title: Prevalence of intestinal parasite infections and associated clinical symptoms among patients with end-stage renal disease undergoing hemodialysis.
abstract: OBJECTIVE
  Intestinal parasitic infections (IPIs) can result in high morbidity and mortality, particularly in immunocompromised patients. Infectious diseases are among the main causes of death in end-stage renal disease (ESRD) patients due to their impaired immune systems. The aim of this study was to determine the prevalence IPIs and their associated symptoms in ESRD patients.
  
  
  METHODS
  In this case-control study, the fecal samples of 78 ESRD patients undergoing hemodialysis and 140 controls without any kidney problems were analyzed for intestinal parasites using direct-smear, formol-ether and modified Ziehl-Neelsen staining techniques.
  
  
  RESULTS
  The difference in the prevalence of IPIs between ESRD patients (30.7 %) and the control group (10.7 %) was significant (OR = 3.7; 95 % CI = 1.8-7.61; P < 0.001). Blastocystis (14.1 %) and Cryptosporidium spp.(11.5 %) were the most common IPIs detected in ESRD patients, and the presence of Cryptosporidium spp. was significantly associated with diarrhea in ESRD patients (OR = 16; 95 % CI = 1.54-166.05; P < 0.05). Leukocytosis, diarrhea, weight loss, nausea/vomiting and bloating were also significantly higher in the hemodialysis group when compared with the control group.
  
  
  CONCLUSIONS
  The current study revealed a high prevalence of intestinal parasites and related clinical symptoms in ESRD patients undergoing hemodialysis. Since hemodialysis patients are immunocompromised and intestinal parasites can cause serious clinical complications, we suggest that stool examination for intestinal parasites, with an emphasis on detection of Cryptosporidium spp. and Blastocystis, should be incorporated into the routine clinical care for these patients. Measures for preventing the acquisition of IPIs are also recommended.
authors: Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.|Department of Biotechnology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors: V Fallah
authors: VF
authors: Omrani
authors: Department of Parasitology and Mycology, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran.
authors: Sh
authors: Sh
authors: Fallahi
authors: Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. alirostami1984@gmail.com.
authors: A
authors: A
authors: Rostami
authors: Department of Parasitology and Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors: A
authors: A
authors: Siyadatpanah
authors: 29-Bahman Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
authors: Gh
authors: G
authors: Barzgarpour
authors: Department of Epidemiology and Statistics, School of Public Health, Tehran University of Medical Science, Tehran, Iran.
authors: S
authors: S
authors: Mehravar
authors: Department of Biotechnology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
authors: F
authors: F
authors: Memari
authors: Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors: F
authors: F
authors: Hajialiani
authors: Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors: Z
authors: Z
authors: Joneidi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D016022:Case-Control Studies; D005243:Feces / Q000469:parasitology; D005260:Female; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000453:epidemiology* / Q000473:pathology*; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010271:Parasites / Q000145:classification / Q000302:isolation & purification*; D015995:Prevalence; D006435:Renal Dialysis; D055815:Young Adult
keywords: ESRD patients; Hemodialysis; Intestinal parasitic infections