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Saudi Journal of Kidney Diseases and Transplantation
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Year : 2013  |  Volume : 24  |  Issue : 3  |  Page : 594-595
Regional disparities in etiology of end-stage renal disease in Africa

1 Department of Nephrology Dialysis and Renal Transplantation, Mohammed V Military Hospital, Faculty of Medicine, Mohammed V, Souissi University, Rabat, Morocco
2 Laboratory of Biostatistics Clinical Research and Epidemiology, Mohammed V Military Hospital, Faculty of Medicine, Mohammed V, Souissi University, Rabat, Morocco

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Date of Web Publication24-Apr-2013

How to cite this article:
Maoujoud O, Aatif T, Bahadi A, Zajjari Y, Benyahya M, Ahid S, Oualim Z. Regional disparities in etiology of end-stage renal disease in Africa. Saudi J Kidney Dis Transpl 2013;24:594-5

How to cite this URL:
Maoujoud O, Aatif T, Bahadi A, Zajjari Y, Benyahya M, Ahid S, Oualim Z. Regional disparities in etiology of end-stage renal disease in Africa. Saudi J Kidney Dis Transpl [serial online] 2013 [cited 2020 Aug 3];24:594-5. Available from: http://www.sjkdt.org/text.asp?2013/24/3/594/111078
To the Editor ,

The epidemiology of end-stage renal disease (ESRD) is well investigated in the developed world. However, in developing countries, this is less well documented due to the absence of national registries. No reliable data are avai­lable on the incidence and prevalence and etio­logy of ESRD in most African countries. [1],[2],[3]

In this study, we undertook a multi-databases literature search to expand our understanding of regional disparities in etiology of ESRD in Africa. Data were obtained from English or French-language studies published till June 2010 discussing the etiologies of ESRD in dif­ferent regions in Africa. The publications were identified through literature searches using Medline (from 1966), CINAHL (from 1982), EMBASE (from 1980), PsycINFO (from 1966), Cochrane Library and reference lists of published articles. Supplementary information was gathered from regional congresses, sym­posia and direct communications. Database search terms included keywords such as: Kid­ney disease, kidney failure, chronic kidney disease, urinary system disease, public health, Africa, Sub-Saharan Africa, North Africa, etio­logy, incidence, prevalence, terminal stage, end­stage renal disease, renal failure, epidemiology and ethnic group. We then identified publica­tions discussing the etiology of ESRD by adding medical subject heading term(s) for the following geographic regions: North Africa (NA) and Sub-Saharan Africa (SSA), including five sub-regions: South Africa, Western Africa, Eastern Africa and Central Africa.

Sixteen publications were included in this study and the results are summarized by sub-regions in [Table 1]. Regarding etiology of ESRD, there were some differences between NA and SSA. The most common etiologies in SSA were hypertensive nephrosclerosis and chronic glomerulonephritis. The situation, which was similar in the four sub-regions of SSA, was different in NA, where diabetes, hyperten­sion and chronic tubulointerstitial nephritis were the leading causes. The pattern of etiologies of ESRD in NA was not different from that in developed countries, where the prevalence and incidence of diabetes and cardiovascular di­sease are increasing; this is consistent with improvement in the living standards and urbanization in Morocco, Tunisia and Egypt.
Table 1: Etiology of end-stage renal disease in different regions of Africa.

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In most African countries, the etiology of a huge proportion of ESRD remains unknown because of late referral of patients, inadequacy of medical care facilities or lack of health-care manpower. Regional disparities in etiology of ESRD probably reflect the ecosystem, ethnic background and lifestyle difference between North Africa and Sub-Saharan Africa. Focus for the future must be on prevention strategies and provision of appropriate health services within the current socioeconomic, demogra­phic and technological restraints. [15]

   References Top

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13.Giovanni BF, Attolou V, Guy A. Kidney diseases in the developing world and ethnic minorities. In: Meguid El Nahas, editor. Nephrology in the Republic of Benin. New York: Taylor and Francis Group; 2005.  Back to cited text no. 13
14.Matekole M, Affram K, Lee SJ, Howie AJ, Michael J, Adu D. Hypertension and end-stage renal failure in tropical Africa. J Hum Hypertens 1993;7:443-6.  Back to cited text no. 14
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Correspondence Address:
Omar Maoujoud
Department of Nephrology Dialysis and Renal Transplantation, Mohammed V Military Hospital, Faculty of Medicine, Mohammed V, Souissi University, Rabat
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DOI: 10.4103/1319-2442.111078

PMID: 23640642

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