OBJECTIVE: To determine the prevalence of vitamin D deficiency in healthy Saudi adults. METHODS: A cross-sectional study carried out as part of the screening and early evaluation of kidney disease project. Vitamin D was measured in subjects recruited at 2 screening camps in Riyadh, Saudi Arabia, between March to May 2008. Subjects from the 2 large commercial centers in Riyadh aged >/=18 years and Saudi nationals were invited. RESULTS: The study sample comprised of 488 subjects. The mean age of the subjects was 37.43 (11.32) years, of which 50.2% (n=245) were males. Twenty-nine percent of subjects were in the vitamin D deficiency group, 22.7% were in the relative insufficiency group, and 47.5% had normal levels of 25-hydroxy vitamin D. We observed that female gender was an independent predictor of vitamin D deficiency or insufficiency (odds ratio [OR]: 2.992; 95% confidence intervals [CI] 2.069-4.327). Anemia was also a predictor for vitamin D deficiency or insufficiency (OR: 3.16; 95% CI 2.02-4.92). Age was positively correlated with vitamin D levels (Pearson correlation=0.183, p<0.000). CONCLUSION: Vitamin D deficiency is common in healthy Saudi adults. This is more pronounced in females and in the younger age groups. Wearing of traditional clothes, deliberate avoidance of the sun, and inadequate dietary intake are likely to be the principal causes of low vitamin D levels.

Introduction: We aimed to assess quality of life (QOL) among Saudi hemodialysis (HD) patients and the impact on the QOL of a certain demographic and clinical factors. Methods: The QOL was assessed using an Arabic version of Kidney Disease Quality of Life Instrument Short Form (KDQOL-SF). Mean scores were compared for individual domain scores and for the three composite summary scores, namely the mental component score (MCS), the physical component score (PCS) and kidney-disease component score (KDCS). Results: The study included one hundred chronic HD patients from King Abdulaziz Medical City, Riyadh. The overall mean score was 60.4. Domains with very low scores were "cognitive function", "role-emotional", "role-physical" and "work status". Domains with high scores were "patient satisfaction", "dialysis staff encouragement" and "quality of social interaction". The mean scores for KDCS, MCS and PCS were 59.7, 54.2 and 52.7 respectively. KDC scores were higher among males and the married group. PCS scores were higher among males, patients aged < 40 years, and the higher income group. MCS scores were higher among males and the higher income groups. There was a positive correlation between KDCS and MCS (r = 0.62, P = 0.0001); and between KDCS and PCS (r = 0.65, P = 0.0001). Conclusion: We provided a detailed description of the QOL scores of a group of Saudi HD patients and the impact of certain factors on their QOL. Low scores were seen in the "work status", "cognitive function", "role-physical" and "role-emotional" while high scores were seen in "patient satisfaction", "dialysis staff encouragement" and "quality of social interaction" domains. Keywords: Hemodialysis; Kidney Disease; Quality of Life; Saudi Arabia

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.

Autoimmune hepatitis (AIH) may present acutely, which can rapidly progress to fulminant type. This pattern has been described worldwide but is generally under-reported. We aim to describe the clinical presentation and treatment outcomes of patients with acute onset AIH. A multicenter retrospective cohort study of patients with acute onset AIH. Clinical, biochemical, and histological data were analyzed and the outcomes were reported. Seventy patients were included. The mean age was 33.8±1.5 years and 58.6% were female. Upon initial presentation, 94% had jaundice, 44% had fatigue, 31% had pruritus, and 29% had abdominal pain. Biochemical analysis revealed elevated alanine transaminase (733±463.6), aspartate transaminase (699±423), and total bilirubin (210±181.8). Antinuclear antibody (ANA) was positive in 61% of patients, anti-smooth muscle antibody (ASMA) in 69%, and both in 31%; immunoglobulin G (IgG) was elevated in 86% of patients. Advanced fibrosis was found in 39%. Complete remission was achieved in 74.3%, two patients required liver transplants and six died. No specific biomarkers were identified as predictive of remission; however, advanced age was associated with poor prognosis. Acute onset AIH is a disease that requires early diagnosis and management. We confirmed that elevated transaminases are the hallmark of biochemical presentation of acute AIH. High IgG, ANA and ASMA are typically present in such patients upon presentation, however, their absence does not totally exclude the diagnosis. Initial response to treatment was excellent; however, the long-term mortality was higher than the general patient population.