Anaemia characteristic in end stage renal disease patients receiving haemodialysis at King Salman armed forced hospital in Tabuk, Saudi Arabia

BackgroundChronic kidney disease (CKD) is a disease associated with high rate of morbidity and mortality mainly due to cardiovascular disease. Anaemia is the most common haematological abnormality in end stage renal disease.AimsThe current Study aimed to determine the laboratory characteristic and management of anaemia among haemodialysis patients.Methods A cross sectional study conducted among 112 adult patients with the diagnosis of end stage renal disease (ESRD) on haemodialysis at King Salman Armed Forced Hospital in Tabuk, Saudi Arabia, data were collected by a pre-tested data collection sheet.Results There were 112 patients with a mean age of 43 years. The mean haemoglobin value was 10.5g/dL, which was lower than the target haemoglobin range recommended by Kidney Disease Outcomes Quality Initiative (KDOQI). Twenty- eight patients (25 per cent) had haemoglobin values between 11.0 and 12.0g/dL. Only seven patients (6.3 per cent) exceeded the recommended range (>12g/dL) and seventy- seven (68.7 per cent) had less than recommended range. The majority of patients had been receiving haemodialysis for two or more years. The most common primary cause of end stage renal failure was diabetic nephropathy. Hypertension was the most common co-morbidity, followed by diabetes, and ischemic heart disease.ConclusionPatients with end stage renal disease at a high risk for anaemia which should be investigated for correctable causes such as Iron-deficiency before initiating erythropoietin replacement therapy

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population