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Background: Several registries and single centers have reported the results of their renal biopsies from different parts of the world. As there are only few data regarding the epidemiology of glomerulonephritides in Iran, this study was conducted to determine the results of renal biopsy findings during the last 10 years in our center., Methods: Data from 1,436 patients who had undergone a renal biopsy in our center between 1998 and 2007 were collected retrospectively for the first 989 patients and prospectively for the rest of them, including demographic data, renal syndrome at presentation and laboratory findings. All kidney specimens were studied with light and immunofluorescent microscopies., Results: Among 1,407 patients with a definite pathologic diagnosis, 1,052 (74.8%) had a primary glomerular disease, 241 (17.2%) had a secondary glomerular disease, 66 (4.6%) had tubular disease, 19 (1.3%) had vascular disease and 7 (0.5%) had end-stage kidney disease. The most frequent types of biopsy-proven renal diseases were membranous glomerulopathy (MG) (377 patients, 26.8%), IgA nephropathy (IgAN) (155 patients, 11%), lupus nephritis (155 patients, 11%), focal segmental glomerulosclerosis (141 patients, 10%) and minimal change disease (117 patients, 8.3%). The predominant presentation was nephrotic syndrome in almost all cases, with the exception of chronic glomerulonephritis, acute tubular necrosis and acute tubulointerstitial nephritis. The epidemiology of our renal biopsy findings was similar to reports from most European countries and United Arab Emirates, but different from many other neighboring countries, North America and Far East., Conclusions: In our report of 1,407 renal biopsy specimens, MG and IgAN were the most frequent biopsy-proven renal diseases. FSGS was the third cause of primary glomerular disease, and lupus nephritis was the most common secondary glomerular disease. The unusually high frequency of presentation as nephrotic syndrome may be due to referral nature of our center and less liberal indications for renal biopsy.

Living unrelated donors (LURDs) constitute the major source of renal allograft in Iran. LURD transplantation (Tx) is performed in a controlled program, supervised by university Tx teams, and assisted by the Dialysis and Transplant Patient's Association (DATPA). This study evaluated the knowledge of donors about possible short- and long-term complications of kidney donation and the need for regular follow-up. We interviewed 100 consecutive living donors/donation candidates (all called donors), 35 in the postoperative period in the renal Tx ward, and 65 after completion of preoperative assessment in the office of the DATPA, to assess their knowledge about complications of nephrectomy and their intention to participate in the postoperative follow-up. Seventy-nine donors were men and 21 women. Mean age was 27 +/- 4.4 years. Ninety-seven donors were unrelated to the recipient and three were related (LRD). The motivation for donation was altruistic in nine (three LRD and six LURD) and financial in 89. Eighty donors were not aware of the possible short- or long-term complications of nephrectomy. Six donors mentioned the possibility of potential intraoperative complications, and 16 mentioned the risk of renal failure. Only 44 donors knew that they should visit doctors regularly after donation, most of them (61%) from the postoperative group. We conclude that most donors do not have enough knowledge about possible in-hospital and long-term complications of kidney donation and may not participate in regular follow-up after operation. Considering the young age of our renal Tx donors, we suggest that they should receive more preoperative orientation (both verbal and written) about possible complications and the need for regular postoperative medical follow-up.

Fatigue is a common complaint in long term dialysis patients that may influence their quality of life. The present study was carried out in order to evaluate the prevalence and course of fatigue in a group of chronic PD patients and to find the possible factor(s) related to its development. We retrospectively reviewed 100 charts of the patients previously on PD. The presence or absence of fatigue in the 1st and last clinic visits and the 1st and 2nd changes in fatigue state were studied according to the monthly clinical records of the primary nurses. Data regarding dialysate volume, urine volume, weekly erythropoietin (EPO) dose, hemoglobin, hematocrit, blood urea, serum creatinine, residual renal creatinine and urea clearances, dialysate to peritoneal creatinine ratio (D/P Cr), total weekly Kt/V and total creatinine clearance/1.73 m2 body surface area (TCrCl) were collected. Fifty-five patients were male and 45 female. The mean age at the 1st clinic visit was 61.3 +/- 16 years. At the 1st visit 55 patients had fatigue and 45 did not. In 32 of the 55 patients fatigue disappeared after a mean duration of 7.9 +/- 8.4 months and in 31 of the 45 patients fatigue appeared after a mean duration of 8 +/- 6.8 months. So at the last visit the frequency of fatigue increased significantly from 55% to 67% (p < 0.001). In patients with fatigue the mean age and female percentage were higher (64.2 +/- 14.1 vs 57.8 +/- 17.6, p = 0.05 and 1.2 vs 0.5, p < 0.05 respectively), mean hemoglobin concentration was lower (104.4 +/- 14.7 vs 110.6 +/- 14.2 g/L, p < 0.04) and mean EPO dose was higher (6379.6 +/- 7142 vs 3395.4 +/- 4337.8 units/week, p < 0.02) at the 1st clinic visit. EPO dose was also higher in patients with fatigue at the last visit (8253.7 +/- 10317.3 units/wk vs 4736.4 +/- 5432.5, p < 0.03). No correlation was found between dialysis adequacy according to either weekly Kt/V or TCrCl and nutritional state according to nPCR and frequency of fatigue. We conclude that fatigue is a common symptom in PD patients and it's prevalence increases over time. Anemia seems to be the most important factor associated with fatigue. Dialysis adequacy and nutritional state did not show any correlation with the frequency of fatigue in our study.