Pediatric renal transplantation in Oman: a single-center experience

Objectives: This study sought to report 22 years experience in pediatric kidney transplantation in Oman

Methods: Electronic charts of all Omani children below 13 years of age who received a kidney transplant from January 1994 to December 2015 were reviewed. Data collected included patient demographics, etiology of end-stage kidney disease, modality and duration of dialysis, donor type, complication of kidney transplantation [including surgical complications, infections, graft rejection] graft and patient survival, and duration of follow-up

Results: During the study period transplantation from 27 living related donors [LRDs], 42 living unrelated donors [LURDs], also referred to as commercial transplant, and one deceased donor were performed. The median age at transplantation was nine years for both groups. The most common primary diagnosis was congenital anomalies of the kidney and urinary tract in 32.8% of patients followed by familial nephrotic syndrome in 20.0% and polycystic kidney disease in 18.5%. Almost half the patients were on hemodialysis before transplantation, 35.7% were on peritoneal dialysis, and 14.2% received preemptive renal transplantation. Children who received LURD kidneys had high surgical complications [42.8%] compared to the LRDs group [17.8%]. Five patients from LURDs group had early graft nephrectomy and four patients developed non-graft function or delayed graft function. In addition, patients in the LURDs group had a higher incidence of hypertension and acute rejection. Graft and patient survival were both better in the LRDs than the LURDs group

Conclusions: Although our pediatric kidney transplant program is a young program it has had successful patient outcomes comparable to international programs. Our study provides evidence that in addition to legal and ethical issues with commercial transplant, it also carries significantly higher morbidity and reduced graft and patient survival

Epidemiology of diabetes mellitus in Oman results from two decades of research

This study aimed to describe the epidemiology of diabetes mellitus over the past two decades in Oman, particularly in terms of its prevalence and incidence. In addition, the study sought to estimate the future incidence of diabetes in Oman. Three national and three regional surveys conducted between 1991 and 2010 were analysed to obtain the age-adjusted prevalence and undiagnosed proportion of type 2 diabetes mellitus [T2DM] among Omani subjects aged >/=20 years. Diabetes mellitus registers and published studies were used to determine incidence rates of both type 1 diabetes mellitus [T1DM] and T2DM in Oman. Linear regression was used to determine trends and projections for diabetes in 2050. The age-adjusted prevalence of T2DM in Oman varied from 10.4% to 21.1%, while the highest prevalence of impaired fasting glucose was found in males [35.1%]. In comparison to men, higher incidence rates of T2DM were found in women [2.7 cases compared to 2.3 cases per 1,000 person-years, respectively]. No significant trends were observed for the prevalence or incidence of T2DM in both genders. Undiagnosed T2DM was more common in men [range: 33-68%] than women [range: 27-53%]. The results of this study show that by 2050, there will be an estimated 350,000 people with T2DM living in Oman [a 174% increase compared to estimates for 2015]. Health authorities need to prioritise diabetes prevention and control in order to prevent or delay long-term complications and avert a potential epidemic of diabetes in Oman

Acute renal failure in a patient with both leptospirosis and dengue fever

The spectrum of tropical nephropathies includes Acute Renal Failure [ARF] or Acute Kidney Injury [AKI] due to infective agents that are endemic in the tropics which include Leptospira [LS] and Dengue Viruses [DV]. The major histological feature is Acute Tubular Necrosis [ATN]. 1, 2 We report the case of a patient who presented ARF with coinfection with both agents. The clinical manifestations were consistent with both diseases. A renal treatment was supportive and the outcome was positive. We conclude that co-infection with these two tropical agents was possible. It may have been overlooked when the diagnosis of one agent was confirmed, especially that aware of the possibility of coinfection, as the management may be different. Spontaneous full recovery in these circumstances is still possible with supportive treatment