Select your timezone:

Kidney - Diagnostics 2

Wednesday September 14, 2022 - 08:00 to 09:30

Room: C2

401.2 Inhibition of proprotein convertase subtilisin/Kexin type A (PCSK-9) among renal transplant recipients: is it beneficial for cases with high cardiovascular risk?

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).


Inhibition of proprotein convertase subtilisin/Kexin type A (PCSK-9) among renal transplant recipients: is it beneficial for cases with high cardiovascular risk?

Torki Al-Otaibi1, Osama Gheith1,2, Ayman M. Nagib1,2, Hasaneen Aboatya1, Medhat A. Halim1, Tarek Said1, Mohamed Emam1, Zakaria El-sayed1, Prasad Nair1.

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

Introduction: Reduction of low-density lipoprotein cholesterol levels is associated with reducing major cardiovascular events. Monoclonal antibodies inhibiting proprotein convertase subtilisin/Kexin type A(PCSK-9) have not been evaluated among renal transplant recipients despite its favorable safety profile.

Aim of the study: To evaluate the safety and efficacy of evolocumab in reducing lipids and cardiovascular events among risky renal transplant recipients. 

Patients and methods: One hundred ninety-five kidney transplant recipients- who were followed up in Hamed Al-Essa organ transplant center with high cardiovascular risk score (>20)-were enrolled in this prospective randomized controlled study between June 2017 and June 2018. Patients who received statin and evolocumab (140mg/ 2 weeks, group1, n=97) while those maintained on statin alone comprised group 2(n=98). After 24 months, they were followed up clinically and by laboratory investigations.

Results:  The two groups were comparable demographics, including pre-transplant co-morbidities (p>0.05). Before enrollment in the study, post-transplant complications were comparable to a higher prevalence of NODAT in group 2(p=0.033). Smokers were significantly more prevalent in group 1. Moreover, basal graft function was significantly higher in group 1, while the type of immunosuppression was equivalent in both groups(p>0.05). Clinically we found no significant differences between the two groups concerning cardiovascular events, and both graft and patient outcomes were comparable (p>0.05). We found significantly higher basal cholesterol in group 1(5.5 vs. 4.7, p<0.001), which came down significantly in the same group after three months and after that (p=0.031) compared to group 2 and basal values (p<0.001). Similarly, cholesterol started to lower significantly at 12 months in group 2. We observed that triglycerides in the two groups were comparable (p>0.05) till the end of the study. However, TG at six months was significantly lower compared to basal values in both groups(p<0.05). We reported 2 cases of acute MI and one atrial fibrillation in group2.

Conclusion: Evolocumab is a promising lipid-lowering agent among kidney transplants with a high cardiovascular risk score. Earlier cholesterol reduction was observed in the add-on evolocumab group but without significant positive cardiovascular impact.

Keywords: Hyperlipidemia, renal transplant, high cardiovascular risk, outcome

Sisters working in the outpatient clinic of Hamed Alessa Organ transplant center of Kuwait: Shereen Mohamed, Bency Baby, and Sijy Paul..

Presentations by Osama Ashry Gheith

Social Media Promotion Image

right-click to download

© 2024 TTS 2022