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This was an observational, analytical, retrospective, nationwide study. We included all adult patients on maintenance dialysis therapy who tested positive for COVID-19 (PCR assay of the nasopharyngeal swab) during the period from February 1, 2020, to July 19, 2020. Our primary outcome was to study the mortality of COVID-19 in dialysis patients in Qatar and risk factors associated with it. Our secondary objectives were to study incidence and severity of COVID-19 in dialysis patients and comparing outcomes between hemodialysis and peritoneal dialysis patients. Patient demographics and clinical features were collected from a national electronic medical record. Univariate Cox regression analysis was performed to evaluate potential risk factors for mortality in our cohort. 76 out of 1064 dialysis patients were diagnosed with COVID-19 (age 56±13.6, 56 hemodialysis and 20 peritoneal dialysis, 56 males). During the study period, 7.1% of all dialysis patients contracted COVID-19. Male dialysis patients had double the incidence of COVID-19 than females (9% versus 4.5% respectively; p<0.01). The most common symptoms on presentation were fever (57.9%), cough (56.6%), and shortness of breath (25%). Pneumonia was diagnosed in 72% of dialysis patients with COVID-19. High severity manifested as 25% of patients requiring admission to the intensive care unit, 18.4% had ARDS, 17.1% required mechanical ventilation, and 14.5% required inotropes. The mean length of hospital stay was 19.2 ± -12 days. Mortality due to COVID-19 among our dialysis cohort was 15%. Univariate Cox regression analysis for risk factors associated with COVID-19-related death in dialysis patients showed significant increases in risks with age (OR 1.077, CI 95%(1.018-1.139), p = 0.01), CHF and COPD (both same OR 8.974, CI 95% (1.039-77.5), p = 0.046), history of DVT (OR 5.762, CI 95% (1.227-27.057), p = 0.026), Atrial fibrillation (OR 7.285, CI 95%(2.029-26.150), p = 0.002), hypoxia (OR: 16.6; CI 95%(3.574-77.715), p = <0.001), ICU admission (HR30.8, CI 95% (3.9-241.2), p = 0.001), Mechanical ventilation (HR 50.07 CI 95% (6.4-391.2)), p<0.001) and using inotropes(HR 19.17, CI 95% (11.57-718.5), p<0.001). In a multivariate analysis, only ICU admission was found to be significantly associated with death [OR = 32.8 (3.5-305.4), p = 0.002)]. This is the first study to be conducted at a national level in Qatar exploring COVID-19 in a dialysis population. Dialysis patients had a high incidence of COVID-19 infection and related mortality compared to previous reports of the general population in the state of Qatar (7.1% versus 4% and 15% versus 0.15% respectively). We also observed a strong association between death related to COVID-19 infection in dialysis patients and admission to ICU.

PloS one, 2021-07, Vol.16 (7), p.e0254246-e0254246

Mortality and associated risk factors of COVID-19 infection in dialysis patients in Qatar: A nationwide cohort study

Hospital-acquired acute kidney injury (H-AKI) is a common cause of avoidable morbidity and mortality. Therefore, in the current study, we investigated whether vital signs data from patients, as defined by a National Early Warning Score (NEWS), can predict H-AKI following emergency admission to hospital. We analysed all emergency admissions (n=33,608) to York Hospital with NEWS data over a 24-month period. Here, we report the area under the curve (AUC) for logistic regression models that used the index NEWS (model A0), plus age and sex (A1), plus subcomponents of NEWS (A2) and two-way interactions (A3), and similarly for maximum NEWS (models B0,B1,B2,B3). Of the total emergency admissions, 4.05% (1,361/33,608) had H-AKI. Models using the index NEWS had lower AUCs (0.59–0.68) than models using the maximum NEWS AUCs (0.75–0.77). The maximum NEWS model (B3) was more sensitive than the index NEWS model (A0) (67.60% vs 19.84%) but identified twice as many cases as being at risk of H-AKI (9581 vs 4099) at a NEWS of 5. Based on these results, we suggest that the index NEWS is a poor predictor of H-AKI. The maximum NEWS is a better predictor but appears to be unfeasible because it is only knowable in retrospect and is associated with a substantial increase in workload, albeit with improved sensitivity.

Clinical medicine (London, England), 2018-02, Vol.18 (1), p.47-53

The National Early Warning Score and its subcomponents recorded within ±24 h of emergency medical admission are poor predictors of hospital-acquired acute kidney injury

BackgroundEffectively managing mineral and bone disease (MBD) is crucial for the well-being of hemodialysis patients, as elevated levels of calcium, phosphorus, and parathyroid hormone (PTH) have been associated with increased mortality rates in this population.1 Our dialysis facilities have encountered suboptimal outcomes in MBD due to inadequate adherence to medication and dietary recommendations. We embraced a collaborative decision-making model (figure 1) involving patients and healthcare professionals that focuses on fostering transparent communication, respecting patients‘ emotions, and perspectives, with providing alternative solutions to overcome challenges that patients face in adapting to lifestyle changes. Our objective was to enhance patient compliance with MBD management and aid them in making well-considered decisions on their care plan, which will impact positively the percentage of PTH levels within our target range (150–500 pg/l).MethodsThe MBD team, consisting of a nephrologist, nurse manager, dietitian, pharmacist, patient educator, and quality reviewer, collaborated closely to deliver comprehensive care. This included crucial emotional support to dialysis patients and advocating for their specific needs. Our interviews aimed to identify reasons behind noncompliance with prescribed medication, revealing connections to financial constraints, tablet preferences, dosing frequency, and symptoms of medication intolerance. We suggested alternative treatment approaches, detailing the advantages and risks of each option and providing additional educational materials for support. Upon the patient‘s agreement with the proposed options, a personalised plan was created. Monthly data collection and analysis were conducted as part of the process.ResultsThe percentage of PTH level within our target range (150–500 pg/l) improved from 64% in Quarter 1 of 2022 to 70% in Quarter 3 of 2023.ConclusionAdopting a shared decision approach improved patients‘ satisfaction and compliance with medicine regimens and showed improvement in PTH levels on the way to achieve the program goal of 70% (figure 2).Abstract 31 Figure 1Shared decision-making approach and strategic key for mineral bone disease management[Figure omitted. See PDF]Abstract 31 Figure 2Haemodialysis patient with parathyroid hormone in target level 150–500 pg/l[Figure omitted. See PDF]ReferencesPerrone V, Dovizio M, Veronesi C, Andretta M, Bartolini F, Cavaliere A, Ferrante F, Lupi A, Pagliaro R, Pagnotta R, Palcic S, Re D, Ubertazzo L, Vercellone A, Degli Esposti L. Real-world evaluation of calcimimetics for the treatment of secondary hyperparathyroidism in chronic kidney disease, in an Italian clinical setting. Healthcare (Basel) 2022 Apr 11;10(4):709. DOI: 10.3390/healthcare10040709.PMID: 35455886Esposito P, Rampino T, Gregorini M, Tinelli C, De Silvestri A, Malberti F, Coppo R, Dal Canton A, IAMM Group. Management of mineral metabolism in hemodialysis patients: discrepancy between interventions and perceived causes of failure. Journal of Nephrology 2014 Dec;27:689–97. DOI: 10.1007/s40620-014-0100-1Ethical Approval/IRB StatementThis study was supported by the Institutional Review Board of Hamad Medical Corporation (HMC), Doha, Qatar, with the approval number: MRC-01-20-377.Disclosures and AcknowledgmentsThe authors have no conflicts of interest.

BMJ open quality, 2025-01, Vol.14 (Suppl 2), p.A38-A39

31 ‘Not deciding alone’: who makes the decision to manage mineral and bone disease in the hemodialysis population?

Abante Catalino Jr Ilagan, 23 Abas Fatma, 52 Abdallah Naji, 39 Abdallah Tasneem, 55 Abdelati Adel, 7 Abdelbary Asmaa, 71, 87 Abdelfadel Abdelrahman, 90 Abdelfateh Mohammed, 26 Abdelghaffir Hassan Shirin Ahmed, 57 Abdelmajid Alaaeldin, 55 Abdul Hamid Patel Ashfaq Ahmad, 26 Abdul-Fattah Samara Haya Ahmed, 46 Abdullah Mohammad, 73 Abdullah Nurin Chong, 50 Abraham Phinoj Kumblanickal, 50, 51 Abraham Thresiamma, 3, 31 Abu-Ghaliah Basim, 43 Abughalieh Basim, 37 Abuhelaiqa Essa Abdulla ME, 9 Aburahma Niveen, 64 Adamana Jilumol, 26 Adawi Rana Al, 33, 34, 62, 83 Adawi Rana M. Al, 30 Adil Syed Ahmed, 29 Afreen Farhana, 90 Afsar Sheriff Mohd Abdullah, 13 Agustin Cherila Sakandal, 94 Ahmad Haseen, 13 Ahmad Karima, 13 Ahmad Shakeb, 13 Ahmad Tawheed, 44 Ahmed Afif, 71, 87 Ahmed Al Amiri Fawwaz Rashad, 23, 44 Ahmed Al-Jalham Khalid Mohammed, 46, 70 Ahmed Dawood Bani, 14 Ahmed Karima, 3, 14, 31 Ahmed Mahmoud Saad Ahmed Hassan, 51 Ahmed Musab, 52 Ahmed Mutie Ullah, 73 Ahmed Nima, 74 Ahmed Tarek, 61 Ajmi Kawthar Al, 54 Akhavanborna Masoud Aliagha, 70 Akram Jaweria, 65 Al Bakri Muna, 59 Al Maslamani Muna, 59 Al-Bakri Muna, 30, 32, 33 Al-Balawi Rida Mohd, 17 Al-Barghothi Maram, 43 Al-Buyaradah Mashaal, 72 Al-Haddad Fatima, 79, 91 Al-Hail Moza, 59, 88 Al-hammadi Ahmed, 53 Al-Hammadi Noora, 74 Al-Harasi Majed, 60 Al-Ishaq Moza, 72 Al-Khader Saja, 36, 37 Al-Khuzaei Noriya, 64 Al-Kuwari Fatma, 43 Al-Kuwari Fatma Jassim, 36, 37 Al-Makhzomi Esraa, 43 Al-Malki Hassan, 13, 14 Al-Mansoor Nadia, 11 Al-Maslamani Muna, 38, 88 Al-Mohanadi Teha, 13 Al-Naemi Enaam, 47 Al-Najjar Mohammed, 14 Al-Nesf Maryam, 32, 35 Al-Rashid Muna, 38, 55 Al-Rauili Nadya, 4 Al-Shaikh Loua, 72 Al-Sharji Maryam, 60 Al-Shukaili Khadija, 15, 16 Al-Shukaili Khadijah, 17 Al-Siyabi Ibtisam, 60 Al-Sulaiti Essa, 71, 87 Alam Fareeda, 74 Alamami Anas, 7 Alansari Lolwa, 39, 86 Alansari Lolwa Mohammed, 1 Alazab Motaz Mohammad, 42 Albakri Muna, 93 Alcala Maria Glenda, 69 Alcantara Ma. Cleo, 12 Alfuqaha Khaldoun, 27, 28, 29, 63, 75 Algallie Hossam Mohamed, 57 Alhail Moza, 71, 87 Alhebail Saadiya Ahmad S A, 46 Ali Dalal, 11 Ali Fadwa Al, 3, 31, 52 Ali Farrukh, 31 Ali Hassan, 61 Ali Maisa, 38 Ali Tabasim, 85 Ali Wafa, 3, 14, 31, 52, 85 Alikutty Jamsheer Parammal, 23 Alinier Guillaume, 48 Almasri Nihad, 19 Almomani Emad, 48 Almudahka Noora R, 52, 85 Alnaimat Ali Mousa, 23, 44 Aloui Mohamed, 89 Alqam Shatha, 64 Alrawaili Salwa, 41, 42 Alrawashdeh Abdulaziz, 10, 70 Alshdafat Tamara, 39 Alsheikh Isra Saleh, 65 Alshurafa Awni A A, 73 Alsmadi Ayat, 41, 42 Altaf Zubaria, 76 Altarwneh Nayel, 74 Altikrity Nawras, 7 Alwash Shahla, 71 Aly Ahmed Hanaa Hamdy, 61 Aly Sahar, 31, 52 Aly Sahar MohamedIsmail, 9 Ambujakshan Chandu Kuttathiparambil, 82 Amdouni Sarra, 39 Amin Lubna G, 27, 28 Amin Mohamed, 31, 85 Amood Abeer, 3, 31 Amri Mohammad Al, 68, 69 Ananthegowda Dore C., 23 Antony Andrin K, 40, 70 Arroyo Yolanda Mia, 61 Asim Muhammad, 9 Assaf Akram, 47 Atchan Mounir, 34 Atrash Muna, 41, 42, 76 Augustine Sheeba, 46 Babay Fatma, 12 Babu Neha, 68 Bacor Eric Palarca, 94 Badawi El Tahir Hiba A Aziz, 73 Bader Al Omari Anees Jamil, 3 Bagorio Lew, 6, 56 Baguio Karl, 37 Baguio Karl Ladera, 43 Bakleh Amineh, 86 Bakr Mohammad, 73 Bakri Muna Al, 34, 35, 62, 66, 83 Bakry Islam, 36, 37, 43 Balluz Fathia, 86 Banat Mohammed, 11 Banerjee Siddhartha, 57 Baqi Sabera Iqbal, 9 Bartolome Juliana, 69 Batashi Mazin Al, 54 Baun Tayag Mark Oliver, 70 Bejona Mary Deth, 40 Boby Saumya, 45 Boppana Ajay, 52 Borja Mark, 38 Bougaila Amina, 65 Bouguerra El Adel, 52, 85 Brahem Hosni Ben, 89 Bushra Ahlam, 61 Busil Lea, 29 Caiso Ortiz Rebecca Joy, 26 Cantara Ma Cleo Al, 72 Capinig Jovelyn, 6, 8, 16, 56 Carino Leah Mananquil, 26 Chaabane Mohamed Ben, 64 Chacko Gracy, 26 Chaeib Ebtissem, 78 Charalil Jaffar Sadiq, 51 Chatila Rama, 32, 35, 93 Chebel Maher, 14 Cherian Merin, 15 Cherif Honar, 74 Christy Aleyamma, 51 Cuevas Marc Ivan, 16 D’Souza Divya Cecilia, 5 Dalla Said Abou, 27, 28, 29 Darwiche Abdallah, 2 Darwish Amal Fathy, 4 Davis Jayakaran Magdalene Rita, 57 Dawood Mohamed, 52 Dawood Mohammad, 31 Dawood Mohammad Ahmad, 13 Dawood Mohammad Ahmad M, 3 Dayag Roderic Batang, 40, 70, 94 Deignan Una, 79 Del Rosario Naz Kim Roger, 23 Delicana Jordana, 73 Dellil Abdenour, 90 Derbel Emna, 12, 72 Derhobi Hatim El, 73 Desoky Walid, 47 Devamani Manual, 7 Devaraj Ankitha, 24 Dham Teha, 61 Dibis Mustafa Al, 89 Dimatatac Rachelle Ann, 20, 77 Donor Leslie Rachel, 22 Doyle Nicola, 18 DSouza Lita Clara, 68 Duerme Editha, 25 Easo Blessy, 45 El-Atiq Mohammed, 66 El-Kassem Wessam, 88 Elajez Reem, 35, 59, 88 Elgaali Musab Ahmed, 31 Elgara Mohamed Salem M, 20 Elhalabi Ihsan, 53 Elmekaty Eman, 38 Elmoheen Amr, 93 Eloueti Montassar, 3 Elsayed Rana, 93 Elsiddig Abdulla, 76 Eltahir Mugahid, 7 Eltous Renan, 92 Elzeni Saad, 15 Elzouki Abdelnasser, 83 Emara Mahmoud, 38 Estacio Castillo Jhernie Jeff, 94 Estigoy De Vera Daphne Lynnette, 50 Etman Hanan Hanafi Mahmoud M, 70 Ezzat Mohammed, 61 Ezzeldin Asmaa, 30, 32, 33, 34, 35, 59 Fae’q Al-Taj Braa Mousa, 51 Farghaly Ahmed, 30, 34 Farhat Hassan, 12, 72, 89 Farid Mohamed, 31 Farooqi Farrukh Ali, 13 Febin Aysha, 68, 69 Felfel Inass, 64 Fitzgerald Audrey, 79, 91 Fleur Soriano Espero Kristine Bella, 82 Fouda Tarek, 3, 13, 14, 31, 52, 85 Francis Tina, 26 Gaali Musab Al, 85 Gad Ehsane, 64 Gellego Pacifico Jr. Gamarcha, 21, 22 George Sybil Binu, 79, 91 Geronimo Richelle, 21 Ghoneim Elhussein, 66 Ghonimi Tarek, 3, 31 Gracia Joash De, 2 Guerra Flordevic, 45 Haba Taicir, 41 Habboub Lina, 84 Habib Ben Amor Manal Bent, 25 Habibi Saber, 89 Habsi Safiya Al, 49 Haddad Fatima Al, 4 Hafezah Mohammad Abu, 64 Hajaji Wafa Ali A, 13 Hamad Abdulah, 3, 31 Hamad Abdulla, 14 Hamad Abdullah, 52, 85 Hamad Abdullah Ibrahim, 13 Hamad Almomani Emad Ali, 1 Hamad Anas, 81 Hamad Hanadi Al, 80 Hamad Yasser, 47 Hamadani Abdullah Al, 54 Hamdy Hanaa, 14 Hamed Abdelbaki Nehal Attia, 94 Hamed Badr Amr Mohamed, 26 Hammoud Eman Al, 76 Hamza Rahees, 63, 75 Hamza Rahees Chemban, 27, 28, 29 Harrasi Fakhria Al, 54 Hashim Samar Mahmoud A, 73 Hassan Al-Weshah Yahya Saleh, 25 Hassan Ibrahim Fawzy, 47 Hassan Sanaa Al, 86 Husain Siddiqui Raana Muzaffar, 70 Ibanez Paula, 53 Ibraheem Mazen, 79 Ibrahim Abdullah, 61 Ibrahim Ala, 31 Ibrahim Ali Soliman Ahmed Abdelfattah, 23 Ibrahim Ezzeddin, 7 Ibrahim Farraj Mohammad Adnan, 51 Ibrahim Iman, 14 Ibrahim Nahid, 3, 61 Ibrahim Rania, 3 Ibrahim Tayseer, 32 Icic Novica, 58 Insao Cherry Mae, 17 Iqbal Qamer, 37 Isidro Pocholo, 76 Ismail Aly Sahar Mohamed, 3 Ismail Bassam, 37 Ismail Ibrahim, 47 Ismail Omar, 74 Ismail Sahar, 14 Ison Emelita, 73 Jacob Beena Koshy, 25 Jacob Binoop, 13 Jacob Cicy, 73 Jacob Jeny, 45, 57 Jacob Murphy Mol, 57 Jacob Murphymol, 45 Jaison Betty, 68, 69 James Jomy Kochupulicakl, 25, 82 James Kiran, 38, 55 Jamil Anees, 31 Jamil Issa Mohammad Jamal, 70 Jay Yasey Gonzalez, 43 Jebril Rawand Abdelnaser, 65 Jibril Farah, 73 John Jincy, 68 Jose Asha, 3 Jose Betty, 41 Jose Cunano Ann Kartine, 26 Joseph Chithra Maria, 77 Joseph Shajahan, 13 Joseph Tina, 79 Joy Riyamol, 45 Juaiter Ayman Abou, 62 Kabir Zainab, 90 Kamal Gamila, 64 Kamar Hatem, 52, 85 Kanfosh Zenat, 67 Karawia Ahmed, 35, 88 Karbon Ali Darwish K A, 89 Karic Edin, 1, 92 Kchaou Hela Mehdi EP, 20 Kehoe Aidan Paul, 16 Khalaf Wael, 45 Khalafallah Hani, 68, 69 Khalid Madeha, 65 Khalid Mohga Ahmad, 4 Khalil Moaaz, 52 Khalil Rawan, 93 Khamis Fatma Mohammed, 4 Khater Iman, 52 Khawaja Raja Al, 62 Khawly Yehia El, 86 Khedhir Rafik, 72 Khedhiri Rafik, 12 Khenissi Mohamed Chaker B T, 89 Klai Amira, 1 Kochudevassy Johnson, 13 Kotb Fouda Alaa Mohd, 13 Koujan Farhan, 86 Kujan Farhan, 39 Kumar Devendra, 84 Kuruvilla Lijin Thomas, 44 Kuttikrishnan Nikhil, 29 Kuwari Enas Al, 90 Kuzhichalil Aneesa, 45 Labathkhan Zubair, 45 Lakshmi Seetha, 68 Laughton James, 12, 72, 89 Lirazan Marissa, 2 Logrono Kenneth Jun, 6, 8, 15, 16, 17, 56, 77 Ma’aitah Khaled Al, 89 Maadadi Huda Al, 68, 69 Macaaly Rosario, 17 Magbanua Jenna, 22 Mahadiva Aneesa, 1 Mahamoud Ibrahim, 87 Maher Ahmed, 64 Mahfoodh Hani, 60 Mahfouz Yaser, 81 Mahmoud Hesham, 30, 34 Mahmoud Kamel Asmaa Kamel, 70, 94 Mahmoud Nagwa Ibrahim, 4 Mahrous Iman, 11 Mahrous Zawat, 66 Makdesi Adeeb, 37 Malaluan Gay Ann, 80 Malaluan Gay-Ann, 58 Maliyakkal Abdul Majeed, 76 Malki Hassan Al, 3, 9, 31, 52, 85 Mallya Meera, 24 Mansour Yasser, 52, 85 Martin Savio, 13 Maslamani Muna Al, 35, 55 Mathew Jincy, 26 Matroshi Zainab Al, 54 McDermott Paul, 19 Medina Ervin, 2 Mehta Shital, 67, 84 Melville Julie, 18 Mendoza Mary Grace, 6, 8, 56 Michael Teena Maria, 26 Mobayed Hassan, 32, 35 Mohamed Ali Balal Abdelrahman Faroug, 57 Mohamed Asmaa, 62, 66, 83, 88, 93 Mohamed Awad Noha Abdelrahman, 26 Mohamed Islam, 52 Mohamed Nesrin, 61 Mohamed Sahar, 61 Mohammad Maaz Uddin, 93

BMJ open quality, 2025-01, Vol.14 (Suppl 2), p.A126-A129

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Mortality and associated risk factors of COVID-19 infection in dialysis patients in Qatar: A nationwide cohort study

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The National Early Warning Score and its subcomponents recorded within ±24 h of emergency medical admission are poor predictors of hospital-acquired acute kidney injury

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31 ‘Not deciding alone’: who makes the decision to manage mineral and bone disease in the hemodialysis population?

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