1
|
Ghonimi T, Hamad A, Fouda T, AlAli F, Ezzat M, Awad M, Ibrahim R, Amin M, Alkadi M, Al-Malki HA. Cardiovascular calcification in hemodialysis patients: A Qatar-based prevalence and risk factors study. Qatar Med J 2024; 2024:18. [PMID: 38654817 PMCID: PMC11037094 DOI: 10.5339/qmj.2024.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 02/25/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Patients with end-stage kidney disease on hemodialysis (HD) have an increased risk of death due to the high prevalence of cardiovascular disease. Vascular calcification (VC) is predictive of cardiovascular disease and mortality. We conducted a study to evaluate the prevalence and risk factors for VC in dialysis patients in Qatar. METHODS This is a retrospective nationwide study including all chronic ambulatory dialysis patients in Qatar from 2020 to 2022. We used our national electronic medical record to track demographics, clinical characteristics, comorbidities, laboratory values, and diagnostic data for each patient. Calcifications were assessed by echocardiography (routinely done for all our dialysis population per national protocol), computed tomography, X-ray, and ultrasound. The study protocol was approved by the local medical research ethics committee (MRC-01-20-377). RESULTS 842 HD patients were included in this study. Vascular calcifications (VC) were prevalent in 52.6% of patients. The main site of VC was Mitral valve calcifications in 55.5% of patients. Patients with VC were significantly older and had more prevalence of diabetes mellitus (p = 0.001 and p = 0.006, respectively). There was no statistically significant difference between patients with calcifications and patients without calcifications regarding serum calcium, phosphorus, and PTH level. In multivariate analysis, age and diabetes significantly increased the risk factor for calcification (95% CI 1.033-1.065, p < 0.0001, and 95% CI 1.128-2.272, p < 0001, respectively). Moreover, higher vitamin D levels and higher doses of IV Alfacalcidol were significant risk factors for calcifications (95% CI 1.005-1.030, p < 0.007, and 95% CI 1.092-1.270, p < 0.0001, respectively). CONCLUSION Our study found that vascular calcification was widespread among our dialysis population in Qatar. Implementing the practice of echocardiography in dialysis patients was extremely helpful and the most productive in detecting vascular calcification. Diabetes mellitus almost doubles the risk for vascular calcifications in dialysis patients. These results are beneficial in identifying risk factors for vascular calcification, which can help stratify dialysis patients' risk of cardiovascular disease and optimize prevention efforts.
Collapse
Affiliation(s)
- Tarek Ghonimi
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Abdullah Hamad
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Tarek Fouda
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Fadwa AlAli
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mohamad Ezzat
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed Awad
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Rania Ibrahim
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed Amin
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mohamad Alkadi
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Hassan Ali Al-Malki
- Division of Nephrology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| |
Collapse
|
2
|
Hamad A, Fouda T, Alkadi M, Abdellatif T, Al Omari A, Alakhras A, Amood A, Ibrahim R, Aly S, Farooqi F, Almalki H. MO537: Effects of COVID-19 on Mineral and Bone Disease Outcomes in Hemodialysis Patients: A Retrospective Study From Qatar. Nephrol Dial Transplant 2022. [PMCID: PMC9383848 DOI: 10.1093/ndt/gfac073.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND AND AIMS Management of end-stage renal disease (ESRD) on dialysis has been challenging during the COVID19 epidemic. Staff illness led to a shortage of manpower that affected patient care. We established a specialty nursing management for mineral and bone disease (MBD) in the ambulatory dialysis service in Qatar in 2016. We are presenting a retrospective study about the effects of the COVID-19 epidemic on MBD outcomes in ambulatory dialysis patients in the State of Qatar. METHOD A retrospective cohort study in all adult patients with ESRD on chronic hemodialysis therapy (>1 month) in ambulatory dialysis clinics in the State of Qatar. Data collected were patient's characteristics, laboratory and diagnostic investigations for each patient through our electronic data system (nationwide). We focused on parathyroid hormone (PTH), calcium and phosphorus levels done routinely on monthly basis. The study duration was 31 months (January 2019–September 2021). RESULTS We included 623 patients. Age was 56 ± 11 years old and 61% were male. The main comorbidities were diabetes mellitus (63%), hypertension (92%) and cardiovascular disease (22%). The percentage of patients with PTH levels within targets ranged from 63 to 74%. It was stable before and during the first wave of COVID-19 in Qatar (March–June 2020) then dropped afterward briefly for 3 months (October–December 2020) (74% versus 63% respectively P = 0.0003). PTH level in target improved afterward and also during the second wave of COVID-19 (February–May 2021) but then dropped again for 3 months (July–September 2021) [72% versus 66% respectively P = 0.02 (graph below with details)]. Patients with phosphorus and calcium in the target were mostly stable [79% (77–83%) and 76% (74–79%), respectively]. CONCLUSION Our retrospective study regarding the effect of the COVID-19 epidemic on MBD outcomes in hemodialysis (HD) showed a temporary drop in PTH level in the target without affecting calcium and phosphorus targets. The delayed drop after COVID-19 waves in PTH in target could be related to the routine quarterly measurement of PTH. We think that establishing a solid management system for MBD led to reasonably stable outcomes despite all challenges during the COVID-19 epidemic.
Collapse
Affiliation(s)
| | - Tarek Fouda
- Hamad Medical Corporation, Nephrology, Doha, Qatar
| | | | | | | | | | - Abeer Amood
- Hamad Medical Corporation, Nephrology, Doha, Qatar
| | | | - Sahar Aly
- Hamad Medical Corporation, Nephrology, Doha, Qatar
| | | | | |
Collapse
|
3
|
Fouda T, Yasin F, Aly S, Ravinder Singh P, Ezzat Hussain Mohammed M, Elesnawi M, Hamad A, Almalki H. MO851: Impact of COVID-19 on Dialysis Patients: Reported Experience in Qatar. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac083.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Patient-centred care is a concept focussing on meeting the specific health needs of patients as expressed by them. There is increasing evidence to show that patient centred care can help to achieve higher rates of patient satisfaction, clinical outcomes and overall better experience, particularly for patients with chronic disease. Patients Reported Experience Measures (PREM) is another concept associated with patient-cantered care. PREM surveys capture information about the healthcare experience as perceived by patients. Its importance lies in the incorporation of patient feedback into the clinical decisions and service evolution. Dialysis patients play an important role in their treatment and their voice matters to provide proper care. PREM was first conducted in 2019 in our dialysis unit including 200 patients. In 2020, COVID-19 impacted the dialysis services and resulted in many challenges including staff shortage and deployment.
METHOD
We used a validated questionnaire from the National Health Service in United Kingedm. It consisted of 7 questions covering demographics, dialysis options, patient portal, patient's relationship with the staff, teamwork and travelling abroad. The survey involved 317 randomly selected patients who have been at least 1 year on dialysis. We performed a comparison of the 2019 and 2020 results using Chi-squared test.
RESULTS
257 patients on hemodialysis and 60 on peritoneal dialysis participated in the survey. Majority of the surveyed patients (65%) were on dialysis from 1–5 years and 32% with more than 5 years’ survival on dialysis. Sixty five % of patients responded that they were on follow up in nephrology or low clearance clinic before starting dialysis. Access to dialysis team, nurses and doctors from home declined in 2020 due to the shortage of staff in the dialysis services and deployment of many staff to COVID-19 facilities, 62% of surveyed patients were able to contact their care givers from home compared with 87% in 2019 (P < 0.0001). Regarding education, 78% of the patients responded that they received education before starting dialysis and it was in an understandable manner while patients' response to the same question was 85% in 2019 (P = 0.047). 44% received education on side effects, which is remarkably less compared with 74% in 2019 (P = 0.0001).
CONCLUSION
Patient reported experience helps in the evaluation of health services. Exploring patient experience in dialysis patients in Qatar, we found negative impact of COVID-19 from patients’ perspectives. Our PREM survey showed significant decline in many parameters likely attributed to COVID-19 consequences including the shortage of staff.
Collapse
|
4
|
Yasin F, Fouda T, El-sayed A, Al-mohanadi T, Khaled K, Hajaji W, Aly S, Lonappan V, Hamdy H, Hamad A, Moustafa N, Aly Atta A, Navarrete E, Al-Abdulla T, Al-Ali F, Al-Malki H. Impact of COVID-19 on dialysis patients: Reported experience in Qatar. Journal of Emergency Medicine, Trauma and Acute Care 2022. [DOI: 10.5339/jemtac.2022.qhc.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Fadumo Yasin
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Tarek Fouda
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Aisha El-sayed
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Teha Al-mohanadi
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Karima Khaled
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Wafa Hajaji
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Sahar Aly
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Vimala Lonappan
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Hanaa Hamdy
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Abdullah Hamad
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Neama Moustafa
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Amira Aly Atta
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Edward Navarrete
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | | | - Fadwa Al-Ali
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Hassan Al-Malki
- Nephrology Division, Hamad Medical Corporation, Doha, Qatar E-mail:
| |
Collapse
|
5
|
Saqar Al Ali F, Fouda T, Jamil Al Omari A, Yahya M, Mohamed Ismail Aly S, Ali Farooqi F, Ibrahim Omar A, Alsaid Ahmad A, Yeihya NG, Ibrahim A. Vascular calcification: “The silent killer” in the hemodialysis population in Qatar. Journal of Emergency Medicine, Trauma and Acute Care 2021. [DOI: 10.5339/jemtac.2021.qhc.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Fadwa Saqar Al Ali
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Tarek Fouda
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Anees Jamil Al Omari
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Mohamed Yahya
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | | | - Farrukh Ali Farooqi
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Ala Ibrahim Omar
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Abeer Alsaid Ahmad
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Nermeen Galal Yeihya
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Abdullah Ibrahim
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| |
Collapse
|
6
|
Azoubi O, Abdullatif T, Hamad A, Fouda T, Ismail SM, lonappan VK, Hamid Tolba HA, Ali Ben Amro M, Al Ali F. Utilizing diabetes mellitus risk assessment tool in screening of hemodialysis patients at risk of diabetes mellitus. Journal of Emergency Medicine, Trauma and Acute Care 2021. [DOI: 10.5339/jemtac.2021.qhc.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Osama Azoubi
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Tarek Abdullatif
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Abdullah Hamad
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Tarek Fouda
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Sahar M Ismail
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Vimala K lonappan
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Hoda A Hamid Tolba
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Mohamed Ali Ben Amro
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Fadwa Al Ali
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| |
Collapse
|
7
|
Fouda T, Ibrahim A, Elgaalib MA, Farooqig FA, Ismail Aly SM, Abdel Latif Akl TA, Diamant MC, Abdulla AES, Al-Malki H. Effective approach to manage COVID-19 challenges in Hamad General Hospital dialysis facilities. Journal of Emergency Medicine, Trauma and Acute Care 2021. [DOI: 10.5339/jemtac.2021.qhc.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Tarek Fouda
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Abdullah Ibrahim
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Musab Ahmed Elgaalib
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Farrukh Ali Farooqig
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | | | | | - Michael Catli Diamant
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Aisha El Sayed Abdulla
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Hasan Al-Malki
- Nephrology Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:
| |
Collapse
|
8
|
Abd El Azeem I, Helal A, Derbala A, Abd-El Rahman M, Fouda T. ENGINEERING STUDIES ON GRADING OF ORANGE. Misr Journal of Agricultural Engineering 2017; 34:1757-1768. [DOI: 10.21608/mjae.2017.96087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
|
9
|
Derbala A, Abd El-Kader N, Fouda T. EFFECT OF SEED BED PREPARATION SYSTEM AND FERTILIZER MANAGEMENT ON SOIL WATER STORGE AND BARLEY PRODUCTION YIELD. Misr Journal of Agricultural Engineering 2008; 25:1131-1147. [DOI: 10.21608/mjae.2008.131504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
|