End-Stage Kidney Failure in Oman: An Analysis of Registry Data with an Emphasis on Congenital and Inherited Renal Diseases.

Intisar Al Alawi,Yacoub Al Maimani,John A Sayer,Issa Al Salmi,Adhra Al Mawali

doi:10.1155/2017/6403985

Abstract

Globally, end-stage kidney disease (ESKD) is a huge burden on health care systems. The aims of this study were to perform a comprehensive epidemiological and etiological report of ESKD patients commencing RRT in Oman with an emphasis on genetic causes and inherited kidney disease. All newly registered Omani patients with ESKD commencing RRT from 2001 until 2015 (n = 2,922) were analysed using the RRT register in Oman. All potentially genetic or inherited causes of ESKD were reviewed. In Oman, ESKD is more prevalent in males (57.1%) than females (42.9%) with a median age of incident ESKD of 53 years. Diabetic nephropathy was the most prevalent cause of ESKD (46%), followed by hypertensive nephropathy (19%), glomerulonephritis (15%), and inherited kidney disease (5%). For patients less than 20 years of age inherited kidney disease accounted for 32.5% of cases. Of this cohort with inherited renal disease, 40.3% had autosomal dominant polycystic kidney disease, 11.5% had congenital anomalies of the kidney and urinary tract, 9.4% had Alport syndrome, and 7.2% had autosomal recessive polycystic kidney disease. This study represents a comprehensive population-based epidemiological and etiological report of ESKD patients in Oman commencing RRT. Inherited kidney disease was the leading cause of paediatric ESKD.

Highlights

Chronic kidney disease (CKD) is a common condition characterized by irreversible kidney damage and reduced glomerular filtration rates that may progress to end-stage kidney disease (ESKD), where renal replacement therapy (RRT) is necessary for long term survival
In the United States (US) and Europe, congenital anomalies of the kidney and urinary tract (CAKUT) and inherited nephropathies are the major causes of CKD among youngest ESKD groups [4]
This data is completed by nephrologists in all renal dialysis units throughout the country once the patient reached ESKD using a standardized form and sent to the main renal dialysis unit in Muscat, where the RRT registry is maintained in a comprehensive database [5]

Summary

Introduction

Chronic kidney disease (CKD) is a common condition characterized by irreversible kidney damage and reduced glomerular filtration rates that may progress to end-stage kidney disease (ESKD), where renal replacement therapy (RRT) is necessary for long term survival. The number of patients receiving RRT worldwide in 2010 was estimated to be 2.6 million, whereas the estimated number of actual patients demanding RRT was 4.9 million [1]. This RRT gap is one of the global challenges presented with the growing rate of ESKD. Inherited kidney diseases are important causes of morbidity and may lead to both progressive CKD and ESKD. Inherited kidney disease accounts for approximately 20% of all CKD cases and is an important cause of ESKD [2]. The situation in the Middle East countries was revealed to be the same, but the prevalence of inherited kidney disease is reported to be much higher (up to 30%) compared to Europe due to high rates of consanguinity [4]

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