Burden of chronic kidney disease: North Africa.
Burden of chronic kidney disease: North Africa.
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慢性肾脏疾病的负担：北非。
DOI：
10.1038/kisup.2013.5
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发表时间：
2013-05
影响因子：
5.5
通讯作者：
Barsoum, Rashad S.
中科院分区：
文献类型：
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作者：
Barsoum, Rashad S.
北非由位于非洲撒哈拉的六个国家组成，即西撒哈拉、摩洛哥、阿尔及利亚、突尼斯、利比亚和埃及。这些国家之间的共同特征包括相似的气候、生态、人口遗传学和社会经济环境。这种共性反映在这些国家的慢性肾脏疾病(CKD)概况上。虽然对终末期肾病的流行病学有一些估计，但早期阶段的估计尚不清楚。目前有几个国家筛查项目正在解决这一问题，例如埃及的Egipt-CKD项目和摩洛哥的MAREMAR研究。前者的初步结果表明，在接受常规透析治疗的患者亲属中，有10.6%的人存在蛋白尿。尽管缺乏可靠的登记，但可以通过与这些国家的主要肾病学家直接联系来收集关于慢性肾脏病病因的信息。肾小球肾炎(GN)占9-20%，糖尿病占11-18%，高血压肾硬化占10-35%，慢性间质性肾炎占7-17%，多囊肾病占2-3%。与二十年前相比，在突尼斯成年人中，糖尿病以肾小球肾炎、增生性肾炎和退行性淀粉样变性倾向于IgA和膜性肾病而变得更加常见。在埃及人中，传统的血吸虫肾病正在退化，倾向于丙型肝炎病毒(HCV)肾病。局灶性节段性肾小球硬化增加，损害了整个区域的增生性肾小球肾炎。尽管丙型肝炎病毒感染、结核病和蛋白质-卡路里营养不良的发病率很高，但在过去十年中，定期透析的机会得到了优化，取得了良好的结果。除西撒哈拉外，所有NAF国家都可以进行肾脏移植。每年约有650例活体捐赠者进行移植，其中大部分在埃及，来自曼苏拉最大中心的数据显示，移植物10年存活率为62%。许多移植手术都是由在世的无血缘关系的捐赠者进行的，特别是在埃及，这引发了一场伦理辩论。在过去的二十年里，突尼斯、摩洛哥、阿尔及利亚和埃及相继通过了关于已故供者移植的立法，预计这将在不久的将来从数量和质量上反映移植活动。
North Africa (NAF) is composed of six countries located in the African Sahara, namely the Western Sahara, Morocco, Algeria, Tunisia, Libya, and Egypt. Common features between these countries include similar climate, ecology, population genetics, and the socioeconomic environment. This commonality reflects on the chronic kidney disease (CKD) profile in these countries. While there are some estimates on the epidemiology of end-stage kidney disease, that of earlier stages is unknown. Several national screening programs are currently addressing this issue, such as the EGIPT-CKD project in Egypt and the MAREMAR study in Morocco. Preliminary results from the former suggest a prevalence of proteinuria in 10.6% of the relatives of patients on regular dialysis treatment. Despite the lack of reliable registries, it was possible to gather information on the etiology of CKD by direct contact with leading nephrologists in those countries. It turns out that glomerulonephritis (GN) accounts for 9–20%, diabetes 11–18%, hypertensive nephrosclerosis 10–35%, chronic interstitial nephritis 7–17%, and polycystic disease 2–3%. Compared to two decades earlier, diabetes has become more common at the expense of GN, proliferative GN, and amyloidosis regressed in favor of IgA and membranous nephropathies in Tunisian adults. Conventional schistosomal nephropathies are regressing in favor of hepatitis C viral (HCV) nephropathy in Egyptians. Focal segmental glomerulosclerosis is increasing at the expense of proliferative GNs in the region at large. Access to regular dialysis has been optimized during the past decade, with favorable outcomes despite the high incidence of HCV infection, tuberculosis, and protein-calorie malnutrition. Kidney transplantation is available in all NAF countries except the Western Sahara. About 650 transplants are performed annually from live donors, the majority in Egypt, where data from the largest center in Mansoura display a 10-year graft survival of 62%. Many transplants are performed from living unrelated donors, particularly in Egypt, which creates an ethical debate. Legislation for deceased-donor transplantation has been passed successively over the past two decades in Tunisia, Morocco, Algeria, and Egypt, which is expected to reflect quantitatively and qualitatively on the transplantation activity in the near future.
影响因子：
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作者：
Persy, Veerle P.;Remuzzi, Giuseppe;De Broe, Marc E.
通讯作者：
De Broe, Marc E.
影响因子：
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作者：
Daw MA;Dau AA
通讯作者：
Dau AA
影响因子：
19.6
作者：
Hurtado, A;Johnson, RJ
通讯作者：
Johnson, RJ