Goleg Fathea Abobker, Kong Norella Chiew-Tong, Sahathevan Ramesh
Nephrology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Center, National University of Malaysia, Jalaln Yaacob Latif, Bandar Tun Razak, 56000, Cheras, Kuala Lumpur, Malaysia.
Int Urol Nephrol. 2014 Aug;46(8):1581-7. doi: 10.1007/s11255-014-0694-1. Epub 2014 Mar 27.
End-stage kidney disease (ESKD) is now a worldwide pandemic. In concert with this, ESKD in Libya has also increased exponentially in recent decades. This review aims to define the magnitude of and risks for this ESKD epidemic among Libyans as there is a dearth of published data on this subject.
A systematic review was conducted by searching PubMed, EMBASE and Google scholar databases to identify all relevant papers published in English from 2003 to 2012, using the following keywords: end stage, terminal, chronic, renal, kidney, risk factors, Arab, North Africa and Libya.
In 2003, the reported incidence of ESKD and prevalence of dialysis-treated ESKD in Libya were the same at 200 per million population (pmp). In 2007, the prevalence of dialysis-treated ESKD was 350 pmp, but the true incidence of ESKD was not available. The most recent published WHO data in 2012 showed the incidence of dialysis-treated ESKD had risen to 282 pmp and the prevalence of dialysis-treated ESKD had reached 624 pmp. The leading causes of ESKD were diabetic kidney disease (26.5 %), chronic glomerulonephritis (21.1 %), hypertensive nephropathy (14.6 %) and congenital/hereditary disease (12.3 %). The total number of dialysis centers was 40 with 61 nephrologists. Nephrologist/internist to patient ratio was 1:40, and nurse to patient ratio was 1:3.7. Only 135 living-related kidney transplants had been performed between 2004 and 2007. There were no published data on most macroeconomic and renal service factors.
ESKD is a major public health problem in Libya with diabetic kidney disease and chronic glomerulonephritis being the leading causes. The most frequent co-morbidities were hypertension, obesity and the metabolic syndrome. In addition to provision of RRT, preventive strategies are also urgently needed for a holistic integrated renal care system.
终末期肾病（ESKD）目前已成为全球性的流行病。与此同时，近几十年来利比亚的ESKD病例数也呈指数级增长。由于关于这一主题的已发表数据匮乏，本综述旨在明确利比亚ESKD流行的规模和风险。
通过检索PubMed、EMBASE和谷歌学术数据库进行系统综述，以识别2003年至2012年期间以英文发表的所有相关论文，使用以下关键词：终末期、晚期、慢性、肾脏、肾病、危险因素、阿拉伯人、北非和利比亚。
2003年，利比亚报告的ESKD发病率和接受透析治疗的ESKD患病率相同，均为每百万人口200例（pmp）。2007年，接受透析治疗的ESKD患病率为350 pmp，但ESKD的实际发病率未知。世界卫生组织2012年发布的最新数据显示，接受透析治疗的ESKD发病率已升至282 pmp，接受透析治疗的ESKD患病率已达到624 pmp。ESKD的主要病因是糖尿病肾病（26.5%）、慢性肾小球肾炎（21.1%）、高血压肾病（14.6%）和先天性/遗传性疾病（12.3%）。透析中心总数为40个，有61名肾病专家。肾病专家/内科医生与患者的比例为1:40，护士与患者的比例为1:3.7。2004年至2007年期间仅进行了135例亲属活体肾移植。关于大多数宏观经济和肾脏服务因素没有已发表的数据。
ESKD是利比亚的一个主要公共卫生问题，糖尿病肾病和慢性肾小球肾炎是主要病因。最常见的合并症是高血压、肥胖和代谢综合征。除了提供肾脏替代治疗外，还迫切需要采取预防策略，以建立一个全面综合的肾脏护理系统。
