The aetiology of chronic renal failure in adult Sudanese patients

Abboud, Olivier; Osman, Eman; Musa, A.

doi:10.1080/00034983.1989.11812365

Cited by 16 publications

(9 citation statements)

References 8 publications

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“…Chronic glomerulonephritis accounted for 25.4% of our patients with CRF and was the commonest identifiable aetiology. Similar reports from adult Sudanese patients reported the predominance of chronic glomerulonephritis as a cause of CRF in 33% and 38% of patients [15,16]. Studies from other developing countries in Asia, Latin America, and Africa have shown a high prevalence of glomerulonephritis in their patients, with rates of over 50% in Nigeria and China [5,7,14,17].…”

Section: Discussionsupporting

confidence: 53%

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Chronic renal failure in Sudanese children: aetiology and outcomes

Ali¹,

Abdelraheem²,

Mohamed³

et al. 2009

Pediatr Nephrol

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The provision of tertiary paediatric nephrology facilities has led to increasing referrals of children with chronic renal failure (CRF). We report the aetiology and outcomes over 5 years, during which period the improving socio-economic situation has allowed increasing provision of dialysis and transplantation. The records of 205 children (124 male; 60.5%) who were referred to a tertiary paediatric nephrology unit in Khartoum between 2001 and 2006 with a glomerular filtration rate of less than 50 ml/min per 1.73 m(2) body surface area were reviewed. The mean age at the time of diagnosis with CRF was 9.8 years (range 3 months-17 years). The aetiology was chronic glomerulonephritis in 52 (25.4%), congenital urological malformations in 36 (17.5%), urolithiasis in 19 (9.3%), hereditary nephropathy in 14 (6.8%), multisystem diseases in 4 (2%), and cause unknown in 80 (39.1%). Of the 205 children, 136 (63%) had reached end-stage renal failure, with chronic haemodialysis being undertaken in 48 (35.3%), intermittent peritoneal dialysis in 43 (31.6%), continuous ambulatory peritoneal dialysis in 17 (14.7%), and no treatment in 25 (18.4%). At the end of the study period 53 of the 205 (25.9%) remained on dialysis, 51 (25%) were on conservative treatment, 8 (3.9%) had received transplants, 48 (23.4%) had died, and 45 (22%) had been lost to follow-up. The results illustrate the geographical variations in CRF aetiology in different countries, which may be influenced by current patterns of referral as well as environmental and society factors. The large number with an unknown aetiology for their CRF requires further prospective investigation. We hope the current high mortality rate will improve with earlier referral, improved nutrition, family support, and better access to treatment modalities, especially the provision of kidney transplantation from living related donors.

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Section: Discussionsupporting

confidence: 53%

“…High rates have also been reported in Africa and Asia [12,13]. Reports from adult Sudanese patients also showed high frequencies of cause unknown, at 16% and 20% [15,16]. This could have been due to the pattern of late referrals, with failure of detection of the primary cause and lack of intensive imaging modalities.…”

Section: Discussionmentioning

confidence: 69%

Chronic renal failure in Sudanese children: aetiology and outcomes

Ali¹,

Abdelraheem²,

Mohamed³

et al. 2009

Pediatr Nephrol

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“…A small study conducted in Sudan among 61 patients in 1987 reported that the causes of chronic kidney disease (CKD) are chronic glomerulonephritis, obstructive nephropathy, hypertension and diabetes mellitus in that order [ 9 ]. Furthermore in study conducted among 100 Sudanese patients, chronic glomerulonephritis was found to be the leading cause of ESRF [ 10 ]. Other study conducted in central Sudan in 2009 among 224 ESRF patients found that hypertension (14.3 %) is a leading cause of ESRF followed by obstructive uropathy (11.6 %), glomerulonephritis (9.8 %), diabetes mellitus (8 %), however in (53.57 %) no cause was found [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Causes of end stage renal failure among haemodialysis patients in Khartoum State/Sudan

Banaga

Mohammed²,

Siddig³

et al. 2015

BMC Res Notes

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BackgroundEnd stage renal failure (ESRF) has become a major health problem in Sub Saharan Africa (SSA). There were limited data about causes of ESRF in the Sudan.MethodsThis is a cross sectional hospital based descriptive study. The subjects of the study are ESRF adults’ patients on regular haemodialysis treatment in 15 haemdoialysis centres in Khartoum State—Sudan. Clinical and epidemiological data were obtained from 1583 patients. The medical files of each patient were reviewed to identify the cause of ESRF. Concerning the causes of ESRF, diabetes was diagnosed based on the past medical history and result of the glucose tolerance test, hypertension was diagnosed based on past history of hypertension based on blood pressure of more than 140/90 mmHg, glomerulonephritis was diagnosed based on results of previous kidney biopsies and on clinical grounds, polycystic kidney disease and obstructive uropathy were diagnosed based on abdominal ultrasound and other imaging modalities, sickle cell anaemia was diagnosed based on the result of haemoglobin electrophoresis, systemic lupus erythematosus was diagnosed based on the clinical criteria in addition to lab results of auto antibodies, and analgesic nephropathy was diagnosed based on past medical history of chronic analgesic drugs usage with no other identifiable risk factors. We included all ESRF patients on regular haemodialysis treatment. We excluded ESRF patients less than 18 years old.ResultsThe results showed that the mean age of ESRF Patients was 49 ± 15.8 (years) and 63.4 % were male and 76.3 % were unemployed. The mean duration of haemodialysis is 4.38 ± 4.24 (years). The most common cause of ESRF in our patients was hypertension (34.6 %) followed by chronic glomerulonephritis (17.6 %), diabetes mellitus (12.8 %), obstructive uropathy (9.6 %), autosomal dominant poly cystic kidney disease (ADPKD) (4.7 %), chronic pyelonephritis (4.6 %), analgesic nephropathy (3.5 %). However in (10.7 %) no cause was found. In patient aged less than 40 years old the leading cause of ESRF was glomerulonephritis (29.3 %) followed by hypertension (25 %). In patient aged between 40 to 60 years old the leading cause of ESRF was hypertension (38.5 %) followed by diabetes mellitus (14 %). In patient aged older than 60 years the leading cause of ESRF was hypertension (38.4 %) followed by diabetes mellitus (23.3 %).ConclusionsESRF in Sudan affects the economically productive age group; unemployment rate among ESRF patients is high. The study showed that hypertension is a leading cause of ESRF in Sudan followed by chronic glomerulonephritis. Hypertension and diabetes mellitus are the leading causes of ESRF among patients over 40 years old.

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“…32, No. 3 PERITONEAL DIALYSIS IN CAPE TOWN between 25% and 48% (4)(5)(6)(7)(8). Primary and secondary glomerular diseases also commonly occur in SSA, and for various reasons-such as late presentation of patients, inadequate tools to make a diagnosis, and inadequate treatment-premature ESRD may result (9).…”

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confidence: 99%

Peritoneal Dialysis in Cape Town, South Africa

2012

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♦ Background: Chronic kidney disease is a major public health problem in sub-Saharan Africa (SSA), which encompasses 70% of the least-developed countries in the world. Most people in SSA have no access to any form of renal replacement therapy (RRT). Given its ease of performance and patient independence, peritoneal dialysis (PD) should be an ideal form of RRT in SSA, but several complex and interdependent factors make PD a difficult option in SSA. The present review describes the practice of PD in SSA, with emphasis on Cape Town, South Africa. ♦ Methods and Results: After a review of the recent PubMed literature on RRT in SSA and an appraisal of nephrology practice in South Africa, factors that make the provision of RRT (especially PD) a challenge in SSA include the low number of qualified health care workers, socio-demographic issues (poor housing, electricity, and water supplies), and the cost of PD fluids in the region. Although South Africa has the largest PD population in all of SSA, the growth of PD in South Africa is specifically impeded by the system of RRT rationing, which favors HD; the methods of funding for dialysis and for remuneration of doctors in private practice; and many other socio-economic factors. The peritonitis rate remains relatively high, and it is a significant contributor to morbidity in PD patients in Cape Town. ♦ Conclusions: In many parts of SSA, PD could be the main dialysis modality. However, African governments must start taking responsibility for their people by providing adequate funds for renal replacement programs. Attempts to produce PD fluids locally and to train and educate health care workers will greatly improve the use of PD as a RRT option in SSA. Perit Dial Int

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The aetiology of chronic renal failure in adult Sudanese patients

Cited by 16 publications

References 8 publications

Chronic renal failure in Sudanese children: aetiology and outcomes

Chronic renal failure in Sudanese children: aetiology and outcomes

Causes of end stage renal failure among haemodialysis patients in Khartoum State/Sudan

Peritoneal Dialysis in Cape Town, South Africa

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