scholarly journals Etiology of Renal Replacement Therapy in Iran

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Negar Morovatdar ◽  
Gholamreza Tayebi Nasrabad ◽  
Konstantinos Tsarouhas ◽  
Ramin Rezaee

Introduction. End-stage renal disease (ESRD) is one of the most common life-threatening diseases. In the past two decades, several factors were held responsible as the cause of this condition. The present study aimed to determine the causes of ESRD in the province of Khorasan Razavi, Iran. Materials and Methods. This cross-sectional study was conducted on 2404 ESRD patients who referred to 39 hemodialysis centers in Khorasan Razavi province, Iran, and were registered in the Mashhad University of Medical Sciences (MUMS), between 2000 and December 2018. Sociodemographic data and causes of ESRD were extracted from data registry. Results. The mean age at onset of hemodialysis for 2404 patients was 52.8 ± 16.4 years, and 57.1% of the patients were male. Clinical profile of hypertension (28.3%) and diabetes mellitus (24.8%) were the most common known causes of ESRD in our patients. Hypertension was more prevalent in male patients compared with females (30 vs 25%, respectively) while diabetes was more prevalent in females compared with males (25.4 vs 24.4%, respectively), p=0.009. Educational level was significantly associated with the cause of ESRD (p<0.001). Age of onset of ESRD in hypertensive patients was significantly lower compared with diabetic patients (51.5 ± 16.3 vs 58.28 ± 12.9 years, respectively; p<0.001). Conclusions. In the current study, the most common causes of ESRD were hypertension and diabetes mellitus. Primary prevention of hypertension and diabetes and proper treatment must be considered to reduce the burden of ESRD in Iran.

2004 ◽  
Vol 10 (4-5) ◽  
pp. 620-626 ◽  
Author(s):  
A. Afifi ◽  
M. El Setouhy ◽  
M. El Sharkawy ◽  
M. Ali ◽  
H. Ahmed ◽  
...  

The prevalence of diabetic nephropathy as a cause of end-stage renal disease [ESRD] in Egypt has been examined in small cross-sectional studies, with conflicting results. The need for a large-scale study prompted us to perform this 6-year multiple cross-sectional study. A sample of ESRD patients enrolled in the Egyptian renal data system was evaluated during the period 1996-2001 for the prevalence of diabetic nephropathy. Prevalence gradually increased from 8.9% in 1996, to 14.5% in 2001. The mean age of patients with diabetic nephropathy was significantly higher than that of patients with ESRD from other causes. Mortality was also significantly higher in diabetic patients with ESRD


2021 ◽  
Vol 59 (233) ◽  
Author(s):  
Madhav Ghimire ◽  
Shreeju Vaidya ◽  
Hari Prasad Upadhyay

Introduction: End-stage renal disease patients are in rising trend globally, and they have been foundto occur predominantly in developing countries. Many studies have been published before, withinand across the countries, to know the clinicodemographic profile of end-stage renal disease patients.However, no such studies were done in Chitwan, Nepal. This study’s main objective was to find theprevalence of newly diagnosed end-stage renal disease patients. Methods: A hospital-based descriptive cross-sectional study was carried out in the Department ofNephrology from May 2016 to April 2019. Convenient sampling was done, and all the consecutivenew end-stage renal disease patients were included in the study. The ethical approval was takenfrom the Institutional Review Committee (reference number. 2016/COMSTH/IRC/042). Theprevalence and demographic profile of new end-stage renal disease patients were studied. The datawere analyzed with appropriate statistical tools. Results: A total of 250 new end-stage renal disease patients were found among 2200 admittedpatients. The prevalence of new end-stage renal disease was found to be 250 (11.36%). Out of 250patients, males were 156 (62.4%), and females were 94 (37.6%). The mean age was 49.6±15.5 years. Thecommonest cause of the incident end-stage renal disease was Type 2 Diabetes mellitus 89 (35.6%). Conclusions: The prevalence of new end-stage renal disease was found to be quite high. Thecommonest cause of the incident end-stage renal disease was Type 2 Diabetes Mellitus.


Author(s):  
Mohy Eldin Abd EL-Fattah ◽  
Taghrid B. El-abaseri ◽  
Hegazy Mohamed Abd Elaziz Mohamed

Background: Type 2 diabetes mellitus (DM) is the most common cause of end- stage renal disease. Albuminuria is the foremost commonly utilized marker to anticipate onset of diabetic nephropathy (DN) without sufficient affectability and specificity to identify early DN. Aim: This study aimed to evaluate Plasma cyclophilin A (CypA) as a new biomarker for early DN. Methods: This cross sectional study included 125 Egyptian subjects attending the out Patients Clinic of the Department of Internal Medicine, 10Th of Ramadan city Health Insurance Hospital and divided into-:control group, patient with diabetic mellitus, patients with Diabetic nephropathy and patient with diabetic nephropathy and other complications. Patients were subjected to measurement of plasma cyclophyline A, FBS, HbAIC, serum creatinine, serum urea, serum uric acid, k, Na, serum phosphorus, Albumin:Creatinine Ratio, GFR, Chol, TG, LDL HDL, AST, ALT, T.BIL, D.BIL ALB, TP, GLB and A/G ratio. Results: Results showed that Cyclophilin A was significantly correlated with duration of DM, CR, Urea, UR.A, Na, phosphorus, ACR, Chol, TG, LDL, AST, ALT, T.BIL, D.BIL. Meanwhile, Cyclophilin A was negatively correlated with HA1C, K, GFR, HDL, ALB, TP, GLB and A/G ratio. At cut-off level ≥84.14, cyclophilin A had 91% sensitivity and 62% specificity for diagnosing diabetic nephropathy. Conclusion: CypA can be used as an early marker for DN as we found early significant high levels of urinary CypA in diabetic patients with stage 2 DN even before the appearance of albuminuria.


Author(s):  
Ashok Kumar ◽  
Ardaman Singh ◽  
Vikram S. Tanwar ◽  
Nikhil Govil

Background: Diabetes mellitus is a metabolic disorder of multiple etiology, characterized by chronic hyperglycemia and associated with various microvascular, macrovascular and nonvascular complications leading to increasing morbidity and mortality. Microvascular complications are daibetes specific and their relation with associated comorbidities studied worldwide. To estimate the prevalence of microvascular complications in diabetic patients and to find their relation with various comorbid conditions.Methods: A total of hundred diagnosed patients of diabetes mellitus with age ranging from 18 to 75 years were enrolled in the study. Patients were assessed for the presence of microvascular complications and associated comorbidities. The effect of various comorbidities on frequency of microvascular complications was also determined. Data collected was statistically analyzed.Results: In this study, the mean age of the study group was 55.77±11.75 years. Mean age of onset of the disease was 48.89±11.50 years. Mean duration of the disease in the study group was 6.86±5.02 years. Diabetic retinopathy, neuropathy and nephropathy was found in 76%, 63% and 69% patients, respectively. Among patients with hypertension, 91.7%, 83.3%, and 81.7% cases were found to have retinopathy, neuropathy and nephropathy, respectively. The corresponding figures for those with comorbid IHD were 91.1%, 83.9% and 76.8% respectively whereas among patients with coexisting metabolic syndrome, 92.5%, 80.6%, and 79.1% were found to have retinopathy, neuropathy, and nephropathy, respectively.Conclusions: The most frequent microvascular complication reported by this study was diabetic retinopathy. comorbid conditions like hypertension, ischemic heart disease, and metabolic syndrome were associated with higher prevalence of microvascular complications in diabetic patients.


Author(s):  
Singam Sivasankar Reddy ◽  
Syeda Rahath ◽  
Rakshitha H N ◽  
Godson K Lal ◽  
Swathy S ◽  
...  

The objective of the study was to evaluate the risk of diabetes mellitus in elderlywith age above 20 years in a hospital setting using Indian Diabetes risk score and to provide patient counselling regarding their life style modifications and health related quality of life among participants with high risk of developing diabetes.A total of 125 non diabetic patients were interviewed with a pre designed selfstructured questionnaire (IDRS). Participants were chosen voluntarily and a written consent was obtained before the administration of the questionnaire from individual patients. In our study we observed that out of 125 patients,males 26[59%]and 18[41%] females were at high risk, males 39[58.2%] and 28[41.8%] females were at moderate risk, males 5[35.7%] and 9[64.3%] females were at low risk of developing diabetes mellitus.


1969 ◽  
Vol 2 (2) ◽  
pp. 187-191
Author(s):  
Sahibzada Saeed Jan ◽  
Taj Muhammad Khan ◽  
Alamzeb ◽  
Izaz-urrahman ◽  
Amanullah ◽  
...  

Background: As hypertension is the most important risk factor for stroke, it is generally considered to beasymptomatic condition and require lifetime therapy which may include chemotherapy and lifestylechanges. Hypertension also clearly contributes to the risk of macrovascular disease in patients with type-IIdiabetes mellitus. Therefore, the present study was conducted to evaluate the prevalence of hypertension indiabetic and non-diabetic stroke patients in community hospital district Swat. Methodology: This was a cross-sectional study, comprised of 100 subjects, 50 were diabetic and 50 werenon-diabetic stroke patients of ages between 28 to 90 years. The blood sugar (random and fasting), bloodpressure (systolic and diastolic) of Diabetic stroke subjects were compared with Non-diabetic strokesubjects. Results: The prevalence of hypertension was significantly high in diabetic stroke subject as compared tonon-diabetic stroke subjects. Conclusion: Diabetic patients with persistently elevated blood pressure are more prone to develop stroke ascompared to non diabetic with hypertension KEYWORDS:Stroke, Diabetes mellitus, hypertension.


Author(s):  
Muhammad Zohaib Siddiq ◽  
Shahid Hussain Memon ◽  
Anwar Ali ◽  
Tabassum Almas ◽  
Atiya Razzaq ◽  
...  

Background: Previous studies have established the fact that diabetic patients are predominantly inclined towards silent myocardial infarction (SMI). The objective of the present study is to determine the incidence of SMI in diabetes mellitus (DM) patients. Methodology: In this cross-sectional study, patient data was gathered on a predesigned proforma regarding the detailed history of dyspnea, DM and its duration, chest pain either present or not. Those patients who had normal ECG labeled negative for SMI, while those who had either ST-segment elevation or ST-segment deviation on resting ECG were positive for SMI. Study was conducted at the National Institute of Cardiovascular Diseases (NICVD) Karachi- Pakistan. Results: The mean age of the enrolled patients was 54.21±8.65 (40-70) years. Out of 210, majority were female (51.90%).Overall, 94(44.76%) patients were obese, 122(58.09%) were hypertensive, 90(42.85%) had dyslipidemia and 98(46.66%) diabetic patients were smokers. There were 93 (44.3%) DM patients who had SMI. Moreover, 109(51.90%) patients had a family history of myocardial ischemia. Conclusion:  The SMI incidence among diabetic patients was found higher in local population. It is proposed that diabetic patients with demonstrated cardiovascular autonomic neuropathy must be screened for the manifestation of SMI.


Author(s):  
Kareem Mohsin Yousif ◽  
Hamid Obaid Khadhim Al Jaaed

Background: End stage renal disease (ESRD) is irreversible loss of renal function which is physiologically defined by a GFR of less than 15 ml / minute. ESRD is associated with a higher incidence of coronary artery disease and serious arrhythmia especially ventricular arrhythmia. The goal of study is to determine whether ESRD and haemodialysis (HD)are associated with occurrence of significant electrocardiogram (ECG) changes or not.Methods: This is a cross-sectional study design which involved 22 patients with ESRD on regular HD in Al Sadre teaching hospital / Al Najaf. Both sexes was included in this study. All patients underwent full medical history and examination which included the following aspects: Age, Sex, Occupation, BP, HR, RBS, B.urea, S.creatinine , Serum electrolyte (Na+, K+, Cl-, Ca++), Lipid profile (Cholesterol , Triglyceride, HDL, LDL), Duration of CRF, Duration of dialysis, Social history including (smoking, alcohol) and Drug used by the patient. Resting EGC and Hotler ECG.Results: Eighteen patients exhibited emergence of simple ectopic activity premature atrial complex (PAC) and premature ventricular complex (PVC) events and four patients exhibited (ST,T changes). Potentially lethal arrhythmias and other serious ECG changes are not detected in our patient’s sample.Conclusion: In this study, neither ESRD nor haemodialysis were associated with development of serious ECG changes or emergence of significant arrhythmia.


2018 ◽  
Vol 8 (3) ◽  
pp. 210-214
Author(s):  
Rushda Sharmin Binte Rouf ◽  
SM Ashrafuzzaman ◽  
Zafar Ahmed Latif

Background: Diabetic retinopathy (DR) and nephropathy are two major complications of diabetes mellitus carrying significant morbidity and mortality. In this study DR was investigated in different stages of chronic kidney disease (CKD) to find out possible association of these two devastating complications.Methods: This cross-sectional study was conducted in 150 diabetic patients having CKD in BIRDEM. CKD was defined as estimated glomerular filtration rate (eGFR) of <60ml/min/1.73m2and/or urinary albumin excretion rate (UAER) >30 mg/day in at least two occasions in 3 months apart. Retinopathy was assessed by direct fundoscopic examination and confirmed by color fundus photography. Severe DR (SDR) included proliferative diabetic retinopathy, severe non-proliferative DR and maculopathy; whereas microaneurysm regarded as non-severe retinopathy.Results: Majority (68%) of the respondents had some form of retinopathy (38.35% SDR and 29.65% nonsevere). There was strong association between different levels of albuminuria (UAER) and DR (p<0.0001). On the contrary DR did not correspond with stages of CKD (P=0.349). Hypertension (79.5%) and dyslipidaemia (59%) were common co-morbidities.Conclusion: This study concluded that DR prevalence was more in nephropathy along with significant association with UAER. Whereas different stages of CKD was not associated with stages of DR . This finding focused the necessity of regular retinal examination irrespective of the stage of renal involvement.Birdem Med J 2018; 8(3): 210-214


2012 ◽  
Vol 52 (187) ◽  
Author(s):  
R K Agrawal ◽  
S Khakurel ◽  
R Hada ◽  
D Shrestha ◽  
A Baral

Introduction: Hemodialysis is the preferred method of treatment for Nepalese patients with End Stage Renal Disease. Despite the technological advances and better understanding of physiology associated with hemodialysis, a number of complications are known to be associated with hemodialysis. This study was undertaken to study the frequency of acute intradialytic complications in patients undergoing hemodialysis. Methods: A cross-sectional study was conducted at Nephrology unit of a tertiary care hospital from 15 June, 2007 to 15 December, 2007. A total of 28 patients were included in the study. Patients with acute renal failure and acute on chronic renal failure were excluded from the study. Results: Total sessions of hemodialysis during the period were 1455. Hypotensive episode were 66 (4.5%) and was the commonest complication and followed by hypertensive episodes were 58 (3.8%). Other problems encountered were transfusion reactions were 23 episodes (1.5%), rigors not related to transfusions were 13 episodes (0.8%), nausea/vomiting were 20 episodes (1.4%), muscle cramps were 12 episodes (0.8%), hypoglycemia were 6 episodes 5(0.4%). Conclusions: The frequency of intradialytic complications is low and many of them are not life threatening. Keywords: complications; end stage renal disease; hemodialysis; hypertension; hypotension.


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