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Hamad A, Alkadi MM, Al-Malki H. COVID-19 and patients on renal replacement therapy: Perspective from the State of Qatar. Qatar Med J 2024; 2024:1. [PMID: 38757061 PMCID: PMC11097679 DOI: 10.5339/qmj.2024.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 04/29/2024] [Indexed: 05/18/2024] Open
Affiliation(s)
- Abdullah Hamad
- Division of Nephrology, Department of Medicine, Hamad General Hospital, Doha, Qatar
| | - Mohamad M Alkadi
- Division of Nephrology, Department of Medicine, Hamad General Hospital, Doha, Qatar
| | - Hassan Al-Malki
- Division of Nephrology, Department of Medicine, Hamad General Hospital, Doha, Qatar
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Ghonimi T, Hamad A, Fouda T, AlAli F, Ezzat M, Awad M, Ibrahim R, Amin M, Alkadi M, Al-Malki HA. Cardiovascular calcification in hemodialysis patients: A Qatar-based prevalence and risk factors study. Qatar Med J 2024; 2024:18. [PMID: 38654817 PMCID: PMC11037094 DOI: 10.5339/qmj.2024.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 02/25/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Patients with end-stage kidney disease on hemodialysis (HD) have an increased risk of death due to the high prevalence of cardiovascular disease. Vascular calcification (VC) is predictive of cardiovascular disease and mortality. We conducted a study to evaluate the prevalence and risk factors for VC in dialysis patients in Qatar. METHODS This is a retrospective nationwide study including all chronic ambulatory dialysis patients in Qatar from 2020 to 2022. We used our national electronic medical record to track demographics, clinical characteristics, comorbidities, laboratory values, and diagnostic data for each patient. Calcifications were assessed by echocardiography (routinely done for all our dialysis population per national protocol), computed tomography, X-ray, and ultrasound. The study protocol was approved by the local medical research ethics committee (MRC-01-20-377). RESULTS 842 HD patients were included in this study. Vascular calcifications (VC) were prevalent in 52.6% of patients. The main site of VC was Mitral valve calcifications in 55.5% of patients. Patients with VC were significantly older and had more prevalence of diabetes mellitus (p = 0.001 and p = 0.006, respectively). There was no statistically significant difference between patients with calcifications and patients without calcifications regarding serum calcium, phosphorus, and PTH level. In multivariate analysis, age and diabetes significantly increased the risk factor for calcification (95% CI 1.033-1.065, p < 0.0001, and 95% CI 1.128-2.272, p < 0001, respectively). Moreover, higher vitamin D levels and higher doses of IV Alfacalcidol were significant risk factors for calcifications (95% CI 1.005-1.030, p < 0.007, and 95% CI 1.092-1.270, p < 0.0001, respectively). CONCLUSION Our study found that vascular calcification was widespread among our dialysis population in Qatar. Implementing the practice of echocardiography in dialysis patients was extremely helpful and the most productive in detecting vascular calcification. Diabetes mellitus almost doubles the risk for vascular calcifications in dialysis patients. These results are beneficial in identifying risk factors for vascular calcification, which can help stratify dialysis patients' risk of cardiovascular disease and optimize prevention efforts.
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Affiliation(s)
- Tarek Ghonimi
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Abdullah Hamad
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Tarek Fouda
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Fadwa AlAli
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mohamad Ezzat
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed Awad
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Rania Ibrahim
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed Amin
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mohamad Alkadi
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Hassan Ali Al-Malki
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
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Yasin F, Khraim F, Santos M, Forgrave D, Hamad A. Factors influencing self-care management in adult hemodialysis patients: An integrative review. Qatar Med J 2024; 2024:12. [PMID: 38654818 PMCID: PMC11037095 DOI: 10.5339/qmj.2024.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/04/2024] [Indexed: 04/26/2024] Open
Abstract
Background: End-stage renal disease (ESRD) poses a significant health challenge, with hemodialysis (HD) being the most prevalent therapy. Patients undergoing HD must comply with a strict therapeutic regimen, including dietary control, fluid restriction, and medication adherence. Successful disease management and improved outcomes rely on patients' involvement and participation in their care. Aim: To identify the factors that hinder or facilitate self-care management (SCM) in HD patients. Methodology: This review followed Whittemore and Knafl's integrative review framework. A comprehensive literature search of articles published between 2017 and 2022 was conducted in CINAHL, Medline, and PubMed using the keywords end-stage renal disease, hemodialysis, self-care management, self-care, and self-management. This search yielded 21 suitable articles for review. Results: SCM is influenced by three main factors: facilitators, barriers, and outcomes. Facilitators of SCM include self-care management interventions, patient knowledge, socio-demographic factors, family support, healthcare professionals, peer support, and psychological factors. Barriers encompass psychological and physical conditions. Outcomes include both physiological and psychological aspects. Conclusion: Understanding the factors influencing SCM in HD patients is vital for developing reliable and effective self-care strategies and interventions to enhance both physical and psychological outcomes.
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Affiliation(s)
| | - Fadi Khraim
- Faculty of Nursing, Qatar University, Doha, Qatar
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Habib MB, Ali K, Rahhal A, Obeidat I, Altermanini M, Sawaf B, Latif TA, Hamad A, Bougmiza I, Aly SI, Mahmoud KM. Determinants of vaccine adherence among non-dialysis chronic kidney disease patients in Qatar. Qatar Med J 2024; 2023:33. [PMID: 38187993 PMCID: PMC10770734 DOI: 10.5339/qmj.2023.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/29/2023] [Indexed: 01/09/2024] Open
Abstract
INTRODUCTION Chronic kidney disease (CKD) is a global health problem. Reduced innate and adaptive immunological responses predispose CKD patients to infections. Despite the clinical and epidemiological importance of CKD and the great value of vaccination as a prophylactic measure, the utilization of recommended vaccines in Qatar has not yet been evaluated. METHODS We conducted a cross-sectional study to estimate the level of influenza, pneumococcal, and hepatitis B vaccination and the predictors of adherence to these recommended vaccines among non-dialysis CKD patients receiving renal ambulatory care in Qatar from 1 September 2020 to 30 April 2021. Complete vaccination was defined as receiving the three vaccines, and partial vaccination was defined as receiving one or two vaccines. The full and partial vaccination predictors were assessed using multivariate logistic regression and reported as odds ratio (OR) with p<0.05 indicating statistical significance. RESULTS 416 non-dialysis CKD patients were included in our analysis. 73% were males; the mean age was 56 ± 15 years. More than 50% of the patients were from the Middle East, followed by 36% from Asia. Most patients had concurrent hypertension, concurrent diabetes mellitus, and were stage V CKD. Only 12% of the patients were fully vaccinated, while 73% received partial vaccination. The predictors of vaccination included age, gender, Asian origin, employment, living conditions, concurrent medical conditions, CKD stage, allergy to medications, and use of injectable medications. Only stage V CKD positively predicted adherence to full and partial vaccinations in non-dialysis CKD patients. CONCLUSION There is very low adherence to the recommended vaccines in CKD patients, with a prevalence of complete vaccination of 12% only. Increased public awareness about the importance of vaccination in CKD may improve the adherence rates among these patients in Qatar.
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Affiliation(s)
- Mhd Baraa Habib
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Khaled Ali
- Community Medicine Department, Hamad Medical Corporation, Doha, Qatar ORCID iD: 0000-0002-8073-4375
| | - Alaa Rahhal
- Pharmacy Department, Hamad Medical Corporation, Doha, Qatar
| | - Ibrahim Obeidat
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | | | - Bisher Sawaf
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Tarek Abdel Latif
- Nephrology Division, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Abdullah Hamad
- Nephrology Division, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Iheb Bougmiza
- Community Medicine Department, Primary Health Care Corporation, Doha, Qatar
| | - Sahar Ismail Aly
- Nephrology Division, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
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Al Sahlawi M, AlRukhaimi M, Al-Ghamdi SM, Al Salmi I, Al-Aradi AH, Hamad A, AlSahow A. Peritoneal dialysis in the Arabian Gulf countries: Challenges and opportunities. Perit Dial Int 2023:8968608231204107. [PMID: 37846093 DOI: 10.1177/08968608231204107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023] Open
Abstract
The Gulf Cooperation Council (GCC) is a regional organisation, consisting of six Arab countries that share common objectives and cultural identities, with a total population of 57.3 million. The prevalence of patients requiring dialysis in GCC countries is increasing, with a current mean prevalence of 551 per million population. Despite the several patient-level and healthcare system benefits of peritoneal dialysis (PD) compared to in-centre haemodialysis, the growth in PD utilisation has been limited. This is related to several factors, including deficiencies in modality education for chronic kidney disease patients, nephrology training and governmental policies advocating for this dialysis modality. Establishing a detailed PD registry in GCC countries is an important step towards understanding our patients' characteristics, outcomes, current PD practices and challenges in order to increase the use of PD and to facilitate future initiatives aimed at optimising the management of PD patients in this part of the world. This article reviews common challenges around PD practices and utilisation in GCC countries and provides possible solutions to overcome these challenges. It should be noted that the literature on PD patients, outcomes and treatment practices in GCC countries is limited, and as a result, many of our recommendations and discussion are based on clinical observations, experience and data when available.
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Affiliation(s)
- Muthana Al Sahlawi
- Department of Internal Medicine, College of Medicine, King Faisal University, Al-Hasa, Saudi Arabia
| | | | - Saeed Mg Al-Ghamdi
- Department of Medicine, College of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | | | - Ali H Al-Aradi
- Department of Nephrology, Salmaniya Medical Complex, Manama, Bahrain
| | - Abdullah Hamad
- Division of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Ali AlSahow
- Division of Nephrology, Jahra Hospital, Jahra, Kuwait
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Hamad A, Elgaali M, Ghonimi T, Elshirbeny M, Ali M, Ibrahim R, Othman M, Abuhelaiqa E, Ezzat H, Boubaker K, Alkadi M, Al-Malki H. From past to present: Exploring COVID-19 in Qatar's hemodialysis population across Omicron dominant and pre-Omicron periods. PLoS One 2023; 18:e0291266. [PMID: 37708230 PMCID: PMC10501587 DOI: 10.1371/journal.pone.0291266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 08/24/2023] [Indexed: 09/16/2023] Open
Abstract
COVID-19 carries a high risk of morbidity and mortality in dialysis patients. Multiple SARS-CoV-2 variants have been identified since the start of the COVID-19 pandemic. The current study aimed to compare the incidence and outcomes of the COVID-19 Omicron dominant period versus other pre-Omicron period in hemodialysis patients. In this observational, analytical, retrospective, nationwide study, we reviewed adult chronic hemodialysis patients between March 1, 2020, and January 31, 2022. Four hundred twenty-one patients had COVID-19 during the study period. The incidence of COVID-19 due to the Omicron dominant period was significantly higher than other pre-Omicron period (30.3% vs. 18.7%, P<0.001). In contrast, the admission rate to ICU was significantly lower in the Omicron dominant period than in the pre-Omicron period (2.8% vs. 25%, P<0001) but with no significant difference in ICU length of stay. The mortality rate was lower in the Omicron dominant period compared to the pre-Omicron period (2.4% vs. 15.5%, P<0.001). Using multivariate analysis, older age [OR 1.093 (95% CI 1.044-1.145); P<0.0001] and need for mechanical ventilation [OR 70.4 (95% CI 20.39-243.1); P<0.0001] were identified as two independent risk factors for death in hemodialysis patients with COVID-19. In Conclusion, the COVID-19 Omicron variant had a higher incidence and lower morbidity and mortality than pre-Omicron period in our hemodialysis population.
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Affiliation(s)
- Abdullah Hamad
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Musab Elgaali
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Tarek Ghonimi
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mostafa Elshirbeny
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed Ali
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Rania Ibrahim
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Muftah Othman
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Essa Abuhelaiqa
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Hany Ezzat
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Karima Boubaker
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mohamad Alkadi
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Hassan Al-Malki
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
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Finco MG, Najafi B, Zhou H, Hamad A, Ibrahim R, Al-Ali F. Game-based intradialytic non-weight-bearing exercise training on gait speed and balance in older adults with diabetes: a single-blind randomized controlled trial. Sci Rep 2023; 13:14225. [PMID: 37648695 PMCID: PMC10469197 DOI: 10.1038/s41598-023-41290-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 08/24/2023] [Indexed: 09/01/2023] Open
Abstract
Older adults with diabetes receiving hemodialysis have impaired gait speed and balance compared to the general population, which have been associated with increased risks of falls and mortality. This study evaluated the effectiveness of a game-based intradialytic exercise training program (iExergame) on improving gait speed and balance. This was a single-blind randomized controlled trial. The intervention group (IG) received iExergame training using real-time audiovisual feedback with wearable inertial sensors. The control group (CG) received conventional training without any technology. Both trainings were intradialytic, non-weight-bearing, and used ankle range of motion. Gait and balance parameters were collected at baseline and 4-week follow-up. Data from 70 adults (age 64.2 ± 9.0 years) were analyzed. Compared to the CG, the IG showed greater changes between baseline and 4-week follow-up in several parameters. Gait parameters included faster speeds and longer stride lengths, particularly during dual task walking (p < 0.050). Balance parameters included reductions in center of mass (p = 0.004), ankle (p < 0.001), and hip (p = 0.010) sways during semi-tandem stance, particularly in users of assistive devices. iExergame training could improve gait speed and balance in this population and might be an option to increase intradialytic exercise adherence while reducing burdens of exercise administration.
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Affiliation(s)
- M G Finco
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
| | - He Zhou
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
- Shenzhen Mass Medical Co., Ltd., Shenzhen, China
- Shanghai Dengding BioAI Co., Ltd., Shanghai, China
| | - Abdullah Hamad
- Department of Nephrology, Fahad Bin Jassim Kidney Center, Hamad General Hospital, Doha, Qatar
| | - Rania Ibrahim
- Department of Nephrology, Fahad Bin Jassim Kidney Center, Hamad General Hospital, Doha, Qatar
| | - Fadwa Al-Ali
- Department of Nephrology, Fahad Bin Jassim Kidney Center, Hamad General Hospital, Doha, Qatar
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Mishra RK, Najafi B, Hamad A, Bara R, Lee M, Ibrahim R, Mathew M, Talal T, Al-Ali F. Intradialytic plantar electrical nerve stimulation to improve mobility and plantar sensation among adults with diabetes undergoing hemodialysis: a randomized double-blind trial. J Nephrol 2023:10.1007/s40620-023-01625-9. [PMID: 37326952 DOI: 10.1007/s40620-023-01625-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 03/08/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Impaired mobility is a debilitating consequence of hemodialysis. We examined the efficacy of intradialytic-plantar-electrical-nerve-stimulation (iPENS) to promote mobility among diabetes patients undergoing hemodialysis.. METHODS Adults with diabetes undergoing hemodialysis received either 1-h active iPENS, (Intervention-Group) or non-functional iPENS (Control-Group) during routine hemodialysis for 12 weeks (3 sessions/week). Participants and care-providers were blinded. Mobility (assessed using a validated pendant-sensor) and neuropathy (quantified by vibration-perception-threshold test) outcomes were assessed at baseline and 12 weeks. RESULTS Among 77 enrolled subjects (56.2 ± 2.6 years old), 39 were randomly assigned to the intervention group, while 38 were assigned to the control group. No study-related adverse events and dropouts were reported in the intervention group. Compared to the control group, significant improvements with medium to large effect sizes were observed in the intervention group at 12 weeks for mobility-performance metrics, including active-behavior, sedentary-behavior, daily step counts, and sit-to-stand duration variability (p < 0.05), Cohen's d effect size (d = 0.63-0.84). The magnitude of improvement in active-behavior was correlated with improvement in the vibration-perception-threshold test in the intervention group (r = - 0.33, p = 0.048). A subgroup with severe-neuropathy (vibration-perception-threshold > 25 V) showed a significant reduction in plantar numbness at 12 weeks compared to baseline (p = 0.03, d = 1.1). CONCLUSIONS This study supports feasibility, acceptability, and effectiveness of iPENS to improve mobility and potentially reduce plantar numbness in people with diabetes undergoing hemodialysis. Considering that exercise programs are not widely used in hemodialysis clinical practice, iPENS may serve as a practical, alternative solution to reduce hemodialysis-acquired weakness and promote mobility.
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Affiliation(s)
- Ram Kinker Mishra
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, MS: BCM390, Houston, TX, 77030, USA
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, MS: BCM390, Houston, TX, 77030, USA.
| | - Abdullah Hamad
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Rasha Bara
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, MS: BCM390, Houston, TX, 77030, USA
| | - Myeounggon Lee
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, MS: BCM390, Houston, TX, 77030, USA
| | - Rania Ibrahim
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Mincy Mathew
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Talal Talal
- Diabetic Foot and Wound Clinic, Hamad Medical Co, Doha, Qatar
| | - Fadwa Al-Ali
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
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Mishra RK, Hamad A, Ibrahim R, Mathew M, Talal T, Al-Ali F, Park C, Davuluri V, Fernando ME, Najafi B. Objective assessment of mobility among adults with diabetes and end-stage renal disease using walking aid: A cross-sectional cohort study. Clin Biomech (Bristol, Avon) 2023; 107:106014. [PMID: 37290375 DOI: 10.1016/j.clinbiomech.2023.106014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND This cross-sectional study aimed to compare physical activity levels, plantar sensation, and fear of falling between individuals with diabetes undergoing hemodialysis, with or without walking aids. METHODS Sixty-four participants were recruited, with 37 not using walking aids (age = 65.8 ± 0.7 years, 46% female) and 27 using walking aids (age = 69.2 ± 1.2 years, 63% female). Physical activity was measured using validated pendant sensors over two consecutive days. Concern for falling and plantar numbness were assessed using the Falls Efficacy Scale-International and vibration perception threshold test, respectively. FINDINGS Participants using walking aids exhibited a greater fear of falling (84% vs. 38%, p < 0.01) and fewer walking bouts (p < 0.01, d = 0.67) and stand-to-walk transitions (p < 0.01, d = 0.72) compared to those not using walking aids. The number of walking bouts was negatively correlated with concern for falling scores (ρ = -0.35, p = 0.034) and vibration perception threshold (R = -0.411, p = 0.012) among individuals not using walking aids. However, these correlations were not significant among those using the walking aid. There was no significant group difference in active behavior (walking + standing %) and sedentary behavior (sitting + lying %). INTERPRETATION Those undergoing hemodialysis often lead sedentary lives, with mobility affected by fear of falling and plantar numbness. Using walking aids can help, but it doesn't guarantee more walking. A combined psychosocial and physical therapy approach is key for managing fall concerns and improving mobility.
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Affiliation(s)
- Ram Kinker Mishra
- Interdisciplinary Consortium on Advanced Motion Performance, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Abdullah Hamad
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Rania Ibrahim
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Mincy Mathew
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Talal Talal
- Diabetic Foot and Wound Clinic, Hamad Medical Co, Doha, Qatar
| | - Fadwa Al-Ali
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Catherine Park
- Interdisciplinary Consortium on Advanced Motion Performance, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Vyshnavi Davuluri
- Interdisciplinary Consortium on Advanced Motion Performance, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Malindu E Fernando
- Interdisciplinary Consortium on Advanced Motion Performance, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA; Ulcer and wound Healing consortium, Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia; Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Newcastle, New South Wales, Australia
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
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Almalki M, Alghamdi EA, Alasmari R, Aldossary N, Hussain T, Hamad A. A C1 Jefferson Fracture With Vertebral Artery Occlusion and Cerebellar Infarction: A Case Report. Cureus 2023; 15:e38789. [PMID: 37303435 PMCID: PMC10250134 DOI: 10.7759/cureus.38789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Jefferson fracture is a C1 fracture, which happens when an axial load is from the occiput downward to the C1 ring. Usually, it causes outward displacement of the C1 arch, which can injure the vertebral artery. We present a Jefferson fracture with vertebral artery injury, resulting in an asymptomatic ischemic stroke of the left cerebellum. Usually, vertebral artery injuries are asymptomatic since the contralateral vertebral artery and the collateral arteries will adequately supply the cerebellum. Vertebral artery injury (VAI) is typically treated with conservative management with anticoagulants and antiplatelet therapy.
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Affiliation(s)
| | | | - Reem Alasmari
- Medicine and Surgery, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, SAU
| | - Norah Aldossary
- Medicine, Princess Nourah Bint Abdul Rahman University, Riyadh, SAU
| | - Turki Hussain
- Orthopedic Surgery, King Saud Medical City, Riyadh, SAU
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Hamad A, Mefleh Al Halabi A, Ghazouani H, Habas EM, Mohamed Borham A, Mohamed Ismail S, Ali Al-Malki H, Alkadi MM. Time-Series Forecasting of Hemodialysis Population in the State of Qatar by 2030. Qatar Med J 2023; 2023:6. [PMID: 36846274 PMCID: PMC9943994 DOI: 10.5339/qmj.2023.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/30/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND There are few statistics on dialysis-dependent individuals with end-stage kidney disease (ESKD) in Qatar. Having access to this information can aid in better understanding the dialysis development model, aiding higher-level services in future planning. In order to give data for creating preventive efforts, we thus propose a time-series with a definitive endogenous model to predict ESKD patients requiring dialysis. METHODS In this study, we used four mathematical equations linear, exponential, logarithmic decimal, and polynomial regression, to make predictions using historical data from 2012 to 2021. These equations were evaluated based on time-series analysis, and their prediction performance was assessed using the mean absolute percentage error (MAPE), coefficient of determination (R2), and mean absolute deviation (MAD). Because it remained largely steady for the population at risk of ESKD in this investigation, we did not consider the population growth factor to be changeable. (FIFA World Cup 2022 preparation workforce associated growth was in healthy and young workers that did not influence ESKD prevalence). RESULT The polynomial has a high R2 of 0.99 and is consequently the best match for the prevalence dialysis data, according to numerical findings. Thus, the MAPE is 2.28, and the MAD is 9.87%, revealing a small prediction error with good accuracy and variability. The polynomial algorithm is the simplest and best-calculated projection model, according to these results. The number of dialysis patients in Qatar is anticipated to increase to 1037 (95% CI, 974-1126) in 2022, 1245 (95% CI, 911-1518) in 2025, and 1611 (95% CI, 1378-1954) in 2030, with a 5.67% average yearly percentage change between 2022 and 2030. CONCLUSION Our research offers straightforward and precise mathematical models for predicting the number of patients in Qatar who will require dialysis in the future. We discovered that the polynomial technique outperformed other methods. Future planning for the need for dialysis services can benefit from this forecasting.
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Affiliation(s)
- Abdullah Hamad
- Department of Medicine, Division of Nephrology, Hamad Medical Corporation, Doha, Qatar. E-mail: ; ORCID: (0000-0003-4677-7686)
| | | | - Hafedh Ghazouani
- Department of Quality and Patient Safety, Hamad Medical Corporation, Doha, Qatar
| | - Elmukhtar M. Habas
- Department of Quality and Patient Safety, Hamad Medical Corporation, Doha, Qatar
| | | | - Sahar Mohamed Ismail
- Department of Medicine, Division of Nephrology, Hamad Medical Corporation, Doha, Qatar. E-mail: ; ORCID: (0000-0003-4677-7686)
| | - Hassan Ali Al-Malki
- Department of Medicine, Division of Nephrology, Hamad Medical Corporation, Doha, Qatar. E-mail: ; ORCID: (0000-0003-4677-7686)
| | - Mohamad M. Alkadi
- Department of Medicine, Division of Nephrology, Hamad Medical Corporation, Doha, Qatar. E-mail: ; ORCID: (0000-0003-4677-7686)
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12
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Alkadi MM, Hamad A, Ghazouani H, Elshirbeny M, Ali MY, Ghonimi T, Ibrahim R, Abuhelaiqa E, Abou-Samra AB, Al-Malki H, Butt AA. Effectiveness of Messenger RNA Vaccines against SARS-CoV-2 Infection in Hemodialysis Patients: A Case-Control Study. Vaccines (Basel) 2022; 11:vaccines11010049. [PMID: 36679894 PMCID: PMC9863461 DOI: 10.3390/vaccines11010049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/08/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022] Open
Abstract
Patients with end-stage kidney disease (ESKD) are at increased risk for SARS-CoV-2 infection and its complications compared with the general population. Several studies evaluated the effectiveness of COVID-19 vaccines in the dialysis population but showed mixed results. The aim of this study was to determine the effectiveness of COVID-19 mRNA vaccines against confirmed SARS-CoV-2 infection in hemodialysis (HD) patients in the State of Qatar. We included all adult ESKD patients on chronic HD who had at least one SARS-CoV-2 PCR test done after the introduction of the COVID-19 mRNA vaccines on 24 December 2020. Vaccinated patients who were only tested before receiving any dose of their COVID-19 vaccine or within 14 days after receiving the first vaccine dose were excluded from the study. We used a test-negative case−control design to determine the effectiveness of the COVID-19 vaccination. Sixty-eight patients had positive SARS-CoV-2 PCR tests (cases), while 714 patients had negative tests (controls). Ninety-one percent of patients received the COVID-19 mRNA vaccine. Compared with the controls, the cases were more likely to be older (62 ± 14 vs. 57 ± 15, p = 0.02), on dialysis for more than one year (84% vs. 72%, p = 0.03), unvaccinated (46% vs. 5%, p < 0.0001), and symptomatic (54% vs. 21%, p < 0.0001). The effectiveness of receiving two doses of COVID-19 mRNA vaccines against confirmed SARS-CoV-2 infection was 94.7% (95% CI: 89.9−97.2) in our HD population. The findings of this study support the importance of using the COVID-19 mRNA vaccine in chronic HD patients to prevent SARS-CoV-2 infection in such a high-risk population.
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Affiliation(s)
- Mohamad M. Alkadi
- Department of Medicine, Division of Nephrology, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar
- Correspondence: ; Tel.: +974-55518771
| | - Abdullah Hamad
- Department of Medicine, Division of Nephrology, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar
| | - Hafedh Ghazouani
- Department of Quality and Patient Safety, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar
| | - Mostafa Elshirbeny
- Department of Medicine, Division of Nephrology, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar
| | - Mohamed Y. Ali
- Department of Medicine, Division of Nephrology, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar
| | - Tarek Ghonimi
- Department of Medicine, Division of Nephrology, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar
| | - Rania Ibrahim
- Department of Medicine, Division of Nephrology, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar
| | - Essa Abuhelaiqa
- Department of Medicine, Division of Nephrology, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar
| | - Abdul Badi Abou-Samra
- Department of Quality and Patient Safety, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar
| | - Hassan Al-Malki
- Department of Medicine, Division of Nephrology, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar
| | - Adeel A. Butt
- Department of Quality and Patient Safety, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar
- Departments of Medicine and Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA
- Departments of Medicine and Population Health Sciences, Weill Cornell Medicine, Doha P.O. Box 3050, Qatar
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13
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Muacevic A, Adler JR, Hamad A, Alzahrani AA. Spontaneous Fusion of L5/S1 Spondylolisthesis in an Elderly Female: A Case Report. Cureus 2022; 14:e32863. [PMID: 36694526 PMCID: PMC9867869 DOI: 10.7759/cureus.32863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
We report a case of a 65-year-old female presenting with an Anterolisthesis grade I, L5-S1. With a history of lower back pain that started two years ago with weak big toe extension. CT scan revealed that There is anterolisthesis grade I, L5-S1. No pars defect was seen, and degenerative changes in the bilateral facet joint L5-S1, with narrow joint space & sclerosis. The patient underwent conservative management to strengthen and stretch her back muscles for three months and had spontaneous fusion develop at an unstable level with relief of symptoms after nonoperative treatment.
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14
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Hamad A, Fouda T, Alkadi M, Abdellatif T, Al Omari A, Alakhras A, Amood A, Ibrahim R, Aly S, Farooqi F, Almalki H. MO537: Effects of COVID-19 on Mineral and Bone Disease Outcomes in Hemodialysis Patients: A Retrospective Study From Qatar. Nephrol Dial Transplant 2022. [PMCID: PMC9383848 DOI: 10.1093/ndt/gfac073.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND AND AIMS Management of end-stage renal disease (ESRD) on dialysis has been challenging during the COVID19 epidemic. Staff illness led to a shortage of manpower that affected patient care. We established a specialty nursing management for mineral and bone disease (MBD) in the ambulatory dialysis service in Qatar in 2016. We are presenting a retrospective study about the effects of the COVID-19 epidemic on MBD outcomes in ambulatory dialysis patients in the State of Qatar. METHOD A retrospective cohort study in all adult patients with ESRD on chronic hemodialysis therapy (>1 month) in ambulatory dialysis clinics in the State of Qatar. Data collected were patient's characteristics, laboratory and diagnostic investigations for each patient through our electronic data system (nationwide). We focused on parathyroid hormone (PTH), calcium and phosphorus levels done routinely on monthly basis. The study duration was 31 months (January 2019–September 2021). RESULTS We included 623 patients. Age was 56 ± 11 years old and 61% were male. The main comorbidities were diabetes mellitus (63%), hypertension (92%) and cardiovascular disease (22%). The percentage of patients with PTH levels within targets ranged from 63 to 74%. It was stable before and during the first wave of COVID-19 in Qatar (March–June 2020) then dropped afterward briefly for 3 months (October–December 2020) (74% versus 63% respectively P = 0.0003). PTH level in target improved afterward and also during the second wave of COVID-19 (February–May 2021) but then dropped again for 3 months (July–September 2021) [72% versus 66% respectively P = 0.02 (graph below with details)]. Patients with phosphorus and calcium in the target were mostly stable [79% (77–83%) and 76% (74–79%), respectively]. CONCLUSION Our retrospective study regarding the effect of the COVID-19 epidemic on MBD outcomes in hemodialysis (HD) showed a temporary drop in PTH level in the target without affecting calcium and phosphorus targets. The delayed drop after COVID-19 waves in PTH in target could be related to the routine quarterly measurement of PTH. We think that establishing a solid management system for MBD led to reasonably stable outcomes despite all challenges during the COVID-19 epidemic.
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Affiliation(s)
| | - Tarek Fouda
- Hamad Medical Corporation, Nephrology, Doha, Qatar
| | | | | | | | | | - Abeer Amood
- Hamad Medical Corporation, Nephrology, Doha, Qatar
| | | | - Sahar Aly
- Hamad Medical Corporation, Nephrology, Doha, Qatar
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15
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Fouda T, Yasin F, Aly S, Ravinder Singh P, Ezzat Hussain Mohammed M, Elesnawi M, Hamad A, Almalki H. MO851: Impact of COVID-19 on Dialysis Patients: Reported Experience in Qatar. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac083.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Patient-centred care is a concept focussing on meeting the specific health needs of patients as expressed by them. There is increasing evidence to show that patient centred care can help to achieve higher rates of patient satisfaction, clinical outcomes and overall better experience, particularly for patients with chronic disease. Patients Reported Experience Measures (PREM) is another concept associated with patient-cantered care. PREM surveys capture information about the healthcare experience as perceived by patients. Its importance lies in the incorporation of patient feedback into the clinical decisions and service evolution. Dialysis patients play an important role in their treatment and their voice matters to provide proper care. PREM was first conducted in 2019 in our dialysis unit including 200 patients. In 2020, COVID-19 impacted the dialysis services and resulted in many challenges including staff shortage and deployment.
METHOD
We used a validated questionnaire from the National Health Service in United Kingedm. It consisted of 7 questions covering demographics, dialysis options, patient portal, patient's relationship with the staff, teamwork and travelling abroad. The survey involved 317 randomly selected patients who have been at least 1 year on dialysis. We performed a comparison of the 2019 and 2020 results using Chi-squared test.
RESULTS
257 patients on hemodialysis and 60 on peritoneal dialysis participated in the survey. Majority of the surveyed patients (65%) were on dialysis from 1–5 years and 32% with more than 5 years’ survival on dialysis. Sixty five % of patients responded that they were on follow up in nephrology or low clearance clinic before starting dialysis. Access to dialysis team, nurses and doctors from home declined in 2020 due to the shortage of staff in the dialysis services and deployment of many staff to COVID-19 facilities, 62% of surveyed patients were able to contact their care givers from home compared with 87% in 2019 (P < 0.0001). Regarding education, 78% of the patients responded that they received education before starting dialysis and it was in an understandable manner while patients' response to the same question was 85% in 2019 (P = 0.047). 44% received education on side effects, which is remarkably less compared with 74% in 2019 (P = 0.0001).
CONCLUSION
Patient reported experience helps in the evaluation of health services. Exploring patient experience in dialysis patients in Qatar, we found negative impact of COVID-19 from patients’ perspectives. Our PREM survey showed significant decline in many parameters likely attributed to COVID-19 consequences including the shortage of staff.
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Hamad A, Al-Ali F, Kinker Mishra R, Ibrahim R, Mathew M, Ateya H, Yahya M, Khan S, Talal T, Najafi B. MO922: Intradialytic Plantar Electrical Nerve Stimulation During Routine Hemodialysis Process Facilitate Physical Activities of Daily Life in Adults With Diabetes and End-Stage Renal Disease––A Randomized Double-Blinded Controlled Trial. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac084.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Reduced physical activity in daily life is a persistent problem in patients undergoing hemodialysis (HD). Although exercise could be beneficial, factors such as post-dialysis fatigue, time limitation and severe frailty may result in poor compliance. We are exploring an alternative therapy using intradialytic plantar electrical nerve stimulation (IPENS) provided during the routine hemodialysis process to address this gap.
METHOD
A total of 20 participants undergoing hemodialysis (age = 55 ± 2.7 years, BMI = 30.6 ± 1.3 kg/m2 female = 31%) were randomly assigned to the intervention group (IG), and 18 participants (age = 56 ± 2.2 years, BMI = 32.2 ± 1.2 kg/m2 female = 41%) were assigned to the control group (CG). The IG received 1-h IPENS during the routine hemodialysis process (three sessions/week) for 12 weeks. The CG received an identical but non-functional device for the same period. Participants and therapy-providers were blinded to the group allocation. Daily life physical activity was assessed remotely at baseline and every 12 week using a pendant wearable. To determine the effect of intervention, we estimated Cohen's effect size d. In addition, time effects, group and time × group effects were estimated using a general linear model.
RESULTS
We observed a significant increase in (Cohen's d = 0.97, P < 0.01) number of postural transitions, (d = 0.71, P = 0.04) daily step counts and (d = 0.73, P = 0.03) episodes of walking due to IPENS. All participants in the IG tolerated the IPENS and completed all therapy sessions, indicating the feasibility.
CONCLUSION
These are early results related to IPENS therapy's feasibility and effectiveness to improve mobility among individuals undergoing routine hemodialysis. We can recommend routine IPENS therapy as a practical alternative for those who may not engage in routine exercise programs if the results will be held in the larger sample.
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Affiliation(s)
| | - Fadwa Al-Ali
- Nephrology, Hamad Medical Corporation, Doha, Qatar
| | - Ram Kinker Mishra
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Houston, USA
| | | | - Mincy Mathew
- Nephrology, Hamad Medical Corporation, Doha, Qatar
| | - Heba Ateya
- Nephrology, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Talal Talal
- Diabetic Foot and Wound Clinic, Hamad Medical Corporation, Doha, Qatar
| | - Bijan Najafi
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Houston, USA
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Hamad A, Soboleva AV, Vorobyev PO, Mahmoud M, Vasilenko KV, Chumakov PM, Lipatova AV. Development of a recombinant oncolytic poliovirus type 3 strain with altered cell tropism. BRSMU 2022. [DOI: 10.24075/brsmu.2022.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Diffuse gliomas are incurable, prevalent, and aggressive central nervous system tumors. Therefore, the development of selective oncolytic viral strains for malignant neoplasms is highly relevant. This study aimed to create an oncolytic virus based on a vaccine strain of poliovirus type 3 with natural antitumor activity. To achieve this goal, we replaced the internal ribosome entry site (IRES) of poliovirus with the corresponding fragment of human rhinovirus 30. The resulting recombinant oncolytic strain RVP3 retained the serotype of poliovirus type 3, as confirmed by virus neutralization micro-test with specific antiserum. In addition, the oncolytic efficacy of RVP3 was assessed in vitro on a broad panel of cell cultures. According to the results, RVP3 has changed its tropism, losing the ability to replicate in conditionally normal cell lines of embryonic astrocytes and embryonic fibroblasts while retaining the ability to replicate in tumor cells.
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Affiliation(s)
- A Hamad
- Engelhardt Institute of Molecular Biology, Moscow, Russia
| | - AV Soboleva
- Engelhardt Institute of Molecular Biology, Moscow, Russia
| | - PO Vorobyev
- Engelhardt Institute of Molecular Biology, Moscow, Russia
| | - M Mahmoud
- Engelhardt Institute of Molecular Biology, Moscow, Russia
| | | | - PM Chumakov
- Engelhardt Institute of Molecular Biology, Moscow, Russia
| | - AV Lipatova
- Engelhardt Institute of Molecular Biology, Moscow, Russia
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Yasin F, Fouda T, El-sayed A, Al-mohanadi T, Khaled K, Hajaji W, Aly S, Lonappan V, Hamdy H, Hamad A, Moustafa N, Aly Atta A, Navarrete E, Al-Abdulla T, Al-Ali F, Al-Malki H. Impact of COVID-19 on dialysis patients: Reported experience in Qatar. Journal of Emergency Medicine, Trauma and Acute Care 2022. [DOI: 10.5339/jemtac.2022.qhc.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Fadumo Yasin
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Tarek Fouda
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Aisha El-sayed
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Teha Al-mohanadi
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Karima Khaled
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Wafa Hajaji
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Sahar Aly
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Vimala Lonappan
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Hanaa Hamdy
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Abdullah Hamad
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Neama Moustafa
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Amira Aly Atta
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Edward Navarrete
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | | | - Fadwa Al-Ali
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Hassan Al-Malki
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
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Alali F, Derbala M, al-kaabi S, Hamad A, Al-malki H, Khater I, Alhassan E, Amin M, Dawood M, Ali F, Mohamed S, Al-Sayed A. Dialysis and advanced chronic kidney disease population Free from Hepatitis C virus infection: A safe nephrology approach. Journal of Emergency Medicine, Trauma and Acute Care 2022. [DOI: 10.5339/jemtac.2022.qhc.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Fadwa Alali
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Moutaz Derbala
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Saad al-kaabi
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Abdullah Hamad
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Hassan Al-malki
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Iman Khater
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Eltahir Alhassan
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Mohamed Amin
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Mohamed Dawood
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Farooq Ali
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Sahar Mohamed
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Aisha Al-Sayed
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
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Singh P, Othman M, Elgaali M, Amin M, Ezzat M, Elsayed A, AL Mohanadi T, Ahmed K, Ali W, Hamdy H, Ali T, Khater I, Aly S, Ahmed Elsayed Fouda T, Hamad A, Al-Malki H. Challenges to improve the Coronavirus disease 2019 (COVID-19) Immunization among dialysis population in Hamad General Hospital in the Nephrology Division, Hamad Medical Corporation, Doha, State of Qatar. Journal of Emergency Medicine, Trauma and Acute Care 2022. [DOI: 10.5339/jemtac.2022.qhc.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Poonam Singh
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Muftah Othman
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Musab Elgaali
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Mohamed Amin
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Mohammed Ezzat
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Aisha Elsayed
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Teha AL Mohanadi
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Karima Ahmed
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Wafa Ali
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Hanaa Hamdy
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Tabasim Ali
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Iman Khater
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Sahar Aly
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | | | - Abdullah Hamad
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Hassan Al-Malki
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
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21
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Arabi Z, Hamad A, Bukhari M, Altheaby A, Kaysi S. Practice Patterns for the Acceptance of Medically Complex Living Kidney Donors with Hematuria, Sickle Cell Trait, Smoking, Illegal Drug Use, or Urological Issues: A Multinational Survey. Avicenna J Med 2021; 11:185-195. [PMID: 34881201 PMCID: PMC8648410 DOI: 10.1055/s-0041-1736542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Background To review the practice patterns for the acceptance of medically complex living kidney donors (MCLKD) among the transplant providers of the international transplant community. Methods We distributed a survey globally, through major international transplantation societies, among nephrologists and transplant surgeons (TS). The survey contained questions regarding potential donors with microscopic hematuria, sickle cell trait, renal cysts, kidney stones, smoking, or illegal drug use. Results There were 239 respondents from 29 countries, including nephrologists (42%) and TS (58%). Although most respondents would investigate microscopic hematuria, one-third of them indicated they would decline these potential donors without investigation. Interestingly, most respondents accepted heavy smokers, intermittent illegal drug users (with advice to quit), and those with incidentally identified kidney stones, remote history of renal colic or simple renal cysts. We found multiple areas of consensus in practice with some interesting differences between nephrologists and TS. Conclusions This survey highlights the practice patterns of the acceptance of MCLKDs among the international community. In the absence of clear guidelines, this survey provides additional information to counsel kidney donors with microscopic hematuria, sickle cell trait, renal cysts, kidney stones, heavy smoking, or illegal drug use.
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Affiliation(s)
- Ziad Arabi
- Department of the Organ Transplant Center, Division of Adult Transplant Nephrology, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdullah Hamad
- Department of Medicine, Division of Nephrology, Regional Medical Center of Orangeburg and Calhoun Counties, Orangeburg, South Carolina, United Sates
| | - Muhammad Bukhari
- Department of Medicine, Division of Adult Nephrology, Taif University, Taif, Saudi Arabia
| | - Abdulrahman Altheaby
- Department of the Organ Transplant Center, Division of Adult Transplant Nephrology, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Saleh Kaysi
- Department of Medicine, Division of Nephrology, CHU Clermont-Ferrand, France
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Arabi Z, Bukhari M, Hamad A, Altheaby A, Kaysi S. Practice Patterns in the Acceptance of Medically Complex Living Kidney Donors with Obesity, Hypertension, Family History of Kidney Disease, or Donor-Recipient Age Discrepancy. Avicenna J Med 2021; 11:172-184. [PMID: 34881200 PMCID: PMC8648409 DOI: 10.1055/s-0041-1736541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background
To assess the practice patterns of the acceptance of medically complex living kidney donors (MCLKDs).
Methods
We distributed a survey to nephrologists and transplant surgeons (TS) across the world through major international transplant societies. The survey contained questions regarding obesity, abnormal blood glucose profile, mild hypertension, donor-recipient age discrepancy, or family history of kidney disease of unknown etiology.
Results
In total, 239 respondents from 29 countries (42% were nephrologists and 58% were TS).
Most respondents would allow donations from obese donors, especially if they intended to lose weight but would be cautious if these donors had abnormal blood glucose or family history of diabetes mellitus. In hypertensive donors, future pregnancy plans mattered in decisions regarding the acceptance of female donors. Most respondents would allow young donors but would be more cautious if they had a future risk of hypertension or a family history of kidney disease of unknown etiology. They would also allow donations from an older person if prolonged waiting time was anticipated. We found multiple areas of consensus of practice among the diverse members of international transplant societies, with some interesting variations among nephrologists and TS. Conclusions
This survey highlights the practice patterns of the acceptance of MCLKDs among the international community. In the absence of clear guidelines, this survey provides additional information to counsel kidney donors with these conditions.
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Affiliation(s)
- Ziad Arabi
- Department of the Organ Transplant Center, Division of Adult Transplant Nephrology, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Muhammad Bukhari
- Department of Medicine, Division of Adult Nephrology, Taif University, Taif, Saudi Arabia
| | - Abdullah Hamad
- Department of Medicine, Division of Nephrology, Regional Medical Center of Orangeburg and Calhoun Counties, Orangeburg, South Carolina, United States
| | - Abdulrahman Altheaby
- Department of the Organ Transplant Center, Division of Adult Transplant Nephrology, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Saleh Kaysi
- Department of Medicine, Division of Nephrology, CHU, Clermont-Ferrand, France
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Omar NE, Fahmy Soliman AI, Eshra M, Saeed T, Hamad A, Abou-Ali A. Postmarketing safety of anaplastic lymphoma kinase (ALK) inhibitors: an analysis of the FDA Adverse Event Reporting System (FAERS). ESMO Open 2021; 6:100315. [PMID: 34864500 PMCID: PMC8649649 DOI: 10.1016/j.esmoop.2021.100315] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/28/2021] [Accepted: 10/31/2021] [Indexed: 12/24/2022] Open
Abstract
Background Inhibitors of the anaplastic lymphoma kinase (ALK) gene mutation are highly effective treatments for ALK-positive lung cancer. We conducted this pharmacovigilance analysis using the Food and Drug Administration Adverse Event Reporting System (FAERS). Patients and methods FAERS files from 2012 to 2020 were used. Reports for crizotinib, ceritinib, alectinib, brigatinib, and lorlatinib were filtered. We used the Medical Dictionary for Regulatory Activities (MedDRA version 22.1). Further, we searched for adverse events on the preferred term (PT) level based on case reports in the literature. After filtering duplicate reports, disproportionality analysis was used to detect safety signals by calculating proportional reporting ratios (PRRs), reporting odds ratios (RORs), empirical Bayesian geometric mean, and information component. Reports were considered statistically significant if the 95% confidence interval did not contain the null value. Results Within the system organ classes, significant safety signals were found, including those for crizotinib [eye disorders (PRR 2.09, ROR 2.12)], ceritinib [gastrointestinal disorders (PRR 2.19, ROR 2.41), hepatobiliary disorders (PRR 4.4, ROR 4.52), respiratory disorders (PRR 1.96, ROR 2.08)], alectinib [hepatobiliary disorders (PRR 2.60, ROR 2.63)], brigatinib [respiratory disorders (PRR 2.15, ROR 2.31)], and lorlatinib [metabolism disorders (PRR 3.34, ROR 3.53)]. For adverse events on the PT level, we found several significant signals, including pneumothorax with crizotinib (PRR 3.29, ROR 3.29), ceritinib (PRR 3.13, ROR 3.13), and alectinib (PRR 4.88, ROR 4.89); myasthenia gravis with lorlatinib (PRR 6.05, ROR 6.05); photosensitivity reactions with crizotinib (PRR 2.20, ROR 2.20), ceritinib (PRR 4.30, ROR 4.31), alectinib (PRR 20.43, ROR 20.51), and brigatinib (PRR 20.97, ROR 21.05); pulmonary arterial hypertension with brigatinib (PRR 2.92, ROR 2.92) and lorlatinib (PRR 9.2, ROR 9.24); and rectal perforation with crizotinib (PRR 7.83, ROR 7.83). All the detected safety signals were confirmed using Bayesian methods. Conclusion ALK inhibitors differed in their safety profile reports. We found several significant safety signals that matched previously published case reports, including pulmonary arterial hypertension, rectal perforation, myasthenia gravis, and photosensitivity. These signals require further regulatory investigation to determine their significance and potentially update the product labels to inform patients and clinicians. ALK inhibitors differed in their safety profile reports. We found several significant safety signals. These signals include pulmonary arterial hypertension, rectal perforation, myasthenia gravis, and photosensitivity. Further regulatory investigations are required to determine the significance of these signals and update the product labels.
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Affiliation(s)
- N E Omar
- Pharmacy Department, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar.
| | | | - M Eshra
- Faculty of Pharmacy, Alexandria University, Alexandria, Egypt
| | - T Saeed
- Faculty of Computer Sciences and Information Technology, Cairo University, Cairo, Egypt
| | - A Hamad
- Pharmacy Department, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
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Al-Amer OM, Oyouni AAA, Alshehri MA, Alasmari A, Alzahrani OR, Aljohani SAS, Alasmael N, Theyab A, Algahtani M, Al Sadoun H, Alsharif KF, Hamad A, Abdali WA, Hawasawi YM. Association of SNPs within TMPRSS6 and BMP2 genes with iron deficiency status in Saudi Arabia. PLoS One 2021; 16:e0257895. [PMID: 34780475 PMCID: PMC8592490 DOI: 10.1371/journal.pone.0257895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 09/13/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Globally, iron-deficiency anemia (IDA) remains a major health obstacle. This health condition has been identified in 47% of pre-school students (aged 0 to 5 years), 42% of pregnant females, and 30% of non-pregnant females (aged 15 to 50 years) worldwide according to the WHO. Environmental and genetic factors play a crucial role in the development of IDA; genetic testing has revealed the association of a number of polymorphisms with iron status and serum ferritin. AIM The current study aims to reveal the association of TMPRSS6 rs141312 and BMP2 rs235756 with the iron status of females in Saudi Arabia. METHODS A cohort of 108 female university students aged 18-25 years was randomly selected to participate: 50 healthy and 58 classified as iron deficient. A 3-5 mL sample of blood was collected from each one and analyzed based on hematological and biochemical iron status followed by genotyping by PCR. RESULTS The genotype distribution of TMPRSS6 rs141312 was 8% (TT), 88% (TC) and 4% (CC) in the healthy group compared with 3.45% (TT), 89.66% (TC) and 6.89% (CC) in the iron-deficient group (P = 0.492), an insignificant difference in the allelic distribution. The genotype distribution of BMP2 rs235756 was 8% (TT), 90% (TC) and 2% (CC) in the healthy group compared with 3.45% (TT), 82.76% (TC) and 13.79% (CC) in iron-deficient group (P = 0.050) and was significantly associated with decreased ferritin status (P = 0.050). In addition, TMPRSS6 rs141312 is significantly (P<0.001) associated with dominant genotypes (TC+CC) and increased risk of IDA while BMP2 rs235756 is significantly (P<0.026) associated with recessive homozygote CC genotypes and increased risk of IDA. CONCLUSION Our finding potentially helps in the early prediction of iron deficiency in females through the genetic testing.
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Affiliation(s)
- Osama M. Al-Amer
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Kingdom of Saudi Arabia
- Genome and Biotechnology Unit, Faculty of Sciences, University of Tabuk, Tabuk, Kingdom of Saudi Arabia
- * E-mail: (OMA); (YMH)
| | - Atif Abdulwahab A. Oyouni
- Genome and Biotechnology Unit, Faculty of Sciences, University of Tabuk, Tabuk, Kingdom of Saudi Arabia
- Department of Biology, Faculty of Sciences, University of Tabuk, Tabuk, Kingdom of Saudi Arabia
| | - Mohammed Ali Alshehri
- Genome and Biotechnology Unit, Faculty of Sciences, University of Tabuk, Tabuk, Kingdom of Saudi Arabia
- Department of Biology, Faculty of Sciences, University of Tabuk, Tabuk, Kingdom of Saudi Arabia
| | - Abdulrahman Alasmari
- Genome and Biotechnology Unit, Faculty of Sciences, University of Tabuk, Tabuk, Kingdom of Saudi Arabia
- Department of Biology, Faculty of Sciences, University of Tabuk, Tabuk, Kingdom of Saudi Arabia
| | - Othman R. Alzahrani
- Genome and Biotechnology Unit, Faculty of Sciences, University of Tabuk, Tabuk, Kingdom of Saudi Arabia
- Department of Biology, Faculty of Sciences, University of Tabuk, Tabuk, Kingdom of Saudi Arabia
| | - Saad Ali S. Aljohani
- Department of Basic Medical Sciences, Faculty of Medicine, Alrayan Colleges, Almadinah Almunawarah, Kingdom of Saudi Arabia
| | - Noura Alasmael
- King Abdullah University for Science and Technology, Thuwal, Kingdom of Saudi Arabia
| | - Abdulrahman Theyab
- Department of Laboratory Medicine, Security Forces Hospital, Mecca, Kingdom of Saudi Arabia
| | - Mohammad Algahtani
- Department of Laboratory Medicine, Security Forces Hospital, Mecca, Kingdom of Saudi Arabia
| | - Hadeel Al Sadoun
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Khalaf F. Alsharif
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, Kingdom of Saudi Arabia
| | - Abdullah Hamad
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Kingdom of Saudi Arabia
| | - Wed A. Abdali
- Research Center, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Yousef MohammedRabaa Hawasawi
- Research Center, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia
- College of Medicine, Al-Faisal University, Riyadh, Saudi Arabia
- * E-mail: (OMA); (YMH)
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25
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Hamad A, Ezzat H, Latif Ghonimi TA, Ibrahim R, Ramadan F, Noor N, Yasin F, Ismail S, Al-Ali F. Effects of novel anemia nurse manager program on hemodialysis: a retrospective study from Qatar. Qatar Med J 2021; 2021:46. [PMID: 34733708 PMCID: PMC8530808 DOI: 10.5339/qmj.2021.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/18/2021] [Indexed: 11/12/2022] Open
Abstract
Introduction: Anemia management in dialysis is challenging. Keeping hemoglobin levels within a tight range is difficult. A new program (anemia nurse manager [ANM]) was started for better anemia management. This study aimed to compare traditional anemia management with the new ANM model regarding the achievement of better hemoglobin targets (range, 10–12 g/dL), avoidance of extreme hemoglobin levels ( < 9 or >13 g/dL), and evaluation of the cost-effectiveness of the new model. Methods: This retrospective observational study compared traditional anemia management with management involving our new ANM model. Patients on hemodialysis in all ambulatory dialysis clinics in Qatar were included. The study included three phases: phase 1 (observation): June 2015 to August 2015, 460 patients; phase 2 (pilot): September 2015 to May 2016, 211 patients; and phase 3 (expansion in two phases): June 2016 to February 2017 and October 2017 to June 2018, 610 patients. Hemoglobin, iron saturation, and ferritin were evaluated according to the protocol. Results: In this study, 55% of the patients achieved the target hemoglobin in phase 1 compared with 75% in phase 2 (p = 0.0007). The hemoglobin level within the target range was sustained at 72% ± 5% of patients in phase 3. The achievement rate of the target hemoglobin level increased from 56% (May 2015) to 72% (July 2018) (p < 0.001). The proportion of patients with extreme hemoglobin declined from 10.7% in phase 1 to 6.4% in phase 2 and sustained at 8% afterward. Reducing the doses of erythropoietin stimulating agents, owing to the use of the ANM model, saved costs by approximately 11%. Conclusions: The ANM model was able to achieve and maintain hemoglobin levels within the target range and decrease extreme hemoglobin levels. These outcomes improved patient care by avoiding high hemoglobin (increase thrombosis, cancer recurrence, stroke, and death) and low hemoglobin (weakness, poor quality of life, and need for transfusion) levels. The ANM model was cost effective even after including the salaries of nurses. This model can be considered in other aspects of patient care in dialysis.
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Affiliation(s)
| | - Hany Ezzat
- Hamad Medical Corporation, Doha, Qatar E-mail:
| | | | | | | | - Nadia Noor
- Hamad Medical Corporation, Doha, Qatar E-mail:
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Hamad A, Hiner D, Jue V, Shi Y, Stoffella S, Thakar S, Budzik J, Chau-Etchepare F, Dawson D, Gibb E, Jahwar S, Kamerman-Kretzmer R, Kleinhenz M, Ly N, Morrissey B, Nandalike K, Perez A, Yu M. 548: Evaluation of elexacaftor/tezacaftor/ivacaftor on pulmonary function in cystic fibrosis patients. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01971-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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27
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Azoubi O, Abdullatif T, Hamad A, Fouda T, Ismail SM, lonappan VK, Hamid Tolba HA, Ali Ben Amro M, Al Ali F. Utilizing diabetes mellitus risk assessment tool in screening of hemodialysis patients at risk of diabetes mellitus. Journal of Emergency Medicine, Trauma and Acute Care 2021. [DOI: 10.5339/jemtac.2021.qhc.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Osama Azoubi
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Tarek Abdullatif
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Abdullah Hamad
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Tarek Fouda
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Sahar M Ismail
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Vimala K lonappan
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Hoda A Hamid Tolba
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Mohamed Ali Ben Amro
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Fadwa Al Ali
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
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Mishra RK, Al-Ali F, Hamad A, Ibrahim R, Mathew M, Najafi B. MO623EFFECT OF PLANTAR ELECTRICAL NERVE STIMULATION DURING ROUTINE HEMODIALYSIS PROCESS ON THE DAILY PHYSICAL ACTIVITY IN ADULTS WITH DIABETES AND END-STAGE RENAL DISEASE - A RANDOMIZED DOUBLE-BLINDED CONTROLLED TRIAL. Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab093.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Physical inactivity among patients undergoing hemodialysis (HD) is a long-standing clinical problem. While exercise could be beneficial, post-dialysis fatigue, limited time availability, and severe frailty to travel often lead to poor adherence to conventional exercise programs. To address this gap, we proposed testing an alternative therapy using intradialytic plantar electrical nerve stimulation (IPENS) provided during the routine hemodialysis process.
Methods
Participants were randomized into either an intervention group (IG: n=16, age=57.6±3.6 years, BMI=29.7±1.5 kg/m2, female=31%) or a control group (CG: n=15, age=63.5±1.6 years, BMI=29.9±1.6 kg/m2, female=41%). The IG received 1-hour IPENS during routine hemodialysis process (3 sessions/week) for 12 weeks. The CG was provided with an identical but non-functional device for the same period. Participants and therapy-providers were blinded to the group allocation. Daily life physical activity (e.g., cumulative postures including sitting, standing, lying, and walking; walking characteristics including step count, number of unbroken walking bout, and postural transitions including sit to stand and stand to sit) was monitored remotely at baseline and 12-week for a period of 48h using a validated pendant sensor. To determine the effect of intervention, we estimated Cohen’s effect size d. In addition, time effect, group effect, and time×group effect were estimated using general linear model.
Results
All participants in the IG tolerated the IPENS and completed all therapy sessions, indicating the feasibility. In the IG, we observed significant increase in time spent in standing (Cohen's d=0.8, p=0.039) and walking (Cohen's d=0.82, p=0.034), number of walking episodes (d=0.88, p=0.024), and number of postural transitions (d=0.93, p=0.018) with a decrease in the average duration for sit to stand transition (d=0.87, p=0.032) compared to the CG.
Conclusions
This is an ongoing study and our target sample is 100 eligible participants. This study provides earlier results on IPENS therapy's feasibility and effectiveness as an alternative to exercise programs to improve daily life physical activity among people undergoing routine hemodialysis process. If the results were held at a larger sample, we could recommend routine
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Affiliation(s)
- Ram kinker Mishra
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, United States of America
| | - Fadwa Al-Ali
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Abdullah Hamad
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Rania Ibrahim
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Mincy Mathew
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, United States of America
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Park C, Al-Ali F, Zhou H, Hamad A, Talal T, Ibrahim R, Najafi B. MO614A PRACTICAL SOLUTION TO SCREEN COGNITIVE FRAILTY AMONG HEMODIALYSIS PATIENTS USING A GAME-BASED INTRADIALYTIC EXERCISE WITH WEARABLE SENSORS. Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab091.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
Assessing and monitoring cognitive frailty (CF; coexistence of physical frailty and cognitive impairment) are critical for hemodialysis patients. For administering physical frailty and cognitive assessments, however, clinical settings need to address challenges (e.g., cost, human and technical resources, patient’s fatigue, etc.). This study aims to investigate the feasibility and accuracy of a novel intradialytic cognitive-demanding exercise program based on wearables, called, intradialytic-exergame for screening CF in hemodialysis patients.
Method
Individuals diagnosed with diabetes and end-stage renal disease requiring hemodialysis (n=28, age: 61.36 ± 6.85 years, 54% female) participated. All participants were assessed for physical frailty using the Fried frailty phenotype method and cognitive impairment using the Mini-Mental State Examination (MMSE). The Fried frailty phenotype method assesses physical frailty, which ranges between 0 and 5 based on five criteria (unintentional weight loss, weakness, slowness, exhaustion, and low physical activity). CF was determined with a frailty phenotype greater than or equal to 1 and a MMSE score less than or equal to 24.
The intradialytic-exergame system consists of an inertial wearable sensor and an interactive software installed on a standard laptop. A clinician attaches one wearable sensor to each foot after the participant sits or lies down on a bed (Figure A). While undergoing hemodialysis treatment, the participant performs 15 non-weight-bearing cognitively-demanding dorsiflexion and plantarflexion exercises for each foot. For each exercise, the laptop’s screen displays a target (solid yellow circle) and a cursor (solid red square), which the participant points down for a dorsiflexion motion or up for a plantarflexion motion (Figure B). When the participant successfully puts the cursor in the target, the target disappears, and a new target appears in a different location on the screen (dashed yellow circle shown in Figure B). If the participant moves the cursor to a target in less than 2s, the custom software provides both visual (the target explodes) and auditory (positive sound) feedback as a reward (success).
The three outcome measures (Exergame-slowness, frailty, and cognitive performance) were analyzed. Exergame-slowness was computed as an average of the ranges of ankle angular velocity measured by wearable sensors. Linear regression analysis was conducted for the three outcome measures to examine correlations between each outcome measure. Binary logistic regression model was conducted, and its area-under-curve (AUC) was calculated to determine the ability of Exergame-slowness to identify CF. An independent t-test was conducted to compare the differences of Exergame-slowness for CF and non-CF conditions. Significance was defined at the 2-sided p < 0.05 level.
Results
Five out of 28 participants were identified with CF. Significant correlations were observed between Exergame-slowness and frailty (p = 0.004, R = -0.531), Exergame-slowness and cognitive performance (p = 0.023, R = 0.437), and frailty and cognitive performance (p = 0.015, R = -0.463). The model was significantly reliable (p = 0.012) and its AUC was 0.90. Results indicated that Exergame-slowness was significantly higher (lower velocity) for participants with CF than for those with non-CF (CF: 27.41 ± 3.58 degree/s, non-CF: 34.25 ± 5.24 degree/s, p = 0.010).
Conclusion
To our knowledge, this is the first study to investigate the feasibility and accuracy of intradialytic-exergame with wearable sensors, as a practical tool for routine screening CF assessment in hemodialysis patients. The results of this study indicate that speed of ankle rotation, measurable using a wearable sensor during a simple intradialytic cognitive-demanding exercise, can be used as a practical digital biomarker for screening CF in hemodialysis patients.
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Affiliation(s)
- Catherine Park
- Baylor College of Medicine, Department of Surgery, Houston, United States of America
| | - Fadwa Al-Ali
- Hamad General Hospital, Department of Nephrology, Doha, Qatar
| | - He Zhou
- BioSensics LLC, Newton, United States of America
| | - Abdullah Hamad
- Hamad General Hospital, Department of Nephrology, Doha, Qatar
| | - Talal Talal
- Hamad Medical Co, Diabetic Foot and Wound Clinic, Doha, Qatar
| | - Rania Ibrahim
- Hamad General Hospital, Department of Nephrology, Doha, Qatar
| | - Bijan Najafi
- Baylor College of Medicine, Department of Surgery, Houston, United States of America
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Ghonimi TA, Hamad A, Iqbal Z, Yasin F, Ali F, Ismail S, Abdul Aziz R, Al-Ali F. Mortality of dialysis patients in Qatar: A retrospective epidemiologic study. Qatar Med J 2021. [DOI: 10.5339/qmj.2021.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background: End-stage kidney disease (ESKD) patients on maintenance renal replacement therapy (RRT) have far lower life spans than those of the general population. No previous studies have been performed to assess the mortality of dialysis patients in the State of Qatar. We designed this study to assess the mortality of dialysis patients in Qatar and the impact of dialysis modality.
Methods: All chronic ambulatory dialysis patients (both on hemodialysis (HD) and peritoneal dialysis (PD) between 2014 and 2016) were included in the study, whereas patients undergoing dialysis for less than 3 months were excluded. We reviewed patients’ demographics, comorbidities, and general laboratory investigations through our electronic record system and collected and analyzed them. We identified patients who died during that period and compared them to those who survived. We performed a subanalysis for HD versus PD patients who died.
Results: The total number of deceased dialysis patients was 164, with an overall crude mortality rate of 6.4%. They were significantly older than those who survived (p = 0.0001). The mortality rate was significantly higher in female than in male patients (51.2% and 38.9%, respectively) (p = 0.004) but significantly lower in PD than HD patients (1.36%, PD; 5.0%, HD; p = 0.007). It was also significantly higher in natives than in the expats (60.3% and 39.6%, respectively) (p = 0.0008); however, no significant differences were noted between deceased natives and expats in most demographic and laboratory characteristics. The most common cause of patient death was CVD (62 patients, 37.8%), followed by sepsis (44 patients, 26.8%). Diabetes, cerebrovascular accident, and dyslipidemia were more common in HD deceased patients than in PD patients (80.6%, 47%, and 59%, respectively, in HD patients vs 68.5%, 42%, and 31%, respectively, in PD patients). Albumin and potassium levels in deceased PD patients were significantly lower than in HD patients (p = 0.001).
Conclusion: Our study found that the high-risk population had a significant mortality, which was higher in HD than PD patients. This is the first study to look at these outcomes in Qatar. We identified multiple mortality associated factors, such as comorbid conditions and old age. We believe that improving treatment and close monitoring for comorbid conditions in the dialysis population might improve survival.
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Affiliation(s)
- Tarek A Ghonimi
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Abdullah Hamad
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Zafer Iqbal
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Fadumo Yasin
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Farrukh Ali
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Sahar Ismail
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Rania Abdul Aziz
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Fadwa Al-Ali
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail:
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AlSahow A, Muenz D, Al-Ghonaim MA, Al Salmi I, Hassan M, Al Aradi AH, Hamad A, Al-Ghamdi SMG, Shaheen FAM, Alyousef A, Bieber B, Robinson BM, Pisoni RL. Kt/V: achievement, predictors and relationship to mortality in hemodialysis patients in the Gulf Cooperation Council countries: results from DOPPS (2012-18). Clin Kidney J 2021; 14:820-830. [PMID: 33777365 PMCID: PMC7986324 DOI: 10.1093/ckj/sfz195] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 12/16/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Dialysis adequacy, as measured by single pool Kt/V, is an important parameter for assessing hemodialysis (HD) patients' health. Guidelines have recommended Kt/V of 1.2 as the minimum dose for thrice-weekly HD. We describe Kt/V achievement, its predictors and its relationship with mortality in the Gulf Cooperation Council (GCC) (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates). METHODS We analyzed data (2012-18) from the prospective cohort Dialysis Outcomes and Practice Patterns Study for 1544 GCC patients ≥18 years old and on dialysis >180 days. RESULTS Thirty-four percent of GCC HD patients had low Kt/V (<1.2) versus 5%-17% in Canada, Europe, Japan and the USA. Across the GCC countries, low Kt/V prevalence ranged from 10% to 54%. In multivariable logistic regression, low Kt/V was more common (P < 0.05) with larger body weight and height, being male, shorter treatment time (TT), lower blood flow rate (BFR), greater comorbidity burden and using HD versus hemodiafiltration. In adjusted Cox models, low Kt/V was strongly related to higher mortality in women [hazard ratio (HR) = 1.91, 95% confidence interval (CI) 1.09-3.34] but not in men (HR = 1.16, 95% CI 0.70-1.92). Low BFR (<350 mL/min) and TT (<4 h) were common; 41% of low Kt/V cases were attributable to low BFR or TT (52% for women and 36% for men). CONCLUSION Relatively large proportions of GCC HD patients have low Kt/V. Increasing BFR to ≥350 mL/min and TT to ≥4 h thrice weekly will reduce low Kt/V prevalence and may improve survival in GCC HD patients-particularly among women.
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Affiliation(s)
- Ali AlSahow
- Nephrology Division, Jahra Hospital, Jahra, Kuwait
| | - Daniel Muenz
- Arbor Research Collaborative for Health, Ann Arbor, MI, USA
| | - Mohammed A Al-Ghonaim
- Medicine Department, Saudi Center for Organ Transplantation, King Saud University, Riyadh, KSA
| | - Issa Al Salmi
- Renal Medicine Department, Royal Hospital, Muscat, Oman
| | - Mohamed Hassan
- Nephrology Division, Shaikh Khalifa Medical Center, Abu Dhabi, UAE
| | - Ali H Al Aradi
- Nephrology Division, Salmaniya Medical Complex, Manama, Bahrain
| | | | - Saeed M G Al-Ghamdi
- Medicine Department, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
| | | | - Anas Alyousef
- Nephrology Division, Farwaniya Hospital, Sabah AlNasser, Kuwait
| | - Brian Bieber
- Arbor Research Collaborative for Health, Ann Arbor, MI, USA
| | - Bruce M Robinson
- Arbor Research Collaborative for Health, Ann Arbor, MI, USA
- Division of Nephrology, University of Michigan, Ann Arbor, MI, USA
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Ghonimi TA, Hamad A, Iqbal Z, Yasin F, Ali F, Ismail S, Abdul Aziz R, Al-Ali F. Mortality of dialysis patients in Qatar: A retrospective epidemiologic study. Qatar Med J 2021; 2021:02. [PMID: 33628714 DOI: 10.5339/qmj.2020.02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/19/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND End-stage kidney disease (ESKD) patients on maintenance renal replacement therapy (RRT) have far lower life spans than those of the general population. No previous studies have been performed to assess the mortality of dialysis patients in the State of Qatar. We designed this study to assess the mortality of dialysis patients in Qatar and the impact of dialysis modality. METHODS All chronic ambulatory dialysis patients (both on hemodialysis (HD) and peritoneal dialysis (PD) between 2014 and 2016) were included in the study, whereas patients undergoing dialysis for less than 3 months were excluded. We reviewed patients' demographics, comorbidities, and general laboratory investigations through our electronic record system and collected and analyzed them. We identified patients who died during that period and compared them to those who survived. We performed a subanalysis for HD versus PD patients who died. RESULTS The total number of deceased dialysis patients was 164, with an overall crude mortality rate of 6.4%. They were significantly older than those who survived (p = 0.0001). The mortality rate was significantly higher in female than in male patients (51.2% and 38.9%, respectively) (p = 0.004) but significantly lower in PD than HD patients (1.36%, PD; 5.0%, HD; p = 0.007). It was also significantly higher in natives than in the expats (60.3% and 39.6%, respectively) (p = 0.0008); however, no significant differences were noted between deceased natives and expats in most demographic and laboratory characteristics. The most common cause of patient death was CVD (62 patients, 37.8%), followed by sepsis (44 patients, 26.8%). Diabetes, cerebrovascular accident, and dyslipidemia were more common in HD deceased patients than in PD patients (80.6%, 47%, and 59%, respectively, in HD patients vs 68.5%, 42%, and 31%, respectively, in PD patients). Albumin and potassium levels in deceased PD patients were significantly lower than in HD patients (p = 0.001). CONCLUSION Our study found that the high-risk population had a significant mortality, which was higher in HD than PD patients. This is the first study to look at these outcomes in Qatar. We identified multiple mortality associated factors, such as comorbid conditions and old age. We believe that improving treatment and close monitoring for comorbid conditions in the dialysis population might improve survival.
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Affiliation(s)
- Tarek A Ghonimi
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Abdullah Hamad
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Zafer Iqbal
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Fadumo Yasin
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Farrukh Ali
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Sahar Ismail
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Rania Abdul Aziz
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Fadwa Al-Ali
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar E-mail:
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Asim M, Alkadi M, Hamad A, Othman M, Abuhelaiqa E, Fituri O, El-Madhoun I, Al-Malki H. Restructuring nephrology services to combat COVID-19 pandemic: Report from a Middle Eastern country. World J Nephrol 2020; 9:9-17. [PMID: 33312898 PMCID: PMC7701933 DOI: 10.5527/wjn.v9.i2.9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/26/2020] [Accepted: 11/05/2020] [Indexed: 02/06/2023] Open
Abstract
Coronavirus disease 2019 has spread across the world and has been classified as a pandemic. It has overwhelmed the healthcare systems. Specifically, it has overstretched the intensive care units and renal replacement therapy services in many countries. In this paper, we discuss the reconfiguration of nephrology services in the State of Qatar during the current pandemic. We highlight the key strategies that have been implemented to ensure that renal replacement therapy capacity is not constrained in either the intensive care or ambulatory setting. Some innovative approaches for the safe delivery of ambulatory care to dialysis and kidney transplant patients are also discussed.
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Affiliation(s)
- Muhammad Asim
- Nephrology Division, Department of Medicine, Hamad Medical Corporation, Doha 3050, Qatar
| | - Mohamad Alkadi
- Nephrology Division, Department of Medicine, Hamad Medical Corporation, Doha 3050, Qatar
| | - Abdullah Hamad
- Nephrology Division, Department of Medicine, Hamad Medical Corporation, Doha 3050, Qatar
| | - Muftah Othman
- Nephrology Division, Department of Medicine, Hamad Medical Corporation, Doha 3050, Qatar
| | - Essa Abuhelaiqa
- Nephrology Division, Department of Medicine, Hamad Medical Corporation, Doha 3050, Qatar
| | - Omar Fituri
- Nephrology Division, Department of Medicine, Hamad Medical Corporation, Doha 3050, Qatar
| | - Ihab El-Madhoun
- Nephrology Division, Department of Medicine, Hamad Medical Corporation, Doha 3050, Qatar
| | - Hassan Al-Malki
- Nephrology Division, Department of Medicine, Hamad Medical Corporation, Doha 3050, Qatar
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Elbardisi H, Majzoub A, Al-Ali F, Elesnawi M, Hamad A, Al Emadi I, Arafa M. P0955IS THERE AN ENDOCRINE CONTRIBUTION TO THE SEXUAL DYSFUNCTION SEEN IN END STAGE RENAL DISEASE PATIENTS? Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
Male sexual dysfunction is commonly prevalent in patients with end stage renal disease (ESRD) and has been partly attributed to the concurrent state of hyperprolactinemia and hypogonadism, often observed in this patient population. The aim of this study was to evaluate the hormone profile and sexual function of ESRD patient, using validated questionnaires, in attempt to explore this association.
Method
This was a prospective study which included 98 patients with ESRD who followed in the outpatient department of a tertiary medical centre over a period of 1 year. Patients receiving treatment for hyperprolactinemia or those known to have an endocrine disorder were excluded in addition to patients receiving medical or surgical treatment for erectile dysfunction (ED) or premature ejaculation (PE). After filling the international index for erectile function-5 and the Arabic index for PE questionnaire, morning serum samples were taken from patients to measure testosterone and prolactin levels. Descriptive statistics was used to report frequency or means of variables. Chi-square test was used to examine associations between categorical variables. P<0.05 was considered statistically significant.
Results
Out of the 98 ESRD patients, 72 (73.6%) were treated with hemodialysis, 13 (13.2%) with peritoneal dialysis and 13 (13.2%) with medical treatment only. Diabetes mellitus was observed in all patients (type 1, 52%; and type 2, 48%), while hypertension, coronary heart disease and dyslipidemia were detected in 97.1%, 34.3% and 25.5%, respectively. The mean age, serum testosterone and prolactin levels were 52.4 ± 12.1 years, 12.95 ± 6.5 nmol/L and 514.2 ± 592.8mIU/L. Results of the PE index questionnaire revealed that 86 (87.7) patients had PE, 9 (9.1%) probable PE and 3 (3.1%) no PE. With IIEF-5, ED was detected in 96 patients; it was severe in 23 (23.5%), moderate- severe ED in 29 (29.4%), mild-moderate ED in 30 (30.4%) and mild in 14 (14.7%). 55 patients had high prolactin while 33 had low testosterone levels. Table 1 presents the IIEF-5 and PE questionnaire results in patients with low/normal testosterone and normal/high prolactin. No significant differences were observed in IIEF or PE levels between patients with low/normal testosterone and normal/high prolactin.
Conclusion
ESRD is commonly associated with sexual dysfunction that is more likely to be attributed to organic causes rather than solely to endocrine disturbances.
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Affiliation(s)
| | | | - Fadwa Al-Ali
- Hamad Medical Corporation, Nephrology, Doha, Qatar
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Al-Ali F, Ibrahim R, Mathew M, Kheir N, Awaisu A, Izham M, Almansouri A, Hamad A. P1549TREATMENT BURDEN AND ITS IMPACT ON QUALITY OF LIFE AMONG CHRONIC KIDNEY DISEASE PATIENTS WITH DIABETES MELLITUS IN QATAR. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p1549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
Diabetes mellitus (DM) is the leading cause of chronic kidney disease (CKD) and on of its top comorbidities. Its management places significant burden on patients and results in impairment of their health-related quality of life (HR-QOL). Little is known about diabetes mellitus treatment-related burden in patients with CKD. This study aimed to investigate the impact of diabetes mellitus on treatment-related burden and HR-QOL among CKD patients in Qatar.
Method
This was a mixed-method, sequential explanatory study conducted at Fahad Bin Jassim Kidney Center in Qatar on hemodialysis and pre-dialysis (GFR<20 but not on dialysis yet) patients. Treatment-related burden and HR-QOL were assessed quantitatively using the Treatment Burden Questionnaire (TBQ) and the Kidney Disease Quality of Life (KDQOL™) questionnaire, respectively. To gain a deeper insight, qualitative one-to-one semi-structured interviews were conducted among the CKD patients. Quantitative data were analyzed descriptively and inferentially using SPSS version 24. Thematic content analysis was performed for the qualitative data.
Results
Two hundred-eighty CKD patients (hemodialysis = 223 and pre-dialysis (GFR <20) = 57) were included. 157 has DM and 66 were non-DM (in hemodialysis) while 32 patients had DM vs 25 non-DM (in pre-dialysis). In general, 35% of patients reported moderate to high burden. Hemodialysis patients experienced significantly higher treatment burden compared to pre-dialysis patients with median (IQR) of 45 (36) versus 25 (33), respectively (p<0.001). DM patients expressed significantly higher TBQ score compared to non-DM (47(40) vs. 36(27) p<0.001). Retinopathy was associated with worsened treatment burden (TBQ 46.5(29) vs. 40(38) p=0.019). Medication burden and lifestyle change burden were the highest perceived treatment-related burden, followed by administrative, social, and financial burden. The presence of antidiabetic medications correlated with worse TBQ score (0.207 p<0.001). There was a strong, negative correlation between TBQ score and KDQOL-36™ score [rs (251) = -0.616, p <0.001]. Presence of DM was associated with worse KDQOL (2110(1055) vs. 2685(1170) p<0.001). Thematic content analysis identified religion and faith in God as well as quality of the care provided as factors that reduce perceived treatment burden and improve patients’ HR-QOL. Conversely, medication burden, lifestyle changes, challenges with international travelling, financial burden, and empathy were factors that worsen perceived treatment-related burden and HR-RQOL.
Conclusion
This study suggests that diabetes mellitus and its treatment negatively impacts treatment-related burden and quality of life in CKD patients. This result should be considered in management strategies when designing healthcare interventions directed to CKD patients with diabetes mellitus.
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Affiliation(s)
| | | | | | - Nadir Kheir
- Qatar University, Pharmacy Department, Qatar
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Arabi Z, Saleh K, Hamad A, Bukhari M, Mateen A, El Hassan EW, Altheaby A. P1716MULTI-NATIONAL SURVEY AMONG NEPHROLOGISTS & TRANSPLANT SURGEONS ABOUT THE SUITABILITY & ACCEPTANCE OF MARGINAL LIVE KIDNEY DONORS REGARDING AGE DISCREPANCY. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p1716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
Living donor kidney transplantation is the best option for patients on dialysis. There are no guidelines or generally accepted consensus about the acceptable kidney donor age and what is the acceptable donor-recipient age discrepancy.
Method
This is a cross sectional survey of nephrologists and transplant surgeons about acceptable age of living kidney donors. The survey was sent to participants in different countries and through AST and ERA/EDTA.
Results
122 respondents from 22 countries answered 4 questions related to donor age. Most respondents (N=86, 70%) would allow an 18-years old man to donate to his older sibling. However, this percentage would fall to (N=69, 57%) if the donor was an 18-years old woman (P=0.02), reflecting the impact of childbearing period as a major criterion in considering kidney donation. On the opposite side, up to 20% of respondents will decline a very young donor regardless of the gender of the donor. The acceptance rate of a very young donor drops to only 37% if the recipient is 75-year-old (versus 70% in case of younger recipient, P = 0.004). In case of old donor( > 65 years old) old to an 18 year old recipient with expected prolonged waiting time for deceased donor, ( N= 80, 65%) will advise to find an alternative donor but will allow the donation if no alternative donor is available.
Conclusion
The majority of the nephrologists and transplant surgeons will allow a very young donor to donate to a sibling especially if the donor is a male. However up to 20% will decline this donation regardless of the gender of the donor.
The transplant community is divided about allowing a very young donor to donate to a very old recipient. However, the majority will accept > 65 years old donor to donate to an 18 years old recipient with expected prolonged waiting time for deceased donor.
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Affiliation(s)
- Ziad Arabi
- King Abdulaziz Medical City, King Abdullah International Medical Research Center & King Saud Bin Abdulaziz University for Health Sciences, Adult Transplant Nephrology, Organ Transplant Center, Riyadh, Saudi Arabia
| | - Kaysi Saleh
- CHU Clermont-Ferrand,, Department of Nephrology, Saint Pryv/ Saint Mesmin, France
| | - Abdullah Hamad
- The Regional Medical Center, Orangeburg, SC,, United States of America
| | | | - Atif Mateen
- King Abdulaziz Medical City, Department of Nephrology, Riyadh, Saudi Arabia
| | | | - Abdulrahman Altheaby
- King Abdulaziz Medical City, King Abdullah International Medical Research Center & King Saud Bin Abdulaziz University for Health Sciences, Department of Nephrology, Riyadh, Saudi Arabia
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Arabi Z, Mateen A, Altheaby A, Hamad A, Saleh K, El Hassan EW. P1710MULTI-NATIONAL SURVEY AMONG NEPHROLOGISTS AND TRANSPLANT SURGEONS ABOUT THE SUITABILITY AND ACCEPTANCE OF MARGINAL LIVE KIDNEY DONORS WITH SICKLE CELL TRAIT. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p1710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
Due to organ shortage, many transplant centers may consider “marginal” kidney donors as those with sickle cell trait (SCT) for donation. Acceptance of kidney donors with SCT is in the grey zone, where there are no clear guidelines or consensus toward them. To form a consensus, we conducted a short survey about the suitability and acceptance of living kidney donors with SCT.
Method
This is a cross-sectional survey of nephrologists and transplant surgeons about Suitability and Acceptance of The Marginal Live Kidney Donors. The survey was sent to nephrologists in different countries and it was also distributed through AST& ERA-EDTA.
Results
Of a total of (n=122) respondents from 22 countries: 80.17% (N= 96) were nephrologists and 19.83% (N=23) were transplant surgeons. N= 88 of the respondents (72%) have more than 6 years in practice and they are heavily involved in pre- transplant evaluations of donors and recipients (68.5% of respondents perform donors’ evaluation on weekly or monthly basis and 60 % perform recipient evaluation on weekly basis). The majority (45%) of the respondents were from USA. The completion rate of the survey was 99%. The presence of sickle cell trait was not considered as a contraindication to donor nephrectomy by the majority of respondents (57.38%). Of those (N= 34) 27.87 % of respondents consider them fit for donor nephrectomy after explanation of the risks involved while (N= 36) 29.51 consider them for donor nephrectomy only if there is no other suitable donor available. Out of the total respondents (N= 52) 42.62% considered the presence of sickle cell trait a contraindication to donor nephrectomy.
Conclusion
With lack of consensus and guidelines we found that a significant pool of the transplant physicians and surgeons will consider donors with sickle cell trait for kidney donation especially if there is no other acceptable donor.
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Affiliation(s)
- Ziad Arabi
- King Abdulaziz Medical City, King Abdullah International Medical Research Center & King Saud Bin Abdulaziz University for Health Sciences, Adult Transplant Nephrology, Organ Transplant Center, Riyadh, Saudi Arabia
| | - Atif Mateen
- King Abdulaziz Medical City, Department of Nephrology, Riaydh, Saudi Arabia
| | - Abdulrahman Altheaby
- King Abdulaziz Medical City, King Abdullah International Medical Research Center & King Saud Bin Abdulaziz University for Health Sciences, Adult Transplant Nephrology, Organ Transplant Center, Riyadh, Saudi Arabia
| | - Abdullah Hamad
- The Regional Medical Center, Orangeburg, SC,, United States of America
| | - Kaysi Saleh
- CHU Clermont-Ferrand,, Saint Pryv/ Saint Mesmin, France
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Arabi Z, Saleh K, Hamad A, Bukhari M. P1686MULTI-NATIONAL SURVEY AMONG NEPHROLOGISTS AND TRANSPLANT SURGEONS ABOUT THE SUITABILITY AND ACCEPTANCE OF MARGINAL LIVE KIDNEY DONORS WITH MICROSCOPIC HEMATURIA. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p1686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and Aims
Potential kidney donors with isolated hematuria are often excluded from donating although there is a wide controversy about the definition and threshold of investigations or exclusion form donation. Many centers use the cut off of > 3 RBC in men and > 5 RBC in women. Some centers consider positive dipstick on urinalysis as the definition of microscopic hematuria. Kidney biopsy in these donors can be borderline and inconclusive. We conducted a short survey about the suitability of these marginal living kidney donors with microscopic hematuria.
Method
This is a cross-sectional survey of nephrologists and transplant surgeons (TS) about suitability and acceptance of marginal live kidney donors with isolated microscopic hematuria. The question was about a 35-yr. old man non-smoker with isolated microscopic hematuria (4 RBC on repeated UA and trace hematuria on dipstick) and negative imaging. The survey was mainly distributed through American Society of Transplantation, American Society of Transplant Surgeons and European Renal Association-European Dialysis and Transplant Association. In-training nephrologists or transplant surgeons were excluded.
Results
A total of (n= 122 from 22 countries, 80% nephrologists and 20% TS) responded to the survey. Most respondents were experienced in donor evaluation (72% of physicians have over 6 years’ experience and 68.5% of them perform donors’ evaluation on weekly or monthly bases). Interestingly, at this low level of microscopic hematuria (4 RBC on repeated UA and trace hematuria on dipstick) only very limited number of respondents (7.5%) would allow donation without further work up. Instead, most respondents (n= 75, 63%) would ask for kidney biopsy prior to taking further steps. Many physicians (n=35, 29%) choose to ask for an alternative donor to avoid the hassle of kidney biopsy which may not change the management. There was no difference in acceptance rate for donors between TS and nephrologists (7.2% versus 8.3% respectively, p=NS), requesting kidney biopsy (63.9% vs. 62.5%) or in declining these donors (28.8% versus 29.1%, p=NS).
Conclusion
Young kidney donors with persistent isolated microscopic hematuria (even at mild degree) require further evaluation with kidney biopsy before donation. However up to one third of the nephrologist and transplant surgeon will ask for an alternative donor to avoid the hassle of kidney biopsy which can be borderline or inconclusive.
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Affiliation(s)
- Ziad Arabi
- King Abdulaziz Medical City, King Abdullah International Medical Research Center & King Saud Bin Abdulaziz University for Health Sciences, Adult Transplant Nephrology, Organ Transplant Center, Riyadh, Saudi Arabia
| | - Kaysi Saleh
- CHU Clermont-Ferrand,, Saint Pryv/ Saint Mesmin, France
| | - Abdullah Hamad
- The Regional Medical Center, Orangeburg, SC,, United States of America
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Arabi Z, El Hassan EW, Altheaby A, Hamad A, Saleh K. P1698MULTI- NATIONAL SURVEY AMONG NEPHROLOGISTS AND TRANSPLANT SURGEONS ABOUT THE SUITABILITY AND ACCEPTANCE OF MARGINAL LIVE KIDNEY DONORS WITH MILD HYPERTENSION. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p1698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and Aims
There is variability among transplant centers in the acceptance of living donor candidates with well-controlled hypertension. Increased gestational hypertension and preeclampsia are more common in donors than in the general population especially if the donor is hypertensive at baseline. The purpose of this survey is to form a consensus about the evaluation of marginal live kidney donors (women and men) with hypertension.
Method
This is a cross-sectional survey of nephrologists and transplant surgeons about Suitability and Acceptance of The Marginal live Kidney Donors. The survey was sent to nephrologists in different countries and it was also distributed through AST & ERA-EDTA.
Results
A total of 122 practitioners from 22 countries responded to the survey. Of those, (N=96, 80.2%) were nephrologists and (n=23 19.83%) were transplant surgeons. The majority (45%) of the respondents were from USA. Most of the respondents (N=85, 69.7%) would allow a multiparous female (MPW) with mild and controlled hypertension (on a single blood pressure medication) who is not planning to have more children to donate. The rest would either advise against donation unless there is no alternative donor (n=23, 18.85%), or decline it altogether (n=14, 11.5%). In contrast, more respondents would reject a primiparous donor woman (PPW) with the same clinical scenario who considers having children (n=51, 42.2%, P=0.00001 ), or accept it only if there is no alternative donor (n=46, 38.0%, P=0.0009). Furthermore, most would not allow donation of a 20 years old male ( M) with an apparent white coat hypertension if his 24-hour ambulatory blood pressure monitoring shows non-dipping nocturnal pattern (n=67, 54.9%), or only accept it if there is no alternative donor (n=36, 29.5%). When comparing the rejection rate among the three donors: 11% for MPW, 41% for PPW and 54% for M. (P = 0.0001 for MPW vs PPW; P=0.00001 for MPW vs M; P=0.04 for PPW vs M).
Conclusion
Most of the nephrologists and transplant surgeons will clear mulptiparous women with mild and controlled hypertension for kidney donation as long as there no further plans for pregnancy. However, the majority of respondents will not clear a hypertensive primiparous due to the increased risk of gestational hypertension and preeclampsia after kidney donation. Most would be also reluctant to accept very young male donors if they show indicators of higher risk of developing hypertension in future.
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Affiliation(s)
- Ziad Arabi
- King Abdulaziz Medical City, King Abdullah International Medical Research Center & King Saud Bin Abdulaziz University for Health Sciences, Adult Transplant Nephrology, Organ Transplant Center, Riyadh, Saudi Arabia
| | - El Waleed El Hassan
- King Abdulaziz Medical City, Department of Nephrology, Riaydh, United States of America
| | - Abdulrahman Altheaby
- King Abdulaziz Medical City, King Abdullah International Medical Research Center & King Saud Bin Abdulaziz University for Health Sciences, Adult Transplant Nephrology, Organ Transplant Center, Riaydh, Saudi Arabia
| | - Abdullah Hamad
- The Regional Medical Center, Orangeburg, SC,, United States of America
| | - Kaysi Saleh
- CHU Clermont-Ferrand,, Saint Pryv/ Saint Mesmin, France
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Arabi Z, Hamad A, Saleh K, Bukhari M. P1684MULTI-NATIONAL SURVEY AMONG NEPHROLOGISTS AND TRANSPLANT SURGEONS ABOUT THE SUITABILITY AND ACCEPTANCE OF MARGINAL LIVE KIDNEY DONORS WITH HEAVY SMOKING OR INTERMITTENT DRUG ABUSE. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p1684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and Aims
Potential kidney donors who actively smoke heavily or had intermittent illegal drug use (IIDU) are mostly excluded from donating a kidney. Tobacco use in kidney donor has been linked to worse outcomes for donors and while less evidence exists for IIDU as they mostly excluded from donation. We conducted a short survey about the suitability of these marginal living kidney donors. The purpose of this survey is to form a consensus on live kidney donor with using smoking or illegal drugs.
Method
This is a cross-sectional survey of nephrologists and transplant surgeons about suitability and acceptance of marginal live kidney donors. We asked physicians about accepting kidney donors who are actively smoking or using illegal drugs. The survey was mainly distributed through AST and ERA-EDTA. The role of these organization is limited to facilitate the distribution of the survey as an external study. We excluded in-training nephrologists or transplant surgeons.
Results
One hundred twenty-two physicians from 22 countries (80% nephrologists and 20% transplant surgeons (TS)) participated in the survey. Most physicians were experienced in pre-transplant evaluation (72% over 6 years’ experience and 68.5% of responders perform donors’ evaluation on weekly or monthly bases). Interestingly, most physicians would allow donation in active smoker with advice to quit later (56.2%) (62% of nephrologists versus only 29% of TS (p=0.002). TS would decline active smoker patients than nephrologists (42% versus 25%, p=0.09). Less physicians considered donors with IDU (after psychiatric counselling) than active smoking (30% versus 56.2%, p=0.00003). There was no difference in acceptance rate for donors with IIDU between TS and nephrologists (33.3% versus 29% respectively, p=NS) or in declining these donors (37.5% versus 45.3%, p=0.4). TS would accept more active smokers to donate if no alternative donor available than nephrologists (29.2% vs. 12.3%, p=0.04) but not IDU (29.2% vs. 25.8%, p=ns).
Conclusion
Active heavy smoking and intermittent illegal drug use are not viewed as solo contraindications for kidney donation by most physicians. Nephrologists and TS did not differ in attitude regarding donors with IIDU. Nephrologist seems more confident to accept donors who are actively smoking with advice to quit afterward while TS would accept them more if no alternative donor available or would decline them completely.
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Affiliation(s)
- Ziad Arabi
- King Abdulaziz Medical City, King Abdullah International Medical Research Center & King Saud Bin Abdulaziz University for Health Sciences, Adult Transplant Nephrology, Organ Transplant Center, Riyadh, Saudi Arabia
| | - Abdullah Hamad
- The Regional Medical Center, Department of Nephrology, Orangeburg, SC,, United States of America
| | - Kaysi Saleh
- CHU Clermont-Ferrand,, Saint Pryv/ Saint Mesmin, France
| | - Mohammad Bukhari
- University of Taif, Department of Nephrology, Taif, Saudi Arabia
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Hartanti D, Septiyaningrum N, Hamad A. Combination of Clove and Lemon Basil Essential Oils for Preservation of Chicken Meat. JFQHC 2020. [DOI: 10.18502/jfqhc.7.2.2888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Clove and lemon basil are widely used in Indonesian culinary and known for their antimicrobial properties. This study was designed to identify the chemical constituents of single clove and lemon basil Essential Oils (EOs) as well as determine the potential of the combinations of both EO for preserving chicken meats.
Methods: The compositions of clove and lemon basil EOs were evaluated with Gas Chromatography-Mass Spectrometer. Three different concentration ratios of the combination of clove and lemon basil EOs (2:0.2, 1:1, and 0.1:2% v/v) were prepared along with single clove and lemon basil EOs in a concentration of 1% v/v. Their potential preservation effect was evaluated by observing the reduction of the microbial growth on the meats by evaluating Optical Density (OD) of cultured bacterial suspensions during 15 days of refrigerated storage. Statistical analyses were conducted by SPSS Statistics v. 20.
Results: The major constituents of clove EO were eugenol, β-caryophyllene, and αhumulene, while those of lemon basil were estragol, linalool, E-citral, and Z-citral. Both treatment groups and storage time affected significantly on ODs of the samples. Combination of these two EOs, particularly at the optimum ratio of 1:1%, showed the best microbial inhibitory activity, and delayed the sensorial changes of the meats for 12 days.
Conclusion: The combinations of cloves and lemon basil EOs showed a better microbial growth inhibitory activity and preservation potential than those of the single use. This meat preservation effects might be related to the presence of high fractions of oxygenated compounds, mainly eugenol, Z-citral, and E-citral in both clove and lemon basil EOs.
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Hamad A, Chumakov S. Engineering a recombinant Herpesvirus saimiri strain by co-culturing transfected and permissive cells. BRSMU 2019. [DOI: 10.24075/brsmu.2019.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Recombinant herpesviruses can be used as oncolytic therapeutic agents and high packaging capacity vectors for delivering expression cassettes into the cell. Herpesvirus saimiri is a gamma-herpesvirus that normally infects squirrel monkeys but also has a unique ability to infect and immortalize human lymphocytes while allowing them to retain their mature phenotype and functional activity. Recombination of the Herpesvirus saimiri genome in permissive cells is impeded by its resistance to chemical transfection and electroporation. The aim of this study was to develop an effective method for incorporating expression cassettes into the genome of Herpesvirus saimiri without having to transfect a permissive cell culture. Transfected HEK-293T cells expressing glycoproteins of the measles virus vaccine strain were co-cultured with permissive OMK cells infected with Herpesvirus saimiri. Cell fusion and formation of syncytia stimulated recombination between the viral genome and the expression cassette; this allowed us to obtain a recombinant Herpesvirus saimiri variant without chemical transfection in permissive cells. The genetically modified virus expressed a selectable marker and retained its ability to persist in the cell in the latent state; it also caused immortalization of primary lymphoid cells. The proposed approach allows engineering recombinant Herpesvirus saimiri strains carrying a variety of expression cassettes in its genome.
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Affiliation(s)
- A. Hamad
- Moscow Institute of Physics and Technology, Dolgoprudny, Russia
| | - S.P. Chumakov
- Shemyakin and Ovchinnikov Institute of Bioorganic Chemistry of the Russian Academy of Sciences, Moscow, Russia
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43
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Kadoguchi T, Shimada K, Hamad A, Aikawa T, Ouchi S, Kitamura K, Kunimoto M, Fukao K, Yokoyama M, Sugita Y, Shiozawa T, Matsushita S, Miyazaki T, Isoda K, Daida H. P629Voluntary exercise associated with myokine production ameliorates cardiac remodeling and inflammation in a myocardial infarction mouse model. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Left ventricular (LV) remodeling, through excessive inflammation, leads to heart failure. Exercise (Ex) training is associated with a risk reduction in heart failure through direct and indirect mechanisms by which Ex contributes an anti-inflammatory effect. During Ex, contracting muscle fibers release myokines, including interleukins (ILs), tumor necrosis factor α (TNF-α), follistatin-like protein 1 (FSTL-1), and fibroblast growth factor 21 (FGF-21), into the bloodstream. These myokines may have beneficial effects on other damaged organs, such as an infarcted myocardium, through anti-inflammatory effects. However, the exact mechanisms of the anti-inflammatory effects of voluntary Ex in myocardial infarction (MI) are poorly understood. Therefore, we investigated the effect of voluntary Ex on cardiac remodeling and inflammation, the relationship between cardiac remodeling and skeletal muscle (SKM) response, and circulating myokine levels in a mouse model of MI.
Methods
Twelve-week-old male C57BL/6J mice were used and divided into the following 4 groups: sham operation (Sham), MI, Sham+Ex, and MI+Ex. MI was induced by ligation of the left anterior descending coronary artery. Ex groups began voluntary wheel running for 4 weeks after the operation. An echocardiography was performed at baseline and 4 weeks after the operation. The mRNA levels in the LV infarcted area and SKM were measured with RT-PCR and western blot analysis. Plasma levels of myokines were also measured with immunoassays.
Results
Four weeks after MI induction, echocardiographic evaluation showed that the MI mice had a larger LV end-diastolic diameter (LVEDD) and end-systolic diameter (LVESD) than the Sham mice. The MI mice also showed higher mRNA levels of TNF-α, IL-1β, IL-6, and IL-10 in the LV tissue when compared to the Sham mice. These changes were significantly ameliorated in the MI+Ex mice. Interestingly, in the MI+Ex mice, mRNA levels of IL-6, IL-1β, FSTL-1, and FGF-21 in the SKM were significantly higher than in the MI mice, while there were no significant differences in TNF-α and IL-10 levels in all groups. Similarly, protein expression levels of peroxisome proliferator-activated receptor gamma coactivator 1-alpha, sirtuin-1, and mitochondrial transcriptional factor A of mitochondrial function markers in SKM were also significantly higher in the MI+Ex mice than in the MI mice. Furthermore, there were significant correlations between plasma levels of IL-1β, but not other myokines, and LVEDD, and LVESD. In addition, there was also a significant correlation between the SKM IL-1β level and LVESD in the Sham+Ex mice (all, P<0.05).
Conclusions
Amelioration of cardiac remodeling and inflammation by voluntary Ex is associated with increased myokines, especially IL-1β, in a MI mouse model. These results suggest that increased myokine levels, through voluntary exercise, may play an important role in the prevention of cardiac remodeling after MI.
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Affiliation(s)
- T Kadoguchi
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Shimada
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - A Hamad
- Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | - T Aikawa
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - S Ouchi
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Kitamura
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - M Kunimoto
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Fukao
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - M Yokoyama
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - Y Sugita
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Shiozawa
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - S Matsushita
- Juntendo University, Cardiovascular Surgery, Tokyo, Japan
| | - T Miyazaki
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Isoda
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - H Daida
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
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AlSahow A, Muenz D, Al-Ghonaim M, Al Salmi I, Hassan M, Al Aradi A, Hamad A, Al-Ghamdi S, Shaheen F, Alyousef A, Bieber B, Robinson B, Pisoni R. FP530KT/V ACHIEVEMENT AND SURVIVAL IN HEMODIALYSIS PATIENTS IN THE GULF COOPERATION COUNCIL (GCC) COUNTRIES: INTERNATIONAL RESULTS FROM DOPPS 5 & 6 (2012-2018). Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz106.fp530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Daniel Muenz
- Arbor Research Collaborative for Health, Ann Arbor, United States of America
| | | | | | | | | | | | | | | | | | - Brian Bieber
- Arbor Research Collaborative for Health, Ann Arbor, United States of America
| | - Bruce Robinson
- Arbor Research Collaborative for Health, Ann Arbor, United States of America
| | - Ronald Pisoni
- Arbor Research Collaborative for Health, Ann Arbor, United States of America
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Zhou H, Al-Ali F, Rahemi H, Kulkarni N, Hamad A, Ibrahim R, Talal TK, Najafi B. Hemodialysis Impact on Motor Function beyond Aging and Diabetes-Objectively Assessing Gait and Balance by Wearable Technology. Sensors (Basel) 2018; 18:s18113939. [PMID: 30441843 PMCID: PMC6263479 DOI: 10.3390/s18113939] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 10/25/2018] [Accepted: 11/09/2018] [Indexed: 12/13/2022]
Abstract
Motor functions are deteriorated by aging. Some conditions may magnify this deterioration. This study examined whether hemodialysis (HD) process would negatively impact gait and balance beyond diabetes condition among mid-age adults (48–64 years) and older adults (65+ years). One hundred and ninety-six subjects (age = 66.2 ± 9.1 years, body-mass-index = 30.1 ± 6.4 kg/m2, female = 56%) in 5 groups were recruited: mid-age adults with diabetes undergoing HD (Mid-age HD+, n = 38) and without HD (Mid-age HD−, n = 40); older adults with diabetes undergoing HD (Older HD+, n = 36) and without HD (Older HD−, n = 37); and non-diabetic older adults (Older DM−, n = 45). Gait parameters (stride velocity, stride length, gait cycle time, and double support) and balance parameters (ankle, hip, and center of mass sways) were quantified using validated wearable platforms. Groups with diabetes had overall poorer gait and balance compared to the non-diabetic group (p < 0.050). Among people with diabetes, HD+ had significantly worsened gait and balance when comparing to HD− (Cohen’s effect size d = 0.63–2.32, p < 0.050). Between-group difference was more pronounced among older adults with the largest effect size observed for stride length (d = 2.32, p < 0.001). Results suggested that deterioration in normalized gait speed among HD+ was negatively correlated with age (r = −0.404, p < 0.001), while this correlation was diminished among HD−. Interestingly, results also suggested that poor gait among Older HD− is related to poor ankle stability, while no correlation was observed between poor ankle stability and poor gait among Older HD+. Using objective assessments, results confirmed that the presence of diabetes can deteriorate gait and balance, and this deterioration can be magnified by HD process. Among HD− people with diabetes, poor ankle stability described poor gait. However, among people with diabetes undergoing HD, age was a dominate factor describing poor gait irrespective of static balance. Results also suggested feasibility of using wearable platforms to quantify motor performance during routine dialysis clinic visit. These objective assessments may assist in identifying early deterioration in motor function, which in turn may promote timely intervention.
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Affiliation(s)
- He Zhou
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Fadwa Al-Ali
- Fahad Bin Jassim Kidney Center, Department of Nephrology, Hamad General Hospital, PO Box 3050 Doha, Qatar.
| | - Hadi Rahemi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Nishat Kulkarni
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Abdullah Hamad
- Fahad Bin Jassim Kidney Center, Department of Nephrology, Hamad General Hospital, PO Box 3050 Doha, Qatar.
| | - Rania Ibrahim
- Fahad Bin Jassim Kidney Center, Department of Nephrology, Hamad General Hospital, PO Box 3050 Doha, Qatar.
| | - Talal K Talal
- Diabetic Foot and Wound Clinic, Hamad Medical Co, PO Box 3050 Doha, Qatar.
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
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Miligy I, Gaber A, Toss M, Hamad A, Nolan C, Diez-Rodriguez M, Ellis I, Green A, Rakha E. Aurora Kinase A (AURKA) is an independent predictor of recurrence in breast ductal carcinoma in situ (DCIS). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy047.090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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47
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Hamad A, Ismail H, Elsayed M, Kaddourah A, Ahmed H, Ibrahim R, Ali A, Alali F. The epidemiology of acute peritonitis in end-stage renal disease patients on peritoneal dialysis in Qatar: An 8-year follow-up study. Saudi J Kidney Dis Transpl 2018; 29:88-94. [PMID: 29456212 DOI: 10.4103/1319-2442.225203] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Acute peritonitis (AP) is a common and devastating complication in end-stage renal disease patients on peritoneal dialysis (PD). We are reporting an epidemiologic study of AP in Qatar over 8-year follow-up. We retrospectively reviewed medical records of all PD patients in Qatar from 2007 to 2014. The analysis was conducted to report epidemiology, outcome, and associated risk factors of AP. We had 318 AP episodes in 180 patients between 2007 and 2014. Six (3.3%) patients died as a result AP. Six cases of fungal peritonitis were reported. AP rate has decreased from 1 episode/29.7 PD-months in 2007 to 1/43.7 PD-months in 2014. Ninety-nine (55%) patients had single AP while 81 (45%) patients had 2 episodes or more (multiple AP). Patients on automated PD carried a higher risk of developing multiple AP [odds ratio (OR) = 1.46, 95% confidence interval (CI): 1.01-1.71]. The first episode of AP caused by Gram-positive cocci carried a significant risk of multiple AP (OR = 4.3, 95 % CI: 2.2-8.2). Negative-culture AP carried a significant protective role from multiple AP (OR = 0.35, 95% CI: 0.19-0.66). Most deaths occurred with the first episode of AP (4 out of 6). In this 8-year follow-up, epidemiologic study from Qatar, fungal peritonitis and mortality rate were very low, AP rate improved overall, multiple AP was prevalent (45%), and its risk increases with Gram-positive cocci infections. Our results signify the importance of implementing more efficient care bundles to prevent multiple AP.
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Affiliation(s)
- Abdullah Hamad
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Hany Ismail
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Mohamed Elsayed
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | | | - Hanaa Ahmed
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Rania Ibrahim
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Ahlam Ali
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
| | - Fadwa Alali
- Department of Nephrology, Hamad General Hospital, Doha, Qatar
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48
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Kadoguchi T, Shimada K, Shiozawa T, Takahashi S, Hamad A, Aikawa T, Ouchi S, Kitamura K, Sugita Y, Miyazaki T, Akita K, Isoda K, Daida H. P4483NADPH oxidase 4 induces muscle wasting via regulation of NF-E2-related factor 2 in angiotensin ii-infusion mice. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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49
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Al-Ali F, Hamdy AF, Hamad A, Elsayed M, Zafar Iqbal Z, Elsayed A, Ibrahim R, Tolba H, Buanan H, Fawzy A. Safety and efficacy of taurolidine/urokinase versus taurolidine/heparin as a tunneled catheter lock solution in hemodialysis patients: a prospective, randomized, controlled study. Nephrol Dial Transplant 2017; 33:619-626. [DOI: 10.1093/ndt/gfx187] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Accepted: 04/07/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
- Fadwa Al-Ali
- Nephrology Department, Hamad Medical Corp., Doha, Qatar
| | - Ahmad F Hamdy
- Nephrology Department, Hamad Medical Corp., Doha, Qatar
| | | | | | | | - Aisha Elsayed
- Nephrology Department, Hamad Medical Corp., Doha, Qatar
| | - Rania Ibrahim
- Nephrology Department, Hamad Medical Corp., Doha, Qatar
| | - Hoda Tolba
- Nephrology Department, Hamad Medical Corp., Doha, Qatar
| | - Hisham Buanan
- Nephrology Department, Hamad Medical Corp., Doha, Qatar
| | - Ashraf Fawzy
- Nephrology Department, Hamad Medical Corp., Doha, Qatar
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50
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Hamad A, Khalifa S, Bouanane H, Tolba H, Abdulla A, Alali F. Applying a Successful New Protocol for Storing a Tissue Plasminogen Activator for Locking Dysfunctional Permcath: A Single-Center Study. Blood Purif 2017; 44:234-235. [DOI: 10.1159/000478968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 06/25/2017] [Indexed: 11/19/2022]
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