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Farag, Youssef M.

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Farag

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Youssef M.

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Farag, Youssef M.
Author's Publications: search.filters.isAuthorOfPublication.a2b98c54-e4a2-4a8c-92cf-62b4c1a2f759

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    Predictors of renal replacement therapy and mortality in children with chronic kidney disease
    (Saudi Medical Journal, 2015) Kari, Jameela A.; Desoky, Sherif M. El; Farag, Youssef M.; Singh, Ajay K.
    Objectives: To study the epidemiology of chronic kidney disease (CKD) in children, and to look for risk factors to predict renal replacement therapy (RRT) and mortality. Methods: This is a retrospective cohort study conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia between 2006 and 2014, where the files of 1,000 children with CKD were reviewed. We determined the effect of consanguinity and hypertension, and being a Saudi indigene on mortality and RRT. We compared children with congenital versus non-congenital causes of CKD. Results: The mean±standard deviation age at presentation was 4.9±4.3 years. The median duration of follow up was 1.5 (interquartile range [IQR]: 0.4-4.0) years. Only 9.7% of children received RRT, and 8.3% died. The underlying etiology for CKD was congenital in 537 children. The congenital CKD group presented at a younger age group (3.5±4.0 versus 6.6±3.9 years, p<0.0001), had more advanced stages of CKD (p<0.0001), higher rates of consanguinity (75.4% versus 47.1%, p<0.0001), and RRT (p<0.004) than children with non-congenital CKD. Risk factors for RRT among children with CKD include being a Saudi indigene (relative risk [RR]=1.49, 95% confidence interval (CI): 1.01-2.21), and hypertensive (RR=5.29, 95% CI: 3.54-7.91). The risk factor for mortality was hypertension (RR=2.46, 95% CI: 1.66-3.65). Conclusion: Congenital causes of CKD represent the main etiology of CKD in children living in the western province of Saudi Arabia. Significant risk factors for RRT include congenital CKD, Saudi nationality, and hypertension. Hypertension is also a predictor of mortality in children with CKD.
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    Burden and predictors of hypertension in India: results of SEEK (Screening and Early Evaluation of Kidney Disease) study
    (BioMed Central, 2014) Farag, Youssef M.; Mittal, Bharati V; Keithi-Reddy, Sai Ram; Acharya, Vidya N; Almeida, Alan F; C, Anil; HS, Ballal; P, Gaccione; R, Issacs; Jasuja, Sanjiv; AL, Kirpalani; V, Kher; GK, Modi; Nainan, Georgy; Prakash, Jai; Rajapurkar, Mohan M; DS, Rana; Sreedhara, Rajanna; DK, Sinha; Shah, Bharat V; Sunder, Sham; Sharma, Raj Kumar; Seetharam, Sridevi; Raju, Tatapudi Ravi; Singh, Ajay K
    Background: Hypertension (HTN) is one of the major causes of cardiovascular morbidity and mortality. The objective of the study was to investigate the burden and predictors of HTN in India. Methods: 6120 subjects participated in the Screening and Early Evaluation of Kidney disease (SEEK), a community-based screening program in 53 camps in 13 representative geographic locations in India. Of these, 5929 had recorded blood pressure (BP) measurements. Potential predictors of HTN were collected using a structured questionnaire for SEEK study. Results: HTN was observed in 43.5% of our cohort. After adjusting for center variation (p < 0.0001), predictors of a higher prevalence of HTN were older age ≥40 years (p < 0.0001), BMI of ≥ 23 Kg/M2 (p < 0.0004), larger waist circumference (p < 0.0001), working in sedentary occupation (p < 0.0001), having diabetes mellitus (p < 0.0001), having proteinuria (p < 0.0016), and increased serum creatinine (p < 0.0001). High school/some college education (p = 0.0016), versus less than 9th grade education, was related with lower prevalence of HTN. Of note, proteinuria and CKD were observed in 19% and 23.5% of HTN subjects. About half (54%) of the hypertensive subjects were aware of their hypertension status. Conclusions: HTN was common in this cohort from India. Older age, BMI ≥ 23 Kg/M2, waist circumference, sedentary occupation, education less, diabetes mellitus, presence of proteinuria, and raised serum creatinine were significant predictors of hypertension. Our data suggest that HTN is a major public health problem in India with low awareness, and requires aggressive community-based screening and education to improve health.
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    Epidemiology and risk factors of chronic kidney disease in India – results from the SEEK (Screening and Early Evaluation of Kidney Disease) study
    (BioMed Central, 2013) Singh, Ajay K; Farag, Youssef M.; Mittal, Bharati V; Subramanian, Kuyilan Karai; Reddy, Sai Ram Keithi; Acharya, Vidya N; Almeida, Alan F; Channakeshavamurthy, Anil; Ballal, H Sudarshan; P, Gaccione; Issacs, Rajan; Jasuja, Sanjiv; Kirpalani, Ashok L; Kher, Vijay; Modi, Gopesh K; Nainan, Georgy; Prakash, Jai; Rana, Devinder Singh; Sreedhara, Rajanna; Sinha, Dilip Kumar; V, Shah Bharat; Sunder, Sham; Sharma, Raj K; Seetharam, Sridevi; Raju, Tatapudi Ravi; Rajapurkar, Mohan M
    Background: There is a rising incidence of chronic kidney disease that is likely to pose major problems for both healthcare and the economy in future years. In India, it has been recently estimated that the age-adjusted incidence rate of ESRD to be 229 per million population (pmp), and >100,000 new patients enter renal replacement programs annually. Methods: We cross-sectionally screened 6120 Indian subjects from 13 academic and private medical centers all over India. We obtained personal and medical history data through a specifically designed questionnaire. Blood and urine samples were collected. Results: The total cohort included in this analysis is 5588 subjects. The mean ± SD age of all participants was 45.22 ± 15.2 years (range 18–98 years) and 55.1% of them were males and 44.9% were females. The overall prevalence of CKD in the SEEK-India cohort was 17.2% with a mean eGFR of 84.27 ± 76.46 versus 116.94 ± 44.65 mL/min/1.73 m2 in non-CKD group while 79.5% in the CKD group had proteinuria. Prevalence of CKD stages 1, 2, 3, 4 and 5 was 7%, 4.3%, 4.3%, 0.8% and 0.8%, respectively. Conclusion: The prevalence of CKD was observed to be 17.2% with ~6% have CKD stage 3 or worse. CKD risk factors were similar to those reported in earlier studies. It should be stressed to all primary care physicians taking care of hypertensive and diabetic patients to screen for early kidney damage. Early intervention may retard the progression of kidney disease. Planning for the preventive health policies and allocation of more resources for the treatment of CKD/ESRD patients are imperative in India.