Yasser El-shahawy - Academia.edu (original) (raw)

Papers by Yasser El-shahawy

Renal Failure, 2012

Introduction: Many studies support the role of vitamin D in the pathogenesis of both types of dia... more Introduction: Many studies support the role of vitamin D in the pathogenesis of both types of diabetes. Pancreatic tissues express the vitamin D receptor (VDR) and vitamin D-binding protein; some allelic variations in genes involved in vitamin D metabolism and VDR are associated with glucose intolerance, defective insulin secretion, and sensitivity. Epidemiological links have been established between type 2 diabetes mellitus (DM) and hepatitis C virus (HCV) infection. Aim: To explore the possible therapeutic potential of pharmacologic doses of 1-α-hydroxy vitamin D therapy in improving pancreatic β-cell function in HCV seropositive hemodialysis (HD) patients. Patients and methods: Twenty HCV seropositive HD patients and 20 HCV seronegative patients as control group were randomly selected from HD units. 1-α-Hydroxy vitamin D therapy was administrated in the dose ranged from 0.25 to 0.5 μg/day for 3 months. Corrected total serum calcium, phosphorus, intact parathyroid hormone (iPTH), 25-hydroxy vitamin D [25(OH) vitamin D], 1,25-dihydroxy vitamin D, and glucoparameters [fasting blood glucose, glycohemoglobin test (HbA1c%), homeostatic model assessment (HOMA)-insulin resistance, and HOMA-β-cell function% (B%)] were measured under basal conditions and after 3 months of therapy. Results: There was highly significant improvement in the concentrations of fetal bovine serum (FBS), serum insulin, HbA1c%, 25 (OH) vitamin D, and HOMA-β-cell function in HCV seropositive and HCV seronegative groups after oral 1-alphacalcidiol therapy (p < 0.001). Positive correlation exists between the percentage increase in serum insulin and that in HOMA-β-cell function versus 25(OH) vitamin D (p < 0.021 and p < 0.027, respectively) in HCV negative group. Conclusion: 1-α-Hydroxy vitamin D oral therapy may improve glycemic control in HCV seropositive and HCV seronegative HD patients.

Saudi Journal of Kidney Diseases and Transplantation, 2015

To evaluate the prevalence, risk factors, possible etiology, prognosis and management of proteinu... more To evaluate the prevalence, risk factors, possible etiology, prognosis and management of proteinuria in renal transplant recipients, we studied 435 adult renal transplant recipient patients randomly selected from our center; 394 patients were reviewed retrospectively and 41 patients were followed-up prospectively for a period of one year. The patients were classified into three groups according to the results of urinalysis and spot urinary albumin creatinine ratio: Group A patients with normoalbuminuria; Group B patients with microalbuminuria; and Group C patients with macroalbuminuria. Persistent post-transplantation proteinuria was detected in 125 (28.8%) patients. The etiology of post-transplantation proteinuria included chronic allograft dysfunction in 44 (35.2%) patients, acute rejection in 40 (32%) patients, transplant glomerulopathy in eight (6.4%) patients, glomerular disease in 16 (12.8%) patients and other etiology in 17 (13.6%) patients. Proteinuric patients demonstrated ...

Saudi Journal of Kidney Diseases and Transplantation, 2015

Left ventricular hypertrophy (LVH) and left ventricular dysfunction are highly prevalent in patie... more Left ventricular hypertrophy (LVH) and left ventricular dysfunction are highly prevalent in patients with end-stage renal disease (ESRD). Several studies suggest that left ventricular mass and function is strongly modulated by the nitric oxide (NO) system. Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of endothelial-based NO synthase, is emerging as an important cardiovascular risk factor in ESRD patients. Our objective is to evaluate the relationship between plasma ADMA level and LVH among hemodialysis (HD) patients. Plasma ADMA measurements by enzyme-linked immunesorbent assay and echocardiographic evaluation were performed for 40 patients on regular HD, 20 patients with pre-dialysis chronic kidney disease, 20 hypertensive patients with left ventricular hypertrophy and normal kidney function and 20 healthy age and sex-matched subjects as a control group. Residual renal function (RRF) was measured in HD patients by urea clearance from a urine collection. Mean values o...

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2012

In some renal allograft recipients, anemia persists or develops following transplantation. Anemia... more In some renal allograft recipients, anemia persists or develops following transplantation. Anemia is associated with pre-operative blood loss and allograft dysfunction, including delayed graft function, acute rejection and chronic allograft dysfunction. To study the prevalence and association of post-renal transplant anemia, we studied 200 renal transplant recipients; 131 (65.5%) patients were males and 69 (34.5%) patients were females, and age ranged from 17 to 67 years, with a mean of 37.7 ± 10.8 years. All patients were receiving cyclosporine, prednisolone and mycophenolate mofetil (MMF). Complete blood count was done at two times: three and six months post-renal transplant. There were 74% anemic patients three months after renal transplantation and 45% anemic patients six months after renal transplantation. High creatinine value, female gender, delayed graft function, episodes of acute rejection, perioperative blood loss and infections were the only significant independent risk ...

The Egyptian Journal of Hospital Medicine, 2013

Background: Insulin resistance (IR) is one of the important causes of abnormal glucose homeostasi... more Background: Insulin resistance (IR) is one of the important causes of abnormal glucose homeostasis in CKD even in the absence of overt diabetes mellitus. Retinol-binding protein 4 (RBP4) is a lipocalin superfamily molecule that is synthesized primarily by hepatocytes and adipocytes. CKD may contribute to the increased survival and retention of RBP4 in the circulation. RBP has recently been proposed as a novel adipokine involved in the metabolism of glucose. Objective: To evaluate Retinol Binding Protein 4 in stage 5 Chronic kidney disease patients on regular hemodialysis and its contribution to insulin resistance in those patients. Patients &Methods: The patients divided into 2 groups: Group I: Patients group consist of 50 ESRD patients on regular hemodialysis; they were 20 females (40.0%) and 30 males (60.0%) with age ranged from 19 years to 52 years and with mean±SD (38.08±7.1 years). Group II: Control group consists of 50 normal subjects; 26 females (52%) and 24 males (48%) wi...

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2015

To evaluate the prevalence, risk factors, possible etiology, prognosis and management of proteinu... more To evaluate the prevalence, risk factors, possible etiology, prognosis and management of proteinuria in renal transplant recipients, we studied 435 adult renal transplant recipient patients randomly selected from our center; 394 patients were reviewed retrospectively and 41 patients were followed-up prospectively for a period of one year. The patients were classified into three groups according to the results of urinalysis and spot urinary albumin creatinine ratio: Group A patients with normoalbuminuria; Group B patients with microalbuminuria; and Group C patients with macroalbuminuria. Persistent post-transplantation proteinuria was detected in 125 (28.8%) patients. The etiology of post-transplantation proteinuria included chronic allograft dysfunction in 44 (35.2%) patients, acute rejection in 40 (32%) patients, transplant glomerulopathy in eight (6.4%) patients, glomerular disease in 16 (12.8%) patients and other etiology in 17 (13.6%) patients. Proteinuric patients demonstrated ...

Journal of biological regulators and homeostatic agents

Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide (NO) associated wit... more Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide (NO) associated with an increased risk of cardiovascular disease (CVD). In this study we assessed the relationship between ADMA and asymptomatic carotid intima-media thickness (CIMT). Eighty subjects underwent a complete history and physical examination, determination of serum chemistries and ADMA levels, and carotid ultrasound investigation (CUI). None of the subjects had symptoms of carotid atherosclerosis and nor were they taking any medication. Statistical analyses showed that high plasma levels of ADMA were positively correlated to CIMT (p less than 0.001). Total cholesterol, low density lipoprotein cholesterol, triglycerides and C-reactive protein plasma concentrations were significantly associated with asymptomatic carotid atherosclerosis (p less than 0.001). High serum concentrations of ADMA were associated with early carotid atherosclerotic lesions as measured by CIMT and represent a new marker of...

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2012

In some renal allograft recipients, anemia persists or develops following transplantation. Anemia... more In some renal allograft recipients, anemia persists or develops following transplantation. Anemia is associated with pre-operative blood loss and allograft dysfunction, including delayed graft function, acute rejection and chronic allograft dysfunction. To study the prevalence and association of post-renal transplant anemia, we studied 200 renal transplant recipients; 131 (65.5%) patients were males and 69 (34.5%) patients were females, and age ranged from 17 to 67 years, with a mean of 37.7 ± 10.8 years. All patients were receiving cyclosporine, prednisolone and mycophenolate mofetil (MMF). Complete blood count was done at two times: three and six months post-renal transplant. There were 74% anemic patients three months after renal transplantation and 45% anemic patients six months after renal transplantation. High creatinine value, female gender, delayed graft function, episodes of acute rejection, perioperative blood loss and infections were the only significant independent risk ...

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2012

Cognitive dysfunction includes reduced mental alertness, intellectual impairment, decreased atten... more Cognitive dysfunction includes reduced mental alertness, intellectual impairment, decreased attention and concentration, memory deficits and diminished perceptual-motor coordination. Chronic kidney disease (CKD) patients may suffer from cognitive impairment, which may decrease an individual's quality of life, increase resource utilization and result in suboptimal medical care. This study was carried out on 120 patients with different stages of CKD from our nephrology outpatient clinic divided into three groups: Group I: 50 CKD patients, stage 3 and stage 4; Group II: 50 end-stage renal disease patients on regular hemodialysis with K t/v >1.1; and Group III: 20 acute kidney injury patients, followed-up till their renal functions stabilized besides Group IV: 20 healthy subjects served as controls. All patients underwent laboratory investigations and psychometric tests, which include trial making test part B, digit span test, digit symbol test and mini-mental state examination. ...

Middle East Current Psychiatry, 2013

NDT Plus, Jun 1, 2011

INTRODUCTION AND AIMS: Many preclinical and observational studies support a role for vitamin D in... more INTRODUCTION AND AIMS: Many preclinical and observational studies support a role for vitamin D in the pathogenesis of both types of diabetes (T1D and T2D). Pancreatic tissue (more specifically the insulin-producing beta-cells) express the vitamin D receptor (VDR) and vitamin D-binding protein, some allelic variations in genes involved in vitamin D metabolism and VDR are associated with glucose (in) tolerance, insulin secretion, and sensitivity. Hepatitis C virus (HCV) infection may contribute to the development of diabetes ...

American Journal of Kidney Diseases, 2009

Background-It is not clear which serum creatinine-based glomerular filtration rate (GFR) estimati... more Background-It is not clear which serum creatinine-based glomerular filtration rate (GFR) estimating model performs best in kidney donors. Study Design-Study of diagnostic accuracy. Setting and Participants-From a population of 3,698 kidney donors, 255 donors underwent iohexol GFR measurement (mGFR). Index Test (Intervention)-mGFR by the plasma disappearance of iohexol. Reference Test or Outcome-eGFR was estimated using the Cockcroft-Gault equation, (eGFR CG), the Mayo Clinic equation (eGFR MC), and the MDRD Study equation (eGFR MDRD). Results-Mean mGFR was 71.8±11.8 mL/min/1.73m 2 and 85.5% had mGFR > 60 mL/min/ 1.73m 2. eGFR CG underestimated mGFR by 3.96±13.3 mL/min/1.73m2 and was within 30% of mGFR in 89.4% of the time. eGFR MC overestimated mGFR by 8.44±11.9 mL/min/1.73m 2 and was within 30% of mGFR in 83.1% of cases. eGFR MDRD underestimated mGFR by only 0.43±11.7 mL/ min/1.73m 2 and the proportion within 30% of mGFR was the highest amongst the tested model; 94.1% of the time. The eGFR MC , however, was most accurate in classifying donors according to having eGFR < 60 mL/min/1.73m 2. Limitations-Lack of ethnic diversity and response bias.

Saudi Journal of Kidney Diseases and Transplantation, 2015

To evaluate the prevalence, risk factors, possible etiology, prognosis and management of proteinu... more To evaluate the prevalence, risk factors, possible etiology, prognosis and management of proteinuria in renal transplant recipients, we studied 435 adult renal transplant recipient patients randomly selected from our center; 394 patients were reviewed retrospectively and 41 patients were followed-up prospectively for a period of one year. The patients were classified into three groups according to the results of urinalysis and spot urinary albumin creatinine ratio: Group A patients with normoalbuminuria; Group B patients with microalbuminuria; and Group C patients with macroalbuminuria. Persistent post-transplantation proteinuria was detected in 125 (28.8%) patients. The etiology of post-transplantation proteinuria included chronic allograft dysfunction in 44 (35.2%) patients, acute rejection in 40 (32%) patients, transplant glomerulopathy in eight (6.4%) patients, glomerular disease in 16 (12.8%) patients and other etiology in 17 (13.6%) patients. Proteinuric patients demonstrated significantly lower graft survival rates than did those without proteinuria (48.3% versus 51.7%, respectively; P = 0.017; Risk Ratio = 0.403; 95% confidence interval 0.188-0.862). We conclude that proteinuria is prevalent after kidney transplant in our population, and that it is most commonly associated with chronic allograft nephropathy, transplant glomerulopathy, glomerulonephritis and acute rejection. Post-transplant proteinuria is associated with decreased allograft survival.

Renal Failure, 2012

Introduction: Many studies support the role of vitamin D in the pathogenesis of both types of dia... more Introduction: Many studies support the role of vitamin D in the pathogenesis of both types of diabetes. Pancreatic tissues express the vitamin D receptor (VDR) and vitamin D-binding protein; some allelic variations in genes involved in vitamin D metabolism and VDR are associated with glucose intolerance, defective insulin secretion, and sensitivity. Epidemiological links have been established between type 2 diabetes mellitus (DM) and hepatitis C virus (HCV) infection. Aim: To explore the possible therapeutic potential of pharmacologic doses of 1-α-hydroxy vitamin D therapy in improving pancreatic β-cell function in HCV seropositive hemodialysis (HD) patients. Patients and methods: Twenty HCV seropositive HD patients and 20 HCV seronegative patients as control group were randomly selected from HD units. 1-α-Hydroxy vitamin D therapy was administrated in the dose ranged from 0.25 to 0.5 μg/day for 3 months. Corrected total serum calcium, phosphorus, intact parathyroid hormone (iPTH), 25-hydroxy vitamin D [25(OH) vitamin D], 1,25-dihydroxy vitamin D, and glucoparameters [fasting blood glucose, glycohemoglobin test (HbA1c%), homeostatic model assessment (HOMA)-insulin resistance, and HOMA-β-cell function% (B%)] were measured under basal conditions and after 3 months of therapy. Results: There was highly significant improvement in the concentrations of fetal bovine serum (FBS), serum insulin, HbA1c%, 25 (OH) vitamin D, and HOMA-β-cell function in HCV seropositive and HCV seronegative groups after oral 1-alphacalcidiol therapy (p < 0.001). Positive correlation exists between the percentage increase in serum insulin and that in HOMA-β-cell function versus 25(OH) vitamin D (p < 0.021 and p < 0.027, respectively) in HCV negative group. Conclusion: 1-α-Hydroxy vitamin D oral therapy may improve glycemic control in HCV seropositive and HCV seronegative HD patients.

Saudi Journal of Kidney Diseases and Transplantation, 2015

To evaluate the prevalence, risk factors, possible etiology, prognosis and management of proteinu... more To evaluate the prevalence, risk factors, possible etiology, prognosis and management of proteinuria in renal transplant recipients, we studied 435 adult renal transplant recipient patients randomly selected from our center; 394 patients were reviewed retrospectively and 41 patients were followed-up prospectively for a period of one year. The patients were classified into three groups according to the results of urinalysis and spot urinary albumin creatinine ratio: Group A patients with normoalbuminuria; Group B patients with microalbuminuria; and Group C patients with macroalbuminuria. Persistent post-transplantation proteinuria was detected in 125 (28.8%) patients. The etiology of post-transplantation proteinuria included chronic allograft dysfunction in 44 (35.2%) patients, acute rejection in 40 (32%) patients, transplant glomerulopathy in eight (6.4%) patients, glomerular disease in 16 (12.8%) patients and other etiology in 17 (13.6%) patients. Proteinuric patients demonstrated ...

Saudi Journal of Kidney Diseases and Transplantation, 2015

Left ventricular hypertrophy (LVH) and left ventricular dysfunction are highly prevalent in patie... more Left ventricular hypertrophy (LVH) and left ventricular dysfunction are highly prevalent in patients with end-stage renal disease (ESRD). Several studies suggest that left ventricular mass and function is strongly modulated by the nitric oxide (NO) system. Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of endothelial-based NO synthase, is emerging as an important cardiovascular risk factor in ESRD patients. Our objective is to evaluate the relationship between plasma ADMA level and LVH among hemodialysis (HD) patients. Plasma ADMA measurements by enzyme-linked immunesorbent assay and echocardiographic evaluation were performed for 40 patients on regular HD, 20 patients with pre-dialysis chronic kidney disease, 20 hypertensive patients with left ventricular hypertrophy and normal kidney function and 20 healthy age and sex-matched subjects as a control group. Residual renal function (RRF) was measured in HD patients by urea clearance from a urine collection. Mean values o...

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2012

In some renal allograft recipients, anemia persists or develops following transplantation. Anemia... more In some renal allograft recipients, anemia persists or develops following transplantation. Anemia is associated with pre-operative blood loss and allograft dysfunction, including delayed graft function, acute rejection and chronic allograft dysfunction. To study the prevalence and association of post-renal transplant anemia, we studied 200 renal transplant recipients; 131 (65.5%) patients were males and 69 (34.5%) patients were females, and age ranged from 17 to 67 years, with a mean of 37.7 ± 10.8 years. All patients were receiving cyclosporine, prednisolone and mycophenolate mofetil (MMF). Complete blood count was done at two times: three and six months post-renal transplant. There were 74% anemic patients three months after renal transplantation and 45% anemic patients six months after renal transplantation. High creatinine value, female gender, delayed graft function, episodes of acute rejection, perioperative blood loss and infections were the only significant independent risk ...

The Egyptian Journal of Hospital Medicine, 2013

Background: Insulin resistance (IR) is one of the important causes of abnormal glucose homeostasi... more Background: Insulin resistance (IR) is one of the important causes of abnormal glucose homeostasis in CKD even in the absence of overt diabetes mellitus. Retinol-binding protein 4 (RBP4) is a lipocalin superfamily molecule that is synthesized primarily by hepatocytes and adipocytes. CKD may contribute to the increased survival and retention of RBP4 in the circulation. RBP has recently been proposed as a novel adipokine involved in the metabolism of glucose. Objective: To evaluate Retinol Binding Protein 4 in stage 5 Chronic kidney disease patients on regular hemodialysis and its contribution to insulin resistance in those patients. Patients &Methods: The patients divided into 2 groups: Group I: Patients group consist of 50 ESRD patients on regular hemodialysis; they were 20 females (40.0%) and 30 males (60.0%) with age ranged from 19 years to 52 years and with mean±SD (38.08±7.1 years). Group II: Control group consists of 50 normal subjects; 26 females (52%) and 24 males (48%) wi...

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2015

To evaluate the prevalence, risk factors, possible etiology, prognosis and management of proteinu... more To evaluate the prevalence, risk factors, possible etiology, prognosis and management of proteinuria in renal transplant recipients, we studied 435 adult renal transplant recipient patients randomly selected from our center; 394 patients were reviewed retrospectively and 41 patients were followed-up prospectively for a period of one year. The patients were classified into three groups according to the results of urinalysis and spot urinary albumin creatinine ratio: Group A patients with normoalbuminuria; Group B patients with microalbuminuria; and Group C patients with macroalbuminuria. Persistent post-transplantation proteinuria was detected in 125 (28.8%) patients. The etiology of post-transplantation proteinuria included chronic allograft dysfunction in 44 (35.2%) patients, acute rejection in 40 (32%) patients, transplant glomerulopathy in eight (6.4%) patients, glomerular disease in 16 (12.8%) patients and other etiology in 17 (13.6%) patients. Proteinuric patients demonstrated ...

Journal of biological regulators and homeostatic agents

Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide (NO) associated wit... more Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide (NO) associated with an increased risk of cardiovascular disease (CVD). In this study we assessed the relationship between ADMA and asymptomatic carotid intima-media thickness (CIMT). Eighty subjects underwent a complete history and physical examination, determination of serum chemistries and ADMA levels, and carotid ultrasound investigation (CUI). None of the subjects had symptoms of carotid atherosclerosis and nor were they taking any medication. Statistical analyses showed that high plasma levels of ADMA were positively correlated to CIMT (p less than 0.001). Total cholesterol, low density lipoprotein cholesterol, triglycerides and C-reactive protein plasma concentrations were significantly associated with asymptomatic carotid atherosclerosis (p less than 0.001). High serum concentrations of ADMA were associated with early carotid atherosclerotic lesions as measured by CIMT and represent a new marker of...

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2012

In some renal allograft recipients, anemia persists or develops following transplantation. Anemia... more In some renal allograft recipients, anemia persists or develops following transplantation. Anemia is associated with pre-operative blood loss and allograft dysfunction, including delayed graft function, acute rejection and chronic allograft dysfunction. To study the prevalence and association of post-renal transplant anemia, we studied 200 renal transplant recipients; 131 (65.5%) patients were males and 69 (34.5%) patients were females, and age ranged from 17 to 67 years, with a mean of 37.7 ± 10.8 years. All patients were receiving cyclosporine, prednisolone and mycophenolate mofetil (MMF). Complete blood count was done at two times: three and six months post-renal transplant. There were 74% anemic patients three months after renal transplantation and 45% anemic patients six months after renal transplantation. High creatinine value, female gender, delayed graft function, episodes of acute rejection, perioperative blood loss and infections were the only significant independent risk ...

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2012

Cognitive dysfunction includes reduced mental alertness, intellectual impairment, decreased atten... more Cognitive dysfunction includes reduced mental alertness, intellectual impairment, decreased attention and concentration, memory deficits and diminished perceptual-motor coordination. Chronic kidney disease (CKD) patients may suffer from cognitive impairment, which may decrease an individual's quality of life, increase resource utilization and result in suboptimal medical care. This study was carried out on 120 patients with different stages of CKD from our nephrology outpatient clinic divided into three groups: Group I: 50 CKD patients, stage 3 and stage 4; Group II: 50 end-stage renal disease patients on regular hemodialysis with K t/v >1.1; and Group III: 20 acute kidney injury patients, followed-up till their renal functions stabilized besides Group IV: 20 healthy subjects served as controls. All patients underwent laboratory investigations and psychometric tests, which include trial making test part B, digit span test, digit symbol test and mini-mental state examination. ...

Middle East Current Psychiatry, 2013

NDT Plus, Jun 1, 2011

INTRODUCTION AND AIMS: Many preclinical and observational studies support a role for vitamin D in... more INTRODUCTION AND AIMS: Many preclinical and observational studies support a role for vitamin D in the pathogenesis of both types of diabetes (T1D and T2D). Pancreatic tissue (more specifically the insulin-producing beta-cells) express the vitamin D receptor (VDR) and vitamin D-binding protein, some allelic variations in genes involved in vitamin D metabolism and VDR are associated with glucose (in) tolerance, insulin secretion, and sensitivity. Hepatitis C virus (HCV) infection may contribute to the development of diabetes ...

American Journal of Kidney Diseases, 2009

Background-It is not clear which serum creatinine-based glomerular filtration rate (GFR) estimati... more Background-It is not clear which serum creatinine-based glomerular filtration rate (GFR) estimating model performs best in kidney donors. Study Design-Study of diagnostic accuracy. Setting and Participants-From a population of 3,698 kidney donors, 255 donors underwent iohexol GFR measurement (mGFR). Index Test (Intervention)-mGFR by the plasma disappearance of iohexol. Reference Test or Outcome-eGFR was estimated using the Cockcroft-Gault equation, (eGFR CG), the Mayo Clinic equation (eGFR MC), and the MDRD Study equation (eGFR MDRD). Results-Mean mGFR was 71.8±11.8 mL/min/1.73m 2 and 85.5% had mGFR > 60 mL/min/ 1.73m 2. eGFR CG underestimated mGFR by 3.96±13.3 mL/min/1.73m2 and was within 30% of mGFR in 89.4% of the time. eGFR MC overestimated mGFR by 8.44±11.9 mL/min/1.73m 2 and was within 30% of mGFR in 83.1% of cases. eGFR MDRD underestimated mGFR by only 0.43±11.7 mL/ min/1.73m 2 and the proportion within 30% of mGFR was the highest amongst the tested model; 94.1% of the time. The eGFR MC , however, was most accurate in classifying donors according to having eGFR < 60 mL/min/1.73m 2. Limitations-Lack of ethnic diversity and response bias.

Saudi Journal of Kidney Diseases and Transplantation, 2015

To evaluate the prevalence, risk factors, possible etiology, prognosis and management of proteinu... more To evaluate the prevalence, risk factors, possible etiology, prognosis and management of proteinuria in renal transplant recipients, we studied 435 adult renal transplant recipient patients randomly selected from our center; 394 patients were reviewed retrospectively and 41 patients were followed-up prospectively for a period of one year. The patients were classified into three groups according to the results of urinalysis and spot urinary albumin creatinine ratio: Group A patients with normoalbuminuria; Group B patients with microalbuminuria; and Group C patients with macroalbuminuria. Persistent post-transplantation proteinuria was detected in 125 (28.8%) patients. The etiology of post-transplantation proteinuria included chronic allograft dysfunction in 44 (35.2%) patients, acute rejection in 40 (32%) patients, transplant glomerulopathy in eight (6.4%) patients, glomerular disease in 16 (12.8%) patients and other etiology in 17 (13.6%) patients. Proteinuric patients demonstrated significantly lower graft survival rates than did those without proteinuria (48.3% versus 51.7%, respectively; P = 0.017; Risk Ratio = 0.403; 95% confidence interval 0.188-0.862). We conclude that proteinuria is prevalent after kidney transplant in our population, and that it is most commonly associated with chronic allograft nephropathy, transplant glomerulopathy, glomerulonephritis and acute rejection. Post-transplant proteinuria is associated with decreased allograft survival.