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Article: Impact of Sodium-Glucose Cotransporter-2 Inhibitors in the Management of Chronic Kidney Disease: A Middle East and Africa Perspective.

Elkeraie, Ahmed Fathi / Al-Ghamdi, Saeed / Abu-Alfa, Ali K / Alotaibi, Torki / AlSaedi, Ali Jasim / AlSuwaida, Abdulkareem / Arici, Mustafa / Ecder, Tevfik / Ghnaimat, Mohammad / Hafez, Mohamed Hany / Hassan, Mohamed H / Sqalli, Tarik

International journal of nephrology and renovascular disease

2024 Volume 17, Page(s) 1–16

Abstract: Chronic kidney disease (CKD) is a major public health concern in the Middle East and Africa (MEA) region and a leading cause of death in patients with type 2 diabetes mellitus (T2DM) and hypertension. Early initiation of sodium-glucose cotransporter - 2 ... ...

Abstract	Chronic kidney disease (CKD) is a major public health concern in the Middle East and Africa (MEA) region and a leading cause of death in patients with type 2 diabetes mellitus (T2DM) and hypertension. Early initiation of sodium-glucose cotransporter - 2 inhibitors (SGLT-2i) and proper sequencing with renin-angiotensin-aldosterone system inhibitors (RAASi) in these patients may result in better clinical outcomes due to their cardioprotective properties and complementary mechanisms of action. In this review, we present guideline-based consensus recommendations by experts from the MEA region, as practical algorithms for screening, early detection, nephrology referral, and treatment pathways for CKD management in patients with hypertension and diabetes mellitus. This study will help physicians take timely and appropriate actions to provide better care to patients with CKD or those at high risk of CKD.
Language	English
Publishing date	2024-01-03
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2508160-3
ISSN	1178-7058
ISSN	1178-7058
DOI	10.2147/IJNRD.S430532
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Article: Capacity for the management of kidney failure in the International Society of Nephrology Middle East region: report from the 2023 ISN Global Kidney Health Atlas (ISN-GKHA).

Kidney international supplements

2024 Volume 13, Issue 1, Page(s) 57–70

Abstract: The highest financial and symptom burdens and the lowest health-related quality-of-life scores are seen in people with kidney failure. A total of 11 countries in the International Society of Nephrology (ISN) Middle East region responded to the ISN-Global ...

Abstract	The highest financial and symptom burdens and the lowest health-related quality-of-life scores are seen in people with kidney failure. A total of 11 countries in the International Society of Nephrology (ISN) Middle East region responded to the ISN-Global Kidney Health Atlas. The prevalence of chronic kidney disease (CKD) in the region ranged from 4.9% in Yemen to 12.2% in Lebanon, whereas prevalence of kidney failure treated with dialysis or transplantation ranged from 152 per million population (pmp) in the United Arab Emirates to 869 pmp in Kuwait. Overall, the incidence of kidney transplantation was highest in Saudi Arabia (20.2 pmp) and was lowest in Oman (2.2 pmp). Chronic hemodialysis (HD) and peritoneal dialysis (PD) services were available in all countries, whereas kidney transplantation was available in most countries of the region. Public government funding that makes acute dialysis, chronic HD, chronic PD, and kidney transplantation medications free at the point of delivery was available in 54.5%, 72.7%, 54.5%, and 54.5% of countries, respectively. Conservative kidney management was available in 45% of countries. Only Oman had a CKD registry; 7 countries (64%) had dialysis registries, and 8 (73%) had kidney transplantation registries. The ISN Middle East region has a high burden of kidney disease and multiple challenges to overcome. Prevention and detection of kidney disease can be improved by the design of tailored guidelines, allocation of additional resources, improvement of early detection at all levels of care, and implementation of sustainable health information systems.
Language	English
Publishing date	2024-04-08
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	193442-9
ISSN	2157-1716 ; 2157-1724 ; 0098-6577
ISSN (online)	2157-1716
ISSN	2157-1724 ; 0098-6577
DOI	10.1016/j.kisu.2024.01.009
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Article: A Jordanian Multidisciplinary Consensus Statement on the Management of Dyslipidemia.

Al Mousa, Eyas / Al-Azzam, Sayer / Araydah, Mohammad / Karasneh, Reema / Ghnaimat, Mohammad / Al-Makhamreh, Hanna / Al Khawaldeh, Abdelkarim / Ali Abu Al-Samen, Muneer / Haddad, Jihad / Al Najjar, Said / Alsalaheen Abbadi, Hatem / Hammoudeh, Ayman J

Journal of clinical medicine

2023 Volume 12, Issue 13

Abstract: Atherosclerotic cardiovascular disease (ASCVD) is the primary contributor to global mortality rates, which significantly escalates healthcare expenditures. Risk factors for ASCVD (including dyslipidemia) frequently present in clusters rather than ... ...

Abstract	Atherosclerotic cardiovascular disease (ASCVD) is the primary contributor to global mortality rates, which significantly escalates healthcare expenditures. Risk factors for ASCVD (including dyslipidemia) frequently present in clusters rather than separately. Addressing these risk factors is crucial in the early initiation of a comprehensive management plan that involves both lifestyle modifications and pharmacotherapy to reduce the impact of ASCVD. A team of Jordanian professionals from various medical organizations and institutes took the initiative to create a set of guidelines for dyslipidemia screening and therapy. A detailed, comprehensive literature review was undertaken utilizing several databases and keywords. This consensus statement provides recommendations for dyslipidemia management in Jordanians on several issues including cardiovascular risk estimation, screening eligibility, risk categories, treatment goals, lifestyle changes, and statin and non-statin therapies. It is recommended that all Jordanian individuals aged 20 years old or older undergo lipid profile testing. This should be followed by determining the level of cardiovascular risk depending on the presence or absence of ASCVD and cardiovascular risk factors, eligibility for lipid-lowering therapy, and the target low-density cholesterol serum level to be achieved. In conclusion, prioritizing the management of dyslipidemia is of the utmost importance in improving public health and reducing the burden of cardiovascular diseases.
Language	English
Publishing date	2023-06-27
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12134312
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Article: International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in the Middle East.

Amouzegar, Atefeh / Abu-Alfa, Ali K / Alrukhaimi, Mona N / Bello, Aminu K / Ghnaimat, Mohammad A / Johnson, David W / Jha, Vivekanand / Harris, David C H / Levin, Adeera / Tonelli, Marcello / Lunney, Meaghan / Saad, Syed / Khan, Maryam / Zaidi, Deenaz / Osman, Mohamed A / Ye, Feng / Okpechi, Ikechi G / Ossareh, Shahrzad

Kidney international supplements

2021 Volume 11, Issue 2, Page(s) e47–e56

Abstract: Kidney failure is the permanent impairment of kidney function associated with increased morbidity, hospitalization, and requirement for kidney replacement therapy. A total of 11 countries in the Middle East region (84.6%) responded to the survey. The ... ...

Abstract	Kidney failure is the permanent impairment of kidney function associated with increased morbidity, hospitalization, and requirement for kidney replacement therapy. A total of 11 countries in the Middle East region (84.6%) responded to the survey. The prevalence of chronic kidney disease in the region ranged from 5.2% to 10.6%, whereas prevalence of treated kidney failure ranged from 152 to 826 per million population. Overall, the incidence of kidney transplantation was highest in Iran (30.9 per million population) and lowest in Oman and the United Arab Emirates (2.2 and 3.0 per million population, respectively). Long-term hemodialysis services were available in all countries, long-term peritoneal dialysis services were available in 9 (69.2%) countries, and transplantation services were available in most countries of the region. Public funding covered the costs of nondialysis chronic kidney disease care in two-thirds of countries, and kidney replacement therapy in nearly all countries. More than half of the countries had dialysis registries; however, national noncommunicable disease strategies were lacking in most countries. The Middle East is a region with high burden of kidney disease and needs cost-effective measures through effective health care funding to be available to improve kidney care in the region. Furthermore, well-designed and sustainable health information systems are needed in the region to address current gaps in kidney care in the region.
Language	English
Publishing date	2021-04-12
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	193442-9
ISSN	2157-1716 ; 2157-1724 ; 0098-6577
ISSN (online)	2157-1716
ISSN	2157-1724 ; 0098-6577
DOI	10.1016/j.kisu.2021.01.002
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Article ; Online: National health policies and strategies for addressing chronic kidney disease: Data from the International Society of Nephrology Global Kidney Health Atlas.

Neuen, Brendon L / Bello, Aminu K / Levin, Adeera / Lunney, Meaghan / Osman, Mohamed A / Ye, Feng / Ashuntantang, Gloria E / Bellorin-Font, Ezequiel / Gharbi, Mohammed Benghanem / Davison, Sara / Ghnaimat, Mohammad / Harden, Paul / Jha, Vivekanand / Kalantar-Zadeh, Kamyar / Kerr, Peter G / Klarenbach, Scott / Kovesdy, Csaba P / Luyckx, Valerie / Ossareh, Shahrzad /

PLOS global public health

2023 Volume 3, Issue 2, Page(s) e0001467

Abstract: National strategies for addressing chronic kidney disease (CKD) are crucial to improving kidney health. We sought to describe country-level variations in non-communicable disease (NCD) strategies and CKD-specific policies across different regions and ... ...

Abstract	National strategies for addressing chronic kidney disease (CKD) are crucial to improving kidney health. We sought to describe country-level variations in non-communicable disease (NCD) strategies and CKD-specific policies across different regions and income levels worldwide. The International Society of Nephrology Global Kidney Health Atlas (GKHA) was a multinational cross-sectional survey conducted between July and October 2018. Responses from key opinion leaders in each country regarding national NCD strategies, the presence and scope of CKD-specific policies, and government recognition of CKD as a health priority were described overall and according to region and income level. 160 countries participated in the GKHA survey, comprising 97.8% of the world's population. Seventy-four (47%) countries had an established national NCD strategy, and 53 (34%) countries reported the existence of CKD-specific policies, with substantial variation across regions and income levels. Where CKD-specific policies existed, non-dialysis CKD care was variably addressed. 79 (51%) countries identified government recognition of CKD as a health priority. Low- and low-middle income countries were less likely to have strategies and policies for addressing CKD and have governments which recognise it as a health priority. The existence of CKD-specific policies, and a national NCD strategy more broadly, varied substantially across different regions around the world but was overall suboptimal, with major discrepancies between the burden of CKD in many countries and governmental recognition of CKD as a health priority. Greater recognition of CKD within national health policy is critical to improving kidney healthcare globally.
Language	English
Publishing date	2023-02-01
Publishing country	United States
Document type	Journal Article
ISSN	2767-3375
ISSN (online)	2767-3375
DOI	10.1371/journal.pgph.0001467
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Article: Challenges for sustainable end-stage kidney disease care in low-middle-income countries: the problem of the workforce.

Swanepoel, Charles R / McCulloch, Mignon I / Abraham, Georgi / Donner, Jo-Ann / Alrukhaimi, Mona N / Blake, Peter G / Bunnag, Sakarn / Claus, Stefaan / Dreyer, Gavin / Ghnaimat, Mohammad A / Ibhais, Fuad M / Liew, Adrian / McKnight, Marla / Mengistu, Yewondwossen Tadesse / Naicker, Saraladevi / Niang, Abdou / Obrador, Gregorio T / Perl, Jeffrey / Rashid, Harun Ur /

Tonelli, Marcello / Tungsanga, Kriang / Vachharajani, Tushar / Zakharova, Elena / Zuniga, Carlos / Finkelstein, Fredric O

Kidney international supplements

2020 Volume 10, Issue 1, Page(s) e49–e54

Abstract: Prevention and early detection of kidney diseases in adults and children should be a priority for any government health department. This is particularly pertinent in the low-middle-income countries, mostly in Asia, Africa, Latin America, and the ... ...

Abstract	Prevention and early detection of kidney diseases in adults and children should be a priority for any government health department. This is particularly pertinent in the low-middle-income countries, mostly in Asia, Africa, Latin America, and the Caribbean, where up to 7 million people die because of lack of end-stage kidney disease treatment. The nephrology workforce (nurses, technicians, and doctors) is limited in these countries and expanding the size and expertise of the workforce is essential to permit expansion of treatment for both chronic kidney disease and end-stage kidney disease. To achieve this will require sustained action and commitment from governments, academic medical centers, local nephrology societies, and the international nephrology community.
Language	English
Publishing date	2020-02-19
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	193442-9
ISSN	2157-1716 ; 2157-1724 ; 0098-6577
ISSN (online)	2157-1716
ISSN	2157-1724 ; 0098-6577
DOI	10.1016/j.kisu.2019.11.007
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Article ; Online: Availability, Accessibility, and Quality of Conservative Kidney Management Worldwide.

Lunney, Meaghan / Bello, Aminu K / Levin, Adeera / Tam-Tham, Helen / Thomas, Chandra / Osman, Mohamed A / Ye, Feng / Bellorin-Font, Ezequiel / Benghanem Gharbi, Mohammed / Ghnaimat, Mohammad / Htay, Htay / Cho, Yeoungjee / Jha, Vivekanand / Ossareh, Shahrzad / Rondeau, Eric / Sola, Laura / Tchokhonelidze, Irma / Tesar, Vladimir / Tungsanga, Kriang /

Kazancioglu, Rumeyza Turan / Wang, Angela Yee-Moon / Yang, Chih-Wei / Zemchenkov, Alexander / Zhao, Ming-Hui / Jager, Kitty J / Jindal, Kailash K / Okpechi, Ikechi G / Brown, Edwina A / Brown, Mark / Tonelli, Marcello / Harris, David C / Johnson, David W / Caskey, Fergus J / Davison, Sara N

Clinical journal of the American Society of Nephrology : CJASN

2020 Volume 16, Issue 1, Page(s) 79–87

Abstract: Background and objectives: People with kidney failure typically receive KRT in the form of dialysis or transplantation. However, studies have suggested that not all patients with kidney failure are best suited for KRT. Additionally, KRT is costly and ... ...

Abstract	Background and objectives: People with kidney failure typically receive KRT in the form of dialysis or transplantation. However, studies have suggested that not all patients with kidney failure are best suited for KRT. Additionally, KRT is costly and not always accessible in resource-restricted settings. Conservative kidney management is an alternate kidney failure therapy that focuses on symptom management, psychologic health, spiritual care, and family and social support. Despite the importance of conservative kidney management in kidney failure care, several barriers exist that affect its uptake and quality. Design, setting, participants, & measurements: The Global Kidney Health Atlas is an ongoing initiative of the International Society of Nephrology that aims to monitor and evaluate the status of global kidney care worldwide. This study reports on findings from the 2018 Global Kidney Health Atlas survey, specifically addressing the availability, accessibility, and quality of conservative kidney management. Results: Respondents from 160 countries completed the survey, and 154 answered questions pertaining to conservative kidney management. Of these, 124 (81%) stated that conservative kidney management was available. Accessibility was low worldwide, particularly in low-income countries. Less than half of countries utilized multidisciplinary teams (46%); utilized shared decision making (32%); or provided psychologic, cultural, or spiritual support (36%). One-quarter provided relevant health care providers with training on conservative kidney management delivery. Conclusions: Overall, conservative kidney management is available in most countries; however, it is not optimally accessible or of the highest quality.
MeSH term(s)	Conservative Treatment/standards ; Decision Making, Shared ; Developed Countries/statistics & numerical data ; Developing Countries/statistics & numerical data ; Health Services Accessibility/statistics & numerical data ; Humans ; Internationality ; Kidney Failure, Chronic/therapy ; Patient Care Team/statistics & numerical data ; Quality of Health Care ; Religion ; Social Support ; Surveys and Questionnaires
Language	English
Publishing date	2020-12-15
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2226665-3
ISSN	1555-905X ; 1555-9041
ISSN (online)	1555-905X
ISSN	1555-9041
DOI	10.2215/CJN.09070620
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Article ; Online: Temporary Vascular Access for Hemodialysis Patients

Haddad Ayman / Akash Nabil / Ghnaimat Mohammad / El-Lozi Mohammad

Saudi Journal of Kidney Diseases and Transplantation, Vol 11, Iss 1, Pp 74-

2000 Volume 75

Keywords	Medicine ; R
Language	English
Publishing date	2000-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Current status of health systems financing and oversight for end-stage kidney disease care: a cross-sectional global survey.

Yeung, Emily / Bello, A K / Levin, Adeera / Lunney, Meaghan / Osman, Mohamed A / Ye, Feng / Ashuntantang, Gloria / Bellorin-Font, Ezequiel / Benghanem Gharbi, Mohammed / Davison, Sara / Ghnaimat, Mohammad / Harden, Paul / Jha, Vivekanand / Kalantar-Zadeh, Kamyar / Kerr, Peter / Klarenbach, Scott / Kovesdy, Csaba / Luyckx, Valerie / Neuen, Brendon /

O'Donoghue, Donal / Ossareh, Shahrzad / Perl, Jeffrey / Ur Rashid, Harun / Rondeau, Eric / See, Emily / Saad, Syed / Sola, Laura / Tchokhonelidze, Irma / Tesar, Vladimir / Tungsanga, Kriang / Turan Kazancioglu, Rumeyza / Wang, Angela Yee-Moon / Wiebe, Natasha / Yang, Chih-Wei / Zemchenkov, Alexander / Zhao, Minhui / Jager, Kitty J / Caskey, Fergus / Perkovic, Vlado / Jindal, Kailash / Okpechi, Ikechi G / Tonelli, Marcello / Feehally, John / Harris, David Ch / Johnson, David

BMJ open

2021 Volume 11, Issue 7, Page(s) e047245

Abstract: Objectives: The Global Kidney Health Atlas (GKHA) is a multinational, cross-sectional survey designed to assess the current capacity for kidney care across all world regions. The 2017 GKHA involved 125 countries and identified significant gaps in ... ...

Abstract	Objectives: The Global Kidney Health Atlas (GKHA) is a multinational, cross-sectional survey designed to assess the current capacity for kidney care across all world regions. The 2017 GKHA involved 125 countries and identified significant gaps in oversight, funding and infrastructure to support care for patients with kidney disease, especially in lower-middle-income countries. Here, we report results from the survey for the second iteration of the GKHA conducted in 2018, which included specific questions about health financing and oversight of end-stage kidney disease (ESKD) care worldwide. Setting: A cross-sectional global survey. Participants: Key stakeholders from 182 countries were invited to participate. Of those, stakeholders from 160 countries participated and were included. Primary outcomes: Primary outcomes included cost of kidney replacement therapy (KRT), funding for dialysis and transplantation, funding for conservative kidney management, extent of universal health coverage, out-of-pocket costs for KRT, within-country variability in ESKD care delivery and oversight systems for ESKD care. Outcomes were determined from a combination of desk research and input from key stakeholders in participating countries. Results: 160 countries (covering 98% of the world's population) responded to the survey. Economic factors were identified as the top barrier to optimal ESKD care in 99 countries (64%). Full public funding for KRT was more common than for conservative kidney management (43% vs 28%). Among countries that provided at least some public coverage for KRT, 75% covered all citizens. Within-country variation in ESKD care delivery was reported in 40% of countries. Oversight of ESKD care was present in all high-income countries but was absent in 13% of low-income, 3% of lower-middle-income, and 10% of upper-middle-income countries. Conclusion: Significant gaps and variability exist in the public funding and oversight of ESKD care in many countries, particularly for those in low-income and lower-middle-income countries.
MeSH term(s)	Cross-Sectional Studies ; Developing Countries ; Health Services Accessibility ; Humans ; Kidney Failure, Chronic/therapy ; Renal Dialysis
Language	English
Publishing date	2021-07-09
Publishing country	England
Document type	Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2020-047245
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Article ; Online: Peritoneal Dialysis Use and Practice Patterns: An International Survey Study.

Cho, Yeoungjee / Bello, Aminu K / Levin, Adeera / Lunney, Meaghan / Osman, Mohamed A / Ye, Feng / Ashuntantang, Gloria E / Bellorin-Font, Ezequiel / Gharbi, Mohammed Benghanem / Davison, Sara N / Ghnaimat, Mohammad / Harden, Paul / Htay, Htay / Jha, Vivekanand / Kalantar-Zadeh, Kamyar / Kerr, Peter G / Klarenbach, Scott / Kovesdy, Csaba P / Luyckx, Valerie /

American journal of kidney diseases : the official journal of the National Kidney Foundation

2020 Volume 77, Issue 3, Page(s) 315–325

Abstract: Rationale & objective: Approximately 11% of people with kidney failure worldwide are treated with peritoneal dialysis (PD). This study examined PD use and practice patterns across the globe.: Study design: A cross-sectional survey.: Setting & ... ...

Abstract	Rationale & objective: Approximately 11% of people with kidney failure worldwide are treated with peritoneal dialysis (PD). This study examined PD use and practice patterns across the globe. Study design: A cross-sectional survey. Setting & participants: Stakeholders including clinicians, policy makers, and patient representatives in 182 countries convened by the International Society of Nephrology between July and September 2018. Outcomes: PD use, availability, accessibility, affordability, delivery, and reporting of quality outcome measures. Analytical approach: Descriptive statistics. Results: Responses were received from 88% (n=160) of countries and there were 313 participants (257 nephrologists [82%], 22 non-nephrologist physicians [7%], 6 other health professionals [2%], 17 administrators/policy makers/civil servants [5%], and 11 others [4%]). 85% (n=156) of countries responded to questions about PD. Median PD use was 38.1 per million population. PD was not available in 30 of the 156 (19%) countries responding to PD-related questions, particularly in countries in Africa (20/41) and low-income countries (15/22). In 69% of countries, PD was the initial dialysis modality for≤10% of patients with newly diagnosed kidney failure. Patients receiving PD were expected to pay 1% to 25% of treatment costs, and higher (>75%) copayments (out-of-pocket expenses incurred by patients) were more common in South Asia and low-income countries. Average exchange volumes were adequate (defined as 3-4 exchanges per day or the equivalent for automated PD) in 72% of countries. PD quality outcome monitoring and reporting were variable. Most countries did not measure patient-reported PD outcomes. Limitations: Low responses from policy makers; limited ability to provide more in-depth explanations underpinning outcomes from each country due to lack of granular data; lack of objective data. Conclusions: Large inter- and intraregional disparities exist in PD availability, accessibility, affordability, delivery, and reporting of quality outcome measures around the world, with the greatest gaps observed in Africa and South Asia.
MeSH term(s)	Administrative Personnel ; Cost Sharing ; Costs and Cost Analysis ; Cross-Sectional Studies ; Delivery of Health Care ; Developed Countries ; Developing Countries ; Health Expenditures ; Health Policy ; Health Services Accessibility ; Humans ; Internationality ; Kidney Failure, Chronic/therapy ; Nephrologists ; Nephrology ; Outcome Assessment, Health Care ; Patient Reported Outcome Measures ; Peritoneal Dialysis ; Physicians ; Practice Patterns, Physicians' ; Quality of Health Care ; Surveys and Questionnaires
Language	English
Publishing date	2020-08-12
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	604539-x
ISSN	1523-6838 ; 0272-6386
ISSN (online)	1523-6838
ISSN	0272-6386
DOI	10.1053/j.ajkd.2020.05.032
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