Chronic Renal Disease in Kuwaiti Nationals: A Prospective Study During the Past 4 Years

Abstract

Our study is a prospective one conducted at Al-Amiri Hospital and including all new cases of chronic renal disease (CRD) seen at the capital area of Kuwait between 1 January 1999 and 30 December 2003. Diagnosis of CRD was based on clinical, laboratory, and radiological features. Kidney biopsies were done when indicated. A total of 271 cases of chronic renal failure (CRF) were diagnosed, of whom 143 were women. The median age was 40 years (range, 5 to 80 years; mean +/- SD: 40 +/- 14). The most common cause of CRF was glomerulonephritis (32%), of which systemic lupus erythematosis and vasculitis constituted 5% and 4%, respectively. Diabetic glomerulosclerosis was the second leading cause of CRD (24%), followed by tubulointerstitial disease (11%) and nephroangiosclerosis (10%). Less frequent causes included renovascular/ischemic disease (6%), obstructive nephropathy (3%), and adult polycystic kidney disease (3%). One hundred and seven patients had 121 incidents of acute deterioration of underlying renal disease. This was mostly due to drugs (22%), infection (21%), and volume depletion (13%). Antiinflammatory drugs were the most common drugs (63%) responsible for the acute decline in renal function. By the end of the study, 18 (7%) patients died, 55 (20%) required maintenance dialysis, and 40 (15%) had received a kidney allograft. Diabetic patients did not differ from nondiabetic with regard mortality, although had more renal replacement therapy (p = .002). Using the Cox regression model, analysis of the relative risk factors likely to contribute to mortality, viz. age, gender, original kidney disease, fitness for transplantation, and mode of presentation, did not show significant factors except for less hazard to death in those diagnosed early with CRD (i.e., on routine testing; relative risk 0.06, p = .01). In conclusion, our study indicates that early diagnosis and management of CRD can improve the patient's quality of life and decrease the cost of frequent hospitalization, morbidity, and even mortality associated with end-stage renal disease.

Epidemiology and aetiology of dialysis-treated end-stage kidney disease in Libya

“…Glomerulonephritis was the second most frequent cause of ESKD in Libya in prevalent and incident cases and was significantly more common among young and male patients. The observed proportion is midway between very high levels reported from countries like China and Kuwait of approximately 35% [36,37], Costa Rica (30%) [38] and Yemen (25%) [39] and lower prevalence observed in countries like Qatar (13%) [16], Sri Lanka (12%) [40] and Pakistan (10%) [41]. Reasons for the high prevalence of glomerulonephritis require further investigation, which is hampered by the shortage of facilities able to perform renal biopsies and histology.…”

International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in the Middle East

“…10 Studies have shown that the incidence and prevalence of treated KF, both indexes of KRT service delivery, ranged from 0 to 175 pmp (mean, <100 pmp) and from 0 to 753 pmp (mean, <250 pmp), respectively, in the Middle East region. 26,[29][30][31][32] In addition to wide governmental support for KRT, it is equally important that KRT services should be reasonably priced in the region to enable countries with low health care budgets to access KRT. The cost of KRT in the region, although comparable to global values, was excessively high in some countries (Table 1).…”

Reasons for hospitalizations in adults with diabetes in Kuwait

“…The Eastern Mediterranean Approach for Non-communicable diseases survey, conducted in 2006 by the Ministry of Health, in conjunction with the World Health Organization for surveillance of the non-communicable disease risk factors, estimated the prevalence of diabetes to be at 12.4% in Kuwaiti nationals aged 20-65 years, using fasting blood glucose [11]. Further, diabetes is a major risk factor for acute myocardial infarction, stroke and chronic renal failure [12][13][14]. Yet data on hospitalizations related to diabetes are scant [15].…”