Background: Chronic kidney disease (CKD) is a common problem globally and has heavy burden on patients and health authorities. Knowing the risk factors of CKD will reduce the prevalence of CKD and its socio-economic effects.
Objectives The literature on health and disease during Ramadan fasting (RF) is widely spread in many journals making it not readily accessible to those interested in the subject. Here, we provide an overview of the research on the interplay of RF with various aspects of well-being published in 2022. Materials and Methods A narrative, nonsystematic review of the international literature from a single major medical online database, PubMed, in one calendar year (2022) was conducted. The search term “Ramadan fasting” was used to retrieve the appropriate records. The relevant literature with substantial data-based content was presented in a concise thematic account, excluding those concerned with diabetes. Results Themes that emerged from the review included the pathophysiology of metabolic changes during RF, nutritional aspects including body composition and energy metabolism, cardiovascular disease and risk factors, renal function and structure, endocrinology (mainly thyroid), neurological disorders, mental health, pregnancy and fetal life, and infections (including COVID). Some miscellaneous clinical themes were identified, such as patients' and professional perspectives. Conclusions In 2022, the medical interest in RF was again widely spread across specialties. Cardiovascular disease and risk factors attract the most interest in terms of original articles and professional guidelines. We hope with this review to present a concise summary of the scholarly work on the subject in this year.
Introduction: Despite efforts to increase community awareness of kidney donation and transplantation, there remains a huge gap between the number of kidneys needed and those available. Objectives: We aimed to document the types of relationship between donors and recipients of kidney transplants in a previously unexamined community. Patients and Methods: This was a descriptive retrospective study of 454 living-related kidney transplant patients registered during 2019 in the posttransplant clinic at the National Centre for Organ Transplantation, Tripoli, Libya. Demographic data and the type of relationship between recipients and donors were studied. Results: There was a male donor predominance (67.4%), with a male-to-female ratio of 2: 1. The mean age of the donors was 34.2 ± 10.27 years. The sibling constituted the majority (62.2%) of donors, with brother predominance. They were followed by off-spring donors (17.6%), with a predominance of sons and parents (12.4%), with mothers acting as donors more than fathers. Donation from spouses was relatively infrequent (3.5%). Conclusions: The study revealed that brothers are the most common donor and all donors more commonly donate to male recipients, except mothers who donate more commonly to female recipients. This may be reflective of the sociocultural factors. More social awareness is needed regarding organ donation, especially among females, to increase their contribution in donation.
Objective New-onset diabetes mellitus after transplantation (NODAT), also known as posttransplant diabetes mellitus, is a common complication after kidney transplantation. It is associated with an increased risk of graft failure and death. Therefore, minimizing the risk of NODAT is a priority after kidney transplantation. This study aimed to determine the incidence of NODAT, the risk factors for its development, and the therapeutic drugs used for its management. Patients and Methods This is an observational, retrospective study on kidney recipients who were followed up in our center in 2021. After excluding known diabetic patients, second transplant patients, and those with follow-up periods less than 6 months, 308 recipients were included in the study. Demographic, clinical, and laboratory data were collected from the patient records. The patients were categorized as diabetic or nondiabetic. Results All patients' mean age was 35.9±11.6 years (standard deviation). The male-to-female ratio was 2.13:1. The overall incidence of NODAT was 38.3%. The median time to NODAT diagnosis was 6 months. Patients older than 40 were more likely to develop NODAT (61.1%; p = 0.000). The prevalence of pretransplant body mass index (BMI) more than 25 was significantly higher (67.6%) in diabetic than among nondiabetic patients (p = 0.000). NODAT patients were more likely to have had a rejection episode (65 vs. 35% in nondiabetic patients; p = 0.011). A high trough level of calcineurin inhibitors carried a significant risk of NODAT development. Tacrolimus trough level more than or equal to 10 ng/mL had an odds ratio of 57.9 (95% confidence interval [CI] 7.689–1262.2; p = 0.0007) for the development of NODAT. Likewise, a cyclosporine-A trough level more than or equal to 150 ng/mL had an odds ratio of 100.7 (95% CI: 7.31–4293.5; p = 0.0028). Conclusion NODAT incidence was high in this study. Older age, high BMI, prior rejection episode, steroid dose, and high calcineurin inhibitors trough levels were significant risk factors for developing NODAT.
Background: End-Stage Renal Disease (ESRD) is a global health problem due to increasing its burden worldwide. High-risk groups include family members of patients with ESRD. Objectives: To determine the prevalence of ESRD among dialysis patients' families. At Al-Shat kidney dialysis Center, Tripoli, Libya. So can conclude that the ESRD patient is an index case for a high- risk population. Methods: All patients' data were collected through direct interview with the patients for 15- 20 minutes and by reviewing patients' charts. Patients who decline consent to participate and those with mental or speech disability were excluded, and patients on peritoneal dialysis. The study carried at Al-Shat kidney dialysis centre, Tripoli, Libya. In January 2019. Results: 261 patients were interviewed, mean age 51.8 years (±15), nearly half (48.7%) of them, between 45 to 65 years and 31.8% younger than 45 years. 56.3% were men, and 43.7% were women. The leading causes of ESRD in these patients were DM, HTN, congenital abnormalities (APCKD/VUR) and GN (35.2%, 22.2%, 10%, 8%). Positive family history of ESRD was reportedby 26.8% of these patients. From them, 47% (33/70) were between 45 to 65 years ofage. 58.6% were male (41/70). 34.3% have diabetic, 20% have HTN, 13%have congenital abnormalities, and 7% GN. Conclusions: Positive familyhistory of ESRD was high in dialysis patients. These patients can be used as anindex case to identify high- risk population.
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