Predictors of renal replacement therapy and mortality in children with chronic kidney disease

To study the epidemiology of chronic kidney disease [CKD] in children, and to look for risk factors to predict renal replacement therapy [RRT] and mortality. This is a retrospective cohort study conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia between 2006 and 2014, where the files of 1,000 children with CKD were reviewed. We determined the effect of consanguinity and hypertension, and being a Saudi indigene on mortality and RRT. We compared children with congenital versus non-congenital causes of CKD. The mean +/- standard deviation age at presentation was 4.9 +/- 4.3 years. The median duration of follow up was 1.5 [interquartile range [IQR]: 0.4-4.0] years. Only 9.7% of children received RRT, and 8.3% died. The underlying etiology for CKD was congenital in 537 children. The congenital CKD group presented at a younger age group [3.5 +/- 4.0 versus 6.6 +/- 3.9 years, p<0.0001], had more advanced stages of CKD [p<0.0001], higher rates of consanguinity [75.4% versus 47.1%, p<0.0001], and RRT [p<0.004] than children with non-congenital CKD. Risk factors for RRT among children with CKD include being a Saudi indigene [relative risk [RR]=1.49, 95% confidence interval [CI]: 1.01-2.21], and hypertensive [RR=5.29, 95% CI: 3.54-7.91]. The risk factor for mortality was hypertension [RR=2.46, 95% CI: 1.66-3.65]. Congenital causes of CKD represent the main etiology of CKD in children living in the western province of Saudi Arabia. Significant risk factors for RRT include congenital CKD, Saudi nationality, and hypertension. Hypertension is also a predictor of mortality in children with CKD

Prevalence of vitamin D deficiency in Saudi adults

To determine the prevalence of vitamin D deficiency in healthy Saudi adults. 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. 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]. 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