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Cohen-Hagai K, Goldman S, Wald R, Frajewicki V, Chernin G, Iaina NL, Beckerman P, Antebi A, Haviv YS, Benchetrit S, Rozen-Zvi B. Delivering Dialysis during Wartime: The Israeli Experience. Kidney360 2024; 5:615-617. [PMID: 38317277 DOI: 10.34067/kid.0000000000000385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 01/30/2024] [Indexed: 02/07/2024]
Affiliation(s)
- Keren Cohen-Hagai
- Department of Nephrology and Hypertension, Meir Medical Center and Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shira Goldman
- Department of Nephrology and Hypertension, Rabin Medical Center and Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ron Wald
- Division of Nephrology, St. Michael's Hospital and the University of Toronto, Toronto, Ontario, Canada
| | - Victor Frajewicki
- Department of Nephrology and Hypertension, Carmel Medical Center and Rappaport Faculty of Medicine, Haifa, Israel
| | - Gil Chernin
- Department of Nephrology and Hypertension, Kaplan Medical Center and Hebrew University School of Medicine, Rehovot, Israel
| | - Nomy Levin Iaina
- Department of Nephrology and Hypertension, Barzilai Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Pazit Beckerman
- Department of Nephrology and Hypertension, Sheba Medical Center and Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Yosef S Haviv
- Department of Nephrology and Hypertension, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Sydney Benchetrit
- Department of Nephrology and Hypertension, Meir Medical Center and Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Benaya Rozen-Zvi
- Department of Nephrology and Hypertension, Rabin Medical Center and Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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2
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Shlomovitz O, Atias-Varon D, Yagel D, Barel O, Shasha-Lavsky H, Skorecki K, Eliyahu A, Bathish Y, Frajewicki V, Kushnir D, Zaid R, Paperna T, Ofir A, Tchirkov M, Hassan K, Kruzel E, Khazim K, Geron R, Weisman I, Hanut A, Nakhoul F, Kenig-Kozlovsky Y, Refael G, Antebi A, Storch S, Leiba M, Kagan M, Shukrun R, Rechavi G, Dekel B, Ben Moshe Y, Weiss K, Assady S, Vivante A. Genetic Markers Among the Israeli Druze Minority Population With End-Stage Kidney Disease. Am J Kidney Dis 2024; 83:183-195. [PMID: 37717846 DOI: 10.1053/j.ajkd.2023.06.006] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 06/05/2023] [Accepted: 06/12/2023] [Indexed: 09/19/2023]
Abstract
RATIONALE & OBJECTIVE Genetic etiologies have been identified among approximately 10% of adults with chronic kidney disease (CKD). However, data are lacking regarding the prevalence of monogenic etiologies especially among members of minority groups. This study characterized the genetic markers among members of an Israeli minority group with end-stage kidney disease (ESKD). STUDY DESIGN A national-multicenter cross-sectional study of Israeli Druze patients (an Arabic-speaking Near-Eastern transnational population isolate) who are receiving maintenance dialysis for ESKD. All study participants underwent exome sequencing. SETTING & PARTICIPANTS We recruited 94 adults with ESKD, comprising 97% of the total 97 Druze individuals throughout Israel being treated with dialysis during the study period. PREDICTORS Demographics and clinical characteristics of kidney disease. OUTCOME Genetic markers. ANALYTICAL APPROACH Whole-exome sequencing and the relationship of markers to clinical phenotypes. RESULTS We identified genetic etiologies in 17 of 94 participants (18%). None had a previous molecular diagnosis. A novel, population-specific, WDR19 homozygous pathogenic variant (p.Cys293Tyr) was the most common genetic finding. Other monogenic etiologies included PKD1, PKD2, type IV collagen mutations, and monogenic forms of noncommunicable diseases. The pre-exome clinical diagnosis corresponded to the final molecular diagnosis in fewer than half of the participants. LIMITATIONS This study was limited to Druze individuals, so its generalizability may be limited. CONCLUSIONS Exome sequencing identified a genetic diagnosis in approximately 18% of Druze individuals with ESKD. These results support conducting genetic analyses in minority populations with high rates of CKD and for whom phenotypic disease specificity may be low. PLAIN-LANGUAGE SUMMARY Chronic kidney disease (CKD) affects many people worldwide and has multiple genetic causes. However, there is limited information on the prevalence of genetic etiologies, especially among minority populations. Our national-multicenter study focused on Israeli Druze patients. Using exome-sequencing, we identified previously undetected genetic causes in nearly 20% of patients, including a new and population-specific WDR19 homozygous pathogenic variant. This mutation has not been previously described; it is extremely rare globally but is common among the Druze, which highlights the importance of studying minority populations with high rates of CKD. Our findings provide insights into the genetic basis of end-stage kidney disease in the Israeli Druze, expand the WDR19 phenotypic spectrum, and emphasize the potential value of genetic testing in such populations.
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Affiliation(s)
- Omer Shlomovitz
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed
| | - Danit Atias-Varon
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed
| | - Dina Yagel
- Genomics Unit, Sheba Cancer Research Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Ortal Barel
- Genomics Unit, Sheba Cancer Research Center, Sheba Medical Center, Tel-Hashomer, Israel; The Wohl Institute for Translational Medicine, Sheba Medical Center, Tel-Hashomer, Israel
| | - Hadas Shasha-Lavsky
- Azrieili Faculty of Medicine in Galilee, Bar-Ilan University, Safed, Israel; Department of Pediatric Nephrology, Galilee Medical Center, Nahariya, Israel
| | - Karl Skorecki
- Azrieili Faculty of Medicine in Galilee, Bar-Ilan University, Safed, Israel
| | - Aviva Eliyahu
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed; The Danek Gertner Institute of Human Genetics, Sheba Medical Center, Tel-Hashomer, Israel
| | | | - Victor Frajewicki
- Institute of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
| | - Daniel Kushnir
- Institute of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
| | - Rinat Zaid
- The Genetics Institute, Rambam Health Care Campus, Haifa, Israel
| | - Tamar Paperna
- The Genetics Institute, Rambam Health Care Campus, Haifa, Israel
| | - Ayala Ofir
- The Genetics Institute, Rambam Health Care Campus, Haifa, Israel
| | - Marina Tchirkov
- Department of Nephrology and Hypertension, Rambam Health Care campus, Haifa, Israel
| | - Kamal Hassan
- Nephrology Unit, Galilee Medical Center, Nahariya, Israel
| | - Etty Kruzel
- Nephrology Unit, Galilee Medical Center, Nahariya, Israel
| | - Khaled Khazim
- Nephrology Unit, Galilee Medical Center, Nahariya, Israel
| | - Ronit Geron
- Nephrology Unit, Galilee Medical Center, Nahariya, Israel
| | - Irit Weisman
- Nephrology Unit, Galilee Medical Center, Nahariya, Israel
| | - Anaam Hanut
- Division of Nephrology and Hypertension Baruch Padeh Medical Center Poriya, Tiberias, Israel
| | - Farid Nakhoul
- Division of Nephrology and Hypertension Baruch Padeh Medical Center Poriya, Tiberias, Israel
| | - Yael Kenig-Kozlovsky
- Department of Nephrology and Hypertension, Rambam Health Care campus, Haifa, Israel
| | - Gery Refael
- Nephrology Unit, Mayanei HaYeshua Medical Center, Bnei Brak, Israel
| | - Alon Antebi
- Institute of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
| | - Shimon Storch
- Nephrology and Hypertension Unit, Bnai-Zion Medical Center, Haifa, Israel
| | | | - Maayan Kagan
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed
| | - Rachel Shukrun
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed
| | - Gidi Rechavi
- Genomics Unit, Sheba Cancer Research Center, Sheba Medical Center, Tel-Hashomer, Israel; The Wohl Institute for Translational Medicine, Sheba Medical Center, Tel-Hashomer, Israel; Azrieili Faculty of Medicine in Galilee, Bar-Ilan University, Safed, Israel
| | - Benjamin Dekel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed; Pediatric Stem Cell Research Institute, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Division of Pediatric Nephrology, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel
| | - Yishay Ben Moshe
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed
| | - Karin Weiss
- The Genetics Institute, Rambam Health Care Campus, Haifa, Israel; The Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Suheir Assady
- Department of Nephrology and Hypertension, Rambam Health Care campus, Haifa, Israel; The Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Asaf Vivante
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Safed; Division of Pediatric Nephrology, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel.
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Gil A, Kushnir D, Frajewicki V. The Association of Urolithiasis with Uricosuria, Uricemia and their Combination. Isr Med Assoc J 2024; 26:18-23. [PMID: 38420637] [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] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
BACKGROUND There are conflicting data on the significance of hyperuricemia or hyperuricosuria in urolithiasis formation and on the need for medical treatment. OBJECTIVES To assess the significance of hyperuricemia or hyperuricosuria in urolithiasis formation, particularly when hyperuricemia occurs with normal uricosuria. METHODS The electronic medical records of patients treated in Haifa and the Western Galilee district of Clalit Health Services, Israel, were retrospectively screened for diagnosis of nephrolithiasis or renal or urinary tract/bladder calculi between February 2014 and April 2019. The diagnosis was confirmed by ultrasonography or computed tomography. The study group included patients with one of these diagnoses. Patients in the control group did not have these diagnoses. The inclusion criterion for all patients was the presence of both serum and urinary uric acid levels. RESULTS The study group included 359 patients and the control group 267. After adjustment by logistic regression, we found no significant differences in the prevalence of hyperuricosuria in the study group (14.8%) compared to the control group (9.7%), odds ratio (OR) 1.54 (95% confidence interval [95%CI] 0.74-3.2, P = 0.245). No significant differences between the groups were observed for hyperuricemia prevalence (45.4% vs. 55.1%, respectively, OR 0.82, 95%CI 0.54-1.25, P = 0.355), nor among those without hyperuricosuria (OR 0.83, 95%CI 0.52-1.33, P = 0.438) and after propensity score matching (OR 0.93, 95%CI 0.66-1.3, P = 0.655). CONCLUSIONS There were no significant differences in hyperuricemia or hyperuricosuria between the two groups of patients or in hyperuricemia among participants without hyperuricosuria.
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Affiliation(s)
- Amnon Gil
- Department of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel, Department of Nephrology and Hypertension, Lin Medical Center, Haifa, Israel, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Daniel Kushnir
- Department of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Victor Frajewicki
- Department of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Einbinder Y, Hornik-Lurie T, Cohen-Hagai K, Goldman S, Tanasiychuk T, Nacasch N, Erez D, Magen S, Zitman-Gal T, Wiener-Well Y, Frajewicki V, Benchetrit S, Shavit L, Bnaya A. Correction to: Comparison of long-term antibody response to mRNA SARS-CoV-2 vaccine among peritoneal dialysis and hemodialysis patients. Nephrol Dial Transplant 2022; 37:1780. [PMID: 35639832 DOI: 10.1093/ndt/gfac141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Yael Einbinder
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Keren Cohen-Hagai
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shira Goldman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Nephrology and Hypertension, Rabin Medical Center, Pathach Tikva, Israel
| | - Tatiana Tanasiychuk
- Department of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
| | - Naomi Nacasch
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Daniel Erez
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Internal Medicine D, Meir Medical Center, Kfar Saba, Israel
| | - Sophie Magen
- Clinical Endocrinology Laboratory, Shaare Zedek Medical Center, Jerusalem, Israel.,Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tali Zitman-Gal
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yonit Wiener-Well
- Hebrew University of Jerusalem, Jerusalem, Israel.,Infectious Disease Unit, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Victor Frajewicki
- Department of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
| | - Sydney Benchetrit
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Linda Shavit
- Hebrew University of Jerusalem, Jerusalem, Israel.,Institute of Nephrology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Alon Bnaya
- Hebrew University of Jerusalem, Jerusalem, Israel.,Institute of Nephrology, Shaare Zedek Medical Center, Jerusalem, Israel
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Shlomovitz O, Yagel D, Barel O, Atias-Varon D, Eliyahu A, Bathish Y, Frajewicki V, Kushnir D, Zaid R, Assady S, Tchirkov M, Hassan K, Khazim K, Geroמ R, Hanut A, Nakhoul F, Kenig Y, Gery R, Kruzel-Davila E, Leiba M, Storch S, Kagan M, Dekel B, Rechavi G, Shukrun R, Ben Moshe Y, Weiss K, Vivante A. MO046: Exome sequencing of Israeli Druze individuals on dialysis reveals common as well as population- specific monogenic etiologies in ∼30%. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac062.027] [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
Genetic etiologies are estimated to affect ∼10% of adults with advanced CKD. However, significant population disparities in genetic kidney disease exist and population-based screening are lacking especially among minority groups. The Druze population is a middle-eastern minority with high rates of end-stage renal disease (ESRD) and consanguinity, which suggests high rates of population-specific monogenic CKD etiologies. We therefore hypothesized that by exome sequencing we will identify a unique distribution of monogenic ESRD causes as compared with prior studies and that important ramifications for clinical practice may ensue.
METHOD
We initiated a national multicenter study of all Israeli dialysis units in order to provide comprehensive evidence for ESRD's genetic basis (Israeli ESRD Genetic Consortium Cohort). Specifically, during 2020, we recruited 97% (n = 94) of Israeli Druze individuals on dialysis from 12 different hospitals and community-based units. We conducted exome sequencing and diagnostic analysis for all patients. We assessed the diagnostic yield of genetic analysis and its relation to baseline clinical phenotypes.
RESULTS
Overall, the cohort consists of 94 individuals from 91 different families with first-degree consanguinity rate of 28%. Participants mean age was 62 years (ranging from 18 to 88 years). Most common primary clinical diagnoses were diabetic kidney disease, nephropathy of unknown origin, glomerular or cystic kidney disease, together encompassing 90% of all cases. None had previous molecular diagnosis. Using exome sequencing, we identified a genetic etiology in 27 out of 94 (28.7%) participants. We identified WDR19 (NPHP13) homozygous mutation c.878G > A (p.C293Y) as the most common genetic diagnosis (5.3%). Follow-up clinical characterization revealed that all affected individuals exhibited non-syndromic adulthood-onset ESRD, supporting a profound mutation-dependent phenotypic heterogeneity and weak pre-exome phenotypic specificity. Other prevalent genetic diagnoses included type IV collagen, PKD1, PKD2 and UMOD mutations as well as monogenic forms of diabetes and hyperlipidemia. Molecular diagnosis corresponded to the pre-exome clinical diagnosis in only one-third of the participants.
CONCLUSION
Exome sequencing in Druze with ESRD yields a genetic diagnosis in just <30% of cases with WDR19 mutation being the most prevalent single-gene etiology. These results, which remarkably inform clinical management, emphasize the importance of revealing population-specific mutations given the underutilization of genetic testing, particularly among adult minorities.
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Affiliation(s)
- Omer Shlomovitz
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Dina Yagel
- Genomics Unit, Sheba Cancer Research Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Ortal Barel
- Genomics Unit, Sheba Cancer Research Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Danit Atias-Varon
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Aviva Eliyahu
- Genomics Unit, Sheba Cancer Research Center, Sheba Medical Center, Tel-Hashomer, Israel
| | | | - Victor Frajewicki
- Institute of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
| | - Daniel Kushnir
- Institute of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
| | - Rinat Zaid
- The Genetics Institute, Rambam Health Care Campus, Haifa, Israel
| | - Suheir Assady
- Department of Nephrology and Hypertension, Rambam Health Care campus, Haifa, Israel
| | - Marina Tchirkov
- Department of Nephrology and Hypertension, Rambam Health Care campus, Haifa, Israel
| | - Kamal Hassan
- Nephrology Unit, Galilee Medical Center, Nahariya, Israel, Israel
| | - Khaled Khazim
- Nephrology Unit, Galilee Medical Center, Nahariya, Israel, Israel
| | - Ronit Geroמ
- Nephrology Unit, Galilee Medical Center, Nahariya, Israel, Israel
| | - Anaam Hanut
- Division of Nephrology and Hypertension, Baruch Padeh Medical Center, Poriya, Tiberias, Israel
| | - Farid Nakhoul
- Division of Nephrology and Hypertension, Baruch Padeh Medical Center, Poriya, Tiberias, Israel
| | - Yael Kenig
- Department of Nephrology and Hypertension, Rambam Health Care campus, Haifa, Israel
| | | | | | | | - Shimon Storch
- Nephrology and Hypertension Unit, Bnai-Zion Medical Center, Haifa, Israel
| | - Maayan Kagan
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Benjamin Dekel
- Division of Pediatric Nephrology and Pediatric Stem Cell Research Institute, Edmond and Lily Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Gidi Rechavi
- The Wohl Institute for Translational Medicine, Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel
| | - Rachel Shukrun
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Yishay Ben Moshe
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Karin Weiss
- The Genetics Institute, Rambam Health Care Campus, Haifa, Israel
| | - Asaf Vivante
- Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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GIL A, Frajewicki V. POS-460 THE PREVALENCE OF HYPERURICEMIA IN PATIENTS WITH URINARY STONES AND HYPERURICOSURIA OR NORMAL URICOSURIA. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.489] [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: 11/24/2022] Open
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7
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Einbinder Y, Hornik-Lurie T, Cohen-Hagai K, Goldman S, Tanasiychuk T, Nacasch N, Erez D, Magen S, Zitman-Gal T, Wiener-Well Y, Frajewicki V, Benchetrit S, Shavit L, Bnaya A. Comparison of long-term antibody response to mRNA SARS-CoV-2 vaccine among peritoneal dialysis and hemodialysis patients. Nephrol Dial Transplant 2021; 37:602-604. [PMID: 34788861 PMCID: PMC8767896 DOI: 10.1093/ndt/gfab321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Indexed: 11/21/2022] Open
Affiliation(s)
- Yael Einbinder
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Keren Cohen-Hagai
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shira Goldman
- Department of Nephrology and Hypertension, Rabin Medical Center, Pathach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tatiana Tanasiychuk
- Department of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
| | - Naomi Nacasch
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Daniel Erez
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Internal Medicine D, Meir Medical Center, Kfar Saba, Israel
| | - Sophie Magen
- Clinical Endocrinology Laboratory, Shaare Zedek Medical Center, Jerusalem, Israel.,Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tali Zitman-Gal
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yonit Wiener-Well
- Infectious Disease Unit, Shaare Zedek Medical Center, Jerusalem, Israel.,Hebrew University of Jerusalem, Jerusalem, Israel
| | - Victor Frajewicki
- Department of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
| | - Sydney Benchetrit
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Linda Shavit
- Clinical Endocrinology Laboratory, Shaare Zedek Medical Center, Jerusalem, Israel.,Hebrew University of Jerusalem, Jerusalem, Israel
| | - Alon Bnaya
- Clinical Endocrinology Laboratory, Shaare Zedek Medical Center, Jerusalem, Israel.,Hebrew University of Jerusalem, Jerusalem, Israel
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8
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Tanasiychuk T, Kushnir D, Sura O, Darawsha H, Chami A, Bitterman A, Frajewicki V. MO701COMBINED PROCEDURE OF PRE- EXISTING ABDOMINAL WALL HERNIA REPAIR AND PERITONEAL CATHETER INSERTION. LONG TERM FOLLOW- UP IN PERITONEAL DIALYSIS TREATMENT. Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab101.0023] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
Successful peritoneal dialysis (PD) program requires a combination of optimal peritoneal access and low incidence of complications. Between pitfalls of this modality are early mechanical complications such as leak, malfunction, and new abdominal wall hernia formation in the long term of PD treatment. Pre-existing abdominal wall hernia is a relative contraindication for PD. Hernias are also a known and not uncommon complication over the course of PD and one of the causes of technique failure. In our center, a physical examination and an ultrasound for hernias detection are routine procedures before the start of PD. If a hernia is discovered, combined hernia repair and catheter implantation are performed. The aim of this study was to assess to long- term results of this approach.
Method
The current study presents the retrospective analysis of 10 years' experience of our PD program (1.01.2009 – 31.12. 2018) including all incident PD patients who underwent their first peritoneal catheter placement procedure during the study period. The primary endpoints of the study were the rate of hernia formation in the course of PD treatment, type of hernias, identification risk factors for hernia formation and rate of hernia recurrence after previous repair. The secondary endpoint was the rate of procedure-related complications: infectious, leaks and primary catheter malfunction in patients who underwent surgical catheter insertion compared to percutaneous technique. Patients were followed until the end of PD treatment or until 31.10.2019.
Results
A total of 211 patients were included in the analysis. Of these, 24.5% underwent surgical procedures and 75.5% percutaneous insertion. Mean follow-up was 23.3 ± 25 months (2 to 96 months). About half (53.1%) of the patients were diabetic, aged 64.2±13 years. In 32 patients (15%) a preventive hernia repair with a simultaneous catheter implantation were performed. Patients who underwent a preventive hernia repair were significantly older than other patients (69.4±11.1 years versus 63.2±13.1 years, P=0.013).
During the study period, 203 of 211 patients were treated by PD. Thirty three (16.1%) have developed 38 new hernias. Patients suffering from a new hernia during PD were predominantly male, with longer dialysis vintage than patients without new hernia formation (35.3±22.8 months versus 23±22.9, respectively. P=0.001). Five of 33 patients suffered multiple hernias, including recurrent hernias at the same site. Most common types were inguinal and umbilical (44.7% each other), while only few were incisional or ventral. None of our patients suffered from a pericatheter one. The overall rate of new hernias development was 0.09/patient/years. Neither age, comorbidities, obesity nor polycystic kidney disease did not increase the rate of hernia formation during the course of PD treatment. There was no significant association between type of catheter insertion procedure (surgical/percutaneous) and infections, leakages or catheter function.
Leak incidence in diabetic patients was significantly higher in comparison with nondiabetic patients (8% versus 1%, P=0.021). Infectious complications were not different between diabetic and not diabetics patients (5.4% among diabetic patients versus 2% nondiabetic, P=0.29).
Conclusion
Our findings show that male gender and prolonged peritoneal dialysis duration are the main risk factors for the appearance of hernias in the course of PD therapy. Our data also confirm previous observations that the placement of PD catheter using a paramedian incision approach significantly reduces the incidences of exit site and incision hernias. We suggest that early diagnosis of latent asymptomatic hernias and hernia repair prior to starting PD can improve technique survival.
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Affiliation(s)
- Tatiana Tanasiychuk
- Carmel Medical Center, Department of Nephrology and Hypertension, Haifa, Israel
| | - Daniel Kushnir
- Carmel Medical Center, Department of Nephrology and Hypertension, Haifa, Israel
| | - Oleg Sura
- Carmel Medical Center, Department of Nephrology and Hypertension, Haifa, Israel
| | - Husein Darawsha
- Carmel Medical Center, Department of Emergency Medicine, Haifa, Israel
| | - Ariel Chami
- Carmel Medical Center, Department of General Surgery A, Haifa, Israel
| | - Arie Bitterman
- Carmel Medical Center, Department of General Surgery A, Haifa, Israel
| | - Victor Frajewicki
- Carmel Medical Center, Department of Nephrology and Hypertension, Haifa, Israel
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9
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Tanasiychuk T, Kushnir D, Vardi Y, Cohen-Hagai K, Zitman-Gal T, Frajewicki V, Benchetrit S, Einbinder Y. A simple novel device can provide independence for peritoneal dialysis patients. Perit Dial Int 2020; 41:344-346. [PMID: 32964803 DOI: 10.1177/0896860820958956] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Tatiana Tanasiychuk
- Department of Nephrology and Hypertension, 549236Carmel Medical Center, Haifa, Israel
| | - Daniel Kushnir
- Department of Nephrology and Hypertension, 549236Carmel Medical Center, Haifa, Israel
| | - Yafa Vardi
- Department of Nephrology and Hypertension, 549236Carmel Medical Center, Haifa, Israel
| | - Keren Cohen-Hagai
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Tali Zitman-Gal
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Victor Frajewicki
- Department of Nephrology and Hypertension, 549236Carmel Medical Center, Haifa, Israel
| | - Sydney Benchetrit
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
| | - Yael Einbinder
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel
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Tanasiychuk T, Selgas R, Kushnir D, Abd Elhalim M, Antebi A, Del Peso G, Bajo MA, Frajewicki V. The ideal position of the peritoneal dialysis catheter is not always ideal. Int Urol Nephrol 2019; 51:1867-1872. [PMID: 31264086 DOI: 10.1007/s11255-019-02177-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 05/14/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE Peritoneal catheter dysfunction is a frequent complication of peritoneal dialysis (PD). Traditionally, dysfunction has been attributed to catheter malposition, but whether the location of the catheter tip in the small pelvis really determines proper function is unclear. METHODS We reviewed 900 abdominal X-ray images of PD patients from a 7-year period in two PD units that use different catheter types (straight and Swan Neck Curled). RESULTS In 52% of the images, the dialysis catheter tip was located in the ideal position in the small pelvis and in 48% in other sites. Peritoneal catheter function was normal at the time of imaging in 87% of those with ideal catheter tip position, and in 74% of those with other than ideal position. The tip was located in small pelvis in 35% of images performed during catheter dysfunction and in 56% of those performed during normal catheter function. There were no differences between two catheter types. The positive predictive value of abdominal X-ray images to predict catheter function was 26%, and the negative predictive value 87%. We also found a significant positive correlation between polycystic kidney disease and normal catheter function. In contrast, obese patients were more likely to have catheter malfunction. Previous abdominal surgery was not associated with catheter dysfunction. CONCLUSION Our data showed a higher probability of normal function of peritoneal catheters whose tips were located in the small pelvis. However, also malpositioned catheters generally functioned well, and malpositioning of the PD catheter did not in itself explain its malfunction.
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Affiliation(s)
- Tatiana Tanasiychuk
- Department of Nephrology and Hypertension, Carmel Medical Center, 7 Michal Street, 34361, Haifa, Israel.
| | - Rafael Selgas
- Nephrology Department, La Paz University Hospital, FIBHULP-IdiPAZ, Universidad Autonoma, Madrid, Spain
| | - Daniel Kushnir
- Department of Nephrology and Hypertension, Carmel Medical Center, 7 Michal Street, 34361, Haifa, Israel
| | - Muhammad Abd Elhalim
- Department of Nephrology and Hypertension, Carmel Medical Center, 7 Michal Street, 34361, Haifa, Israel
| | - Alon Antebi
- Department of Nephrology and Hypertension, Carmel Medical Center, 7 Michal Street, 34361, Haifa, Israel
| | - Gloria Del Peso
- Nephrology Department, La Paz University Hospital, FIBHULP-IdiPAZ, Universidad Autonoma, Madrid, Spain
| | - Maria A Bajo
- Nephrology Department, La Paz University Hospital, FIBHULP-IdiPAZ, Universidad Autonoma, Madrid, Spain
| | - Victor Frajewicki
- Department of Nephrology and Hypertension, Carmel Medical Center, 7 Michal Street, 34361, Haifa, Israel
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11
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Tanasiychuk T, Kushnir DA, Antebi A, Frajewicki V. Paradoxically normal location of peritoneal dialysis catheter. Kidney Int 2019; 95:470. [DOI: 10.1016/j.kint.2018.07.016] [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: 04/24/2018] [Revised: 07/14/2018] [Accepted: 07/20/2018] [Indexed: 11/28/2022]
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12
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Gil A, Brod V, Awad H, Heyman SN, Abassi Z, Frajewicki V. Neutrophil gelatinase-associated lipocalin in a triphasic rat model of adenine-induced kidney injury. Ren Fail 2016; 38:1448-1454. [PMID: 27291966 DOI: 10.1080/0886022x.2016.1194164] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The aim of this study is to investigate whether NGAL, given its advantages over traditional biomarkers, can be used to describe the dynamic characteristics of the renal tubulointerstitial insult caused by adenine. Subsequently, it will be possible to assess NGAL as a biomarker of any acute kidney injury, on top of chronic interstitial disease, if NGAL levels are stable through the chronic phase of our adenine model. Study group rats were fed an adenine diet, and control group rats were fed a regular diet only. Blood and urine samples for urea, creatinine and NGAL were drawn from each rat at the beginning of the study and after 1, 3, 4, 5, 6, 7 and 8 weeks. Kidney slices from these rats were stained with Hematoxylin-eosin (HE) and β-actin stainings. Serum urea, creatinine and NGAL levels and urinary NGAL/creatinine ratio in the study group were higher than baseline and than in the control group; these differences were statistically significant in some of the intervals. Tubulointerstitial changes and adenine crystals were evident in the study group rats. In the rats fed adenine, serum urea, creatinine and NGAL levels and urinary NGAL/creatinine ratio followed a triphasic pattern of kidney injury: an acute phase while on the adenine diet, a partial recovery phase after switching to the regular diet and a chronic kidney disease phase after stabilization of renal function. NGAL can serve a biomarker for acute kidney injury and possibly for chronic kidney disease in the tubulointerstitial rat model.
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Affiliation(s)
- Amnon Gil
- a Department of Nephrology and Hypertension , Lady Davis Carmel Medical Center , Haifa , Israel
| | - Vera Brod
- b Ischemia-Shock Research Laboratory , Lady Davis Carmel Medical Center , Haifa , Israel
| | - Hoda Awad
- c Department of Physiology, Rappaport Faculty of Medicine , Haifa , Israel
| | - Samuel N Heyman
- d Department of Medicine , Hadassah Hebrew University Hospitals , Jerusalem , Israel
| | - Zaid Abassi
- c Department of Physiology, Rappaport Faculty of Medicine , Haifa , Israel
| | - Victor Frajewicki
- a Department of Nephrology and Hypertension , Lady Davis Carmel Medical Center , Haifa , Israel
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13
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Lai CF, Lin SL, Chiang WC, Chen YM, Kuo ML, Tsai TJ, Hwang HS, Choi YA, Park KC, Yang KJ, Choi HS, Kim SH, Lee SJ, Chang YK, Kim SY, Yang CW, Xiujuan Z, Yoshimura R, Matsuyama M, Chargui J, Touraine JL, Yoshimura N, Zulkarnaev AB, Vasilenko IA, Artemov DV, Vatazin AV, Park SK, Kang KP, Lee S, Kim W, Schneider R, Betz B, Moller-Ehrlich K, Wanner C, Sauvant C, Yang KJ, Park KC, Choi HS, Kim SH, Choi YA, Chang YK, Park CW, Kim SY, Lee SJ, Yang CW, Hwang HS, Sohotnik R, Nativ O, Abbasi A, Awad H, Frajewicki V, Armaly Z, Heyman SN, Nativ O, Abassi Z, Chen PY, Chen BL, Yang CC, Chiang CK, Liu SH, Abozahra AE, Abd-Elkhabir AA, Shokeir A, Hussein A, Awadalla A, Barakat N, Abdelaziz A, Yamaguchi J, Tanaka T, Eto N, Nangaku M, Quiros Y, Lopez-Hernandez FJ, Perez de Obanos MP, Ruiz J, Lopez-Novoa JM, Shin HS, Kim MJ, Choi YJ, Ryu ES, Choi HS, Kang DH, Jankauskas SS, Pevzner IB, Zorova LD, Babenko VA, Morosanova MA, Plotnikov EY, Zorov DB, Huang CY, Huang TM, Wu VC, Young GH, Plotnikov EY, Pevzner IB, Zorova LD, Chupyrkina AA, Zorov SD, Zorov DB, Grande JP, Hartono SP, Knudsen BE, Mederle K, Castrop H, Hocherl K, Iwakura T, Fujikura T, Ohashi N, Yasuda H, Fujigaki Y, Matsui I, Hamano T, Inoue K, Obi Y, Nakano C, Kusunoki Y, Tsubakihara Y, Rakugi H, Isaka Y, Shimomura A, Wallentin Guron C, Nguy L, Lundgren J, Grimberg E, Kashioulis P, Guron G, Guron G, DiBona GF, Nguy L, Grimberg E, Lundgren J, Nedergaard Mikkelsen M, Marcussen N, Saeed A, Edvardsson K, Lindberg K, Larsson T, Ito K, Nakashima H, Watanabe M, Abe Y, Ogahara S, Saito T, Albertoni G, Borges F, Schor N, Beresneva ON, Parastayeva MM, Kucher AG, Ivanova GT, Shved N, Rybakova MG, Kayukov IG, Smirnov AV, Chen JF, Ni HF, Pan MM, Liu H, Xu M, Zhang MH, Liu BC, Kim Y, Choi BS, Kim YS, Han JS, Reis LA, Christo JS, Simoes MDJ, Schor N, Mulay SR, Santhosh Kumar VR, Kulkarni OP, Darisipudi M, Lech M, Anders HJ, Zorov DB, Plotnikov EY, Silachev DN, Jankauskas SS, Pevzner IB, Zorova LD, Zorov SD, Morosanova MA, Sola A, Jung M, Ventayol M, Mastora C, Buenestado S, Hotter G, Rong S, Shushakova N, Wensvoort G, Haller H, Gueler F, Pan MM, Zhang MH, Ni HF, Chen JF, Xu M, Liu BC, Morais C, Vesey DA, Johnson DW, Gobe GC, Godo M, Kaucsar T, Revesz C, Hamar P, Cheng Q, Wen J, Ma Q, Zhao J, Castellano G, Stasi A, Di Palma AM, Gigante M, Netti GS, Curci C, Intini A, Divella C, Prattichizzo C, Fiaccadori E, Pertosa G, Grandaliano G, Gesualdo L, Wei QW, Jing QQ, Ying NJ, Dong QZ, Yong G, Choi YJ, Kim MJ, Shin HS, Ryu ES, Choi HS, Kang DH, Pevzner IB, Pulkova NV, Plotnikov EY, Zorova LD, Silachev DN, Morosanova MA, Sukhikh GT, Zorov DB, Kim S, Lee J, Nam NJ, Na KY, Han JS, Ma SK, Joo SY, Kim CS, Choi JS, Bae EH, Lee J, Kim SW, Cernaro V, Medici MA, Donato V, Trimboli D, Lorenzano G, Santoro D, Montalto G, Buemi M, Longo V, Segreto HRC, Almeida W, Schor N, Ramos MF, Gomes L, Razvickas C, Schor N, Gueler F, Rong S, Gutberlet M, Meier M, Mengel M, Wacker D, Haller H, Hueper K, Uzum A, Ersoy R, Cakalagaoglu F, Karaman M, Kolatan E, Sahin O, Yilmaz O, Cirit M, Inal S, Koc E, Okyay GU, Pasaoglu O, Gonul I, Oyar E, Pasaoglu H, Guz G, Sabbatini M, Rossano R, Andreucci M, Pisani A, Riccio E, Choi DE, Jeong JY, Kim SS, Chang YK, Na KR, Lee KW, Shin YT, Silva AF, Teixeira VC, Schor N, Meszaros K, Koleganova-Gut N, Schaefer F, Ritz E, Walacides D, Ruskamp N, Rong S, Hueper K, Meier M, Haller H, Schiffer M, Gueler F, Marom O, Haick H, Nakhoul F, Chen JF, Liu H, Ni HF, Lv LL, Zhang MH, Tang RN, Zhang JD, Ma KL, Chen PS, Liu BC, Wu VC, Young GH, Chen YM, Ko WJ, Misiara GP, Coimbra TM, Silva GEB, Costa RS, Francescato HDC, Neto MM, Dantas M, Lindberg K, Olauson H, Amin R, Ponnusamy A, Goetz R, Mohammadi M, Canfield A, Kublickiene K, Larsson T, Rodriguez J, Reyes EP, Cortes PP, Fernandez R, Yoon HE, Koh ES, Chung S, Shin SJ, Pazzano D, Montalto G, Cernaro V, Lupica R, Torre F, Costantino G, Buemi M, Prieto M, Gonzalez-Buitrago JM, Lopez-Hernandez F, Lopez-Novoa JM, Morales AI, Vicente-Vicente L, Ferreira L, Christo JS, Reis LA, Simoes MJ, Passos CD, Schor NS, Shimizu MHM, Canale D, de Braganca AC, Andrade L, Luchi WM, Seguro AC, Canale D, de Braganca AC, Goncalves J, Shimizu MHM, Volpini RA, Andrade L, Seguro AC, Garrido P, Fernandes J, Ribeiro S, Vala H, Parada B, Alves R, Belo L, Costa E, Santos-Silva A, Reis F. AKI - experimental models. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft107] [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: 11/13/2022] Open
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Abassi Z, Shalabi A, Sohotnik R, Nativ O, Awad H, Bishara B, Frajewicki V, Sukhotnik I, Abbasi A, Nativ O. Urinary NGAL and KIM-1: Biomarkers for Assessment of Acute Ischemic Kidney Injury Following Nephron Sparing Surgery. J Urol 2013; 189:1559-66. [DOI: 10.1016/j.juro.2012.10.029] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2012] [Indexed: 01/20/2023]
Affiliation(s)
- Zaid Abassi
- Department of Physiology and Biophysics, Rappaport Faculty of Medicine, Haifa, Israel
- Rambam Research Unit, Haifa, Israel
| | - Amjad Shalabi
- Department of General Surgery, Rambam Medical Center, Haifa, Israel
| | - Rima Sohotnik
- Department of Nephrology, Carmel Hospital, Haifa, Israel
| | - Omri Nativ
- Department of Urology, Bnai Zion Hospital, Haifa, Israel
| | - Hoda Awad
- Department of Physiology and Biophysics, Rappaport Faculty of Medicine, Haifa, Israel
| | - Bishara Bishara
- Department of General Surgery, Rambam Medical Center, Haifa, Israel
| | | | - Igor Sukhotnik
- Department of Pediatric Surgery, Bnai Zion Hospital, Haifa, Israel
| | - Abeer Abbasi
- Department of Urology, Bnai Zion Hospital, Haifa, Israel
| | - Ofer Nativ
- Department of Urology, Bnai Zion Hospital, Haifa, Israel
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15
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Sohotnik R, Nativ O, Abbasi A, Awad H, Frajewicki V, Bishara B, Sukhotnik I, Armaly Z, Aronson D, Heyman SN, Nativ O, Abassi Z. Phosphodiesterase-5 inhibition attenuates early renal ischemia-reperfusion-induced acute kidney injury: assessment by quantitative measurement of urinary NGAL and KIM-1. Am J Physiol Renal Physiol 2013; 304:F1099-104. [PMID: 23364806 DOI: 10.1152/ajprenal.00649.2012] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Acute kidney injury (AKI) is a common clinical problem that still lacks effective treatment. Phosphodiesterase-5 (PDE5) inhibitors possess anti-apoptotic and anti-oxidant properties, making it a promising therapy for ischemia-reperfusion (I/R) injury of various organs. The present study evaluated the early nephroprotective effects of Tadalafil, a PDE5 inhibitor, in an experimental model of renal I/R. Sprague-Dawley rats were divided into two groups: vehicle-treated I/R (n = 10), and Tadalafil (10 mg/kg po)-treated I/R group (n = 11). After removal of the right kidney and collection of two baseline urine samples, the left renal artery was clamped for 45 min followed by reperfusion for 60, 120, 180, and 240 min. Functional and histological parameters of the kidneys from the various groups were determined. In the vehicle-treated I/R group, glomerular filtration rate was significantly reduced compared with that in normal kidneys. In addition, the ischemic kidney showed remarkable cast formation, necrosis, and congestion, a consistent pattern of acute tubular necrosis. Furthermore, urinary excretion of NGAL and KIM-1, two novel biomarkers of kidney injury, substantially increased following I/R insult. In contrast, Tadalafil treatment resulted in a significant improvement in kidney function and amelioration of the adverse histological alterations of the ischemic kidney. Noteworthy, the urinary excretion of NGAL and KIM-1 markedly decreased in the Tadalafil-treated I/R group. These findings demonstrate that Tadalafil possesses early nephroprotective effects in rat kidneys subjected to I/R insult. This approach may suggest a prophylactic therapy for patients with ischemic AKI.
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Affiliation(s)
- Rima Sohotnik
- Department of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
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16
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Frajewicki V, Brod V, Kushnir D, Kohan R, Bitterman H. Acute effects of peritoneal dialysis solutions in the mesenteric microcirculation. Transl Res 2009; 153:249-56. [PMID: 19375686 DOI: 10.1016/j.trsl.2009.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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] [Received: 10/21/2008] [Revised: 01/17/2009] [Accepted: 01/19/2009] [Indexed: 11/25/2022]
Abstract
Long-term peritoneal dialysis induces morphological changes that may lead to gradual functional impairment of the peritoneal membrane. These changes are characterized by progressive reduction in solute transport or ultrafiltration failure. The mechanism of the peritoneal response to dialysis fluids has not yet been fully elucidated. We used video-microscopy for in vivo evaluation of microhemodynamics and peritoneal microvascular inflammatory response, after a single intraperitoneal exposure of rats to commercial PD fluids: (1) glucose 1.5 % PD solution; (2) lactate buffered glucose 4.25% PD solution; (3) Icodextrin 7%; (4) bicarbonate buffered glucose 3.86% PD fluid; and 5) Hanks solution. Sham-control groups were not injected. A 5-h exposure of the peritoneal membrane to glucose 1.5% PD solution or to Hanks solution did not induce a significant change in leukocyte rolling and adhesion. In contrast, PD solutions containing glucose 4.25% or Icodextrin 7.5% caused a significant 2-3-fold increase in leukocyte rolling (P < 0.001) and adhesion (P < 0.001) and a significant increase in venular blood flow velocity (P < 0.01) and shear rates (P < 0.05 for glucose 4.25%, and P < 0.01 for Icodextrin). Exposure to glucose 3.86% bicarbonate buffered (Physioneal) solution was associated with the lowest values of leukocyte rolling and adhesion among the PD solutions and with extremely higher venular flow velocities and shear rates. A single exposure to conventional PD solutions with a high concentration of glucose (4.25%) or polyglucose (Icodextrin 7.5%) induces changes consistent with an early peritoneal inflammatory response that may be attenuated by the use of bicarbonate-based fluids.
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Affiliation(s)
- Victor Frajewicki
- Institute of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel.
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17
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Kruzel-Davila E, Frajewicki V, Kushnir D, Eyal A, Kohan R. Retroperitoneal hematoma in a hemodialysis patient receiving low molecular weight heparin. Isr Med Assoc J 2005; 7:611-2. [PMID: 16190491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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18
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Dori G, Denekamp Y, Fishman S, Rosenthal A, Frajewicki V, Lewis BS, Bitterman H. Non-invasive computerised detection of acute coronary occlusion. Med Biol Eng Comput 2004; 42:294-302. [PMID: 15191073 DOI: 10.1007/bf02344703] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The goal of this study was to evaluate the role of a computerised, non-invasive ECG method for detecting acute coronary occlusion (ACO). Ninety-five standard ECG leads were recorded, before and during ACO, from 18 patients undergoing balloon angioplasty. ECG amplitude and derivative parameters were calculated for the ORS, ST and T components of the ECG signal, before and during ACO. Results were obtained for each lead. Sensitivity of the standard visual ECG analysis for detecting ACO was 48%, whereas the percentage of conventional ECG changes during baseline was 14%. For the best ECG parameter, the amplitude parameter of the ORS component, sensitivity was 82%, and the percentage of parameter changes during baseline was 20%. The sensitivity for detecting ACO with five of the six ECG parameters studied was greater than that of the standard visual analysis. Ischaemic changes were detected in 4.3 +/- 1.6 leads per patient using the amplitude parameter of the ORS component, whereas, with the standard visual analysis, 2.5 +/- 2.1 leads demonstrated such changes (p<0.001). Results were then summarized per patient. The standard visual ECG analysis detected ACO in 15 of 18 patients (83%), if at least one lead showed ischaemic changes. The computerised analysis detected ACO in all 18 patients using the same criterion. The sensitivity of the computerised method for detecting ACO in the clinical setting of angioplasty was greater than that of the standard visual analysis. It is suggested that the computerised method may be useful for detecting myocardial ischaemia in other clinical settings of acute myocardial ischaemia.
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Affiliation(s)
- G Dori
- Department of Internal Medicine, Carmel Medical Center, Haifa, Israel.
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19
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Habib GS, Kushnir D, Hyams M, Frajewicki V. Tubulointerstitial nephritis and uveitis syndrome: a diagnosis that should be considered by rheumatologists. Ann Rheum Dis 2003; 62:281-2. [PMID: 12594128 PMCID: PMC1754469 DOI: 10.1136/ard.62.3.281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Frajewicki V, Kushnir D, Wajsbrot V, Kohan R, Shostak A, Gotloib L. Peritoneal transport after long-term exposure to Icodextrin in rats. Nephron Clin Pract 2002; 92:174-82. [PMID: 12187100 DOI: 10.1159/000064481] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Icodextrin, an effective osmotic substance that has been proposed as an alternative agent for peritoneal dialysis induces ultrafiltration over long dwells. This study examines the peritoneal transport after exposure to Icodextrin in rats. METHODS Animals were divided in 4 groups and injected daily for 30 days with Icodextrin 7.5 % (n = 14), Glucose 4.25 % (n = 19) or glucose 4.25% plus Icodextrin 7.5 % (n = 13). Rats of the control group (n = 15) were not exposed. A 4-hour permeability study was performed using glucose at days 1, 30 and 60. At days 2, 31 and 61 the same animals were injected with Icodextrin. RESULTS Slopes of effluent sodium at day 30 were significantly higher (p < 0.001) in the glucose (0.006 +/- 0.016), Icodextrin (0.013 +/- 0.014) and mixed groups (0.012 +/- 0.017) than in the control group (-0.041 +/- 0.021). Urea D/P ratio was not significantly different in the 4 groups. After 30 days, glucose effluent levels were significantly lower (p < 0.001) in the glucose (701 +/- 278 mg/dl), Icodextrin (552 +/- 209 mg/dl) and mixed groups (587 +/- 344 mg/dl) than in control rats (1519 +/- 413 mg/dl). Effluent protein (mg/l) in the mixed group (1,555 +/- 357) was significantly higher (p < 0.001) than control (376 +/- 33), glucose (1,015 +/- 232) and Icodextrin (765 +/- 75) groups at day 30. CONCLUSION The long-term use of Icodextrin does not affect small molecule transport, but induces changes in the peritoneal protein excretion, especially when Icodextrin and glucose are injected together.
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Affiliation(s)
- Victor Frajewicki
- Institute of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
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Kohan R, Frajewicki V, Ben-Ari J, Shostak A, Golan N, Gotloib L. Experimental use of raffinose as an osmotic agent for peritoneal dialysis. J Lab Clin Med 1998; 131:71-6. [PMID: 9452129 DOI: 10.1016/s0022-2143(98)90079-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Conventional glucose-based solutions for peritoneal dialysis fluids have been shown to raise problems of biocompatibility. We therefore evaluated the ultrafiltration capabilities of raffinose as an alternative osmotic agent in a non-uremic rat model. Animals were divided into four groups and injected intraperitoneally with solutions containing raffinose (4.5%, 345 mOsm/kg; 16.7%, 518 mOsm/kg) or glucose (1.5%, 346 mOsm/kg; 4.25%, 489 mOsm/kg). Data obtained from animals exposed to 16.7% raffinose were excluded because of precipitation of the osmotic agent. Low-osmolality raffinose solution induced higher ultrafiltered volume than the low-osmolality glucose-enriched fluid at 120 minutes of dwelling time. No significant differences were observed in effluent sodium and potassium concentration and protein dialysate-to-plasma (D/P) ratio. The D/P ratio of phosphate was higher in the low-osmolality raffinose-based fluid than in the low-osmolality glucose solution. The osmolality of the solutions was significantly decreased after a dwelling time of 120 minutes. We conclude that 4.5% raffinose is an effective osmotic agent. Total or partial replacement of glucose by raffinose for clinical peritoneal dialysis could be eventually considered after appropriate evaluation of its biocompatibility and general side effects.
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Affiliation(s)
- R Kohan
- Department of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
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Frajewicki V, Kohan R, Shostak A, Gotloib L. Chronic Administration of Iron Dextran into the Peritoneal Cavity of Rats. Perit Dial Int 1997. [DOI: 10.1177/089686089701700619] [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: 11/16/2022] Open
Affiliation(s)
| | - R. Kohan
- Carmel Medical Center Haifa, Israel
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Frajewicki V, Kohan R, Shostak A, Gotloib L. Chronic administration of iron dextran into the peritoneal cavity of rats. ARCH ESP UROL 1997; 17:616-7. [PMID: 9655166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Frajewicki V, Kahana L, Yechieli H, Brod V, Kohan R, Bitterman H. Effects of severe hemorrhage on plasma ANP and glomerular ANP receptors. Am J Physiol 1997; 273:R1623-30. [PMID: 9374802 DOI: 10.1152/ajpregu.1997.273.5.r1623] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Atrial natriuretic peptide (ANP) plays an important role in blood volume and electrolyte homeostasis in normovolemia and in hypervolemic states. The currently available information on the effects of hypovolemia on plasma ANP is contradictory. Moreover, possible regulation of ANP receptors during severe hemorrhagic hypovolemia has not been investigated. This study evaluated the effects of severe hemorrhage on plasma ANP and on the regulation of glomerular ANP receptor subtypes in anesthetized rats. Constant rate bleeding of 50% of total blood volume within 2 h induced a reproducible shock state characterized by marked decreases in blood pressure, heart rate, and hematocrit and an increase in plasma renin activity and aldosterone. Hemorrhaged rats exhibited a gradual significant increase in plasma ANP from 39.3 +/- 2.9 to 114.7 +/- 20.0 pmol/l 1 h after the bleeding (P < 0.001 from the initial value and P < 0.02 from the final value of sham-shock rats). Hemorrhage induced a significant decrease in total glomerular ANP binding sites (172 +/- 25 vs. 363 +/- 39 fmol/mg protein in hemorrhaged and sham-shock rats, respectively, P < 0.05). This decrease was mainly due to a significant decrease in ANPC receptors (132 +/- 22 vs. 312 +/- 40 fmol/mg protein in hemorrhaged and sham-shock rats, respectively, P < 0.05). Hemorrhage did not change glomerular ANPA receptor density. No significant differences in the affinity of the glomerular receptor subtypes for ANP were detected. Our data indicate that plasma ANP increases after prolonged severe hemorrhage. It is suggested that downregulation of renal ANPC receptors leads to reduced clearance of ANP and contributes to elevation of its plasma level after severe hemorrhage.
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Affiliation(s)
- V Frajewicki
- Ischemia-Shock Research Laboratory, Carmel Medical Center, Rappaport Family Institute for Research in the Medical Sciences, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Hardoff R, Frajewicki V. Bone scintigraphy in hungry bone syndrome following parathyroidectomy. J Nucl Med 1996; 37:1371-3. [PMID: 8708777] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
A 59-yr-old man with chronic renal failure was admitted for evaluation of generalized skeletal pain and frontal bone mass, which was lytic on radiography. Bone scintigraphy demonstrated several foci of moderately increased uptake, without involvement of the skull mass. Radiographs of these lesions were compatible with brown tumors. Serum parathormone level was elevated and CT demonstrated a lower right cervical mass, consistent with parathyroid tumor. Following the removal of the mass and decrease in parathormone levels, the patient suffered from a prolonged period of hypocalcemia and his bone pain worsened. Repeat bone scintigraphy showed an increase in the number and intensity of the areas of focal uptake, consistent with hungry bone syndrome. This flare-up phenomenon is due to an increase in bone metabolism and is an uncommon finding following parathyroidectomy for primary hyperparathyroidism.
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Affiliation(s)
- R Hardoff
- Department of Nuclear Medicine, Carmel Medical Center, Haifa, Israel
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Israel O, Gips S, Hardoff R, Rudoy J, Frajewicki V, Iosilevsky G, Bettman L, Frenkel A, Hoffman A, Kolodny GM. Bone loss in patients with chronic renal disease: prediction with quantitative bone scintigraphy with SPECT. Radiology 1995; 196:643-6. [PMID: 7644623 DOI: 10.1148/radiology.196.3.7644623] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE To determine whether quantitative bone scintigraphy (QBS) with single-energy photon emission computed tomography (SPECT) can help predict which patients with chronic renal disease will show bone mineral density (BMD) loss. MATERIALS AND METHODS In 18 patients, the percentage of injected dose of technetium-99m methylene diphosphonate per cubic centimeter of bone was measured with QBS SPECT in the lumbar vertebrae and femoral neck. The differences in BMD over an average of 20 months were measured and compared with SPECT measurements. QBS values were also compared with serum bone turnover markers. RESULTS There was a negative correlation (r = -.54, P < .05 for the lumbar spine and r = -.60, P < .01 for the femoral neck) between QBS values and bone loss. Positive and negative predictive values, sensitivity, and specificity of QBS for bone loss in the lumbar spine were 78%, 71%, 78%, and 71%, respectively, and in the femoral neck, 82%, 100%, 100%, and 78%, respectively. Differences between predictive values of serum bone turnover markers were not statistically significant. CONCLUSION QBS with SPECT enabled prediction of rapid bone loss in patients with renal disease.
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Affiliation(s)
- O Israel
- Department of Nuclear Medicine, Rambam Medical Center, Haifa, Israel
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Frajewicki V, Kohan R, Ben-Ari J. Intraperitoneal Phosphate for Severe Hypophosphatemia. Perit Dial Int 1991. [DOI: 10.1177/089686089101100416] [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: 11/16/2022] Open
Affiliation(s)
- Victor Frajewicki
- Department of Nephrology, Carmel Medical Center, 7 Michal St, 34362 Haifa, Israel
| | - Ricardo Kohan
- Department of Nephrology, Carmel Medical Center, 7 Michal St, 34362 Haifa, Israel
| | - Jackie Ben-Ari
- Department of Nephrology, Carmel Medical Center, 7 Michal St, 34362 Haifa, Israel
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Frajewicki V, Kohan R, Abu-Ata M, Leiba M, Cohen O, Ben-Ari J. Intraperitoneal phosphate administration in hungry bone syndrome. Clin Nephrol 1990; 34:223-4. [PMID: 2176580] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Hypophosphatemia complicating parathyroidectomy for secondary hyperparathyroidism in renal failure is usually corrected by the oral or intravenous routes. We present a case in which those methods of treatment were not possible, and the phosphate was administered intraperitoneally. Phosphate was added as one molar sodium diphosphate solution to the dialysis fluid. In our case the procedure was well tolerated, phosphate blood levels were rapidly corrected, no alterations in calcium, magnesium or other parameters were detected and the patient was discharged in good condition. In selected cases of hungry bone syndrome after parathyroidectomy, intraperitoneal phosphate can be used safely.
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Affiliation(s)
- V Frajewicki
- Department of Nephrology, Carmel Medical Center, Haifa, Israel
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Frajewicki V, Kohan R, Ben-Ari J. An unusual complication of the Cimino-Brescia fistula. N Engl J Med 1987; 316:1348. [PMID: 3574408 DOI: 10.1056/nejm198705213162118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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