LETTER TO THE EDITOR
Year : 2016 | Volume
: 27 | Issue : 2 | Page : 423--424
Hypertension and diabetes remain the main causes of chronic renal failure in Fars Province, Iran 2013
Leila Malekmakan1, Alireza Malekmakan2, Arghavan Daneshian3, Maryam Pakfetrat4, Jamshid Roosbeh4,
1 Department of Community Medicine, Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
2 VU University Medical Center, Amsterdam, The Netherlands
3 Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
4 Department of Internal Medicine, Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Dr. Leila Malekmakan
Department of Community Medicine, Shiraz University of Medical Sciences, Shiraz
|How to cite this article:|
Malekmakan L, Malekmakan A, Daneshian A, Pakfetrat M, Roosbeh J. Hypertension and diabetes remain the main causes of chronic renal failure in Fars Province, Iran 2013.Saudi J Kidney Dis Transpl 2016;27:423-424
|How to cite this URL:|
Malekmakan L, Malekmakan A, Daneshian A, Pakfetrat M, Roosbeh J. Hypertension and diabetes remain the main causes of chronic renal failure in Fars Province, Iran 2013. Saudi J Kidney Dis Transpl [serial online] 2016 [cited 2020 Apr 9 ];27:423-424
Available from: http://www.sjkdt.org/text.asp?2016/27/2/423/178594
To the Editor,
Many of the common causes of chronic kidney disease (CKD) are treatable, if diagnosed and managed early.  We previously reported the causes of CKD among Iranian hemodialysis (HD) patients.  We would like to update on the causes of renal failure in all of end-stage renal disease (ESRD) population in our center.
To determine the etiology of CKD among our ESRD population in Fars Province, Iran, in 2013, we studied all the HD (91 cases), peritoneal dialysis (1352 cases), and transplant (536 cases) patients for two years. The mean age in total population was 51.8 ± 19.5 years, and 58.8% (1164) of them were men. The mean duration of ESRD was 52.8 ± 19.5 months in total population, 49.2 ± 15.5 months in peritoneal dialysis patients, and 53.1 ± 19.8 months in HD patients. Hypertension (26%), diabetes (18%) and hypertension, and diabetes (10.3%) were the most common causes of ESRD, followed by renal stone (4.9%) and glomerulonephritis (3.7%). The main causes of CRF did not significantly differ in subgroups from overall results (P <0.050).
In our study, hypertension and diabetic mellitus accounted for 54.3% of cases of ESRD. In this study, the causes of CKD were similar in comparison with our previous study,  although the frequencies differed; hypertension accounted for 30.5% and diabetes for 30.1%. In the USA, diabetes mellitus accounted for 44.4% of the causes of CKD, whereas hypertension was the cause in 26.6%. 
A similar study in Saudi Arabia found that hypertensive nephropathy (30.4%) and diabetic nephropathy (25.2%) were the main causes of renal failure.  A study from UK  found diabetes (18%) and glomerulonephritis (10.4%) as the leading causes of ESRD whereas in Germany, diabetes (34%) and renovascular (22%) diseases were the leading causes. In another study that was carried out in Australia,  diabetes (30%), glomerulonephritis (25%), and hypertension (13%) were the leading causes of ESRD.
Diabetes and hypertension are the leading causes of CKD in all developed and many developing countries, but glomerulonephritis and unknown causes are more common in countries of Asia and sub-Saharan Africa.  The variation in the reported rates of hypertensive nephrosclerosis likely results from the different definitions of these conditions rather than a true variation of prevalence.
Rapid increase in the prevalence of risk factors such as diabetes, hypertension, and obesity will result in an even greater burden of CKD in the future, and is likely to have substantial socioeconomic and public health consequences in resource-poor countries.
The Shiraz Nephro-Urology Research Center of Shiraz University of Medical Sciences funded this study.
Conflict of interest: None declared.
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