Qatar enters its first Nephrology World Cup as the host nation (Carousel 1). As NephroWorldCup 2018 players have seen before, nations that first enter the world of Nephrology research generally target the "lowest hanging fruit": retrospective chart reviews or database-driven observational studies (Table1). For Qatar, their entry into the 2022 competition focuses on the DOPPS database.

Carousel 1: The World Cup: Qatari style

Database analyses are a time-tested method that, if done correctly, can generate a number of testable hypotheses. DOPPS collects data from various dialysis centers around the world, making it a valuable container for research. In this study, the investigators studied the nutritional values of hemodialysis patients in six nations: Qatar, United Arab Emirates, Saudi Arabia, Bahrain, Kuwait, and Oman (collectively known as the Gulf Cooperation Council nations [GCC]) (Figure 1).

Table 1: Components of the retrospective study (zoom in for details)

As predicted, individuals with lower nutritional states had a higher mortality. Women and patients over the age of 65 typically had more unfavorable nutritional markers than younger males. Qataris had the best nutritional parameters in the GCC and Kuwaitis the worst. This may be due differences in practice patterns. Observational studies, however, don't allow for such theories to be proven (at least not easily). Overall, the DOPPS analysis of nutrition in GCC patients revealed findings similar to those in other nations (European and North American) (Figure 2). And as is the case with most observational database studies, no causal relationships could be identified.

Figure 2: Relationship between albumin and mortality in hemodialysis patients