Mojgan Jalalzadeh

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Simultaneous pancreas-kidney transplantation is increasingly offered to type 2 diabetics, but how blood sugar behaves in the days right after surgery is not well characterized. This study compared early post-operative glucose patterns between type 1 and type 2 diabetic recipients and found similar metabolic profiles. Equivalent early glycemic behavior suggests that careful type 2 diabetic recipients can be managed with the same post-transplant protocols used for type 1.

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Arteriovenous fistulas and grafts created for hemodialysis access redirect large volumes of blood through the heart, which can cause long-term cardiac strain. This review synthesizes how dialysis access blood flow affects heart structure and function, and when intervention is warranted. Understanding these hemodynamic effects is critical to preventing heart failure in dialysis-dependent patients.

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Yacon root has been proposed as a natural remedy for blood sugar and cholesterol, but trial results have been mixed. This meta-analysis of randomized controlled trials found that yacon consumption modestly improves fasting glucose and certain lipid markers. The benefit is real but modest, suggesting yacon may complement—not replace—standard diabetes management.

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This cross-sectional study looked at how diet quality, body composition, and lifestyle factors relate to the development and severity of diabetic foot ulcers in type 2 diabetes patients. Poor dietary patterns and elevated anthropometric indices were associated with worse foot ulcer outcomes. The findings point to nutrition and weight management as underutilized levers in preventing and treating diabetic foot complications.

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A kidney transplant patient simultaneously developed immune-mediated organ rejection and BK virus nephropathy—two conditions that pull treatment in opposite directions, since fighting rejection requires more immune suppression while fighting the virus requires less. This case report describes how clinicians navigated that tension and achieved graft stabilization. It illustrates the complexity of managing competing immunological threats after transplant.

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The amount and quality of carbohydrates a person with type 2 diabetes eats may influence how severe their foot ulcers become. This cross-sectional study of 300 diabetic foot ulcer patients found that higher glycemic-load diets and lower fiber intake were associated with larger and deeper ulcers. Dietary carbohydrate modification could be an accessible intervention to improve foot ulcer healing.

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Fat intake composition—plant vs. animal fats, saturated vs. unsaturated—may affect wound healing in diabetic foot ulcers, but this has not been studied directly. This cross-sectional study found that higher animal fat and cholesterol intake was associated with more severe foot ulcer indices, while omega-3 intake showed a protective trend. The results support dietary fat modification as part of comprehensive wound care.

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Red meat consumption has been linked to various cancers, but its association with pancreatic cancer is debated. This dose-response meta-analysis of prospective cohort studies found that total and processed red meat intake significantly increased pancreatic cancer risk, while unprocessed red meat had a weaker association. Reducing processed meat intake may lower pancreatic cancer risk at a population level.

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Monounsaturated fatty acids—found in olive oil and avocados—have been proposed as protective against stroke, but studies conflict. This systematic review and dose-response meta-analysis found that higher MUFA intake was associated with a reduced risk of total stroke and ischemic stroke. The findings support dietary guidelines favoring unsaturated fats for cardiovascular and cerebrovascular health.

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Plant-based compounds (phytochemicals) in food may reduce inflammation and improve metabolic health in diabetes, but their relationship to foot ulcer severity is unclear. This study measured dietary phytochemical index alongside anthropometric measures in type 2 diabetic adults with foot ulcers and found that higher phytochemical intake correlated with better wound and metabolic profiles. Encouraging fruit, vegetable, and whole grain intake may be a simple adjunct to diabetic foot ulcer management.

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Bitter melon is a traditional remedy for high cholesterol and triglycerides, but clinical evidence has been inconsistent. This meta-analysis of randomized trials found that bitter melon supplementation significantly lowered triglycerides and LDL cholesterol while modestly raising HDL. These effects suggest a real but limited lipid-lowering role that may be useful in patients who cannot tolerate or afford standard drugs.

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The DASH diet—rich in fruits, vegetables, and low-fat dairy—improves several cardiovascular risk factors, but its role in diabetic foot ulcer care has not been examined. This cross-sectional study found that type 2 diabetic patients with higher DASH diet adherence had better anthropometric and inflammatory markers, and less severe foot ulcer indicators. The DASH diet may be a practical dietary strategy for reducing foot ulcer risk in diabetes.

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Policosanol, derived from sugarcane wax, is marketed to lower blood sugar, but evidence is inconsistent. This systematic review and dose-response meta-analysis found no significant effect of policosanol on fasting glucose or insulin levels in randomized trials. The findings do not support using policosanol as a glycemic control supplement.

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Garcinia cambogia extract is widely sold as a weight-loss and lipid-lowering supplement, but clinical evidence is weak. This meta-analysis of randomized trials found no significant effect of hydroxycitric acid (the active compound) on total cholesterol, LDL, or triglycerides. The results do not support Garcinia cambogia supplementation for lipid management.

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Hemodialysis patients gain fluid between sessions, and this interdialytic weight gain is thought to raise blood pressure and worsen nutrition. This study of a large HD population found that higher percent weight gain was independently associated with elevated pre-dialysis blood pressure, but its relationship to nutritional markers was more complex. Clinicians should monitor weight gain not just for blood pressure but also as a nutritional signal.

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Gitelman syndrome is a rare genetic kidney disorder that causes low potassium and magnesium, and it typically goes undiagnosed for years. This case report describes a patient whose Gitelman syndrome was uncovered only when they presented with diabetic ketoacidosis, as the overlapping electrolyte abnormalities complicated diagnosis. The case highlights the importance of considering rare inherited conditions in patients with unusual electrolyte patterns during metabolic crises.

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Osmotic demyelination syndrome usually occurs when severe low sodium is corrected too rapidly, destroying myelin in the brain. This case report describes the rare occurrence of ODS triggered by hyperosmolar hyperglycemic state rather than sodium correction in a dialysis patient with type 1 diabetes. The case expands clinicians' awareness that extreme hyperglycemia alone can cause this devastating neurological complication.

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ANCA-associated vasculitis is a rare autoimmune disease that can destroy kidney function, and its occurrence in patients with scleroderma is unusual. This case report describes a patient with scleroderma who developed ANCA glomerulonephritis shortly after a COVID-19 diagnosis. The overlap suggests that COVID-19 may trigger or accelerate autoimmune kidney disease in genetically susceptible individuals.

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Snake venom can cause widespread tissue damage and fluid shifts, leading to kidney failure through muscle breakdown or hemolysis. This case describes acute kidney failure following a snake bite, attributed to increased abdominal pressure compressing the kidneys rather than direct toxin injury. Abdominal compartment syndrome is an underappreciated mechanism of snakebite nephropathy that requires prompt recognition.

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Cone beam CT is used to detect cracks in tooth roots, but accuracy may degrade when images are taken long after the fracture. This study tested whether the delay between creating a vertical root fracture and scanning affected detection accuracy. Time lapse significantly worsened diagnostic performance, meaning early imaging is critical for reliably catching root fractures.

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Metabolic syndrome—a cluster of high blood pressure, elevated blood sugar, and abnormal cholesterol—is a strong predictor of heart disease in the general population. This study tested whether the same relationship holds in hemodialysis patients and found that metabolic syndrome did significantly increase coronary heart disease risk in this population. The findings support aggressive management of metabolic syndrome components in dialysis patients.

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Acute rejection episodes after kidney transplant are known to damage the graft, but how the timing—early versus late—affects long-term outcomes is debated. This long-term follow-up study found that late acute rejection was more damaging to graft survival than early rejection. Preventing late rejection events is critical to maximizing transplant longevity.

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Staphylococcus epidermidis biofilm on intraocular lenses is a leading cause of post-cataract surgery eye infections. This lab study compared biofilm formation on four lens types—two foldable (hydrophilic) and two rigid (hydrophobic)—and found that hydrophilic materials supported significantly more biofilm growth. Choosing the right lens material may reduce the risk of post-operative intraocular infection.

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H. pylori infection is common in hemodialysis patients and difficult to eradicate. This randomized trial compared triple therapy using azithromycin versus clarithromycin and found similar eradication rates, but azithromycin-based therapy was substantially cheaper. For hemodialysis patients with H. pylori, azithromycin triple therapy offers equal effectiveness at lower cost.

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Quality of life in hemodialysis patients is affected by many factors beyond just dialysis adequacy. This large multicenter Iranian study of nearly 7,000 HD patients identified age, comorbidities, and nutritional status as key predictors of health-related quality of life. The results provide benchmarks and highlight modifiable targets for improving patient wellbeing in this population.

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High uric acid levels are associated with hypertension and may contribute to blood pressure elevation in dialysis patients. This randomized crossover trial found that allopurinol—a uric acid-lowering drug—significantly reduced blood pressure in hyperuricemic hemodialysis patients. Treating hyperuricemia with allopurinol may offer a practical and inexpensive way to improve blood pressure control in this high-risk population.

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Hepatitis B infection is a serious problem in kidney disease patients, but dialysis patients respond poorly to the HBV vaccine. This study found that CKD patients in earlier stages (3-4) had better antibody responses to the vaccine than full dialysis patients, and both groups responded worse than healthy controls. Vaccinating against hepatitis B earlier in kidney disease—before dialysis begins—is more effective.

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H. pylori eradication is standard practice in hemodialysis patients with dyspepsia, but the best antibiotic choice is unclear. This randomized double-blind trial found that azithromycin-based triple therapy achieved eradication rates comparable to clarithromycin at lower cost. Azithromycin is a viable first-line option for H. pylori eradication in dialysis patients.

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Dialysis patients with high ferritin but low hemoglobin often don't respond well to erythropoietin because iron is trapped and unavailable. This crossover trial found that short-term intravenous vitamin C (ascorbic acid) lowered ferritin and improved hemoglobin in this group by mobilizing stored iron. IV vitamin C is a low-cost intervention that can overcome EPO resistance in iron-overloaded dialysis patients.

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Chronic infections like H. pylori are associated with poor nutrition in dialysis patients, but the direction of causality is unclear. This study compared body mass index in H. pylori-positive and negative hemodialysis patients before and after eradication therapy and found that eradicating the infection improved BMI. Treating H. pylori may improve nutritional status in this vulnerable population.

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Cancer after kidney transplant is a well-known complication of immunosuppression, but data on living-donor recipients specifically are scarce. This large multicenter Iranian study found a cancer incidence rate about three times that of the general population, with skin and urological cancers most common. The results support lifelong cancer surveillance in living-donor kidney transplant recipients.

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Delayed graft function—where a transplanted kidney doesn't work immediately and requires dialysis—is common after transplant, but its long-term effects on survival are debated. This cohort study found that delayed graft function was independently associated with reduced long-term graft and patient survival. Preventing and aggressively managing DGF is important for maximizing transplant outcomes.

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Metabolic syndrome—a combination of obesity, hypertension, dyslipidemia, and high blood sugar—is common in the general population but its prevalence in dialysis patients is not well defined. This single-center study found metabolic syndrome in over half of hemodialysis patients, with hypertension and low HDL as the most prevalent components. Systematic screening and management of metabolic syndrome in dialysis centers is warranted.

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Colorectal cancer risk after kidney transplant is elevated due to chronic immunosuppression, but data from living-donor recipients are limited. This study of living renal transplant recipients found that older male recipients had the highest colorectal cancer risk. Targeted colonoscopy screening programs for older male kidney transplant patients could enable earlier detection.

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Diagnosing H. pylori in dialysis patients is complicated because some standard tests perform poorly in this population. This study evaluated the stool antigen test as a non-invasive diagnostic method and found it performed well for both initial diagnosis and confirming eradication after treatment. The stool antigen test is a practical, accurate tool for managing H. pylori in hemodialysis patients.

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H. pylori causes stomach inflammation that may trigger systemic inflammatory responses, potentially lowering albumin levels in dialysis patients. This study found that H. pylori-positive hemodialysis patients had significantly lower serum albumin, and eradication of the infection led to albumin improvement. Treating H. pylori may reduce inflammation-driven malnutrition in dialysis patients.

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Teeth that have had root canals and are restored with fiber posts need to withstand biting forces without fracturing. This in vitro study tested different fiber post systems in extracted teeth and compared fracture resistance using multiple measurement approaches. The results provide guidance for selecting post systems that best preserve tooth structure and reduce fracture risk.

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Diabetes complicates kidney transplantation both before and after the procedure, but outcomes for type 1 versus type 2 diabetics—and those who develop diabetes after transplant—have not been well compared. This cohort study found that pre-existing type 2 diabetes and post-transplant diabetes mellitus were associated with worse graft and patient survival than type 1 diabetes. Glycemic management tailored to diabetes type may improve long-term transplant outcomes.