Ways to Overcome Organ Shortage: Increasing Donor Pool by Accepting Suboptimal Kidney Donors.

Many factors affect organ donations worldwide, including religious factors, legislative decisions, economic factors, presence of organ procurement organizations, cultural issues, the presence of commercial transplant, and other unknown factors. The number of patients with end-stage renal disease has increased by 6% worldwide. Even with more transplant procedures, these numbers have not combated the dramatically increased number of patients on wait lists.

Nonimmunologic Factors Affecting Long-Term Outcomes of Deceased-Donor Kidney Transplant.

Objectives: We investigated the impact of nonimmuno-logic factors on patient and graft survival after deceased-donor kidney transplant.

Materials And Methods: All deceased-donor kidney transplants performed between January 2004 and December 2015 were included in our analyses. We used the independent t test to calculate significant differences between means above and below medians of various parameters.

Blood pressure control, lifestyle and disease awareness of Saudi hypertensive patients.

Mortality and morbidity from hypertension have reached epidemic proportion worldwide. It has been estimated that 874 million adults globally have systolic blood pressure (SBP) of 140 mm Hg or higher. A recent study from Saudi Arabia found 15.

A Simple and Cheap Hospitalization Risk Assessment Tool for Use in Hemodialysis Patients.

Objective: To develop a simple, objective, cheap scoring tool incorporating nutritional parameters and other variables to predict hospitalization and mortality among hemodialysis patients - a tool that could be utilized in low resource countries.

Methods: The following variables were scored according to severity into 0, 1, 2 or 3: BMI, functional capacity, HD vintage in years, serum albumin, serum ferritin, and the number of comorbid conditions (diabetes mellitus, hypertension, ischemic heart disease, cerebrovascular disease). This tool was evaluated on our regular hemodialysis patients who were followed up for 24 months (June 2015 till July 2017).

Alport's syndrome with focal segmental glomerulosclerosis lesion - Pattern to recognize.

The association between Alport's syndrome (AS) and focal segmental glomerulosclerosis (FSGS) in the same patient is complex and rarely reported. We report a case of a 42-year-old male presenting with proteinuria, microscopic hematuria, elevated serum creatinine and hypertension with unremarkable physical examination apart from obesity. The renal biopsy showed well-established FSGS pattern of injury with mild interstitial fibrosis and tubular atrophy, while the electron microscopic examination demonstrated glomerular basement membranes (GBM) changes compatible with AS.

Let Us Listen to Patients: Underutilization of Peritoneal Dialysis from Patients' Perspectives.

Despite the fact that many of the medical outcome data of peritoneal dialysis (PD) have been improving over the past few years, PD remains an underutilized modality in many countries worldwide. Most nephrologists in those countries report a high rate of patients' refusal. We conducted this survey-based study to determine the obstacles behind underutilization of PD in Saudi Arabia from patients' perspectives and to understand the reasons for their refusal.

Barriers to Peritoneal Dialysis in Saudi Arabia: Nephrologists' Perspectives.

In Saudi Arabia, only 9% of dialysis patients are on peritoneal dialysis (PD), and this has been the case for years. A number of centers around the world have sought to understand the underutilization of PD by asking nephrologists directly. In this study, we aimed to gather information that will answer the question "Why is PD underutilized in Saudi Arabia?" hoping that a roadmap may be developed to overcome the hurdles the study underscores, allowing for more patients to utilize this valuable modality.

Medical grand rounds in Riyadh, Saudi Arabia: Current attitudes and barriers.

Background: Medical grand rounds (MGRs) are considered key educational tools in most academic medical institutions. In this multi-center cross-sectional survey, we tried to determine the current attitudes of local medical practitioners to MGRs, as well as perceived barriers.

Methodology: A total of 120 physicians from the National Guard Hospital, King Fahad Medical City, King Khalid University Hospital and King Faisal Specialist Hospital participated in the survey.

Family Satisfaction in Critical Care Units: Does an Open Visiting Hours Policy Have an Impact?

Unlabelled: For critically ill patients, the interaction between health care providers and family members is essential in daily decision making. Improving this relationship has a positive impact on satisfaction with the overall care provided to patients and reduces family member symptoms of depression, anxiety, and posttraumatic stress disorder. In this study, we analyzed the impact of visitation policy (open versus restricted) on family satisfaction using the previously well-validated Critical Care Family Satisfaction Survey (CCFSS) questionnaire.

Continuous Mandatory Onsite Consultant Intensivists in the ICU: Impacts on Patient Outcomes.

Objective: The aim of this study was to compare the impacts on patient outcomes of continuous versus on-demand access to certified consultant intensivists in the intensive care unit (ICU).

Methods: Two general adult ICUs within the same health-care organization were compared in terms of patient outcomes. One unit featured continuous mandatory presence of a consultant intensivist (unit A), whereas the other had continuous access to a consultant intensivist during daytime hours but only on-demand access during the night-time hours (unit B).

Advance medical directives: a proposed new approach and terminology from an Islamic perspective.

Advance directives are specific competent consumers' wishes about future medical plans in the event that they become incompetent. Awareness of a patient's autonomy particularly, in relation to their right to refuse or withdraw treatment, a right for the patient to die from natural causes and interest in end of life issues were among the main reasons for developing and legalizing advance medical directives in developed countries. However, in many circumstances cultural and religious aspects are among many factors that can hamper implementation of advance directives.

The impact of introducing automated eGFR reporting on uncovering new cases of chronic kidney disease in a University Hospital in Saudi Arabia.

Objective: To determine the impact of introducing eGFR automated reporting on uncovering new cases of Chronic Kidney Disease.

Methods: All serum creatinine (SCr) in adult patients attending outpatient clinics over a two-month period were recorded and eGFR estimated. Cases with a SCr within normal limits but were in CKD stage 3 (<60 mL/min) or higher were recorded and their numbers, percentages and mean ages calculated.

Comparison of the tuberculin skin test and Quanti-FERON-TB Gold In-Tube (QFT-G) test for the diagnosis of latent tuberculosis infection in dialysis patients.

Dialysis patients are more likely than the general population to develop active tuberculosis (TB). In these patients, the availability of a highly sensitive and specific test to diagnose latent TB will ensure earlier treatment and decreased progression to active disease. In the current study, the Quanti-FERON-TB Gold In-Tube (QFT-G) test was compared with the tuberculin skin test (TST) for the diagnosis of latent tuberculosis infection (LTBI) among 200 hemodialysis patients and 15 confirmed TB disease cases in a tertiary care center in Saudi Arabia.

Home intravenous antibiotics in a tertiary care hospital in Saudi Arabia.

Background And Objective: Home intravenous (IV) antibiotic programs are becoming increasingly popular worldwide because of their efficacy and safety. However, in Saudi Arabia these programs have not yet become an integrated part of the health care system. We present our experience with a home IV antibiotic program, as one of the major health care providers in Saudi Arabia.

Physicians' attitudes toward reporting medical errors-an observational study at a general hospital in Saudi Arabia.

Objective: : Accurate medical error reporting is crucial for reducing the occurrence of such errors and their adverse consequences. This study aims to investigate the views of physicians about medical error reporting in a tertiary care hospital in Saudi Arabia.

Methods: : This is a cross-sectional self-administrated survey study.

Increased risk of hypertension, proteinuria and preeclampsia in pregnant Saudi females with IgA nephropathy.

Background: IgA nephropathy is fairly prevalent in Saudi Arabia. In this paper we examine the natural history of pregnancies and their impact on renal function in Saudi females affected by this condition.

Methods: We followed a series of 12 patients, documented to have IgA nephritis by kidney biopsy, during their gestation.

Insomnia in chronic renal patients on dialysis in Saudi Arabia.

Background: Studies have shown that insomnia is a common sleep disorder among patients with end-stage renal disease (ESRD). This study aimed to assess the prevalence of insomnia in Saudi patients with ESRD who are on maintenance dialysis.

Methods: This was an observational cross-sectional study carried out over a period of five months in two hemodialysis centers in Saudi Arabia.

Factors associated with decision-making about end-of-life care by hemodialysis patients.

The current cross sectional study is based on a questionnaire database on patients with end-stage renal disease (ESRD) to determine their preferences about end-of-life care and differences of certainty regarding the application of cardiopulmonary resuscitation and life sustaining measures in case of cardiac arrest. The study was performed on 100 patients on hemodialysis for at least 2 years and not on the transplant list in two tertiary hospitals in Saudi Arabia; King Fahad National Guard in Riyadh and King Faisal Specialist Hospital in Jeddah in March 2007. More than two thirds of the surveyed patients were willing to make decisive decisions.

Restless legs syndrome in patients on dialysis.

Restless legs syndrome (RLS) is an extremely distressing problem experienced by patients on dialysis; the prevalence appears to be greater than in the general population, with a wide variation from 6.6% to 80%. The diagnosis of RLS is a clinical one, and its definition has been clarified and standardized by internationally recognized diagnostic criteria, published in 1995 by the International Restless Legs Syndrome Study Group (IRLSSG).

Advance care planning preferences among dialysis patients and factors influencing their decisions.

To determine the resuscitation preferences of hemodialysis (HD) Saudi patients, we con-ducted a cross-sectional, observational descriptive questionnaire study in two major tertiary hospitals in Saudi Arabia from March to December 2007. We enrolled all the patients on HD for two years or more, and excluded the patients who were transplant candidates, confused, or demented. The questionnaire was com-posed of 4 sections.

Diagnostic decision making in medicine.

Medical diagnostic decision making, like all decision making instances, involves a cognitive process. It starts with internalizing data, structuring it and generating hypotheses. In simple cases very often the experienced physician utilizes pattern recognition, intuition and retrieval in reaching a diagnostic decision.

Implications of ICU stay after brain death: the Saudi experience.

Objective: The interval from brain death (BD) to organ harvesting is critical to the success of transplantation. We evaluated the time from BD onset to harvesting and analyzed sources of delay.

Materials And Methods: This retrospective study was conducted from January 1999 to December 2003.