Background Renal replacement therapy was first introduced in Yemen in 1978 in the form of hemodialysis. Twenty years later, the first renal transplantation was performed. Kidney transplantations were started in socially and financially challenging circumstances in Yemen in 1998. A structured program was established and has been functioning regularly since 2005. A pediatric transplantation program was started in 2011. Material and Methods This was a prospective study of 181 transplants performed at the Urology and Nephrology Center between May 1998 and 2012. All transplants were from living related donors. The immunosuppressive protocol consisted initially of double therapy with steroid and mycophenolate mofetil (MMF). Subsequently, triple therapy with addition of a calcineurin inhibitor was introduced. Primary graft function was achieved in 176 (97.2%) recipients. Results Cold ischemia time was 48-68 min. Episodes of acute rejection in 12 patients were treated with high-dose steroids. Anti-thymocyte globulin (ATG) was used in cases of vascular or steroid-resistant rejection in 2 patients. The post-transplant complications, either surgical or medical, were comparable to those recorded in the literature. Conclusions Renal transplantation is a good achievement in our country. The patients and graft survival rates are comparable to other reports.

Background: A renal allograft is the optimum therapeutic option for patients with end stage renal diseases. Nevertheless, rejection still represents a large challenge. So as to overcome this matter, treatment strategies comprise the combined use of anti-inflammatory  and immunosuppressive agents, although they are not free from complications . Interestingly, the major cause of morbidity and mortality after the first transplanted year are due to disorders unrelated directly to immunologic etiology or disease related to immunosuppressive drugs. Objectives: The purpose of this study is to determine the side effects in renal transplant Yemeni patients adherence to cyclosporine compared to tacrolimus sharing the same adjuvant agents which are mycophenolate mofetil "MMF" and prednisone. Subject and methods: This prospective study was carried on 100 kidney transplanted Yemeni patients divided into two groups: cyclosporine group (n=50) and tacrolimus group (n=50), each member of these groups was visited three times, blood samples were collected for biochemical functions including fasting blood sugar, liver enzymes, kidney functions, lipid profiles and white blood cells counts and results were obtained from the tests performed. Body weight and blood pressure had been examined; clinical complications were also recorded. Results: This study showed that serum total and direct bilirubine, gamma glutamyl transferase "GGT" and lipid profiles were elevated in cyclosporine group, whereas in tacrolimus group they were within normal range. The incidence of complicated events reported as follows: Hairtusim, gum hyperplasia, herpeszoster, CUSHING face and obesity were obviously present in cyclosporine group, while in tacrolimus group diabetes mellitus, hair loss and gastrointestinal tract infections were in existence. Conclusion: This study found that a tacrolimus-based treatment was significantly better than an immunosuppressive regimen based on cyclosporine due to the generally less side effects associated with tacrolimus, despite its effect on increasing diabetes among kidney transplant patients. Peer Review History: Received: 18 September 2020; Revised: 5 October; Accepted: 16 October, Available online: 15 November 2020 UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 8.0/10 Reviewer(s) detail: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, amaka_mgbahurike@yahoo.com Dr. Mohamed Awad AbdAlaziz Mousnad, International University of Africa (IUA) and Sudan, m_abdalaziz@yahoo.com Maged Almezgagi, The Key Laboratory of high-altitude medical application of Qinghai Province, Qinghai Xining 810001, China. 1902244017@qq.com Ali Awad Allah Ali Moh. Saeed, National University, Sudan, alimhsd@gmail.com Comments of reviewer(s): Similar Articles: LEVEL OF LEAD IN THE BLOOD AMONG FUEL STATION EMPLOYEES AND ITS RELATIONSHIP TO IMPAIRED LIVER AND KIDNEY FUNCTIONS IN DAMASCUS; SYRIA: OCCUPATIONAL EXPOSURE TO LEAD BACTERIAL CONTAMINATION OF DIALYSIS WATER AND DIALYSATE AT MUKALLA ARTIFICIAL KIDNEY CENTER IN MUKALLA CITY - HADHRAMAUT - YEMEN: RATE OF CONTAMINATION AND SENSITIVITY OF BACTERIAL ISOLATES TO ANTIBIOTICS

Objective: To estimate the underlying primary diseases of chronic renal failure (CRF) among patients attending Al-Thawra General Hospital, Sana'a, and Yemen.Methods: This was a cross-sectional, hospital-based study of 566 patients diagnosed with chronic kidney diseases (CKD). It studied the cases attending Al-Thawra General Hospital over a three-year period from January 2013 to December 2015.Results: Out of 566 patients, 339 (59.9%) were males. The mean age of the patients at diagnosis of CKD was 39.51 years, most of whom (36.6%) were of the age group of 21-35 years. Hypertension was the most frequent cause (43.2%) of CRF, followed by different infectious diseases such as malaria, schistosomiasis and bacterial infections (19%) and obstructive nephropathy (17.9%). On the other hand, CRF of unknown etiology represented 15.2% of cases. Other causes of CRF diabetic nephropathy (9.7%), effect of antibiotics and analgesics (7.0%), ischemic heart disease (4.8%, polycystic kidney disease (3.5%) and congenital anomalies (3.4%). The least common causes were autoimmune diseases, bleeding, traumatic accidents and chronic diarrhea, being responsible for 2.2%, 1.8%, 0.9% and 0.4% of CRF cases, respectively. Conclusions:The majority of CKD cases in our study were males aged between 21 and 35 years old. In addition, most cases of CKD are due to hypertension, followed by infections and obstructive nephropathy. Application of future prevention and control measures are highly recommended to reduce the burden of CRF in Yemen for early detection and proper management of its underlying primary conditions/diseases.

Objective: To estimate the underlying primary diseases of chronic renal failure (CRF) among patients attending Al-Thawra General Hospital, Sana'a, and Yemen.Methods: This was a cross-sectional, hospital-based study of 566 patients diagnosed with chronic kidney diseases (CKD). It studied the cases attending Al-Thawra General Hospital over a three‐year period from January 2013 to December 2015.Results: Out of 566 patients, 339 (59.9%) were males. The mean age of the patients at diagnosis of CKD was 39.51 years, most of whom (36.6%) were of the age group of 21–35 years. Hypertension was the most frequent cause (43.2%) of CRF, followed by different infectious diseases such as malaria, schistosomiasis and bacterial infections (19%) and obstructive nephropathy (17.9%). On the other hand, CRF of unknown etiology represented 15.2% of cases. Other causes of CRF diabetic nephropathy (9.7%), effect of antibiotics and analgesics (7.0%), ischemic heart disease (4.8%, polycystic kidney disease (3.5%) and congenital anomalies (3.4%). The least common causes were autoimmune diseases, bleeding, traumatic accidents and chronic diarrhea, being responsible for 2.2%, 1.8%, 0.9% and 0.4% of CRF cases, respectively.Conclusions: The majority of CKD cases in our study were males aged between 21 and 35 years old. In addition, most cases of CKD are due to hypertension, followed by infections and obstructive nephropathy. Application of future prevention and control measures are highly recommended to reduce the burden of CRF in Yemen for early detection and proper management of its underlying primary conditions/diseases.