Mohammad Mehdi Sagheb

Shiraz University of Medical Sciences, Shīrāz, Fars, Iran

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Publications (13)14.57 Total impact

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    ABSTRACT: Cytokines are important factors determining the outcome of transplantation. Since host ability in cytokine production may be affected by cytokine genes polymorphisms. The aim of the present study was to investigate the effect of IL-17, IL-23R and IL-21 gene polymorphisms in outcome of kidney transplantation. A total of 250 kidney transplant recipients were included in this study. Over all 70 recipients (28%) experienced an acute rejection. IL-17 197 A/G, IL-21 +1472G/T, IL-21 5250 C/T, and IL-23R C/T gene polymorphisms were evaluated by PCR-RFLP or ARMS-PCR methods. The serum levels of IL-17 and IL-21 were also checked by ELISA. IL-17 GG carriers and G allele were significantly more frequent in patients with acute rejection compared to patients without any sign of rejection (p=0.045 and p=0.032, respectively). In addition after gender classification, IL-23R AA carriers and A allele were significantly more frequent in male patients experienced an acute rejection compared to non-rejected patients (p=0.03, p=0.011, respectively). The IL-17 serum levels have also shown a significant differences between rejected and non-rejected group (24.37±32.94 for AR and 8.6±9.9 for non-AR groups, respectively; p=0.035). The mentioned results indicate that IL-17GG genotype, G allele and its serum level have predictive values for acute rejection. GG genotype and G allele of IL-17 is a genetic risk factor for development of acute rejection. Also, AA genotype and A allele of IL-23R is a sex dependent genetic risk factor for development of acute rejection, but this subject need to be studied in different population.
    Transplant Immunology 11/2013; · 1.52 Impact Factor
  • Tania Dehesh, Najaf Zare, Peyman Jafari, Mohammad Mehdi Sagheb
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    ABSTRACT: This study aimed to assess the psychometric properties of the Persian version of the Ferrans and Powers 3.0 quality of life index (dialysis type) in patients receiving hemodialysis (HD) in order to describe their health-related quality of life (HRQOL). The sample (n = 150) consisted of adult HD patients receiving HD for at least 6 months from the establishment of the study. A total of 88 men and 62 women, with an average age of 50.47, from Shiraz, southern Iran, were enrolled in this study. The questionnaire was translated into Persian language using back translation and bilingual techniques. Convergent, discriminant, and construct validity of the Ferrans and Powers 3.0 dialysis version was evaluated. To check the internal consistency of the data, Cronbach's alpha, which indicates the reliability of the data, was used for the entire questionnaire and for the subscales. The convergent and discriminant validity and success scaling rate for both sexes were 100 %. Cronbach's alpha was 0.95 overall, which was greater than 0.7 for all the subscales except for the family subscale. Our results suggest that HD patients in southern Iran have higher HRQOL scores when compared with those in other countries. Despite the higher mean HRQOL score for men compared with women, men had significantly higher HRQOL scores only in the health and functioning subscale. There was no significant correlation between HD patients' HRQOL and educational level. The Persian version of Ferrans and Powers 3.0 has sufficient reliability and validity for measuring the quality of life of Persian-speaking HD patients. Female HD patients need more support and attention from family and society.
    International Urology and Nephrology 08/2013; · 1.33 Impact Factor
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    ABSTRACT: Metabolic complications are common after kidney transplantation and can cause considerable morbidity and even threaten graft function. This study aimed to investigate the prevalence of hyperlipidemia and its impact on graft function in 10 years of follow-up of patients undergoing kidney transplantation. This prospective study was conducted on 73 patients who underwent kidney transplantation between April 1996 and April 1998 to evaluate their lipid profile and graft function as well as the effect of hyperlipidemia in long-term kidney allograft function. Kidney allograft dysfunction was defined as a serum creatinine level greater than 1.8 mg/dL. The mean serum triglyceride level was higher at 1, 3, 5, and 10 years, but not 7 years, among patients with graft dysfunction in comparison with patients with normal graft function. However, these differences were not significant. The mean serum total cholesterol level was significantly higher in patients with graft dysfunction at 1 year (P = .03). Of the patients with graft dysfunction, 94.7% developed hypercholesterolemia at the first year visit, as compared to 70.4% of patients with normal graft function (P = .03). The frequency of hypercholesterolemia was higher among those with a serum creatinine greater than 1.8 mg/dL at all other visits, but without significant difference. Hyperlipidemia is common after kidney transplantation, especially in the first year after transplantation. Higher serum total cholesterol levels might be related to graft dysfunction.
    Iranian journal of kidney diseases 01/2012; 6(1):49-55. · 0.94 Impact Factor
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    ABSTRACT: Thiopurine S-methyltransferase is an enzyme that catalyzes S-methylation of azathioprine as an immunosuppressive drug. Genetic polymorphisms influence thiopurine S-methyltransferase activity. There are 3 variant alleles: thiopurine S-methyltransferase*2, *3A, and *3C are responsible for more than 95% cases of low-enzyme activity. We studied these polymorphisms and the occurrence of azathioprine adverse effects in 50 renal transplant recipients undergoing triple immunosuppressive therapy including azathioprine, cyclosporine, and prednisone. Thiopurine S-methyltransferase genetic polymorphism was determined by polymerase chain reaction restriction fragment length polymorphism assay and allele-specific polymerase chain reaction methods. Azathioprine dosage; leukocyte, erythrocyte, and platelet counts; and graft rejection episodes were analyzed during hospitalization. Two patients (2%) were heterozygous for thiopurine S-methyltransferase*3C, the remaining patients were thiopurine S-methyltransferase wild-type *1/*1 (98%). Thiopurine S-methyltransferase wild-type homozygous and heterozygous patients were administered similar azathioprine dosages at the beginning of treatment (2.42 ± 0.50 and 2.52 ± 0.40 mg/kg/24 h). During subsequent days, mean azathioprine dosage administered to thiopurine S-methyltransferase wild-type homozygous patients was similar to heterozygous patients, but with no statistical difference (P = .28). Three patients had an acute rejection episode during this time. Five patients (10%) had reduced azathioprine dosage owing to adverse effects. Adverse reactions consisted of hematotoxicity (n=2), hepatotoxicity (n=1), and gastrointestinal toxicity (n=2). All recipients were wild-type homozygotes. The frequency of thiopurine S-methyltransferase gene mutations is low among our patients. The incidence of adverse reactions to azathioprine was also low, even in patients carrying a variant of thiopurine S-methyltransferase. We conclude that determining thiopurine S-methyltransferase genotype is not useful in our population to predict adverse reactions to azathioprine.
    Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation. 08/2011; 9(4):241-6.
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    ABSTRACT: INTRODUCTION. This study aimed to compare outcomes of kidney transplantation in patients with systemic lupus erythematosus (SLE) and a matched control group of non-SLE kidney recipients. MATERIALS AND METHODS. In a case-control study, 33 patients with kidney transplantation due to end-stage renal disease caused by SLE were matched to a control group consisted of 33 non-SLE patients who had been transplanted during the same period of time in our center. The clinical characteristics, complications, and patient and graft survival were compared between the two groups. RESULTS. In each group, 12 patients (36.4%) received a kidney from a deceased donor, 15 (45.4%) from a living unrelated donor, and 6 (18.2%) from a living related donor. There was no significant difference between the outcome in SLE patients and duration of dialysis before transplantation. The mean duration of hospital stay was 23.4 ± 18.1 days in the SLE group, while it was 13.0 ± 7.3 days in the controls (P = .006). One-year graft survival was 79.0% in patients with SLE and 90.9% in non-SLE patients (P = .17). One-year patient survival was 93.9% in patients with SLE versus 81.8% in the controls (P = .26). Nine patients in the SLE group versus 11 patients in the control group developed posttransplant complications (P = .59). CONCLUSIONS. Although hospital stay after transplantation was longer in the SLE kidney recipients than controls, safety of kidney transplantation was comparable. Graft failure in the SLE patients was not significantly different between patients with different sources of kidneys.
    Iranian journal of kidney diseases 01/2011; 5(1):53-6. · 0.94 Impact Factor
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    ABSTRACT: We present an unusual case of a chronic hemodialysis patient with moderate diffuse acrocyanosis and prominent unilateral clubbing of his right hand fingers, with classic physical features of hypertrophic osteoarthropathy. The patient's left hand, which had a functioning arteriovenous fistula, did not show any evidence of clubbing. We briefly discuss the different theories in regards to the pathogenesis of clubbing, and the potential role of arteriovenous fistula in preventing its occurrence.
    Hemodialysis International 01/2010; 14(1):84-6. · 1.44 Impact Factor
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    ABSTRACT: Generalized pruritus is a significant complication in end-stage renal disease patients. The mechanism is unknown and most treatments are ineffective. This study is the first clinical trial designed to evaluate the effect of cromolyn sodium (CS) on renal itch. Sixty-two haemodialysis (HD) patients with pruritus were enrolled into the study and were randomly assigned to receive CS or placebo (135 mg three times daily) for 8 weeks. Patients were asked to record the severity of their pruritus on each dialysis session on a visual analogue scale (VAS) during the 8 weeks of treatment and 4 weeks following discontinuation of treatment. Serum tryptase levels were determined at baseline, after 8 weeks of treatment and 4 weeks after discontinuation of treatment. Data were analysed in 21 patients in the CS group and 19 patients in the placebo group that completed the study. A significant difference was seen in the severity of pruritus between the two groups during the period of study. Level of pruritus decreased from 8.48 +/- 2.2 to 0.9 +/- 1.8 after 8 weeks of treatment with CS. Geometric mean of serum tryptase at baseline and 8 weeks after treatment were 21.3 and 19.5 ng/ml for the CS group and 18.03 and 18.2 ng/ml for the placebo group, respectively. Although the geometric mean of tryptase had decreased in the CS group, this decrease was not statistically significant (P = 0.214). CS can significantly reduce the severity of pruritus in HD patients, but this effect is not due to a decrease in serum tryptase level.
    Nephrology Dialysis Transplantation 12/2009; 25(5):1541-7. · 3.37 Impact Factor
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    ABSTRACT: Anabolic androgenic steroids are widely used by athletes for increasing their muscle mass. These drugs are also used by some patients with chronic renal disease. But the effect of these drugs on the renal structure has received less attention. To investigate which parts of the kidney are affected by these drugs, mice kidneys were studied stereologically after injection of nandrolone decanoate (ND), an anabolic androgenic steroid. The treated group received nandrolone decanoate intraperitoneally (solved in olive oil) in doses of 3mg/kg of body weight and administered in one, two and three doses, respectively, in the first, second and third week of treatment. The mice in the control group received an olive oil solution. One week after the last injection, the mice were anaesthetized and their kidney removed. The analysis of data revealed that the weight of kidney was increased approximately 30% (p < or = 0.006) and its volume increased approximately 25% (p < or = 0.02) in ND treated mice in comparison with the control group. The volume of the cortex increased in ND treated animals approximately 44% (p < or = 0.006). Proximal convoluted tubules (PCT) and distal convoluted tubules (DCT) volume increased approximately 25% (p < or = 0.02) and approximately 68% (p < or = 0.02) in ND treated mice. The volume of glomeruli, other ducts, connective tissues, vessels and the length of PCT, DCT, collecting and Henle's ducts and vessels did not show significant differences. CONCLUSION: ND can increase the volume of the renal cortex and its two main parts, i.e. PCT and DCT in mice.
    Micron 09/2008; 40(2):226-30. · 1.88 Impact Factor
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    ABSTRACT: Data regarding the socioeconomic status in Iranian kidney transplant (KT) recipients is lacking. In this cross sectional descriptive study we evaluated the socio-economic status of 100 KT recipients in Shiraz organ transplantation center. In a cross-sectional design, we randomly selected and interviewed 100 RT recipients (50 males and 50 females). Data regarding age, gender, martial status, occupation, level of education, number of children, type of insurance, monthly household income, place of residence, ownership of a personal transportation device, duration and frequency of pre-transplant dialysis, family history of CRF (Chronic renal failure), and etiology of renal disease were obtained. There were 50 (50%) patients aged between 16 and 35 years, 55 had a family history of CRF, 60 had been on dialysis for more than a year, 61 were married, 47 did not have any children, 41 had more than 3 children, and 65 were unemployed due to physical and emotional impairment as a result of their disease. The majority (73%) did not have a high school diploma, 15% were illiterate, 85% were below the poverty line, 52% were from rural areas, and 98% were covered by insurance. We conclude that patients with CKD in our study had acquired this condition possibly due to negligence and lack of basic health care in the lower socioeconomic class. In addition, KT is an available therapeutic modality to lower socio-economic level in Iran.
    Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 04/2008; 19(2):286-90.
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    ABSTRACT: Autosomal dominant polycystic kidney disease (ADPKD) is a common cause of end-stage renal disease and a common indication for renal transplantation. Patients with ADPKD show some differences in graft outcome and complications following renal transplantation. This study was undertaken to evaluate the demographics, outcome and complications of renal transplantation in patients with ADPKD. In a retrospective case-control design, 51 patients with ADPKD were recognized amongst a total of 1200 renal transplant patients. For each case, a matched control based on sex, age (+/- 5 years) and type of kidney donor, was selected. All relevant data were gathered using patients' records and PNOT software. There were 34 males (66.7%) and 17 females (33.3%) with ADPKD. Mean age at transplantation was 42.6 +/- 14.3 years and source of donor organ was predominantly live unrelated (72.5%). Forty patients (78.4%) had extra-renal manifestations of ADPKD, the most common of which were cardiac valvular disease (24 cases, 47.1%), and liver cysts (10 cases, 19.6%). Rejection occurred in 12 patients in the case-group (23.5%) in comparison to nine patients (17.6%) in the control group (p > 0.05). Twenty-nine cases (56.9%) did not develop any complications. The common complications noted after transplantation included infections (15.7% in cases vs 19.6% in controls), and cerebrovascular accidents (13.7% in cases vs 16.6% in controls). Patient outcome after short- and long-term follow-up was slightly better in the ADPKD population than the control group; however, it was not statistically significant. Also, no complication was found to occur more frequently in ADPKD patients.
    Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 01/2008; 19(1):72-5.
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    ABSTRACT: With increasing long-term graft survival and life-long immunosuppression, cardiovascular disease and infectious complications are major causes of morbidity and mortality. We retrospectively evaluated 1200 consecutive kidney transplant patients at Shiraz Organ Transplant Center from December 1988 to December 2003. Data on demographic profile, donor source, blood pressure, rejection episodes, cause of death, and hematological and biochemical serum profiles were collected to compare alive and dead recipients. One hundred fifty six patients (13%) died in the post transplant period. Patient death was more prominent during the first years after transplantation. Most common causes of death were cardiovascular (28.3%), graft loss (20.7%), and infection (19.6%). Post transplant systolic and diastolic blood pressures, BUN, creatinine, fasting blood sugar, and total cholesterol were higher, and serum HDL lower in the dead recipients than those who remained alive (P< 0.05). No significant difference was found in LDL, hemoglobin, and triglyceride values between the two groups. The one- and three-year patient survival rates were 94% and 91.5%, respectively. We conclude that the patients who died after transplantation had more risk factors than stable patients who remain alive. A multidisciplinary approach to control the co-morbid factors could be beneficial to decrease the mortality of patients after renal transplantation.
    Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 09/2007; 18(3):439-42.
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    Transplant International 06/2007; 20(5):478-9. · 3.16 Impact Factor