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Article ; Online: Accuracy and precision of the CKD-EPI and MDRD predictive equations compared with glomerular filtration rate measured by inulin clearance in a Saudi population.

Al-Wakeel, Jamal Saleh

2016 Volume 36, Issue 2, Page(s) 128–134

Abstract: ... with the estimated GFR calculated using CKD-EPI and MDRD predictive formulas.: Main outcome measure(s ...

Abstract	Background: Predictive equations for estimating glomerular filtration rate (GFR) in different clinical conditions should be validated by comparing with the measurement of GFR using inulin clearance, a highly accurate measure of GFR. Objectives: Our aim was to validate the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) equations by comparing it to the GFR measured using inulin clearance in chronic kidney disease (CKD) patients. Design: Cross-sectional study performed in adult Saudi patients with CKD. Setting: King Saud University Affiliated Hospital, Riyadh, Saudi Arabia in 2014. Patients and methods: We compared GFR measured by inulin clearance with the estimated GFR calculated using CKD-EPI and MDRD predictive formulas. Main outcome measure(s): Correlation, bias, precision and accuracy between the estimated GFR and inulin clearance. Results: Comparisons were made in 31 participants (23 CKD and 8 transplanted), including 19 males (mean age 42.2 [15] years and weight 68.7 [18] kg). GFR using inulin was 51.54 (33.8) mL/min/1.73 m2 in comparison to inulin clearance, the GFR by the predictive equations was: CKD-EPI creatinine 52.6 (34.4) mL/ min/1.73 m2 (P=.490), CKD-EPI cystatin C 41.39 (30.30) mL/min/1.73 m2 (P=.002), CKD creatinine-cystatin C 45.03 (30.9) mL/min/1.73 m2 (P=.004) and MDRD GFR 48.35 (31.5) mL/min/1.73 m2 (P=.028) (statistical comparisons vs inulin). Bland-Altman plots demonstrated that GFR estimated by the CKD-EPI creatinine was the most accurate compared with inulin clearance, having a mean difference (estimated bias) and limits of agreement of -1.1 (15.6,-17.7). By comparison the mean differences for predictive equations were: CKD-EPI cystatin C 10.2 (43.7,-23.4), CKD creatinine-cystatin C 6.5 (29.3,-16.3) and MDRD 3.2 (18.3,-11.9). except for CKD-EPI creatinine, all of the equations underestimated GFR in comparison with inulin clearance. Conclusions: When compared with inulin clearance, the CKD-EPI creatinine equation is the most accurate, precise and least biased equation for estimation of GFR in the Saudi population and in all subgroups by age, stage of CKD and transplantation status. Limitations: Small sample size and the study did not include patients with comorbid diseases such as diabetes, hepatitis C virus infection, and other co-morbidities as well as old age ( > 80 years).
MeSH term(s)	Adult ; Aged ; Comorbidity ; Creatinine/metabolism ; Cross-Sectional Studies ; Cystatin C/metabolism ; Female ; Glomerular Filtration Rate/physiology ; Humans ; Inulin/metabolism ; Kidney Transplantation ; Male ; Middle Aged ; Renal Insufficiency, Chronic/physiopathology ; Renal Insufficiency, Chronic/surgery ; Reproducibility of Results ; Saudi Arabia ; Young Adult
Chemical Substances	Cystatin C ; Inulin (9005-80-5) ; Creatinine (AYI8EX34EU)
Language	English
Publishing date	2016-03-28
Publishing country	Saudi Arabia
Document type	Comparative Study ; Journal Article ; Validation Studies
ZDB-ID	639014-6
ISSN	0975-4466 ; 0256-4947
ISSN (online)	0975-4466
ISSN	0256-4947
DOI	10.5144/0256-4947.2016.28.3.1715
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Article: Encapsulating peritoneal sclerosis in a peritoneal dialysis patient presenting with complicated Mycobacterium fortuitum peritonitis.

Simbli, Mohammed Amin / Niaz, Faraz A / Al-Wakeel, Jamal S

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia

2012 Volume 23, Issue 3, Page(s) 635–641

Abstract: Encapsulating peritoneal sclerosis (EPS) is a rare but serious complication seen in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysisAPD after prolonged duration on dialysis. Patients usally present ... ...

Abstract	Encapsulating peritoneal sclerosis (EPS) is a rare but serious complication seen in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysisAPD after prolonged duration on dialysis. Patients usally present with vague complaints of abdominal pain, vomitting, diarrhea, weight loss and change in peritoneal transport characte-ristics. High degree of suspicion is needed in PD patients who have been on dialysis for prolonged duration and have been using high-concentrated dialysis fluid. Mycobacterium fortuitum (MF) is a rapidly growing, non-tuberculous mycobacterium that has rarely been reported as a pathogen causing peritonits in patients on PD. We report a case of CAPD presenting with culture-negative peritonits, which, on specific culture, grew MF and, on radiological evaluation, showed diagnostic features of EPS.
MeSH term(s)	Aged ; Anti-Bacterial Agents/therapeutic use ; Diabetic Nephropathies/etiology ; Diabetic Nephropathies/therapy ; Fatal Outcome ; Female ; Humans ; Kidney Failure, Chronic/etiology ; Kidney Failure, Chronic/therapy ; Liver Diseases/etiology ; Multiple Organ Failure/etiology ; Mycobacterium Infections, Nontuberculous/diagnosis ; Mycobacterium Infections, Nontuberculous/etiology ; Mycobacterium Infections, Nontuberculous/microbiology ; Mycobacterium Infections, Nontuberculous/therapy ; Mycobacterium fortuitum/isolation & purification ; Parenteral Nutrition, Total ; Peritoneal Dialysis, Continuous Ambulatory/adverse effects ; Peritoneal Fibrosis/diagnosis ; Peritoneal Fibrosis/etiology ; Peritoneal Fibrosis/therapy ; Peritonitis/diagnosis ; Peritonitis/etiology ; Peritonitis/microbiology ; Peritonitis/therapy ; Renal Dialysis ; Tomography, X-Ray Computed ; Treatment Outcome
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2012-05
Publishing country	Saudi Arabia
Document type	Case Reports ; Journal Article
ZDB-ID	1379955-1
ISSN	1319-2442
ISSN	1319-2442
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Article: Prevalence of vitamin D deficiency in peritoneal dialysis patients.

Alwakeel, Jamal S / Usama, Saira / Mitwalli, Ahmad H / Alsuwaida, Abdulkareem / Alghonaim, Mohammed

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia

2014 Volume 25, Issue 5, Page(s) 981–985

Abstract: Peritoneal dialysis (PD) patients have a high risk of developing vitamin D deficiency as 25(OH) vitamin D, the precursor of active vitamin D, is lost during dialysis. This cross-sectional study was conducted to investigate the prevalence of vitamin D ... ...

Abstract	Peritoneal dialysis (PD) patients have a high risk of developing vitamin D deficiency as 25(OH) vitamin D, the precursor of active vitamin D, is lost during dialysis. This cross-sectional study was conducted to investigate the prevalence of vitamin D deficiency among adult Saudi patients on regular PD The data was collected in the summer of 2010 from patients who were on PD for more than six months at the King Khalid University Hospital, Riyadh. We recorded the demographic and clinical parameters for all patients. Blood samples were taken for serum vitamin D level (25 OH), serum parathyroid hormone (PTH) levels and other necessary biochemical parameters. There were 27 patients (11 males and 16 females) with a mean age of 46 (15-78 ± 21) years. Five patients were on continuous ambulatory PD and 22 patients were using automated PD. The average time on PD was 27.5 (6-84 ± 18.5) months. The mean serum vitamin D 25 (OH) level was 16.1 (4.9-41.5 ± 8.23) nmol/L. Sixteen (59.2%) of the patients had levels below 15 nmol/L, while another eight patients (29.6%) had vitamin D levels between 15 and 25 nmol/L, indicating a marked deficiency. The mean serum calcium was 2.2 (1.7-2.6 ± 0.2) mmol/L and the mean serum phosphorous was 1.48 (0.64-2.22 ± 0.37) mmol/L. Fifteen patients (55.5%) had significant hyperparathyroidism (serum PTH levels above 30 pmol/L). Majority of the PD patients in our center had vitamin D deficiency. The possible reasons include chronic renal failure, dietary restrictions, loss of vitamin D and decreased exposure to sunlight.
MeSH term(s)	Adolescent ; Adult ; Aged ; Biomarkers/blood ; Calcium/blood ; Cross-Sectional Studies ; Female ; Humans ; Hyperparathyroidism/blood ; Hyperparathyroidism/diagnosis ; Hyperparathyroidism/epidemiology ; Male ; Middle Aged ; Parathyroid Hormone/blood ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Phosphorus/blood ; Prevalence ; Renal Insufficiency/blood ; Renal Insufficiency/diagnosis ; Renal Insufficiency/epidemiology ; Renal Insufficiency/therapy ; Risk Factors ; Saudi Arabia/epidemiology ; Vitamin D/analogs & derivatives ; Vitamin D/blood ; Vitamin D Deficiency/blood ; Vitamin D Deficiency/diagnosis ; Vitamin D Deficiency/epidemiology ; Young Adult
Chemical Substances	Biomarkers ; PTH protein, human ; Parathyroid Hormone ; Vitamin D (1406-16-2) ; Phosphorus (27YLU75U4W) ; 25-hydroxyvitamin D (A288AR3C9H) ; Calcium (SY7Q814VUP)
Language	English
Publishing date	2014-09-03
Publishing country	Saudi Arabia
Document type	Journal Article
ZDB-ID	1379955-1
ISSN	1319-2442
ISSN	1319-2442
DOI	10.4103/1319-2442.139873
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Article ; Online: Encapsulating peritoneal sclerosis in a peritoneal dialysis patient presenting with complicated Mycobacterium fortuitum peritonitis

Mohammed Amin Simbli / Faraz A Niaz / Jamal S Al-Wakeel

Saudi Journal of Kidney Diseases and Transplantation, Vol 23, Iss 3, Pp 635-

2012 Volume 641

Abstract	Encapsulating peritoneal sclerosis (EPS) is a rare but serious complication seen in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysisAPD after prolonged duration on dialysis. Patients usally present with vague complaints of abdominal pain, vomitting, diarrhea, weight loss and change in peritoneal transport characte-ristics. High degree of suspicion is needed in PD patients who have been on dialysis for prolonged duration and have been using high-concentrated dialysis fluid. Mycobacterium fortuitum (MF) is a rapidly growing, non-tuberculous mycobacterium that has rarely been reported as a pathogen causing peritonits in patients on PD. We report a case of CAPD presenting with culture-negative peritonits, which, on specific culture, grew MF and, on radiological evaluation, showed diagnostic features of EPS.
Keywords	Medicine ; R
Language	English
Publishing date	2012-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
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Article ; Online: Prevalence of vitamin D deficiency in peritoneal dialysis patients

Jamal S Alwakeel / Saira Usama / Ahmad H Mitwalli / Abdulkareem Alsuwaida / Mohammed Alghonaim

Saudi Journal of Kidney Diseases and Transplantation, Vol 25, Iss 5, Pp 981-

2014 Volume 985

Abstract: Peritoneal dialysis (PD) patients have a high risk of developing vitamin D deficiency as 25(OH) vitamin D, the precursor of active vitamin D, is lost during dialysis. This crosssectional study was conducted to investigate the prevalence of vitamin D ... ...

Abstract	Peritoneal dialysis (PD) patients have a high risk of developing vitamin D deficiency as 25(OH) vitamin D, the precursor of active vitamin D, is lost during dialysis. This crosssectional study was conducted to investigate the prevalence of vitamin D deficiency among adult Saudi patients on regular PD The data was collected in the summer of 2010 from patients who were on PD for more than six months at the King Khalid University Hospital, Riyadh. We recorded the demographic and clinical parameters for all patients. Blood samples were taken for serum vitamin D level (25 OH), serum parathyroid hormone (PTH) levels and other necessary biochemical parameters. There were 27 patients (11 males and 16 females) with a mean age of 46 (15-78 ± 21) years. Five patients were on continuous ambulatory PD and 22 patients were using automated PD. The average time on PD was 27.5 (6-84 ± 18.5) months. The mean serum vitamin D 25 (OH) level was 16.1 (4.9-41.5 ± 8.23) nmol/L. Sixteen (59.2%) of the patients had levels below 15 nmol/L, while another eight patients (29.6%) had vitamin D levels between 15 and 25 nmol/L, indicating a marked deficiency. The mean serum calcium was 2.2 (1.7-2.6 ± 0.2) mmol/L and the mean serum phosphorous was 1.48 (0.64-2.22 ± 0.37) mmol/L. Fifteen patients (55.5%) had significant hyperparathyroidism (serum PTH levels above 30 pmol/L). Majority of the PD patients in our center had vitamin D deficiency. The possible reasons include chronic renal failure, dietary restrictions, loss of vitamin D and decreased exposure to sunlight.
Keywords	Medicine ; R
Subject code	610
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Oxalosis presenting as early renal allograft failure.

Alsuwaida, Abdulkareem / Hayat, Ashik / Alwakeel, Jamal S

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia

2007 Volume 18, Issue 2, Page(s) 253–256

Abstract: Hyperoxaluria can result in the deposition of oxalate in bones, arteries, eyes, heart, nerves, kidneys and other structures when there is a reduction in glomerular filtration rate. Liver and kidney transplantation is curative for patients with Type I ... ...

Abstract	Hyperoxaluria can result in the deposition of oxalate in bones, arteries, eyes, heart, nerves, kidneys and other structures when there is a reduction in glomerular filtration rate. Liver and kidney transplantation is curative for patients with Type I primary hyperoxaluria. Here we report a case of recurrent oxalosis in a post-transplant kidney with early graft failure in an adult male.
MeSH term(s)	Adult ; Biopsy ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Hyperoxaluria/complications ; Hyperoxaluria/diagnosis ; Hyperoxaluria/metabolism ; Kidney Failure, Chronic/surgery ; Kidney Glomerulus/metabolism ; Kidney Glomerulus/pathology ; Kidney Transplantation/diagnostic imaging ; Kidney Transplantation/pathology ; Male ; Oliguria/diagnosis ; Oliguria/etiology ; Oxalates/metabolism ; Ultrasonography, Doppler
Chemical Substances	Oxalates
Language	English
Publishing date	2007-06
Publishing country	Saudi Arabia
Document type	Case Reports ; Journal Article
ZDB-ID	1379955-1
ISSN	1319-2442
ISSN	1319-2442
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Article: Pattern of renal diseases and the need for establishment of renal biopsy registry in Saudi Arabia.

Al-Homrany, Mohammed / Alghamdi, Saeed / Al-Hwiesh, Abdullah / Mousa, Dujanah / Alwakeel, Jamal / Mitwalli, Ahmad / Alsaad, Khalid / Alharbi, Ali / Kari, Jameela

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia

2019 Volume 30, Issue 3, Page(s) 628–633

Abstract: Renal disease is a common medical problem in Saudi Arabia. Varieties of renal lesions if not treated properly or not discovered early will lead to a chronic kidney disease. Identifying the types of renal lesions can help in identifying the high-risk ... ...

Abstract	Renal disease is a common medical problem in Saudi Arabia. Varieties of renal lesions if not treated properly or not discovered early will lead to a chronic kidney disease. Identifying the types of renal lesions can help in identifying the high-risk patients and appropriate treatment can be provided. Glomerulonephritis (GN) is considered one of the leading causes of end-stage renal disease in Saudi Arabia. The prevalence of different renal lesions were identified by different reports; however, these reports showed inconsistency. One important reason for such differences is related to the lack of unified methods in diagnosing and processing renal tissues and to the fact that different reports were reported by different pathologists. In addition, the differences in the reported results may reflect patient selection biases for renal biopsy or to the different policies and protocols adopted by different nephrologists. This is a prospective, multicenter study that involves different patients from different institutes and from different regions in Saudi Arabia to delineate the pattern of renal diseases based on renal biopsies. Four hundred and five cases were selected and studied over two years. This preliminary report shows that the most common primary renal lesion in Saudi Arabia is focal segmental glomerulosclerosis in 24.1%, followed by IgA nephropathy (15.2%), mesangioproliferative non-IgA, (13.2%), and membranoproliferative GN (12.4%). Lupus nephritis was the most common cause of secondary GN in 66% of the secondary causes.
MeSH term(s)	Adolescent ; Adult ; Aged ; Biopsy ; Child ; Female ; Glomerulonephritis, IGA/epidemiology ; Glomerulonephritis, IGA/pathology ; Glomerulonephritis, Membranoproliferative/epidemiology ; Glomerulonephritis, Membranoproliferative/pathology ; Glomerulosclerosis, Focal Segmental/epidemiology ; Glomerulosclerosis, Focal Segmental/physiopathology ; Humans ; Kidney/pathology ; Kidney Diseases/epidemiology ; Kidney Diseases/pathology ; Lupus Nephritis/epidemiology ; Lupus Nephritis/pathology ; Male ; Middle Aged ; Observer Variation ; Predictive Value of Tests ; Prevalence ; Prospective Studies ; Registries ; Reproducibility of Results ; Risk Factors ; Saudi Arabia/epidemiology ; Young Adult
Language	English
Publishing date	2019-06-27
Publishing country	Saudi Arabia
Document type	Journal Article ; Multicenter Study
ZDB-ID	1379955-1
ISSN	1319-2442
ISSN	1319-2442
DOI	10.4103/1319-2442.261335
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Article ; Online: Accuracy and precision of the CKD-EPI and MDRD predictive equations compared with glomerular filtration rate measured by inulin clearance in a Saudi population

Jamal Saleh Al-Wakeel

Annals of Saudi Medicine, Vol 36, Iss 2, Pp 128-

2016 Volume 134

Abstract: ... with the estimated GFR calculated using CKD-EPI and MDRD predictive formulas. MAIN OUTCOME MEASURE(S): Correlation ...

Abstract	BACKGROUND: Predictive equations for estimating glomerular filtration rate (GFR) in different clinical conditions should be validated by comparing with the measurement of GFR using inulin clearance, a highly accurate measure of GFR. OBJECTIVES: Our aim was to validate the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) equations by comparing it to the GFR measured using inulin clearance in chronic kidney disease (CKD) patients. DESIGN: Cross-sectional study performed in adult Saudi patients with CKD. SETTING: King Saud University Affiliated Hospital, Riyadh, Saudi Arabia in 2014. PATIENTS AND METHODS: We compared GFR measured by inulin clearance with the estimated GFR calculated using CKD-EPI and MDRD predictive formulas. MAIN OUTCOME MEASURE(S): Correlation, bias, precision and accuracy between the estimated GFR and inulin clearance. RESULTS: Comparisons were made in 31 participants (23 CKD and 8 transplanted), including 19 males (mean age 42.2 [15] years and weight 68.7 [18] kg). GFR using inulin was 51.54 (33.8) mL/min/1.73 m2. In comparison to inulin clearance, the GFR by the predictive equations was: CKD-EPI creatinine 52.6 (34.4) mL/min/1.73 m2 (P=.490), CKD-EPI cystatin C 41.39 (30.30) mL/min/1.73 m2 (P=.002), CKD creatinine-cystatin C 45.03 (30.9) mL/min/1.73 m2 (P=.004) and MDRD GFR 48.35 (31.5) mL/min/1.73 m2 (P=.028) (statistical comparisons vs inulin). Bland-Altman plots demonstrated that GFR estimated by the CKD-EPI creatinine was the most accurate compared with inulin clearance, having a mean difference (estimated bias) and limits of agreement of −1.1 (15.6, −17.7). By comparison the mean differences for predictive equations were: CKD-EPI cystatin C 10.2 (43.7, −23.4), CKD creatinine-cystatin C 6.5 (29.3, −16.3) and MDRD 3.2 (18.3, −11.9). Except for CKD-EPI creatinine, all of the equations underestimated GFR in comparison with inulin clearance. CONCLUSIONS: When compared with inulin clearance, the CKD-EPI creatinine equation is the most ...
Keywords	Medicine ; R
Subject code	630
Language	English
Publishing date	2016-03-01T00:00:00Z
Publisher	King Faisal Specialist Hospital and Research Centre
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Serum cystatin C: a surrogate marker for the characteristics of peritoneal membrane in dialysis patients.

Al-Wakeel, Jamal S / Hammad, Durdana / Memon, Nawaz Ali / Tarif, Nauman / Shah, Iqbal / Chaudhary, Abdulrauf

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia

2009 Volume 20, Issue 2, Page(s) 227–231

Abstract: To evaluate whether cystatin C levels can be a surrogate marker of creatinine clearance and reflect the characteristics of peritoneal membrane in dialysis patients, we performed peritoneal equilibration tests (PET) in 18 anuric adult chronic peritoneal ... ...

Abstract	To evaluate whether cystatin C levels can be a surrogate marker of creatinine clearance and reflect the characteristics of peritoneal membrane in dialysis patients, we performed peritoneal equilibration tests (PET) in 18 anuric adult chronic peritoneal dialysis (PD) patients with a mean age of 39.7 +/- 20 years. All the samples were analyzed for urea, creatinine, and cystatin C. Peritoneal transport, mass transfer, and peritoneal clearance of cystatin C were calculated. Correlation and regression analysis was done using cystatin C as a dependent variable and age, sex, height, weight, body surface area, and creatinine as independent variables. Cystatin C demonstrated a significant time dependent increase of dialysate concentration and decline in the serum concentrations during PET, and a strong correlation between serum creatinine and serum cystatin C concentrations(r: 0.62, p= 0.008). The trans-peritoneal clearance (mL/min/1.73 m 2 ) of cystatin C was related to its serum concentration and was similar to creatinine in its pattern but of smaller magnitude. Peritoneal mass transfer (mg/4 hr per 1.73 m 2 ) for cystatin C serum creatinine was 1.68 +/- 0.67 and 73.3 +/- 29.8, respectively. The dialysis/plasma D/P cystatin C concentration was > or = 0.1 at 4 hrs of PET denoted high peritoneal transport, while the values of < 0.1 denoted low transport type. We conclude that cystatin C follows the same pattern of peritoneal exchange as creatinine but the magnitude of transfer is many folds lower than creatinine. At present clinical utility of cystatin C in the evaluation of solute clearance is probably limited due to the minute amounts transferred across the membrane and the high renal clearance in the presence of residual renal function.
MeSH term(s)	Adolescent ; Adult ; Aged ; Anuria/blood ; Anuria/therapy ; Biological Transport, Active/physiology ; Biomarkers/blood ; Cystatin C/blood ; Dialysis Solutions/pharmacokinetics ; Female ; Humans ; Male ; Middle Aged ; Nephelometry and Turbidimetry ; Peritoneum/metabolism ; Renal Dialysis/methods ; Young Adult
Chemical Substances	Biomarkers ; Cystatin C ; Dialysis Solutions
Language	English
Publishing date	2009-03
Publishing country	Saudi Arabia
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1379955-1
ISSN	1319-2442
ISSN	1319-2442
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Article: Concomitant macro and microvascular complications in diabetic nephropathy.

Alwakeel, Jamal S / Al-Suwaida, Abdulkareem / Isnani, Arthur C / Al-Harbi, Ali / Alam, Awatif

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia

2009 Volume 20, Issue 3, Page(s) 402–409

Abstract: To determine the prevalence of concomitant microvascular and macrovascular complications of diabetic nephropathy we retrospectively reviewed the medical records of all 1,952 type 2 diabetic patients followed-up at Security Forces Hospital, Riyadh, Saudi ... ...

Abstract	To determine the prevalence of concomitant microvascular and macrovascular complications of diabetic nephropathy we retrospectively reviewed the medical records of all 1,952 type 2 diabetic patients followed-up at Security Forces Hospital, Riyadh, Saudi Arabia from January 1989 to December 2004. There were 626 (32.1%) patients (294 (47%) were males) who developed diabetic nephropathy. Their mean age was 66.9 +/- 11.4 years, mean duration of diabetes was 15.4 +/- 7.5 years, mean age at the onset of nephropathy was 61.5 +/- 12.4 years, and mean duration of nephropathy was 3.9 +/- 3.8 years. Concomitant diabetic complications included cataract (38.2%), acute coronary syndrome (36.1%), peripheral neuropathy (24.9%), myocardial infarction (24.1%), background retinopathy (22.4%), stroke (17.6%), proliferative retinopathy (11.7%), foot infection (7.3%), limb amputation (3.7%) and blindness (3%). Hypertension was documented in 577 (92.2%) patients, dyslipidemia in 266 (42.5%) and mortality from all causes in 86 (13.7%). There were 148 (23.6%) patients with one complication, 81 (12.9%) with two, 83 (13.3%) with three, and 61 (9.7%) with four or more. Deterioration of glomerular filtration rate was observed in 464 (74%) patients and doubling of serum creatinine in 250 (39.9%), while 95 (15.2%) developed end-stage renal disease (ESRD) at the end of study and 79 (12.6%) required dialysis. Complications were significantly more prevalent among males with greater number reaching ESRD level than females (P< 0.05). Relative risks of developing complications were significant after the onset of nephropathy; ACS (1.41), MI (1.49), stroke (1.48), diabetic foot (1.6), amputation (1.58) and death (1.93). We conclude that complications of diabetes are aggressive and progressive including high prevalence of diabetic nephropathy. Careful monitoring and proper institution of management protocols should be implemented to identify diabetic patients at high risk for complications and mitigate progression into ESRD.
MeSH term(s)	Adult ; Age of Onset ; Aged ; Aged, 80 and over ; Blood Glucose/metabolism ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/mortality ; Cardiovascular Diseases/physiopathology ; Cholesterol/blood ; Comorbidity ; Creatinine/blood ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/mortality ; Diabetes Mellitus, Type 2/physiopathology ; Diabetic Angiopathies/etiology ; Diabetic Angiopathies/mortality ; Diabetic Angiopathies/physiopathology ; Diabetic Nephropathies/epidemiology ; Diabetic Nephropathies/etiology ; Diabetic Nephropathies/physiopathology ; Disease Progression ; Female ; Glomerular Filtration Rate ; Humans ; Hypertension/etiology ; Hypertension/physiopathology ; Kidney Failure, Chronic/etiology ; Kidney Failure, Chronic/mortality ; Kidney Failure, Chronic/physiopathology ; Male ; Microcirculation ; Middle Aged ; Odds Ratio ; Prevalence ; Retrospective Studies ; Risk Assessment ; Saudi Arabia/epidemiology ; Sex Factors ; Time Factors
Chemical Substances	Blood Glucose ; Cholesterol (97C5T2UQ7J) ; Creatinine (AYI8EX34EU)
Language	English
Publishing date	2009-05
Publishing country	Saudi Arabia
Document type	Journal Article
ZDB-ID	1379955-1
ISSN	1319-2442
ISSN	1319-2442
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Zs.A 4735: Show issues

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Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
Jg. 1995 - 2021: Lesesall (2.OG)
ab Jg. 2022: Lesesaal (EG)

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In stock of ZB MED Cologne/Königswinter

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Full text online

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In stock of ZB MED Cologne/Königswinter

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In stock of ZB MED Cologne/Königswinter

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