Pub Date : 2023-12-01Epub Date: 2024-07-03DOI: 10.4103/sjkdt.sjkdt_351_22
Ghanim Hamid Al-Khattabi
The adherence of hemodialysis (HD) patients to medical instructions is considered crucial for a longer life expectancy and better quality of life. Despite its importance, there is a remarkable paucity in research dealing with the adherence of patients under HD in Saudi Arabia. The objective of this study was to identify the prevalence of adherence to fluid, diet, medications, and HD sessions among HD patients in Makkah. This was a cross-sectional study in which 361 HD patients were randomly selected from HD centers in three governmental hospitals in Makkah. Individuals were assessed for adherence using the End-Stage Renal Disease Adherence Questionnaire in addition to a clinical examination and laboratory investigations. These methods were used to identify the level of adherence to fluid, diet, medications, and HD sessions. The frequency of adherence of patients was found to be high for dietary guidelines (88.4%), fluid restriction (87.8%), and medications (88.0%), but it was relatively low for adherence to HD sessions (56.0%). The overall adherence rates in the current study population were thought to be within the range of most published international studies.
血液透析(HD)患者遵守医嘱被认为是延长预期寿命和提高生活质量的关键。尽管其重要性不言而喻,但有关沙特阿拉伯血液透析患者遵医嘱情况的研究却少之又少。本研究的目的是确定麦加的 HD 患者在输液、饮食、药物和 HD 治疗过程中的依从性。这是一项横断面研究,从麦加三家政府医院的血液透析中心随机抽取了 361 名血液透析患者。除了进行临床检查和实验室检查外,还使用终末期肾病依从性问卷对患者的依从性进行了评估。这些方法用于确定患者对输液、饮食、药物和血液透析疗程的依从性。结果发现,患者对饮食指南(88.4%)、液体限制(87.8%)和药物治疗(88.0%)的依从性较高,但对血液透析疗程的依从性相对较低(56.0%)。本研究人群的总体依从率被认为在大多数已发表的国际研究范围内。
{"title":"Adherence of Hemodialysis Patients to Fluid, Diet, Medications, and Hemodialysis Sessions, Makkah, Saudi Arabia.","authors":"Ghanim Hamid Al-Khattabi","doi":"10.4103/sjkdt.sjkdt_351_22","DOIUrl":"https://doi.org/10.4103/sjkdt.sjkdt_351_22","url":null,"abstract":"<p><p>The adherence of hemodialysis (HD) patients to medical instructions is considered crucial for a longer life expectancy and better quality of life. Despite its importance, there is a remarkable paucity in research dealing with the adherence of patients under HD in Saudi Arabia. The objective of this study was to identify the prevalence of adherence to fluid, diet, medications, and HD sessions among HD patients in Makkah. This was a cross-sectional study in which 361 HD patients were randomly selected from HD centers in three governmental hospitals in Makkah. Individuals were assessed for adherence using the End-Stage Renal Disease Adherence Questionnaire in addition to a clinical examination and laboratory investigations. These methods were used to identify the level of adherence to fluid, diet, medications, and HD sessions. The frequency of adherence of patients was found to be high for dietary guidelines (88.4%), fluid restriction (87.8%), and medications (88.0%), but it was relatively low for adherence to HD sessions (56.0%). The overall adherence rates in the current study population were thought to be within the range of most published international studies.</p>","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2024-07-03DOI: 10.4103/sjkdt.sjkdt_231_22
Retno Palupi-Baroto, Braghmandita W Indraswari, Asal Wahyuni Erlin Mulyadi, Siti N Rusdhy, Kharisma N Prabowo, Kristia Hermawan
Health-related quality of life (HRQOL) is an important patient-reported outcome. However, HRQOL research in pediatric patients with chronic kidney disease (CKD) in developing countries is limited. This cross-sectional study involved children with CKD who attended Dr. Sardjito General Hospital between January 2017 and September 2018. In total, 82 child-parent pairs were enrolled. Total HRQOL scores were significantly lower in children with Stages 3a-5 CKD than in children with Stages 1-2 CKD in the child (69.89 vs. 82.12, P = 0.004) and parent questionnaires (72.26 vs. 81.20, P = 0.02). The scores for the physical, school, and social function domains were significantly decreased. This study showed that children with Stages 3a-5 CKD had significantly lower HRQOL scores compared with children in the Stages 1-2 CKD group. Multidisciplinary teams can provide patient-centered and comprehensive management to optimize HRQOL scores during childhood and in future adult life.
{"title":"Assessing Health-related Quality of Life in Children with Chronic Kidney Disease in Indonesia: A Single Tertiary Hospital Study.","authors":"Retno Palupi-Baroto, Braghmandita W Indraswari, Asal Wahyuni Erlin Mulyadi, Siti N Rusdhy, Kharisma N Prabowo, Kristia Hermawan","doi":"10.4103/sjkdt.sjkdt_231_22","DOIUrl":"https://doi.org/10.4103/sjkdt.sjkdt_231_22","url":null,"abstract":"<p><p>Health-related quality of life (HRQOL) is an important patient-reported outcome. However, HRQOL research in pediatric patients with chronic kidney disease (CKD) in developing countries is limited. This cross-sectional study involved children with CKD who attended Dr. Sardjito General Hospital between January 2017 and September 2018. In total, 82 child-parent pairs were enrolled. Total HRQOL scores were significantly lower in children with Stages 3a-5 CKD than in children with Stages 1-2 CKD in the child (69.89 vs. 82.12, P = 0.004) and parent questionnaires (72.26 vs. 81.20, P = 0.02). The scores for the physical, school, and social function domains were significantly decreased. This study showed that children with Stages 3a-5 CKD had significantly lower HRQOL scores compared with children in the Stages 1-2 CKD group. Multidisciplinary teams can provide patient-centered and comprehensive management to optimize HRQOL scores during childhood and in future adult life.</p>","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2024-07-03DOI: 10.4103/sjkdt.sjkdt_176_22
Amr Shaker, Ahmed Fayed, Mohamed Abdelkader Morad, Safa Labib, Riem M Elmessiery, Karem Mohamed Salem, Hend A ElSheimy, Hany Hammad, Ahmed Fathy
One of the most significant consequences of systemic lupus erythematosus (SLE) is lupus nephritis (LN). Visfatin, an adipokine that is significantly expressed in visceral fat and is a marker of endothelial dysfunction in chronic kidney disease, has multiple proinflammatory actions. We aimed to evaluate the state of serum visfatin in SLE patients and to detect its possible correlation with the disease's activity and effects on the kidney affection. Fifty patients with active LN, 50 patients with inactive lupus, and 50 healthy people had their serum visfatin levels tested. Chemical and immunological markers of SLE and LN were measured. The SLE Disease Activity Index (SLEDAI) was used to measure the disease's activity. Renal biopsies from the LN subgroup were collected and classified using the modified classification of the World Health Organization. The serum visfatin of patients with active LN was significantly greater than that of inactive lupus patients and the healthy controls (20.56 ± 1.07 ng/mL, 16.77 ± 1.02 ng/mL, and 9.96 ± 1.46 ng/mL, P <0.001). SLEDAI and serum visfatin levels were shown to be significantly correlated (P = 0.000057). Serum visfatin levels were likewise significantly correlated with the index of histological activity in the active group (P <0.00001). Serum visfatin was raised in individuals with active LN and was related to the SLEDAI and disease severity scores. Serum visfatin could be utilized as a noninvasive biomarker for evaluating the severity of LN and risk stratification of the risk.
{"title":"Evaluation of Serum Visfatin as a Biomarker of Lupus Nephritis in Egyptian Patients with Systemic Lupus Erythematosus.","authors":"Amr Shaker, Ahmed Fayed, Mohamed Abdelkader Morad, Safa Labib, Riem M Elmessiery, Karem Mohamed Salem, Hend A ElSheimy, Hany Hammad, Ahmed Fathy","doi":"10.4103/sjkdt.sjkdt_176_22","DOIUrl":"https://doi.org/10.4103/sjkdt.sjkdt_176_22","url":null,"abstract":"<p><p>One of the most significant consequences of systemic lupus erythematosus (SLE) is lupus nephritis (LN). Visfatin, an adipokine that is significantly expressed in visceral fat and is a marker of endothelial dysfunction in chronic kidney disease, has multiple proinflammatory actions. We aimed to evaluate the state of serum visfatin in SLE patients and to detect its possible correlation with the disease's activity and effects on the kidney affection. Fifty patients with active LN, 50 patients with inactive lupus, and 50 healthy people had their serum visfatin levels tested. Chemical and immunological markers of SLE and LN were measured. The SLE Disease Activity Index (SLEDAI) was used to measure the disease's activity. Renal biopsies from the LN subgroup were collected and classified using the modified classification of the World Health Organization. The serum visfatin of patients with active LN was significantly greater than that of inactive lupus patients and the healthy controls (20.56 ± 1.07 ng/mL, 16.77 ± 1.02 ng/mL, and 9.96 ± 1.46 ng/mL, P <0.001). SLEDAI and serum visfatin levels were shown to be significantly correlated (P = 0.000057). Serum visfatin levels were likewise significantly correlated with the index of histological activity in the active group (P <0.00001). Serum visfatin was raised in individuals with active LN and was related to the SLEDAI and disease severity scores. Serum visfatin could be utilized as a noninvasive biomarker for evaluating the severity of LN and risk stratification of the risk.</p>","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2024-07-03DOI: 10.4103/sjkdt.sjkdt_407_22
Ngilyang Sunya, Shalu Gupta, Abhijeet Saha
The primary objective of this study was to determine the performance of the renal angina index (RAI) in predicting subsequent severe acute kidney injury (AKI) on day 3 of admission and whether integrating urinary neutrophil gelatinase-associated lipocalin (NGAL) with RAI would lead to improved prediction of AKI. This was a prospective observational study conducted in the pediatric intensive care unit (PICU) of a tertiary care hospital involving 170 children meeting the inclusion criteria. The RAI was assessed within 24 h of admission to the PICU. Positivity for renal angina was considered RAI ≥8. Urine samples were collected for all enrolled patients within the first 24 h and on day 3 of the PICU stay. NGAL was assayed using human-specific enzyme-linked immunosorbent assay. The overall incidence of AKI was 18.2%. Out of 170 children, 31 (18.2%) were RAI-positive on day 0. A higher proportion of patients in the RAI-positive group developed AKI on day 3 compared with the RAI-negative group (83.9% vs. 3.6%, P <0.001). Those who were RAI-positive on day 0 had a sensitivity, specificity, positive predictive value (PPV), and negative predictive value of 83.8%, 96.4%, 83.8%, and 96.4%, respectively, for predicting severe AKI on day 3. Incorporating urinary NGAL improved the specificity and PPV to 97.8% and 85.7%, respectively. Assessing the RAI is simple and useful for predicting severe AKI in critically ill children. The addition of urinary NGAL to the RAI optimizes its use for identifying patients at risk of subsequent severe AKI.
本研究的主要目的是确定肾心绞痛指数(RAI)在预测入院第 3 天的后续严重急性肾损伤(AKI)方面的性能,以及将尿液中性粒细胞明胶酶相关脂质钙蛋白(NGAL)与 RAI 结合使用是否会改善对 AKI 的预测。这是一项前瞻性观察研究,在一家三级甲等医院的儿科重症监护室(PICU)进行,有170名符合纳入标准的患儿参与。RAI 在儿童重症监护病房入院后 24 小时内进行评估。肾性心绞痛阳性被视为 RAI ≥8。所有入选患者均在入住 PICU 后的 24 小时内和第 3 天采集了尿液样本。采用人类特异性酶联免疫吸附测定法检测 NGAL。AKI 的总发生率为 18.2%。在 170 名患儿中,有 31 名(18.2%)在第 0 天时 RAI 阳性。与 RAI 阴性组相比,RAI 阳性组中第 3 天出现 AKI 的患者比例更高(83.9% 对 3.6%,P<0.05)。
{"title":"Integration of Urinary Neutrophil Gelatinase-associated Lipocalin with the Renal Angina Index to Predict Subsequent Severe Acute Kidney Injury in Critically Ill Children: A Diagnostic Accuracy Study.","authors":"Ngilyang Sunya, Shalu Gupta, Abhijeet Saha","doi":"10.4103/sjkdt.sjkdt_407_22","DOIUrl":"https://doi.org/10.4103/sjkdt.sjkdt_407_22","url":null,"abstract":"<p><p>The primary objective of this study was to determine the performance of the renal angina index (RAI) in predicting subsequent severe acute kidney injury (AKI) on day 3 of admission and whether integrating urinary neutrophil gelatinase-associated lipocalin (NGAL) with RAI would lead to improved prediction of AKI. This was a prospective observational study conducted in the pediatric intensive care unit (PICU) of a tertiary care hospital involving 170 children meeting the inclusion criteria. The RAI was assessed within 24 h of admission to the PICU. Positivity for renal angina was considered RAI ≥8. Urine samples were collected for all enrolled patients within the first 24 h and on day 3 of the PICU stay. NGAL was assayed using human-specific enzyme-linked immunosorbent assay. The overall incidence of AKI was 18.2%. Out of 170 children, 31 (18.2%) were RAI-positive on day 0. A higher proportion of patients in the RAI-positive group developed AKI on day 3 compared with the RAI-negative group (83.9% vs. 3.6%, P <0.001). Those who were RAI-positive on day 0 had a sensitivity, specificity, positive predictive value (PPV), and negative predictive value of 83.8%, 96.4%, 83.8%, and 96.4%, respectively, for predicting severe AKI on day 3. Incorporating urinary NGAL improved the specificity and PPV to 97.8% and 85.7%, respectively. Assessing the RAI is simple and useful for predicting severe AKI in critically ill children. The addition of urinary NGAL to the RAI optimizes its use for identifying patients at risk of subsequent severe AKI.</p>","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2024-07-03DOI: 10.4103/sjkdt.sjkdt_370_22
Safa Nowrooz, Turki Alanazi, Abdulmohsen Al-Ghamdi, Abdulaziz Alzahrani, Abdulrahman Alshammari, Neda AlYaqoot, Mana Almutraid, Ahmed Jaradat, Amgad El-Agroudy
This study examined the effects of the time of hemodialysis (HD) on patients' quality of life (QOL). This study included 175 HD patients (116 males, 59 females), aged 18-80 years (mean = 58.1 ± 11.3 years). Shift 1 was 7:00-11:00 AM, Shift 2 was 12:00-4:00 PM, Shift 3 was 5:00-9:00 PM, and Shift 4 was 10:00-2:00 AM (38, 38, 43, and 56 patients, respectively). Those on Shift 4 had a higher mean age compared with the other shifts, with a higher number of widowed people (8.6%). The proportions of males and females showed no significant differences among the shifts. The mean duration on dialysis was 42.1 ± 39.3 months, with a shorter duration for Shift 4. We observed the highest QOL score for the psychological and spiritual subscale, followed by the family subscale. Half the patients were dissatisfied with their jobs and had less satisfaction with their sexual life, their education, and getting a kidney transplant. We found a significant difference in overall QOL among shifts, with the greatest difference between Shifts 3 and 4. Health and functioning, psychological and spiritual, and social and economic scores were lowest in Shift 4, which was significantly different from Shift 1 and Shift 3. We found significant associations between overall QOL and general health, and the scores from different domains. Satisfaction was moderate in all groups. The study revealed poor QOL among Shift 4 patients; hence, they need more support in clinical practice guidelines.
本研究探讨了血液透析(HD)时间对患者生活质量(QOL)的影响。这项研究包括 175 名血液透析患者(男性 116 人,女性 59 人),年龄在 18-80 岁之间(平均年龄为 58.1 ± 11.3 岁)。第一班为上午 7:00-11:00,第二班为中午 12:00-4:00,第三班为下午 5:00-9:00,第四班为上午 10:00-2:00(分别有 38、38、43 和 56 名患者)。与其他班次相比,四班病人的平均年龄较高,其中丧偶者人数较多(8.6%)。各班次的男女比例没有明显差异。平均透析时间为 42.1 ± 39.3 个月,其中四班的透析时间较短。我们观察到,心理和精神分量表的 QOL 得分最高,其次是家庭分量表。半数患者对工作不满意,对性生活、教育和接受肾移植的满意度较低。我们发现不同班次之间的总体 QOL 有明显差异,其中三班和四班之间的差异最大。四班的健康和功能、心理和精神以及社会和经济得分最低,与一班和三班有显著差异。我们发现,总体 QOL 和一般健康状况与不同领域的得分之间存在明显关联。所有组别的满意度都处于中等水平。研究显示,四班患者的 QOL 较差,因此他们需要更多的临床实践指导支持。
{"title":"Quality of Life among Hemodialysis Patients: Role of the Dialysis Shift.","authors":"Safa Nowrooz, Turki Alanazi, Abdulmohsen Al-Ghamdi, Abdulaziz Alzahrani, Abdulrahman Alshammari, Neda AlYaqoot, Mana Almutraid, Ahmed Jaradat, Amgad El-Agroudy","doi":"10.4103/sjkdt.sjkdt_370_22","DOIUrl":"https://doi.org/10.4103/sjkdt.sjkdt_370_22","url":null,"abstract":"<p><p>This study examined the effects of the time of hemodialysis (HD) on patients' quality of life (QOL). This study included 175 HD patients (116 males, 59 females), aged 18-80 years (mean = 58.1 ± 11.3 years). Shift 1 was 7:00-11:00 AM, Shift 2 was 12:00-4:00 PM, Shift 3 was 5:00-9:00 PM, and Shift 4 was 10:00-2:00 AM (38, 38, 43, and 56 patients, respectively). Those on Shift 4 had a higher mean age compared with the other shifts, with a higher number of widowed people (8.6%). The proportions of males and females showed no significant differences among the shifts. The mean duration on dialysis was 42.1 ± 39.3 months, with a shorter duration for Shift 4. We observed the highest QOL score for the psychological and spiritual subscale, followed by the family subscale. Half the patients were dissatisfied with their jobs and had less satisfaction with their sexual life, their education, and getting a kidney transplant. We found a significant difference in overall QOL among shifts, with the greatest difference between Shifts 3 and 4. Health and functioning, psychological and spiritual, and social and economic scores were lowest in Shift 4, which was significantly different from Shift 1 and Shift 3. We found significant associations between overall QOL and general health, and the scores from different domains. Satisfaction was moderate in all groups. The study revealed poor QOL among Shift 4 patients; hence, they need more support in clinical practice guidelines.</p>","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2024-07-03DOI: 10.4103/sjkdt.sjkdt_249_23
Ghanim Hamid Al-Khattabi
The nonadherence of hemodialysis (HD) patients correlates with morbidity and mortality. Despite severe consequences, noncompliance with their medical regimen is the norm for HD patients rather than the exception. Factors associated with nonadherence to dietary restrictions among HD patients have been explored in many studies; however, most were in Western countries and there is a remarkable paucity of studies in Saudi Arabia. HD patients have several features that put them at an increased risk of nonadherence to dietary restrictions, including prolonged, intensive treatment, and their medical regimens are easily determined with objective measures. This crosssectional study aimed to determine factors related to nonadherence to dietary restrictions among 361 HD patients randomly selected from HD centers in Makkah, Saudi Arabia. Individuals were assessed for adherence using the End-Stage Renal Disease - Adherence Questionnaire in addition to clinical examinations and laboratory investigations. Female patients were more likely to be nonadherent to dietary restrictions. Adherence to dietary restrictions was relatively higher among non-Saudi patients, older people, those who are married, those with university qualifications, those who are employed, and those with higher monthly incomes; nevertheless, these differences were not statistically significant. Despite the relatively higher frequency of adherence to dietary restrictions among patients with a duration of dialysis of <60 months, hypertensive patients, patients with a previous kidney transplant, and those with a previous history of psychiatric illnesses, these differences were not statistically significant. Patients with factors associated with nonadherence to dietary restrictions deserve special attention and support to improve their adherence.
血液透析(HD)患者的不依从性与发病率和死亡率有关。尽管会造成严重后果,但不遵守医嘱是血液透析患者的常态而非例外。许多研究都探讨了与血液透析患者不遵守饮食限制相关的因素;但是,大多数研究都是在西方国家进行的,在沙特阿拉伯进行的研究却非常少。血液透析患者有几个特点使他们不遵守饮食限制的风险增加,其中包括长期、密集的治疗,而且他们的医疗方案很容易通过客观测量来确定。这项横断面研究旨在确定从沙特阿拉伯麦加的 HD 中心随机抽取的 361 名 HD 患者不遵守饮食限制的相关因素。除临床检查和实验室检查外,还使用终末期肾病--依从性问卷对患者的依从性进行了评估。女性患者更有可能不遵守饮食限制。非沙特籍患者、老年人、已婚者、大学学历者、就业者和月收入较高者遵守饮食限制的比例相对较高,但这些差异在统计学上并不显著。尽管透析持续时间为 5 个月的患者遵守饮食限制的频率相对较高,但透析持续时间为 6 个月的患者遵守饮食限制的频率相对较低。
{"title":"Factors Associated with Nonadherence to Dietary Prescriptions among Hemodialysis Patients, Makkah, Saudi Arabia.","authors":"Ghanim Hamid Al-Khattabi","doi":"10.4103/sjkdt.sjkdt_249_23","DOIUrl":"https://doi.org/10.4103/sjkdt.sjkdt_249_23","url":null,"abstract":"<p><p>The nonadherence of hemodialysis (HD) patients correlates with morbidity and mortality. Despite severe consequences, noncompliance with their medical regimen is the norm for HD patients rather than the exception. Factors associated with nonadherence to dietary restrictions among HD patients have been explored in many studies; however, most were in Western countries and there is a remarkable paucity of studies in Saudi Arabia. HD patients have several features that put them at an increased risk of nonadherence to dietary restrictions, including prolonged, intensive treatment, and their medical regimens are easily determined with objective measures. This crosssectional study aimed to determine factors related to nonadherence to dietary restrictions among 361 HD patients randomly selected from HD centers in Makkah, Saudi Arabia. Individuals were assessed for adherence using the End-Stage Renal Disease - Adherence Questionnaire in addition to clinical examinations and laboratory investigations. Female patients were more likely to be nonadherent to dietary restrictions. Adherence to dietary restrictions was relatively higher among non-Saudi patients, older people, those who are married, those with university qualifications, those who are employed, and those with higher monthly incomes; nevertheless, these differences were not statistically significant. Despite the relatively higher frequency of adherence to dietary restrictions among patients with a duration of dialysis of <60 months, hypertensive patients, patients with a previous kidney transplant, and those with a previous history of psychiatric illnesses, these differences were not statistically significant. Patients with factors associated with nonadherence to dietary restrictions deserve special attention and support to improve their adherence.</p>","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2024-07-03DOI: 10.4103/sjkdt.sjkdt_317_22
Mahmoud M Mohamed, Atif Ibrahim, Zareen Razaq, Waleed Hassan
We report a case of a 69-year-old Caucasian male with a history of hypertension, Type 2 diabetes, and Stage IIIa chronic kidney disease (CKD), who presented to the emergency department with positional dizziness, generalized weakness, weight loss, and suppressed appetite. Two months earlier, the patient was diagnosed with coronavirus disease 2019 (COVID-19). The patient had non-oliguric acute kidney injury alongside preexisting CKD. The urinalysis showed hematuria and significant non-nephrotic proteinuria. His serological markers were positive for antineutrophil cytoplasmic antibodies with high titers. A kidney biopsy showed focal crescentic glomerulonephritis of the pauci-immune type. Initially, treatment with immunosuppressive medication was deferred because the biopsy findings suggested a poor renal outcome, as the cortical sample showed tubular atrophy and interstitial fibrosis of more than 50%. The patient was discharged but was later readmitted with worsening renal function, deep venous thrombosis in the lower extremities, and patchy lung consolidation suggesting possible pneumonia, which was ruled out. He required dialysis and brief empiric antibiotics for pneumonia, and anticoagulation for deep venous thrombosis, and was treated with intravenous (IV) pulsed steroids, followed by gradually tapering oral steroids and rituximab induction therapy. He continued dialysis three times a week. Three months after discharge, his renal function improved to near-baseline level, and he no longer required hemodialysis. He continues to be on maintenance IV rituximab therapy and low-dose oral steroids and is followed closely by a rheumatologist. Our case reflects the evolving state of understanding how COVID-19 impacts the immune system, its varying manifestations, and its management.
{"title":"A Case of Postcoronavirus Disease 2019 Antineutrophil Cytoplasmic Antibody-associated Vasculitis Successfully Treated with Rituximab.","authors":"Mahmoud M Mohamed, Atif Ibrahim, Zareen Razaq, Waleed Hassan","doi":"10.4103/sjkdt.sjkdt_317_22","DOIUrl":"https://doi.org/10.4103/sjkdt.sjkdt_317_22","url":null,"abstract":"<p><p>We report a case of a 69-year-old Caucasian male with a history of hypertension, Type 2 diabetes, and Stage IIIa chronic kidney disease (CKD), who presented to the emergency department with positional dizziness, generalized weakness, weight loss, and suppressed appetite. Two months earlier, the patient was diagnosed with coronavirus disease 2019 (COVID-19). The patient had non-oliguric acute kidney injury alongside preexisting CKD. The urinalysis showed hematuria and significant non-nephrotic proteinuria. His serological markers were positive for antineutrophil cytoplasmic antibodies with high titers. A kidney biopsy showed focal crescentic glomerulonephritis of the pauci-immune type. Initially, treatment with immunosuppressive medication was deferred because the biopsy findings suggested a poor renal outcome, as the cortical sample showed tubular atrophy and interstitial fibrosis of more than 50%. The patient was discharged but was later readmitted with worsening renal function, deep venous thrombosis in the lower extremities, and patchy lung consolidation suggesting possible pneumonia, which was ruled out. He required dialysis and brief empiric antibiotics for pneumonia, and anticoagulation for deep venous thrombosis, and was treated with intravenous (IV) pulsed steroids, followed by gradually tapering oral steroids and rituximab induction therapy. He continued dialysis three times a week. Three months after discharge, his renal function improved to near-baseline level, and he no longer required hemodialysis. He continues to be on maintenance IV rituximab therapy and low-dose oral steroids and is followed closely by a rheumatologist. Our case reflects the evolving state of understanding how COVID-19 impacts the immune system, its varying manifestations, and its management.</p>","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2024-07-03DOI: 10.4103/sjkdt.sjkdt_33_22
Nuran Cetin, Evin Kocaturk, Asli Kavaz Tufan, Zeynep Kusku Kiraz, Ozkan Alatas
Immature granulocytes (IGs) are used as markers of infection and systemic inflammation. We aimed to investigate the diagnostic value of IGs in children with urinary tract infections (UTIs). Children with their first UTIs were included in this observational study. Blood samples were obtained before antibiotic therapy. The blood analysis was repeated 2 weeks after the treatment ended. In total, 194 children (95 with febrile UTI, 58 with cystitis, and 41 controls) were included. The percentage of IGs (IG%) and IG count (IGC) measured at the time of admission were higher in the patients with febrile UTI than in the patients with cystitis and the controls (P = 0.000). The IGC and IG% after treatment were higher in patients with renal scarring than in those without scarring (P = 0.012 and P = 0.021, respectively). Cox's regression analysis showed the significant associations of renal scarring with both IGC and IG% (hazard ratio: 8.181, P = 0.002; hazard ratio: 5.106, P = 0.033, respectively). Both IGC and IG% were positively associated with severe vesicoureteral reflux (VUR) [odds ratio (OR): 22.235, P = 0.025; OR: 15.597, P = 0.038, respectively]. In conclusion, the IG% and IGC, which can be easily measured in a routine complete blood count without the need for additional effort, could be used as biomarkers for predicting febrile UTI, renal scarring, and severe VUR in children.
{"title":"Diagnostic Values of Immature Granulocytes Detected by the Sysmex XN 9000 Hematology Analyzer in Children with Urinary Tract Infections.","authors":"Nuran Cetin, Evin Kocaturk, Asli Kavaz Tufan, Zeynep Kusku Kiraz, Ozkan Alatas","doi":"10.4103/sjkdt.sjkdt_33_22","DOIUrl":"https://doi.org/10.4103/sjkdt.sjkdt_33_22","url":null,"abstract":"<p><p>Immature granulocytes (IGs) are used as markers of infection and systemic inflammation. We aimed to investigate the diagnostic value of IGs in children with urinary tract infections (UTIs). Children with their first UTIs were included in this observational study. Blood samples were obtained before antibiotic therapy. The blood analysis was repeated 2 weeks after the treatment ended. In total, 194 children (95 with febrile UTI, 58 with cystitis, and 41 controls) were included. The percentage of IGs (IG%) and IG count (IGC) measured at the time of admission were higher in the patients with febrile UTI than in the patients with cystitis and the controls (P = 0.000). The IGC and IG% after treatment were higher in patients with renal scarring than in those without scarring (P = 0.012 and P = 0.021, respectively). Cox's regression analysis showed the significant associations of renal scarring with both IGC and IG% (hazard ratio: 8.181, P = 0.002; hazard ratio: 5.106, P = 0.033, respectively). Both IGC and IG% were positively associated with severe vesicoureteral reflux (VUR) [odds ratio (OR): 22.235, P = 0.025; OR: 15.597, P = 0.038, respectively]. In conclusion, the IG% and IGC, which can be easily measured in a routine complete blood count without the need for additional effort, could be used as biomarkers for predicting febrile UTI, renal scarring, and severe VUR in children.</p>","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2024-07-03DOI: 10.4103/sjkdt.sjkdt_56_22
Amr Mohamed Shaker, Moataz F Mohamed, Karim K Thabet, Tarek Ramzy, Yasser M Abdelhamid
Interleukin-18 (IL-18) is a pro-inflammatory cytokine that rises approximately 24-48 h before a diagnosis of acute kidney injury (AKI). Kidney injury molecule-1 (KIM-1) is one of the most promising early biomarkers. It participates in the process of both kidney injury and healing, although the precise mechanism of the restoration of tubular integrity after injury still remains unclear. The renal resistive index (RRI) is used for evaluating changes in intrarenal perfusion occurring in renal parenchyma diseases. The study included 80 critically ill patients with sepsis, divided into 40 patients who developed AKI and 40 patients without AKI. All patients were evaluated through their history, clinical examination, laboratory investigations of serum IL-18 and KIM-1, and the RRI. Serum IL 18, serum KIM-1, and the RRI were significantly higher in critically ill patients with sepsis and AKI. Receiver operating characteristic analysis for detecting AKI 1 day after admission showed that the area under the curve (AUC) for serum IL-18 was 86.1%, the AUC for serum KIM-1 was 86%, and the AUC for the RRI was 88%, demonstrating statistical significance for the diagnosis of AKI within the next 24 h. Serum IL-18, KIM-1, and the RRI represent early predictors of AKI in critically ill septic patients.
白细胞介素-18(IL-18)是一种促炎细胞因子,在急性肾损伤(AKI)确诊前约 24-48 小时会升高。肾损伤分子-1(KIM-1)是最有希望的早期生物标志物之一。它参与肾脏损伤和愈合过程,但损伤后肾小管完整性恢复的确切机制仍不清楚。肾脏阻力指数(RRI)用于评估肾脏实质疾病时发生的肾内灌注变化。该研究纳入了 80 名脓毒症重症患者,分为 40 名出现 AKI 的患者和 40 名未出现 AKI 的患者。所有患者均通过病史、临床检查、血清 IL-18 和 KIM-1 实验室检查以及 RRI 进行了评估。脓毒症和 AKI 重症患者的血清 IL 18、血清 KIM-1 和 RRI 均明显升高。入院一天后检测 AKI 的接收者操作特征分析表明,血清 IL-18 的曲线下面积(AUC)为 86.1%,血清 KIM-1 的曲线下面积(AUC)为 86%,RRI 的曲线下面积(AUC)为 88%,这表明在接下来的 24 小时内诊断 AKI 具有统计学意义。
{"title":"Serum Interleukin-18, Kidney Injury Molecule-1, and the Renal Resistive Index for Predicating Acute Kidney Injury in Critically Ill Patients with Sepsis.","authors":"Amr Mohamed Shaker, Moataz F Mohamed, Karim K Thabet, Tarek Ramzy, Yasser M Abdelhamid","doi":"10.4103/sjkdt.sjkdt_56_22","DOIUrl":"10.4103/sjkdt.sjkdt_56_22","url":null,"abstract":"<p><p>Interleukin-18 (IL-18) is a pro-inflammatory cytokine that rises approximately 24-48 h before a diagnosis of acute kidney injury (AKI). Kidney injury molecule-1 (KIM-1) is one of the most promising early biomarkers. It participates in the process of both kidney injury and healing, although the precise mechanism of the restoration of tubular integrity after injury still remains unclear. The renal resistive index (RRI) is used for evaluating changes in intrarenal perfusion occurring in renal parenchyma diseases. The study included 80 critically ill patients with sepsis, divided into 40 patients who developed AKI and 40 patients without AKI. All patients were evaluated through their history, clinical examination, laboratory investigations of serum IL-18 and KIM-1, and the RRI. Serum IL 18, serum KIM-1, and the RRI were significantly higher in critically ill patients with sepsis and AKI. Receiver operating characteristic analysis for detecting AKI 1 day after admission showed that the area under the curve (AUC) for serum IL-18 was 86.1%, the AUC for serum KIM-1 was 86%, and the AUC for the RRI was 88%, demonstrating statistical significance for the diagnosis of AKI within the next 24 h. Serum IL-18, KIM-1, and the RRI represent early predictors of AKI in critically ill septic patients.</p>","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2024-07-03DOI: 10.4103/sjkdt.sjkdt_95_22
Priya Garg, Manjunath Shetty, Vani Krishnamurthy
Diabetic nephropathy (DN), a leading cause of chronic kidney disease, is known to develop in around 40% of patients with diabetes. NGAL, a biomarker expressed by the tubular epithelium, has been evaluated in both acute and chronic kidney injury. However, kidney damage revealed by the histology of renal tissue core biopsies has not been quantified by morphometry and its correlation with urinary NGAL (uNGAL) has not been studied. Our objective was to compare levels of uNGAL with the extent of kidney damage in the histopathological results of morphometry in patients with DN. This prospective analytical study was conducted in a tertiary hospital. Urine samples of 42 patients were collected and freeze-dried. uNGAL was estimated through a chemiluminescent microparticle immunoassay. Pearson's correlation coefficients between kidney damage quantified by morphometry and NGAL values were examined. The correlation of uNGAL with the percentage of acute tubular injury assessed by morphometry in the renal core was 7.35% (P = 0.64). uNGAL had the highest correlation with inflammation (r = 54.2%; P = 0.002). Another parameter with a significant correlation was glomerular sclerosis with r = 35.6% (95% confidence interval: 10%-60%) and an associated P = 0.02. UNGAL was strongly correlated with inflammatory kidney damage in patients with DN.
{"title":"Correlation of Urinary Neutrophil Gelatinase with the Histopathological Extent of Kidney Damage in Patients with Diabetic Nephropathy.","authors":"Priya Garg, Manjunath Shetty, Vani Krishnamurthy","doi":"10.4103/sjkdt.sjkdt_95_22","DOIUrl":"https://doi.org/10.4103/sjkdt.sjkdt_95_22","url":null,"abstract":"<p><p>Diabetic nephropathy (DN), a leading cause of chronic kidney disease, is known to develop in around 40% of patients with diabetes. NGAL, a biomarker expressed by the tubular epithelium, has been evaluated in both acute and chronic kidney injury. However, kidney damage revealed by the histology of renal tissue core biopsies has not been quantified by morphometry and its correlation with urinary NGAL (uNGAL) has not been studied. Our objective was to compare levels of uNGAL with the extent of kidney damage in the histopathological results of morphometry in patients with DN. This prospective analytical study was conducted in a tertiary hospital. Urine samples of 42 patients were collected and freeze-dried. uNGAL was estimated through a chemiluminescent microparticle immunoassay. Pearson's correlation coefficients between kidney damage quantified by morphometry and NGAL values were examined. The correlation of uNGAL with the percentage of acute tubular injury assessed by morphometry in the renal core was 7.35% (P = 0.64). uNGAL had the highest correlation with inflammation (r = 54.2%; P = 0.002). Another parameter with a significant correlation was glomerular sclerosis with r = 35.6% (95% confidence interval: 10%-60%) and an associated P = 0.02. UNGAL was strongly correlated with inflammatory kidney damage in patients with DN.</p>","PeriodicalId":21356,"journal":{"name":"Saudi Journal of Kidney Diseases and Transplantation","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}