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The article employs auto-regressive distributed lag (ARDL) cointegration and error-correction modelling to study the long-run impact of investment, exports, imports, and three components of government expenditures (expenditures on health, education, and other government spending) on GDP growth in Saudi Arabia from 1985 to 2018. We observe the long-run positive relationship between GDP, investment, exports and government education expenditure, but a negative relationship between GDP, imports, government health spending, and government other expenditures. The analysis reveals that investment, exports, and government educational expenditures all have long-run positive effects on the GDP growth, while imports, government health expenditures, and government other expenditures negatively affect GDP growth in Saudi Arabia. The Toda-Yamamoto causality test that applies the Modified Wald test establishes causality from exports, government education spending, and government health spending to GDP. We deduce that education expenditures stimulate economic growth in Saudi Arabia in contrast to health expenditures. Additionally, we infer that the various categories of government expenditures have varying effects on GDP. This necessitates a prudent sectoral allocation of public expenditures to maximize its positive effects on GDP growth and stimulate economic growth in Saudi Arabia. Moreover, the above findings have policy implications for the government in Saudi Arabia while allocating its expenditures. Allocating more government expenditures to education, cutting down inessential spending, and downsizing government healthcare expenditures will enhance long-run economic growth in Saudi Arabia. JEL Classification: O470; I15; I25 [ABSTRACT FROM AUTHOR]

Objective: To identify the prevalence and risk factors for secondary hyperparathyroidism in children with advanced stages of chronic kidney disease (CKD).Methods: A retrospective cross-sectional observational study of clinical and laboratory data of pediatric patients with CKD stage 3, 4 was conducted from 2005 through 2013 at a single center in the Kingdom of Saudi Arabia.Results: One hundred nineteen children (60.5 % boys) with mean age of 10.1 ± 5.1 y were included in the study. The mean eGFR (estimated Glomerular Filtration Rate) was 18.3 ± 15.4 ml/min/1.73m(2) and the mean intact parathyroid hormone (iPTH) level was 62.2 ± 89.4 pmol/L. Patients with a high iPTH had lower eGFR than those who were euparathyroid (16 ± 13.4 vs. 29.7 ± 19 ml/min/1.73m(2), respectively; p = 0.006), had lower calcium levels (2.2 ± 0.3 vs. 2.4 ± 0.3 mmol/L; p = 0.03) and a lower bicarbonate level (21.2 ± 4.2 vs. 23.3 ± 3.2 mmol/L; p = 0.04). Three children with hyperparthyrodism (4.9 %) had fractures, 16 (26.2 %) had bone deformities compared to 5 in the euoparathyroid group (p = 0.012). Parathyroid hormone negatively correlated with the patient's eGFR (r = -0.55), serum calcium (r = -0.43), and positively correlated with serum phosphate (r = 0.38).Conclusions: The single most important predictor of hyperparathyroidism in children in the present sample was eGFR. [ABSTRACT FROM AUTHOR]

Background: Posterior urethral valves (PUV) are a common cause of end-stage renal failure in childhood. Our aim was to describe a cohort of patients with PUV and to investigate the predictors of renal impairment. Methods: We performed a retrospective chart review of children with PUV who were followed at King Abdulaziz University hospital between 2002 and 2011. Results: The cohort comprised 68 boys. There was a significant difference in the duration of follow-up ( p = 0.024), nadir serum creatinine ( p < 0.001), and last known serum creatinine level ( p = 0.001) between the patients with and without renal impairment. The duration of follow-up appeared to be a significant predictor for serum creatinine doubling ( p = 0.003; odds ratio, 1.8). There was no difference in the age of presentation, age at the time of the study, and first or last serum creatinine between children who initially had vesicostomy and children who had ablation. Conclusions: Ablation of PUV or vesicostomy did not influence kidney function in our study cohort. Children with a normal nadir serum creatinine who presented early had a better outcome. [ABSTRACT FROM AUTHOR]

Identification of disease-related genes is a critical step in understanding the molecular basis of disease and developing targeted therapies. The genetic study of diseases occurring in the offspring of consanguineous unions is a powerful way to discover new disease genes. Pediatric nephrology provides an excellent example because ∼70% of cases of kidney disease in childhood are congenital with a likely genetic basis. This percentage is likely to be even higher in countries with a high consanguinity rate, such as the Kingdom of Saudi Arabia. However, there are a number of challenges, such as cultural, legal, and religious restrictions, that should be appreciated before carrying out genetic research in a tradition-bound country. In this article, we discuss the background, opportunities, and challenges involved with this unique opportunity to conduct studies of such genetic disorders. Keys to success include collaboration and an understanding of local traditions and laws., (Copyright © 2014 National Kidney Foundation, Inc. All rights reserved.)

There are no available data about the prevalence of chronic kidney disease (CKD) and its risk factors in the general population of the kingdom of Saudi Arabia. To estimate the prevalence of CKD and its associated risk factors in the Saudi population, we conducted a pilot community-based screening program in commercial centers in Riyadh, Saudi Arabia. Candidates were interviewed and blood and urine samples were collected. Participants were categorized to their CKD stage according to their estimated Modification of Diet in Renal Disease (MDRD3)-based, the new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and the presence of albuminuria. The sample comprised 491 (49.9% were males) adult Saudi nationals. The mean age was 37.4 ± 11.3 years. The over-all prevalence of CKD was 5.7% and 5.3% using the MDRD-3 and CKD-EPI glomerular filtration equations, respectively. Gender, age, smoking status, body mass index, hypertension and diabetes mel-litus were not significant predictors of CKD in our cohort. However, CKD was significantly higher in the older age groups, higher serum glucose, waist/hip ratio and blood pressure. Only 7.1% of the CKD patients were aware of their CKD status, while 32.1% were told that they had protein or blood in their urine and 10.7% had known kidney stones in the past. We conclude that prevalence of CKD in the young Saudi population is around 5.7%. Our pilot study demonstrated the feasibility of screening for CKD. Screening of high-risk individuals is likely to be the most cost-effective strategy to detect CKD patients.