title: Attitude of physicians towards the evaluation and treatment of the glomerulonephritis patients.
abstract: To survey the attitude of the physicians in Saudi Arabia toward the evaluation and treatment of glomerulonephritis (GN) patients, a questionnaire was sent to the medical directors of 175 dialysis centers in the KSA. The study was performed from July to November 2010. A total of 171 (97.7%) medical directors of dialysis centers answered the questionnaire. There were 131 (77%) respondents who followed up hospitalized or out-patients with nephrological problems other than dialysis at their corresponding hospitals. Only 111 (65%) of the respondents attended general nephrology clinics. Furthermore, 115 (80%) respondents followed up GN patients at their corresponding hospitals, with an average of more than 6 patients/year reported by 70 (61%) respondents. The availability of the specific serologic tests, performance of kidney biopsies and a pathologist to read them were disclosed by 55 (32%), 50 (29%), and 46 (27%) respondents, respectively. There were 46 (27%) respondents who encountered very often minimal change disease in the patients they followed up in their corresponding hospitals, 26 (15%) encountered it sometimes, and 21 (12%) encountered the disease rarely, while 78 (46%) never encountered this disease. Similar patterns were stated by the respondents for the rest of the primary and secondary GN; IgAN was the least encountered among the other types of GN. For the steroids and immunosuppressive agents use in the treatment of GN, the respondents were close in frequency to the current practice for the different types of this disease. There were 52 (30%) respondents who believed that the current protocols for treatment of GN are satisfactory, with a minimal room for improvement, while 74 (43%) had no idea about this issue. Moreover, there were only 44-49 (26-29%) respondents who answered the questions about the use of rituximab in the different types of GN and believed that the indications of it could cover most GN with variable degrees; the most popular use of rituximab in GN included MGN and lupus nephritis. We conclude that the set-up for the evaluation and treatment of GN patients is restricted in Saudi Arabia. The exposure and expertise in treatment of the GN is limited and needs better addressing through more availability of nephrologists and performance of kidney biopsies. The quest for innovative effective therapy, such as rituximab, to prevent progression of CKD secondary to GN is still warranted.
authors.affiliation: Saudi Center for Organ Transplantation, Riyadh, Saudi Arabia. ziadsouqiyyeh@yahoo.com
authors.forename: Muhammad Ziad
authors.initials: MZ
authors.lastname: Souqiyyeh
authors.forename: Faisal A M
authors.initials: FA
authors.lastname: Shaheen
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D001706:Biopsy; D016009:Chi-Square Distribution; D018450:Disease Progression; D005921:Glomerulonephritis / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D019983:Guideline Adherence; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D000069283:Rituximab; D012529:Saudi Arabia / Q000453:epidemiology; D012698:Serologic Tests; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007166:Immunosuppressive Agents; D000069283:Rituximab