Publications by authors named "Keren Cohen Hagai"
Introduction: Individuals with chronic kidney disease (CKD) are at increased risk of thrombotic events and bleeding. Acetylsalicylic acid (ASA), an effective antiplatelet agent, is one of the most frequently used medications for both primary and secondary prevention of cardiovascular disease (CVD). However, it can also contribute to bleeding events due to its inherent antiplatelet effect.
View Article and Find Full Text PDFThe gold standard to estimate muscle mass and quality is computed tomography (CT) scan. Lower mass and density (intramuscular fat infiltration) of skeletal muscles are markers of sarcopenia, associated with increased mortality risk, impaired physical function, and poorer prognosis across various populations and medical conditions. We aimed to describe standard reference values in healthy population, prospective kidney donors, and correlate clinical parameters to muscle mass and density.
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- - This study examined the use of tunneled dialysis catheters (TDC) in chronic hemodialysis patients, focusing on their frequency of dysfunction and replacement over five years.
- - Out of 625 TDC inserted, 37.4% (234) had to be replaced due to dysfunction, with diabetes identified as a significant predictor of TDC issues.
- - The findings emphasize the growing use of TDC in dialysis, the problem of dysfunction, and the necessity for ongoing research to enhance dialysis access and catheter performance.
Background: Polycystic kidney disease (PKD) is the most common hereditary kidney disorder. In most patients, the disease progresses to end stage kidney disease, which is treated preferably by kidney transplantation. In certain clinical circumstances, a pretransplant nephrectomy is indicated.
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- - This study found that patient satisfaction and quality of life during dialysis treatment varied significantly among three different centers, indicating that local factors might affect these outcomes.
- - Although one center with better dialysis measures reported lower patient satisfaction, the relationship between satisfaction and quality of care remains complex and requires further research.
- - The findings suggest that patient demographics and experiences significantly influence satisfaction, which does not always align with clinical quality metrics like Kt/V, highlighting the need for a more comprehensive understanding of patient-centered care.
Article Synopsis
- Since late 2021, the Omicron variant (B.1.1.529) of SARS-CoV-2 has become the dominant strain globally, replacing Delta (B.1.617.2), which had worse outcomes despite similar transmission rates.
- A study of patients on maintenance hemodialysis showed that those infected with Delta had significantly more severe COVID-19 cases and higher mortality rates (19.2%) compared to those infected with Omicron (0%).
- Even though Omicron infections were generally milder, there was still a notable 90-day mortality rate among affected patients, highlighting the ongoing risks associated with COVID-19 for those with pre-existing conditions.
Background: Chronic kidney disease (CKD) is associated with a high burden of coronary artery disease (CAD), which remains the leading cause of death in CKD patients. Despite the high cardiovascular risk, ACS patients with renal dysfunction are less commonly treated with guideline-based medical therapy and are less frequently referred for coronary revascularization.
Summary: The management of CAD is more challenging in patients with CKD than in the general population due to concerns regarding side effects and renal toxicity, as well as uncertainty regarding clinical benefit of guideline-based medical therapy and interventions.
Living kidney donation has increased significantly, but little is known about the post-donation health-related quality of life (HRQoL) of non-directed donors (NDs) vs. directed donors (DDs). We thus examined the outcomes of 112 living kidney donors (82 NDs, 30 DDs).
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- - The study explores the concept of remission for severe asthma patients on biological treatments, aiming to establish clearer criteria for successful remission which typically includes reduced steroid use, fewer exacerbations, minimal symptoms, and improved lung function.
- - In a cross-sectional analysis of 39 adults with severe asthma, the research found that a significant percentage met some remission criteria, but there was considerable variability in outcomes depending on the specific criteria used.
- - The findings suggest that while achieving clinical remission is possible for patients using biological therapies, there is a need for more consistent and clearly defined criteria to effectively measure and compare remission across different patients.
Article Synopsis
- Vascular calcification, especially Intra Cranial Arterial Calcifications (ICAC), is common in maintenance hemodialysis (MHD) patients and is a key factor in the risk of cardiovascular disease.
- A study analyzed 280 patients, finding MHD patients had higher ICAC scores (2.3) compared to a control group (1.4), with over 90% of MHD patients experiencing some level of calcification.
- The presence of ICAC was linked to lower albumin levels and higher phosphorus and CRP levels, indicating it can predict increased mortality risk in MHD patients due to the complex interactions of inflammation and blood vessel changes.
Background: With the aging of the population, more older patients are being considered for kidney transplantation; therefore, it is crucial to evaluate the risks and benefits of transplantation in this population. This study aimed to assess long-term outcomes of kidney transplantation in a cohort of patients who underwent kidney transplantation at age >70 years, compared with patients aged 60 to 69 years at transplantation.
Methods: Included in the study were 261 consecutive kidney transplant recipients: 52 were aged >70 years, and 209 were aged 60 to 69 years at transplantation.
Introduction: The incidence of chronic kidney disease (CKD) is growing rapidly, along with the increasing geriatric population. CKD patients have higher incidence of fractures, stroke, and hospitalizations requiring rehabilitation. This is accompanied with the need for suitable rehabilitation programs to decrease disability and improve functionality to help elderly CKD patients maintain independence in activities of daily living.
View Article and Find Full Text PDF: Dyslipidemia is one of the most important modifiable risk factors in the pathogenesis of cardiovascular disease in the general population, but its importance in the hemodialysis (HD) population is uncertain. : This retrospective cohort study includes HD patients hospitalized due to acute coronary syndrome (ACS) in the period 2015-2020 with lipid profile data during ACS. A control group with preserved kidney function was matched.
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- Patients with end-stage kidney disease on maintenance hemodialysis (MHD) often face challenges like malnutrition and infections, which can worsen their health outcomes.
- This study assessed how dysfunction in polymorphonuclear (PMN) cells affects the health outcomes of MHD patients, with a focus on their nutritional status over a 24-month follow-up period.
- Findings showed that patients with lower PMN oxidative activity (measured by MFI-PMA levels) had worse nutrition, more frequent and severe infections, and higher mortality rates, indicating that PMN dysfunction could be a key predictor of health in malnourished MHD patients.
Article Synopsis
- * It analyzed data from 1,030 chronic dialysis patients, finding that those who received a fourth dose had lower rates of severe COVID-19 outcomes and mortality compared to those with just three doses.
- * The findings suggest that, similar to the general population, a fourth vaccine dose significantly boosts protection against severe illness and death from COVID-19 in this vulnerable group, indicating the need for further research on optimal vaccination strategies.
Article Synopsis
- - This study explored how serum from hemodialysis (HD) patients affects a specific pathway (TXNIP-eNOS-STAT3) linked to inflammation and endothelial dysfunction, both of which are serious concerns in patients with chronic kidney disease (CKD).
- - Researchers found that serum from HD patients significantly increased the expression of TXNIP, IL-8, and STAT3 in human umbilical vein endothelial cells, while decreasing eNOS expression, suggesting a detrimental impact on vascular health.
- - Importantly, the results indicated that this inflammatory response happened independently of the patients' nutritional status, emphasizing the significant biological effects of HD patient sera on inflammation pathways.
Introduction: Metrics for posttransplant immune monitoring to prevent over or under immunosuppression in renal transplant recipients (RTRs) are lacking.
Methods: We surveyed 132 RTRs, 38 in the first year posttransplant and 94 >1-year posttransplant, to study the clinical expression of immunosuppressive therapy. A questionnaire administered to these RTRs was divided into physical (Q physical) and mental (Q mental) symptoms.
Article Synopsis
- The study focused on the immune response to the BNT162b2 COVID-19 vaccine in patients undergoing hemodialysis (HD) and peritoneal dialysis (PD), measuring antibody levels at various time points after vaccination.
- Results showed significant increases in antibody levels after the third vaccine dose, but these levels declined after six months. HD patients were found to have a higher risk of COVID-19 infection compared to PD patients.
- The conclusion highlighted that while both groups had a strong antibody response post-vaccination, the type of dialysis (HD vs. PD) significantly affected the likelihood of contracting COVID-19.
Data about in-hospital AKI in RTRs is lacking. We conducted a retrospective study of 292 RTRs, with 807 hospital admissions, to reveal predictors and outcomes of AKI during admission. In-hospital AKI developed in 149 patients (51%).
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- Keratin-based hair-straightening treatments are common in Israel but have been linked to severe acute kidney injury (AKI), with reports indicating potential systemic absorption of harmful ingredients.
- A study reviewed 26 patients aged 14-58, who experienced AKI symptoms like nausea and abdominal pain after using these treatments from 2019-2022, with significant findings from kidney biopsies.
- The study highlights acute oxalate nephropathy as a primary concern, suggesting that the absorption of glycolic acid derivatives could be a largely unrecognized cause of kidney issues, especially in young and otherwise healthy individuals.
Article Synopsis
- A third dose of the BNT162b2 vaccine significantly boosts antibody levels in healthy individuals.
- Antibody levels were monitored in healthcare workers over one year, showing a notable increase right after the third dose, followed by a gradual decline.
- Despite the decline, antibody levels remained higher than those recorded after previous doses even six months later.