Hada Rajani, Khakurel S, Agrawal R K, Kafle R K, Bajracharya S B, Raut K B
National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal.
Kathmandu Univ Med J (KUMJ). 2009 Jul-Sep;7(27):301-5. doi: 10.3126/kumj.v7i3.2742.
End stage renal disease patients are treated with dialysis in Nepal. But there is no renal registry to indicate the burden of disease in the country.
The objective of this study is to find out the incidence of ESRD on renal replacement therapy and their out come.
It is a retrospective analysis (audit) of all ESRD patients who had received dialysis inside Nepal and had under gone transplantation from 1990 to 1999. The haemodialysis (HD) registry, HD patients file, intermittent peritoneal dialysis (IPD) registry of Bir Hospital, Shree Birendra Hospital, Tribhuwan University Teaching hospital and National Kidney Center were reviewed. Acute renal failure and acute on chronic renal failure were excluded and the demographic profile, dialysis session, dialysis duration and outcome of all ESRD patients were computed. One patient was counted only once in spite of attending more than one center for dialysis. SPSS package was used for analysis.
Total number of 1393 ESRD patients received renal replacement therapy (RRT) in the decade. Mean age of patients were 46.7 +/- 16.7 with 70% of ESRD were between 20-60 years age with male: female ratio of 1.8:1. Initial mode of RRT was IPD in 58.2%, HD in 41.7% and pre-emptive transplantation in 0.1% patients. Records of 189 patients could not be found and out of remaining 1208 patients, 85.8% received dialysis for < 3 months, 6% received dialysis for more than a year and 9.5% had undergone kidney transplantation. The incidence of ESRD had increased gradually with 3.4 per million populations (pmp) in 1990 to 11.89 pmp in 1999 with an average annual incidence of 6 pmp and only 0.31% of expected ESRD patients received RRT.
The incidence of ESRD is increasing but majority discontinue or die within 3 months. Dialysis centers needs to be expanded to different parts of country and prospective studies have to be carried out to fi nd out of cause of ESRD and to institute preventive measures.
尼泊尔的终末期肾病患者接受透析治疗。但该国没有肾脏登记系统来表明疾病负担。
本研究的目的是找出接受肾脏替代治疗的终末期肾病的发病率及其结局。
这是一项对1990年至1999年期间在尼泊尔境内接受透析并接受移植的所有终末期肾病患者的回顾性分析（审计）。审查了比尔医院、什里·比伦德拉医院、特里布万大学教学医院和国家肾脏中心的血液透析（HD）登记册、HD患者档案、间歇性腹膜透析（IPD）登记册。排除急性肾衰竭和慢性肾衰竭急性发作，计算所有终末期肾病患者的人口统计学特征、透析次数、透析持续时间和结局。尽管有患者在多个中心接受透析，但一名患者只计算一次。使用SPSS软件包进行分析。
在这十年中，共有1393名终末期肾病患者接受了肾脏替代治疗（RRT）。患者的平均年龄为46.7±16.7岁，70%的终末期肾病患者年龄在20至60岁之间，男女比例为1.8:1。RRT的初始模式为IPD的患者占58.2%，HD的患者占41.7%，预先移植的患者占0.1%。找不到189名患者的记录，在其余1208名患者中，85.8%的患者接受透析不到3个月，6%的患者接受透析超过一年，9.5%的患者接受了肾脏移植。终末期肾病的发病率逐渐上升，从1990年的每百万人口3.4例（pmp）上升到1999年的11.89 pmp，年平均发病率为6 pmp，只有0.31%的预期终末期肾病患者接受了RRT。
终末期肾病的发病率在上升，但大多数患者在3个月内停止治疗或死亡。透析中心需要扩展到该国不同地区，必须进行前瞻性研究以找出终末期肾病的病因并制定预防措施。
