A5042696455- Dialysis and Renal Disease Management
- Health Systems, Economic Evaluations, Quality of Life
- Chronic Kidney Disease and Diabetes
- Iron Metabolism and Disorders
- Central Venous Catheters and Hemodialysis
- Nutrition and Health in Aging
- Blood Pressure and Hypertension Studies
- Healthcare Systems and Reforms
- Renal Diseases and Glomerulopathies
- COVID-19 Clinical Research Studies
- Diabetes Treatment and Management
- Erythropoietin and Anemia Treatment
- Parathyroid Disorders and Treatments
- Global Health Care Issues
- Heart Failure Treatment and Management
- Pharmacogenetics and Drug Metabolism
- Acute Kidney Injury Research
- Renal Transplantation Outcomes and Treatments
- Organ Donation and Transplantation
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Child Nutrition and Water Access
- SARS-CoV-2 and COVID-19 Research
- Primary Care and Health Outcomes
- Hemoglobinopathies and Related Disorders
- Clinical practice guidelines implementation
Hospital Kuala Lumpur
2015-2024
University of Oxford
2023
Ministry of Health
2019-2022
Sultanah Aminah Hospital
2016
Serdang Hospital
2016
Leicester General Hospital
2005
University of Leicester
2005
Peritoneal dialysis (PD) catheter-related infections are important risk factors for catheter loss and peritonitis. The 2023 updated recommendations have revised clarified definitions classifications of exit site infection tunnel infection. A new target the overall rate should be no more than 0.40 episodes per year at risk. recommendation about topical antibiotic cream or ointment to has been downgraded. New include suggestion dressing cover treatment duration with emphasis on early clinical...
Individuals with kidney failure undergoing maintenance dialysis frequently report a high symptom burden that can interfere functioning and diminish life satisfaction. Until recently, the focus of nephrology care for patients has been related primarily to numerical targets laboratory measures, outcomes such as cardiovascular disease mortality. Routine assessment is not universal or standardized in care. Even when symptoms are identified, treatment options limited initiated infrequently, part...
Abstract Background The prevalence of chronic kidney disease (CKD) in Malaysia was 9.07% 2011. We aim to determine the current CKD and its associated risk factors. Methods A population-based study conducted on a total 890 respondents who were representative adult population Malaysia, i.e., aged ≥18 years old. Respondents randomly selected using stratified cluster method. estimated glomerular filtration rate (eGFR) from calibrated serum creatinine CKD-EPI equation. defined as eGFR < 60...
Background . The incidence of patients with end-stage renal disease (ESRD) requiring dialysis has been growing rapidly in Malaysia from 18 per million population (pmp) 1993 to 231 pmp 2013. Objective To forecast the and prevalence ESRD who will require treatment until 2040. Methodology Univariate forecasting models using number new current patients, by Malaysian Dialysis Transplant Registry 2013 were used. Four evaluated, model smallest error was selected for prediction. Result ARIMA (0, 2,...
Improving Global Outcomes (KDIGO) Clinical Practice Guideline on Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) 2009 provided recommendations the detection, evaluation, treatment of CKD-MBD in patients CKD who are not undergoing dialysis. Because accumulation evidence since this initial publication, underwent a selective update 2017. In April 2018, KDIGO convened Implementation Summit Japan with key objective to discuss various barriers uptake implementation 8 Asian...
Malnutrition is highly prevalent in Malaysian dialysis patients and there a need for valid screening tool early identification management. This cross-sectional study aims to examine the sensitivity of Dialysis Score (DMS) Inflammation (MIS) tools predicting protein-energy wasting (PEW) among patients.A total 155 haemodialysis (HD) 90 peritoneal (PD) were screened risk malnutrition using DMS MIS comparisons made with established guidelines by International Society Renal Nutrition Metabolism...
Poor appetite could be indicative of protein energy wasting (PEW) and experts recommend assessing in dialysis patients. Our study aims to determine the relationship between PEW haemodialysis (HD) patients.HD patients (n=205) self-rated their on a scale 1 5 as very good (1), (2), fair (3), poor (4) or (5). Nutritional markers were compared against ratings. Using logistic regression analysis associations dichotomized with diagnosis determined per International Society Renal Nutrition...
Background Peritonitis is one of the most common complications peritoneal dialysis (PD). Understanding risk factors peritonitis in a multi-racial Asian population may help to improve outcomes on PD. Methods We conducted prospective observational study identify for PD-related over 1-year period 15 adult PD centers. All episodes were independently adjudicated. Results A total 1,603 participants with mean age 51.6 years comprising 52.7% females, 62.6% ethnic Malays, 27.0% Chinese, and 8.1%...
Background and aimsPoor dietary intake is commonly associated with malnutrition in the dialysis population oral nutritional supplementation strategized to redress inadequacy. Knowledge on clinical efficacy of whey protein (WPS) as an option treat continuous ambulatory peritoneal (CAPD) patients limited.MethodsThis multicenter, parallel, open-label, randomized controlled trial investigated WPS 126 malnourished CAPD serum albumin <40 g/L body mass index (BMI) <24 kg/m2. Patients intervention...
Health related quality of life (HRQOL) is an important predictor clinical outcomes for End Stage Renal Disease (ESRD) patients and to establish adjusted years (QALYs) economic evaluation studies. This study aims measure the health utilities identify socio-demographic factors associated with HRQOL haemodialysis (HD) continuous ambulatory peritoneal dialysis (CAPD) in Malaysia. A total 141 (77 HD 64 CAPD) from 1 federal four state hospitals participated this cross-sectional study. Patients...
In Malaysia, there is exponential growth of patients on dialysis. Dialysis treatment consumes a considerable portion healthcare expenditure. Comparative assessment their cost effectiveness can assist in providing rational basis for preference dialysis modalities.A utility study hemodialysis (HD) and continuous ambulatory peritoneal (CAPD) was conducted from Ministry Health (MOH) perspective. A Markov model also developed to investigate the increasing uptake incident CAPD 55% 60% versus...
Sources of dietary phosphate differentially contribute to hyperphosphatemia in maintenance haemodialysis (MHD) patients. This cross-sectional study Malaysia investigated association between patterns and serum phosphorus MHD Dietary were derived by principal component analysis, based on 27 food groups shortlisted from 3-day recalls 435 Associations examined with identified patterns. Three emerged: Home foods (HFdp), Sugar-sweetened beverages (SSBdp), Eating out noodles (EO-Ndp). The highest...
The International Diabetes Federation (IDF) estimated that 425 million people were living with diabetes mellitus (DM) in 2017 (1), which had far exceeded what was originally predicted 2003 (333 by 2025). Consequently, the IDF provided a new projection of near doubling 629 DM 2045, 4 out 5 low- and middle-income countries (LMICs), majority from South East Asia (82 million) Western Pacific (159 regions. increasing prevalence has contributed to growing burden ESKD, it is DKD responsible for...
Hyperphosphatemia afflicts end-stage chronic kidney disease (CKD) patients, contributing to comorbidities and mortality. Management strategies are dialysis, phosphate binder, limiting dietary intake, but treatment barriers poor patient compliance low health literacy arising from self-efficacy lack of educational resources. This study describes developing validating a mobile application (PMA). The PMA development based on the seven-stage Precaution Adoption Process Model prioritized titrating...
In the present study, we investigated potential of N-BNP (N-terminal B-type natriuretic peptide) as a prognostic marker for risk CV (cardiovascular) events, overall mortality and progression to ESRD (end-stage renal disease) in cohort 83 pre-dialysis CKD (chronic kidney patients without clinical evidence heart failure. During ten reached combined end point and/or event. Univariate factors associated with were plasma (P&lt;0.0005), creatinine (P&lt;0.002), systolic blood pressure...
Kidney transplantation is the optimal therapy for majority of patients with end-stage renal disease. However, cost and health outcomes have not been assessed in a middle-income nation low volume transplantation, such as Malaysia.This study used microcosting methods to determine living deceased donor kidney adult pediatric recipients. The perspective was from Ministry Health Malaysia. Cost-effectiveness measures were per life year (LY) quality-adjusted LYs. time horizon lifetime transplant...
In the 2018 iteration of United States Renal Data System (USRDS) report, 6 out top 10 countries in world with diabetic kidney disease (DKD) as cause end-stage (ESKD) were from Asia-Pacific region, Malaysia and Singapore topping charts consistently over previous years (1). It is, therefore, unsurprising that DKD is a significant healthcare burden for countries, considerable amount countries' medical expenditure being spent on replacement therapy (KRT) (2). Specifically, differences...
In 2018, Kidney Disease: Improving Global Outcomes (KDIGO) published a clinical practice guideline on the prevention, diagnosis, evaluation, and treatment of hepatitis C virus (HCV) infection in chronic kidney disease (CKD). The synthesized recent advances, especially HCV therapeutics diagnostics, provided recommendations suggestions to aid healthcare providers improve care for CKD patients with HCV. To gain insight into extent that 2018 has been adopted Asia, KDIGO convened an...