The epidemiology of end‐stage renal disease in Iran in an international perspective

Haghighi, Ali Nobakht; Broumand, Behrooz; D’Amico, Marco; Locatelli, Francesco; Ritz, Eberhard

doi:10.1093/ndt/17.1.28

Cited by 62 publications

(35 citation statements)

References 14 publications

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“…Today diabetes is the most common global cause of chronic kidney disease (CKD), present in one fourth to two thirds of all patients with renal impairment [4,16] . Anemia is more severe in diabetic ESRD patients and 2-3 times more prevalent in diabetics with CKD and ESRD than in non-diabetics with the same degree of renal impairment [17] .…”

Section: Changing the Fate Of Diabetics In The Dialysis Unitmentioning

confidence: 99%

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Diabetes: Changing the Fate of Diabetics in the Dialysis Unit

Broumand¹

2006

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The prevalence of diabetes mellitus (DM) is very high worldwide. According to the World Health Organization in 2000 the worldwide prevalence of DM was 171,000,000. Diabetic nephropathy is a major vascular complication of DM. If DM is not treated early and adequately, many diabetic patients may reach end-stage renal disease (ESRD) secondary to advanced irreversible diabetic nephropathy. In many countries diabetic nephropathy has become the single most frequent cause of prevalent ESRD patients undergoing maintenance hemodialysis (MHD). In the early era of renal replacement therapy (RRT) by means of intermittent hemodialysis the prognosis of diabetic patients undergoing MHD was extremely poor and disappointing. While the prognosis of patients suffering from diabetic ESRD and maintained by chronic intermittent dialysis has greatly improved, the rehabilitation rate and survival of these patients continue to be worse than those of non-diabetic patients. A preexisting severely compromised cardiovascular condition, vascular access problems, diabetic foot disease, interdialytic weight gain, and intradialytic hypotension explain most of the less favorable outcome. Despite improved techniques and more aggressive medical therapy in recent years, a review of the fate of diabetics in dialysis units since 1972 reveals that these patients have had significant morbidity and mortality. We still have a long way to go in order to achieve more ideal outcomes for our patients. Most of the diabetic ESRD patients are still maintained by MHD, but they can choose other modalities of RRT such as chronic ambulatory peritoneal dialysis (CAPD), kidney and kidney plus pancreas transplantation. The results of different studies and national registries on the mortality and morbidity of ESRD patients being maintained on different modalities of dialysis are conflicting. It can be concluded that the two modalities of dialysis (CAPD and MHD) are almost comparable in terms of survival. The recent suggestions for nocturnal daily hemodialysis, short daily hemodialysis, and an integrative care approach for the management of diabetics with ESRD provides better promise for these patients.

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Section: Changing the Fate Of Diabetics In The Dialysis Unitmentioning

confidence: 99%

“…36 and 22% of incident dialysis patients in Germany and Australia, respectively, have ESRD due to DN [3] . This figure is no less in developing countries, for instance in Iran 25.2% of incident dialysis patients are reported to have ESRD as a result of DN [4] . Figure 3 shows the incidence of RRT according to different registries [5] .…”

Section: Introductionmentioning

confidence: 96%

Diabetes: Changing the Fate of Diabetics in the Dialysis Unit

Broumand¹

2006

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“…Consequently with an increasing DM global prevalence and an aging population, DM has become the leading single cause of ESRD in many developed and developing countries [19][20][21][22][23][24]. Moreover, it is now proven that even a mild reduction in kidney function is accompanied by an increased cardiovascular (CV) risk [25,26].…”

Section: Risk In Diabetic Kidney Diseasementioning

confidence: 99%

Cardiovascular Risk Assessment in Diabetes and Chronic Kidney Diseases: A New Insight and Emerging Strategies

Khoshdel¹

2012

Cardiovascular Risk Factors

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“…The prevalence of RRT in Iran is 238 cases per one million population and its treatment generally include hemodialysis (53.7%) and kidney transplant (45.5%) (4). One of the long-term complications of hemodialysis is development of amyloidosis that is caused by Vol.1 No.1, Spring 2017 accumulation of beta-2 microglobulin (β2M) (5).…”

Section: Introductionmentioning

confidence: 99%

An Investigation of the Relationship between Beta-2 Microglobulin (β2M) and Inflammatory Factors (Serum Levels of CRP and Albumin) and High Density Lipoproteins (HDL) in Hemodialysis Patients

et al. 2018

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Background and Objective: Beta-2 Microglobulin (β2M) is a middle molecular weight uremic toxin. Lack of β2M removal leads to β2M accumulation and amyloidosis in hemodialysis patients. The present research aims to determine the relationship between β2M and inflammatory factors, such as C-reactive protein (CRP), albumin, and high-density lipoprotein (HDL) in hemodialysis patients.Methods: Fifty-four hemodialysis patients were selected and their pre-and post-dialysis serum levels of β2M, CRP, albumin, and HDL, were measured.Result: There was an obvious inverse relationship between β2M level and serum level of albumin, while no relationship was found between β2M and CRP or HDL.Conclusion: According to the findings of this study, it was identified that inflammatory-induced increase in β2M level in dialysis patients leads to reduced serum albumin.

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The epidemiology of end‐stage renal disease in Iran in an international perspective

Abstract: The epidemiology of RRT in Iran is characterized by: (i) young patient age (younger than the international average); (ii) high proportion of patients receiving renal allograft; (iii) use of living-unrelated donors as the major source of renal allografts.

Cited by 62 publications

References 14 publications

Diabetes: Changing the Fate of Diabetics in the Dialysis Unit

Diabetes: Changing the Fate of Diabetics in the Dialysis Unit

Cardiovascular Risk Assessment in Diabetes and Chronic Kidney Diseases: A New Insight and Emerging Strategies

An Investigation of the Relationship between Beta-2 Microglobulin (β2M) and Inflammatory Factors (Serum Levels of CRP and Albumin) and High Density Lipoproteins (HDL) in Hemodialysis Patients

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