Papers by Nagy Sayed-Ahmed
Osteoporosis International
Kidney International Reports, Feb 1, 2022
Book Publisher International (a part of SCIENCEDOMAIN International), Feb 13, 2021
Background: Chronic kidney disease can affect different aspects of female patient’s life includin... more Background: Chronic kidney disease can affect different aspects of female patient’s life including menstrual pattern, marital status and sexuality, fertility, pregnancy outcome, and recommended methods of contraception especially when initiated on HD. It is an underestimated problem in both genders and has not been evaluated comprehensively. In Egypt, it has been noticed that it is infrequent for a hemodialysis (HD) female to start her marriage after initiation of HD; this may be attributed to a negative self-image experienced by the patient and perceived by the community. Moreover, it is also less common for an HD patient to marry another HD partner and it is odd for them to conceive during HD. Aim: To describe the possibility of starting family and plan for successful pregnancy during the course of HD therapy in patients with ESRD. Patient Scenario: Our case is a 36 years old Egyptian female who started HD in 1999 and continued on HD for 17 years. She married four times and conceived five times from three husbands. She got live birth only once from her second HD husband, but unfortunately, the baby died within a few days. The patient used Implanon - with its possible side effects- as a method of contraception during her last four years of life. After hectic 17 years under HD and unfortunate marital and fertility events, she decided to withdraw from her dialysis program, chose to live in isolation, and passed away within five days as a consequence of cerebral hemorrhage. Results and Conclusions: If needed, contraception methods must be chosen carefully with a multi-disciplinary discussion between the obstetrician, the patient, the family, and the nephrologist. Fertility and successful pregnancies are believed to be possible in HD couples if they receive proper care.
Nephrology Dialysis Transplantation, Jun 1, 2023
patients died. Kaplan Meier analysis revealed that there tended to be better survival in patients... more patients died. Kaplan Meier analysis revealed that there tended to be better survival in patients with higher 25D concentration (n = 52) than those with lower concentration (p = 0.1936), although no significant association was seen between 1,25D and survival. Conclusion: These results indicate that hypovitaminosis D (low 25D<30 ng/ml) is seen in all haemodialysis patients, and in most of these patients, serum 1,25D concentrations are low. Lower serum 25D concentrations are significantly associated with lower serum albumin, i.e., poorer nutritional status. Higher serum 1,25D, even in low ranges, is significantly associated with lower intact PHT and alkaline phosphatase, i.e. lower bone metabolism status. The results suggest that, in the era of new CKD-MBD treatments with calcimimetics and new VDRA, serum 25D may represent a nutritional status, and that serum 1,25D concentrations with regard to bone metabolism may be reconsidered for the assessment of CKD-MBD, particularly in regards to prevention of secondary hyperparathyroidism.
Nephrology Dialysis Transplantation, Jun 1, 2023
analysis showing technique (A) and patient survival (B) stratified by patient age. respectively (... more analysis showing technique (A) and patient survival (B) stratified by patient age. respectively (Fig. 1B). Multivariate Cox regression analysis showed that age was the only risk factor for mortality in our cohort of patients (HR = 1.07 [95%CI 1.05-1.08]; p = <0.001) whereas no risk factors for the transition to HD were found in our cohort of patients. Conclusion: In our study PD patients had a high burden of comorbidities and were frequently subject to the transition to HD. Age was an independent predictor of mortality in this dynamic population. No risk factors for the transition from PD to HD were identified in this group of patients.
Book Publisher International (a part of SCIENCEDOMAIN International), Oct 29, 2021
Book Publisher International (a part of SCIENCEDOMAIN International), Oct 28, 2021
Book Publisher International (a part of SCIENCEDOMAIN International), Oct 29, 2021
Asian journal of medicine and health, Mar 19, 2021
Author AFM takes responsibility that this study has been reported honestly, accurately and transp... more Author AFM takes responsibility that this study has been reported honestly, accurately and transparently and accepts accountability for the overall work by ensuring that questions pertaining to the accuracy or integrity of any portion of the work are appropriately investigated and resolved. All authors read and approved the final manuscript.
Asian journal of medicine and health, Jul 9, 2021
Nephrology Dialysis Transplantation
Background and Aims Pregnancy Related Acute kidney injury (PR-AKI) is a global health problem wit... more Background and Aims Pregnancy Related Acute kidney injury (PR-AKI) is a global health problem with substantial maternal and fetal morbidity and mortality. Late referral, and late diagnosis of women with risks of PR-AKI represent the major barriers for curtailment of this ugly trend, particularly in the developing world. Our past experience per se revealed striking maternal and fetal mortality of women with PR-AKI. Great strides are strongly needed to save maternal and fetal lives. This study assessed the impact of implementing an innovative obstetric nephrology service (ONS) and healthcare program on maternal and fetal outcomes in women at risk of PR-AKI. Method An innovative interdisciplinary obstetric nephrology clinic was established in 2020 to improve the quality of care for pregnant women at risk of PR-AKI. The service was staffed by both nephrologists and obstetricians. Women who presented to the clinic were stratified into low, moderate, and high-risk groups. A risk stratific...
Kidney International Reports, 2022
Seminars in Dialysis, 2022
Background and aimThe current literature concerning the reproductive health of end stage renal di... more Background and aimThe current literature concerning the reproductive health of end stage renal disease (ESRD) females is scarce, outdated, and largely unknown in women living in developing countries. This study aims to estimate the prevalence of menstrual abnormalities and their associated factors among ESRD women in reproductive age undergoing chronic hemodialysis (HD) in Egypt.MethodsThirty‐five dialysis centers were selected by simple random sampling to represent the different regions of Egypt. Non‐pregnant women in the reproductive age (15–50 years) receiving dialysis at the participating centers completed a questionnaire about their menstrual health during a routine hemodialysis session. Their responses were verified by reviewing the medical records and assessing their clinical data.ResultsOut of the 472 women, 32.6% had amenorrhea. Menstrual irregularities were reported in 37% of the menstruating women. Premenstrual tension syndrome (PMS) was reported in 70% while dysmenorrhea...
Kidney International Reports, 2021
Kidney International Reports, 2020
Our study has the potential for residual confounding from the limited collection of co-morbidity ... more Our study has the potential for residual confounding from the limited collection of co-morbidity and non-evaluation of severity, and lack of socioeconomic, medication and biochemical data in analyses. Our study indicates that survival outcomes on dialysis are improving with time. This includes survival for patients with medical comorbidity. Compared to previously, the survival of such patients is not meaningfully different on PD versus HD at the current time. This is probably as a result of improved pre-dialysis care, patient selection (eg dialysis versus conservative care in the elderly) but could due to improvements in general care of patient co-morbidities and improvements in dialysis technology and practice.
Asian journal of medicine and health, Nov 7, 2022
Aims: We aimed to observe the effect of modification of the immunosuppressive regimen in response... more Aims: We aimed to observe the effect of modification of the immunosuppressive regimen in response to the severity of COVID-19 infection on the outcome of renal disease patients and to study factors affecting their mortality.
Kidney International Reports, Apr 1, 2021
Nephrology Dialysis Transplantation, Jun 1, 2020
Background and Aims Hyperphosphatemia is frequently encountered in hemodialysis patients and is a... more Background and Aims Hyperphosphatemia is frequently encountered in hemodialysis patients and is an important risk factor of cardiovascular diseases. It is usually difficult to be managed by phosphate binders and hemodialysis. This study was carried out to assess the effect of nutritional education (NE) on the control of serum phosphorus level in hemodialysis patients. Method An open label, single center randomized controlled trial was conducted in the nephrology department, New Mansoura General Hospital, Egypt. One hundred hemodialysis patients were randomized into two groups; intervention Group (IG) (n=50) subjected to NE program for 3 months and Control group (CG) (n=50) received the usual care. Nutritional education was applied for the intervention group, by a trained renal dietitian, in the form of educational sessions, booklets, procures, audio visual teaching aids and patient-tailored counselling. Nutritional evaluation was done for all patients using dietary history, 24 hour diet recall sheet and malnutrition inflammation score (MIS) in addition to assessment of anthropometrics measurements and routine laboratory tests before randomization and at the end of the study. Results Three months after randomization, body mass index, waist circumference and midarm muscle circumference (MAMC) were significantly lower among IG versus the CG (p=0.04, 0.04 and 0.004 respectively). MIS score was significantly lower among the IG compared to the CG (p=0.02). Regarding laboratory tests, serum phosphorus level and calcium X phosphorus product were significantly lower among IG compared to the CG at the end of the study (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001 and =0.04 respectively) with a percent change of serum phosphorus of -13.8 ± 21.41 after NE. The percentage of patients with hyperphosphatemia (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 5.5 mg/dl) were significantly lower in the IG at the end of study (p=0.04). Other laboratory tests including serum albumin, hemoglobin level, iron status and urea reduction ratio did not show any significant difference between both groups. Conclusion NE applied to dialysis patients added to the control of hyperphosphaemia without exposing the patients to the risk of malnutrition, resulting from injudicious dietary restrictions.
Saudi Journal of Kidney Diseases and Transplantation, 2019
There is a paucity of data concerning safety of fasting in Ramadan in chronic kidney disease pati... more There is a paucity of data concerning safety of fasting in Ramadan in chronic kidney disease patients on hemodialysis (HD). The aim of the present study was to assess the frequency of fasting in Ramadan in HD patients in Egypt and the possible effect of fasting on clinical and biochemical variables. This observational multicentric study was carried out during 2016 when fasting duration was around 16 h.
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Papers by Nagy Sayed-Ahmed