Causes Of End Stage Renal Disease In Patients Undergoing Regular Hemodialysis

Study Overview
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Brief Summary
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CKD is defined as kidney damage for ≥3 months, as defined by structural and or functional abnormalities of the kidney, with or without decreased GFR or GFR <60 mL/min/1.73m2 for ≥3 months, with or without kidney damage. CKD is classified based on cause, GFR category, and albuminuria category (CGA). ESRD has become a public health problem worldwide, with recent reports showing that the total number of ESRD patients has been growing dramatically.

Detailed Description
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The prevalence ESRD undergoing maintenance dialysis in 2010 was 284 individuals per million population (pmp) worldwide, which has increased 1.7 times from 165 pmp patients in 1990. In Egypt, the prevalence of dialysis patients has increased from 225 pmp in 1996 to 483 pmp in 2008(according to last Egyptian renal registry) and the main causes of ESKD in Egypt, other than diabetic nephropathy, included hypertensive kidney disease, chronic glomerulonephritis, unknown etiology, chronic pyelonephritis, schistosomal obstructive uropathy, and schistosomal nephropathy . It is well established that diabetic kidney disease is the most common cause or in combination with hypertensive nephropathy are the most common causes of end-stage renal disease (ESRD) in developed and developing countries. Patient survival in diabetics on maintenance renal replacement therapy including hemodialysis (HD), peritoneal dialysis (PD) and kidney transplantation is significantly lower than that seen in nondiabetics with ESRD. The poor prognosis of diabetic patients with ESRD is partly due to presence of significant cardiovascular disease, problems with vascular access, more susceptible to infections, foot ulcer, and hemodynamic instability during HD. Hemodialysis (HD) is the first line of renal replacement therapy in the investigator's country. It is well known that patients on RRT are of greater risk for complications and worse prognosis in comparison to patients with the same co-morbidities but not on RRT. The most common complicatons of hemodialysis are hypotensive episodes, muscular cramps, itching, arrhythmias,and anaphylactic responses during the sessions.

Official Title
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CausesOf End Stage Renal Disease In Patients Undergoing Regular Hemodialysis In Assiut University Hospital

Conditions
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End Stage Renal Disease Patients

Intervention / Treatment
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* Diagnostic Test: s.creatinine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All ESRD patients >18years old in Assuit University Hospital dialysis unit . Patients on regular haemodialysis for more than six months. Exclusion Criteria: ESRD patients<18years old . patients with acute kidney injury . patients on haemodialysis for less than six months.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| End Stage Renal Disease Patients<br>complete blood picture blood urea s.creatinine urine analysis calcium phosphorus parathyroid hormone. 4- Hepatitis BsAg,HCV-Abs and HIV. | Diagnostic Test: s.creatinine<br>* All ESRD patients on regular hemodialysis in dialysis unit of Assiut university Hospital duing one year. will be subjected to 3- Routine investigations including complete blood picture ,blood urea , s.creatinine,urine analysis , calcium, phosphorus, and parathyroid hormone.<br>* Other names: blood urea;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To find out the possible etiologies of ESRD in patients undergoing regular hemodialysis in Assiut university hospital. | prevalence of ESRD on regular hemodialysis(in percentage )among different age groups ( measured by years) frequencies(in percentage)of different etiologies in ESRD on regular hemodialysis. | Within one year | 
| To do registration for ESRD patients undergoing regular haemodialysis in assuit university hospital dialysis unit | • Relation between different causes of ESRD and life expectance. | Within one year |