Egyptian Hemodialysis Patients Research Articles

Monitoring the Seroprevalence of Herpes Simplex Virus-1 Among Egyptian Hemodialysis Patients

Background: Hemodialysis patients are at high risk for infections due to their compromised immune systems. Herpes Simplex Virus (HSV) infections can lead to severe complications in this population. Despite its clinical significance, comprehensive data on the seroprevalence of HSV among hemodialysis patients are limited. Objective: This study aims to evaluate the seroprevalence of HSV-1 among Egyptian hemodialysis patients. Methods: A cross-sectional study was conducted with 218 participants (116 females and 102 males). Among these, 132 (60.6%) were undergoing hemodialysis, while 86 (39.4%) had normal kidney function and were free from HCV, CMV, and HIV infections. Serum samples were analyzed for IgG antibodies against HSV-1. Statistical analyses were performed to determine HSV seroprevalence. Results: The study observed a significantly higher prevalence of HSV-1-IgG antibodies in hemodialysis patients (84.1%) compared to the control group (66.3%, P<0.01). Additionally, HSV-1-IgM positivity was also higher in the hemodialysis group (41.6%) compared to the control group (32.6%, P<0.05). These findings highlight the need for vigilant monitoring and preventive strategies for HSV infections in hemodialysis patients.

Malnutrition among Egyptian hemodialysis patients: prevalence and risk factors

Background Malnutrition commonly affects hemodialysis (HD) patients. Malnourished HD patients have increased morbidity and mortality. We aimed to assess the prevalence and risk factors of malnutrition among Egyptian hemodialysis patients. Material and methods This is a cross-sectional study carried out on ESRD patients with regular HD. All participants were subjected to detailed history taking and complete physical examination. Assessment of nutritional status was done using subjective global assessment (SGA). Anthropometric measures included mid-arm circumference (MAC), triceps skin fold (TSF), and body mass index (BMI) assessment. Results One hundred thirty patients with a mean age of 55.2 ± 12.6 years, completed the study. The mean duration of HD was 4.51 ± 3.68 years. The mean SGA was 12.1 ± 3.9. Malnutrition was present in 34 (26.2%) patients [mild to moderate (23.8%), severe (2.4%)]. Patients had a mean BMI of 25.69 ± 4.5 kg/m2, a mean MAC of 25.9 ± 4.9 cm, and a mean TSF of 18.1 ± 8.9 mm. There was a significant negative correlation between malnutrition and mid arm circumference and serum Na with P value of 0.003 and 0.012, respectively. Patients with malnutrition had a significantly longer duration on HD (P=0.004), lower Kt/V (P=0.040), lower serum albumin (P=0.007), lower BMI (P=0.002), less MAC (P=0.002), less TSF (P=0.002). Conclusions Malnutrition is common in HD patients with a significant inverse correlation with mid arm circumference and serum Na. Malnourished patients had a longer duration on HD, lowered serum albumin, BMI, dialysis adequacy and anthropometric measures.

Short versus long-acting erythropoiesis-stimulating agents for anemia management in Egyptian hemodialysis patients.

Chronic kidney disease (CKD) often results in renal anemia, impacting the well-being of patients and causing various negative consequences. Erythropoiesis-stimulating agents (ESAs) offer promising solutions for managing anemia in CKD. This study aimed to evaluate and compare the effectiveness, safety profile, and cost-effectiveness of short-acting (Eprex®) and long-acting (Aranesp®) ESAs. This comparative prospective cohort cost-effectiveness study was carried out over 6 months among adult Egyptian hemodialysis patients of either gender. Participants were categorized into two groups based on the type of ESA administered: the Eprex group, receiving epoetin alfa, and the Aranesp group, receiving darbepoetin alfa. These two treatment groups' efficacy, safety, and cost were analyzed and compared. Of 127 hemodialysis patients, 60 (47.2%) received Eprex, while 67 (52.8%) were treated with Aranesp. Target hemoglobin (Hb) was achieved by 50.6% of patients in the Eprex group versus 63.4% in the Aranesp group, with a significant difference (P < 0.001). Both treatment groups exhibited a similar safety profile, while Aranesp® was considered the cost-saving protocol. In hemodialysis Egyptian patients, Aranesp with extended dosing intervals proved to be more effective in achieving target Hb with comparable adverse effect profiles, a substantial cost-saving strategy, and offered time-saving advantages for medical staff workload compared to Eprex. The Clinicaltrial.gov registration ID is NCT05699109 (26/01/2023).

Post-COVID anxiety, depression, and quality of life among Egyptian hemodialysis patients.

This study examined the impact of Coronavirus disease 2019 on anxiety, depression, and health-related quality of life (HRQOL) among Egyptian hemodialysis (HD) patients. This multicenter cross-sectional study was carried out in Egypt in the years 2021-2022, where 300 HD patients from four HD centers were allocated into two groups: post-COVID and non-COVID. The Hospital Anxiety and Depression Scale (HADS) and the Kidney Disease QOL-36 questionnaire were used to assess anxiety, depression, and QOL of the included patients. In the post-COVID group, abnormal and borderline cases of anxiety and depression were detected in 38.6% and 62.5% of patients, respectively, with no statistically significant difference between both groups. The post-COVID group showed higher work status and lower sexual and physical functioning, which correlated negatively with anxiety and depression scores. Past-COVID infection did not influence depression and anxiety symptoms in HD patients. Sexual and physical functioning were more affected among COVID-survivors.

Relationship of calcium-sensing receptor gene polymorphism CASR rs 1042636, CASR rs 1802757, and cinacalcet response among Egyptian hemodialysis patients with secondary hyperparathyroidism

Introduction: Secondary hyperparathyroidism (SHPT) is a common complication associated with morbidity and mortality among hemodialysis (HD) patients. Objectives: The current study aims to evaluate the frequency of CASR gene polymorphism variants related to parathyroid hormone (PTH) regulation (CASR rs1042636 and CASR rs1802757) and to test the hypothesis that single nucleotide polymorphisms (SNPs) in the CASR gene alter the response to cinacalcet among Egyptian HD patients with SHPT. Patients and Methods: A case-control study that included 50 HD patients with intact parathyroid hormone (iPTH) ≥300 pg/mL treated with cinacalcet for a 6-month duration and 40 healthy volunteers as a control group. Eligible patients were recruited from Ain Shams university hospitals. Blood samples were collected from patients and controls to assess allele frequencies of CASR gene polymorphism variants using real-time polymerase chain reaction (PCR), corrected calcium (Ca), phosphorus (P), Ca×P product, iPTH level, and alkaline phosphatase before and after treatment. HD patients were categorized into two groups based on the reduction percentage; responders’ patients (iPTH ≥20%) and non-responders to cinacalcet treatment. Results: Of 50 HD patients, 48 (96%) carried the rs1042636 AA wild gene, while only two (4%) carried the rs1042636 AG mutant gene, 42 (87.5%) carried the rs1802757 CC wild genotype, and 6 (12.5%) carried the CT mutant genotype. The minor alleles T and G were (6.3% and 2%) respectively, with no statistically significant difference between the patient and control groups regarding the CASR genotypes or alleles distribution. There was no significant difference between responders and non-responder’s patient groups regarding CASR genotypes or allele frequencies. Moreover, no significant correlation between CASR genotypes or alleles to delta change of Ca, P, Ca×P product, or PTH was seen. However, CASR rs1802757 CT mutant genotype was associated with a significant reduction in alkaline phosphatase levels after treatment. Conclusion: There is no significant association between the gene polymorphism CASR rs1042636 or CASR rs1802757 and the reduction in PTH levels as a response to cinacalcet treatment among Egyptian HD patients with SHPT.

Concordance between muscle mass assessed by bioelectrical impedance analysis and by muscle ultrasound: a cross-sectional study in a cohort of patients on chronic hemodialysis

BackgroundSarcopenia is a common problem in hemodialysis (HD) patients, and it is diagnosed by low muscle mass, strength and/or low physical performance. Muscle ultrasound (US) is a non-invasive portable tool that might be used for assessment of muscle mass. The aim of the current study was to investigate the concordance between muscle US and bioelectrical impedance analysis (BIA) in diagnosis of sarcopenia in HD patients.MethodsThis cross-sectional study included 41 HD patients. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People (EWGSOP). The skeletal mass index was measured by BIA and the muscle strength was measured by handgrip strength. Muscle US was used to measure cross-sectional area (CSA) and thickness of quadriceps and biceps muscles.ResultsThe current study included 41 patients on HD (25 males), with a mean (SD) age of 44.18 (13.11) years and a median HD duration of 48 months. Sarcopenia was diagnosed in 58.5% of the patients. Patients with sarcopenia had significantly lower quadriceps muscle CSA than those without sarcopenia. The optimal cut-offs of quadriceps muscle CSA for both males and females for the diagnosis of sarcopenia were 2.96 and 2.92 cm2, respectively.ConclusionSarcopenia is prevalent among Egyptian HD patients. US on quadriceps muscle CSA could be used for diagnosis of sarcopenia in these patients.

Studies on Hepatitis B and D Viruses Co-Infection in Egyptian Hemodialysis Patients

Studies on Hepatitis B and D Viruses Co-Infection in Egyptian Hemodialysis Patients

Relation between Soluble CD14 Levels, Inflammation, Subclinical Atherosclerosis and Mortality in Hemodialysis Patients.

Chronic kidney disease (CKD) is characterized by persistent lowgrade inflammation. Soluble CD14 (sCD14) is involved in many pathological conditions, including inflammation and atherosclerosis. The present study aimed to assess the relationship between sCD14 levels, subclinical atherosclerosis (SCA), inflammation and mortality in Egyptian hemodialysis (HD) patients. The present longitudinal study included 62 HD patients. All patients were submitted to careful history taking, thorough clinical examination and laboratory assessment for high-sensitivity C-reactive protein (hsCRP) and sCD14. Carotid intima-media thickness (CIMT) was also assessed. Patients were followed for a maximum of 18 months. The primary outcome is patients' mortality. Data were statistically analyzed using standard descriptive, comparative, correlative and regression methods. The present study was conducted on 62 HD patients. They comprised 34 males and 28 females with an age of 54.6 ± 9.0 years. At the end of follow-up, 12 patients (19.4 %) died. It was shown that survivors had significantly lower hsCRP levels (104.2 ± 38.2 versus 134.1 ± 15.3 mg/dL, p < 0.001), lower sCD14 levels (32.7 ± 10.3 versus 47.4 ± 18.4 μg/mL, p = 0.02) and lower CIMT (1.32 ± 0.5 versus 1.5 ± 0.2 mm, p = 0.049). sCD14 levels were significantly correlated with hsCRP (r = 0.4, p = 0.001) and CIMT (r = 0.31, p = 0.013). Multivariate analysis identified HD duration [HR (95% CI): 1.02 (1.0-1.04), p = 0.021] and sCD14 levels [HR (95% CI): 1.06 (1.0-1.12), p = 0.026] as significant predictors of patients' survival. sCD14 levels in this cohort of HD patients are well-correlated with hsCRP levels and CIMT. In addition, they are significant predictors of patients' mortality.

Effect of Ramadan fasting on chronic inflammation markers and gut bacterial endotoxins among Egyptian hemodialysis patients.

Chronic kidney disease (CKD) is associated with a state of chronic inflammation. This study aimed to investigate effects of Ramadan fasting on the markers of chronic inflammation and gut bacterial endotoxin levels in maintenance hemodialysis. A prospective self-controlled observational study included 45 patients. Serum levels of High Sensitive CRP (hsCRP), indoxyl sulfate, and trimethylamine-n-levels were measured within a week before and a week after Ramadan fasting. Twenty-seven patients have fasted more than 15 days (29 ± 2.2 days). The levels of high sensitive C-reactive protein (hsCRP) (median of 62 mg/L vs. 91 mg/L), trimethylamine-n-oxide (TMAO) (median of 4.5 μmoL/L vs. 17 μmoL/L), platelet-to-lymphocyte ratio (PLR) (mean of 98.9 mg/L vs. 111.8 mg/L) and neutrophil-to-lymphocyte ratio (NLR) (median of 1.56 vs. 1.59) were significantly lower after Ramadan fasting with p < 0.001, p < 0.001, p < 0.001, and p = 0.04, respectively. A beneficial effect of Ramadan fasting on levels of bacterial endotoxins and markers of chronic inflammation in hemodialysis patients was observed.

Egyptian hemodialysis patients' willingness to receive the COVID-19 vaccine booster dose: a multicenter survey

BackgroundHealth authorities have struggled to increase vaccination uptake since the COVID-19 vaccines became available. However, there have been increasing concerns about declining immunity after the initial COVID-19 vaccination with the emergence of new variants. Booster doses were implemented as a complementary policy to increase protection against COVID-19. Egyptian hemodialysis (HD) patients have shown a high rate of hesitancy to COVID-19 primary vaccination, yet their willingness to receive booster doses is unknown. This study aimed to assess COVID-19 vaccine booster hesitancy and its associated factors in Egyptian HD patients.MethodsA face-to-face interview was conducted with closed-ended questionnaires distributed to healthcare workers in seven Egyptian HD centers, mainly located in three Egyptian governorates, between the 7th of March and the 7th of April 2022.ResultsAmong 691 chronic HD patients, 49.3% (n = 341) were willing to take the booster dose. The main reason for booster hesitancy was the opinion that a booster dose is unnecessary (n = 83, 44.9%). Booster vaccine hesitancy was associated with female gender, younger age, being single, Alexandria and urban residency, the use of a tunneled dialysis catheter, not being fully vaccinated against COVID-19. Odds of booster hesitancy were higher among participants who did not receive full COVID-19 vaccination and among those who were not planning to take the influenza vaccine (10.8 and 4.2, respectively).ConclusionCOVID-19 booster-dose hesitancy among HD patients in Egypt represents a major concern, is associated with vaccine hesitancy with respect to other vaccines and emphasizes the need to develop effective strategies to increase vaccine uptake.Graphical abstract

COVID-19 Vaccination Trends and Side Effects among Egyptian Hemodialysis Patients: A Multicenter Survey Study.

(1) Background: Vaccination may be a key intervention to prevent infection in chronic hemodialysis (CHD) patients. This study aimed to determine the COVID-19 vaccination status in Egyptian CHD patients and to analyze the safety and detailed side effect profile of the COVID-19 vaccine among these patients. (2) Methods: This survey-based study was conducted on 670 end-stage renal disease (ESRD) patients on CHD from 3 December 2021 to 5 February 2022. Subjects were asked about sociodemographic characteristics, clinical and therapeutic data, in addition to their COVID-19 vaccination status. If the subject had been vaccinated, we inquired about the type of vaccine and the side effects that occurred within a few days after administration of the first and second dose of the COVID-19 vaccine. Additionally, subjects were asked about the onset of side effects (days from vaccination), timing of maximum symptoms, intensity of symptoms and their effect on activity and need for medical attention. (3) Results: The study included 670 CHD patients with a mean age of 50.79 years; 58.1% were females. The vast majority (614; 91.6%) of the studied patients received two doses of the vaccine. Side effects were more commonly reported after the first dose than the second dose. The main side effects reported were generalized weakness/fatigue (56%), headache (43.8%) and fever (40.4%), and sore arm/pain was also reported (29.3%). Adverse events mostly occurred within one day after vaccination and the maximum symptoms usually happened on the second day. The median duration of symptoms was 3 days with a maximum duration up to 5 days. The univariate logistic regression analysis showed that male gender (OR 1.848; (95% CI, 1.242–2.749), p = 0.002), age (OR 0.981; (95% CI, 0.969–0.993), p = 0.003), smoking (OR 6.067; (95% CI, 3.514–10.475), p < 0.001), duration since starting HD (OR 0.998; (95% CI, 0.998–0.999), p < 0.001), associated comorbidities (OR 2.202; (95% CI, 1.478–3.281), p < 0.001) and prior COVID-19 infection (OR 3.318; (95% CI, 1.952–5.642), p < 0.001) were the main determinants of adverse events related to COVID-19 vaccination. (4) Conclusions: our preliminary findings support the favorable short-term safety profile of the COVID-19 vaccine among CHD patients, and hence can reassure both clinicians and patients, as well as further promote COVID-19 vaccine administration among these patients.

Prevalence and determinants of severity of uremic pruritus in hemodialysis patients: a multicentric study

Uremic pruritus (UP) is a common and distressing symptom in patients with advanced or end-stage renal disease under hemodialysis (HD). The present multicentric study aimed to identify prevalence and determinants...

Study of vitamin D3 level in Egyptian hemodialysis patients and the effect of replacement therapy

Background The ability of extrarenal tissues to convert 25-hydroxyvitamin D into 1,25-hydroxyvitamin D and its dependence on substrate levels provide the rationale for supplementing vitamin D in dialysis patients who usually have severe depletion of both calcitriol and vitamin D. The primary aim of the study was to detect serum vitamin D3 levels in a cohort of Egyptian hemodialysis patients and to check the effect of 12-week therapy of cholecalciferol on serum calcium, phosphate, and parathyroid hormone (PTH) in vitamin D-naïve hemodialysis patients with vitamin D deficiency. Patients and methods A total of 40 patients (25 males and 15 females) with chronic kidney disease on regular hemodialysis, attending the Nephrology Unit of internal Medicine Department, Mansoura University Hospital, during the period from January to June 2017, were included. According to laboratory investigations and clinical examination, deficient patients were treated with Devarol-S (cholecalciferol) for 3 months and then revaluated. Deficient patients received intramuscular injection of 50 000 IU monthly for 3 consecutive months. Results The patient group included 40 persons, comprising 27 (73%) male patients and 13 (27%) female patients. Their mean age was 47.16 ± 14.92 years. The mean dialysis duration was 4.68 ± 2.42 years. At 3 months after vitamin D replacement, significant increase in serum calcium (8.33–8.89 mg/dl), phosphorous (4.99–5.85 mg/dl), and vitamin D3 (4.01–28.43 ng/ml) levels were observed compared with pretreatment levels. There was also significant decrease in PTH level (419.30–377.20 pg/ml). After 3 months of follow-up, there were no significant changes in the levels of hemoglobin, Kt/v, albumin, and alkaline phosphatase in the study group. Conclusions In most patients, treatment with cholecalciferol in a 50 000 IU/month dose permits safe correction of vitamin D deficiency and control of PTH level, yet serum phosphorus should be monitored.

Self-efficacy among patients with hemodialysis during the COVID-19 pandemic.

Patients with hemodialysis face various problems with self-care behavior. Therefore, these patients need to control and manage adherence to enhance self-care, especially during the COVID-19 pandemic, which has particularly high morbidity in the elderly and co-morbid peoples. Self-efficacy was identified as a number of psychological factors that improve adherence and treatment outcomes among hemodialysis patients. This study aimed to investigate self-efficacy among patients with hemodialysis during the COVID-19 pandemic. A comparative descriptive research design was used to conduct the study. A convenience sample of 95 hemodialysis patients (male and females) was selected from Port-Said city, Egypt, and 115 hemodialysis patients (male and females) were selected from Saudi Arabia. Data collection included a structured interview with three parts assessing socio-demographic characteristics, anthropometric measurements, and self-efficacy. This study revealed a statistically significant difference between Egyptian and Saudi hemodialysis patients, mainly in the main score and levels of self-efficacy (p=0.001). There is a significant relationship between socio-demographic characteristics and chronic disease self-efficiency among Egyptian hemodialysis patients in terms of sex, age, marital status, work, and level of education.

Study of Vitamin D3 Level in Egyptian Hemodialysis Patients and The Effect of Replacement Therapy

Background: The ability of extrarenal tissues to convert 25- hydroxyvitamin D [25(OH)D] into 1,25-hydroxyvitamin D [1,25(OH)2D] and its dependence on substrate levels provide the rationale for supplementing vitamin D in dialysis patients who usually have severe depletion of both: calcitriol and vitamin D. The primary aim of the study was to detect serum Vit d3 levels in a cohort of Egyptian Hemodialysis patients and to check the effect of its replacement on serum levels serum1,25(OH)2D in hemodialysis patients with vitamin D deficiency. Secondary outcomes were changes in serum calcium, phosphate, parathyroid hormone (PTH). Patients and Methods: 40 patients (25 males and 15 females) with Chronic Kidney Disease CKD (stage V) on regular hemodialysis, attending at Nephrology unit, Internal medicine department, Mansoura University Hospital during the period from January to June 2020. Another 40 persons- Age and sex-matched was selected randomly from the medical workers and served as a control group. According to laboratory investigation and clinical examination, deficient patients were treated with Devarol-S (cholecalciferol) for 3 months and then revaluated. Deficient patients received 50000 IU monthly for 3 Consecutive months. Results: The study was carried out on 80 persons, 27 male patients (73.0%) and 13 female patients (27.0%). Their mean age was (47.16±14.92) years. The mean dialysis duration is (4.68±2.42) years, and 40 people as the control group. 3 Months after vitamin D replacement, a significant increase in serum calcium (8.33 to 8.89) mg/dL, phosphorous (4.99 to 5.85) mg/dL, and Vit D (4.01 to 28.43) ng/mL levels compared to pretreatment level. There is also a significant decrease in parathormone hormone level (419.30 to 377.20) pg/mL. After 3 months of follow-up, there was no significant change in the levels of haemoglobin, KT/v, Albumin, and alkaline phosphatase in the overall sample (p-value = 0.7, 0.4, 0.29, and 0.59, respectively). Conclusions: In most patients, treatment with cholecalciferol in a 50000 IU / month dose permits safe correction of vitamin D deficiency. It is more effective than small doses of alfacalcidol in rising serum 1,25(OH)2D. Keywords: Vitamin d level; Egyptians; Hemodialysis; Supplementation.

Assessment of human parvovirus B19 infection in Egyptian hemodialysis patients.

Parvovirus B19V has been shown to be associated with end-stage renal disease (ESRD) with increased risk of post-infection anemia, especially in hemodialysis (HD) patients. This effect may be due to immunosuppression, insufficient erythropoietin, or short lifespan of red blood cells. Therefore, parvovirus infection should be investigated in this group of patients suffering from anemia or pancytopenia. We assessed the frequency of parvovirus B19 in HD patients attending Suez Canal University Hospital and analyzed the correlation of this infection with hematological parameters in those patients compared with normal individuals. We recruited 80 ESRD patients on hemodialysis and 70 healthy controls. History-taking, full examination, and complete blood count (CBC) were performed for all study subjects. Parvovirus B19 detection was performed through polymerase chain reaction (PCR), which included the QIAamp DNA Mini Kit for extracting DNA, which was amplified using TaqMan Universal Master Mix and detected using TaqMan MGB probes by real-time PCR using Rotor Gene Analyzer (6000). HD patients had a significantly higher frequency of B19V infection than the control group (p= .02). We also found that parvovirus B19-infected HD patients had significantly lower CBC values than uninfected patients. The frequency of parvovirus B19 was significantly higher in HD patients and was associated with lower hematological parameters than in uninfected patients, suggesting a significant role of this virus in the pathogenesis of anemia and/or pancytopenia in ESRD.

Effectiveness and Safety of Ombitasvir/Paritaprevir/Ritonavir in Treatment of Chronic Hepatitis C Egyptian Hemodialysis Patients

Abstract Background prevalence of hepatitis C virus infection in patients with renal diseases is higher compared to the general population FDA has approved ombitasvir/paritaprevir/ritonavir for the treatment of patients with severe renal disease. Aim of the Work to evaluate the efficacy and safety of Ombitasvir/Paritaprevir/Ritonavir in treatment of chronic Hepatitis C Egyptian Prevelant Hemodialysis patients to compare it with the same treatment result in chronic Hepatitis C Egyptian patients with normal renal functions. Patients and methods Written informed consent was obtained from all patients participating in the study .This case-control study was conducted on one hundred patients with confirmed diagnosis of HCV positive infection at Center of National Committee for Control of Viral Hepatitis [NCCVH] at Ain Shams University Hospital. Patients were divided into two groups Group I (Control Group): 50 Chronic Hepatitis C virus patients with normal renal functions Group II (Case Group) 50 chronic Hepatitis C virus Prevelant Hemodialysis patients on regular hemodialysis. Results 95.1% of Prevelant Hemodialysis patients achieved Sustained Virological Response (SVR) while 100% of patients with normal kidney functions achieved Sustained Virological Response. Most common side effects were Hemoglobin drop, GIT disturbance, Sever fatigue and Itching. Conclusion Ombitasvir, paritaprevir, and ritonavir considered as a safe and effective in treatment in HCV infection in patients on regular hemodialysis.

POS-594 INCIDENT VERSUS PREVALENT EGYPTIAN HEMODIALYSIS PATIENTS AND THEIR MORTALITY PREDICTORS: A MULTICENTER PROSPECTIVE STUDY

The number of patients on hemodialysis (HD) increases continuously. The HD population is usually divided into early and late HD patients according to the duration of HD, which are known as incident and prevalent groups. Still, there is a debate about the exact definition of both the incident and prevalent groups. Furthermore, predictors of death of both of these groups are not yet identified, especially in Egyptian HD patients. We have aimed to compare the incident and prevalent HD patients as well as to define predictors of mortality among each of these groups.

Effectiveness and safety of ombitasvir/paritaprevir/ritonavir in treatment of chronic hepatitis C Egyptian hemodialysis patients, case-control study

BackgroundPrevalence of hepatitis C virus infection in patients with renal diseases is higher compared to the general population. FDA has approved ombitasvir/paritaprevir/ ritonavir for the treatment of patients with severe renal disease. This study aimed to evaluate the efficacy and safety of ombitasvir/paritaprevir/ritonavir with or without ribavirin in treatment of chronic hepatitis C Egyptian hemodialysis patients to compare it with the same treatment result in chronic hepatitis C Egyptian patients with normal renal functions. This case-control study was conducted on one hundred patients with confirmed diagnosis of HCV-positive infection at the Center of National Committee for Control of Viral Hepatitis [NCCVH] at Ain Shams University Hospital. Patients were divided into two groups: group I (control group) with 50 chronic hepatitis C virus patients with normal renal functions and group II (Case Group) with 50 chronic hepatitis C virus hemodialysis patients.Results95.1% of prevalent hemodialysis patients achieved sustained virological response (SVR), while 100% of patients with normal kidney functions achieved sustained virological response. Most common side effects were hemoglobin drop, gastrointestinal disturbance, severe fatigue, and itching.ConclusionOmbitasvir, paritaprevir, and ritonavir are considered a safe and effective in treatment in HCV infection in patients on regular hemodialysis as in chronic hepatitis C virus infection patients with normal kidney functions.

Predictors of mortality among Egyptian hemodialysis patients with coronavirus disease 2019: a multicenter retrospective cohort

Predictors of mortality among Egyptian hemodialysis patients with coronavirus disease 2019: a multicenter retrospective cohort