Alanine Transaminase ; Alleles ; Azathioprine ; Biopsy ; Child ; Chronic Disease ; Diagnosis ; Fibrosis ; Genotype ; Hepatitis, Autoimmune ; Humans ; Liver ; Macrophages ; Recurrence ; T-Lymphocytes

BACKGROUND: In dialysis patients, the obesity-survival paradox still requires an explanation. Anemia and high doses of erythropoiesis-stimulating agents (ESAs) are associated with worse outcomes in the hemodialysis (HD) population. In the present study, we explored the relation between obesity and anemia control in a sample of maintenance HD patients in Egypt. METHODS: This multicenter observational study included 733 patients on maintenance HD from 9 hemodialysis centers in Egypt. Clinical and laboratory data as well as average doses of ESAs and parenteral iron were recorded. The erythropoietin resistance index (ERI) was calculated. RESULTS: Obesity, defined as a body mass index (BMI) ≥ 30 kg/m2, was present in 22.6% of the studied population. The target hemoglobin level (10.0–11.5 g/dL) was achieved in 27.3% of non-obese and 25.3% of obese patients, with no significant difference. The median serum ferritin and the values of transferrin saturation index did not differ significantly between these two groups. The weekly ESA dose was significantly lower in obese than in non-obese patients (P = 0.0001). A trend toward higher ESA doses and ERI values was observed in patients with lower BMIs (P < 0.0001). Multiple linear regression revealed that the BMI and urea reduction ratio were the strongest predictors of the ERI. CONCLUSION: Our study adds more evidence to obesity-associated advantages in HD patients. BMI may determine ESA response, with better responses observed in patients with higher BMIs.
Anemia ; Body Mass Index ; Dialysis ; Egypt ; Erythropoietin* ; Ferritins ; Humans ; Iron ; Linear Models ; Obesity* ; Observational Study ; Renal Dialysis* ; Transferrin ; Urea

Objective: To compare the genotype frequencies of HLA class- II DRB1 alleles in Giardia (G.) lamblia-infected children. Methods: A total of 490 Egyptian children aged 2-16 years were subjected to microscopic stool examination to detect G. lamblia infection, and to exclude other intestinal pathogens. On the basis of their microscopic findings, a group of 80 children were chosen as giardiasis cases, another 80 children were confirmed as Giardia free control group by immunochromatographic test, and the remaining children were excluded. Both giardiasis and control groups were then subjected to blood examination to identify their genetic type of HLA-DRB1 alleles. Results: HLA class-II DRB1∗03:01 and DRB1∗13:01 alleles were significantly associated with G. lamblia infection (P<0.001 for each variable). On the other hand, HLA class-II DRB1∗04:02, DRB1∗10:01, DRB1∗14:01 and DRB1∗15:01 alleles were significantly demonstrated in Giardia free children. However, other HLA-DRB1 alleles did not show any significant association with giardiasis. Conclusions: HLA class-II DRB1∗03, DRB1∗13, DRB1∗04, DRB1∗10, DRB1∗14 and DRB1∗15 alleles may be involved in the establishment of host immune response to G. lamblia infection.