Background. Maintenance dialysis is the most common treatment for end-stage renal disease (ESRD) patients. One of the most ignored but important health issue among dialysis patients is sexual dysfunction, which interferes with quality of life (QoL). Studies showed that the side effects of the two conventional methods of dialysis (hemodialysis (HD) and peritoneal dialysis (PD)) are different on a patient’s health. Therefore, we sought to compare the sexual dysfunction score, both male and female, between patients undergoing HD and PD. Methods. One hundred seventy adults (85 HD and 85 PD) subject with end-stage renal disease (ESRD) on dialysis for at least 2 months were included. For male subjects, the erectile function (EF) domain of the International Index of Erectile Function (IIEF) questionnaire was calculated. Moreover, the Female Sexual Function Index (FSFI) questionnaire was calculated for females. Data were analyzed via SPSS software. Two independent sample t-test with two-sided significance level of 5% was used for comparing the sexual dysfunction score between HD and PD patients. Results. Out of 170 patients with mean age of 49.34 ± 11.7 years, 52.9% were female. Better sexual function scores were obtained in the HD group’s females for desire, orgasm, and satisfaction domains, as well as the total score ( P = 0.03, 0.016, 0.02, and 0.039, respectively). The erectile function was significantly better in the PD group’s males ( P ). Conclusion. We found better sexual life in the HD group’s females and PD group’s males. Considering dialysis as a life-long treatment of CKD patients, this part of a patient’s life must be taken seriously by the healthcare providers to choose the most suitable method for patients based on their personalized conditions.
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Objectives Individual studies in the Eastern Mediterranean Region (EMR) have shown the high prevalence of diabetic retinopathy. We conducted a meta-analysis to yield an estimate of the prevalence of diabetic (type 1 and 2) retinopathy in the EMR. Additionally, we explored its potential modulators. Methods Two-step screening of relevant articles published from 1 January 2000 to 13 December 2019 was carried out. An estimation of summary proportions, subgroup analysis, meta-regression, and publication bias assessment were performed. Results One hundred nine articles were included in the meta-analysis, involving 280,566 patients. The prevalence of diabetic retinopathy was 31% (95% confidence interval [CI] = 28, 33). The highest and lowest diabetic retinopathy prevalence rates were observed in low human development index (HDI) countries (63.6; 95% CI = 52.4, 74.0) and very high HDI countries 22.6 (95% CI = 20.5, 24.7), respectively. Conclusions The prevalence of diabetic retinopathy is high in the EMR. Our results provide important information for diverse healthcare surveillance systems in the EMR to implement the modifiable risk factors, diabetes screening to decrease undiagnosed diabetes, early detection of retinopathy, and proper diabetes care to decrease untreated diabetes.
Objectives: The high prevalence of diabetes leads to an increase in diabetic complications, and diabetic nephropathy as one them is a leading cause of end stage renal disease and renal replacement therapies. Individual studies on the prevalence diabetic nephropathy in Eastern Mediterranean region (EMR) showed the high prevalence of diabetic nephropathy. Therefore, we conducted a systematic review and meta-analysis of relevant studies to estimate nephropathy among type two diabetes patients in EMR. Method: We searched for the relevant keywords in title and abstract of Medline/PubMed, Scopus, Embase, and Web of knowledge, as well as Google Scholar and manual search to identify the published target studies from Jan 1st, 2000 to December 13, 2020. The two-step screening was carried out by two independent researchers and relevant data were extracted. Estimation of summary proportions, subgroup analysis, meta-regressions, and publication bias assessment were performed.Results: Amongst 3225 identified citations, 38 articles were entered into meta-analysis, involving 112,235 patients. We found that the prevalence of nephropathy in type two diabetes was 26.34% (95% confidence interval (CI)= 21.04%, 32%). Prevalence of nephropathy was 30.42% (95% CI= 23.38%, 37.94%) in males 22.1% (95% CI= 16.05%, 28.79%) in females. Low HDI countries and very high HDI countries had the lowest (21.17% (95% CI= 1.1%, 56.22%)) and the highest (30.93% (95% CI= 22.16%, 40.44%)) prevalence rates. The meta-regression analysis showed that HDI, publication year, mean duration of diabetes, mean age, and diagnostic test were not significant moderators (p = .3323, .7247, .2802, .2199, and .4680, respectively).Conclusions: We estimated a high prevalence of diabetic nephropathy in EMR. Our results implicate the importance of diabetes screening, on time and periodic examinations for nephropathy, diabetes care, and risk factor controls. Large-scale longitudinal studies should be conducted in EMR.
Objectives: The global epidemic of Diabetes Mellitus exerts a substantial burden on health services. This high prevalence of diabetes leads to an increase in diabetic complications, especially diabetic nephropathy, a leading cause of end stage renal disease and renal replacement therapies. Due to its’ the high prevalence reported by Individual studies in EMR, we conducted a meta-analysis of relevant studies to estimate diabetic retinopathy in EMR.Method: We searched for the relevant keywords in title and abstract of Medline/PubMed, Scopus, Embase, Web of knowledge, and Gray literature from Jan 1st, 2000 to December 13, 2019. The two-step screening was carried out by two independent researchers and relevant data were extracted. Estimation of summary proportions, subgroup analysis, meta-regressions, and publication bias assessment were performed. Results: Out of 3,225 identified citations, 38 articles were entered into meta-analysis, involving 112,235 patients. The prevalence of nephropathy in type two diabetes was 26.34% (95% confidence interval (CI)= 21.04, 32%); and it was 30.42% (95% CI= 23.38, 37.94%) in males and 22.1% (95% CI= 16.05, 28.79%) in females. The meta-regression analysis showed that HDI, publication year, mean duration of diabetes, mean age, and diagnostic test were not significant moderators (p = .332, .725, .280, .220, and .468, respectively).Conclusions: Diabetic nephropathy high prevalence in EMR implicates the importance of diabetes screening, periodic examinations, diabetes care, and risk factor controls. Large-scale longitudinal studies should be conducted in EMR.
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