Diabetes Prevalence, Treatment, Control, and Outcomes Among Hemodialysis Patients in the Gulf Cooperation Council Countries

Al-Ghamdi, Saeed; Bieber, Brian; Alrukhaimi, Mona; AlSahow, Ali; Salmi, Issa Al; Al-Ali, Fadwa; Aradi, Ali Al; Filho, R. A. Freitas; Robinson, Bruce M.; Pisoni, Ronald L.

doi:10.1016/j.ekir.2022.02.012

Cited by 15 publications

(10 citation statements)

References 39 publications

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“…Key pathomechanisms include a proinflammatory status, increased oxidative stress and cellular senescence ( 2 , 3 ), thereby contributing to increased mortality with about 40-50% of deaths attributed to cardiovascular diseases ( 4 ). Cardiometabolic disease states frequently observed in patients with CKD and kidney failure (KF) include diabetes ( 5 , 6 ), dyslipidemia ( 7 ) and a proinflammatory phenotype. Therefore, potential endocrine cytokines linking cardiometabolic diseases with impaired renal function need to be investigated.…”

Section: Introductionmentioning

confidence: 99%

Renal function is a major predictor of circulating acyl-CoA-binding protein/diazepam-binding inhibitor

Schürfeld¹,

Sandner²,

Hoffmann

et al. 2023

Front. Endocrinol.

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ObjectiveAcyl-CoA-binding protein (ACBP)/diazepam-binding inhibitor has lately been described as an endocrine factor affecting food intake and lipid metabolism. ACBP is dysregulated in catabolic/malnutrition states like sepsis or systemic inflammation. However, regulation of ACBP has not been investigated in conditions with impaired kidney function, so far.Design/methodsSerum ACBP concentrations were investigated by enzyme-linked immunosorbent assay i) in a cohort of 60 individuals with kidney failure (KF) on chronic haemodialysis and compared to 60 individuals with a preserved kidney function; and ii) in a human model of acute kidney dysfunction (AKD). In addition, mACBP mRNA expression was assessed in two CKD mouse models and in two distinct groups of non-CKD mice. Further, mRNA expression of mACBP was measured in vitro in isolated, differentiated mouse adipocytes - brown and white - after exposure to the uremic agent indoxyl sulfate.ResultsMedian [interquartile range] serum ACBP was almost 20-fold increased in KF (514.0 [339.3] µg/l) compared to subjects without KF (26.1 [39.1] µg/l) (p<0.001). eGFR was the most important, inverse predictor of circulating ACBP in multivariate analysis (standardized β=-0.839; p<0.001). Furthermore, AKD increased ACBP concentrations almost 3-fold (p<0.001). Increased ACBP levels were not caused by augmented mACBP mRNA expression in different tissues of CKD mice in vivo or in indoxyl sulfate-treated adipocytes in vitro.ConclusionsCirculating ACBP inversely associates with renal function, most likely through renal retention of the cytokine. Future studies need to investigate ACBP physiology in malnutrition-related disease states, such as CKD, and to adjust for markers of renal function.

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Section: Introductionmentioning

confidence: 99%

Renal function is a major predictor of circulating acyl-CoA-binding protein/diazepam-binding inhibitor

Schürfeld¹,

Sandner²,

Hoffmann

et al. 2023

Front. Endocrinol.

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“…Among HD patients in GCC countries, diabetes prevalence ranges even from 45 to 74% (median 68%). 25 Since also physical inactivity, a key driver of the above-mentioned conditions, is widespread in the region (Kuwait 67%, KSA 53%), 26 the panel supports all efforts to increase physical activity and reduce obesity. Furthermore, checks of potassium levels during regular visits of patients with these conditions are recommended.…”

Section: Medical Conditions Associated With Hyperkalemiamentioning

confidence: 92%

“…Only Oman (8.0%) has a moderate diabetes prevalence, but an increase of cases is foreseeable. Among HD patients in GCC countries, diabetes prevalence ranges even from 45 to 74% (median 68%) 25 …”

Section: Definition Prevalence and Risk Factors Of Hyperkalemiamentioning

confidence: 99%

Prevalence and management of hyperkalemia in chronic kidney disease and heart failure patients in the Gulf Cooperation Council (GCC)

AlSahow

AbdulShafy

Al-Ghamdi

et al. 2023

J of Clinical Hypertension

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Hyperkalemia is a frequent complication in patients with chronic kidney disease (CKD) or heart failure (HF) and associated with neuromuscular manifestations, changes in the electrocardiogram, and increased risk of mortality. While data on the prevalence and management of hyperkalemia in the gulf region are scarce, risk factors such as preference for potassium-rich foods (e.g., dates and dried fruits/vegetables), periods of intense fasting (e.g., Ramadan), and diabetes (an ancestor of CKD and HF) are common.Therefore, a panel of nephrologists and cardiologists from countries of the Gulf Cooperation Council (GCC) convened to collate and review available data on the prevalence, regional drivers, and current practice in the management of hyperkalemia in the region.Eventually, this review provides consensus recommendations on a balanced utilization of dietary and pharmacological options including new potassium binders for achieving and sustainably maintaining desirable serum potassium levels in countries of the GCC region. Alignment with regional habits and practice was a key aspect to facilitate the uptake of the recommendations into physicians' practice and patients' lives. K E Y W O R D Schronic kidney disease, heart failure, hyperkalemia, potassium binding INTRODUCTIONHyperkalemia is a frequent complication in chronic kidney disease (CKD) and heart failure (HF) patients, particularly those on reninangiotensin-aldosterone inhibitor (RAASi) therapy. 1,2 It is associ-All authors contributed equally to the preparation of this manuscript.

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“… 2 In the majority of the Middle East, diabetes mellitus (DM) and hypertension account for 45%–74% of end-stage kidney disease (ESKD). 3 , 4 …”

Section: Introductionmentioning

confidence: 99%

Impact of Sodium-Glucose Cotransporter-2 Inhibitors in the Management of Chronic Kidney Disease: A Middle East and Africa Perspective

Elkeraie,

Al-Ghamdi,

Abu-Alfa

et al. 2024

IJNRD

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Chronic kidney disease (CKD) is a major public health concern in the Middle East and Africa (MEA) region and a leading cause of death in patients with type 2 diabetes mellitus (T2DM) and hypertension. Early initiation of sodium-glucose cotransporter - 2 inhibitors (SGLT-2i) and proper sequencing with renin-angiotensin-aldosterone system inhibitors (RAASi) in these patients may result in better clinical outcomes due to their cardioprotective properties and complementary mechanisms of action. In this review, we present guideline-based consensus recommendations by experts from the MEA region, as practical algorithms for screening, early detection, nephrology referral, and treatment pathways for CKD management in patients with hypertension and diabetes mellitus. This study will help physicians take timely and appropriate actions to provide better care to patients with CKD or those at high risk of CKD.

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Diabetes Prevalence, Treatment, Control, and Outcomes Among Hemodialysis Patients in the Gulf Cooperation Council Countries

Cited by 15 publications

References 39 publications

Renal function is a major predictor of circulating acyl-CoA-binding protein/diazepam-binding inhibitor

Renal function is a major predictor of circulating acyl-CoA-binding protein/diazepam-binding inhibitor

Prevalence and management of hyperkalemia in chronic kidney disease and heart failure patients in the Gulf Cooperation Council (GCC)

Impact of Sodium-Glucose Cotransporter-2 Inhibitors in the Management of Chronic Kidney Disease: A Middle East and Africa Perspective

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