ABSTRACT. Diabetes is the main cause of end-stage renal disease (ESRD) in the developed countries and its prevalence and incidence have been constantly increasing over the years. To determine the prevalence and profile of diabetic nephropathy in our ESRD population, we retrospectively studied 564 hemodialysis patients in ten dialysis units in Casablanca. The mean age was 49 ±16.2 years. The diabetic nephropathy came at the third rank with a prevalence of 13.5% behind chronic glomerulonephritis (21.8%) and hypertensive nephropathy (14.7%). Almost 74% of our diabetics were type 2. From the time of diagnosis the type 2 diabetics reached the ESRD earlier than the type 1 diabetics with a mean period of 15.1 ± 7 years and 18.8 ± 5 years, respectively; however, the difference was not statistically significant. There was at least another microangiopathic complication in 95.4% of the patients and macroangiopathic complication in 82%. The median hemoglobin A1C in all patients was higher than normal value. We conclude that ESRD is a serious complication of diabetes, which is constantly increasing. The appropriate management of diabetes and a multidisciplinary approach are necessary to avoid it or at least delay its occurrence.

Key Words: Diabetic nephropathy, End-stage renal disease, Prevalence, Angiopathic, Hemodialysis.
 

ABSTRACT. Chronic kidney disease (CKD) is a world-wide public health problem, the causes of which differ in children from that reported in adult patients. There is an increased incidence of congenital and hereditary diseases causing chronic renal failure in the pediatric age-group and virtually no diabetic nephropathy. To determine the major causes, clinical expression, course, and outcomes of CKD in Syrian children we conducted a prospective study from February 2002 to February 2003 in the pediatric nephrology department at the Kidney Hospital in Damascus, Syria. Fifty-five patients with varying degrees of renal impairment were involved in the analysis. A total of 31 children (56%) had obstructive nephropathy (ON) as the cause of chronic renal insufficiency and 24 children (44%) had non-obstructive nephropathy (Non-ON). Neurogenic bladder was the commonest cause of ON, seen in 15 patients (27%), nephrolithiasis was seen in 10 patients (18%), urethral stenosis in three (5%), Uretro-Pelvie Junction (UPJ) stenosis in two (3%), and posterior urethral valves in one case (2%). Chronic glomerulonephritis and renal hypoplasia were the commonest causes of non-ON seen in six patients each (11%). Reflux nephropathy was seen in four patients (7%), hereditary nephritis in three (5%), polycystic kidney, nephrocalcinosis and Prune Belly syndrome in one case each (2%), and the cause was unknown in two patients (3%). The study is still ongoing and will be reviewed after two years with a bigger sample and possibly more reliable results.

Key Words: Chronic kidney disease, Obstructive nephropathy, Children, Syria.