Trends of Incident Dialysis Patients in Tunisia Between 1992 and 2001

Counil, Émilie; Cherni, Noureddine; Kharrat, Mamhoud; Achour, A.; Trimech, Hichem

doi:10.1053/j.ajkd.2007.10.032

Cited by 27 publications

(27 citation statements)

References 25 publications

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“…In North Africa, the reported annual incidence of end-stage kidney disease ranges from 34 to 200 cases per million population, depending on the country (Barsoum, 2003; Counil et al, 2008). Hemodialysis (HD) remains the most frequent renal replacement therapy for patients at end-stage kidney disease particularly in developing countries.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Interdialytic Combined Resistance and Aerobic Exercise Training on Health Related Outcomes in Chronic Hemodialysis Patients: The Tunisian Randomized Controlled Study

et al. 2017

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Background: Tunisia has the highest prevalence of hemodialysis patients compared to the other countries in North Africa. Dialysis centers rarely offer an exercise program to prevent physiological and psychological dialysis therapy-related alterations in chronic hemodialysis patients.Aim: To examine the effect of combined endurance-resistance training program on physiological and psychological outcomes in patients undergoing hemodialysis.Methods: We designed a single blinded, randomized, controlled study for a period of 4 months. Patients were randomized to intervention group or control group. Intervention group patients received 4 training sessions per week, held on non-hemodialysis days for a period of 4 months, whereas control group patients continued their regular lifestyle practice without direct intervention from the personnel of this investigation. Patients were evaluated at baseline (initial assessment) and after the four-month study period (final assessment) by the same investigator blinded to treatment group assignment using physical, physiological, and psychological measurements.Results: Compared with control group, intervention group showed significant improvement in physical performance during the sit-to-stand-to-sit tests (STS-10: −16.2%, ES = −1.65; STS-60: +23.43%, ES = 1.18), handgrip force task (+23.54%, ES = 1.16), timed up and go test (−13.86%, ES = −1.13), and 6-min walk test (+15.94%, ES = 2.09). Likewise, mini nutritional assessment long form scores after intervention period were significantly higher in the intervention group compared to the control group (ES = 1.43). Physical and mental component scores of SF-36 questionnaire increased significantly in the intervention group (ES = 1.10 and ES = 2.06, respectively), whereas hospital anxiety and depression scale scores decreased significantly (ES = −1.65 and ES = −2.72, respectively). Regarding biological parameters, intervention group displayed improvement in systolic and diastolic blood pressures (ES = −2.77 and ES = −0.87, respectively), HDL-cholesterol, LDL-cholesterol, and triglycerides systematic levels (ES = 1.15, ES = −0.98, and ES = −1.01, respectively); however no significant effect of intervention period was observed on C-reactive protein, hemoglobin, albumin, and total cholesterol levels (P > 0.05).Conclusion: The current study showed that combined endurance-resistance training program had a beneficial effect on physical capacity and quality of life in chronic hemodialysis patients.

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Section: Introductionmentioning

confidence: 99%

The Effect of Interdialytic Combined Resistance and Aerobic Exercise Training on Health Related Outcomes in Chronic Hemodialysis Patients: The Tunisian Randomized Controlled Study

et al. 2017

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“…Only young people with social insurance, and without severe co morbidities (like neoplasia or severe heart disease) were treated with dialysis. End stage renal disease incidence rose from 81.6 per million people (pmp) to 137 in 2007 [1, 2]. This sharp increase could be linked to a political decision made in 1991 to treat all patients, regardless of their social insurance and comorbidities, but without significant increased number of renal transplantation which was at 14 pmp in 2007.…”

Section: Introductionmentioning

confidence: 99%

“…Increase in the prevalence of ESRD treated with dialysis has led to an increase in costs of dialysis treatment, and dialysis expenditures represented 4.5% of Tunisian Health budget in 2000 [1]. Primary and secondary CKD prevention is therefore essential to our country which has limited resources.…”

Section: Introductionmentioning

confidence: 99%

Diet in chronic kidney disease in a Mediterranean African country

et al. 2017

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BackgroundMediterranean diet is characterized by low to moderate consumption of animal protein and high consumption of fruits, vegetables, bread, beans, nuts, seeds and other cereals. It has been associated with reduced risk of cardiovascular disease. However, it is not suitable for chronic kidney disease because of high potassium intake.DiscussionTunisia is an emerging Mediterranean country with limited resources, a high prevalence of chronic hemodialysis treatment and high dialysis expenditures. In order to limit dialysis cost, primary and secondary prevention of chronic renal disease are of paramount importance. In addition to drugs, secondary prevention includes diet measures (e.g. salt diet, protein diet). The aims of diet practice in chronic kidney disease are to slow chronic renal failure progression and to prevent its complications like hyperphosphatemia and hyperkaliemiae. A few decades ago, a Tunisian diet was exclusively Mediterranean, and protein consumption was not excessive. However, today, protein consumption is more comparable to western countries. Salt consumption is also excessive. Some Tunisian diets still include food with high potassium intake, which are not suitable for patients with chronic kidney disease. Therefore, the role of the dietician is extremely important to help calculate and create a dietary regimen tailored to each of our patients.SummaryAdvice about diets should be adapted to both the patient and population habits to improve adherence rate. As such, the purpose of this article is to provide our own experience regarding medical nutrition therapy in patients with chronic kidney disease in Tunisia, with some changes in food habits. Prevention is far better than treatment. In this perspective, dietary measures must be at the core of our intervention.

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“…3 The treatment is provided at no cost to the patient by the Ministry of Health or through social security funds without any restrictive policy. 3,4 The program has expanded and, currently, there is a large network of dialysis centers throughout the country serving about 10 000 patients.…”

Section: Introductionmentioning

confidence: 99%

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Abderrahim

Zammouri²,

Bacha³

et al. 2017

Exp Clin Transplant

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Objectives: The aim of this study was to report the results of 30 years of experience at the first kidney transplant center in Tunisia. Materials and Methods: All kidney transplants performed at the center between June 1986 and June 2016 were included. The study period was divided into 3 decades. Recipient and donor data and follow-up information were obtained from a local database and patient medical records. Comparative analyses were performed using the t test for continuous variables and the χ 2 test for qualitative variables. Patient and graft survival rates were calculated according to the actuarial method, and comparison of survival curves was performed according to the logrank test. Results: The mean age of recipients was 32.7 ± 11.5 years (range, 6-65 y) with a gender ratio of 2.2. Duration of prekidney transplant dialysis varied from 2 months to 20 years (median, 27.5 mo); 1.7% of patients underwent transplant preemptively. Kidneys were recovered from deceased donors in 21.2% of cases and from living donors in 78.8%. The proportion of deceased donors dropped from 27.4% during the period 2006-2010 to 12.9% during the period 2011-2015 (P < 0.04). Patient survival rates at 1, 5, 10, 15, and 20 years were 96%, 89.3%, 79.5%, 71.1%, and 65.4%. Graft survival rates were 95%, 86.5%, 76.2%, 66.3%, and 57.2%. The annual graft loss was 2.9%, with a mortality rate of 2.4% and without significant differences between patients receiving deceaseddonor and living-donor organs. Conclusions: Kidney transplant activity remains suboptimal in our country. The reduction in deceaseddonor organs could be related to the political transformations facing our country with their resulting social and economic consequences. Efforts should be made to increase governmental resources and to improve both public awareness of organ donation and the motivation of transplant teams.

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Trends of Incident Dialysis Patients in Tunisia Between 1992 and 2001

Cited by 27 publications

References 25 publications

The Effect of Interdialytic Combined Resistance and Aerobic Exercise Training on Health Related Outcomes in Chronic Hemodialysis Patients: The Tunisian Randomized Controlled Study

The Effect of Interdialytic Combined Resistance and Aerobic Exercise Training on Health Related Outcomes in Chronic Hemodialysis Patients: The Tunisian Randomized Controlled Study

Diet in chronic kidney disease in a Mediterranean African country

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