Kalantar-Zadeh, K., M. B. Lockwood, C. M. Rhee, E. Tantisattamo, S. Andreoli, A. Balducci, P. Laffin, T. Harris, R. Knight, L. Kumaraswami, et al., "Patient-centred approaches for the management of unpleasant symptoms in kidney disease.", Nature reviews. Nephrology, 2022. Abstract

Patients with chronic kidney disease (CKD) frequently experience unpleasant symptoms. These can be gastrointestinal (constipation, nausea, vomiting and diarrhoea), psychological (anxiety and sadness), neurological (lightheadedness, headache and numbness), cardiopulmonary (shortness of breath and oedema), dermatological (pruritus and dry skin), painful (muscle cramps, chest pain and abdominal pain) or involve sexual dysfunction, sleep disorders and fatigue. These symptoms often occur in clusters, with one of them as the lead symptom and others as secondary symptoms. Uraemic toxins (also called uremic toxins) are often considered to be the main cause of CKD-associated symptom burden, but treatment of uraemia by dialysis often fails to resolve them and can engender additional symptoms. Indeed, symptoms can be exacerbated by comorbid conditions, pharmacotherapies, lifestyle and dietary regimens, kidney replacement therapy and ageing. Patients with kidney disease, including those who depend on dialysis or transplantation, should feel actively supported in their symptom management through the identification and targeting of unpleasant symptoms via a tailored palliative care approach. Such an approach may help minimize the burden and consequences of kidney disease, and lead to improved patient outcomes including health-related quality of life and better life participation.

Kalantar-Zadeh, K., P. Kam-Tao Li, E. Tantisattamo, L. Kumaraswami, V. Liakopoulos, S. - F. Lui, I. Ulasi, S. Andreoli, A. Balducci, S. Dupuis, et al., "Living well with kidney disease by patient and care-partner empowerment: kidney health for everyone everywhere.", Kidney international, vol. 99, issue 2, pp. 278-284, 2021. Abstract

Living with chronic kidney disease (CKD) is associated with hardships for patients and their care partners. Empowering patients and their care partners, including family members and friends involved in their care, may help minimize the burden and consequences of CKD-related symptoms to enable increased life participation. There is a need to broaden the focus on living well with kidney disease and reengagement in life, including emphasis on the patient being in control. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of "Living Well with Kidney Disease" in an effort to increase education about and awareness of the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to assess and address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care or to support labeling claims for medicines and devices. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care partners should feel supported to live well through concerted efforts by kidney care communities, including during pandemics. In the overall wellness program for patients with kidney disease, the need for prevention should be reiterated. Early detection with prolonged course of wellness despite kidney disease, after effective secondary and tertiary prevention programs, should be promoted. WKD 2021 continues to call for increased awareness of the importance of preventive measures across populations, professionals, and policy makers, applicable to both developed and developing countries.

Saadi, G., and M. E. S. Nahid, "Renal Disease Burden in Sample Countries from Five Continents ", Int J Nephrol Kidney Fail , vol. 6, issue 4, 2020.
Saadi, G., I. Khaled, abdelaal mohammed, W. Ismail, M. El-Ansary, and R. Ramadan, "Upregulation of CD133 and CD44 as Markers of Resident Renal Progenitor Cells Following BM-MSCs Transfusion for Renal Regeneration", Cancer Sci Res, vol. 2, issue 2, pp. 1-4, 2019.
El-Ansary, M., G. Saadi, W. Ismail, A. Osman, and I. Bishai, "Allogenic BM-MSCs Transfusion for Treatment of r(LN)", Journal of Urology and Renal Diseases, vol. 2018, issue 9, 2018.
Saadi, G., M. El-Ansary, S. A. El-Hamid, and I. Abdel-Aziz, "Mesenchymal Stem Cell Transfusion as a Novel Immunosuppressive Regimen with Possible induction of microchimerism", Dynamic Biochemistry, Process Biotechnology and Molecular Biology, vol. 4, issue Special Issue 1 , pp. 55 - 60, 2010.
Aufy, S. M., A. M. A. Mahgoub, M. G. E. - D. Saadi, and M. A. Elmallawany, "Serological detection of Toxoplasma gondii in chronic renal failure patients and renal transplant recipients.", Journal of the Egyptian Society of Parasitology, vol. 39, issue 3, pp. 943-50, 2009. Abstract

Toxoplasma gondii antibodies were detected in 78 patients with renal disease by ELISA. Patients were classified according to the renal status; chronic renal failure patients not on haemodialysis (G1 = 19), chronic renal failure patients on regular haemodialysis (G2 = 30), renal transplant recipient (G3 = 29) and 13 normal controls. Anti-Toxoplasma IgG & IgM antibodies were 36.8% & 10.5% in renal failure patients not on haemodialysis, 56.7% &16.7% in patients on regular haemodialysis and 69% & 24.1% in renal transplant recipients versus 23.1% & 0% in controls with statistical significant difference for Toxoplasma IgG antibodies only. Anti-Toxoplasma IgG antibodies levels of G3 were lower than that of G1. It was observed that the more the exposure to dialysis, the more the risk of toxoplasmosis. It was found that 85.71% of renal transplant recipient seropositive cases for anti-Toxoplasma IgM antibodies were detected in one year post-transplantation and 14.28% of cases after the first year of transplantation.

Mahgoub, A. M. A., S. M. Aufy, M. G. E. - D. Saadi, and M. A. Elmallawany, "Risk factors predisposing to toxoplasmosis in chronic renal failure patients and renal transplant recipients.", Journal of the Egyptian Society of Parasitology, vol. 39, issue 3, pp. 963-73, 2009. Abstract

This work evaluated risk factors predisposing to toxoplasmosis in chronic renal failure patients and renal transplant recipients. The present study included 91 cases classified according to their renal status into four groups; control group, renal failure patients not on haemodialysis, renal failure patients on regular haemodialysis and renal transplant recipients group. The age groups (< 20) and (30-) had the highest positivity for anti-Toxoplasma IgG & IgM antibodies in comparison to the other age groups. The results showed no sex difference in positivity rate for anti-Toxoplasma IgG & IgM in groups. There was no significant difference between groups regarding risk factors for contracting toxoplasmosis, clinical presentation suggestive of toxoplasmosis and diabetes mellitus. There was significant difference between all groups as regarding intake of immunosuppressive drugs and blood transfusion.

Saadi, G., F. Fadel, M. El Ansary, and A. S. El-Hamid, "Mesenchymal stem cell transfusion for desensitization of positive lymphocyte cross-match before kidney transplantation: outcome of 3 cases.", Cell proliferation, vol. 46, issue 2, pp. 121-6, 2013. Abstract

OBJECTIVES: Donor specific antibodies (DSA) and a positive cross-match are contraindications for kidney transplantation. Trials of allograft transplantation across the HLA barrier have employed desensitization strategies, including the use of plasmapheresis, intravenous immunoglobulins, anti-B-cell monoclonal antibodies and splenectomy, associated with high-intensity immunosuppressive regimens. Our case 1 report suffered from repeatedly positive lymphocyte cross match after 1st renal transplantation. Graft nephrectomy could not correct the state of sensitization. Splenectomy was done in a trial to get rid of the antibody producing clone. Furthermore plasmapheresis with low dose IVIG could not as well revert the state of sensitization for the patient.

MATERIAL AND METHODS: About 50 millions donor specific MSCs were injected to the patient.

RESULTS: MSCs transfusion proved to be the only procedure which could achieve successful desensitization before performing the second transplantation owing to their immunosuppressive properties.

CONCLUSION: This case indicates that DS-MSCs is a potential option for anti-HLA desensitization. In cases 2 and 3 IV DS-MSCs transfusion was selected from the start as a successful line of treatment for pre renal transplantation desensitization to save other unnecessary lines of treatment that were tried in case 1.

Ansary, M. E., M. O. F. Hanna, G. Saadi, M. Elshazly, F. I. Fadel, H. A. E. A. Ahmed, A. M. Aziz, A. ElSharnouby, and M. M. E. D. T. Kandeel, "Passenger lymphocyte syndrome in ABO and Rhesus D minor mismatched liver and kidney transplantation: A prospective analysis.", Human immunology, vol. 76, issue 6, pp. 447-52, 2015. Abstract

The increasing demand for solid organs has necessitated the use of ABO and Rhesus (Rh) D minor mismatched transplants. The passenger lymphocyte syndrome (PLS) occurs when donor lymphocytes produce antibodies that react with host red blood cell (RBC) antigens and result in hemolysis. Our aim was to evaluate prospectively the role of PLS in post transplant anemia and hemolysis in ABO and RhD minor mismatched recipients of liver and kidney grafts and to study the association of PLS with donor lymphocyte microchimerism. We examined 11 liver and 10 kidney recipients at Day +15 for anemia, markers of hemolysis, direct antiglobulin test and eluates, and serum RBC antibodies. Microchimerism was determined in peripheral blood lymphocytes by genotyping of simple sequence length polymorphisms encoding short tandem repeats. Immune hemolytic anemia and anti-recipient RBC antibodies were observed in 2 out of 11 liver (18.2%) and 2 out of 10 kidney (20%) transplants. RBC antibody specificity reflected the donor to recipient transplant, with anti-blood group B antibodies identified in 2 cases of O to B and 1 case of A to AB transplants while anti-D antibodies were detected in 1 case of RhD-negative to RhD-positive transplant. Donor microchimerism was found in only 1 patient. In conclusion, passenger lymphocyte mediated hemolysis is frequent in minor mismatched liver and kidney transplantation. Recognizing PLS as a potential cause of post transplant anemia may allow for early diagnosis and management to decrease the morbidity and mortality in some patients.