Javid Safa

Tabriz University of Medical Sciences, Tabrīz, East Azarbaijan, Iran

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Publications (14)14.36 Total impact

  • Article: Serum Receptor Activator of Nuclear Factor-κ B Ligand, Osteoprotegrin, and Intact Parathyroid Hormone in Hemodialysis and Renal Transplant Patients.
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    ABSTRACT: Serum receptor activator of nuclear factor-κ B ligand and osteoprotegrin are mediated to vascular calcification in the general population. Our knowledge is very sparse in hemodialysis and renal transplant patients. Receptor activator of nuclear factor-κ B ligand, osteoprotegrin, intact parathyroid hormone, calcium, and phosphorus were measured in blood samples of 45 hemodialysis and 45 age-matched renal transplant patients. Osteoprotegrin (P = 0.001) and intact parathyroid hormone (P = 0.001) levels in the hemodialysis patients were higher than the renal transplant recipients. Osteoprotegrin had positive correlation with duration of dialysis and age in the hemodialysis (r = 0.88, P = 0.001 and r = 0.34, P = 0.02, respectively) and renal transplant patients (r = 0.92, P = 0.001 and r = 0.46, P = 0.001, respectively). Hemodialysis patients have higher osteoprotegrin levels than the renal transplant recipients. It may act as a protective factor for renal osteodystrophy or only as a secondary phenomenon of advanced renal failure.
    Therapeutic apheresis and dialysis: official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy 12/2012; 16(6):600-4. · 1.39 Impact Factor
  • Article: Serum Fetuin-A and Pentraxin3 in hemodialysis and renal transplant patients.
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    ABSTRACT: The aim of the present study was to evaluate of Fetuin-A and Pentraxin3 (PTX3) as the main factors for vascular calcification and inflammation in hemodialysis (HD) and renal transplant (RT) patients. Serum was obtained from 45 stable chronic HD patients and 44 stable RT recipients. Biochemical factors, intact Parathormone, high-sensitive C-reactive protein (hsCRP), Fetuin-A and PTX3 levels were determined by standard methods. In the RT recipients PTX3 level was significantly higher than the HD patients [5.78(1.09-20.36) ng/mL vs. 1.65(0.24-7.89) ng/mL, p ≤ 0.001]. Serum Fetuin-A concentration was significantly higher in the HD compared to RT group [43.39(27.75-81.48) ng/mL vs. 38.76(22.26-89.07) ng/mL, p=0.020]. hsCRP level was also higher in the HD than the RT group [2.90(0.1-8.50) mg/L vs. 1.1(0.1-7.9) mg/L, p=0.003]. Although our study shows that serum PTX3 is increased and Fetuin-A is decreased after successful RT, their direct role on atherosclerosis needs further studies in the future.
    Clinical biochemistry 04/2012; 45(10-11):775-9. · 2.02 Impact Factor
  • Article: Effect of lovastatin therapy and withdrawal on serum uric acid level in people with type 2 diabetic nephropathy.
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    ABSTRACT: BaCKGROUND/AIM: A high uric acid (UA) level is demonstrated as a major risk factor of nephropathy and cardiovascular events in people with type 2 diabetes (T2D). This study aimed to evaluate the lovastatin effect on serum UA levels in people with type 2 diabetic nephropathy (T2DN). Thirty patients completed the study course, out of 38 adult male patients with T2DN who were initially enrolled. Lovastatin, 20 mg/d, was administered for 90 days. Afterwards, lovastatin was withdrawn for the next 30 days. Blood samples were obtained at baseline, after 45 and 90 days of intervention, and 30 days after the withdrawal of lovastatin. The serum level of UA was assessed by the uricase/PAP method. The lipid profile and high-sensitivity C-reactive protein (hs-CRP) were determined using commercial reagents and the ELISA method. After 90 days of lovastatin intervention, cholesterol (Chol) and low-density lipoprotein cholesterol (LDL-C) levels significantly decreased and the high-density lipoprotein cholesterol (HDL-C) level increased significantly, despite the unchanged level of triglyceride (TG). After withdrawal, Chol, TG, and LDL-C levels were significantly increased, without any change in the HDL-C level. The baseline serum UA level was 5.94 ± 2.02 mg/dL and not changed after the intervention (5.95 ± 2.21 mg/dL; p = 0.969) and withdrawal period (5.80 ± 1.51 mg/dL; p = 0.647). The changes of serum UA levels were not correlated with the changes of serum hs-CRP levels, both after intervention and withdrawal (p = 0.963 & p = 0.835). Lovastatin does not have any effect on the serum UA level in people with T2DN. There is no correlation between the anti-lipidemic and anti-inflammatory effects of lovastatin and its effect on serum UA.
    Nucleosides Nucleotides &amp Nucleic Acids 04/2012; 31(4):353-63. · 0.90 Impact Factor
  • Article: Effects of alpha-lipoic acid supplementation on inflammation, oxidative stress, and serum lipid profile levels in patients with end-stage renal disease on hemodialysis.
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    ABSTRACT: We examined the effects of alpha-lipoic acid (ALA) supplementation on inflammation, oxidative stress, and serum lipid profile levels in hemodialysis (HD) patients. This was a double-blinded, randomized, placebo-controlled clinical trial. The present study involved HD centers in Tabriz, Iran. Participants included 63 patients with end-stage renal disease (43 men and 20 women; age range: 22-79 years) undergoing maintenance HD. HD patients were randomly assigned into the supplemented group (n = 31), receiving a daily dose of ALA (600 mg), or a control group (n = 32), receiving placebo for 8 weeks. High sensitivity C-reactive protein (hsCRP), malondialdehyde, total antioxidant status, total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were measured at baseline and after 8 weeks of supplementation. At the end of intervention, 11 patients were excluded from the study. HsCRP levels decreased by 18.7% in the supplemented group after 8 weeks of supplementation, and the reduction was significant in comparison with the placebo group (P < .05); this finding was also significant after adjusting for baseline values of hsCRP. The mean malondialdehyde and total antioxidant status levels did not change significantly in the 2 groups during the study. The mean high-density lipoprotein cholesterol concentrations increased significantly in the supplemented group at the end of the study (P < .05); however, this improvement was not statistically significant as compared with the placebo group. No significant alterations were observed in the other lipid profile parameters within each group during the study. ALA supplementation significantly reduced hsCRP levels, which is a risk factor for cardiovascular disease in HD patients.
    Journal of Renal Nutrition 09/2011; 22(2):244-50. · 1.57 Impact Factor
  • Article: Lovastatin raises serum osteoprotegerin level in people with type 2 diabetic nephropathy.
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    ABSTRACT: Osteoprotegerin (OPG), a glycoprotein, is a member of the tumor necrotizing factor alpha receptor super-family. By considering the possible role of OPG in cardiovascular disease (CVD), higher incidence of CVD in people with type 2 diabetic nephropathy (T2DN), and anti-atherosclerotic effects of statins, the present study aimed to investigate the effects of lovastatin on serum levels of OPG and soluble receptor activator of nuclear factor-κB ligand (sRANKL) in people with T2DN. Thirty patients completed the study course, out of 38 adult male patients with T2DN who were initially enrolled. Lovastatin, 20mg/d, was administered for 90 days. Afterwards, lovastatin was withdrawn for the next 30 days. Serum levels of OPG and sRANKL were measured using commercial ELISA kits at baseline, after 90 days of intervention, and after 30 days of withdrawal of lovastatin. Serum level of OPG was significantly increased (10.76 ± 16.44) and decreased (-7.38 ± 11.98) during 90 days of intervention and 30 days of withdrawal periods, respectively, while, sRANKL level was significantly decreased (-1192.08 ± 578.20) and increased (4418.67 ± 2124.66) during the same periods, respectively. Lovastatin therapy increased serum OPG level and decreased sRANKL level in people with T2DN. The withdrawal of lovastatin decreased serum OPG level, while sRANKL level was extensively increased.
    Clinical biochemistry 11/2010; 43(16-17):1294-9. · 2.02 Impact Factor
  • Article: Lovastatin enhances paraoxonase enzyme activity and quells low-density lipoprotein susceptibility to oxidation in type 2 diabetic nephropathy.
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    ABSTRACT: : To investigate the effect of lovastatin therapy and withdrawal on paraoxonase 1 (PON1) and arylesterase (ARE) activities, and low-density lipoprotein cholesterol (LDL-C) susceptibility to oxidation in people with type 2 diabetic nephropathy (T2DN). : Lovastatin (20mg/day) was administered to 30 people with T2DN for 90days and then withdrawn for 30days. PON1 and ARE activities were measured by the spectrophotometric method. Susceptibility of LDL-C to oxidation was determined as the production of conjugated dienes. : After 90days of lovastatin intervention, PON1 and ARE activities and LDL-C lag phase were significantly increased (p=0.004, 0.002, and <0.001), while after 30days of lovastatin withdrawal, PON1 and ARE activities and LDL-C lag phase had not changed significantly. : Lovastatin therapy improves PON1 and ARE activities, and LDL-C susceptibility to oxidation. Despite withdrawal of lovastatin, PON1 and ARE activities, and LDL-C susceptibility to oxidation remain unchanged in people with T2DN.
    Clinical biochemistry 10/2010; 44(2-3):165-70. · 2.02 Impact Factor
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    Article: Protective effect of grape seed extract on gentamicin-induced acute kidney injury.
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    ABSTRACT: INTRODUCTION. This study was designed to determine the protective effect of red grape seed extract (RGSE) on gentamicin-induced nephrotoxicity in rats. MATERIALS AND METHODS. Thirty male Wistar rats were divided into 3 groups to receive RGSE, for 60 days followed by intraperitoneal injection of saline solution (as placebo) for 8 days (group 1); RGSE followed by gentamicin for 8 days (group 2); and gentamicin without pre-medication of RGSE (group 3). Oral RGSE, 40 mg/kg/d, and intraperitoneal injection of gentamicin, 100 mg/kg/d, were administered in these groups of rats. Blood and urine samples were collected on days 0 and 68 of the study. Then, the kidneys were removed for pathologic examination. RESULTS. On day 68, serum creatinine and blood urea nitrogen concentrations were highest in group 3, which was significantly higher than in group 1 (P = .001 and P = .004, respectively), while slightly higher than in group 2 (P = .30 and P = .50, respectively). Fractional excretion of sodium was not significantly different between the three groups. Histopathological evaluation showed that rats in group 3 had significantly higher degrees of severe acute tubular necrosis and interstitial mononuclear cell infiltration than the rats in groups 1 and 2 (P < .001). CONCLUSIONS. This animal study suggests that pretreatment with RGSE protects against gentamicin-induced acute kidney injury as evident on tissue histology. However, this was not accompanied with significant improvement in biochemical markers of kidney injury.
    Iranian journal of kidney diseases 10/2010; 4(4):285-91. · 0.87 Impact Factor
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    Article: C-reactive protein level following treatment and withdrawal of lovastatin in diabetic nephropathy.
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    ABSTRACT: We aimed to evaluate the high-sensitivity C-reactive protein (HS-CRP) level changes at the beginning and after withdrawal of lovastatin therapy in patients with diabetic nephropathy. Thirty male patients with type 2 diabetes mellitus and diabetic nephropathy were enrolled in the study. Lovastatin, 20 mg/d, was administered for 90 days. Afterwards, Lovastatin was withdrawn for the next 30 days. Blood samples were obtained before the intervention, on the 90th day, and days 1, 7, and 30 after withdrawal of Lovastatin. Serum level of HS-CRP was determined by enzyme-linked immunosorbent assay. Alterations in lipid profile was assessed, as well, and compared with that of HS-CRP. Serum level of HS-CRP was significantly reduced after 90 days of lovastatin therapy (P < .001). Then, the HS-CRP reached the pretreatment baseline level on the 7th day after lovastatin withdrawal and maintained until the 30th day (P < .001). Serum HS-CRP changes showed no significant association with lipid profile except for serum total cholesterol level (r = 0.9, P = .006) after 3 months of lovastatin therapy. Their association was re-evaluated after 7 days and 1 month of treatment withdrawal and no significant correlations were found. Our findings suggest that lovastatin decreases serum CRP level in patients with diabetic nephropathy, and 7 days after lovastatin cessation, CRP level increases again.
    Iranian journal of kidney diseases 04/2009; 3(2):93-8. · 0.87 Impact Factor
  • Article: Post-transplant urological and vascular complications
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    ABSTRACT: To determine the prevalence of urological and vascular complications in renal trans-plant recipients (RTx) at Tabriz Renal Transplant Center, we studied 55 recipients of renal allo-grafts (25 male and 29 female patients with a mean age of 38.3 ± 13.4 years) from October 2005 to November 2006. The surgical complications in our study included hematomas: 20.4%, renal artery stenosis: 20.4%, calculi: 7.4%, hydronephrosis or ureteral stricture: 5.6%, urinary leakage: 5.6%, lymphoceles: 1.9%, and renal vein thrombosis: 1.9%. We conclude that the most common urologic complications in our center were ureteric strictures and urine leaks, and the most common vascular complication was renal artery stenosis.
    Saudi Journal of Kidney Diseases and Transplantation. 01/2009;
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    Article: Prevention of DNA damage in renal transplantation by losartan and enalapril: the role of renin-angiotensin system polymorphisms.
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    ABSTRACT: In this study the effect of losartan and enalapril on the reduction of DNA damage was evaluated in regard to renin-angiotensin system (RAS) polymorphisms. After determination of genotypes of RAS polymorphism by PCR, 64 renal transplant recipients were randomly allocated to one of four groups: the first and second groups were treated with E (E+: 10 mg/day) and L (L+: 50 mg/day) alone, respectively. The third group received E+L (E+L+: 10 + 50 mg/day), and the forth group received no medication (E-L-). The subjects were followed for 8 weeks. After a 2-week washout period, the E group changed to L and vice versa as a cross-over design. They were followed for another 8 weeks. Before and after treatment, we checked 8-OHdG and malondialdehyde (MDA) as biomarkers of DNA damage and lipid peroxidation, respectively. 8-OHdG levels were significantly decreased after treatment in the E+L+ and L+ groups (P < 0.001, P = 0.001, respectively). Only the TT genotype of AGT had the most antioxidative role regarding the treatment (P = 0.01). We found a remarkable correlation between MDA and DNA damage levels before and after intervention (r = 0.48, P < 0.001; r = 0.35, P = 0.006). The protective effects of L+ and E+L+ on DNA breaks are surprising regarding the RAS polymorphisms.
    Clinical and Experimental Nephrology 02/2008; 12(1):65-73. · 1.37 Impact Factor
  • Article: Calcium and phosphorus metabolism in stable renal transplant recipients.
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    ABSTRACT: This study sought to elucidate the status of calcium, phosphorus, and parathyroid hormone in patients following kidney transplant. In this cross-sectional study, 20 renal transplant recipients were evaluated. For each patient, age, sex, time since transplant, and body weight were recorded. Inclusion criteria were age > 14 years and good allograft function defined as a serum creatinine level < 132.6 micromol/L for at least 6 months after transplant. Exclusion criteria were immunosuppressive therapy other than the standard triple regimen (cyclosporine, prednisolone, and mycophenolate mofetil or azathioprine) and use of any drug known to alter calcium hemostasis. Levels of 24-hour urine calcium, phosphorus, creatinine, and uric acid, as well as concentrations of hemoglobin, serum creatinine, calcium, and phosphorus were measured. To obtain a mean value of serum intact parathyroid hormone in transplant recipients at our center, serum intact parathyroid hormone levels were additionally quantitated in another group of 30 renal transplant recipients. The mean hemoglobin level was 135.6 +/- 17.7 g/L, the mean serum creatinine level was 105.0 +/- 15.3 micromol/L, and the mean serum calcium and phosphorus levels were 2.25 +/- 0.17 mmol/L (normal range, 2.02-2.60 mmol/L) and 1.28 +/- 0.24 mmol/L (normal range, 0.81-1.61 mmol/L), respectively. The mean serum intact parathyroid hormone level was 33.17 +/- 14.67 ng/L (normal range, 10-60 ng/L). Mean 24-hour urine calcium and phosphorus values were 2.32 +/- 1.68 mmol/day (normal, 2.49-6.24 mmol/day) and 19.77 +/- 8.31 mmol/day (normal, 12.91-41.98 mmol/day), respectively. A positive correlation was found between serum calcium and alkaline phosphatase levels (r = +0.71, P = .006). Hemoglobin level was negatively correlated with serum phosphorus level (r = -0.65, P = .003) and sex (r = -0.57, P = .003) and positively correlated with urine creatinine levels (r = +0.69, P = .001). Renal transplant recipients with stable allograft function may have normal serum calcium, phosphorus, and intact parathyroid hormone levels. However, presence of hypocalciuria and elevated serum alkaline phosphatase levels might imply impaired calcium metabolism in these patients.
    Experimental and clinical transplantation: official journal of the Middle East Society for Organ Transplantation 12/2007; 5(2):670-2. · 0.81 Impact Factor
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    Article: Respiratory failure in organophosphate insecticide poisoning.
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    ABSTRACT: Organophosphate compounds (OP) are usual insecticides and may poison human beings in a suicide attempt or accidental exposure. They inhibit activity of cholinesterase. Poisoning may be enough sever for intensive care support. In this paper, we study the prevalence and management of sever cases as well. We studied patients with OP poisoning, from November 2002 to November 2005 in Sina Hospital, Tabriz, Iran, retrospectively and found patients who needed intensive care. During 4 years study, we documented 80 patients who were hospitalized due to OP poisoning and used drugs. Treatment with intravenous atropine and pralidoxime was started as soon as possible. We did not administer pralidoxim for 20 patients due to late admission (5 patients) and unavailability of the medicine (15 patients). Forty-five male and 35 female patients were enrolled in our study. The majority of the patients used OP for suicide attempt and 4 patients had accidental exposure. The mortality rate was 18% in patients who were treated with pralidoxim and patients without pralidoxim had a mortality rate of 21%. Ten patients were mechanically ventilated and the mortality rate was 50%. In patients without MV the mortality rate was 11.7%. The duration of intensive care stay was 7.1 +/- 2 days. Organophosphate compounds poisoning is a serious and lethal condition and needs early diagnosis and appropriate treatment. In patients with respiratory failure the mortality is very high; therefore we recommended early diagnosis, careful monitoring and appropriate management of complications in reducing the mortality rate.
    Saudi medical journal 04/2007; 28(3):405-7. · 0.52 Impact Factor
  • Article: Aspergillosis after renal transplantation.
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    ABSTRACT: We report a case of a 32-year-old man who presented with invasive pulmonary aspergillosis and bronchial ulcerations that resulted in massive hemoptysis and concomitant thrombotic microangiopathy shortly after cadaveric renal transplantation. Despite vigorous antifungal therapy the patient succumbed due to apoplexy of brain fungal mass lesion.
    Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 16(3):330-3.
  • Article: Post-transplant urological and vascular complications.
    [show abstract] [hide abstract]
    ABSTRACT: To determine the prevalence of urological and vascular complications in renal trans-plant recipients (RTx) at Tabriz Renal Transplant Center, we studied 55 recipients of renal allo-grafts (25 male and 29 female patients with a mean age of 38.3 +/- 13.4 years) from October 2005 to November 2006. The surgical complications in our study included hematomas: 20.4%, renal artery stenosis: 20.4%, calculi: 7.4%, hydronephrosis or ureteral stricture: 5.6%, urinary leakage: 5.6%, lymphoceles: 1.9%, and renal vein thrombosis: 1.9%. We conclude that the most common urologic complications in our center were ureteric strictures and urine leaks, and the most common vascular complication was renal artery stenosis.
    Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 20(5):867-71.