Publications by authors named "Gafter U"

Posttransplantation anemia (PTA) is common among kidney transplant patients. Early PTA is usually defined as anemia which develops up to 6 months after transplantation, and late PTA is defined as anemia which develops after 6 months. There are multiple causes, with iron deficiency being the major contributor.

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Background: Post transplantation anemia (PTA) is common among kidney transplant patients. PTA is associated with increased graft loss and in most studies with increased mortality. However, the effect of the severity of anemia on this associations was not thoroughly evaluated.

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We sought to assess the frequency and predictors of early and late posttransplantation anemia (PTA). In addition, we aimed to assess the outcomes of patients with anemia and to assess the impact of anemia on mortality, graft function, and graft failure.Patients who underwent kidney transplantation in a single center during a 4-year period were included.

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  • - Proteinuria and albuminuria are crucial indicators of kidney health and can help assess the risk of cardiovascular issues in both diabetic and non-diabetic individuals.
  • - A study analyzing 245 diabetic patients revealed a significant linear correlation between proteinuria levels between 162-300 mg/24 hours and albuminuria, with a new cutoff established at 160.5 mg/24 hours for abnormal proteinuria.
  • - Findings suggest that while proteinuria below 300 mg/24 hours is important, it shouldn't be the only predictor for kidney failure, as changes in creatinine clearance were only linked to albuminuria levels.
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Purpose: Immunosuppressive therapy plays a major role in the development of post-transplant cancer. In this nested case-control study of kidney transplant recipients (KTRs), we investigated whether the incidence of post-transplant cancer is associated with the level of tacrolimus exposure over time.

Methods: We screened the Rabin Medical Center database for adults who received kidney transplants between 2001 and 2014 and developed post-transplant cancer (excluding basal and squamous cell skin cancers).

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Crescentic glomerulonephritis (CGN) is the most aggressive form of GN and, if untreated, patients can progress to end-stage renal failure within weeks of presentation. The α4β1 integrin very late antigen-4 (VLA-4) is an adhesion molecule of fundamental importance to the recruitment of leukocytes in inflammation. We addressed the role of VLA-4 in mediating progressive renal injury in a rat model of CGN using a small tellurium compound.

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Background: The variability of tacrolimus blood levels has been shown to be associated with inferior graft survival. However, the effect of variability during the early post-transplantation period has not been evaluated. We sought to evaluate the association between time-weighted variability in the early post-transplantation period and graft survival.

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  • Iron supplementation is essential for treating anemia in patients with chronic kidney disease (CKD), and the effectiveness of intravenous (IV) iron versus oral iron for CKD stages 3 to 5 remains debated.!
  • A systematic review and meta-analysis of 24 trials found that IV iron significantly improved hemoglobin levels in patients with CKD, especially in those on dialysis (stage 5D), with risk ratios indicating a higher likelihood of achieving desired hemoglobin increases.!
  • While IV iron was more effective, it also presented a greater risk of causing hypotension compared to oral iron, although overall safety regarding mortality and severe adverse effects was similar between both methods of supplementation.!
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Obesity and diabetes mellitus are the leading causes of renal disease. In this study, we determined the regulation and role of the G protein-coupled bile acid receptor TGR5, previously shown to be regulated by high glucose and/or fatty acids, in obesity-related glomerulopathy (ORG) and diabetic nephropathy (DN). Treatment of diabetic db/db mice with the selective TGR5 agonist INT-777 decreased proteinuria, podocyte injury, mesangial expansion, fibrosis, and CD68 macrophage infiltration in the kidney.

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Aims: Obesity is an important risk factor for the development of chronic kidney disease. One of the major factors involved in the pathogenesis of obesity-associated kidney disease is glomerular hyperfiltration. Increasing salt-delivery to the macula densa is expected to decrease glomerular filtration rate (GFR) by activating tubuloglomerular feedback.

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  • The study investigated autoantibodies related to DNA in healthy individuals and those with autoimmune diseases using antigen microarrays and analysis.
  • All 135 participants had high levels of IgG antibodies to the G20 oligonucleotide, showing this reactivity is common among both healthy and diseased individuals.
  • The prevalence of anti-G20 antibodies in humans, along with the genomic survey revealing more T20 runs than G20 in humans, suggests unique immune characteristics and prompts further research on their role in health and disease.
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  • A study examined the relationship between serum interleukin-6 (IL-6) levels and mortality in hemodialysis (HD) patients over a 3-year follow-up period.
  • Out of 57 adult patients, over half (50.8%) died during the study, with higher IL-6 levels during dialysis linked to increased mortality risks.
  • The findings suggest that increased IL-6 levels during a single HD session may indicate an inflammatory response affecting patients' survival, independent of initial CRP or IL-6 levels before dialysis.
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  • Patients with β-thalassemia major (TM) can show kidney dysfunction, but standard methods to measure kidney filtration (eGFR) may overestimate their true renal function.
  • The study compared traditional creatinine clearance methods and newer inulin clearance techniques in patients from an Israeli thalassemia clinic, revealing inconsistent results.
  • Ultimately, the findings indicated that many estimation methods for GFR in TM patients significantly overestimate kidney function, leading to clinical concerns regarding their reliability.
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Diabetic nephropathy (DN) is characterized by proliferation of mesangial cells, mesangial expansion, hypertrophy and extracellular matrix accumulation. Previous data have cross-linked PKB (AKT) to TGFβ induced matrix modulation. The non-toxic compound AS101 has been previously shown to favorably affect renal pathology in various animal models and inhibits AKT activity in leukemic cells.

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Background: Most previously published studies of patients with membranoproliferative glomerulonephritis type I are small or have short follow-up period. We report the outcome of a fairly large cohort of patients followed up for nearly 10 years.

Methods: Retrospective cohort study.

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Background: Anti-complement factor H (CFH) antibodies is an extremely rare cause of atypical hemolytic uremic syndrome (aHUS) in adults, with less than 10 cases reported thus far. Although infectious diarrhea is a common inciting trigger for aHUS episode, there are no reports of an association with inflammatory bowel disease. Eculizumab is an emerging treatment for aHUS.

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Pemphigus vulgaris (PV) is an autoimmune skin disease, which has been characterized by IgG autoantibodies to desmoglein 3. Here we studied the antibody signatures of PV patients compared with healthy subjects and with patients with two other autoimmune diseases with skin manifestations (systemic lupus erythematosus and scleroderma), using an antigen microarray and informatics analysis. We now report a previously unobserved phenomenon--patients with PV, compared with the healthy subjects and the two other diseases, show a significant decrease in IgG autoantibodies to a specific set of self-antigens.

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  • A study evaluated the mortality rates and key predictors of death in patients over 84 years old undergoing chronic hemodialysis from 2004 to 2012.
  • It involved 29 patients with a mean age of 88 years, revealing a median survival of 38 months and a 1-year survival rate of 80%.
  • The findings indicated that lower serum albumin levels and shorter weekly dialysis treatment time significantly increased the risk of mortality in these patients.
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  • Animal studies show that lipid build-up can lead to kidney problems, but it was unclear if this happened in humans, especially with diabetic nephropathy (DN).
  • In a study of kidney biopsies from DN patients, researchers found significant lipid deposits and changes in genes related to lipid metabolism compared to normal kidneys.
  • Key lipid metabolism pathways were downregulated, indicating that altered lipid processing could contribute to kidney dysfunction, suggesting that targeting lipid metabolism may help slow down DN progression.
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Systemic lupus erythematosus (SLE) is an autoimmune disease that can attack many different body organs; the triggering event is unknown. SLE has been associated with more than 100 different autoantibody reactivities - anti-dsDNA is prominent. Nevertheless, autoantibodies to dsDNA occur in only two-thirds of SLE patients.

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  • Obesity leads to changes in kidney function, characterized by hyperfiltration and increased sodium reabsorption, which may affect kidney structure, potentially leading to enlarged glomeruli and proximal tubules.
  • A study analyzed kidney biopsies from 11 obese patients with proteinuria and 14 lean patients, finding significant increases in glomerular tuft volume and proximal tubular areas in the obese group.
  • The findings suggest that obesity causes hypertrophy (growth) of kidney tubules and enlarged urinary spaces, likely due to increased filtration rather than an increase in cell numbers.
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Background: DNA repair is a cellular defence mechanism responding to DNA damage caused in large part by oxidative stress. There is a controversy with regard to the effect of red blood cells on DNA damage and cellular response.

Aim: To investigate the effect of red blood cells on H2O2-induced DNA damage and repair in human peripheral blood mononuclear cells.

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Background: Various cytokines are increased in hemodialysis (HD) patients, and are considered prognostic markers. Metabolic acidosis is common among chronic HD patients and is associated with survival. The relationship between acidosis and cytokines in HD patients has not been fully explored.

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Background: The incidence of left ventricular hypertrophy (LVH) in primary aldosteronism (PA) is higher than in essential hypertension. LVH is an independent cardiovascular risk factor. Treatment of PA with mineralocorticoid receptor blockers (MRBs) improves LVH.

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  • High hemoglobin (Hb) variability in the first six months post-kidney transplantation is linked to worse graft and patient survival rates.
  • A retrospective study involving 752 patients used statistical methods to analyze Hb data and found that those in the highest quartile of Hb variability had significantly increased risks of graft failure.
  • This study suggests that monitoring and managing Hb levels post-transplant could be crucial for improving patient outcomes, as no strong link was found between Hb variability and overall mortality.
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