Etiology of Renal Replacement Therapy in Iran.

Negar Morovatdar,Konstantinos Tsarouhas,Gholamreza Tayebi Nasrabad,Ramin Rezaee

doi:10.1155/2019/5010293

Abstract

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.

Highlights

End-stage renal disease (ESRD) is one of the most common life-threatening diseases
It is estimated that more than 24,000 people with ESRD live in Iran, and their population has drastically increased over the recent years [2]. e disability-adjusted life years (DALY) for ESRD and chronic kidney disease (CKD) were 21,490 and 1, 124, 164 years, respectively, in Iran [2]. e prevalence and incidence of ESRD increased in Iran from, respectively, 137 and 13.82 per million in 1997, to 238 and 49.9 per million in 2000, and 357 and 63.8 per million people in 2006 [3]
Many studies reported the epidemiological aspects as well as the cause of ESRD in different developed countries, but few studies were conducted in developing countries. e aim of this study was to present the epidemiological pattern of ESRD patients undergoing maintenance hemodialysis and the most common causes of this morbidity in Khorasan Razavi province of Iran

Summary

Introduction

End-stage renal disease (ESRD) is one of the most prevalent life-threatening diseases. E prevalence and incidence of ESRD increased in Iran from, respectively, 137 and 13.82 per million in 1997, to 238 and 49.9 per million in 2000, and 357 and 63.8 per million people in 2006 [3] Different methods such as hemodialysis/peritoneal dialysis and kidney transplantation are employed as renal replacement therapies. E most common renal replacement therapy in Iran is hemodialysis, and the prevalence and incidence rates of ESRD patients undergoing hemodialysis increased from 98 and 38.2 per million per year, to 169 and 66 per million. Educational level was significantly associated with the cause of ESRD, as hypertension was more prevalent in patients with high school diploma or lower education, compared with patients with higher education among whom, diabetes was the most common cause of ESRD (37.8 vs 28.7%, p < 0.001 (Figure 3). Age of onset of ESRD significantly differed among various causes; in this regard, age of onset of ESRD in hypertensive patients was significantly lower than that of diabetic patients (51.5 ± 16.3 vs 58.28 ± 12.9 years, respectively; p < 0.001) (Figure 4)

Discussion

Findings

Conclusion