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1. Recovery of dialysis patients with COVID-19: health outcomes 3 months after diagnosis in ERACODA

Author

Hemmelder, Marc H, Noordzij, Marlies, Vart, Priya, Hilbrands, Luuk B, Jager, Kitty J, Abrahams, Alferso C, Arroyo, David, Battaglia, Yuri, Ekart, Robert, Mallamaci, Francesca, Malloney, Sharon-Rose, Oliveira, Joao, Rydzewski, Andrzej, Sridharan, Sivakumar, Vogt, Liffert, Duivenvoorden, Raphaël, Gansevoort, Ron T, Franssen, Casper FM, van der Net, Jeroen B, Essig, Marie, du Buf-Vereijken, Peggy WG, van Ginneken, Betty, Maas, Nanda, van Jaarsveld, Brigit C, Bemelman, Frederike J, Klingenberg-Salahova, Farah, Heenan-Vos, Frederiek, Vervloet, Marc G, Nurmohamed, Azam, Abramowicz, Daniel, Verhofstede, Sabine, Maoujoud, Omar, Malfait, Thomas, Fialova, Jana, Melilli, Edoardo, Favà, Alexandre, Cruzado, Josep M, Perez, Nuria Montero, Lips, Joy, Krepel, Harmen, Adilovic, Harun, Hengst, Maaike, Konings, Constantijn JAM, Braconnier, Philippe, Weis, Daniel, Gellert, Ryszard, Alferes, Daniela G, Radulescu, Daniela, Zakharova, Elena V, Ambuehl, Patrice Max, Guidotti, Rebecca, Walker, Andrea, Lepeytre, Fanny, Rabaté, Clémentine, Rostoker, Guy, Marques, Sofia, Azasevac, Tijana, Majstorovic, Gordana Strazmester, Katicic, Dajana, Dam, Marc ten, Krüger, Thilo, Brzosko, Szymon, Liakopoulos, Vassilios, Zanen, Adriaan L, Logtenberg, Susan JJ, Fricke, Lutz, Kuryata, Olexandr, Slebe, Jeroen JP, ElHafeez, Samar Abd, Kemlin, Delphine, van de Wetering, Jacqueline, Reinders, Marlies EJ, Hesselink, Dennis A, van Gestel, J Kal-, Eiselt, Jaromir, Kielberger, Lukas, El-Wakil, Hala S, Verhoeven, Martine AM, Logan, Ian, Canal, Cristina, Facundo, Carme, Ramos, Ana M, Debska-Slizien, Alicja, Veldhuizen, Nicoline MH, Tigka, Eirini, Konsta, Maria Anna Polyzou, Panagoutsos, Stylianos, Postorino, Adele, Cambareri, Francesco, Matceac, Irina, Nistor, Ionut, Covic, Adrian, Groeneveld, JHM, Jousma, Jolanda, van Buren, Marjolijn, Diekmann, Fritz, Oppenheimer, Federico, Blasco, Miquel, Pereira, Tiago Assis, and dos Santos, Augusto Cesar Soares

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Kidney Disease, Patient Safety, Clinical Research, 4.1 Discovery and preclinical testing of markers and technologies, Detection, screening and diagnosis, Good Health and Well Being, Aged, Aged, 80 and over, COVID-19, COVID-19 Testing, Female, Humans, Intensive Care Units, Male, Middle Aged, Outcome Assessment, Health Care, Renal Dialysis, SARS-CoV-2, ERACODA Collaborators, dialysis, functional health status, mental health status, survival, Urology & Nephrology, Clinical sciences
Abstract

BackgroundCoronavirus disease 2019 (COVID-19)-related short-term mortality is high in dialysis patients, but longer-term outcomes are largely unknown. We therefore assessed patient recovery in a large cohort of dialysis patients 3 months after their COVID-19 diagnosis.MethodsWe analyzed data on dialysis patients diagnosed with COVID-19 from 1 February 2020 to 31 March 2021 from the European Renal Association COVID-19 Database (ERACODA). The outcomes studied were patient survival, residence and functional and mental health status (estimated by their treating physician) 3 months after COVID-19 diagnosis. Complete follow-up data were available for 854 surviving patients. Patient characteristics associated with recovery were analyzed using logistic regression.ResultsIn 2449 hemodialysis patients (mean ± SD age 67.5 ± 14.4 years, 62% male), survival probabilities at 3 months after COVID-19 diagnosis were 90% for nonhospitalized patients (n = 1087), 73% for patients admitted to the hospital but not to an intensive care unit (ICU) (n = 1165) and 40% for those admitted to an ICU (n = 197). Patient survival hardly decreased between 28 days and 3 months after COVID-19 diagnosis. At 3 months, 87% functioned at their pre-existent functional and 94% at their pre-existent mental level. Only few of the surviving patients were still admitted to the hospital (0.8-6.3%) or a nursing home (∼5%). A higher age and frailty score at presentation and ICU admission were associated with worse functional outcome.ConclusionsMortality between 28 days and 3 months after COVID-19 diagnosis was low and the majority of patients who survived COVID-19 recovered to their pre-existent functional and mental health level at 3 months after diagnosis.

Published
2022

2. Clinical triage of patients on kidney replacement therapy presenting with COVID-19: an ERACODA registry analysis

Author

Mitra, Sandip, Jayanti, Anuradha, Vart, Priya, Coca, Armando, Gallieni, Maurizio, Øvrehus, Marius Altern, Midtvedt, Karsten, Abd ElHafeez, Samar, Gandolfini, Iliaria, Büttner, Stefan, Franssen, Casper FM, Hemmelder, Marc H, van der Net, Jeroen B, Essig, Marie, du Buf-Vereijken, Peggy WG, van Ginneken, Betty, Vogt, Nanda Maas Liffert, van Jaarsveld, Brigit C, Jager, Kitty J, Bemelman, Frederike J, Klingenberg-Salahova, Farah, Heenan-Vos, Frederiek, Vervloet, Marc G, Nurmohamed, Azam, Abramowicz, Daniel, Maoujoud, Sabine Verhofstede Omar, Malfait, Thomas, Fialova, Jana, Melilli, Edoardo, Favà, Alexandre, Cruzado, Josep M, Perez, Nuria Montero, Lips, Joy, Krepel, Harmen, Adilovic, Harun, Hengst, Maaike, Rydzewski, rzej, Gellert, Ryszard, Oliveira, João, Alferes, Daniela G, Zakharova, Elena V, Ambuehl, Patrice Max, Walker, rea, Winzeler, Rebecca, Lepeytre, Fanny, Rabaté, Clémentine, Rostoker, Guy, Marques, Sofia, Azasevac, Tijana, Katicic, Dajana, Dam, Marc ten, Krüger, Thilo, Brzosko, Szymon, Zanen, Adriaan L, Logtenberg, Susan JJ, Fricke, Lutz, Slebe, Jeroen JP, Kemlin, Delphine, van de Wetering, Jacqueline, Reinders, Marlies EJ, Eiselt, Jaromir, Kielberger, Lukas, El-Wakil, Hala S, Verhoeven, Martine AM, Canal, Cristina, Facundo, Carme, Ramos, Ana M, Debska-Slizien, Alicja, Veldhuizen, Nicoline MH, Tigka, Eirini, Konsta, Maria Anna Polyzou, Panagoutsos, Stylianos, Mallamaci, Francesca, Postorino, Adele, Cambareri, Francesco, Covic, Adrian, Matceac, Irina, Nistor, Ionut, Cordos, Monica, Groeneveld, JHM, van Buren, Jolanda Jousma Marjolijn, Pereira, Fritz Diekmann Tiago Assis, Santos, Augusto Cesar S, Arias-Cabrales, Carlos, Crespo, Marta, Llinàs-Mallol, Laura, Buxeda, Anna, Tàrrega, Carla Burballa, Redondo-Pachon, Dolores, Jimenez, Maria Dolores Arenas, Hofstra, Julia M, Franco, Antonio, Arroyo, David, Rodríguez-Ferrero, Maria Luisa, Manzanos, Sagrario Balda, Haridian Sosa Barrios, R, Ávila, Gonçalo, Laranjinha, Ivo, Mateus, Catarina, and Lemahieu, Wim

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Transplantation, Clinical Research, Kidney Disease, Prevention, Renal and urogenital, Good Health and Well Being, Aged, COVID-19, Hospitalization, Humans, Oxygen Saturation, Registries, Renal Replacement Therapy, SARS-CoV-2, Triage, dialysis, kidney, mortality, second presentation, transplantation, ERACODA Collaborators, Urology & Nephrology, Clinical sciences
Abstract

BackgroundPatients on kidney replacement therapy (KRT) are at very high risk of coronavirus disease 2019 (COVID-19). The triage pathway for KRT patients presenting to hospitals with varying severity of COVID-19 illness remains ill-defined. We studied the clinical characteristics of patients at initial and subsequent hospital presentations and the impact on patient outcomes.MethodsThe European Renal Association COVID-19 Database (ERACODA) was analysed for clinical and laboratory features of 1423 KRT patients with COVID-19 either hospitalized or non-hospitalized at initial triage and those re-presenting a second time. Predictors of outcomes (hospitalization, 28-day mortality) were then determined for all those not hospitalized at initial triage.ResultsAmong 1423 KRT patients with COVID-19 [haemodialysis (HD), n = 1017; transplant, n = 406), 25% (n = 355) were not hospitalized at first presentation due to mild illness (30% HD, 13% transplant). Of the non-hospitalized patients, only 10% (n = 36) re-presented a second time, with a 5-day median interval between the two presentations (interquartile range 2-7 days). Patients who re-presented had worsening respiratory symptoms, a decrease in oxygen saturation (97% versus 90%) and an increase in C-reactive protein (26 versus 73 mg/L) and were older (72 vs 63 years) compared with those who did not return a second time. The 28-day mortality between early admission (at first presentation) and deferred admission (at second presentation) was not significantly different (29% versus 25%; P = 0.6). Older age, prior smoking history, higher clinical frailty score and self-reported shortness of breath at first presentation were identified as risk predictors of mortality when re-presenting after discharge at initial triage.ConclusionsThis study provides evidence that KRT patients with COVID-19 and mild illness can be managed effectively with supported outpatient care and with vigilance of respiratory symptoms, especially in those with risk factors for poor outcomes. Our findings support a risk-stratified clinical approach to admissions and discharges of KRT patients presenting with COVID-19 to aid clinical triage and optimize resource utilization during the ongoing pandemic.

Published
2021

3. Association of obesity with 3-month mortality in kidney failure patients with COVID-19

Author

Tantisattamo, Ekamol, Imhof, Celine, Jager, Kitty J., Hilbrands, Luuk B., Guidotti, Rebecca, Islam, Mahmud, Katicic, Dajana, Konings, Constantijn, Molenaar, Femke M., Nistor, Ionut, Noordzij, Marlies, Rodríguez Ferrero, Mariá Luisa, Verhoeven, Martine A. M., de Vries, Aiko P. J., Kalantar-Zadeh, Kamyar, Gansevoort, Ron T., Vart, Priya, van der Net, Jeroen B., Essig, Marie, du Buf-Vereijken, Peggy W. G., van Ginneken, Betty, Maas, Nanda, van Jaarsveld, Brigit C., Bemelman, Frederike J., Klingenberg-Salahova, Farah, Heenan-Vos, Frederiek, Vervloet, Marc G., Nurmohamed, Azam, Vogt, Liffert, Abramowicz, Daniel, Verhofstede, Sabine, Maoujoud, Omar, Malfait, Thomas, Fialova, Jana, Melilli, Edoardo, Favà, Alexandre, Cruzado, Josep M., Perez, Nuria Montero, Lips, Joy, Krepel, Harmen, Adilovic, Harun, Radulescu, Daniela, Hengst, Maaike, Rydzewski, Andrzej, Braconnier, Philippe, Weis, Daniel, Gellert, Ryszard, Oliveira, Joaõ, Alferes, Daniela G., Zakharova, Elena V., Ambuehl, Patrice Max, Walker, Andrea, Lepeytre, Fanny, Rabate, Clementine, Rostoker, Guy, Marques, Sofia, Azasevac, Tijana, Majstorovic, Gordana Strazmester, ten Dam, Marc, Krüger, Thilo, Brzosko, Szymon, Liakopoulos, Vassilios, Zanen, Adriaan L., Logtenberg, Susan J. J., Fricke, Lutz, Kuryata, Olexandr, Slebe, Jeroen J. P., Elhafeez, Samar Abd, Kemlin, Delphine, van de Wetering, Jacqueline, Reinders, Marlies E. J., Hesselink, Dennis A., Kal-van Gestel, J., Eiselt, Jaromir, Kielberger, Lukas, el-Wakil, Hala S., Logan, Ian, Canal, Cristina, Facundo, Carme, Ramos, Ana M., Debska-Slizien, Alicja, Veldhuizen, Nicoline M. H., Tigka, Eirini, Konsta, Maria Anna Polyzou, Panagoutsos, Stylianos, Mallamaci, Francesca, Postorino, Adele, Cambareri, Francesco, Matceac, Irina, Covic, Adrian, Groeneveld, J. H. M., Jousma, Jolanda, van Buren, Marjolijn, Diekmann, Fritz, Oppenheimer, Federico, Blasco, Miquel, Pereira, Tiago Assis, Santos, Augusto Cesar S., Arias-Cabrales, Carlos, Crespo, Marta, Llinàs-Mallol, Laura, Buxeda, Anna, Tàrrega, Carla Burballa, Redondo-Pachon, Dolores, Jimenez, Maria Dolores Arenas, Mendoza-Valderrey, Alberto, Martins, Ana Cristina, Mateus, Catarina, Alvila, Goncalo, Laranjinha, Ivo, Hofstra, Julia M., Siezenga, Machiel A., Franco, Antonio, Arroyo, David, Castellano, Sandra, Manzanos, Sagrario Balda, Haridian Sosa Barrios, R., Lemahieu, Wim, Bartelet, Karlijn, Dirim, Ahmet Burak, Demir, Erol, Sever, Mehmet Sukru, Turkmen, Aydin, Safak, Seda, Hollander, Daan A. M. J., Büttner, Stefan, Meziyerh, Soufian, van der Helm, Danny, Mallat, Marko, Bouwsma, Hanneke, Sridharan, Sivakumar, Petruliene, Kristina, Maloney, Sharon-Rose, Verberk, Iris, van der Sande, Frank M., Christiaans, Maarten H. L., Hemmelder, Marc H., Kumar, Mohan N., di Luca, Marina, Tuǧlular, Serhan Z., Ziekenhuis, Martini, Kramer, Andrea B., Beerenhout, Charles, Luik, Peter T., Kerschbaum, Julia, Tiefenthaler, Martin, Watschinger, Bruno, Adema, Aaltje Y., Stepanov, Vadim A., Zulkarnaev, Alexey B., Turkmen, Kultigin, Gandolfini, Ilaria, Maggiore, Umberto, Fliedner, Anselm, Åsberg, Anders, Mjoen, Geir, Miyasato, Hitoshi, de Fijter, Carola W. H., Mongera, Nicola, Pini, Stefano, de Biase, Consuelo, Kerckhoffs, Angele, Els van de Logt, Anne, Maas, Rutger, Duivenvoorden, Raphaël, Lebedeva, Olga, Lopez, Veronica, Reichert, Louis J. M., Verhave, Jacobien, Titov, Denis, Parshina, Ekaterina V., Zanoli, Luca, Marcantoni, Carmelita, van Kempen, Gijs, van Gils-Verrij, Liesbeth E. A., Harty, John C., Meurs, Marleen, Myslak, Marek, Battaglia, Yuri, Lentini, Paolo, den Deurwaarder, Edwin, Stendahl, Maria, Rahimzadeh, Hormat, Schouten, Marcel, Rychlik, Ivan, Cabezas-Reina, Carlos J., Roca, Ana Maria, Nauta, Ferdau, Sahin, Idris, Goffin, Eric, Kanaan, Nada, Labriola, Laura, Devresse, Arnaud, Diaz-Mareque, Anabel, Coca, Armando, de Arriba, Gabriel, Meijers, Björn K. I., Naesens, Maarten, Kuypers, Dirk, Desschans, Bruno, Tonnerlier, Annelies, Wissing, Karl M., Dedinska, Ivana, Pessolano, Giuseppina, Malik, Shafi, Dounousi, Evangelia, Papachristou, Evangelos, Berger, Stefan P., Meijer, Esther, Sanders, Jan Stephan F., Franssen, Casper F. M., Özyilmaz, Akin, Ponikvar, Jadranka Buturović, Pernat, Andreja Marn, Kovac, Damjan, Arnol, Miha, Ekart, Robert, Abrahams, Alferso C., van Zuilen, Arjan D., Meijvis, Sabine C. A., Dolmans, Helma, Esposito, Pasquale, Krzesinski, Jean-Marie, Barahira, Jean Damacène, Gallieni, Maurizio, Martin-Moreno, Paloma Leticia, Guglielmetti, Gabriele, Guzzo, Gabriella, Toapanta, Nestor, Soler, Maria Jose, Luik, Antinus J., van Kuijk, Willi H. M., Stikkelbroeck, Lonneke W. H., Hermans, Marc M. H., Rimsevicius, Laurynas, Righetti, Marco, Heitink-ter Braak, Nicole, Medical Informatics, APH - Aging & Later Life, APH - Quality of Care, APH - Global Health, ACS - Pulmonary hypertension & thrombosis, Nephrology, ACS - Microcirculation, APH - Health Behaviors & Chronic Diseases, Clinical sciences, UCL - SSS/IREC/NEFR - Pôle de Néphrologie, UCL - (SLuc) Service de néphrologie, ACS - Diabetes & metabolism, Internal Medicine, Cardiovascular Centre (CVC), Groningen Kidney Center (GKC), van der Net, Jeroen B, Essig, Marie, du Buf-Vereijken, Peggy W G, van Ginneken, Betty, Maas, Nanda, van Jaarsveld, Brigit C, Bemelman, Frederike J, Klingenberg-Salahova, Farah, Heenan-Vos, Frederiek, Vervloet, Marc G, Nurmohamed, Azam, Vogt, Liffert, Abramowicz, Daniel, Verhofstede, Sabine, Maoujoud, Omar, Malfait, Thomas, Fialova, Jana, Melilli, Edoardo, Favà, Alexandre, Cruzado, Josep M, Perez, Nuria Montero, Lips, Joy, Krepel, Harmen, Adilovic, Harun, Radulescu, Daniela, Hengst, Maaike, Rydzewski, Andrzej, Braconnier, Philippe, Weis, Daniel, Gellert, Ryszard, Oliveira, João, Alferes, Daniela G, Zakharova, Elena V, Ambuehl, Patrice Max, Walker, Andrea, Lepeytre, Fanny, Rabaté, Clémentine, Rostoker, Guy, Marques, Sofia, Azasevac, Tijana, Majstorovic, Gordana Strazmester, Ten Dam, Marc, Krüger, Thilo, Brzosko, Szymon, Liakopoulos, Vassilios, Zanen, Adriaan L, Logtenberg, Susan J J, Fricke, Lutz, Kuryata, Olexandr, Slebe, Jeroen J P, ElHafeez, Samar Abd, Kemlin, Delphine, van de Wetering, Jacqueline, Reinders, Marlies E J, Hesselink, Dennis A, Kal-van Gestel, J., Eiselt, Jaromir, Kielberger, Lukas, El-Wakil, Hala S, Logan, Ian, Canal, Cristina, Facundo, Carme, Ramos, Ana M, Debska-Slizien, Alicja, Veldhuizen, Nicoline M H, Tigka, Eirini, Konsta, Maria Anna Polyzou, Panagoutsos, Stylianos, Mallamaci, Francesca, Postorino, Adele, Cambareri, Francesco, Matceac, Irina, Covic, Adrian, Groeneveld, J H M, Jousma, Jolanda, van Buren, Marjolijn, Diekmann, Fritz, Oppenheimer, Federico, Blasco, Miquel, Pereira, Tiago Assis, Santos, Augusto Cesar S, Arias-Cabrales, Carlos, Crespo, Marta, Llinàs-Mallol, Laura, Buxeda, Anna, Tàrrega, Carla Burballa, Redondo-Pachon, Dolores, Jimenez, Maria Dolores Arenas, Mendoza-Valderrey, Alberto, Martins, Ana Cristina, Mateus, Catarina, Alvila, Goncalo, Laranjinha, Ivo, Hofstra, Julia M, Siezenga, Machiel A, Franco, Antonio, Arroyo, David, Castellano, Sandra, Manzanos, Sagrario Balda, Haridian Sosa Barrios, R., Lemahieu, Wim, Bartelet, Karlijn, Dirim, Ahmet Burak, Demir, Erol, Sever, Mehmet Sukru, Turkmen, Aydin, Şafak, Seda, Hollander, Daan A M J, Büttner, Stefan, Meziyerh, Soufian, van der Helm, Danny, Mallat, Marko, Bouwsma, Hanneke, Sridharan, Sivakumar, Petrulienė, Kristina, Maloney, Sharon-Rose, Verberk, Iris, van der Sande, Frank M, Christiaans, Maarten H L, Hemmelder, Marc H, Kumar N, Mohan, Di Luca, Marina, Tuğlular, Serhan Z, Ziekenhuis, Martini, Kramer, Andrea B, Beerenhout, Charles, Luik, Peter T, Kerschbaum, Julia, Tiefenthaler, Martin, Watschinger, Bruno, Adema, Aaltje Y, Stepanov, Vadim A, Zulkarnaev, Alexey B, Turkmen, Kultigin, Gandolfini, Ilaria, Maggiore, Umberto, Fliedner, Anselm, Åsberg, Anders, Mjoen, Geir, Miyasato, Hitoshi, de Fijter, Carola W H, Mongera, Nicola, Pini, Stefano, de Biase, Consuelo, Kerckhoffs, Angele, Els van de Logt, Anne, Maas, Rutger, Duivenvoorden, Raphaël, Lebedeva, Olga, Lopez, Veronica, Reichert, Louis J M, Verhave, Jacobien, Titov, Denis, Parshina, Ekaterina V, Zanoli, Luca, Marcantoni, Carmelita, van Kempen, Gijs, van Gils-Verrij, Liesbeth E A, Harty, John C, Meurs, Marleen, Myslak, Marek, Battaglia, Yuri, Lentini, Paolo, den Deurwaarder, Edwin, Stendahl, Maria, Rahimzadeh, Hormat, Schouten, Marcel, Rychlik, Ivan, Cabezas-Reina, Carlos J, Roca, Ana Maria, Nauta, Ferdau, Sahin, İdris, Goffin, Eric, Kanaan, Nada, Labriola, Laura, Devresse, Arnaud, Diaz-Mareque, Anabel, Coca, Armando, de Arriba, Gabriel, Meijers, Björn K I, Naesens, Maarten, Kuypers, Dirk, Desschans, Bruno, Tonnerlier, Annelies, Wissing, Karl M, Dedinska, Ivana, Pessolano, Giuseppina, Malik, Shafi, Dounousi, Evangelia, Papachristou, Evangelos, Berger, Stefan P, Meijer, Esther, Sanders, Jan Stephan F, Franssen, Casper F M, Özyilmaz, Akin, Ponikvar, Jadranka Buturović, Pernat, Andreja Marn, Kovac, Damjan, Arnol, Miha, Ekart, Robert, Abrahams, Alferso C, van Zuilen, Arjan D, Meijvis, Sabine C A, Dolmans, Helma, Esposito, Pasquale, Krzesinski, Jean-Marie, Barahira, Jean Damacène, Gallieni, Maurizio, Martin-Moreno, Paloma Leticia, Guglielmetti, Gabriele, Guzzo, Gabriella, Toapanta, Nestor, Soler, Maria Jose, Luik, Antinus J, van Kuijk, Willi H M, Stikkelbroeck, Lonneke W H, Hermans, Marc M H, Rimševičius, Laurynas, Righetti, Marco, and Heitink-Ter Braak, Nicole

Subjects
Transplantation, COVID-19, infectious diseases, mortality, DIALYSIS PATIENTS, kidney failure, BODY-MASS INDEX, obesity paradox, Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], TRANSPLANT, SDG 3 - Good Health and Well-being, Nephrology, ERACODA, reverse epidemiology, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11]
Abstract

Background In the general population with coronavirus disease 2019 (COVID-19), obesity is associated with an increased risk of mortality. Given the typically observed obesity paradox among patients on kidney function replacement therapy (KFRT), especially dialysis patients, we examined the association of obesity with mortality among dialysis patients or living with a kidney transplant with COVID-19. Methods Data from the European Renal Association COVID-19 Database (ERACODA) were used. KFRT patients diagnosed with COVID-19 between 1 February 2020 and 31 January 2021 were included. The association of Quetelet's body mass index (BMI) (kg/m2), divided into: Results In 3160 patients on KFRT (mean age: 65 years, male: 61%), 99 patients were lean, 1151 normal weight (reference), 1160 overweight, 525 obese I and 225 obese II/III. During follow-up of 3 months, 28, 20, 21, 23 and 27% of patients died in these categories, respectively. In the fully adjusted model, the hazard ratios (HRs) for 3-month mortality were 1.65 [95% confidence interval (CI): 1.10, 2.47], 1 (ref.), 1.07 (95% CI: 0.89, 1.28), 1.17 (95% CI: 0.93, 1.46) and 1.71 (95% CI: 1.27, 2.30), respectively. Results were similar among dialysis patients (N = 2343) and among those living with a kidney transplant (N = 817) (Pinteraction = 0.99), but differed by sex (Pinteraction = 0.019). In males, the HRs for the association of aforementioned BMI categories with 3-month mortality were 2.07 (95% CI: 1.22, 3.52), 1 (ref.), 0.97 (95% CI: 0.78. 1.21), 0.99 (95% CI: 0.74, 1.33) and 1.22 (95% CI: 0.78, 1.91), respectively, and in females corresponding HRs were 1.34 (95% CI: 0.70, 2.57), 1 (ref.), 1.31 (95% CI: 0.94, 1.85), 1.54 (95% CI: 1.05, 2.26) and 2.49 (95% CI: 1.62, 3.84), respectively. Conclusion In KFRT patients with COVID-19, on dialysis or a kidney transplant, obesity is associated with an increased risk of mortality at 3 months. This is in contrast to the obesity paradox generally observed in dialysis patients. Additional studies are required to corroborate the sex difference in the association of obesity with mortality.

Published
2022

4. COVID-19-related mortality in kidney transplant and haemodialysis patients

Author

Goffin, Eric, Candellier, Alexandre, Vart, Priya, Noordzij, Marlies, Arnol, Miha, Covic, Adrian, Lentini, Paolo, Malik, Shafi, Reichert, Louis J., Sever, Mehmet S., Watschinger, Bruno, Jager, Kitty J., Gansevoort, Ron T., van der Net, Jeroen B., Essig, Marie, du Buf-Vereijken, Peggy W. G., van Ginneken, Betty, Vogt, Liffert, van Jaarsveld, Brigit C., Bemelman, Frederike J., Klingenberg-Salahova, Farah, Heenan-Vos, Frederiek, Vervloet, Marc G., Nurmohamed, Azam, Abramowicz, Daniel, Verhofstede, Sabine, Maoujoud, Omar, Malfait, Thomas, Avitum, B. Braun, Fialova, Jana, Melilli, Edoardo, Favà, Alexandre, Cruzado, Josep M., Perez, Nuria Montero, Lips, Joy, Krepel, Harmen, Adilovic, Harun, Hengst, Maaike, Rydzewski, Andrzej, Gellert, Ryszard, Oliveira, João, Alferes, Daniela G., Zakharova, Elena V., Ambuehl, Patrice Max, Walker, Andrea, Winzeler, Rebecca, Lepeytre, Fanny, Rabaté, Clémentine, Rostoker, Guy, Marques, Sofia, Azasevac, Tijana, Katicic, Dajana, ten Dam, Marc, Krüger, Thilo, Brzosko, Szymon, Zanen, Adriaan L., Logtenberg, Susan J. J., Fricke, Lutz, Slebe, Jeroen J. P., Kemlin, Delphine, van de Wetering, Jacqueline, Reinders, Marlies E. J., Eiselt, Jaromir, Kielberger, Lukas, el-Wakil, Hala S., Verhoeven, Martine A. M., Canal, Cristina, Facundo, Carme, Ramos, Ana M., Debska-Slizien, Alicja, Veldhuizen, Nicoline M. H., Tigka, Eirini, Konsta, Maria Anna Polyzou, Panagoutsos, Stylianos, Mallamaci, Francesca, Matceac, Irina, Nistor, Ionut, Cordos, Monica, Groeneveld, J. H. M., Jousma, Jolanda, van Buren, Marjolijn, Elhafeez, Samar Abd, Diekmann, Fritz, Pereira, Tiago Assis, Santos, Augusto Cesar S., Arias-Cabrales, Carlos, Crespo, Marta, Llinàs-Mallol, Laura, Buxeda, Anna, Tàrrega, Carla Burballa, Redondo-Pachon, Dolores, Jimenez, Maria Dolores Arenas, Hofstra, Julia M., Franco, Antonio, Arroyo, David, Rodríguez-Ferrero, Maria Luisa, Manzanos, Sagrario Balda, Barrios, R. Haridian Sosa, Ávila, Gonçalo, Laranjinha, Ivo, Mateus, Catarina, Lemahieu, Wim, Dirim, Ahmet Burak, Demir, Erol, Å afak, Seda, Turkmen, Aydin, Hollander, Daan A. M. J., Büttner, Stefan, de Vries, Aiko P. J., Meziyerh, Soufian, van der Helm, Danny, Mallat, Marko, Bouwsma, Hanneke, Sridharan, Sivakumar, Petruliene, Kristina, Maloney, Sharon-Rose, Verberk, Iris, van der Sande, Frank M., Christiaans, Maarten H. L., Hemmelder, Marc, Kumar, Mohan N., di Luca, Marina, Tuǧlular, Serhan Z., Kramer, Andrea, Beerenhout, Charles, Luik, Peter T., Kerschbaum, Julia, Tiefenthaler, Martin, Adema, Aaltje Y., Stepanov, Vadim A., Zulkarnaev, Alexey B., Turkmen, Kultigin, Fliedner, Anselm, Åsberg, Anders, Mjoen, Geir, Miyasato, Hitoshi, de Fijter, Carola W. H., Mongera, Nicola, Pini, Stefano, de Biase, Consuelo, Duivenvoorden, Raphaël, Hilbrands, Luuk, Kerckhoffs, Angele, Maas, Rutger, Lebedeva, Olga, Lopez, Veronica, Verhave, Jacobien, Titov, Denis, Parshina, Ekaterina V., Zanoli, Luca, Marcantoni, Carmelita, van Gils-Verrij, Liesbeth E. A., Harty, John C., Meurs, Marleen, Myslak, Marek, Battaglia, Yuri, den Deurwaarder, Edwin, Stendahl, Maria, Rahimzadeh, Hormat, Schouten, Marcel, Rychlik, Ivan, Cabezas-Reina, Carlos J., Roca, Ana Maria, Nauta, Ferdau, Kanaan, Nada, Labriola, Laura, Devresse, Arnaud, Diaz-Mareque, Anabel, Coca, Armando, Meijers, Björn K. I., Naesens, Maarten, Kuypers, Dirk, Desschans, Bruno, Tonnelier, Annelies, Wissing, Karl M., de Arriba, Gabriel, Dedinska, Ivana, Pessolano, Giuseppina, Gandolfini, Ilaria, Maggiore, Umberto, Papachristou, Evangelos, Franssen, Casper F. M., Berger, Stefan P., Meijer, Esther, Özyilmaz, Akin, Sanders, Jan Stephan F., Ponikvar, Jadranka Buturović, Pernat, Andreja Marn, Kovac, Damjan, Ekart, Robert, Abrahams, Alferso C., Molenaar, Femke M., van Zuilen, Arjan D., Meijvis, Sabine C. A., Dolmans, Helma, Tantisattamos, Ekamol, Esposito, Pasquale, Krzesinski, Jean-Marie, Barahira, Jean Damacène, Gallieni, Maurizio, Sabiu, Gianmarco, Martin-Moreno, Paloma Leticia, Guglielmetti, Gabriele, Guzzo, Gabriella, Toapanta, Nestor, Luik, Antinus J., van Kuijk, Willi H. M., Stikkelbroeck, Lonneke W. H., Hermans, Marc M. H., Rimsevicius, Laurynas, Righetti, Marco, Islam, Mahmud, Braak, Nicole Heitink-Ter, UCL - SSS/IREC/NEFR - Pôle de Néphrologie, UCL - (SLuc) Service de néphrologie, Internal Medicine, Clinical sciences, Nephrology, ACS - Diabetes & metabolism, AII - Inflammatory diseases, AII - Infectious diseases, Groningen Kidney Center (GKC), Cardiovascular Centre (CVC), Medical Informatics, ACS - Pulmonary hypertension & thrombosis, APH - Aging & Later Life, APH - Quality of Care, ACS - Microcirculation, APH - Health Behaviors & Chronic Diseases, and APH - Global Health

Subjects
medicine.medical_specialty, kidney, Original Article - Dialysis, medicine.medical_treatment, infectious diseases, law.invention, Kidney Failure, SDG 3 - Good Health and Well-being, Renal Dialysis, Risk Factors, law, Internal medicine, medicine, Humans, COVID-19, dialysis, mortality, transplantation, Registries, Renal replacement therapy, Chronic, AcademicSubjects/MED00340, Kidney transplantation, Dialysis, Transplantation, SARS-CoV-2, business.industry, Kidney Transplantation/adverse effects, Hazard ratio, medicine.disease, Kidney Transplantation, Intensive care unit, Comorbidity, Transplant Recipients, Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], Kidney Failure, Chronic/therapy, Nephrology, Kidney Failure, Chronic, Hemodialysis, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business
Abstract

BACKGROUND AND AIMS: Studies examining kidney failure patients with COVID-19 reported higher mortality in hemodialysis patients than in kidney transplant recipients. However, hemodialysis patients are often older and have more comorbidities. This study investigated the association of type of kidney replacement therapy with COVID-19 severity adjusting for differences in characteristics. METHOD: Data were retrieved from the European Renal Association COVID-19 Database (ERACODA), which includes kidney replacement therapy patients diagnosed with COVID-19 from all over Europe. We included all kidney transplant recipients and hemodialysis patients who presented between February 1st and December 1st 2020 and had complete information reason for COVID-19 screening and vital status at day 28. The diagnosis of COVID-19 was made based on a PCR of a nasal or pharyngeal swab specimens and/or COVID-19 compatible findings on a lung CT scan. The association of kidney transplantation or hemodialysis with 28-day mortality was examined using Cox proportional-hazards regression models adjusted for age, sex, frailty and comorbidities. Additionally, this association was investigated in the subsets of patients that were screened because of symptoms or have had routine screening. RESULTS: A total of 1,670 patients (496 functional kidney transplant recipients and 1,174 hemodialysis patients) were examined. 16.9% of kidney transplant recipients and 23.9% of hemodialysis patients died within 28 days of presentation. In an unadjusted model, the risk of 28-day mortality was 33% lower in kidney transplant recipients compared with hemodialysis patients (hazard ratio (HR): 0.67, 95% CI: 0.52, 0.85). However, in an age, sex and frailty adjusted model, the risk of 28-day mortality was 29% higher in kidney transplant recipients (HR=1.29, 95% CI: 1.00, 1.68), whereas in a fully adjusted model the risk was even 43% higher (HR=1.43, 95% CI: 1.06, 1.93). This association in patients who were screened because of symptoms (n=1,145) was similar (fully adjusted model HR=1.46, 95% CI: 1.05, 2.04). Results were similar when other endpoints were studied (e.g. risk for hospitalization, ICU admission or mortality beyond 28 days) as well as across subgroups. Only age was found to interact significantly, suggesting that the increased mortality risk associated with kidney transplantation was especially present in elderly subjects. CONCLUSION: In this study, kidney transplant recipients had a greater risk of a more severe course of COVID-19 compared with hemodialysis patients when adjusted for age, sex and comorbidities.

Published
2021

5. Sex differences in COVID-19 mortality risk in patients on kidney function replacement therapy

Author

Vart, Priya, Duivenvoorden, Raphaël, Adema, Aaltje, Covic, Adrian, Finne, Patrik, Braak, Nicole Heijtink-ter, Laine, Kaisa, Noordzij, Marlies, Schouten, Marcel, Jager, Kitty J., Gansevoort, Ron T., van der Net, Jeroen B., Essig, Marie, du Buf-Vereijken, Peggy W. G., van Ginneken, Betty, Maas, Nanda, van Jaarsveld, Brigit C., Bemelman, Frederike J., Klingenberg-Salahova, Farah, Heenan-Vos, Frederiek, Vervloet, Marc G., Nurmohamed, Azam, Vogt, Liffert, Abramowicz, Daniel, Verhofstede, Sabine, Maoujoud, Omar, Malfait, Thomas, Fialova, Jana, Melilli, Edoardo, Favà, Alexandre, Cruzado, Josep M., Perez, Nuria Montero, Lips, Joy, Krepel, Harmen, Adilovic, Harun, Radulescu, Daniela, Hengst, Maaike, Konings, Constantijn, Rydzewski, Andrzej, Braconnier, Philippe, Weis, Daniel, Gellert, Ryszard, Oliveira, João, Alferes, Daniela G., Zakharova, Elena V., Ambühl, Patrice Max, Guidotti, Rebecca, Walker, Andrea, Lepeytre, Fanny, Rabaté, Clémentine, Rostoker, Guy, Marques, Sofia, Azasevac, Tijana, Majstorovic, Gordana Strazmester, Katicic, Dajana, ten Dam, Marc, Krüger, Thilo, Brzosko, Szymon, Liakopoulos, Vassilios, Zanen, Adriaan L., Logtenberg, Susan J. J., Fricke, Lutz, Kuryata, Olexandr, Slebe, Jeroen J. P., ElHafeez, Samar Abd, Kemlin, Delphine, van de Wetering, Jacqueline, Reinders, Marlies E. J., Hesselink, Dennis A., Kal-van Gestel, J., Eiselt, Jaromir, Kielberger, Lukas, El-Wakil, Hala S., Verhoeven, Martine, Logan, Ian, Canal, Cristina, Facundo, Carme, Ramos, Ana M., Debska-Slizien, Alicja, Veldhuizen, Nicoline M. H., Tigka, Eirini, Konsta, Maria Anna Polyzou, Panagoutsos, Stylianos, Mallamaci, Francesca, Postorino, Adele, Cambareri, Francesco, Matceac, Irina, Nistor, Ionut, Groeneveld, J. H.M., Jousma, Jolanda, van Buren, Marjolijn, Diekmann, Fritz, Oppenheimer, Federico, Blasco, Miquel, Pereira, Tiago Assis, Santos, Augusto Cesar S., Arias-Cabrales, Carlos, Crespo, Marta, Llinàs-Mallol, Laura, Buxeda, Anna, Tàrrega, Carla Burballa, Redondo-Pachon, Dolores, Jimenez, Maria Dolores Arenas, Mendoza-Valderrey, Alberto, Martins, Ana Cristina, Mateus, Catarina, Alvila, Goncalo, Laranjinha, Ivo, Hofstra, Julia M., Siezenga, Machiel A., Franco, Antonio, Arroyo, David, Castellano, Sandra, Rodríguez-Ferrero, Maria Luisa, Manzanos, Sagrario Balda, Barrios, R. Haridian Sosa, Lemahieu, Wim, Bartelet, Karlijn, Dirim, Ahmet Burak, Demir, Erol, Sever, Mehmet Sukru, Turkmen, Aydin, Şafak, Seda, Hollander, Daan A. M. J., Büttner, Stefan, de Vries, Aiko P. J., Meziyerh, Soufian, van der Helm, Danny, Mallat, Marko, Bouwsma, Hanneke, Sridharan, Sivakumar, Petrulienė, Kristina, Maloney, Sharon-Rose, Verberk, Iris, van der Sande, Frank M., Christiaans, Maarten H. L., Hemmelder, Marc H., MohanKumar, N., Di Luca, Marina, Tuğlular, Serhan Z., Kramer, Andrea B., Beerenhout, Charles, Luik, Peter T., Kerschbaum, Julia, Tiefenthaler, Martin, Watschinger, Bruno, Stepanov, Vadim A., Zulkarnaev, Alexey B., Turkmen, Kultigin, Gandolfini, Ilaria, Maggiore, Umberto, Fliedner, Anselm, Åsberg, Anders, Mjoen, Geir, Miyasato, Hitoshi, de Fijter, Carola W. H., Mongera, Nicola, Pini, Stefano, de Biase, Consuelo, Kerckhoffs, Angele, van de Logt, Anne Els, Maas, Rutger, Hilbrands, Luuk B., Lebedeva, Olga, Lopez, Veronica, Reichert, Louis J. M., Verhave, Jacobien, Titov, Denis, Parshina, Ekaterina V., Zanoli, Luca, Marcantoni, Carmelita, van Kempen, Gijs, van Gils-Verrij, Liesbeth E. A., Harty, John C., Meurs, Marleen, Myslak, Marek, Battaglia, Yuri, Lentini, Paolo, den Deurwaarder, Edwin, Stendahl, Maria, Rahimzadeh, Hormat, Rychlik, Ivan, Cabezas-Reina, Carlos J., Roca, Ana Maria, Nauta, Ferdau, Sahin, İdris, Goffin, Eric, Kanaan, Nada, Labriola, Laura, Devresse, Arnaud, Diaz-Mareque, Anabel, Coca, Armando, de Arriba, Gabriel, Meijers, Björn K. I., Naesens, Maarten, Kuypers, Dirk, Desschans, Bruno, Tonnerlier, Annelies, Wissing, Karl M., Dedinska, Ivana, Pessolano, Giuseppina, Malik, Shafi, Dounousi, Evangelia, Papachristou, Evangelos, Berger, Stefan P., Sanders, Jan Stephan F., Franssen, Casper F. M., Özyilmaz, Akin, Ponikvar, Jadranka Buturović, Pernat, Andreja Marn, Kovac, Damjan, Arnol, Miha, Ekart, Robert, Abrahams, Alferso C., Molenaar, Femke M., van Zuilen, Arjan D., Meijvis, Sabine C. A., Dolmans, Helma, Tantisattamo, Ekamol, Esposito, Pasquale, Krzesinski, Jean-Marie, Barahira, Jean Damacène, Gallieni, Maurizio, Martin-Moreno, Paloma Leticia, Guglielmetti, Gabriele, Guzzo, Gabriella, Toapanta, Nestor, Soler, Maria Jose, Luik, Antinus J., van Kuijk, Willi H. M., Stikkelbroeck, Lonneke W. H., Hermans, Marc M. H., Rimševičius, Laurynas, Righetti, Marco, Islam, Mahmud, Clinical sciences, Nephrology, Groningen Kidney Center (GKC), Cardiovascular Centre (CVC), Groningen Institute for Organ Transplantation (GIOT), Medical Informatics, APH - Aging & Later Life, APH - Quality of Care, APH - Global Health, ACS - Pulmonary hypertension & thrombosis, AII - Inflammatory diseases, ACS - Microcirculation, APH - Health Behaviors & Chronic Diseases, Internal Medicine, Department of Medicine, Clinicum, University of Helsinki, Helsinki University Hospital Area, ACS - Diabetes & metabolism, UCL - SSS/IREC/NEFR - Pôle de Néphrologie, and UCL - (SLuc) Service de néphrologie

Subjects
Male, kidney, Transplant, infectious diseases, Kidney, All institutes and research themes of the Radboud University Medical Center, COVID‐19, Renal Dialysis, Risk Factors, risk factors, Humans, Eracoda, Aged, Sex Characteristics, Multidisciplinary, Dialysis patients, Kidney Transplantation/adverse effects, COVID-19, Middle Aged, Kidney Transplantation, Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], Nephrology, 3121 General medicine, internal medicine and other clinical medicine, mortality risk, Immunosuppressive Agents/therapeutic use, Female, Immunosuppressive Agents
Abstract

In the general population with COVID-19, the male sex is an established risk factor for mortality, in part due to a more robust immune response to COVID-19 in women. Because patients on kidney function replacement therapy (KFRT) have an impaired immune response, especially kidney transplant recipients due to their use of immunosuppressants, we examined whether the male sex is still a risk factor for mortality among patients on KFRT with COVID-19. From the European Renal Association COVID-19 Database (ERACODA), we examined patients on KFRT with COVID-19 who presented between February 1st, 2020, and April 30th, 2021. 1204 kidney transplant recipients (male 62.0%, mean age 56.4 years) and 3206 dialysis patients (male 61.8%, mean age 67.7 years) were examined. Three-month mortality in kidney transplant recipients was 16.9% in males and 18.6% in females (p = 0.31) and in dialysis patients 27.1% in males and 21.9% in females (p = 0.001). The adjusted HR for the risk of 3-month mortality in males (vs females) was 0.89 (95% CI 65, 1.23, p = 0.49) in kidney transplant recipients and 1.33 (95% CI 1.13, 1.56, p = 0.001) in dialysis patients (pinteraction = 0.02). In a fully adjusted model, the aHR for the risk of 3-month mortality in kidney transplant recipients (vs. dialysis patients) was 1.39 (95% CI 1.02, 1.89, p = 0.04) in males and 2.04 (95% CI 1.40, 2.97, p interaction = 0.02). In patients on KFRT with COVID-19, the male sex is not a risk factor for mortality among kidney transplant recipients but remains a risk factor among dialysis patients. The use of immunosuppressants in kidney transplant recipients, among other factors, may have narrowed the difference in the immune response to COVID-19 between men and women, and therefore reduced the sex difference in COVID-19 mortality risk.

Published
2022

6. Clinical, Functional, and Mental Health Outcomes in Kidney Transplant Recipients 3 Months After a Diagnosis of COVID-19

Author

Duivenvoorden, Raphaël, Vart, Priya, Noordzij, Marlies, Soares Dos Santos, Augusto C., Zulkarnaev, Alex B., Franssen, Casper F. M., Kuypers, Dirk, Demir, Erol, Rahimzadeh, Hormat, Kerschbaum, Julia, Jager, Kitty J., Turkmen, Kultigin, Hemmelder, Marc H., Schouten, Marcel, Rodríguez-Ferrero, María Luisa, Crespo, Marta, Gansevoort, Ron T., Hilbrands, Luuk B., van der Net, Jeroen B., Essig, Marie, du Buf-Vereijken, Peggy W. G., van Ginneken, Betty, Maas, Nanda, Vogt, Liffert, van Jaarsveld, Brigit C., Bemelman, Frederike J., Klingenberg-Salahova, Farah, Heenan-Vos, Frederiek, Vervloet, Marc G., Nurmohamed, Azam, Abramowicz, Daniel, Verhofstede, Sabine, Maoujoud, Omar, Malfait, Thomas, Fialova, Jana, Melilli, Edoardo, Favà, Alexandre, Cruzado, Josep M., Montero Perez, Nuria, Lips, Joy, Krepel, Harmen, Adilovic, Harun, Hengst, Maaike, Konings, Constantijn, Rydzewski, Andrzej, Braconnier, Philippe, Weis, Daniel, Gellert, Ryszard, Oliveira, João, Alferes, Daniela G., Radulescu, Daniela, Zakharova, Elena V., Ambuehl, Patrice Max, Guidotti, Rebecca, Walker, Andrea, Lepeytre, Fanny, Rabaté, Clémentine, Rostoker, Guy, Marques, Sofia, Azasevac, Tijana, Strazmester Majstorovic, Gordana, Katicic, Dajana, ten Dam, Marc, Krüger, Thilo, Brzosko, Szymon, Liakopoulos, Vassilios, Zanen, Adriaan L., Logtenberg, Susan J. J., Fricke, Lutz, Kuryata, Olexandr, Slebe, Jeroen J. P., Abd Elhafeez, Samar, Kemlin, Delphine, van de Wetering, Jacqueline, Reinders, Marlies E. J., Hesselink, Dennis A., Kal-van Gestel, J., Eiselt, Jaromir, Kielberger, Lukas, el-Wakil, Hala S., Verhoeven, Martine, Logan, Ian, Canal, Cristina, Facundo, Carme, Ramos, Ana M., Debska-Slizien, Alicja, Veldhuizen, Nicoline M. H., Tigka, Eirini, Polyzou Konsta, Maria Anna, Panagoutsos, Stylianos, Mallamaci, Francesca, Postorino, Adele, Cambareri, Francesco, Matceac, Irina, Nistor, Ionut, Covic, Adrian, Groeneveld, J. H. M., Jousma, Jolanda, van Buren, Marjolijn, Diekmann, Fritz, Oppenheimer, Federico, Blasco, Miquel, Assis Pereira, Tiago, Arias-Cabrales, Carlos, Llinàs-Mallol, Laura, Buxeda, Anna, Tàrrega, Carla Burballa, Redondo-Pachon, Dolores, Jimenez, Maria Dolores Arenas, Mendoza-Valderrey, Alberto, Martins, Ana Cristina, Mateus, Catarina, Alvila, Goncalo, Laranjinha, Ivo, Hofstra, Julia M., Siezenga, Machiel A., Franco, Antonio, Arroyo, David, Castellano, Sandra, Balda Manzanos, Sagrario, Sosa Barrios, R. Haridian, Lemahieu, Wim, Bartelet, Karlijn, Burak Dirim, Ahmet, Sukru Sever, Mehmet, Turkmen, Aydin, Şafak, Seda, Hollander, Daan A. M. J., Büttner, Stefan, de Vries, Aiko P. J., Meziyerh, Soufian, van der Helm, Danny, Mallat, Marko, Bouwsma, Hanneke, Sridharan, Sivakumar, Petruliene, Kristina, Maloney, Sharon-Rose, Verberk, Iris, van der Sande, Frank M., Christiaans, Maarten H. L., Mohan Kumar, N., di Luca, Marina, Tuǧlular, Serhan Z., Kramer, Andrea, Beerenhout, Charles, Luik, Peter T., Tiefenthaler, Martin, Watschinger, Bruno, Adema, Aaltje Y., Stepanov, Vadim A., Gandolfini, Ilaria, Maggiore, Umberto, Fliedner, Anselm, Åsberg, Anders, Mjoen, Geir, Miyasato, Hitoshi, de Fijter, Carola W. H., Mongera, Nicola, Pini, Stefano, de Biase, Consuelo, Kerckhoffs, Angele, van de Logt, Anne Els, Maas, Rutger, Lebedeva, Olga, Lopez, Veronica, Reichert, Louis J. M., Verhave, Jacobien, Titov, Denis, Parshina, Ekaterina V., Zanoli, Luca, Marcantoni, Carmelita, van Kempen, Gijs, van Gils-Verrij, Liesbeth E. A., Harty, John C., Meurs, Marleen, Myslak, Marek, Battaglia, Yuri, Lentini, Paolo, den Deurwaarder, Edwin, Stendahl, Maria, Rychlik, Ivan, Cabezas-Reina, Carlos J., Maria Roca, Ana, Nauta, Ferdau, Sahin, İdris, Goffin, Eric, Kanaan, Nada, Labriola, Laura, Devresse, Arnaud, Diaz-Mareque, Anabel, Coca, Armando, de Arriba, Gabriel, Meijers, Björn K. I., Naesens, Maarten, Desschans, Bruno, Tonnerlier, Annelies, Wissing, Karl M., Dedinska, Ivana, Pessolano, Giuseppina, Malik, Shafi, Dounousi, Evangelia, Papachristou, Evangelos, Berger, Stefan P., Meijer, Esther, Sanders, Jan Stephan F., Özyilmaz, Akin, Buturović Ponikvar, Jadranka, Marn Pernat, Andreja, Kovac, Damjan, Arnol, Miha, Ekart, Robert, Abrahams, Alferso C., Molenaar, Femke M., van Zuilen, Arjan D., Meijvis, Sabine C. A., Dolmans, Helma, Tantisattamo, Ekamol, Esposito, Pasquale, Krzesinski, Jean-Marie, Barahira, Jean Damacène, Gallieni, Maurizio, Martin-Moreno, Paloma Leticia, Guglielmetti, Gabriele, Guzzo, Gabriella, Toapanta, Nestor, Jose Soler, Maria, Luik, Antinus J., van Kuijk, Willi H. M., Stikkelbroeck, Lonneke W. H., Hermans, Marc M. H., Rimsevicius, Laurynas, Righetti, Marco, Islam, Mahmud, Heitink-ter Braak, Nicole, Groningen Kidney Center (GKC), Cardiovascular Centre (CVC), UCL - SSS/IREC/NEFR - Pôle de Néphrologie, UCL - (SLuc) Service de néphrologie, Medical Informatics, ACS - Pulmonary hypertension & thrombosis, APH - Aging & Later Life, APH - Quality of Care, APH - Global Health, Nephrology, ACS - Diabetes & metabolism, Internal Medicine, Interne Geneeskunde, RS: Carim - V02 Hypertension and target organ damage, and Clinical sciences

Subjects
kidney transplant, Adult, Kidney Disease, Outcome Assessment, Renal and urogenital, infectious diseases, Medical and Health Sciences, clinical, DISEASE, All institutes and research themes of the Radboud University Medical Center, Rare Diseases, SDG 3 - Good Health and Well-being, 7.1 Individual care needs, Clinical Research, Outcome Assessment, Health Care, Humans, Retrospective Studies, Transplantation, SARS-CoV-2, MORTALITY, Rehabilitation, COVID-19, mental health outcomes, survive, Organ Transplantation, Original Clinical Science—General, Middle Aged, SOLID-ORGAN TRANSPLANT, Kidney Transplantation, Transplant Recipients, DIALYSIS PATIENTS, Health Care, functional, Intensive Care Units, Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], Good Health and Well Being, Nephrology, ERACODA, ERACODA Collaborators, Surgery, Management of diseases and conditions, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11]
Abstract

BACKGROUND: Kidney transplant patients are at high risk for coronavirus disease 2019 (COVID-19)-related mortality. However, limited data are available on longer-term clinical, functional, and mental health outcomes in patients who survive COVID-19.METHODS: We analyzed data from adult kidney transplant patients in the European Renal Association COVID-19 Database who presented with COVID-19 between February 1, 2020, and January 31, 2021.RESULTS: We included 912 patients with a mean age of 56.7 (±13.7) y. 26.4% were not hospitalized, 57.5% were hospitalized without need for intensive care unit (ICU) admission, and 16.1% were hospitalized and admitted to the ICU. At 3 mo follow-up survival was 82.3% overall, and 98.8%, 84.2%, and 49.0%, respectively, in each group. At 3 mo follow-up biopsy-proven acute rejection, need for renal replacement therapy, and graft failure occurred in the overall group in 0.8%, 2.6%, and 1.8% respectively, and in 2.1%, 10.6%, and 10.6% of ICU-admitted patients, respectively. Of the surviving patients, 83.3% and 94.4% reached their pre-COVID-19 physician-reported functional and mental health status, respectively, within 3 mo. Of patients who had not yet reached their prior functional and mental health status, their treating physicians expected that 79.6% and 80.0%, respectively, still would do so within the coming year. ICU admission was independently associated with a low likelihood to reach prior functional and mental health status.CONCLUSIONS: In kidney transplant recipients alive at 3-mo follow-up, clinical, physician-reported functional, and mental health recovery was good for both nonhospitalized and hospitalized patients. Recovery was, however, less favorable for patients who had been admitted to the ICU.

Published
2022

8. COVID-19-related mortality in kidney transplant and dialysis patients: results of the ERACODA collaboration

Author

Hilbrands, L. B., Duivenvoorden, R., Vart, P., Franssen, C. F. M., Hemmelder, M. H., Jager, K. J., Kieneker, L. M., Noordzij, M., Pena, M. J., de Vries, H., Arroyo, D., Covic, A., Crespo, M., Goffin, E., Islam, M., Massy, Z. A., Montero, N., Oliveira, J. P., Munoz, A. R., Sanchez, J. E., Sridharan, S., Winzeler, R., Gansevoort, R. T., van der Net, Jeroen B., Marie, Essig, Peggy W, G du Buf-Vereijken, Betty van Ginneken, Nanda, Maas, Liffert, Vogt, van Jaarsveld, Birgit C., Bemelman, Frederike J., Farah, Klingenberg-Salahova, Frederiek, Heenan-Vos, Vervloet, Marc G., Azam, Nurmohamed, Daniel, Abramowicz, Sabine, Verhofstede, Omar, Maoujoud, Jana, Fialova, Edoardo, Melilli, Alex, Favà, Cruzado, Josep M., Joy, Lips, Maaike, Hengst, Ryszard, Gellert, Andrzej, Rydzewski, Alferes, Daniela G., Ivan, Rychlik, Zakharova, Elena V., Patrice Max Ambuehl, Fanny, Lepeytre, Clémentine, Rabaté, Guy, Rostoker, Sofia, Marques, Tijana, Azasevac, Dajana, Katicic, Marc ten Dam, Thilo, Krüger, Susan J, J Logtenberg, Lutz, Fricke, L van Zanen, A, Jeroen J, P Slebe, Delphine, Kemlin, Jacqueline van de Wetering, Jaromir, Eiselt, Lukas, Kielberger, El-Wakil, Hala S., Samar Abd ElHafeez, Christina, Canal, Carme, Facundo, Ramos, Ana M., Alicja, Debska-Slizien, Nicoline M, H Veldhuizen, Stylianos, Panagoutsos, Irina, Matceac, Ionut, Nistor, Monica, Cordos, J H, M Groeneveld, Marjolijn van Buren, Fritz, Diekmann, Ferreira, Ana C., Augusto Cesar, S. Santos Jr., Carlos, Arias-Cabrales, Laura, Llinàs-Mallol, Anna, Buxeda, Carla Burballa Tàrrega, Dolores, Redondo-Pachon, Maria Dolores Arenas Jimenez, Hofstra, Julia M., Antonio, Franco, Rodríguez-Ferrero, María L., Sagrario Balda Manzanos, Gabriel de Arriba, Haridian Sosa Barrios, R., Karlijn, Bartelet, Erol, Demir, Daan A M, J Hollander, Angele, Kerckhoffs, Stefan, Büttner, Aiko P, J de Vries, Soufian, Meziyerh, Danny van der Helm, Marlies, Reinders, Hanneke, Bouwsma, Kristina, Petruliene, Sharon, Maloney, Iris, Verberk, Marina Di Luca, Tuğlular, Serhan Z., Charles, Beerenhout, Luik, Peter T., Julia, Kerschbaum, Martin, Tiefenthaler, Bruno, Watschinger, Adema, Aaltje Y., Stepanov, Vadim A., Zulkarnaev, Alexey B., Kultigin, Turkmen, Bonucchi, Decenzio, Anselm, Fliedner, Hitoshi, Miyasato, Anders, Åsberg, Geir, Mjoen, Stefano, Pini, Consuelo de Biase, Anne Els van de Logt, Rutger, Maas, Olga, Lebedeva, Veronica, Lopez, Louis J, M Reichert, Jacobien, Verhave, Denis, Titov, Parshina, Ekaterina V., Liesbeth E, A van Gils-Verrij, Charlotte J, R de Bruin, Harty, John C., Marleen, Meurs, Marek, Myslak, Yuri, Battaglia, Paolo, Lentini, Edwin den Deurwaarder, Hormat, Rahimzadeh, Marcel, Schouten, Cabezas-Reina, Carlos J., Anabel, Diaz-Mareque, Armando, Coca, Björn K, I Meijers, Maarten, Naesens, Dirk, Kuypers, Bruno, Desschans, Annelies, Tonnerlier, Wissing, Karl M., Ivana, Dedinska, Giuseppina, Pessolano, van der Sande, Frank M., Maarten H, L Christiaans, Ilaria, Gandolfini, Umberto, Maggiore, Nada, Kanaan, Laura, Labriola, Arnaud, Devresse, Shafi, Malik, Berger, Stefan P., Esther, Meijer, Sanders, Jan Stephan F., Jadranka Buturović Ponikvar, Abrahams, Alferso C., Molenaar, Femke M., van Zuilen, Arjan D., S C, A Meijvis, Helma, Dolmans, Luca, Zanoli, Carmelita, Marcantoni, Esposito, Pasquale, Jean-Marie, Krzesinski, Jean Damacène Barahira, Maurizio, Gallieni, Gianmarco, Sabiu, Paloma Leticia Martin-Moreno, Gabriele, Guglielmetti, Gabriella, Guzzo, Luik, Antinus J., Willi H, M van Kuijk, Lonneke W, H Stikkelbroeck, Hermans, Marc M. H., Laurynas, Rimsevicius, Marco, Righetti, Nicole Heitink-ter Braak, UCL - SSS/IREC/NEFR - Pôle de Néphrologie, UCL - (SLuc) Service de néphrologie, Groningen Kidney Center (GKC), Cardiovascular Centre (CVC), Clinical sciences, Nephrology, Medical Informatics, ACS - Pulmonary hypertension & thrombosis, APH - Aging & Later Life, APH - Global Health, and APH - Quality of Care

Subjects
Male, Databases, Factual, Kidney Failure, Chronic/mortality, medicine.medical_treatment, 030232 urology & nephrology, Waiting Lists/mortality, Kidney Failure, 0302 clinical medicine, Risk Factors, Epidemiology, Kidney Transplantation/mortality, 80 and over, Medicine, 030212 general & internal medicine, Prospective Studies, Chronic, Prospective cohort study, Kidney transplantation, Aged, 80 and over, Renal Dialysis/mortality, SARS-CoV-2/isolation & purification, Hazard ratio, Age Factors, Middle Aged, Prognosis, Europe, Survival Rate, Nephrology, COVID-19, Dialysis, Kidney, Mortality, Transplantation, Adult, Aged, Female, Humans, Kidney Failure, Chronic, Kidney Transplantation, Renal Dialysis, SARS-CoV-2, Waiting Lists, Hemodialysis, medicine.medical_specialty, kidney, Europe/epidemiology, 03 medical and health sciences, Databases, All institutes and research themes of the Radboud University Medical Center, Internal medicine, AcademicSubjects/MED00340, Survival rate, Factual, COVID-19/chemically induced, business.industry, Original Articles, medicine.disease, mortality, Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], dialysis, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business, transplantation
Abstract

Background. Patients on kidney replacement therapy comprise a vulnerable population and may be at increased risk of death from coronavirus disease 2019 (COVID-19). Currently, only limited data are available on outcomes in this patient population. Methods. We set up the ERACODA (European Renal Association COVID-19 Database) database, which is specifically designed to prospectively collect detailed data on kidney transplant and dialysis patients with COVID-19. For this analysis, patients were included who presented between 1 February and 1 May 2020 and had complete information available on the primary outcome parameter, 28-day mortality. Results. Of the 1073 patients enrolled, 305 (28%) were kidney transplant and 768 (72%) dialysis patients with a mean age of 60 ± 13 and 67 ± 14 years, respectively. The 28-day probability of death was 21.3% [95% confidence interval (95% CI) 14.3–30.2%] in kidney transplant and 25.0% (95% CI 20.2–30.0%) in dialysis patients. Mortality was primarily associated with advanced age in kidney transplant patients, and with age and frailty in dialysis patients. After adjusting for sex, age and frailty, in-hospital mortality did not significantly differ between transplant and dialysis patients [hazard ratio (HR) 0.81, 95% CI 0.59–1.10, P = 0.18]. In the subset of dialysis patients who were a candidate for transplantation (n = 148), 8 patients died within 28 days, as compared with 7 deaths in 23 patients who underwent a kidney transplantation Conclusions. The 28-day case-fatality rate is high in patients on kidney replacement therapy with COVID-19 and is primarily driven by the risk factors age and frailty. Furthermore, in the first year after kidney transplantation, patients may be at increased risk of COVID-19-related mortality as compared with dialysis patients on the waiting list for transplantation. This information is important in guiding clinical decision-making, and for informing the public and healthcare authorities on the COVID-19-related mortality risk in kidney transplant and dialysis patients.

Published
2020
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9. Endothelial dysfunction as an early marker for cardiovascular disease in patients with chronic kidney disease on maintenance hemodialysis: its relation with serum magnesium level.

Author

Abo Alia, Mona M. S. A. E., El-Wakil, Hala S., Zeid, Abla A. Abou, Ahmad, Lamia I., Emara, Doaa M., and Mohamed, Ragaa R.

Subjects
*ENDOTHELIUM diseases, *CARDIOVASCULAR diseases, *KIDNEY disease treatments, *HEMODIALYSIS, *CAROTID intima-media thickness
Abstract

Background Cardiovascular disease is a major cause of mortality in dialysis patients. Magnesium (Mg) level has been found to correlate positively with endothelial function. Moreover, it is suggested that low Mg is associated with increased all-cause and cardiovascular mortality in hemodialysis (HD) patients. Objective Therefore, this study was conducted to define the relationship between Mg level and endothelial dysfunction as an early marker of cardiovascular disease in patients with end-stage renal disease (ESRD) on maintenance HD. Patients and methods In this cross-sectional study, 85 patients with ESRD on maintenance HD were included. Serum angiopoietin-2 (Ang-2) level, brachial flow-mediated dilation (BFMD), and carotid intima-media thickness (CIMT) were measured as indicators of endothelial dysfunction and atherosclerosis. Patients' serum Mg levels were measured. All data are presented as mean and SD or percent frequency. Statistical tests, mainly t test, Mann-Whitney test, or X2 test, are used in comparison between groups for quantitative and qualitative data correspondingly. Results Our results indicate that Ang-2 and BFMD are associated and can predict atherosclerosis early in HD patients (P=0.036 and 0.006, respectively). When the patients were divided according to their serum Mg, there was no significant difference regarding Ang-2, BFMD, and CIMT between the two groups. Conclusion This study demonstrated that endothelial dysfunction markers such as Ang-2 and BFMD are associated and can predict atherosclerosis early in HD patients. On the contrary, Mg might not affect neither endothelial function (FMD and Ang-2) nor CIMT as a marker of atherosclerosis in ESRD on HD. [ABSTRACT FROM AUTHOR]

Published
2021
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10. Renin-Angiotensin System Blockers and the Risk of COVID-19–Related Mortality in Patients with Kidney Failure

Author

Soler, Maria Jose, Noordzij, Marlies, Abramowicz, Daniel, de Arriba, Gabriel, Basile, Carlo, van Buren, Marjolijn, Covic, Adrian, Crespo, Marta, Duivenvoorden, Raphaël, Massy, Ziad A., Ortiz, Alberto, Sanchez, J. Emilio, Petridou, Emily, Stevens, Kate, White, Colin, Vart, Priya, Gansevoort, Ron T., van der Net, Jeroen B., Essig, Marie, du Buf-Vereijken, Peggy W.G., van Ginneken, Betty, Maas, Nanda, Vogt, Liffert, van Jaarsveld, Brigit C., Jager, Kitty J., Bemelman, Frederike J., Klingenberg-Salahova, Farah, Heenan-Vos, Frederiek, Vervloet, Marc G., Nurmohamed, Azam, Verhofstede, Sabine, Maoujoud, Omar, Malfait, Thomas, Fialova, Jana, Melilli, Edoardo, Favà, Alexandre, Cruzado, Josep M., Perez, Nuria Montero, Lips, Joy, Krepel, Harmen, Adilovic, Harun, Hengst, Maaike, Rydzewski, Andrzej, Gellert, Ryszard, Oliveira, João, Alferes, Daniela G., Zakharova, Elena V., Ambuehl, Patrice Max, Winzeler, Rebecca, Lepeytre, Fanny, Rabaté, Clémentine, Rostoker, Guy, Marques, Sofia, Azasevac, Tijana, Katicic, Dajana, Dam, Marc ten, Krüger, Thilo, Brzosko, Szymon, van Zanen, A.L., Logtenberg, Susan J.J., Fricke, Lutz, Slebe, Jeroen J.P., Kemlin, Delphine, van de Wetering, Jacqueline, Reinders, Marlies E.J., Eiselt, Jaromir, Kielberger, Lukas, El-Wakil, Hala S., ElHafeez, Samar Abd, Canal, Cristina, Facundo, Carme, Ramos, Ana M., Debska-Slizien, Alicja, Veldhuizen, Nicoline M.H., Panagoutsos, Stylianos, Matceac, Irina, Nistor, Ionut, Cordos, Monica, Groeneveld, J.H.M, Jousma, Jolanda, Diekmann, Fritz, Pereira, Tiago Assis, Santos, Augusto Cesar S., Arias-Cabrales, Carlos, Llinàs-Mallol, Laura, Buxeda, Anna, Tàrrega, Carla Burballa, Redondo-Pachon, Dolores, Arenas Jimenez, Maria Dolores, Hofstra, Julia M., Franco, Antonio, Arroyo, David, Rodríguez-Ferrero, Maria Luisa, Manzanos, Sagrario Balda, Sosa Barrios, R. Haridian, Lemahieu, Wim, Bartelet, Karlijn, Dirim, Ahmet Burak, Demir, Erol, Sever, Mehmet Sukru, Turkmen, Aydin, Hollander, Daan A.M.J., Büttner, Stefan, de Vries, Aiko P.J., Meziyerh, Soufian, van der Helm, Danny, Mallat, Marko, Bouwsma, Hanneke, Sridharan, Sivakumar, Petruliene, Kristina, Maloney, Sharon-Rose, Verberk, Iris, van der Sande, Frank M., Christiaans, Maarten H.L., Hemmelder, Marc, Di Luca, Marina, Tuğlular, Serhan Z., Beerenhout, Charles, Luik, Peter T., Kerschbaum, Julia, Tiefenthaler, Martin, Watschinger, Bruno, Adema, Aaltje Y., Stepanov, Vadim A., Zulkarnaev, Alexey B., Turkmen, Kultigin, Fliedner, Anselm, Åsberg, Anders, Mjoen, Geir, Miyasato, Hitoshi, de Fijter, Carola W.H., Pini, Stefano, de Biase, Consuelo, Hilbrands, Luuk, Kerckhoffs, Angele, van de Logt, Anne Els, Maas, Rutger, Lebedeva, Olga, Lopez, Veronica, Reichert, Louis J.M., Verhave, Jacobien, Titov, Denis, Parshina, Ekaterina V., Zanoli, Luca, Marcantoni, Carmelita, van Gils-Verrij, Liesbeth E.A., Harty, John C., Meurs, Marleen, Myslak, Marek, Battaglia, Yuri, Lentini, Paolo, den Deurwaarder, Edwin, Stendahl, Maria, Rahimzadeh, Hormat, Schouten, Marcel, Rychlik, Ivan, Cabezas-Reina, Carlos J., Roca, Ana Maria, Nauta, Ferdau, Goffin, Eric, Kanaan, Nada, Labriola, Laura, Devresse, Arnaud, Diaz-Mareque, Anabel, Coca, Armando, Meijers, Björn K.I., Naesens, Maarten, Kuypers, Dirk, Desschans, Bruno, Tonnerlier, Annelies, Wissing, Karl M., Dedinska, Ivana, Pessolano, Giuseppina, Gandolfini, Ilaria, Maggiore, Umberto, Malik, Shafi, Papachristou, Evangelos, Franssen, Casper F.M., Berger, Stefan P., Meijer, Esther, Sanders, Jan Stephan F., Ponikvar, Jadranka Buturović, Pernat, Andreja Marn, Kovac, Damjan, Arnol, Miha, Ekart, Robert, Abrahams, Alferso C., Molenaar, Femke M., van Zuilen, Arjan D., Meijvis, Sabine C.A., Dolmans, Helma, Esposito, Pasquale, Krzesinski, Jean-Marie, Barahira, Jean Damacène, Gallieni, Maurizio, Martin-Moreno, Paloma Leticia, Guglielmetti, Gabriele, Guzzo, Gabriella, Luik, Antinus J., van Kuijk, Willi H.M., Stikkelbroeck, Lonneke W.H., Hermans, Marc M.H., Rimsevicius, Laurynas, Righetti, Marco, Islam, Mahmud, and Braak, Nicole Heitink-ter

Published
2021
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15. Application of adult worm and lung-stage antigens to immunize against Schistosoma mansoni using cytokines as adjuvants.

Author

Afifi MA, El-Wakil HS, Abdel-Ghaffar MM, and Mohamed RT

Subjects
Animals, Antibodies, Helminth biosynthesis, Antibodies, Helminth blood, Female, Immunity, Cellular, Parasite Egg Count, Random Allocation, T-Lymphocytes, Antigens, Helminth immunology, Interferon-gamma immunology, Interleukin-4 immunology, Schistosoma mansoni immunology, Schistosomiasis mansoni prevention & control, Vaccination
Abstract

Different Schistosoma mansoni antigens; adult worm antigen (SWAP) and lung-stage antigen (SLAP) together with different cytokine adjuvants (Interferon-gamma and Interleukin-4) were used to immunize mice against. S. mansoni. Immunization program was directed towards the production of an intense immune response together with balanced T-helper1 and T-helper2 immune responses. The goal of immunization was not only to protect from infection but also to modulate the pathology inflicted by the parasite. Parameters like adult load, egg counts, anti-Schistosoma antibody titers and liver pathology were used to evaluate the different immunization scheme. SLAP antigen has proven to be a better antigen not only in protection but also in pathology modulation. SLAP plus IFN-gamma as an adjuvant was the best immunization regimen with almost 50% protection and a remarkable resolving of parasite pathology. Unexpectedly, IL-4 had a weak but observed adjuvant protective effect. The results is a step in the path for a Schistosoma vaccine that guides the immune system towards a balanced response targeting the pathology induced by the parasite rather than the parasite itself.

Published
2006

16. Molecular characterization of Egyptian Giardia lamblia isolates.

Author

Mohamed NH, Salama MM, Moustafa MA, El-Wakil HS, Mohareb EW, and Thabet HS

Subjects
Animals, Electrophoresis, Cellulose Acetate, Electrophoresis, Polyacrylamide Gel methods, Genotype, Giardia lamblia classification, Giardia lamblia enzymology, Giardiasis parasitology, Molecular Weight, Phenotype, Random Amplified Polymorphic DNA Technique methods, Giardia lamblia genetics, Giardiasis diagnosis
Abstract

Six Giardia lamblia strains (4 from Egypt, one from the USA and one from Sudan) were used to study the phenotypic and genotypic variation in some Egyptian G. lamblia strains compared to other G. lamblia strains, which may be responsible for the difference in their behavioral characteristics. By using SDS-PAGE for antigenic study, E1 strain appeared different from the rest of the strains with two bands; one at 121 Kda and the other at 34 Kda which were not present in other strains, while bands at 130 and 43 Kda were present in all strains but absent in E1 strain. Another difference between E1 strain and the rest of the strains was obtained by CAE, using PGM enzyme where E1 strain gave a different zymodeme than the other strains. Based on the computerized RAPD- PCR analysis, 4 rapdemes were identified; rapdeme 1 contained E1 strain, rapdeme 2 contained E2, E3 and E4 isolates, rapdeme 3 contained Sudan strain and rapdeme 4 contained USA strain. In conclusion this study revealed diversity between G. lamblia strains especially E1 strain which showed unique characters.

Published
2004

17. Characterization of three types of Schistosoma mansoni soluble egg antigen and determination of their immunodiagnostic potential by western blot immunoassay.

Author

Hussein HM, el-Gindy IM, Abdel-Hamid DM, el-Wakil HS, and Maher KM

Subjects
Adolescent, Adult, Aged, Animals, Blotting, Western, Cell Fractionation, Child, Cross Reactions immunology, Echinococcosis immunology, Egg Proteins isolation & purification, Electrophoresis, Polyacrylamide Gel, Fascioliasis immunology, Female, Humans, Immune Sera immunology, Male, Middle Aged, Ovum chemistry, Ovum immunology, Schistosomiasis mansoni immunology, Sensitivity and Specificity, Serologic Tests methods, Egg Proteins immunology, Schistosoma mansoni immunology, Schistosomiasis mansoni diagnosis
Abstract

On the search of highly sensitive and specific antigenic components for use in serological tests, the serologic activities of the various protein fractions of three types of Schistosoma mansoni soluble egg antigen (SEA) were compared in an immunoblot analysis for their ability to detect schistosomiasis mansoni infections . Three types of soluble egg antigen (SEA) were prepared from three suspensions of Schistosoma mansoni eggs; namely living SEA (L-SEA), dead SEA (D-SEA) and mixed SEA (M-SEA). The three antigens were resolved by sodium dodecyl sulphate polyacrylamide gel electrophoresis. A total of 80 Egyptian individuals were enrolled in the present study. After being screened by clinical examination, urine and stool analysis, sigmoidoscopy rectal snip examination, abdominal ultrasonography and indirect haemagglutination test (IHAT), the study population were grouped into an active intestinal schistosomiasis group (group I, n=20), a schistosomiasis seropositive group by IHA test (group II, n=20), a parasite control group including 10 patients with hydatidosis & 10 patients with fascioliasis (group III, n = 20) and a normal control group (group IV, n=20). Sera of all subjects were studied by immunoblotting for the presence of IgG antibodies against the various protein fractions of the three prepared types of SEA. Several protein bands from the 3 types of SEA reacted with the schistosomiasis patients' sera in a heterogenous manner. However, a 31-32 kilo daltons (kDa) protein fraction of L-SEA reacted with 80% (16/20) of group I sera, 40% (8/20) of group II sera, one hydatidosis serum, but no reaction occurred with normal sera. Also, in the active intestinal schistosomiasis group, the 31-32 kDa fraction of L-SEA was more recognized by patients with early active intestinal schistosomiasis without organomegaly (100%, 12/12) than in those with organomegaly (50%, 4/8) (P < 0.05). On the other hand, a 80-82 kDa band of M-SEA was recognized by 70% (14/20) of group 1, 30% (6/20) of group II & sera from 3 hydatidosis and 2 fascioliasis cases, but not by normal human sera. So, it can be concluded that the 31-32 kDa protein fraction of L-SEA is highly immunogenic, with the least cross reaction with other parasitic infections, and may be a useful serologic marker for diagnosing and differentiating between early and chronic schistosomiasis mansoni infection.

Published
2004

18. Effect of schistosoma mansoni egg deposition on multiple low doses streptozotocin induced insulin dependent diabetes.

Author

El-Wakil HS, Aboushousha TS, El Haddad O, Gamil NB, Mansour T, and El-Said H

Subjects
Animals, Diabetes Mellitus, Experimental chemically induced, Diabetes Mellitus, Experimental pathology, Diabetes Mellitus, Type 1 chemically induced, Diabetes Mellitus, Type 1 pathology, Dose-Response Relationship, Immunologic, Female, Islets of Langerhans pathology, Mice, Mice, Inbred C57BL, Parasite Egg Count, Schistosomiasis mansoni complications, Diabetes Mellitus, Experimental prevention & control, Diabetes Mellitus, Type 1 prevention & control, Schistosoma mansoni physiology, Schistosomiasis mansoni immunology, Streptozocin
Abstract

To explore the role of Schistosoma mansoni infection in the prevention of autoimmune mediated insulin dependant diabetes mellitus, we examined the effects of multiple low doses of the pancreatic islets beta cell toxin, streptozotocin (STZ) 40mg/kg body weight i.p., given 8 weeks post infection, period of S. mansoni egg deposition, on S. mansoni infected C57BL/6J mice, in comparison to non-infected STZ given group. Mice treated with STZ (G III) became gradually hyperglycemic reaching highest level on days 17 post STZ with mean blood glucose level of 334.9 +/- 14.9 vs 130.3 +/- 9.2 mg/dl in control group (G IV). S. mansoni infection (G II) significantly reduced the elevation in blood glucose levels from days 7 post STZ onwards reaching 224mg/dl +/- 12.7 on days 17 (P < .0.001). Morphologic examination of pancreas on day 21 post STZ, revealed that the non-infected STZ (G III) given mice had significantly smaller mean islets area (5,060.51 mu2 +/- 1,567.28) and significantly fewer mean number of beta cells/islets (76.23 +/- 19.18) than the infected STZ given group (G II) which had mean islets area (9,305. 3l mu2 +/- 3,277.59) and 116.75 +/- 27.27 beta-cells/islets. Pancreatic tissue revealed also focal degeneration in the cells of islets of Langrhans in the non-infected STZ given mice (G III), in comparison, to the infected STZ given group (G II). which had much less evident cells degeneration. These findings revealed that S. mansoni egg deposition which leads to a shift from Th1 (IFN-gamma mainly) to Th2 (IL4, IL5, IL10 and TGF-beta cytokine profiles causes down-regulation of the Th1 cell mediated autoimmune insulin dependant diabetes mellitus (IDDM). On the other hand, S. mansoni eggs excretions were significantly lower in the infected STZ given group (G II) than the infected group (G I). This finding may be the result of impaired maturation of egg in diabetic mice. It is concluded that the modulation of immune response in S. mansoni infected mice with S. mansoni egg deposition, can suppress the autoimmune type 1 insulin dependant diabetes mellitus induced by multiple low doses streptozotocin.

Published
2002

19. A preliminary study on the relationship between Trichomonas vaginalis and cervical cancer in Egyptian women.

Author

Sayed el-Ahl SA, el-Wakil HS, Kamel NM, and Mahmoud MS

Subjects
Adult, Animals, Blotting, Western, Egypt, Female, Humans, Middle Aged, Risk Factors, Trichomonas Vaginitis immunology, Adenocarcinoma parasitology, Antibodies, Protozoan blood, Carcinoma, Squamous Cell parasitology, Trichomonas Vaginitis complications, Trichomonas vaginalis immunology, Uterine Cervical Neoplasms parasitology
Abstract

The relationship between Trichomonas vaginalis and cancer cervix was investigated by detection of T. vaginalis antibodies, in the sera of 48 invasive cervical cancer patients and 100 random age matched female control, using western immunoblot technique. It was found that antibodies to T. vaginalis were detected in sera of 18.75% (9/48) of cervical cancer patients compared with 5% (5/100) of controls. The increase was evident in age group, 40-49 years (21.05% vs 5%) and of those with squamous cell carcinoma (6/9) and mainly with grade II & III. All the reactive sera of invasive cancer patients reacted strongly with T. vaginalis surface antigen of about (109.9, 86.1, 56.2, 48.2 and 30 Kda). So, there may be an association between T. vaginalis and the risk of cervical cancer, as there was more than 3 fold increase in the prevalence of T. vaginalis antibodies in patients with invasive cervical cancer compared to age matched female controls. This study highlights the importance of clinically detection of T. vaginalis infection, which is one of the group of factors involved in the genesis and progression of cervical cancer. In addition, its treatment would aid in restricting the rising incidence of this dreaded disease.

Published
2002

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