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  • 1
    Online Resource
    Online Resource
    Effects of Caffeinated and Decaffeinated Coffee on Hemodialysis-Related Headache (CoffeeHD): A Randomized Multicenter Clinical Trial
    Elsevier BV ; 2021
    In:  Journal of Renal Nutrition Vol. 31, No. 6 ( 2021-11), p. 648-660
    Details
    In: Journal of Renal Nutrition, Elsevier BV, Vol. 31, No. 6 ( 2021-11), p. 648-660
    Type of Medium: Online Resource
    ISSN: 1051-2276
    URL: Article
    DOI: 10.1053/j.jrn.2021.01.025
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
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  • 2
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    First live birth after uterus transplantation in the Middle East
    Springer Science and Business Media LLC ; 2020
    In:  Middle East Fertility Society Journal Vol. 25, No. 1 ( 2020-12)
    Details
    In: Middle East Fertility Society Journal, Springer Science and Business Media LLC, Vol. 25, No. 1 ( 2020-12)
    Abstract: The first live birth after uterus transplantation took place in Sweden in 2014. It was the first ever cure for absolute uterine factor infertility. We report the surgery, assisted reproduction, and pregnancy behind the first live birth after uterus transplantation in the Middle East, North Africa, and Turkey (MENAT) region. A 24-year old woman with congenital absence of the uterus underwent transplantation of the uterus donated by her 50-year-old multiparous mother. In vitro fertilization was performed to cryopreserve embryos. Both graft retrieval and transplantation were performed by laparotomy. Donor surgery included isolation of the uterus, together with major uterine arteries and veins on segments of the internal iliac vessels bilaterally, the round ligaments, and the sacrouterine ligaments, as well as with bladder peritoneum. Recipient surgery included preparation of the vaginal vault, end-to-side anastomosis to the external iliac arteries and veins on each side, and then fixation of the uterus. Results One in vitro fertilization cycle prior to transplantation resulted in 11 cryopreserved embryos. Surgical time of the donor was 608 min, and blood loss was 900 mL. Cold ischemia time was 85 min. Recipient surgical time was 363 min, and blood loss was 700 mL. Anastomosis time was 105 min. Hospital stay was 7 days for both patients. Ten months after the transplantation, one previously cryopreserved blastocyst was transferred which resulted in viable pregnancy, which proceeded normally (except for one episode of minor vaginal bleeding in the 1st trimester) until cesarean section at 35 + 1 weeks due to premature contractions and shortened cervix. A healthy girl (Apgar 9-10-10) weighing 2620 g was born in January 2020, and her development has been normal during the first 6 months. Conclusions This is the first report of a healthy live birth after uterus transplantation in the MENAT region. We hope that this will motivate further progress and additional clinical trials in this area in the Middle East Region, where the first uterus transplantation attempt ever, however unsuccessful, was performed already three decades ago.
    Type of Medium: Online Resource
    ISSN: 2090-3251
    URL: Article
    DOI: 10.1186/s43043-020-00041-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2196955-3
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  • 3
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    MO361: Erythropoietin Treatment in Acute Kidney Injury (EAKI): A Pragmatic Randomized Clinical Trial
    Oxford University Press (OUP) ; 2022
    In:  Nephrology Dialysis Transplantation Vol. 37, No. Supplement_3 ( 2022-05-03)
    Details
    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 37, No. Supplement_3 ( 2022-05-03)
    Abstract: Treatment with erythropoietin (EPO) is well established for anemia in chronic kidney disease patients but not well studied in acute kidney injury (AKI). This study aims to assess the transfusion need, renal recovery and all-cause mortality of AKI patients with anemia whether treated or not with EPO. METHOD This is a multicenter, randomized, pragmatic controlled clinical trial. It included 134 hospitalized patients with anemia [hemoglobin (Hb) & lt;11 g/dL] and AKI [serum creatinine (Scr) of 0.3 mg/dL in 48 h or 1.5 times baseline] . Patients with active bleeding were excluded. Patients received EPO 4000 UI every other day (n = 67) or standard of care (control; n = 67) during the hospitalization until discharge or death. The study got the approval of the ethics committee of Saint-Joseph University number CE-HDF1115. The trial is registered on ClinicalTrials.gov (NCT03401710). RESULTS The general characteristics of both groups are summarized in Table 1. There was no statistically significant difference in transfusions, renal recovery or mortality between the treated group and the control (Table 2). A conditional regression analysis found phosphate, Hb on admission, CRP at the end of the hospitalization, the need for transfusions, the absence of renal recovery and inotrope use as factors associated with mortality (OR = 1.34, 95% CI 1.09–1.63; P = 0.004; OR = 0.61, 95% CI 0.41–0.92; P = 0.018; OR = 1.014, 95% CI 1.005–1023; P = 0.003; OR = 4.48, 95% CI 1.53–13.07; P = 0.006; OR = 22.1, 95% CI 6.36–76.74; P  & lt; 0.001; OR = 9.16, 95% CI 2.89–28.99; P  & lt; 0.001, respectively). CONCLUSION EPO treatment in patients with AKI and anemia has no significant impact on transfusion need, renal recovery or death.
    Type of Medium: Online Resource
    ISSN: 0931-0509 , 1460-2385
    URL: Article
    DOI: 10.1093/ndt/gfac135.016
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 1465709-0
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  • 4
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    Refractory Hypocalcemia Effectively Treated with Steroids in Prostate Cancer Metastatic to Bone
    OMICS Publishing Group ; 2017
    In:  Endocrinology & Metabolic Syndrome Vol. 06, No. 04 ( 2017)
    Details
    In: Endocrinology & Metabolic Syndrome, OMICS Publishing Group, Vol. 06, No. 04 ( 2017)
    Type of Medium: Online Resource
    ISSN: 2161-1017
    URL: Journal
    URL: Article
    DOI: 10.4172/2161-1017
    DOI: 10.4172/2161-1017.1000269
    Language: Unknown
    Publisher: OMICS Publishing Group
    Publication Date: 2017
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  • 5
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    The impact of the SARS-CoV-2 pandemic on the mental health of hemodialysis patients in Lebanon
    Beaini, Chadia ; Department of Nephrology, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon ; Department of Nephrology, Bellevue Medical Center, Mansourieh, Lebanon ; [et al.]
    S.C. JURNALUL PENTRU MEDICINA SI VIATA S.R.L ; 2021
    In:  Journal of Medicine and Life Vol. 14, No. 4 ( 2021-8), p. 523-530
    Details
    In: Journal of Medicine and Life, S.C. JURNALUL PENTRU MEDICINA SI VIATA S.R.L, Vol. 14, No. 4 ( 2021-8), p. 523-530
    Abstract: Hemodialysis is a necessary treatment for end-stage kidney disease patients. It imposes undergoing three sessions of dialysis per week in a specialized center. Amid the SARS-CoV-2 pandemic, precautionary measures were mandatory in all dialysis facilities and may have negatively impacted patients’ well-being. This study aimed to uncover the scale of this effect. We performed a cross-sectional study of all patients undergoing chronic hemodialysis in two dialysis units (one urban and another rural). Patients with Alzheimer’s disease were excluded. Patients filled a questionnaire including information on socio-demographics, factors related to the dialysis facility, and the impact of the COVID-19 epidemic on their mental health. A total of 72 patients responded. Their median age was 70 (60.79) years. Of them, 68% were males, 71% were married, and 10% were living alone. Following the pandemic, 35% felt more anxious, with a higher incidence of anxiety in the rural unit (p=0.021). Half of them felt very limited in their relationships, and 29% were isolated from their families. In total, 98% of patients were satisfied with the staff support. The imposed preventive measures were perceived as very strict in 27% of the surveyed patients. The majority of the urban group were bothered for not eating during the session, and they felt significantly more stress than the rural group (p=0.001). The SARS-CoV-2 pandemic increased anxiety among hemodialysis patients from a rural setting. Stress was more prevalent in the urban group and most probably related to limitations in eating during sessions. The majority were satisfied with staff support.
    Type of Medium: Online Resource
    ISSN: 1844-122X , 1844-3117
    URL: Article
    DOI: 10.25122/jml-2020-0165
    Language: English
    Publisher: S.C. JURNALUL PENTRU MEDICINA SI VIATA S.R.L
    Publication Date: 2021
    detail.hit.zdb_id: 2559353-5
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  • 6
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    P1869COFFEE INTAKE AND HEADACHE IN HAEMODIALYSIS (COFFEEHD TRIAL): A RANDOMIZED DOUBLE BLIND MULTICENTER CLINICAL TRIAL
    Oxford University Press (OUP) ; 2020
    In:  Nephrology Dialysis Transplantation Vol. 35, No. Supplement_3 ( 2020-06-01)
    Details
    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), Vol. 35, No. Supplement_3 ( 2020-06-01)
    Abstract: Coffee with its major component caffeine can enhance alertness and decrease tiredness and headache. Headache was reported in 40 to 75 % of hemodialysis patients. Caffeine circulates unbound in the blood and passes the dialysis membrane. Some authors suggested that headache can result from caffeine withdrawal. This study aims to compare the incidence of headache and hypotension between patients taking or not coffee during dialysis. Method This is a randomized double-blind multicenter trial. Patients of three hemodialysis units were included. Patients with atrial fibrillation were excluded. 156 patients were randomized to two groups, group A was given 80 cc of coffee and group B 80 cc of decaffeinated coffee in the middle of the session for 12 consecutive sessions. Ultrafiltration rate was fixed to a maximum of 13 ml/kg/h. The primary outcome was the incidence of headache and the secondary incidence of hypotension. This clinical trial received the approval of the ethics committee of Saint-Joseph University (HDF-1463) and was registered on ClinicalTrials.Gov (NCT04057313). Results A total of 139 patients completed the trial (6.4% vs 15.4 % of withdrawal in groups A and B respectively). Baseline characteristics are summarized in Table 1. The number of sessions with headache was not significantly different between group A and B (34% vs 37% respectively, p=0.522), nor the number of sessions with hypotension (27% vs 26% respectively, p= 0.539). In a subgroup analysis, headache was higher in group B (p=0.06) in two categories of patients: those with the highest potassium dialysate (K=2) and the non-hypertensive patients. Conclusion Headache occurred in 34 to 37% of dialysis sessions. There was no difference in headache or hypotensive episodes between patients in the coffee versus decaffeinated group.
    Type of Medium: Online Resource
    ISSN: 0931-0509 , 1460-2385
    URL: Article
    DOI: 10.1093/ndt/gfaa145.P1869
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 1465709-0
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  • 7
    Online Resource
    Online Resource
    Erythropoietin in Acute Kidney Injury (EAKI): a pragmatic randomized clinical trial
    Springer Science and Business Media LLC ; 2022
    In:  BMC Nephrology Vol. 23, No. 1 ( 2022-12)
    Details
    In: BMC Nephrology, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2022-12)
    Abstract: Treatment with erythropoietin is well established for anemia in chronic kidney disease patients but not well studied in acute kidney injury. Methods This is a multicenter, randomized, pragmatic controlled clinical trial. It included 134 hospitalized patients with anemia defined as hemoglobin  〈  11 g/dL and acute kidney injury defined as an increase of serum creatinine of ≥ 0.3 mg/dL within 48 h or 1.5 times baseline. One arm received recombinant human erythropoietin 4000 UI subcutaneously every other day (intervention; n  = 67) and the second received standard of care (control; n  = 67) during the hospitalization until discharge or death. The primary outcome was the need for transfusion; secondary outcomes were death, renal recovery, need for dialysis. Results There was no statistically significant difference in transfusion need (RR = 1.05, 95%CI 0.65,1.68; p  = 0.855), in renal recovery full or partial (RR = 0.96, 95%CI 0.81,1.15; p  = 0.671), in need for dialysis (RR = 11.00, 95%CI 0.62, 195.08; p  = 0.102) or in death (RR = 1.43, 95%CI 0.58,3.53; p  = 0.440) between the erythropoietin and the control group. Conclusions Erythropoietin treatment had no impact on transfusions, renal recovery or mortality in acute kidney injury patients with anemia. The trial was registered on ClinicalTrials.gov (NCT03401710, 17/01/2018).
    Type of Medium: Online Resource
    ISSN: 1471-2369
    URL: Article
    DOI: 10.1186/s12882-022-02727-5
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2041348-8
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  • 8
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    Routine laboratory testing in hemodialysis: how frequently is it needed?
    Springer Science and Business Media LLC ; 2022
    In:  BMC Nephrology Vol. 23, No. 1 ( 2022-10-27)
    Details
    In: BMC Nephrology, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2022-10-27)
    Abstract: Hemodialysis patients are followed by routine laboratory testing. There is uncertainty whether these tests always lead to a change in decision-making. This study aims to discover the number of yearly interventions/changes in prescription based on these tests and depict the group of patients who would benefit from reduced or increased laboratory blood tests. Methods: This is a multi-center retrospective study that included patients on hemodialysis for more than one year. Laboratory data collected included yearly average of hemoglobin, urea reduction ratio (URR), serum phosphate, calcium, potassium, parathormone (PTH), ferritin and transferrin saturation (TSAT); changes in prescription of erythropoietin-stimulating agents (ESAs), intravenous (IV) iron, alfacalcidol, phosphate binders and dialysis parameters were retrieved from medical records. A multivariate regression analysis assessed factors associated with high number of interventions. Results: A total of 210 hemodialysis patients were included: 62.4% males, 47.1% diabetics. Their median age was 72 (62,78.5) years. Their laboratory parameters were within KDIGO targets. The median number of yearly interventions was 5 (3,7) for ESAs, 4 (2,6) for IV iron, 1 (0,2.25) for phosphate binders, 0 (0,1) for alfacalcidol. Based on the multivariate analysis, patients with higher ferritin, frequent changes in ESA, more changes in alfacalcidol and higher PTH had higher number of prescription’s changes in ESA, IV iron, phosphate binders and alfacalcidol respectively. Conclusion: While maintaining KDIGO targets, therapeutic interventions following routine laboratory testing did not exceed six times yearly for all parameters. This suggests that a reduced testing frequency in hemodialysis patients is possible without any impact on quality of care. A personalized approach remains safe for hemodialysis patients while reducing the cost. This is very relevant in low-resource settings and during economic crises and needs to be evaluated in prospective studies.
    Type of Medium: Online Resource
    ISSN: 1471-2369
    URL: Article
    DOI: 10.1186/s12882-022-02971-9
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2041348-8
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  • 9
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    Age and multimorbidities as poor prognostic factors for COVID-19 in hemodialysis: a Lebanese national study
    Springer Science and Business Media LLC ; 2021
    In:  BMC Nephrology Vol. 22, No. 1 ( 2021-12)
    Details
    In: BMC Nephrology, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2021-12)
    Abstract: Hemodialysis patients with COVID-19 have been reported to be at higher risk for death than the general population. Several prognostic factors have been identified in the studies from Asian, European or American countries. This is the first national Lebanese study assessing the factors associated with SARS-CoV-2 mortality in hemodialysis patients. Methods This is an observational study that included all chronic hemodialysis patients in Lebanon who were tested positive for SARS-CoV-2 from 31st March to 1st November 2020. Data on demographics, comorbidities, admission to hospital and outcome were collected retrospectively from the patients’ medical records. A binary logistic regression analysis was performed to assess risk factors for mortality. Results A total of 231 patients were included. Mean age was 61.46 ± 13.99 years with a sex ratio of 128 males to 103 females. Around half of the patients were diabetics, 79.2% presented with fever. A total of 115 patients were admitted to the hospital, 59% of them within the first day of diagnosis. Hypoxia was the major reason for hospitalization. Death rate was 23.8% after a median duration of 6 (IQR, 2 to 10) days. Adjusted regression analysis showed a higher risk for death among older patients (odds ratio = 1.038; 95% confidence interval: 1.013, 1.065), patients with heart failure (odds ratio = 4.42; 95% confidence interval: 2.06, 9.49), coronary artery disease (odds ratio = 3.27; 95% confidence interval: 1.69, 6.30), multimorbidities (odds ratio = 1.593; 95% confidence interval: 1.247, 2.036), fever (odds ratio = 6.66; 95% confidence interval: 1.94, 27.81), CRP above 100 mg/L (odds ratio = 4.76; 95% confidence interval: 1.48, 15.30), and pneumonia (odds ratio = 19.18; 95% confidence interval: 6.47, 56.83). Conclusions This national study identified older age, coronary artery disease, heart failure, multimorbidities, fever and pneumonia as risk factors for death in patients with COVID-19 on chronic hemodialysis. The death rate was comparable to other countries and estimated at 23.8%.
    Type of Medium: Online Resource
    ISSN: 1471-2369
    URL: Article
    DOI: 10.1186/s12882-021-02270-9
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2041348-8
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