Arogundade F A, Sanusi A A, Hassan M O, Akinsola A
Department of Medicine, Obafemi Awolowo University / Teaching Hospitals Complex P.M.B 5538 Ile-Ife, Osun State, Nigeria.
Afr Health Sci. 2011 Dec;11(4):594-601.
The prevalence of chronic renal failure and End Stage Renal Disease (ESRD) has remained high worldwide and the epidemiology has changed significantly in the last decade in industrialised countries. While there have been significant improvements in these patient's outcomes in developed countries, their state and survival is still appalling in developing countries.
To determine the clinical pattern, presentation and management outcomes in our ESRD population over a 19-year period (1989-2007).
Seven hundred and sixty patients' records were reviewed. Data on major causes, clinical presentation, management and survival were retrieved and collated. Data was analysed using SPSS package version 16.
Their ages ranged between 15-90 years (mean ± SD; 39.9±1.67years) with male preponderance (70.3%). Major presenting complaints were body swelling and uraemic symptoms in most studied patients. The predisposing conditions included chronic glomerulonephritis, hypertension, obstructive uropathy and diabetes mellitus. Renal replacement therapy offered included HD in 556(73.2%), Continous Ambulatory Peritoneal Dialysis (CAPD) in only 9(1.2%) patients and renal transplantation in only 7(0.9%). Only 38(6.8%) survived on HD for longer than three months while 7(77.8%) CAPD patients and all transplanted patients survived for between six months and four years (p<0.00001). Median duration of survival after diagnosis for all the patients was 2 weeks (range 0-50 months).
End stage renal disease is still prevalent with chronic glomerulonephritis and hypertension being the common causes. Prognosis is still grave hence subsidized renal replacement therapy and preventive nephrology should be targeted in such underserved populations.
慢性肾衰竭和终末期肾病（ESRD）在全球范围内的患病率一直居高不下，在过去十年中，工业化国家的流行病学情况发生了显著变化。虽然发达国家这些患者的治疗效果有了显著改善，但在发展中国家，他们的状况和生存率仍然令人震惊。
确定19年期间（1989 - 2007年）我们ESRD患者群体的临床模式、表现和治疗结果。
回顾了760例患者的记录。检索并整理了关于主要病因、临床表现、治疗和生存情况的数据。使用SPSS 16版软件包进行数据分析。
他们的年龄在15 - 90岁之间（平均±标准差；39.9±1.67岁），男性占多数（70.3%）。大多数研究患者的主要主诉是身体肿胀和尿毒症症状。诱发因素包括慢性肾小球肾炎、高血压、梗阻性尿路病和糖尿病。提供的肾脏替代治疗包括556例（73.2%）进行血液透析（HD），仅9例（1.2%）患者进行持续非卧床腹膜透析（CAPD），仅7例（0.9%）患者进行肾移植。只有38例（6.8%）接受血液透析的患者存活超过三个月，而7例（77.8%）接受CAPD治疗的患者和所有接受移植的患者存活时间在六个月至四年之间（p<0.00001）。所有患者诊断后的中位生存时间为2周（范围0 - 50个月）。
终末期肾病仍然普遍，慢性肾小球肾炎和高血压是常见病因。预后仍然严峻，因此在这些医疗服务不足的人群中应提供补贴的肾脏替代治疗和预防性肾脏病治疗。
