Dialysis in Developing Countries

Barsoum, Rashad S.

doi:10.1007/978-0-585-36947-1_68

Cited by 7 publications

(4 citation statements)

References 14 publications

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“…End‐stage renal disease (ESRD) is common in the developing countries, but providing renal replacement therapy (RRT) to uremic patients raises a serious medical problem with ethical and social aspects in view of limited financial resources (1–8). Thus, in many of these countries, access to RRT, if available, is rather restricted to a low proportion of patients reaching the end stage of their renal disease (2,7,9).…”

Section: Factors Predisposing Patients Undergoing Renal Replacement Tmentioning

confidence: 99%

“…Thus, in many of these countries, access to RRT, if available, is rather restricted to a low proportion of patients reaching the end stage of their renal disease (2,7,9). The majority of these privileged patients have to start RRT in poor conditions related to the late referral and the patient load in dialysis centers (1). Anemia, which represents another factor leading to the poor outcome observed in patients undergoing RRT, is more severe than that of uremic patients of developed countries in view of the prevalence of multiple factors influencing erythropoiesis and iron storage in these countries, such as malnutrition, infectious diseases, and hemoglobinopathies (Table 1).…”

Section: Factors Predisposing Patients Undergoing Renal Replacement Tmentioning

confidence: 99%

“…At the end of 1999, 4,194 patients were on RRT representing a prevalence rate of 430 per million population (pmp) with an incidence of 110 pmp during the same year (17). Tunisia is not representative of many of the developing countries in view of the liberal acceptance of uremic patients for chronic dialysis and the rarity of many pathologic conditions that expose to chronic anemia which remain endemic in the majority of developing countries (1,18).…”

Section: Local Experience In Tunisiamentioning

confidence: 99%

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Anemia and End‐Stage Renal Disease in the Developing World

2002

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In developing countries, multiple comorbidities such as malnutrition, parasitoses, and hemoglobinopathies contribute to the aggravation of anemia observed in patients with end-stage renal diseases. We analyze here the results of a retrospective evaluation of red-cells indices and iron parameters conducted at the end of December 2000 in 304 prevalent Tunisian patients (sex ratio, 1.05; mean age, 53.7 years) receiving chronic hemodialysis for a median duration of 49.6 months (range, 1.6 to 278). Anemia, observed in 87.8% of patients, was normochromic and normocytic in 73% of cases. Only 2% of patients had microcytic and hypochromic anemia. Iron deficiency was observed in 21.6% of anemic patients. The mean rate of hemoglobin was significantly higher in men and in patients with polycystic kidney disease as the cause of renal failure. There was a positive correlation between hemoglobin values and the quality of dialysis. Only 10.8% of patients were on recombinant human erythropoietin (rHuEPO) and 38% required regular transfusions. We conclude that anemia observed in our patients had, in most cases, the characteristics of renal anemia and could be attributed to a deficit of renal production of erythropoietin. However, for financial reasons, prescription of rHuEPO is rather restrictive and blood transfusion remains largely used. The nephrology community and dialysis providers should increase their efforts to improve the anemia care of dialyzed patients in developing countries.

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Section: Factors Predisposing Patients Undergoing Renal Replacement Tmentioning

confidence: 99%

Section: Factors Predisposing Patients Undergoing Renal Replacement Tmentioning

confidence: 99%

Section: Local Experience In Tunisiamentioning

confidence: 99%

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Anemia and End‐Stage Renal Disease in the Developing World

2002

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“…The question arises as to how many ESRD patients are receiving RRT in the rest of the world. It is well known that in India and major parts of Latin America and Africa, there exist very poor networks of dialysis facilities, and a very low number of ESRD patients are dialyzed ( 6, 7). Even in such a country as South Africa with a relatively well developed economy, access to RRT is very limited ( 8).…”

mentioning

confidence: 99%

Treatment of End‐Stage Renal Disease in Central and Eastern Europe: Overview of Current Status and Future Needs

Rutkowski¹,

Ciocalteu²,

Djukanović

et al. 1998

Artificial Organs

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The situation of end-stage renal disease (ESRD) patients in central and eastern Europe was very poor for many years during the so called socialistic era. Economical and political liberation resulted in the significant growth of renal replacement facilities in this region. The number of hemodialysis units increased significantly (56%) during the period 1990-1996, and the number of patients treated with this modality has risen by 75%. More dramatic progress was achieved in peritoneal dialysis. The number of units performing this method of renal replacement therapy (RRT) increased by 277% and the number of patients by more than 300%. Not only quantitative but also qualitative changes were observed. More modern hemodialysis machines installed in the vast majority of units allow for the performance of bicarbonate dialysis, controlled ultrafiltration, and sodium profile modeling. Also, a wider choice of biocompatible dialyzers has become available during the last few years. The number of centers performing renal transplantation has increased significantly, but the number of renal transplants has not followed this progress. Despite all the progress, further development of all RRT methods is necessary to achieve acceptance rates comparable to those observed in developed countries.

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Acute kidney injury in tropics

Gokulnath

Ram

2012

Clinical Queries: Nephrology

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Dialysis in Developing Countries

Cited by 7 publications

References 14 publications

Anemia and End‐Stage Renal Disease in the Developing World

Anemia and End‐Stage Renal Disease in the Developing World

Treatment of End‐Stage Renal Disease in Central and Eastern Europe: Overview of Current Status and Future Needs

Acute kidney injury in tropics

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