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Article History

Received: 9 January 2025

Accepted: 30 June 2025

First Online: 8 July 2025

Declarations

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: This questionnaire-based, non-interventional study was conducted in accordance with the regulations of Egyptian universities and the Ministry of Health, which require ethical approval from the Institutional Review Board (IRB) of the principal investigator’s affiliated university. Ethical approval was obtained from the Mansoura University Faculty of Medicine IRB under approval number R.22.10.1913.R1. Additionally, administrative approvals were secured from the dialysis units involved in the study, with representatives from each center facilitating data collection and coordination. The participating centers included those from Dakahlia Governorate, Mansoura International Hospital, along with Sherbin, Nabarouh, Elgamalia, Elmataria, Shabrahour, Aga, Bilqas, Dekernes, Menyet El Nasr, Temai El Amdid, Elshawami, Elmanzalah, Talkha, Tanah, Mitghamar, Elsinbillawin, and Damas, with oversight by the Head of Dakahlia Nephrology Units. From Alexandria Governorate, approvals were obtained from Alexandria University Hospital, Alexandria Faculty of Medicine, Qabbary Specialized Hospital, and Al-Amerya General Hospital, with Alexandria University providing an additional IRB approval (IRB number 0306136). Participating centers from other governorates included Aswan University Hospitals, Aswan Faculty of Medicine, Aswan; Internal Medicine Department, Sohag Faculty of Medicine, Sohag; Internal Medicine Department, Port Said Faculty of Medicine, Port Said; Internal Medicine Department, Suez Canal Faculty of Medicine, Ismailia; Hemodialysis Unit, Obour Health Insurance Hospital, Kafr El-Sheikh; Internal Medicine Department, Assiut Faculty of Medicine, Assiut; Saint Mark Kidney Center, Cairo; Internal Medicine Department, Ain Shams Faculty of Medicine, Cairo; Al-Fayoum General Hospital, National Health Service, Al-Fayoum; and Internal Medicine Department, Al-Fayoum Faculty of Medicine, Al-Fayoum. The National Health Service dialysis units do not have independent IRBs and were represented by administrative approval from their respective directors. The last author, serving as the Director of Nephrology Administration in the Egyptian Ministry of Health, further ensured compliance with national regulatory standards. Informed consent was obtained from all participants, and no names or identifying patient data were collected, ensuring full privacy and confidentiality. This study was conducted in accordance with relevant ethical guidelines and regulations, as required by Egyptian universities and the Ministry of Health.

: Not applicable.

: The authors declare no competing interests.