Khakurel S, Agrawal R K, Hada R
Nephrology Unit, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2009 Apr-Jun;48(174):126-30.
End Stage renal disease (ESRD) is a major public health problem across the world and it is rising. The incidence prevalence and causes of ESRD is not known in Nepal. With a population of 27 million people the estimated incidence of ESRD is around 2700/year if we take 100/million population at par with India and Pakistan. However majority of patients do not reach hospitals with dialysis facilities. The aim of the present study was to analyze the clinico-epidemiological profile of ESRD in the Nepalese context.
A retrospective, cross sectional study was conducted on newly diagnosed ESRD patients within five years in a tertiary care center. Their demographic profile, etiology and follow up were studied.
The mean age of the patients was 42 years, male to female ratio being 1.7:1. Chronic glomerulonephritis (41%) was the leading cause of ESRD, followed by diabetic nephropathy (16.8%) and hypertensive nephrosclerosis (13.7%). Unexplained renal failure constituted 18% of our cases. Intermittent peritoneal dialysis (IPD) remained the initial mode of therapy due to easy accessibility. Most of the patients dropped out after having single session of IPD. Others went for repeat sessions of IPD or haemodialysis. Out of the 23.6% who went for haemodialysis only 13% could continue dialysis for more than three months and 3.8% could go to neighboring country for renal transplantation.
CGN is the leading cause of ESRD followed by diabetic nephropathy and hypertension. It affected younger age group people. ESRD treatment is costly and unaffordable by most Nepalese people. Stress should be given to the health education and screening programme for prevention and early detection of CKD.
终末期肾病（ESRD）是全球主要的公共卫生问题，且其发病率正在上升。尼泊尔ESRD的发病率、患病率及病因尚不清楚。尼泊尔人口为2700万，若按照印度和巴基斯坦每百万人口100例的比例计算，ESRD的估计发病率约为每年2700例。然而，大多数患者无法前往设有透析设施的医院就诊。本研究的目的是分析尼泊尔背景下ESRD的临床流行病学特征。
在一家三级医疗中心对5年内新诊断的ESRD患者进行了一项回顾性横断面研究。研究了他们的人口统计学特征、病因及随访情况。
患者的平均年龄为42岁，男女比例为1.7:1。慢性肾小球肾炎（41%）是ESRD的主要病因，其次是糖尿病肾病（16.8%）和高血压性肾硬化（13.7%）。不明原因的肾衰竭占我们病例的18%。由于易于操作，间歇性腹膜透析（IPD）仍然是初始治疗方式。大多数患者在进行单次IPD后退出。其他患者进行了重复的IPD或血液透析。在进行血液透析的23.6%的患者中，只有13%能够持续透析超过三个月，3.8%能够前往邻国进行肾移植。
慢性肾小球肾炎是ESRD的主要病因，其次是糖尿病肾病和高血压。它影响了较年轻的人群。ESRD治疗费用高昂，大多数尼泊尔人无力承担。应重视健康教育和筛查计划，以预防和早期发现慢性肾脏病。
