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P8.026 Contrast-induced nephropathy in kidney transplant recipients: a single-center experience

Osama Ashry Gheith, Egypt

Mansoura university



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).


Contrast-induced nephropathy in kidney transplant recipients: a single-center experience

Osama Gheith1,2, Ayman M. Nagib1,2, Medhat A. halim1, Tarek Mahmoud1, Prasad Nair1, Hasaneen Abo-Atya1, Mohamed Shaker1, Hosam Attia3, Mohamed Mostafa 1, Torki Al-Otaibi1.

1Nephrology , Otc, Kuwait, Kuwait; 2Nephrology , MUNC, Mansoura, Egypt; 3Radiology, Otc, Kuwait, Kuwait

Introduction: Although published papers studying contrast-induced nephropathy (CIN) in native kidneys are abundant in the medical literature, data related to CIN in renal allografts are relatively rare. Moreover, kidney transplants are at higher risk for developing CIN due to unique factors to renal allografts as immunosuppressive agents, lack of sympathetic denervation, glomerular hyperfiltration, and burden of cardiovascular disease.

Aim of the study: To determine the prevalence of contrast-induced nephropathy among renal transplant recipients who received low-osmolality iodine-based contrast material before radiological assessment.

Patients and methods:  Out of 3180 renal transplants, which are followed up in Hamed Al-Essa organ transplant center, 79 patients received low osmolality iodine-based contrast before radiological assessment for different indications during the period between 2010 and 2020. According to our protocol, all patients received pre-contrast precautions (to hold metformin, IV hydration, sodium bicarbonate, and N acetylcysteine). CIN was defined when serum creatinine rose by 25% from baseline within one week of contrast exposure. Risk factors of CIN were assessed.

Results: Seventy-nine patients were enrolled for statistical analyses and divided into groups 1(CIN, N= 7) and 2(control, N=72) without any early rise of serum creatinine. The mean age was 52.1±12.3years, 44 of them were males, most of them reached ESKD due to diabetic nephropathy. The pre-transplant co-morbidities, virology status, and HLA typing were comparable in the two groups. Forty-seven cases received contrast for coronary angiography, while 32 received it for CT studies. Post-transplant ischemic heart disease (P 0.03) was significantly higher among group 1(N=46). The renal function deteriorated among CIN patients, especially after one week and four weeks, but the renal function between the two groups was comparable at the end of the study.

Conclusion: CIN is not uncommon in renal transplant recipients receiving CM especially ischemic heart disease recipients. Risk stratification, optimize hemodynamics and avoid potential nephron-toxins in transplant recipients planned to receive contrast-enhanced trials. Prospective controlled trials of CIN in transplant settings are justified.

Presentations by Osama Ashry Gheith

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