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Tawhari M, Alhamadh M, Alhabeeb A, Ureeg A, Alghnam S, Alhejaili F, Alnasser LA, Sayyari A. Establishing the Kidney dIsease in the National guarD (KIND) registry: an opportunity for epidemiological and clinical research in Saudi Arabia. BMC Nephrol 2024; 25:59. [PMID: 38374104 PMCID: PMC10875783 DOI: 10.1186/s12882-024-03479-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/23/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND In Saudi Arabia (SA), there has been an alarming increase in the prevalence of chronic kidney diseases (CKD) over the last three decades. Despite being one of the largest countries in the Middle East, renal conditions remain understudied, and there is limited data on their epidemiology and outcomes in SA. OBJECTIVES To document the experience of establishing a local renal registry assessing the epidemiology of CKD and identifying potential areas for improving the quality and delivery of care for CKD patients. METHODS This is a multi-center retrospective registry. Potential participants were identified through the ICD-10 codes from five hospitals serving the National Guard affiliates in SA. Patients aged ≥ 18 years treated in any National Guard hospital since 2010 for glomerulonephritis, CKD, or received hemodialysis, peritoneal dialysis, or renal transplant were enrolled. Once enrolled in the registry, patients were followed to the last visit date. RedCap was used to create and host the online registry platform. RESULTS A total of 2,912 patients were included, and more than half were younger than 60 years old. Two-thirds of the patients were overweight (25%) or obese (37%). Glomerulonephritis was diagnosed in 10% of the patients, and dialysis-dependent and kidney transplant patients accounted for 31.4% and 24.4%, respectively. Hypertension and diabetes mellitus were detected among 52% and 43% of the participants, respectively. Hemodialysis was the most prevalent dialysis method, with patients spending 3.6 ± 0.4 h per session to receive this treatment. One in every five participants had a kidney biopsy taken (21%). Several barriers and facilitators of the success of this registry were identified. CONCLUSIONS The KIND registry provides much-needed information about CKD in Saudi Arabia and serves as a model for future projects investigating the natural history and progression of the spectrum of renal diseases. Logistic and financial challenges to the sustainability of registries are identified and discussed.
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Affiliation(s)
- Mohammed Tawhari
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
- Department of Medicine, Division of Nephrology, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
- Population Health Research Section, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Moustafa Alhamadh
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
- Population Health Research Section, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Abdulrahman Alhabeeb
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
- Population Health Research Section, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Abdulaziz Ureeg
- Population Health Research Section, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Ministry of the National Guard--Health Affairs, Riyadh, Saudi Arabia
| | - Suliman Alghnam
- Population Health Research Section, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Ministry of the National Guard--Health Affairs, Riyadh, Saudi Arabia
| | - Fayez Alhejaili
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
- Department of Medicine, Division of Nephrology, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Lubna A Alnasser
- Population Health Research Section, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
- King Saud bin Abdulaziz University for Health Sciences, Ministry of the National Guard--Health Affairs, Riyadh, Saudi Arabia.
| | - Abdullah Sayyari
- Department of Medicine, Division of Nephrology, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
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Alattab NA, Suliman Y, Wani TM, Alhazmi KA, Bin Onayq AI, Mahjoub ST. Pseudoaneurysm and Renal Artery Stenosis Post-renal Transplant: A Rare Presentation. Cureus 2023; 15:e47315. [PMID: 38022252 PMCID: PMC10656789 DOI: 10.7759/cureus.47315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
We report the case of a 51-year-old gentleman who underwent living renal transplantation in Pakistan for end-stage renal disease one and a half years ago. He presented to our hospital with renal artery stenosis and an extra-renal pseudoaneurysm at the anastomotic site of the transplanted kidney. This can cause graft dysfunction and hypertension due to impairment of arterial perfusion in the transplanted kidney. Treatment with percutaneous transluminal angioplasty and covered stenting of the pseudoaneurysm and stenosis improved kidney function and hypertension.
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Affiliation(s)
| | - Yasir Suliman
- Vascular Surgery, Burjeel Medical City, Abu Dhabi, ARE
| | - Tariq M Wani
- Vascular Surgery, King Fahad Medical City, Riyadh, SAU
| | | | | | - Saleh T Mahjoub
- Medicine and Surgery, King Saud University Medical City, Riyadh, SAU
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Tawhari M, Radwi M. A Three-Year Experience With Overseas Kidney Transplantation in a Tertiary Transplant Center in Saudi Arabia. Cureus 2022; 14:e23988. [PMID: 35419250 PMCID: PMC8994614 DOI: 10.7759/cureus.23988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2022] [Indexed: 11/06/2022] Open
Abstract
Background Overseas kidney transplantation is known to be associated with adverse outcomes. In this study, we aim to present a detailed analysis of our three years of experience with overseas kidney transplantation at one of the largest kidney transplant referral sites in the Kingdom of Saudi Arabia. Materials and methods A retrospective cohort study included patients who underwent kidney transplantation overseas and were subsequently followed up at King Abdulaziz Medical City from January 2016 to July 31, 2019. In addition, we compared the outcomes of the patients who underwent kidney transplantation overseas with a cohort of patients who were transplanted locally within the same period. Patients in both cohorts had to have at least one year of follow-up post-transplantation. Results We included a total of 51 patients who underwent kidney transplantation overseas. The mean age of the cohort was 44.7 years, and 69% were male. Almost 60% of the cohort had one or no comorbidity prior to transplant, with hypertension (84%) and diabetes mellitus (37%) being the leading comorbidities. The cause of end-stage kidney disease was unknown in 55% of our patients. In those who had an identifiable cause, lupus nephropathy and diabetes were the most common causes of kidney failure. In comparison with the locally transplanted cohort, no difference was detected between these groups in their baseline characteristics, type or number of comorbidities, medical or surgical complications postoperatively, and one-year mortality. However, we found that the graft rejection rate was significantly higher in patients transplanted overseas (OR=5.4, p<0.001). In addition, the proportion of patients who received anti-thymocyte globulin (ATG) induction was also less in the group with overseas kidney transplantation (58% vs. 22%, p<0.001). Conclusion Overseas transplantation is associated with an increased risk for graft rejection. Our study suggests that overseas kidney transplantation is possibly driven by a lack of donors, especially cadaveric. Counseling patients about risks associated with overseas kidney transplantation and encouraging the public to register for organ donation after death may help curb out this practice.
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