Glomerulonephritis disease pattern at Saudi tertiary care center

Context: Chronic kidney disease (CKD) is characterized by the presence of kidney damage or decreased kidney function. In the Kingdom of Saudi Arabia, the prevalence of CKD is at 5.7%, which represents a high burden on health care systems. Aims: This study aimed to assess the knowledge, attitudes, and practices of high-risk patients towards prevention and early detection of chronic kidney disease in Saudi Arabia. Setting and Design: Descriptive cross-sectional study in Saudi Arabia. Methods and Material: This study was designed using a newly developed instrument, the CKD Screening Index. It was conducted from December 2021 to May 2022 by a self-administered questionnaire. The questionnaire has three parts: socio-demographic data, clinical factors, and the CKD screening index tool. Statistical analyses used: Independent t-test, One-Way ANOVA, LSD, Games–Howell tests. Results: Knowledge of kidney function had a significant difference across patient groups with varying employment status. Monthly income is a significant factor for the patient attitude on healthcare towards preventing kidney disease. On the other hand, educational level significantly affects the overall attitude of patients towards preventing kidney disease. Conclusion: Understanding knowledge, attitudes, and practices associated with CKD is vital to informing optimal policy and public health responses in the country.

Background: SARS-CoV-2 infection has a high mortality rate and continues to be a global threat, which warrants the identification of all mortality risk factors in critically ill patients. Methods: This is a retrospective multicenter cohort study conducted in five hospitals in the Kingdom of Saudi Arabia (KSA). We enrolled patients with confirmed SARS-COV-2 infection admitted to any of the intensive care units from the five hospitals between March 2020 and July 2020, corresponding to the peak of recorded COVID-19 cases in the KSA. Results: In total, 229 critically ill patients with confirmed SARS-CoV-2 infection were included in the study. The presenting symptoms and signs of patients who died during hospitalization were not significantly different from those observed among patients who survived. The baseline comorbidities that were significantly associated with in-hospital mortality were diabetes (62% vs. 48% among patients who died and survived (p = 0.046)), underlying cardiac disease (38% vs. 19% (p = 0.001)), and underlying kidney disease (32% vs. 12% (p < 0.001)). Conclusion: In our cohort, the baseline comorbidities that were significantly associated with in-hospital mortality were diabetes, underlying cardiac disease, and underlying kidney disease. Additionally, the factors that independently influenced mortality among critically ill COVID-19 patients were high Activated Partial Thromboplastin Time (aPTT )and international normalization ratio (INR), acidosis, and high ferritin.

Purpose: The COVID-19 pandemic has limited the traditional way of teaching due to contact restrictions and the trainees being the front-line providers of patient care in certain specialties. During the pandemic, many academic institutes have adopted various methods for utilizing online learning as an alternative to traditional teaching. Numerous studies reported the impact of these changes on medical education with varying results. As such, comprehensive assessments are necessary to evaluate the outcomes of this rapid transformation. The aim of this study was to provide qualitative and quantitative assessments of post-graduate online medical education during the COVID-19 pandemic in Saudi Arabia. Participants and Methods: In this cross-sectional study, an online questionnaire was distributed among postgraduate trainers and trainees in Riyadh second health cluster. The questionnaire was used to assess the experiences, perception, coping, satisfaction and preferences of medical trainers and trainees towards online education during the COVID-19 pandemic. Results: A total of 207 participants were involved in this study. While the sociodemographics differed between trainers and trainees, age was significantly associated with negative pre-pandemic online learning experiences. Stress was reported among both groups and was significantly correlated with the pre-pandemic computer and internet competency. Coping was reported to be easier by trainers compared to trainees. The overall perception of online learning was positive in 73% of the respondents. Perception significantly correlated with age, stress, coping and satisfaction (P < 0.0001). The majority of trainees were interested in a hybrid mode learning, combining traditional teaching with online education. Conclusion: There is a significant difference between trainers and trainees with regard to their experience of online education. Further studies are required to assess how to effectively implement online education in postgraduate training programs and identify strategies to overcome the reported deficiencies.

Objectives: To develop evidence-based national guidelines incorporating recent advancements in clinical research and therapeutic strategies for the management of patients with diabetic kidney disease (DKD) in the Kingdom of Saudi Arabia (KSA). Methods: We developed the guidelines using the GRADE methodology and a multidisciplinary expert panel comprising nephrologists, endocrinologists, clinical pharmacists, and methodologists across KSA. We conducted a systematic literature review of studies published between 2014–2024. The evidence certainty was evaluated across 5 domains using GRADEpro and categorized into 4 levels: “high”, “moderate”, “low”, and “very low”. Recommendations were formulated based on the benefit-risk ratio, evidence quality, and expert consensus, with a minimum agreement threshold of 70%. Results: We established 39 evidence-based recommendations addressing key aspects of DKD management, including monitoring and treatment. Among the 39 recommendations, 6 focus on lifestyle interventions, 7 address glucose-lowering therapies, one discusses glycemic monitoring and targets, 8 address DKD evaluation and risk assessment, 7 emphasize comprehensive management approaches, and 10 discuss DKD pharmacological management. Two recommendations related to the comprehensive management of DKD were based on expert opinions owing to a lack of supporting evidence. Conclusion: These Saudi national guidelines offer an evidence-based approach for managing DKD in adults with DM and provide a comprehensive framework for monitoring and treatment. Nevertheless, further local research and data collection are warranted to refine and enhance the guidelines’ effectiveness.

Introduction Renal complications are increasingly recognized after chimeric antigen receptor (CAR) T-cell therapy. We evaluated the incidence and severity of acute kidney injury (AKI), the prevalence of electrolyte disturbances, and clinical factors associated with AKI in adult patients with hematological malignancies. Methods We retrospectively reviewed all adult patients with hematological malignancies who received CAR T-cell therapy at a single tertiary center between November 2023 and April 2025. Baseline demographics, comorbidities, prior therapies, and post-infusion events were collected from electronic medical records. AKI was defined and staged according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines based on serum creatinine (Cr) levels. Electrolyte disturbances (sodium, potassium, and phosphate) occurring within 100 days post-infusion were recorded. Data were analyzed using R statistical software (version 4.5.1). Continuous variables are presented as the mean ± SD or median (IQR). Groups were compared using t-tests, Wilcoxon rank-sum tests, and Fisher’s exact tests. Associations between AKI and patient characteristics were assessed using logistic regression. Hospitalization outcomes were evaluated using Kaplan-Meier and Cox proportional hazards models. A p-value < 0.05 was considered statistically significant. Results This study included 16 patients (mean age: 56.7 ± 17.7 years; 50% male), 25% of whom developed AKI (all stage 1). Pre-existing chronic kidney disease (CKD), baseline Cr ≥75 μmol/L, and diabetes mellitus showed the strongest associations with AKI. Electrolyte disturbances were common, particularly potassium and phosphate abnormalities. AKI was not significantly associated with ICU admission, longer hospitalization, or early mortality. Conclusion In this cohort, renal events after CAR T-cell therapy were mainly mild. Pre-existing CKD and diabetes mellitus were associated with an increased risk of AKI. Therefore, we suggest close monitoring of kidney function and other risk factors (such as nephrotoxic medications, contrast exposure, and dehydration) during treatment. Further studies with larger cohorts and longer follow-up are required to clarify the mechanisms of renal impairment and better assess outcomes.