Demographic study with risk factors of hemodialysis patients in Damietta Governorate, Egypt

Background: The causes of end-stage renal disease (ESRD) vary from one geographical area to another due to genetic and environmental factors. Renal registries offer an important source of information for characterizing the ESRD population, describing the prevalence and incidence of ESRD and investigating relationships among their demographics, treatment modalities, morbidity and mortality. The aim of this study was to map and define the magnitude of ESRD on maintenance hemodialysis (HD), its epidemiology, prevalence, etiology, and risk factors in Damietta Governorate, Egypt. Subjects and methods: This descriptive study was carried out in Damietta Governorate, Egypt, during the period from January 2013-December 2013. All dialysis centers in Damietta Governorate (11 centers); governmental and private were included, serving a total number of 673 ESRD patients. Face to face interviews and renal registries using a data collection-complementary questionnaire (divided into 4 parts) have been conducted to patients at the dialysis centers. The first part: demographic information (gender, age, place of living, marital status, number of children, occupation, special habits, weight, height, and menstrual cycles in females). The second part: dialysis data (type of dialysis, access, duration and number of sessions per week, type of dialyzer and dialysate, and complications during and in-between dialysis sessions). The third part: medical history and risk factors. The fourth part: laboratory investigations. Results: The prevalence of ESRD under HD in Damietta Governorate, Egypt in the year 2013 was found to be 611 per million population (pmp). The total number of ESRD patients under HD was 673 patients, in 11 centers. Their data were as follows; mean age±SD (52.73±13.31 years), males (61.4%), females (38.6%), urban areas (52.0%), rural areas (48.0%), not working (86.3%) and furniture laborers (34.6%). Hypertension was the cause of ESRD in 55.1% of patients, followed by obstructive uropathy in 19.0%, and diabetes mellitus in 17.9%. The commonest complications during dialysis were hypotension in 52.1% of patients, followed by hypertension in 16.5%, while in-between sessions, the commonest complications were hypertension in 45.9% of patients, followed by itching in 13.5%. The number of patients per 10.000 population varied among centers; being highest in Kafr Saad (41/10.000) and lowest in New Damietta (3/10.000). Conclusion: Hypertension, obstructive uropathy and diabetes mellitus were found to be the commonest causes of ESRD in dialysis patients in Damietta Governorate, Egypt. The prevalence of ESRD varied among centers, reflecting genetic and environmental factors.