<i  >Objective</i>. To investigate changes in serum pituitary-gonadal hormones and restoration of sexual and reproductive functions after successful kidney transplantation. 
<i  >Patients and Methods</i>. Serum pituitary-gonadal hormones before and after kidney transplantation were measured in 78 patients with end-stage renal disease (ESRD) and in 30 healthy adults. Pre- and postoperative semen specimens of 46 male recipients and 15 male controls were collected and compared. Additional 100 married kidney transplant recipients without children were followed up for 3 years to observe their sexual function and fertility. 
<i  >Results</i>. Serum PRL, LH, and T or <svg     style="vertical-align:-3.27605pt;width:16.112499px;" id="M1" height="15.25" version="1.1" viewBox="0 0 16.112499 15.25" width="16.112499"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,11.112)"><path id="x45" d="M517 162l29 -4q-18 -100 -35 -158h-482v28q68 5 83.5 20t15.5 77v398q0 66 -13 80t-73 19v28h446q0 -8 8 -144l-29 -4q-11 51 -32 85q-11 17 -35 23t-78 6h-76q-23 0 -28 -5t-5 -27v-228h94q67 0 83 12t25 63h29v-191h-29q-10 54 -26 65.5t-81 11.5h-95v-189&#xA;q0 -65 24 -81q19 -13 104 -13q57 0 83 7t43 27q28 33 50 94z" /></g>

			<g transform="matrix(.012,-0,0,-.012,9.712,15.187)"><path id="x32" d="M412 140l28 -9q0 -2 -35 -131h-373v23q112 112 161 170q59 70 92 127t33 115q0 63 -31 98t-86 35q-75 0 -137 -93l-22 20l57 81q55 59 135 59q69 0 118.5 -46.5t49.5 -122.5q0 -62 -29.5 -114t-102.5 -130l-141 -149h186q42 0 58.5 10.5t38.5 56.5z" /></g>

		
	
</svg> levels gradually restored to the normal ranges in all kidney transplant recipients, and sperm density, motility, viability, and morphology significantly improved in the male recipients 4 months after successful kidney transplantation (<svg     style="vertical-align:-0.1638pt;width:50.549999px;" id="M2" height="11.375" version="1.1" viewBox="0 0 50.549999 11.375" width="50.549999"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,11.112)"><path id="x1D443" d="M619 482q0 -69 -40.5 -119t-96 -72.5t-118.5 -26.5h-44l-70 20l-31 -151q-14 -67 0.5 -83t89.5 -22l-5 -28h-287l8 28q65 7 81.5 22t29.5 83l79 398q12 56 0.5 70.5t-78.5 20.5l7 28h255q108 0 164 -43t56 -125zM524 478q0 141 -146 141q-25 0 -47 -8q-16 -6 -20.5 -13.5&#xA;t-10.5 -39.5l-43 -241q37 -13 83 -13q67 0 125.5 45t58.5 129z" /></g><g transform="matrix(.017,-0,0,-.017,15.582,11.112)"><path id="x3C" d="M512 -3l-437 233v51l437 233v-58l-378 -200v-2l378 -199v-58z" /></g><g transform="matrix(.017,-0,0,-.017,30.286,11.112)"><path id="x2E" d="M113 -12q-24 0 -39.5 16t-15.5 42q0 24 16 40.5t40 16.5t40 -16.5t16 -40.5q0 -26 -16 -42t-41 -16z" /></g><g transform="matrix(.017,-0,0,-.017,34.162,11.112)"><path id="x30" d="M241 635q53 0 94 -28.5t63.5 -76t33.5 -102.5t11 -116q0 -58 -11 -112.5t-34 -103.5t-63.5 -78.5t-94.5 -29.5t-95 28t-64.5 75t-34.5 102.5t-11 118.5q0 58 11.5 112.5t34.5 103t64.5 78t95.5 29.5zM238 602q-32 0 -55.5 -25t-35.5 -68t-17.5 -91t-5.5 -105&#xA;q0 -76 10 -138.5t37 -107.5t69 -45q32 0 55.5 25t35.5 68.5t17.5 91.5t5.5 105t-5.5 105.5t-18 92t-36 68t-56.5 24.5z" /></g><g transform="matrix(.017,-0,0,-.017,42.321,11.112)"><path id="x35" d="M153 550l-26 -186q79 31 111 31q90 0 141.5 -51t51.5 -119q0 -93 -89 -166q-85 -69 -173 -71q-32 0 -61.5 11.5t-41.5 23.5q-18 17 -17 34q2 16 22 33q14 9 26 -1q61 -50 124 -50q60 0 93 43.5t33 104.5q0 69 -41.5 110t-121.5 41q-53 0 -102 -20l38 305h286l6 -8&#xA;l-26 -65h-233z" /></g>

		
	
</svg>). Thirty-three male recipients (55.93&#x25;) reobtained normal erectile function, and 49 kidney transplant recipients (61.25&#x25;) had children within the 3-year follow-up period. 
<i  >Conclusion</i>. Successful kidney transplantation could effectively improve pituitary-gonadal hormone disturbance and sexual and reproductive dysfunctions of ESRD patients. 


Guang-chun Wang

Jun-hua Zheng

Long-gen Xu

Zhi-lian Min

You-hua Zhu

Jun Qi

Qiang-lin Duan

Measurements of Serum Pituitary-Gonadal Hormones and Investigation of Sexual and Reproductive Functions in Kidney Transplant Recipients

Continuous venovenous hemodiafiltration (CVVHDF) using solutions designed to maintain hypernatremia is described in an end-stage renal disease (ESRD) patient with cerebral edema (CE) due to an intracerebral hemorrhage (ICH). Hypernatremia was readily achieved and maintained without complication. CVVHDF should be considered as an alternative treatment option in ESRD patients with cerebral edema who require hypertonic saline therapy.

Stephen I. Rifkin

Ali R. Malek

Reza Behrouz

Use of Hypertonic Continuous Venovenous  Hemodiafiltration to Control Intracranial Hypertension in  an End-Stage Renal Disease Patient

<i  >Objectives</i>. The primary objective of this study was to determine the relationship between waist-to-hip ratio (WHR), cardiovascular (CV) events, and mortality in peritoneal dialysis (PD) patients.  A secondary objective was to investigate the association between abdominal obesity and systemic inflammatory markers. <i  >Methods</i>. This is a prospective study of 22 prevalent PD patients. WHR was measured at baseline. C-reactive protein (CRP), tumour necrosis factor-<svg     style="vertical-align:-0.1638pt;width:9.7749996px;" id="M1" height="7.9499998" version="1.1" viewBox="0 0 9.7749996 7.9499998" width="9.7749996"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
    
        
            <g transform="matrix(.017,-0,0,-.017,.062,7.675)"><path id="x1D6FC" d="M545 106q-67 -118 -134 -118q-24 0 -40 37.5t-30 129.5h-2q-47 -72 -103 -119.5t-108 -47.5q-47 0 -76 45.5t-29 119.5q0 113 85 204t174 91q47 0 70 -33.5t43 -119.5h3q32 47 80 140l55 13l10 -9q-47 -80 -138 -201q17 -99 27.5 -136t22.5 -37q23 0 69 61zM333 204&#xA;q-14 98 -31 149.5t-50 51.5q-49 0 -94 -70t-45 -164q0 -55 15.5 -86t40.5 -31q70 0 164 150z" /></g>

        
    
</svg> (TNF-<svg     style="vertical-align:-0.1638pt;width:9.7749996px;" id="M2" height="7.9499998" version="1.1" viewBox="0 0 9.7749996 7.9499998" width="9.7749996"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
    
        
            <g transform="matrix(.017,-0,0,-.017,.062,7.675)"><use xlink:href="#x1D6FC"/></g>

        
    
</svg>), and interleukin-6 (IL-6) were measured.  Main outcomes were first CV event and death from all causes.  Survival analysis was used to examine the relationship between anthropomorphic measures and clinical outcomes. <i  >Results</i>. Mean follow-up period was 3.1 years.  In Kaplan-Meier analysis, survival was lower in those with higher WHR (<svg     style="vertical-align:-0.1638pt;width:58.712502px;" id="M3" height="11.375" version="1.1" viewBox="0 0 58.712502 11.375" width="58.712502"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
    
        
            <g transform="matrix(.017,-0,0,-.017,.062,11.112)"><path id="x1D443" d="M619 482q0 -69 -40.5 -119t-96 -72.5t-118.5 -26.5h-44l-70 20l-31 -151q-14 -67 0.5 -83t89.5 -22l-5 -28h-287l8 28q65 7 81.5 22t29.5 83l79 398q12 56 0.5 70.5t-78.5 20.5l7 28h255q108 0 164 -43t56 -125zM524 478q0 141 -146 141q-25 0 -47 -8q-16 -6 -20.5 -13.5&#xA;t-10.5 -39.5l-43 -241q37 -13 83 -13q67 0 125.5 45t58.5 129z" /></g><g transform="matrix(.017,-0,0,-.017,15.582,11.112)"><path id="x3D" d="M535 323h-483v50h483v-50zM535 138h-483v50h483v-50z" /></g><g transform="matrix(.017,-0,0,-.017,30.286,11.112)"><path id="x2E" d="M113 -12q-24 0 -39.5 16t-15.5 42q0 24 16 40.5t40 16.5t40 -16.5t16 -40.5q0 -26 -16 -42t-41 -16z" /></g><g transform="matrix(.017,-0,0,-.017,34.162,11.112)"><path id="x30" d="M241 635q53 0 94 -28.5t63.5 -76t33.5 -102.5t11 -116q0 -58 -11 -112.5t-34 -103.5t-63.5 -78.5t-94.5 -29.5t-95 28t-64.5 75t-34.5 102.5t-11 118.5q0 58 11.5 112.5t34.5 103t64.5 78t95.5 29.5zM238 602q-32 0 -55.5 -25t-35.5 -68t-17.5 -91t-5.5 -105&#xA;q0 -76 10 -138.5t37 -107.5t69 -45q32 0 55.5 25t35.5 68.5t17.5 91.5t5.5 105t-5.5 105.5t-18 92t-36 68t-56.5 24.5z" /></g><g transform="matrix(.017,-0,0,-.017,42.321,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,50.481,11.112)"><path id="x32" d="M412 140l28 -9q0 -2 -35 -131h-373v23q112 112 161 170q59 70 92 127t33 115q0 63 -31 98t-86 35q-75 0 -137 -93l-22 20l57 81q55 59 135 59q69 0 118.5 -46.5t49.5 -122.5q0 -62 -29.5 -114t-102.5 -130l-141 -149h186q42 0 58.5 10.5t38.5 56.5z" /></g>

        
    
</svg>). In Cox regression, WHR independently predicted mortality and first CV event after adjustment for known ischemic heart disease (hazard ratio [HR] 1.17, confidence interval [CI] 1.05&#x2013;1.30 for death; HR 1.13, CI 1.01&#x2013;1.26 for CV event). WHR correlated with serum TNF-<svg     style="vertical-align:-0.1638pt;width:9.7749996px;" id="M4" height="7.9499998" version="1.1" viewBox="0 0 9.7749996 7.9499998" width="9.7749996"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
    
        
            <g transform="matrix(.017,-0,0,-.017,.062,7.675)"><use xlink:href="#x1D6FC"/></g>

        
    
</svg> (<svg     style="vertical-align:-0.1638pt;width:55.075001px;" id="M5" height="11.125" version="1.1" viewBox="0 0 55.075001 11.125" width="55.075001"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
    
        
            <g transform="matrix(.017,-0,0,-.017,.062,10.862)"><path id="x1D45F" d="M393 379q-9 -16 -28 -29q-15 -10 -23 -2q-19 19 -36 19q-21 0 -52 -38q-57 -72 -82 -126l-40 -197q-23 -3 -75 -18l-7 7q49 196 74 335q7 43 -2 43q-7 0 -30 -14.5t-47 -37.5l-16 23q37 42 82 73t67 31q41 0 15 -113l-11 -50h4q41 71 85 117t77 46q29 0 45 -26&#xA;q13 -21 0 -43z" /></g><g transform="matrix(.017,-0,0,-.017,11.945,10.862)"><use xlink:href="#x3D"/></g><g transform="matrix(.017,-0,0,-.017,26.649,10.862)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,34.808,10.862)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,38.684,10.862)"><path id="x34" d="M456 178h-96v-72q0 -51 12.5 -62.5t72.5 -16.5v-27h-256v27q65 5 78 17t13 62v72h-260v28q182 271 300 426h40v-407h96v-47zM280 225v295h-2q-107 -148 -196 -295h198z" /></g><g transform="matrix(.017,-0,0,-.017,46.843,10.862)"><path id="x35" d="M153 550l-26 -186q79 31 111 31q90 0 141.5 -51t51.5 -119q0 -93 -89 -166q-85 -69 -173 -71q-32 0 -61.5 11.5t-41.5 23.5q-18 17 -17 34q2 16 22 33q14 9 26 -1q61 -50 124 -50q60 0 93 43.5t33 104.5q0 69 -41.5 110t-121.5 41q-53 0 -102 -20l38 305h286l6 -8&#xA;l-26 -65h-233z" /></g>

        
    
</svg>; <svg     style="vertical-align:-0.1638pt;width:50.549999px;" id="M6" height="11.375" version="1.1" viewBox="0 0 50.549999 11.375" width="50.549999"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
    
        
            <g transform="matrix(.017,-0,0,-.017,.062,11.112)"><use xlink:href="#x1D443"/></g><g transform="matrix(.017,-0,0,-.017,15.582,11.112)"><use xlink:href="#x3D"/></g><g transform="matrix(.017,-0,0,-.017,30.286,11.112)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,34.162,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,42.321,11.112)"><use xlink:href="#x35"/></g>

        
    
</svg>). <i  >Conclusion</i>. The results of this study suggest WHR may be a risk factor for increased CV events and mortality in PD patients. Abdominal obesity is also associated with inflammatory markers. Larger studies are warranted to confirm these findings.

Winnie S. Su

Catherine M. Clase

K. Scott Brimble

Peter J. Margetts

Trevor J. Wilkieson

Azim S. Gangji

Waist-to-Hip Ratio, Cardiovascular Outcomes, and Death in Peritoneal Dialysis Patients

The increased level of plasma total homocysteine (tHcy) in chronic kidney disease patients has been reported as a new and independent risk factor for cardiovascular disease. However, after the description of reverse epidemiology in the renal population, the association of tHcy and nutrition became less clear. We evaluated the association between homocysteine, nutritional status, and inflammation, and their impact on mortality in 95 predialysis patients. High sensitivity C-Reactive Protein (hs-CRP), interleukin 6 (IL-6), Tumor Necrosis Factor <svg style="vertical-align:-0.1254pt;width:8.9375px;" id="M1" height="7.1750002" version="1.1" viewBox="0 0 8.9375 7.1750002" width="8.9375"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,7.175)">
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				<tspan style="font-size: 12.50px; " x="0" y="0">𝛼</tspan>
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	</g>
</svg> (TNF-<svg style="vertical-align:-0.1254pt;width:8.9375px;" id="M2" height="7.1750002" version="1.1" viewBox="0 0 8.9375 7.1750002" width="8.9375"  xmlns="http://www.w3.org/2000/svg">
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</svg>)], and tHcy were evaluated, as was the nutritional status by the modified Subjective Global Nutritional Assessment (mSGA). We divided our population in four groups according to their tHcy and mSGA values being above or below the mean level and found the lowest survival in the group with tHcy and mSGA above the mean level, as well as higher levels of IL-6 (<svg style="vertical-align:-0.17555pt;width:48.337502px;" id="M3" height="10.9125" version="1.1" viewBox="0 0 48.337502 10.9125" width="48.337502"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,10.9125)">
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				<tspan style="font-size: 12.50px; " x="0" y="0">𝑃</tspan>
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				<tspan style="font-size: 12.50px; " x="22.930502" y="0">.</tspan>
				<tspan style="font-size: 12.50px; " x="26.056252" y="0">0</tspan>
				<tspan style="font-size: 12.50px; " x="32.307751" y="0">3</tspan>
			</text>

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</svg>) and TNF-<svg style="vertical-align:-0.1254pt;width:8.9375px;" id="M4" height="7.1750002" version="1.1" viewBox="0 0 8.9375 7.1750002" width="8.9375"  xmlns="http://www.w3.org/2000/svg">
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</svg> (<svg style="vertical-align:-0.17555pt;width:56.150002px;" id="M5" height="11.1" version="1.1" viewBox="0 0 56.150002 11.1" width="56.150002"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,11.1)">
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				<tspan style="font-size: 12.50px; " x="38.559254" y="0">5</tspan>
			</text>

		</g>
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</svg>). Higher levels of homocysteine can be associated with higher mortality in predialysis patients, as long as they are associated with malnutrition and inflammation.

Ana de Lurdes Agostinho Cabrita Vieira

Alexandre Baptista

Anabela Malho

Ana Pinho

Ana Paula Silva

Idal&#233;cio Bernardo

Pedro Le&#227;o Neves

Homocysteine Is a Risk Factor in Predialysis Patients When Associated with Malnutrition and Inflammation

<i>Objective</i>. Uncertainty has arisen as to whether renal function can be recovered from after long-term regular dialysis treatment. We therefore conducted an analysis and scrutinized one patient report. <i>Material and Methods</i>. Swedish registry of patients with kidney disease and one patient case. <i>Results</i>. 39 patients (0.2&#x25;) from the Swedish registry comprising 17590 patients who commenced RRT (renal replacement therapy) between 1991 and 2008 had recovered from renal function after more than 365 days of regular dialysis treatment. The most common diagnosis was renovascular disease with hypertension but a large group had uremia of unknown cause.  HUS, cortical/tubular necrosis, and autoimmune diseases were also found.  The mean treatment time before withdrawal was 2 years. <i>Conclusions</i>. A small number of patients recover after a long period of regular dialysis treatment. One could discuss whether it is difficult to identify patients who have recovered while undergoing regular dialysis treatment. Regular monitoring of renal function may be important.

Ingela Fehrman-Ekholm

Ann-Charlotte Bergenhag

Olof Heimburger

Staffan Sch&#xf6;n

Recovery of Renal Function after One-Year of Dialysis Treatment: Case Report and Registry Data

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<p><em>International Journal of Nephrology</em> publishes original research articles and&nbsp;review articles on the prevention, diagnosis, and management of kidney diseases and associated disorders.</p>


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<p>Chief Editor, Professor Mattoo, is a renowned Pediatric Nephrologist from the Wayne State University School of Medicine, a Professor of Pediatrics (Nephrology), Urology &amp; Vice Chair of the Department of Pediatrics. He has received research grants &amp; published 200 works including book chapters</p>


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title

International Journal of Nephrology publishes original research articles and review articles on the prevention, diagnosis, and management of kidney diseases and associated disorders.

International Journal of Nephrology