Pattern of End Stage Renal Disease in a Tertiary Care Center

Abstract

Introduction: End Stage renal disease (ESRD) is a major public health problem across the world and
it is rising. The incidence prevalence and causes of ESRD is not known in Nepal. With a population
of 27 million people the estimated incidence of ESRD is around 2700/year if we take 100/million
population at par with India and Pakistan. However majority of patients do not reach hospitals with
dialysis facilities. The aim of the present study was to analyze the clinico-epidemiological profile of
ESRD in the Nepalese context.
Methods: A retrospective, cross sectional study was conducted on newly diagnosed ESRD patients
within fi ve years in a tertiary care center. Their demographic profi le, etiology and follow up were
studied.
Results: The mean age of the patients was 42 years, male to female ratio being 1.7:1. Chronic
glomerulonephritis (41%) was the leading cause of ESRD, followed by diabetic nephropathy (16.8%)
and hypertensive nephrosclerosis (13.7%). Unexplained renal failure constituted 18% of our cases.
Intermittent peritoneal dialysis (IPD) remained the initial mode of therapy due to easy accessibility.
Most of the patients dropped out after having single session of IPD. Others went for repeat sessions of
IPD or haemodialysis. Out of the 23.6% who went for haemodialysis only 13% could continue dialysis
for more than three months and 3.8% could go to neighboring country for renal transplantation.
Conclusions: CGN is the leading cause of ESRD followed by diabetic nephropathy and hypertension.
It affected younger age group people. ESRD treatment is costly and unaffordable by most Nepalese
people. Stress should be given to the health education and screening programme for prevention and
early detection of CKD.
Key Words: end stage renal disease, intermittent peritoneal dialysis, Nepal