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P8.025 Impact of full correction of post-transplant anemia on the cardiovascular system in renal transplant recipients receiving erythropoietin stimulating agents: prospective randomized controlled trial

Osama Ashry Gheith, Egypt

Mansoura university

Biography

Biography

I am Dr. Osama Ashry Ahmed Gheith, who graduated in 1987 from Mansoura faculty of medicine, Egypt. I have held an MD degree in Internal Medicine and Nephrology since 2003. I have been trained at Mansoura urology and nephrology center, Mansoura University, Egypt from 1991 till 2008 when I join the work at Hamed Al-Essa organ transplant center.

I am a member of the following societies: International Society of Nephrology (ISN), European Dialysis Transplantation Association (EDTA), African Association of Nephrology (AFRAN), Arab Society of Nephrology, and Egyptian Society of Nephrology (ESN).

I have long experience with all nephrology activities including all dialysis modalities, medical care of more than 3500 renal transplant recipients, and surgical Skills of importance in the field of nephrology as vascular access creation, PD catheter insertion, and renal biopsies. Moreover, I am interested in training and supervising Junior Staff in nephrology and renal transplant (in Egypt, Yemen, and Kuwait).

I have completed the NIH Web-based training course “Protecting Human Research Participants”. I am interested in research work and have over 12 research projects ongoing in the department. I am an author and/or co-author of over 85 publications in peer-reviewed international journals. In addition to several abstracts in many Middle East and international conferences. I am interested in the field of immunosuppression in renal transplantation, post-transplant diabetes, infection, and anemia.

I won some of the research prizes with the special concern of Emirates medical association –Nephrology Society EMAN YOUNG INVESTIGATOR AWARD –during the 12th congress of the Arab society of nephrology and renal transplantation 2014, 6th ISN EMAN Update Course in Nephrology 2014, 10-13December 2014 Dubai, UAE; one of the top 5 posters presented in ESNT 2018 (impact of HLA DR mismatch in elderly renal transplant recipients regardless donor sources: single-center experience from the middle east) and one of the top 5 posters presented in ESNT 2019 (Screening for BK viremia/viruria and the Impact of Management of BK Virus Nephropathy in Renal Transplant Recipients).

Abstract

Impact of full correction of post-transplant anemia on the cardiovascular system in renal transplant recipients receiving erythropoietin stimulating agents: prospective randomized controlled trial

Torki Al-Otaibi1, Osama Gheith1,2, Ayman M. Najeeb1,2, Medhat A. halim1, Hasanein Abo-Atteya1, Tarek Mahmoud 1, Nair Prasad1, Hany Adel1, Ahmed Mosaad1, Ahmed Fathy 1, Mohamed Abdul-Hameed 1.

1Nephrology , Otc, Kuwait, Kuwait; 2Nephrology , MUNC, mansoura, Egypt

Objectives: Several studies have shown that PTA might be associated with increased mortality and decreased graft survival and de-novo congestive heart failure.

Aim of the study: So we aimed from this prospective randomized controlled study to assess the impact of full correction of post-transplant anemia on the cardiovascular system of renal transplant recipients receiving erythropoietin stimulating agents.

Patient and methods: We recruited 247 kidney recipients with stable graft function in this RCT with 2 groups according to their target hemoglobin (11-12 g/dl, group 1, n=183) and (13:15 g/dl, group 2, n=64). After correction of deficiencies, the target hemoglobin was achieved using ESA. All patients were followed up clinically and by serum creatinine and eGFR monthly for 12 months.

Results: Diabetic nephropathy was the main cause of ESKD in group 1(p= 0.005). The studied groups were comparable regarding pre-transplant co-morbidities. Most patients received thymoglobulin as induction then cyclosporine-based maintenance immunosuppression. We did not find any significant difference between the two groups concerning post-transplant diabetes, BK viremia or malignancies, and even cardiovascular events (TIA, stroke, ACS), uncontrolled hypertension, heart failure, or arrhythmias (p>0.05). Group 1 showed higher mean blood pressure (p=0.003),  lower LV internal dimensions, higher  LVH, LV mass, IVSD, and LV mass index after one year of the study (p< 0.05). Group 2 did not show any significant change in the same parameters (p >0.05). Moreover, IVSD, mean ejection fraction, and FS were comparable in both groups (p>0.05). Graft outcome was comparable between both groups (p=0.125), meanwhile, mortality cases were significantly higher among group 1 (16 cases, 8.7%) (p=0.005).

Conclusion: Full correction of PTA is associated with stabilized cardiac dimensions indices without any significant cardiovascular comorbidities.

Presentations by Osama Ashry Gheith

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