failure treatment without Sac-Val. Both groups continued regular hemodialysis three times weekly. Statistical analysis included independent t-tests or Mann–Whitney U tests for continuous variables, and chi-square or Fisher’s exact tests for categorical variables. Heart failure improvements, blood pressure, NT-proBNP levels, biochemical markers, and echocardiographic changes were assessed after one year. Results. The Sac-Val group showed significant improvements in systolic blood pressure (P = .027), NT-proBNP levels (P < .05), left ventricular ejection fraction (LVEF) (P < .04) compared to the control group. The Sac-Val group also had a higher total effective rate (85.71%) in alleviating heart failure symptoms compared to the control group (69%, P = .023). Conclusion. Sac-Val is a safe and effective treatment for HFrEF patients undergoing hemodialysis, potentially improving their quality of life, heart function and clinical outcomes.
subject: ORIGINAL | Dialysis
  topic: section
subject: Sacubitril/valsartan
  topic: keywords
subject: Heart failure with reduced ejection fraction
  topic: keywords
subject: Maintenance hemodialysis
  topic: keywords
subject: Chronic heart failure
  topic: keywords
subject: Neprilysin inhibitor
  topic: keywords
subject: Angiotensin receptor-neprilysin inhibitor
  topic: keywords
subject: Sacubitril/Valsartan
  topic: subjects
subject: Heart failure with reduced ejection fraction (HFrEF)
  topic: subjects
subject: Hemodialysis
  topic: subjects
subject: Chronic kidney disease
  topic: subjects
subject: Cardiovascular outcomes
  topic: subjects
subject: Nephrology
  topic: disciplines
subject: Cardiology
  topic: disciplines
subject: Clinical Medicine
  topic: disciplines
subject: Pharmacology
  topic: disciplines
subject: Medical Research
  topic: disciplines
creator: Yan Guo
creator: Weihua Li
creator: Zongli Diao
rights: Copyright (c) 2025 Iranian Journal of Kidney Diseases
date: 2025-09-27
publication date: 2025-09-27
starting page: 222
ending page: 231
doi: 10.61882/ijkd.19.04.8743

Correlation of Left Atrial Volume Index with Estimated Glomerular Filtration Rate in Chronic Kidney Disease: A Cross-Sectional Echocardiographic Study
type: item
description: Introduction. Chronic kidney disease (CKD) drives progressive left heart remodeling through volume overload, inflammation, and hemodynamic stress, manifesting as left atrial enlargement and diastolic dysfunction. This cross-sectional study evaluated correlations between estimated glomerular filtration rate (eGFR) and left heart echocardiographic parameters—including left atrial volume index (LAVi), E/e’ ratio, and atrial filling-related parameters—in CKD stages 2-4 to assess their utility as rapid, non-invasive predictors of renal function decline, particularly in emergency settings without laboratory access. Methods. 100 consecutive CKD patients (eGFR < 60 mL/min/1.73 m², excluding LVEF < 35%, atrial fibrillation, poor acoustic windows) underwent transthoracic echocardiography (Philips EPIQ CVx) at Modarres Hospital, Tehran (2020-2021). Confirmed left heart parameters included: LAVi (biplane area-length method, indexed to BSA); E/e’ ratio (pulsed-wave mitral E-velocity ÷ septal tissue Doppler e’-velocity); atrial filling parameters per ASE guidelines. eGFR calculated via CKD-EPI. Statistical analysis comprised Pearson/Spearman correlations, t-tests/Mann-Whitney U, and ROC curves (SPSS v22, P < .05). Results. Mean age 61.1 ± 12.7 years (65 males); eGFR 60.76 ± 14.15 mL/min/1.73 m². Strong inverse correlation: eGFR vs LAVi (r = -0.92, P < .001). Moderate inverse correlations: eGFR vs E/e’ (r = -0.54, P < .0001). Atrial filling parameters progressively impaired with CKD advancement. LAVi demonstrated excellent discriminatory performance: AUC 0.98 (95% CI 0.97-1.00) for stage 2 vs 3-4; AUC 0.92 (95% CI 0.86-0.97) for stage 3. Optimal cutoffs: ≥ 30 mL/m² (sens 100%, spec 91.4%); ≥ 41 mL/m² (sens 100%, spec 97.9%). Performance robust across LVEF subgroups. Conclusion. LAVi, E/e’, and atrial filling parameters exhibit strong, progressive correlations with eGFR decline in CKD, offering excellent bedside discrimination of disease stages independent of laboratory measures. T…
subject: BRIEF COMMUNICATION | Dialysis
  topic: section
subject: hronic Kidney Disease (CKD)
  topic: keywords
subject: Left Atrial Volume index (LAVi)
  topic: keywords
creator: Abdoulhamid Bagheri
creator: Sepideh Jame Bozorgi
creator: Masoume Hesabi Hesari
creator: Amirhossein Miladpour
rights: Copyright (c) 2026 Iranian Journal of Kidney Diseases
date: 2026-02-25
publication date: 2026-02-25
starting page: 60
ending page: 68
doi: 10.61882/ijkd.20.01.9308

Psychological Burden of Chronic Kidney Disease Caregivers
type: item
description: Introduction. Caregiver roles and responsibilities in chronic kidney disease (CKD) patients have pervasive effects on the physical, social, and emotional well-being of caregivers, yet these issues are often under-prioritized in medical management. This study assessed depression, anxiety, burden, and quality of life (QOL) in caregivers of CKD patients. Methods. Caregiving burden, quality of life, depression, and anxiety were assessed using the Zarit Burden Interview (ZBI), SF-36 QOL questionnaire, Beck Anxiety Inventory, and Beck Depression Inventory, respectively, among caregivers of CKD patients on maintenance hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (TX). Results. The study groups consisted of 100, 105, and 62 caregivers among PD, HD, and TX patients, respectively. The mean scores of depression, anxiety, and burden in all caregivers were 13.44 (SD 11.57), 15.77 (SD 12.49), and 13.33 (SD 9.51), respectively. More than 40% of caregivers had depression, while 68.5% reported moderate to severe anxiety. Although anxiety, depression, and burden did not differ significantly across the three groups, the physical function scores of caregivers of PD patients were significantly better than those of the other groups (P = .033). Caregivers with higher depression, anxiety, and burden scores had significantly lower scores in both physical (P < .001, P < .001, P = .022) and psychological health (all P < .001) domains of QOL. Sex and education had a strong influence on depression, anxiety, burden, and QOL. Conclusion. Caregivers of CKD patients, especially females with lower education, are at increased risk of psychological burden. Early screening for mental health issues in caregivers, along with supportive interventions, should be incorporated into treatment guidelines for CKD patients.
subject: ORIGINAL | Kidney Diseases
  topic: section
subject: Caregiver
  topic: keywords
subject: Depression
  topic: keywords
subject: Anxiety
  topic: keywords
subject: Burden
  topic: keywords
subject: Quality of life
  topic: keywords
subject: Chronic kidney disease
  topic: keywords
creator: Tahere Kermany Ranjbar
creator: Hassan Argani
creator: Saeid Kermaniranjbar
creator: Ahmadali Noorbala
creator: Shahnaz Atabak
creator: Behnaz Riazalhosseini
creator: Nzanin Alipoor
creator: Farid Zaiery
creator: Shania Yoonesi
rights: Copyright (c) 2026 Iranian Journal of Kidney Diseases
date: 2026-02-25
publication date: 2026-02-25
starting page: 54
ending page: 59
doi: 10.61882/ijkd.20.01.9301