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Article ; Online: Study of Serum Ferritin, Zinc, and Copper Levels in Children With Helicobacter pylori Gastritis and the Effect of the Treatment.

Elsaadany, Eman / Amin, Saleh / Abdel-Hafez, Maher / El Amrousy, Doaa / Kasem, Safwat / Abd Elaziz, Dareen / Shawky, Dina

Journal of pediatric gastroenterology and nutrition

2022 Volume 75, Issue 5, Page(s) e88–e93

Abstract: Objectives: This study aimed to assess serum iron, zinc, and copper in symptomatic children with Helicobacter pylori infection, to correlate their serum levels with the degree of gastritis, and to evaluate the effect of H. pylori treatment on their ... ...

Abstract	Objectives: This study aimed to assess serum iron, zinc, and copper in symptomatic children with Helicobacter pylori infection, to correlate their serum levels with the degree of gastritis, and to evaluate the effect of H. pylori treatment on their levels. Methods: This study was carried out on 70 children with upper gastrointestinal tract symptoms. H. pylori infection was diagnosed by the H. pylori antigen test in the stool and histopathologic findings during upper gastrointestinal endoscopy. Patients were divided into 2 groups; H. pylori -positive and H. pylori -negative groups. Hemoglobin, serum ferritin, transferrin (sTfR), zinc, and copper were assessed in all included children. Results: The hemoglobin level, serum ferritin, and zinc were significantly lower in H. pylori -positive patients compared to H. pylori -negative patients. However, the serum copper level was comparable between the 2 groups. After treatment, the hemoglobin level, serum ferritin, and serum zinc significantly increased in H. pylori -positive patients, especially in those who responded to treatment compared to their levels before treatment. There was a significant negative correlation between the severity of histopathologic abnormalities and hemoglobin level, serum ferritin, and zinc levels, but a significant positive relation with sTfR concentrations in H. pylori -positive patients. Conclusions: H. pylori -infected children had low serum ferritin and zinc levels but high sTfR level with no effect on serum copper levels. After treatment, hemoglobin, serum ferritin, and zinc levels significantly improved in H. pylori -positive patients. Gastric histologic findings correlated significantly with hemoglobin, serum ferritin, zinc, and sTfR levels.
MeSH term(s)	Child ; Humans ; Helicobacter Infections/drug therapy ; Helicobacter Infections/diagnosis ; Helicobacter pylori ; Copper ; Zinc ; Anemia, Iron-Deficiency ; Gastritis/drug therapy ; Transferrin ; Hemoglobins ; Ferritins
Chemical Substances	Copper (789U1901C5) ; Zinc (J41CSQ7QDS) ; Transferrin ; Hemoglobins ; Ferritins (9007-73-2)
Language	English
Publishing date	2022-08-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	603201-1
ISSN	1536-4801 ; 0277-2116
ISSN (online)	1536-4801
ISSN	0277-2116
DOI	10.1097/MPG.0000000000003585
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Zs.A 1728: Show issues

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Article ; Online: Spontaneous Third Ventriculostomy in Cases of Aqueductal Stenosis: A Retrospective Case Series.

Aleem Ragab, Omar Abdel / Fathalla, Hussein / El Halaby, Walid / Maher, Wael / Hafez, Mohamed / Zohdi, Ahmed

World neurosurgery

2023 Volume 176, Page(s) e408–e414

Abstract: Background: Spontaneous third ventriculostomy (STV) is a rare occurrence in cases of obstructive hydrocephalus where the walls of the third ventricle rupture, communicating the ventricular system, and the subarachnoid space leading to arrest of active ... ...

Abstract	Background: Spontaneous third ventriculostomy (STV) is a rare occurrence in cases of obstructive hydrocephalus where the walls of the third ventricle rupture, communicating the ventricular system, and the subarachnoid space leading to arrest of active hydrocephalus. We aim to review our series of STVs while reviewing previous reports. Methods: A retrospective review of cases undergoing cine phase-contrast magnetic resonance imaging (PC-MRI) from 2015 to 2022 of any age with imaging evidence of arrested obstructive hydrocephalus was performed. Patients in which aqueductal stenosis was radiologically evident and the presence of third ventriculostomy through which cerebrospinal fluid flow was detectable were included. Patients who previously underwent endoscopic third ventriculostomy were excluded. Data on patient demographics, presentation, and imaging details of STV and aqueductal stenosis were collected. We searched the PubMed database using the following keyword combination: ((("spontaneous ventriculostomy") OR ("spontaneous third ventriculostomy")) OR ("spontaneous ventriculocisternostomy")) including English reports of STV published between 2010 and 2022. Results: Fourteen cases were included (7 adults, 7 pediatrics), all with history of hydrocephalus. STV occurred in the floor of the third ventricle in 57.1% of the cases, at the lamina terminalis in 35.7%, and at both sites in 1 case. Eleven publications reporting 38 cases of STV were identified from 2009 to date. Minimum follow-up period was 10 months and maximum follow-up is 77 months. Conclusions: In cases of chronic obstructive hydrocephalus, neurosurgeons should be minded with the possibility of the presence of an STV on cine phase-contrast magnetic resonance imaging leading to arrested hydrocephalus. The delayed flow at the aqueduct of Sylvius might not be the only determinant of the necessity of cerebrospinal fluid diversion and the presence of an STV should be factored into the neurosurgeon's decision considering the patient's clinical picture.
MeSH term(s)	Adult ; Humans ; Child ; Cerebral Aqueduct/diagnostic imaging ; Cerebral Aqueduct/surgery ; Cerebral Aqueduct/pathology ; Ventriculostomy/methods ; Retrospective Studies ; Third Ventricle/diagnostic imaging ; Third Ventricle/surgery ; Third Ventricle/pathology ; Hydrocephalus/diagnostic imaging ; Hydrocephalus/etiology ; Hydrocephalus/surgery ; Treatment Outcome
Language	English
Publishing date	2023-05-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2023.05.074
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Zs.A 1159: Show issues

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Article ; Online: The pre-conception maternal exposure to Sofosbuvir affects the mitochondrial biogenesis in prenatal fetal tissues: Experimental study on rats.

Mahmoud, Shimaa A / Abdel-Aziz, Maryam M / Khafaga, Rana H M / Hafez, Hala A / Kamel, Maher A / Shaker, Sara A

Molecular medicine (Cambridge, Mass.)

2023 Volume 29, Issue 1, Page(s) 71

Abstract: Background: Hepatitis C virus (HCV) infection is a global public health problem and Egypt has the highest HCV prevalence worldwide. Hence, global efforts target to eliminate HCV by 2030. Sofosbuvir is a nucleotide analogue inhibitor of HCV polymerase ... ...

Abstract	Background: Hepatitis C virus (HCV) infection is a global public health problem and Egypt has the highest HCV prevalence worldwide. Hence, global efforts target to eliminate HCV by 2030. Sofosbuvir is a nucleotide analogue inhibitor of HCV polymerase essential for viral replication. Animal studies prove that Sofosbuvir metabolites cross the placenta and are excreted in the milk of nursing animals. We aimed to investigate the possible effects of preconception maternal exposure to Sofosbuvir on mitochondrial biogenesis in prenatal fetal liver, skeletal muscle, and placental tissues. Methods: The study was conducted on 20 female albino rats divided into a control group receiving a placebo and an exposed group receiving 4 mg/kg orally/day for 3 months of Sofosbuvir. At the end of the treatment period, pregnancy was induced in both groups by mating with healthy male rats overnight. At gestational day 17, all pregnant female rats were sacrificed. Each fetus was dissected to obtain the fetal liver, skeletal muscle, and placental tissues. Results: The results of our study indicated that the exposure of young female rats to Sofosbuvir affects pregnancy outcomes. Fetal liver and muscle showed lower mitochondrial DNA-copy number (mtDNA-CN) by about 24% and 29% respectively, peroxisome proliferator-activated receptor-gamma coactivator-1 alpha and its downstream targets; nuclear respiratory factor-1 and mitochondrial transcription factor A. While the placental tissues showed different patterns, particularly elevated in mtDNA-CN by about 43%. Conclusions: The study provides preliminary evidence of the detrimental effects of Sofosbuvir on the pregnancy outcomes of the exposed females and may impair the placental and fetal organs' development. These effects may be mediated through modulating mitochondrial homeostasis and functions.
MeSH term(s)	Humans ; Female ; Pregnancy ; Male ; Rats ; Animals ; Sofosbuvir/pharmacology ; Sofosbuvir/therapeutic use ; Placenta/metabolism ; Maternal Exposure/adverse effects ; Organelle Biogenesis ; DNA, Mitochondrial/metabolism ; DNA, Mitochondrial/pharmacology ; Fetus ; Hepatitis C/drug therapy ; Hepatitis C/metabolism ; Genotype
Chemical Substances	Sofosbuvir (WJ6CA3ZU8B) ; DNA, Mitochondrial
Language	English
Publishing date	2023-06-06
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1283676-x
ISSN	1528-3658 ; 1076-1551
ISSN (online)	1528-3658
ISSN	1076-1551
DOI	10.1186/s10020-023-00666-x
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Zs.A 4456: Show issues

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Article: The rate and management of prosthetic joint infection in the low-income setting: a cross-sectional study.

Hafez, Mahmoud A / Zamel, Fouad / El-Khadrawi, Tarek / El Ganzoury, Ibrahim / Lotfy, Abdel M / Fansa, Maher / Makram, Abdelrahman M

Annals of medicine and surgery (2012)

2023 Volume 85, Issue 4, Page(s) 790–795

Abstract: Although the rate of prosthetic joint infection (PJI) after total hip and knee arthroplasties (THA and TKA, respectively) is well documented in developed countries, there is a paucity of information in the literature on infection rates in low-and-middle- ... ...

Abstract	Although the rate of prosthetic joint infection (PJI) after total hip and knee arthroplasties (THA and TKA, respectively) is well documented in developed countries, there is a paucity of information in the literature on infection rates in low-and-middle-income countries. This study aims to review the PJI rate and management based on the Egyptian Community Arthroplasty Registry (ECAR) and six arthroplasty surgeons. Methods: Using data from the ECAR, for over 10 years, and surveying six high-volume arthroplasty surgeons, we reviewed the infection rate, common organisms, antibiotics used, and how the revision surgeries were done. The total number of patients included in this study was 210 infection cases out of 5216 THA and TKA. Results: Out of the 5216 joint replacement surgeries, the rate of all infections in THA and TKA was 4.03% (4.73 and 2.94%, respectively). The rate of infections requiring staged revision surgeries was 2.24 and 1.71% (2.03% in total) in the THA and TKA groups, respectively. The most encountered organism was Conclusion: From this study, we conclude that THA was associated with a higher rate of PJI, surgeons' use of antibiotics for a relatively long period, and the rate of PJI in our setting is relatively higher than what is reported in developed countries but lower in other low-income settings. We believe that with improved operating theater design and infection control education, infection rates will decrease significantly. Finally, we acknowledge the need for a national arthroplasty registry that can help in documentation and improving patient outcomes.
Language	English
Publishing date	2023-04-04
Publishing country	England
Document type	Journal Article
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1097/MS9.0000000000000430
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Article: Histopathological patterns of renal diseases in egyptian children: A single-center experience.

Abdel-Hafez, Maher Ahmed / Abdel-Nabi, Hend / El-Gamasy, Mohamed / Zayton, Hossam / Nassar, Ibrahim

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia

2017 Volume 28, Issue 5, Page(s) 1085–1091

Abstract: The present cross-sectional, retrospective study was aimed to determine the histopathological spectrum of renal diseases in Egyptian children and to evaluate the indications, safety, and efficacy of percutaneous renal biopsy (PRB) in a large tertiary ... ...

Abstract	The present cross-sectional, retrospective study was aimed to determine the histopathological spectrum of renal diseases in Egyptian children and to evaluate the indications, safety, and efficacy of percutaneous renal biopsy (PRB) in a large tertiary center in Egypt. PRBs performed at the Department of Pediatrics, Tanta University Hospital over a period of nine years (from January 2007 to December 2015) were included. Light microscopic (LM) examination was performed in all cases while immunofluorescence and electron microscopic examination were performed in selected cases. Two hundred and thirty renal biopsies were performed during the study duration. Nine biopsies were excluded from the study due to insufficient sample (<7 glomeruli per specimen) giving a PRB efficacy rate of 96.1%. Results of 221 renal biopsies performed on 210 patients from native kidneys were described. Ninety-seven patients were male (46.19%) and 113 were female (53.81%) with age ranging from three months to 18 years (mean 10.51 ± 3.81 years). The main indications of renal biopsy were nephrotic syndrome (NS) (43.89%), lupus nephritis (23.53%), and recurrent or persistent hematuria (10.41%). The most common finding on LM examination of renal biopsies from children with NS was minimal change disease (22.17%). Secondary nephropathies were mostly due to lupus (23.53%). IgA nephropathy was found in eight patients (3.62%). Local pain at the site of biopsy was the most common minor complication seen postbiopsy (60.58%). Transient gross hematuria was seen in 13 patients (5.88%) without urinary retention. Major complications that required surgical intervention or blood transfusion did not occur. NS was the main indication and minimal change disease was the most common histological finding of renal biopsies from Egyptian children. Complications and efficacy of renal biopsy procedure were comparable to that reported from developed countries.
MeSH term(s)	Adolescent ; Biopsy ; Child ; Cross-Sectional Studies ; Egypt/epidemiology ; Female ; Fluorescent Antibody Technique ; Hospitals, University ; Humans ; Kidney/pathology ; Kidney/ultrastructure ; Kidney Diseases/epidemiology ; Kidney Diseases/pathology ; Male ; Microscopy, Electron ; Nephrosis, Lipoid/epidemiology ; Nephrosis, Lipoid/pathology ; Nephrotic Syndrome/epidemiology ; Nephrotic Syndrome/pathology ; Retrospective Studies ; Time Factors
Language	English
Publishing date	2017-10-30
Publishing country	Saudi Arabia
Document type	Journal Article
ZDB-ID	1379955-1
ISSN	1319-2442
ISSN	1319-2442
DOI	10.4103/1319-2442.215139
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Zs.A 4735: Show issues

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Article ; Online: Speckle tracking echocardiography for the evaluation of left ventricular function in children with systemic lupus erythematosus.

Emara, Mai / Hafez, Maher Abdel / El-Bendary, Aml / Razaky, Osama El

Lupus

2020 Volume 29, Issue 11, Page(s) 1449–1455

Abstract: Background: Many studies in adult patients with systemic lupus erythematosus (SLE) have demonstrated that myocardial dysfunction was significantly associated with enhanced disease activity. However, similar studies in paediatric patients with SLE are ... ...

Abstract	Background: Many studies in adult patients with systemic lupus erythematosus (SLE) have demonstrated that myocardial dysfunction was significantly associated with enhanced disease activity. However, similar studies in paediatric patients with SLE are limited. The aim of this study was to evaluate the role of speckle tracking echocardiography (STE) to detect left ventricular dysfunction in children with active and inactive SLE. Methods: This prospective case-control study was carried out on 50 children with SLE. Thirty healthy age- and sex-matched children comprised the control group. The patients were further subdivided into two subgroups: active SLE and inactive SLE. Laboratory investigations undertaken included complete blood count, renal function, C3, C4, ANA, anti-dsDNA and serum N-terminal pro-B type natriuretic peptide. Echocardiographic examinations were performed on all children and included conventional echocardiography, tissue Doppler imaging (TDI) and two- and three-dimensional STE. Results: There was no statistically significant difference in N-terminal pro B natriuretic peptide between the studied groups. The myocardial performance index by TDI was statistically significantly higher in SLE patients compared to controls. STE parameters were statistically significantly lower in SLE patients compared to controls. There was no correlation between STE parameters and disease activity. Conclusions: STE could be a promising technique in the early detection of subclinical left ventricular dysfunction in children with SLE.
MeSH term(s)	Adolescent ; Case-Control Studies ; Child ; Early Diagnosis ; Echocardiography, Doppler/methods ; Echocardiography, Three-Dimensional/methods ; Female ; Humans ; Lupus Erythematosus, Systemic/complications ; Male ; Prospective Studies ; Reproducibility of Results ; Ventricular Dysfunction, Left/diagnostic imaging ; Ventricular Dysfunction, Left/etiology ; Ventricular Dysfunction, Left/physiopathology ; Ventricular Function, Left
Language	English
Publishing date	2020-07-28
Publishing country	England
Document type	Journal Article
ZDB-ID	1154407-7
ISSN	1477-0962 ; 0961-2033
ISSN (online)	1477-0962
ISSN	0961-2033
DOI	10.1177/0961203320942296
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Zs.A 3717: Show issues

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Article: Serum levels of N-terminal-pro B-type natriuretic peptide as a diagnostic marker for left ventricular dysfunction in children with end-stage renal disease on hemodialysis.

Zoair, Amr Mohamed / Abdel-Hafez, Maher Ahmed / Mawlana, Wegdan / Sweylam, Mohamed Abdel-Rahman

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia

2016 Volume 27, Issue 6, Page(s) 1114–1122

Abstract: The objective of this study was to determine the diagnostic cutoff value of N-terminal-pro B-type natriuretic peptide (NT-pro BNP) as a marker of left ventricular (LV) dysfunction in children with end-stage renal disease (ESRD) on regular hemodialysis ( ... ...

Abstract	The objective of this study was to determine the diagnostic cutoff value of N-terminal-pro B-type natriuretic peptide (NT-pro BNP) as a marker of left ventricular (LV) dysfunction in children with end-stage renal disease (ESRD) on regular hemodialysis (HD). The study was carried out on thirty children with ESRD on regular HD and thirty healthy controls. Echocardiographic studies were done, including a conventional mode for ejection fraction, fractional shortening, tissue Doppler imaging, and longitudinal global strain by speckle tracking. Serum levels of NT-pro BNP were measured in venous blood samples before and about 30 min after HD by ELISA. Volume status was assessed by calculating interdialytic weight gain %. There were significant higher serum NT-pro BNP levels before HD (mean: 702.3 ± 274.3 ng/L) compared to controls (mean: 365.55 ± 76.5 ng/L) (P <0.001) and these levels decreased significantly after the HD session (mean: 625.1 ± 117.69 ng/L) (P = 0.031). Echocardiographic studies showed a significant impairment of LV function of the patients compared to controls. Patients with LV dysfunction had significant higher serum concentrations of NT-pro BNP compared to patients without dysfunction both before (P = 0.003) and after dialysis (P <0.001). Receiver operating curve demonstrated better prediction of LV dysfunction by NT-pro BNP levels after HD compared to its levels before HD (area under the curve was 0.9 and 0.73, respectively). Using a cutoff value of 630 ng/L, serum NT-pro BNP levels after dialysis were a diagnostic predictor of LV dysfunction with a sensitivity of 86.6%, specificity of 93.3%, positive predictive value of 92.8%, and negative predictive value of 87.5%. Serum NT-pro BNP levels were strongly correlated with the parameters of LV dysfunction in children with ESRD on regular HD. A postdialysis cutoff value of 630 ng/L could serve as a biochemical marker of LV dysfunction in those children regardless of chronic fluid overload.
MeSH term(s)	Biomarkers ; Child ; Echocardiography, Doppler ; Humans ; Kidney Failure, Chronic ; Natriuretic Peptide, Brain ; Peptide Fragments ; Renal Dialysis ; Ventricular Dysfunction, Left
Chemical Substances	Biomarkers ; Peptide Fragments ; Natriuretic Peptide, Brain (114471-18-0)
Language	English
Publishing date	2016-11-30
Publishing country	Saudi Arabia
Document type	Journal Article
ZDB-ID	1379955-1
ISSN	1319-2442
ISSN	1319-2442
DOI	10.4103/1319-2442.194593
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Zs.A 4735: Show issues

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Article ; Online: Histopathological patterns of renal diseases in egyptian children

Maher Ahmed Abdel-Hafez / Hend Abdel-Nabi / Mohamed El-Gamasy / Hossam Zayton / Ibrahim Nassar

Saudi Journal of Kidney Diseases and Transplantation, Vol 28, Iss 5, Pp 1085-

A single-center experience

2017 Volume 1091

Abstract	The present cross-sectional, retrospective study was aimed to determine the histopathological spectrum of renal diseases in Egyptian children and to evaluate the indications, safety, and efficacy of percutaneous renal biopsy (PRB) in a large tertiary center in Egypt. PRBs performed at the Department of Pediatrics, Tanta University Hospital over a period of nine years (from January 2007 to December 2015) were included. Light microscopic (LM) examination was performed in all cases while immunofluorescence and electron microscopic examination were performed in selected cases. Two hundred and thirty renal biopsies were performed during the study duration. Nine biopsies were excluded from the study due to insufficient sample (<7 glomeruli per specimen) giving a PRB efficacy rate of 96.1%. Results of 221 renal biopsies performed on 210 patients from native kidneys were described. Ninety-seven patients were male (46.19%) and 113 were female (53.81%) with age ranging from three months to 18 years (mean 10.51 ± 3.81 years). The main indications of renal biopsy were nephrotic syndrome (NS) (43.89%), lupus nephritis (23.53%), and recurrent or persistent hematuria (10.41%). The most common finding on LM examination of renal biopsies from children with NS was minimal change disease (22.17%). Secondary nephropathies were mostly due to lupus (23.53%). IgA nephropathy was found in eight patients (3.62%). Local pain at the site of biopsy was the most common minor complication seen postbiopsy (60.58%). Transient gross hematuria was seen in 13 patients (5.88%) without urinary retention. Major complications that required surgical intervention or blood transfusion did not occur. NS was the main indication and minimal change disease was the most common histological finding of renal biopsies from Egyptian children. Complications and efficacy of renal biopsy procedure were comparable to that reported from developed countries.
Keywords	Medicine ; R
Subject code	616 ; 610
Language	English
Publishing date	2017-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
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Article: Predictive risk factors of steroid dependent nephrotic syndrome in children.

Abdel-Hafez, Maher Ahmed / Abou-El-Hana, Nagy Mohamed / Erfan, Adel Ali / El-Gamasy, Mohamed / Abdel-Nabi, Hend

Journal of nephropathology

2017 Volume 6, Issue 3, Page(s) 180–186

Abstract: Background: Development of steroid dependency is one of the difficult problems in the management of children with idiopathic nephrotic syndrome, leading to increased morbidity, complications and cost of treatment. Thus, predicting early in the disease ... ...

Abstract	Background: Development of steroid dependency is one of the difficult problems in the management of children with idiopathic nephrotic syndrome, leading to increased morbidity, complications and cost of treatment. Thus, predicting early in the disease course will be useful in counseling parents and may improve treatment strategy. Objectives: To determine the clinical characteristics that can predict the development of steroid dependency early in the initial episodes of steroid sensitive nephrotic syndrome (SSNS). Patients and methods: The study included 52 children with SSNS. Their ages ranged from 3 to 16 years. Patients were divided into two groups. Group A consisted of 24 patients with steroid dependency or frequent relapses nephrotic syndrome and group B consisted of 28 patients with complete remission or recurrent nephrotic syndrome. Data obtained retrospectively from patients' files. Results: Children who require a cumulative steroid dose equal or more than 140 mg/kg to maintain remission during the first 6 months of the disease are at high risk to require steroid sparing agents (SSA) for disease control, and who did not achieve remission by day 20 of the initial prednisone course became steroid dependent with 96% specificity but with low sensitivity (50%). All steroid dependent children in this study showed relapses associated significantly with upper respiratory tract infections. Conclusions: Cumulative steroid dose in the first 6 months of treatment and the need of more than 20 days to achieve initial remission can predict steroid dependency in children with nephrotic syndrome.
Language	English
Publishing date	2017-02-02
Publishing country	Iran
Document type	Journal Article
ZDB-ID	2658164-4
ISSN	2251-8819 ; 2251-8363
ISSN (online)	2251-8819
ISSN	2251-8363
DOI	10.15171/jnp.2017.31
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Article ; Online: Serum levels of N-terminal-pro B-type natriuretic peptide as a diagnostic marker for left ventricular dysfunction in children with end-stage renal disease on hemodialysis

Amr Mohamed Zoair / Maher Ahmed Abdel-Hafez / Wegdan Mawlana / Mohamed Abdel-Rahman Sweylam

Saudi Journal of Kidney Diseases and Transplantation, Vol 27, Iss 6, Pp 1114-

2016 Volume 1122

Abstract	The objective of this study was to determine the diagnostic cutoff value of N-terminal-pro B-type natriuretic peptide (NT-pro BNP) as a marker of left ventricular (LV) dysfunction in children with end-stage renal disease (ESRD) on regular hemodialysis (HD). The study was carried out on thirty children with ESRD on regular HD and thirty healthy controls. Echocardiographic studies were done, including a conventional mode for ejection fraction, fractional shortening, tissue Doppler imaging, and longitudinal global strain by speckle tracking. Serum levels of NT-pro BNP were measured in venous blood samples before and about 30 min after HD by ELISA. Volume status was assessed by calculating interdialytic weight gain %. There were significant higher serum NT-pro BNP levels before HD (mean: 702.3 ± 274.3 ng/L) compared to controls (mean: 365.55 ± 76.5 ng/L) (P <0.001) and these levels decreased significantly after the HD session (mean: 625.1 ± 117.69 ng/L) (P = 0.031). Echocardiographic studies showed a significant impairment of LV function of the patients compared to controls. Patients with LV dysfunction had significant higher serum concentrations of NT-pro BNP compared to patients without dysfunction both before (P = 0.003) and after dialysis (P <0.001). Receiver operating curve demonstrated better prediction of LV dysfunction by NT-pro BNP levels after HD compared to its levels before HD (area under the curve was 0.9 and 0.73, respectively). Using a cutoff value of 630 ng/L, serum NT-pro BNP levels after dialysis were a diagnostic predictor of LV dysfunction with a sensitivity of 86.6%, specificity of 93.3%, positive predictive value of 92.8%, and negative predictive value of 87.5%. Serum NT-pro BNP levels were strongly correlated with the parameters of LV dysfunction in children with ESRD on regular HD. A postdialysis cutoff value of 630 ng/L could serve as a biochemical marker of LV dysfunction in those children regardless of chronic fluid overload.
Keywords	Medicine ; R
Subject code	610
Language	English
Publishing date	2016-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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