Objective The aim of this study is to assay the level of serum klotho protein in chronic kidney d... more Objective The aim of this study is to assay the level of serum klotho protein in chronic kidney disease (CKDs) patients and the relation between its level and cardiovascular complications and mineral bone diseases. Background Klotho protein is a new diagnostic and prognostic biomarker in kidney diseases. Klotho protein deficiency plays an important role in the calcification of vascular and soft tissues. Cardiovascular diseases are the most important causes of morbidity and mortality in CKD patients. Patients and methods The study included 60 CKD patients on hemodialysis, 15 CKD patients without hemodialysis, and 14 apparent healthy persons; all are of different age and sex. All groups underwent the same examination and investigation: serum klotho levels assessment and other routine laboratory investigation, for example, blood urea, serum creatinine, serum phosphorous, serum calcium, complete blood count, and serum parathormone. Echocardiography and abdominal radiography are done to all the studied groups and the results are tabulated and analyzed. Results The serum klotho levels are markedly decreased in CKD patients. Serum klotho level is decreased with the increase in age; there was an inverse relationship between serum klotho, blood urea and serum creatinine (P = 0.001) and between serum klotho and phosphorous (P = 0.004); the relation between serum klotho and echo findings was significant (P = 0.025). Conclusion CKD is a statement of klotho deficiency, there is a marked decrease in serum klotho level in the CKD patients Cardiovascular complications especially aortic calcification were found with low-serum klotho level.
Introduction: Internal jugular vein occlusion often makes necessary the use of less desirable rou... more Introduction: Internal jugular vein occlusion often makes necessary the use of less desirable routes as external jugular, subclavian, and femoral vein approaches in addition to inferior vena cava approaches. This a prospective cross-sectional follow-up study of the alternative approaches for placement of cuffed hemodialysis catheters in end-stage renal disease patients with bilateral internal jugular vein occlusion from the interventional nephrology point of view. Method: The study was conducted on 134 end-stage renal disease patients who were referred for insertion of a challenging hemodialysis catheter due to bilateral internal jugular vein occlusion. Ultrasound Doppler guided catheter insertion was used as a routine practice in addition to fluoroscopy or post insertion X-ray to localize catheter tip position and exclude complications. Follow-up of patients was conducted until the end of the study or catheter removal. Findings: The most highly prevalent alternative approach is the...
iastolic and systolic BP (P< 0.001), fasting blood glucose (P<0.001), TC (P<0.001), TG(P... more iastolic and systolic BP (P< 0.001), fasting blood glucose (P<0.001), TC (P<0.001), TG(P=0.006), LDLc(P=0.004), urea (P<0.001)and creatinine (P<0.001). Males and female patients differ according to cause of hemodialysis (P= 0.02) and serum creatinine (P= 0.007). Control subjects of sirtuin1 rs7895833 showed significant A allele compared with patients (46% vs. 27.78% P= 0.04) while C allele of
Objective The objective of this study was to evaluate the possible role of fibroblast growth fact... more Objective The objective of this study was to evaluate the possible role of fibroblast growth factor 23 (FGF23) in the occurrence of left ventricular hypertrophy and vascular calcification in predialysis chronic kidney disease (CKD) patients. Background FGF23 is a suggested risk factor for poor outcome of CKD. This raises the possibility that FGF23 is a hormone that controls calcium–phosphorus metabolism and is a real risk factor for cardiovascular mortality and morbidity in predialysis CKD patients. Materials and methods Thirty predialysis CKD patients with estimated glomerular filtration rate (90≥eGFR>15 ml/min/1.73 m 2 ) by the modification of diet in renal diseases formula were included in this study. Patients were recruited from the Internal Medicine Department, Menoufia University (Egypt). Our controls were 10 individuals with preserved kidney function of more than 90 ml/min/1.73 m 2 with normal BUN and creatinine matched by age and sex. Routine and specific investigations (...
Background:Reproductive health (RH) is a state of complete physical, mental and social well-being... more Background:Reproductive health (RH) is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. Reproductive health care includes having access to a range of good-quality information and services. Aim of the study: To Study Knowledge of Adolescent Female regarding their Reproductive Health in Hafr Al Batin University. Design and Methods: A descriptive study design was carried out at three faculties. Through purposive sample: 500 female students who were available at the time of data collection. Data were collected through a selfadministered structured questionnaire sheet: It composed of two main parts: Socio-demographic characteristics and knowledge about RH matters. Results, and Practice Implications: The present study revealed that (70.8%) have a fair knowledge and (38.2%) of them have a good knowledge regarding reproductive health matters. A...
Background: Chronic kidney disease (CKD), whether starting HD or not is associated with a sharp i... more Background: Chronic kidney disease (CKD), whether starting HD or not is associated with a sharp increase in the risk for cardiovascular disease, which can only be partially explained by known classical risk factors. However, chronic inflammation and endothelial dysfunction are key events in the development of atherosclerosis; both are observed in CKD and HD patients. A unique cytotoxic CD4+T cell population has been identified, which can be recognized by the loss of the costimulatory cell surface marker CD28, hence their name CD4+ CD28null T cells. These cells are highly proinflammatory.Aims: The aim of the present study is to determine the prevalence of CD4+CD28 null T Helper cells and its relation to atherosclerosis in CKD patients not starting HD and Patients on regular HD for more than 6 months. Materials and Methods: CD4+CD28null T cells were measured in the blood samples of 60 CKD patients (30 CKD patients not start HD (Group ΙΙ) and 30 CKD patients on regular HD more than six...
Article History: Received 15, June, 2014 Received in revised form 27, June, 2014 Accepted 14, Jul... more Article History: Received 15, June, 2014 Received in revised form 27, June, 2014 Accepted 14, July, 2014 Published online 28, July, 2014 Objectives: This study was done to evaluate possible correlation between inflammation detected by the inflammatory marker; high sensitivity C-reactive protein (hs –CRP) and bone mineral disorders in chronic kidney disease patients detected by laboratory and radiological investigations.
Aim: Our study aimed to detect a link between 25(OH) vitamin D deficiency, inflammation and CD4+C... more Aim: Our study aimed to detect a link between 25(OH) vitamin D deficiency, inflammation and CD4+CD28null T-cell expansion, which might contribute to atherosclerosis in CKD subjects. Background: Cardiovascular diseases (CVD) are the main cause of mortality in CKD patients. Atherosclerosis is highly prevalent in advanced renal failure and progresses faster in patients with renal dysfunction than in the general population. Methods: This study was conducted on newly diagnosed 40 chronic kidney disease patients and 30 normal individuals who served as control. Common carotid artery intima media thickness (CCA-IMT) was measured with an ultrasound system. Highly sensitive C-reactive protein (hsCRP) was measured by immunoturbidimetric assay. The frequency of circulating CD4+CD28null T cells was evaluated by flowcytometry.25(OH) vitamin D was measured in serum by enzyme linked immunosorbent assay. Results: CKD subjects exhibited higher CCA-IMT (0.97±0.21 vs 0.56±0.10mm, P <0.001), hs-CRP (...
Objective The objective of this study was to evaluate the association between serum advanced glyc... more Objective The objective of this study was to evaluate the association between serum advanced glycation end products (AGEs) and their soluble receptors assessed on the basis of carboxymethyllysine (CML) and soluble receptor for advanced glycation end products (sRAGE) and the presence of cardiovascular dysfunction in nondiabetic chronic kidney disease (CKD) patients. Background AGE is involved in left ventricular hypertrophy (LVH) and myocardial damage, whereas sRAGE attenuates the progression of heart disease and prevents death in diabetic and nondiabetic CKD patients. Patients and methods Eighty nondiabetic CKD patients were subclassified according to estimated glomerular filtration rate (GFR) into two subgroups, CKD-3 patients with GFR between 30 and 59 ml/min/1.73 m2 and CKD-4 patients with GFR between 16 and 29 ml/min/1.73 m2 (CKD-4), using the modification of diet in renal disease formula. Our controls comprised 40 individuals with preserved kidney function of more than 90 ml/mi...
Sepsis Associated Kidney Injury represents a major health concern as it is frequently associated ... more Sepsis Associated Kidney Injury represents a major health concern as it is frequently associated with increased risk of mortality and morbidity. We aimed to evaluate the potential value of TNF-α (−376 G/A) and cystatin C in the diagnosis of S-AKI and prediction of mortality in critically ill patients. This study included 200 critically ill patients and 200 healthy controls. Patients were categorized into 116 with acute septic shock and 84 with sepsis, from which 142 (71%) developed S-AKI. Genotyping of TNF-α (−376 G/A) was performed by RT-PCR and serum CysC was assessed by Enzyme Linked Immunosorbent Assay. Our results showed a highly significant difference in the genotype frequencies of TNF-α (−376 G/A) SNP between S-AKI and non-AKI patients (p < 0.001). Additionally, sCysC levels were significantly higher in the S-AKI group (p = 0.011). The combination of both sCysC and TNF-α (−376 G/A) together had a better diagnostic ability for S-AKI than sCysC alone (AUC = 0.610, 0.838, res...
Objective The aim of this study is to assay the level of serum klotho protein in chronic kidney d... more Objective The aim of this study is to assay the level of serum klotho protein in chronic kidney disease (CKDs) patients and the relation between its level and cardiovascular complications and mineral bone diseases. Background Klotho protein is a new diagnostic and prognostic biomarker in kidney diseases. Klotho protein deficiency plays an important role in the calcification of vascular and soft tissues. Cardiovascular diseases are the most important causes of morbidity and mortality in CKD patients. Patients and methods The study included 60 CKD patients on hemodialysis, 15 CKD patients without hemodialysis, and 14 apparent healthy persons; all are of different age and sex. All groups underwent the same examination and investigation: serum klotho levels assessment and other routine laboratory investigation, for example, blood urea, serum creatinine, serum phosphorous, serum calcium, complete blood count, and serum parathormone. Echocardiography and abdominal radiography are done to all the studied groups and the results are tabulated and analyzed. Results The serum klotho levels are markedly decreased in CKD patients. Serum klotho level is decreased with the increase in age; there was an inverse relationship between serum klotho, blood urea and serum creatinine (P = 0.001) and between serum klotho and phosphorous (P = 0.004); the relation between serum klotho and echo findings was significant (P = 0.025). Conclusion CKD is a statement of klotho deficiency, there is a marked decrease in serum klotho level in the CKD patients Cardiovascular complications especially aortic calcification were found with low-serum klotho level.
Introduction: Internal jugular vein occlusion often makes necessary the use of less desirable rou... more Introduction: Internal jugular vein occlusion often makes necessary the use of less desirable routes as external jugular, subclavian, and femoral vein approaches in addition to inferior vena cava approaches. This a prospective cross-sectional follow-up study of the alternative approaches for placement of cuffed hemodialysis catheters in end-stage renal disease patients with bilateral internal jugular vein occlusion from the interventional nephrology point of view. Method: The study was conducted on 134 end-stage renal disease patients who were referred for insertion of a challenging hemodialysis catheter due to bilateral internal jugular vein occlusion. Ultrasound Doppler guided catheter insertion was used as a routine practice in addition to fluoroscopy or post insertion X-ray to localize catheter tip position and exclude complications. Follow-up of patients was conducted until the end of the study or catheter removal. Findings: The most highly prevalent alternative approach is the...
iastolic and systolic BP (P< 0.001), fasting blood glucose (P<0.001), TC (P<0.001), TG(P... more iastolic and systolic BP (P< 0.001), fasting blood glucose (P<0.001), TC (P<0.001), TG(P=0.006), LDLc(P=0.004), urea (P<0.001)and creatinine (P<0.001). Males and female patients differ according to cause of hemodialysis (P= 0.02) and serum creatinine (P= 0.007). Control subjects of sirtuin1 rs7895833 showed significant A allele compared with patients (46% vs. 27.78% P= 0.04) while C allele of
Objective The objective of this study was to evaluate the possible role of fibroblast growth fact... more Objective The objective of this study was to evaluate the possible role of fibroblast growth factor 23 (FGF23) in the occurrence of left ventricular hypertrophy and vascular calcification in predialysis chronic kidney disease (CKD) patients. Background FGF23 is a suggested risk factor for poor outcome of CKD. This raises the possibility that FGF23 is a hormone that controls calcium–phosphorus metabolism and is a real risk factor for cardiovascular mortality and morbidity in predialysis CKD patients. Materials and methods Thirty predialysis CKD patients with estimated glomerular filtration rate (90≥eGFR>15 ml/min/1.73 m 2 ) by the modification of diet in renal diseases formula were included in this study. Patients were recruited from the Internal Medicine Department, Menoufia University (Egypt). Our controls were 10 individuals with preserved kidney function of more than 90 ml/min/1.73 m 2 with normal BUN and creatinine matched by age and sex. Routine and specific investigations (...
Background:Reproductive health (RH) is a state of complete physical, mental and social well-being... more Background:Reproductive health (RH) is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. Reproductive health care includes having access to a range of good-quality information and services. Aim of the study: To Study Knowledge of Adolescent Female regarding their Reproductive Health in Hafr Al Batin University. Design and Methods: A descriptive study design was carried out at three faculties. Through purposive sample: 500 female students who were available at the time of data collection. Data were collected through a selfadministered structured questionnaire sheet: It composed of two main parts: Socio-demographic characteristics and knowledge about RH matters. Results, and Practice Implications: The present study revealed that (70.8%) have a fair knowledge and (38.2%) of them have a good knowledge regarding reproductive health matters. A...
Background: Chronic kidney disease (CKD), whether starting HD or not is associated with a sharp i... more Background: Chronic kidney disease (CKD), whether starting HD or not is associated with a sharp increase in the risk for cardiovascular disease, which can only be partially explained by known classical risk factors. However, chronic inflammation and endothelial dysfunction are key events in the development of atherosclerosis; both are observed in CKD and HD patients. A unique cytotoxic CD4+T cell population has been identified, which can be recognized by the loss of the costimulatory cell surface marker CD28, hence their name CD4+ CD28null T cells. These cells are highly proinflammatory.Aims: The aim of the present study is to determine the prevalence of CD4+CD28 null T Helper cells and its relation to atherosclerosis in CKD patients not starting HD and Patients on regular HD for more than 6 months. Materials and Methods: CD4+CD28null T cells were measured in the blood samples of 60 CKD patients (30 CKD patients not start HD (Group ΙΙ) and 30 CKD patients on regular HD more than six...
Article History: Received 15, June, 2014 Received in revised form 27, June, 2014 Accepted 14, Jul... more Article History: Received 15, June, 2014 Received in revised form 27, June, 2014 Accepted 14, July, 2014 Published online 28, July, 2014 Objectives: This study was done to evaluate possible correlation between inflammation detected by the inflammatory marker; high sensitivity C-reactive protein (hs –CRP) and bone mineral disorders in chronic kidney disease patients detected by laboratory and radiological investigations.
Aim: Our study aimed to detect a link between 25(OH) vitamin D deficiency, inflammation and CD4+C... more Aim: Our study aimed to detect a link between 25(OH) vitamin D deficiency, inflammation and CD4+CD28null T-cell expansion, which might contribute to atherosclerosis in CKD subjects. Background: Cardiovascular diseases (CVD) are the main cause of mortality in CKD patients. Atherosclerosis is highly prevalent in advanced renal failure and progresses faster in patients with renal dysfunction than in the general population. Methods: This study was conducted on newly diagnosed 40 chronic kidney disease patients and 30 normal individuals who served as control. Common carotid artery intima media thickness (CCA-IMT) was measured with an ultrasound system. Highly sensitive C-reactive protein (hsCRP) was measured by immunoturbidimetric assay. The frequency of circulating CD4+CD28null T cells was evaluated by flowcytometry.25(OH) vitamin D was measured in serum by enzyme linked immunosorbent assay. Results: CKD subjects exhibited higher CCA-IMT (0.97±0.21 vs 0.56±0.10mm, P <0.001), hs-CRP (...
Objective The objective of this study was to evaluate the association between serum advanced glyc... more Objective The objective of this study was to evaluate the association between serum advanced glycation end products (AGEs) and their soluble receptors assessed on the basis of carboxymethyllysine (CML) and soluble receptor for advanced glycation end products (sRAGE) and the presence of cardiovascular dysfunction in nondiabetic chronic kidney disease (CKD) patients. Background AGE is involved in left ventricular hypertrophy (LVH) and myocardial damage, whereas sRAGE attenuates the progression of heart disease and prevents death in diabetic and nondiabetic CKD patients. Patients and methods Eighty nondiabetic CKD patients were subclassified according to estimated glomerular filtration rate (GFR) into two subgroups, CKD-3 patients with GFR between 30 and 59 ml/min/1.73 m2 and CKD-4 patients with GFR between 16 and 29 ml/min/1.73 m2 (CKD-4), using the modification of diet in renal disease formula. Our controls comprised 40 individuals with preserved kidney function of more than 90 ml/mi...
Sepsis Associated Kidney Injury represents a major health concern as it is frequently associated ... more Sepsis Associated Kidney Injury represents a major health concern as it is frequently associated with increased risk of mortality and morbidity. We aimed to evaluate the potential value of TNF-α (−376 G/A) and cystatin C in the diagnosis of S-AKI and prediction of mortality in critically ill patients. This study included 200 critically ill patients and 200 healthy controls. Patients were categorized into 116 with acute septic shock and 84 with sepsis, from which 142 (71%) developed S-AKI. Genotyping of TNF-α (−376 G/A) was performed by RT-PCR and serum CysC was assessed by Enzyme Linked Immunosorbent Assay. Our results showed a highly significant difference in the genotype frequencies of TNF-α (−376 G/A) SNP between S-AKI and non-AKI patients (p < 0.001). Additionally, sCysC levels were significantly higher in the S-AKI group (p = 0.011). The combination of both sCysC and TNF-α (−376 G/A) together had a better diagnostic ability for S-AKI than sCysC alone (AUC = 0.610, 0.838, res...
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