Background Transplantation offers the best survival for patients with end stage organ disease. Transplant of hepatitis C virus (HCV) nucleic acid test (NAT) positive organs into negative recipients is a novel strategy that can expand the donor pool. We aim to evaluate our centre’s experience. Methods We preformed a retrospective review of anti-HCV NAT positive and negative organs into negative recipients transplanted over 27 months. Primary outcome was the success rate of eradication of HCV post-transplant. Secondary outcomes were rate of transmission of HCV, treatment adverse events, and graft failure. Results 33 anti-HCV positive organs were transplanted into negative recipients. 22 (66.7%) were NAT positive. Median recipients age was 49 years (interquartile range [IQR] 44.5–62.0) with the majority being males (57.6%). NAT positive organ transplantations included 16 kidneys, 3 livers, 1 kidney-pancreas, 1 liver-kidney, and 1 heart. The most common HCV genotype was 1a (59.1%). The median time to initiating therapy was 41.5 days. SVR12 was 100% in patients who finished therapy. There were no adverse events with therapy and no graft failure. Conclusions Anti-HCV NAT positive organ transplantation into negative recipients is safe with excellent eradication rates and no significant adverse events or graft failure. This would expand donor pool to close the gap between supply and demand.

Objective: Vaccination hesitance for the COVID-19 booster dosage among hemodialysis patients is an important barrier in reducing morbidity and mortality linked to COVID-19 infection. Hence, this study aimed to explore the predictors of the third (booster) dose of COVID-19 vaccine intention among CKD patients on hemodialysis from the Kingdom of Saudi Arabia (KSA). Methods: This study was a multi-center cross-sectional study conducted at four dialysis centers in KSA from 13 February 2022 to 21 June 2022. The data was collected by the nephrologist in charge of the unit using a structured study questionnaire, which consisted of four parts; socio-demographic and clinical variables, questions about COVID-19 infection and subjective assessment of health state, COVID-19 booster dose vaccination intention and confidence in vaccines and preferences, and a health belief model. The study population consisted of 179 hemodialysis patients. Results: Participants in the study had conflicting health beliefs about their vulnerability to COVID-19 infection and the severity of the COVID-19 infection. Study participants expressed positive health beliefs about the advantages of the COVID-19 booster dose, and reported less perceived obstacles in receiving the vaccine. The influence of cues on action among the study population was high. A total of 140 (78.2%) hemodialysis patients expressed their intention to receive the COVID-19 booster dose. Patients who reported poor health in the self-rating of their health status had a substantially higher definite intention to take the COVID-19 booster dose, according to the chi-square test (11.16, df = 3, p = 0.01). There was a significant association between the constructs in the HBM model and COVID-19 vaccine (booster) intention. Marital status (OR = 1.67, CI 1.07–2.58) was found to be the strongest predictors of a definite intention to receive a COVID-19 booster dose. Confidence in the locally manufactured vaccine (OR = 0.33, CI 0.17–0.60), education (OR = 0.62, CI 0.41–0.93), and rating of health status (OR = 0.43 CI 0.25–0.74) were the strongest significant correlates of having no definite intention to take the COVID-19 vaccination. Conclusions: HBM constructs were found to be significantly associated with vaccination intention, which can be considered while planning policies to promote COVID-19 booster vaccination among hemodialysis patients. The study results could be utilized in drafting policies to improve COVID-19 booster dose vaccination uptake among hemodialysis population.

No abstract

BackgroundDespite abundant sunlight exposure, vitamin D deficiency remains a major challenge in Saudi Arabia. Meanwhile, the widespread use of vitamin D supplements has prompted concerns about toxicity, which although rare, can have severe health consequences. ObjectiveThe objective of this cross-sectional study was to analyze the prevalence and associated factors of iatrogenic vitamin D toxicity among the Saudi population of vitamin D users due to overcorrection. MethodsAn online questionnaire was used to collect data from 1,677 participants across all regions of Saudi Arabia. The questionnaire included responses on the prescription, duration of vitamin D intake, dosage, frequency, history of vitamin D toxicity, symptom onset, and duration. ResultsOne thousand six hundred and seventy-seven responses were included across all regions of Saudi Arabia. A majority of participants were female (66.7%) and around half were aged 18-25 years. A history of vitamin D use was reported by 63.8% of participants, and 48% were still using vitamin D supplements. Most participants (79.3%) consulted a physician, and 84.8% had taken a vitamin D test before using the supplement. Commonly reported motives for taking vitamin D included vitamin D deficiency (72.1%), lack of sun exposure (26.1%), and hair loss (20.6%). Symptoms of overdose were reported by 6.6% of participants, with 3.3% having an overdose and 2.1% experiencing both overdose and symptoms. ConclusionThis study showed that although a large portion of the Saudi population is taking vitamin D supplements, the prevalence of vitamin D toxicity is relatively low. However, this prevalence should not be ignored, and further research is needed to understand the factors contributing to vitamin D toxicity in order to minimize its occurrence.

Introduction Excessive dietary sodium (Na) consumption is a major health care issue in the developed world and linked to many poor health outcomes. Elevated urinary Na may lead to hypercalciuria and an increase in urinary stone risk. Our study aimed to assess the impact of targeted dietary counseling, and its effect on normalizing urinary Na levels in hypercalciuric stone patients. Methods A retrospective analysis of a prospectively collected metabolic stone clinic database was performed. Patients with hypercalciuria and elevated urine Na on 24-hour urine collection (24-HUC) were counselled by the attending nephrologist, urologist or a registered dietician to limit their intake of dietary Na to < 2g/day in addition to receiving general dietary advice. Repeat metabolic testing was performed at least 6 months later. Logistic regression was used to determine correlations between elevated urinary Ca and Na to other urinary abnormalities and to evaluate the effect of normalizing urinary Na on other urinary parameters. Results Metabolic evaluations from 1184 patients were analyzed. The ninety-eight patients with concomitant hypercalciuria and hypernatriuria were predominantly male (67.3%) and had a higher median BMI than the entire cohort. The presence of elevated urinary Na was also associated with hyperuricosuria (p < 0.001) and hyperphosphaturia (p < 0.001). In follow-up, 59.4% corrected their urinary Na, and 43.8% also had their urinary Ca corrected. Patients who corrected their urinary Na were also more likely to have normal urinary values for volume (p = 0.045), oxalate (p = 0.004), and urate (p = 0.008). Conclusions Targeted dietary counseling can be effective in normalizing both elevated urinary Na and Ca levels in stone patients and may obviate the need for pharmacotherapy for the treatment of hypercalciuria in some patients.