International Journal of Nephrology最新文献

{"title":"Peritoneal Dialysis of Three-Cuff Catheter Experience in Qassim Province, Saudi Arabia.","authors":"Ahmed AlSalloom, Chandra Sekhar Kalevaru, Kholoud Alomeri, Sultan Alsayegh","doi":"10.1155/2024/5554703","DOIUrl":"https://doi.org/10.1155/2024/5554703","url":null,"abstract":"<p><p><b>Background:</b> The global rise in noncommunicable diseases, including chronic kidney diseases (CKDs), has led to a significant increase in the use of dialysis units to enhance patient longevity and quality of life. Over time, two-cuff catheters have been replaced by three-cuff catheters, with their usage expanding in nephrology centers across Saudi Arabia. This study aimed to evaluate the benefits, complications, and duration of therapy associated with three-cuff catheters in peritoneal dialysis (PD) patients. <b>Methodology:</b> To ensure the reliability of our results, we conducted a comprehensive cross-sectional study involving 257 patients who underwent three-cuff PD catheter (PDC) insertion and omentopexy. Data were retrospectively collected from 2016 to 2023 at King Fahad Specialist Hospital, Buraidah. The questionnaire was designed based on available variables in the records section and validated by subject experts and experienced research faculty. Data were then entered and analyzed using SPSS version 21.0. Descriptive statistics were employed for inferential statistics, while the chi-square test and logistic regression analysis were used to identify predictors of PD outcomes. <b>Results:</b> The average duration of therapy was 27.84 months, with a standard deviation of 27.23 months. Early complications were minimal, with just 5.1% (<i>n</i> = 13) experiencing peritonitis, 0.8% (<i>n</i> = 2) facing catheter migration, and 0.4% (<i>n</i> = 1 each) encountering omental wrap and exit site infection (ESI) within 30 days of catheter insertion. Remarkably, only 7.8% (<i>n</i> = 20) required catheter reinsertion. In addition, catheter removal due to catheter-related issues was low, affecting only 3.8% of patients. <b>Conclusions:</b> According to the study findings, three-cuff catheters exhibited fewer complications, superior performance, and longer therapy duration. These outcomes may be attributed to the thorough design of the three-cuff catheters, the dedication of the staff, and the implementation of strict policies. To maintain these positive results, it is crucial for the Ministry of Health and the Health Cluster to adopt long-term supportive measures.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2024 ","pages":"5554703"},"PeriodicalIF":1.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11540897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Protective Activity of <i>Withania somnifera</i> Against Mercuric Chloride (HgCl₂)-Induced Renal Toxicity in Male Rats.","authors":"Haddad A El Rabey, Samar M Rezk, Aseel Abusaber, Rwaah Khlabi, Ayah H Alhawiti, Romana M Algorayed, Nadia Bakry","doi":"10.1155/2024/8023989","DOIUrl":"10.1155/2024/8023989","url":null,"abstract":"<p><p>The purpose of this study was to test the protective effect of <i>Withania somnifera</i> (WS) against the harmful effects of mercuric chloride (HgCl₂)-induced kidney failure at the histological, biochemical, and immune levels in Wistar rats. The study assessed the biochemical and immunological changes in five groups (<i>n</i> = 6): Group 1 (G1) was the negative control, and the other rats received a single subcutaneous dose of HgCl₂ (2.5 mg/kg in 0.5 mL of 0.9% saline solution) and randomly divided into 4 groups. Group 2 (G2) was the positive control and left without treatment. Groups 3, 4, and 5 (G3, G4, and G5) were treated with different doses of WS root powder for 30 days. The HgCl₂-positive group showed significant signs of renal toxicity as reflected by increased levels of kidney function parameters (blood urea nitrogen, urea, and creatinine), inflammatory biomarkers, immunological indices (SDF-1, IL-6, NGAL, and KIM-1), and oxidative stress (SOD, TAC, CAT, GSH, and MDA). The positive group rats also showed drastic pathological changes in renal tissues. Different doses of WS treatment significantly reduced the levels of all biochemical markers and decreased pathological damage to the kidney tissues. The antioxidant, phenolic, and flavonoid constituents of WS root powder helped protect rats' kidneys against HgCl₂-induced kidney toxicity in male rats.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2024 ","pages":"8023989"},"PeriodicalIF":1.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11535192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Key Performance Indicators of Secondary Health Care in Chronic Kidney Disease: Experience in Public and Private Services in the State of São Paulo, Brazil.","authors":"Farid Samaan, Cristiane Akemi Vicente, Luiz Antônio Coutinho Pais, Gianna Mastroianni Kirsztajn, Ricardo Sesso","doi":"10.1155/2024/5401633","DOIUrl":"10.1155/2024/5401633","url":null,"abstract":"<p><p><b>Introduction:</b> The objective of this study was to evaluate quality indicators of secondary health care in chronic kidney disease (CKD). <b>Methods:</b> This retrospective longitudinal study was conducted in an outpatient medical nephrology clinic of the Brazilian Unified Health System (UHS) and a multidisciplinary outpatient clinic of a private health plan (PHP). The inclusion criteria were age ≥ 18 years, ≥ 3 medical appointments, and follow-up time ≥ 6 months. <b>Results:</b> Compared to PHP patients (<i>n</i> = 183), UHS patients (<i>n</i> = 276) were older (63.4 vs. 59.7 years, <i>p</i>=0.04), had more arterial hypertension (AH) (91.7% vs. 84.7%, <i>p</i>=0.02) and dyslipidemia (58.3 vs. 38.3%, <i>p</i> < 0.01), and had a lower estimated baseline glomerular filtration rate (eGFR) (29.9 [21.5-42.0] vs. 39.1 [28.6-54.8] mL/min/1.73 m², <i>p</i> < 0.01). Compared to PHP patients, UHS patients had a lower percentage of diabetics with glycated hemoglobin < 7.5% (46.1% vs. 61.2%, <i>p</i>=0.03), fewer people with potassium < 5.5 mEq/L (90.4% vs. 95.6%, <i>p</i>=0.04), and fewer referrals for hemodialysis with functioning arteriovenous fistula (AVF) (9.1% vs. 54.3%, <i>p</i> < 0.01). The percentages of people with hypertension and blood pressure < 140 × 90 mmHg were similar between the UHS and PHP groups (59.7% vs. 66.7%; <i>p</i>=0.17), as was the percentage of people with parathyroid hormone control (85.6% vs. 84.8%; <i>p</i>=0.83), dyslipidemia and LDL-cholesterol < 100 mg/dL (38.3% vs. 49.3%; <i>p</i>=0.13), phosphorus < 4.5 mg/dL (78.5% vs. 72.0%; <i>p</i>=0.16), and 25-OH-vitamin-D > 30 ng/mL (28.4% vs. 36.5%; <i>p</i>=0.11). The crude reduction in eGFR was greater in the UHS group than in PHP (2.3 [-0.1; 5.9] vs. 1.1 [-1.9; 4.6] mL/min/1.73 m²; <i>p</i> < 0.01). In the multivariate linear mixed-effects model, UHS patients also showed faster CKD progression over time than PHS ones (group effect, <i>p</i> < 0.01; time effect, <i>p</i> < 0.01; interaction, <i>p</i> < 0.01). <b>Conclusions:</b> Quality of care for patients with CKD can be improved through both services, and multidisciplinary care may have a positive impact on the control of comorbidities, the progression of CKD, and the planning of the initiation of hemodialysis.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2024 ","pages":"5401633"},"PeriodicalIF":1.7,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Matrix Gla Protein and Nitric Oxide Synthase-3 Genetic Variants in Chronic Kidney Disease and Their Relation with Cardiovascular Risk.","authors":"G Priyadarshini, Sreejith Parameswaran, Jayaprakash Sahoo, Sandhiya Selvarajan, Ananthakrishnan Ramesh, Medha Rajappa","doi":"10.1155/2024/3850055","DOIUrl":"10.1155/2024/3850055","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is defined by gradual deterioration of renal parenchyma and decline of functioning nephrons. The risk of cardiovascular events is drastically increased in patients with CKD. This complicated link of CKD and cardiovascular disease (CVD) is not well understood till date.</p><p><strong>Objective: </strong>We aim to study the influence of genetic variants of matrix Gla protein (<i>MGP</i>) gene rs1800801, rs1800802, and rs4236 and nitric oxide synthase-3 (<i>NOS3</i>) gene rs1799983 and rs2070744 on the risk of CKD and its associated cardiovascular comorbidity in South Indian Tamils.</p><p><strong>Methods: </strong>One hundred and eighty-five CKD patients and 185 controls were recruited in this research. Flow-mediated dilatation (FMD) of brachial artery was measured ultrasonically. Circulating levels of MGP and nitric oxide (NO) were measured by ELISA. Genotyping was done by real-time PCR.</p><p><strong>Results: </strong>We observed a significant difference in the distribution of TT and CT genotypes of <i>NOS3</i> (rs2070744), indicating an increase in the risk of CKD. NO level was significantly decreased in CKD cases than controls. We also found a significant difference in the distribution of TTA and CCG haplotypes of <i>MGP</i> polymorphisms (1-rs4236; 2-rs1800801; 3-rs1800802) between the groups, indicating an increase in the risk of CKD. CT genotype of MGP (rs4236) and CT genotype of NOS3 (rs2070744) variants were found to be associated with decreased FMD, indicating endothelial dysfunction, the harbinger of CVD.</p><p><strong>Conclusion: </strong>We conclude that genetic variants of <i>MGP</i> and <i>NOS3</i> enhance the risk of CKD and its associated cardiovascular comorbidity in South Indian Tamils.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2024 ","pages":"3850055"},"PeriodicalIF":1.7,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Manifestations of IgG4-Related Disease: A Concise Review.","authors":"Shahrukh T Towheed, Wayel Zanjir, Kevin Yi Mi Ren, Jocelyn Garland, Marie Clements-Baker","doi":"10.1155/2024/4421589","DOIUrl":"10.1155/2024/4421589","url":null,"abstract":"<p><p>IgG4-related disease (IgG4-RD) is an immune-mediated disorder marked by fibro-inflammatory masses that can infiltrate multiple organ systems. Due to its relatively recent discovery and limited understanding of its pathophysiology, IgG4-related disease may be difficult to recognize and is consequently potentially underdiagnosed. Renal involvement is becoming regarded as one of the key features of this disease. To date, the most well-recognized renal complication of IgG4-related disease is tubulointerstitial nephritis, but membranous glomerulonephritis, renal masses, and retroperitoneal fibrosis have also been reported. This concise review has two objectives. First, it will briefly encapsulate the history, epidemiology, and presentation of IgG4-related disease. Second, it will examine the reported renal manifestations of IgG4-related disease, exploring the relevant histology, imaging, clinical features, and treatment considerations. This synthesis will be highly relevant for nephrologists, rheumatologists, general internists, and renal pathologists to raise awareness and help improve early recognition of IgG4-related kidney disease (IgG4-RKD).</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2024 ","pages":"4421589"},"PeriodicalIF":1.7,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11217581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141491894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacteremia and Mortality among Patients with Nontunneled and Tunneled Catheters for Hemodialysis.","authors":"Carla Santos De Lima, Flora Braga Vaz, Rodrigo Peixoto Campos","doi":"10.1155/2024/3292667","DOIUrl":"10.1155/2024/3292667","url":null,"abstract":"<p><strong>Introduction: </strong>Central venous catheters for hemodialysis (HD) can be nontunneled catheters (NTC) or tunneled catheters (TC). Bacteremia and dysfunction are complications that can impact morbidity and mortality. We decided to compare the rates of bacteremia and dysfunction between NTC and TC and patient survival 90 days after catheter insertion.</p><p><strong>Methods: </strong>Retrospective cohort to evaluate catheters inserted between January 2011 and December 2020 in a tertiary hospital. Catheters in patients with end-stage chronic kidney disease were included. Patients with acute kidney injury, catheters that lasted less than three HD sessions, and patients who died within one week after insertion were excluded. Bacteremia and dysfunction rates, bacteremia-free survival, and dysfunction-free survival were investigated. Multivariable analysis was performed using a Cox proportional hazards regression model for patient survival at 90 days.</p><p><strong>Results: </strong>670 catheters were analyzed in 287 patients, 422 NTC (63%), and 248 TC (37%). The rates of confirmed bacteremia per 1,000 catheter-days were 1.19 for NTC and 0.20 for TC (<i>p</i> < 0.0001). The confirmed or possible bacteremia rates were 2.27 and 0.37 per 1,000 catheter-days for NTC and TC, respectively (<i>p</i> < 0.0001). The dysfunction rates were 3.96 and 0.86 for NTC and TC, respectively (<i>p</i> < 0.0001). Patient survival at 90 days was higher in the TC group than the NTC group (96.8% vs. 89.1%; <i>p</i> < 0.0001).</p><p><strong>Conclusion: </strong>We found lower rates of bacteremia and dysfunction for TC and demonstrated that using NTC affects patient mortality.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2024 ","pages":"3292667"},"PeriodicalIF":2.1,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10864053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139729581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular versus Surgical Lower Extremity Revascularization among Patients with Chronic Kidney Disease","authors":"Qingzheng Chen, Jialin Han, Gomathy Parvathinathan, E. Ross, Margaret R. Stedman, Tara I. Chang","doi":"10.1155/2023/5586060","DOIUrl":"https://doi.org/10.1155/2023/5586060","url":null,"abstract":"Introduction. Patients with chronic kidney disease (CKD) have a high prevalence of peripheral artery disease. How best to manage lower extremity peripheral artery disease remains unclear in this patient population. We therefore sought to compare the outcomes after endovascular versus surgical lower extremity revascularization among patients with CKD. Methods. We used data from Optum’s de-identifed Clinformatics® Data Mart Database, a nationwide database of commercially insured persons in the United States to study patients with CKD who underwent lower extremity endovascular or surgical revascularization. We used inverse probability of treatment weighting to balance covariates. We employed proportional hazard regression to study the primary outcome of major adverse limb events (MALE), defined as a repeat revascularization or amputation. We also studied each of these events separately and death from any cause. Results. In our cohort, 60,057 patients underwent endovascular revascularization and 9,338 patients underwent surgical revascularization. Endovascular revascularization compared with surgical revascularization was associated with a higher adjusted hazard of MALE (hazard ratio (HR) 1.52; 95% confidence interval (CI) 1.46–1.59). Endovascular revascularization was also associated with a higher adjusted hazard of repeat revascularization (HR 1.65; 95% CI 1.57–1.72) but a lower adjusted risk of amputation (HR 0.71; CI 0.73–0.89). Patients undergoing endovascular revascularization also had a lower adjusted hazard for death from any cause (0.85; CI 0.82–0.88). Conclusions. In this analysis of patients with CKD undergoing lower extremity revascularization, an endovascular approach was associated with a higher rate of repeated revascularization but a lower risk of subsequent amputation and death compared with surgical revascularization. Multiple factors must be considered when counseling patients with CKD, who have a high burden of comorbid conditions. Clinical trials should include more patients with kidney disease, who are often otherwise excluded from participation, to better understand the most effective treatment strategies for this vulnerable patient population.","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"53 17","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138995444","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}

{"title":"The Impact of Hot Ambient Temperature and Prolonged Fasting Duration during Ramadan on Patients with Chronic Kidney Disease: A Literature Review","authors":"A. Alsahow","doi":"10.1155/2023/2636507","DOIUrl":"https://doi.org/10.1155/2023/2636507","url":null,"abstract":"The Islamic (lunar) calendar has 11 fewer days each year than the Gregorian (solar) calendar. Consequently, ambient temperatures during the month of Ramadan and the duration of the presunrise-to-sunset fast will change each year. At some point, individuals observing Ramadan will experience prolonged periods of fasting during the hot summer months. In this manuscript, findings published in the English-language medical literature that address the impact of prolonged fasting during the warmer summer months on patients with chronic kidney disease, including dialysis and transplantation patients, are reviewed. This is of particular concern given the accelerated pace of global warming. The limitations of the evidence that is currently available are also discussed, and an approach that might be used to standardize future evaluations of the impact of fasting on kidney health is suggested.","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"5 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138586180","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}

{"title":"Correlation of the Dietary Protein Intake between Those Estimated from a Short Protein Food-Recall Questionnaire and from 24-Hour Urinary Urea-Nitrogen Excretion in Stages 3-4 Chronic Kidney Disease Patients.","authors":"Teerawat Thanachayanont, Methee Chanpitakkul, Akhathai Saetie, Salyaveth Lekagul, Kriang Tungsanga","doi":"10.1155/2023/9713045","DOIUrl":"10.1155/2023/9713045","url":null,"abstract":"<p><strong>Introduction: </strong>High protein intake may accelerate progression of chronic kidney disease (CKD). Estimation of dietary protein intake (DPI) is indispensable for management of CKD, but to achieve optimum DPI is quite challenging in routine clinical practice. We recently studied a beneficial effect of utilizing integrated care on the management of CKD at the rural community level. In that study, we created a short protein food-recall questionnaire (S-PFRQ) as a working tool to estimate DPI of the CKD patients during home visit by community health personnel. Herein, we reported the initial evaluation of the reliability of S-PFRQ from our previous study.</p><p><strong>Objective: </strong>We compared the amount of DPI obtained from S-PFRQ with that obtained from protein-equivalent of total nitrogen appearance (PNA).</p><p><strong>Methods: </strong>In the previous ESCORT-2 study, 914 patients with CKD stage 3 or 4, who were living in the rural area of Thailand, were prospectively followed while receiving integrated care for 36 consecutive months. During home visits by community nurses from subdistrict health centers, dietary food recall was made, recorded in S-PFRQ, and DPI was obtained. Among these, sixty patients were randomly selected, and 24-h urine was collected for urinary urea-N and estimation of PNA. A correlation was made between DPI obtained from S-PFRQ and PNA.</p><p><strong>Results: </strong>The DPIs derived from S-PFRQ and PNA were 28.8 ± 14.8 and 39.26 ± 17.79 g/day, respectively. The mean difference and 95% CI between the 2 methods was -10.43 (-7.1 to -13.8) g/day, respectively (<i>P</i> < 0.001). Interclass correlation between these 2 methods was 0.24, <i>P</i> = 0.007. The difference between the 2 methods remained constant across different amounts of DPI.</p><p><strong>Conclusion: </strong>The DPI estimated from S-PFRQ significantly correlated to that from PNA. However, the S-PFRQ method yielded a DPI value which was about 10 g of protein or 25% less than the PNA method. Despite this amount of difference, this S-PFRQ is user-friendly and could be used during field work as an easy and simple tool for DPI estimation in resource-limiting condition.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2023 ","pages":"9713045"},"PeriodicalIF":2.1,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10686714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138459902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Findings of Cardiovascular Workup of Kidney Transplant Candidates: A Retrospective Study of a Single-Center in Saudi Arabia.","authors":"Ziad Arabi,&nbsp;Mohammed H Tawhari,&nbsp;Haneen S Al Rajih,&nbsp;Talha M Youssouf,&nbsp;Mohamad Y Abdulgadir","doi":"10.1155/2023/4653069","DOIUrl":"https://doi.org/10.1155/2023/4653069","url":null,"abstract":"<p><strong>Background: </strong>There are limited data about the prevalence of cardiovascular (CV) risk factors and the findings of CV workup among kidney transplant (KTx) recipients (KTRs) in Saudi Arabia.</p><p><strong>Methods: </strong>A single-center retrospective study of KTRs who underwent KTx from 2017 to 2020 was performed. We reviewed the prevalence of CV risk factors and the results of the pre-KTx CV workup which was derived from the American Heart Association guidelines.</p><p><strong>Results: </strong>We included 254 KTRs. The mean age was 43.1 ± 15.9 years, and 55.5% were men and 79.5% were living-donor KTRs. Pre-emptive KTx was 9.8%, peritoneal dialysis was 11.8%, and hemodialysis was 78.3% (arteriovenous fistula: 33.1% versus hemodialysis catheter: 66.9%). The mean dialysis vintage was 4.8 ± 3.3 years for deceased-donor KTRs versus 2.4 ± 2.6 years for living-donor KTRs. CV risk factors were hypertension: 76%, diabetes: 40.6% (type 1 : 25.2% versus type 2 : 74.7%), hyperlipidemia (low-density lipoprotein >2.6 mmol/L): 40.2%, coronary artery disease (CAD): 12.6%, smoking: 9.1%, peripheral vascular disease: 2.8%, and cerebral vascular disease: 2.4%. The prevalence of obesity stage 1 was 19.7% and obesity stage 2 was 4%. Left ventricular hypertrophy was present in 38.5%. The ejection fraction was abnormal (<55%) in 22%. Abnormal wall motion was present in 34 patients (13.4%). A cardiac (PET-CT) stress test was conducted on 129 patients (50.8%) which showed abnormal perfusion in 37 patients (28.7%). Out of those who required PET-CT, 18.6% had a coronary artery calcium scoring (CACS) of more than 400, 41.8% had a CACS of zero, 29.4% had a CACS of 1-100, and 14.7% had a CACS of 100-400. Coronary angiogram was required in only 41 patients (16.1%), 12 (29.3%) required coronary interventions, 25 (61%) were treated medically, and 4 (9.8%) did not have any CAD. CT scans of pelvic arteries were performed in 118 patients (46.5%). It showed moderate or severe calcifications in only 7 patients (5.9%), whereas it was normal in 97 patients (82.2%), or it showed only mild calcifications in 14 patients (11.9%).</p><p><strong>Conclusion: </strong>This study outlines the prevalence of CV risk factors and the findings of the pretransplant CV workup among KTx candidates who underwent KTx. Multicenter national studies will be helpful to validate the generalizability of these findings.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2023 ","pages":"4653069"},"PeriodicalIF":2.1,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10581843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49677326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}