Abdulla A Al Sayyari
King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia
Title: Prevalence and Clinical Characteristics of Saudi Dialysis Patients with or without Positive Family Histories of Kidney Disease
Biography
Biography: Abdulla A Al Sayyari
Abstract
Objective
This study aimed at evaluating the prevalence and clinical characteristics of Saudi dialysis patients with a positive family history of kidney disease and to compare these to those without a family history of kidney disease.
Secondary objectives were to assess the certainty of the diagnoses of causes CKD among the patients by their physicians
Methods & Material
This is a cross-sectional survey based study on adult Saudi patients on hemodialysis in six dialysis centers in four Saudi cities.
The survey had two parts. The first part (filled by the physicians of the patient) asked about the patient’s sex, age, dialysis vintage, CKD vintage, cause of the renal failure and whether the diagnosis is definitive or speculative. The second part (filled by the patients) asked about the presence of kidney disease among first degree relatives ( history of CKD, urinary abnormality and/or is or having been on dialysis.
Results
1080 patients were included, 55.4% males. The Mean age was 56.1±20 years and the mean dialysis vintage was 5.7±5.9 years and the mean time between diagnosis of CKD and onset of dialysis was 3.0±5.6 years
Table 1 shows the causes of the CKD as determined by the patients’ physician and whether this diagnosis is “definitive” or “speculative”. Of all the diagnoses given, 57.8% were either “unknown” (33%) or only “speculative (25.3%). In those with a diagnostic label, the diagnosis was thought to be definitive in only 62.2% of the cases’”.(Table 1).
21.5% had first-degree relatives with kidney disease with no significant difference cities. There were more patients with “unknown” or “hypertensive” diagnosis among patients with FH of kidney than in those without (p=007 and 0.005 respectively). No differences were observed when the cause was DN or GN.
No significant difference in the prevalence FH was seen by age (p=0.5). Dialysis vintage was significantly shorter (p=0.03) and CKD vintage was significantly longer (p=0.0001) in the patients with FH (table 2)
|
Unknown |
33 |
|
|
|
Diabetic nephropathy |
32.2 |
52.3% |
47.7% |
|
Hypertension |
20.1 |
58.5% |
41.5% |
|
Glomerulonephritis |
5.1 |
83.3% |
16.7% |
|
Lupus Nephritis |
2 |
90.5% |
9.5% |
|
APKD |
1.8 |
94.7% |
5.3% |
|
Congenitally small kidneys |
1.4 |
90% |
10% |
|
Calculi |
0.8 |
100% |
0% |
|
Chronic interstitial nephritis |
3.1 |
69% |
31% |
|
Joubert’ s |
0.3 |
50% |
50% |
|
Alport's Syndrome |
0.2 |
100% |
0% |
|
All |
100% |
62.2% |
37.8% |
Table 1 The causes of the CKD as determined by the patients’ physician and whether this diagnosis is “definitive” or “speculative”.
|
Patient characteristics |
Positive FH |
Negative FH |
p |
|
Among male patients |
18.8% |
80.2% |
P=0.09 |
|
Among female patients |
23% |
77% |
|
|
Mean patient age |
55.3 yrs. |
56.4 yrs. |
0.5 |
|
Dx vintage among all patients |
4.9 ±6.4 |
5.9 ±5.8 |
0.03 |
|
CKD vintage among patients |
7.5±7.7 |
2.0±4.5 |
0.0001 |
Table 2 comparing some patient characteristics between those with and those without FH of kidney diseases
Conclusion
More patients with “unknown” or “hypertensive” diagnostic labels were seen in patients with FH but not when the causes of the patients were DN or GN This suggests that under the umbrella of “unknown” or “hypertensive” diagnostic labels, a number of genetically-based kidney diseases might well be concealed. The dialysis vintage was significantly shorter and CKD vintage was significantly longer in the patients with FH.