ABSTRACT
INTRODUCTION: Kidney transplantation is a definitive treatment for end-stage renal disease. It is associated with improved life expectancy and quality of life. One of the most common complications following kidney transplantation is graft rejection. To our knowledge, no previous study has identified rejection risk factors in kidney transplant recipients in Saudi Arabia. Therefore, the purpose of this study was to determine the specific risk factors of graft rejection. METHODS: A multicenter case-control study was conducted at four transplant centers in Saudi Arabia. All adult patients who underwent a renal transplant in the period between 01/01/2015 and 31/12/2021 were screened for eligibility. Included patients were categorized into two groups (cases and control) based on the occurrence of biopsy-proven rejection within two years. The primary outcome was to determine the risk factors for rejection within the first two years of transplant. Exact matching was utilized using a 1:4 ratio based on patients' age, gender, and transplant year. RESULTS: Out of 1320 screened renal transplant recipients, 816 patients were included. The overall prevalence of two-year rejection was 13.9%. In bivariate analysis, deceased donor status, the presence Donor Specific Antibody (DSA), intraoperative hypotension, serum Chloride levels, Pseudomonas aeruginosa, Candida, and any Infection within two years were linked with increased risk of two-year rejection. However, in the logistic regression analysis, DSA was identified as a significant risk for two-year rejection (Adjusted OR 2.68; 95% CI, 1.10, 6.49, p = 0.03). While, the presence of Panel-reactive antibody (PRA) and higher serum chloride levels one week prior to transplant was associated with lower odds of rejection (Adjusted OR 0.12; 95% CI, 0.03, 0.53, p = 0.005 and Adjusted OR 0.93; 95% CI, 0.86, 0.98, p = 0.02, respectively). Furthermore, blood infection, infected with Pseudomonas aeruginosa or BK virus within two years of transplant was associated with higher odds of two-year rejection (Adjusted OR 3.10; 95% CI, 1.48, 6.48, p = 0.003, Adjusted OR 3.23; 95% CI, 0.87, 11.97, p = 0.08 and Adjusted OR 2.76; 95% CI, 0.89, 8.48, p = 0.07, respectively). CONCLUSION: Our findings emphasize the need for appropriate prevention and management of infections following kidney transplantation to avoid more serious problems, such as rejection, which could significantly raise the likelihood of allograft failure and probably death. Further studies with larger sample size are needed to investigate the impact of serum chloride levels prior to transplant and intraoperative hypotension on the risk of rejection.
ABSTRACT
BACKGROUND: The COVID-19 pandemic was declared a public health emergency of international concern by the World Health Organization on March 12, 2020. Natural products and herbal medicine have been used since ancient times to relieve and treat disorders and infections, as well as increase immunity. Despite the beneficial effects of herbal medications, there are many side effects or interactions with other medications or foods that might occur. AIM: This study aims to explore the beliefs of Saudi people towards the use of herbal medicine for COVID-19 infection. METHOD: A cross-sectional study using an online survey was conducted in Saudi Arabia between January 2021 and January 2023. This survey was generated based on a deep review of the literature on COVID-19 as well as the use of medicine and herbal medicine to treat this infection. SPSS software was used to analyze the data, with a significance level of p < 0.05. RESULTS: A total of 1,230 individuals participated in this study. More than half (67.6%, n = 831) were females. Around 32.4% (n = 399) of the participants were aged 20-40 years. The majority were married (77.2%, n = 947), Saudi (96.5%, n = 1186), and living in central provinces (62.5%, n = 768) of the Kingdom. More than half of them (70.0%, n = 861) were bachelor's degree holders; 42.3% and 2.4% (n = 29) reported that they had been or were currently infected with COVID-19. Around 33.0% (n = 405) of the participants reported that they had used herbal products or nutritional supplements during the pandemic period to protect themselves from the disease. CONCLUSION: Our study showed that Saudi Arabia's public takes dietary supplements or herbal products to fight against the illness. We recommend that the Ministry of Health conduct more educational efforts to raise public awareness about disease transmission pathways and preventive actions. Furthermore, to guarantee patient safety, the use of herbal products should be supported by a professional counselor.
